AHA Dietary Guidelines: revision 2000: A statement for healthcare professionals from the Nutrition Committee of the American Heart Association

SERPINE1, PAI-1 protein coding gene, methylation levels and epigenetic relationships with adiposity changes in obese subjects with metabolic syndrome features under dietary restriction

Plasminogen activator inhibitor 1 (PAI-1) has been associated with metabolic disorders, through different mechanisms, which could involve changes in DNA methylation. This work aimed to assess the potential relationships of the cytosine methylation levels within SERPINE1 gene transcriptional regulatory region, which codes for PAI-1, in peripheral white blood cells with anthropometrical, metabolic and inflammatory features. Forty-six obese subjects with metabolic syndrome features followed Control or Metabolic Syndrome Reduction in Navarra (RESMENA) energy-restricted (−30%E) diets for 8 weeks. SERPINE1 transcriptional regulatory region methylation at baseline was analyzed by a microarray technical. Both dietary strategies reduced anthropometric and biochemical parameters. The Control group significantly reduced plasma PAI-1 concentrations but not the RESMENA group. Participants from both nutritional interventions with higher SERPINE1 methylation levels at baseline showed significantly major reductions in body weight, total fat mass, android fat mass, total cholesterol and triglycerides, as compared with those with lower initial SERPINE1 methylation levels. In conclusion, the DNA methylation levels of SERPINE1 transcriptional regulatory region were associated with some metabolic and anthropometric changes in obese subjects with metabolic syndrome under energy restriction, suggesting a complex epigenetic network in the regulation of this recognized pro-inflammatory marker. (www.clinicaltrials.gov; NCT01087086)

Automated interventions for multiple health behaviors using conversational agents

OBJECTIVE

An automated health counselor agent was designed to promote both physical activity and fruit and vegetable consumption through a series of simulated conversations with users on their home computers.

METHODS

The agent was evaluated in a 4-arm randomized trial of a two-month daily contact intervention comparing: (a) physical activity; (b) fruit and vegetable consumption; (c) both interventions; and (d) a non-intervention control. Physical activity was assessed using daily pedometer steps. Daily servings of fruit and vegetables were assessed using the NIH/NCI self-report Fruit and Vegetable Scan.

RESULTS

Participants in the physical activity intervention increased their walking on average compared to the control group, while those in the fruit and vegetable intervention and combined intervention decreased walking. Participants in the fruit and vegetable intervention group consumed significantly more servings per day compared to those in the control group, and those in the combined intervention reported consuming more compared to those in the control group.

CONCLUSION

Automated health intervention software designed for efficient re-use is effective at changing health behavior.

PRACTICE IMPLICATIONS

Automated health behavior change interventions can be designed to facilitate translation and adaptation across multiple behaviors.

Adolescent fruit and vegetable intake: influence of family support and moderation by home availability of relationships with afrocentric values and taste preferences

Economically disadvantaged African-American adolescents have fruit and vegetable (F/V) intakes that are less than optimal. To facilitate intervention planning to address low F/V intake in this population, an understanding of determinants of youths' intake is needed. The influence of determinants consistently supported by evidence (ie, home F/V availability, F/V taste preferences, and parental modeling/intake) and variables hypothesized to influence intake in the targeted population (ie, family support for F/V consumption and Afrocentric values) were examined. Participants were African-American adolescents recruited in 2011 through summer camps serving low-income youths (N=93). Youths completed a cross-sectional survey. Hierarchical logistic regression analysis was used to examine whether availability directly influenced (ie, explained variations in) intake and whether it moderated (ie, affected the direction and/or strength of) the relationships between the other hypothesized determinants and intake. The dependent variable was intake of five or more daily servings of F/V estimated with the Block 7-item food frequency questionnaire. Family support was directly related to intake (odds ratio=1.062; 95% CI 1.007 to 1.120; P=0.026). The relationships between F/V intake and taste preferences and Afrocentric values were moderated by (ie, differed based on) home F/V availability. When availability was high, taste preferences (odds ratio=1.081; 95% CI 1.007 to 1.161; P=0.032) and Afrocentric values (OR=2.504; 95% CI 1.303 to 4.811; P=0.006) had positive influences on intake. To enhance intervention effectiveness, more research is warranted on approaches for increasing home F/V availability and family support for F/V consumption in the targeted population.

Short-term role of the dietary total antioxidant capacity in two hypocaloric regimes on obese with metabolic syndrome symptoms: the RESMENA randomized controlled trial

Background

Dietary strategies seem to be the most prescribed therapy in order to counteract obesity regarding not only calorie restriction, but also bioactive ingredients and the composition of the consumed foods. Dietary total antioxidant capacity (TAC) is gaining importance in order to assess the quality of the diet.

Methods

Ninety-six obese adults presenting metabolic syndrome (MetS) symptoms completed an 8-week intervention trial to evaluate the effects of a novel dietary program with changes in the nutrient distribution and meal frequency and to compare it with a dietary pattern based on the American Heart Association (AHA) guidelines.

Anthropometric and biochemical parameters were assessed at baseline and at the endpoint of the study, in addition to 48-hours food dietary records.

Results

Both diets equally (p > 0.05) improved MetS manifestations. Dietary TAC was the component which showed the major influence on body weight (p = 0.034), body mass index (p = 0.026), waist circumference (p = 0.083) and fat mass (p = 0.015) reductions. Transaminases (ALT and AST) levels (p = 0.062 and p = 0.004, respectively) were associated with lower TAC values.

Conclusion

RESMENA diet was as effective as AHA pattern for reducing MetS features. Dietary TAC was the most contributing factor involved in body weight and obesity related markers reduction.

Trial registration

http://www.clinicaltrials.gov; NCT01087086

Telephone counseling for patients with chronic heart failure: results of an evaluation study

BACKGROUND

The effectiveness of a secondary prevention program for patients suffering from chronic heart failure (CHF) was evaluated.

PURPOSE

The program aimed at improving participants' perceived health and actual physical symptoms. Insurants of a German health insurance company participated in a telephone counseling program with four modules focusing on dietary habits, physical activity, fluid intake, and medication compliance.

METHOD

Multilevel analyses were conducted to analyze changes in health related outcome variables over time in N = 259 participants who completed the program in about 6 months.

RESULTS

The results showed an improvement of perceived health status, physical symptoms, and somatic impairment. Furthermore, differential change was found when comparing "finishers" compared to "non-finishers" of specific modules indicating specific module effects.

CONCLUSION

The results are auspicious and, if sustained, are expected to bring about long-term health benefits for our study's participants. The program proved to be applicable and well accepted in the sample of older, severely impaired CHF patients and effective in changing perceived health.

Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies

OBJECTIVE

To investigate and quantify the potential dose-response association between egg consumption and risk of coronary heart disease and stroke.

DESIGN

Dose-response meta-analysis of prospective cohort studies.

DATA SOURCES

PubMed and Embase prior to June 2012 and references of relevant original papers and review articles.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Prospective cohort studies with relative risks and 95% confidence intervals of coronary heart disease or stroke for three or more categories of egg consumption.

RESULTS

Eight articles with 17 reports (nine for coronary heart disease, eight for stroke) were eligible for inclusion in the meta-analysis (3,081,269 person years and 5847 incident cases for coronary heart disease, and 4,148,095 person years and 7579 incident cases for stroke). No evidence of a curve linear association was seen between egg consumption and risk of coronary heart disease or stroke (P=0.67 and P=0.27 for non-linearity, respectively). The summary relative risk of coronary heart disease for an increase of one egg consumed per day was 0.99 (95% confidence interval 0.85 to 1.15; P=0.88 for linear trend) without heterogeneity among studies (P=0.97, I(2)=0%). For stroke, the combined relative risk for an increase of one egg consumed per day was 0.91 (0.81 to 1.02; P=0.10 for linear trend) without heterogeneity among studies (P=0.46, I(2)=0%). In a subgroup analysis of diabetic populations, the relative risk of coronary heart disease comparing the highest with the lowest egg consumption was 1.54 (1.14 to 2.09; P=0.01). In addition, people with higher egg consumption had a 25% (0.57 to 0.99; P=0.04) lower risk of developing hemorrhagic stroke.

CONCLUSIONS

Higher consumption of eggs (up to one egg per day) is not associated with increased risk of coronary heart disease or stroke. The increased risk of coronary heart disease among diabetic patients and reduced risk of hemorrhagic stroke associated with higher egg consumption in subgroup analyses warrant further studies.

Monounsaturated fatty acids and risk of cardiovascular disease: synopsis of the evidence available from systematic reviews and meta-analyses

No dietary recommendations for monounsaturated fatty acids (MUFA) are given by the National Institute of Medicine, the United States Department of Agriculture, European Food and Safety Authority and the American Diabetes Association. In contrast, the Academy of Nutrition and Dietetics, and the Canadian Dietetic Association both promote <25% MUFA of daily total energy consumption, while the American Heart Association sets a limit of 20% MUFA in their respective guidelines. The present review summarizes systematic reviews and meta-analyses of randomized controlled trials and cohort studies investigating the effects of MUFA on cardiovascular and diabetic risk factors, cardiovascular events and cardiovascular death. Electronic database Medline was searched for systematic reviews and meta-analyses using "monounsaturated fatty acids", "monounsaturated fat", and "dietary fat" as search terms with no restriction to calendar date or language. Reference lists and clinical guidelines were searched as well. Sixteen relevant papers were identified. Several studies indicated an increase of HDL-cholesterol and a corresponding decrease in triacylglycerols following a MUFA-rich diet. The effects on total and LDL-cholesterol appeared not consistent, but no detrimental effects on blood lipids were observed. Values for systolic and diastolic blood pressure were found to be reduced both during short- and long-term protocols using high amounts of MUFA as compared to low-MUFA diets. In type 2 diabetic subjects, MUFA exerted a hypoglycemic effect and reduced glycosylated hemoglobin in the long term. Data from meta-analyses exploring evidence from long-term prospective cohort studies provide ambiguous results with respect to the effects of MUFA on risk of coronary heart disease (CHD). One meta-analysis reported an increase in CHD events, however, most meta-analyses observed a lesser number of cases in participants subjected to a high-MUFA protocol. Although no detrimental side effects of MUFA-rich diets were reported in the literature, there still is no unanimous rationale for MUFA recommendations in a therapeutic regimen. Additional long-term intervention studies are required to characterized efficacy and effectiveness of recommending MUFA-rich diet among general and clinical populations.

Eating a larger number of high-salt foods is not associated with short-term risk of acute decompensation in patients with chronic heart failure

BACKGROUND

Risk factors for exacerbation of congestive heart failure have not been consistently validated.

OBJECTIVE

Our objective was to examine the role of short-term dietary sodium intake in acute decompensated heart failure.

METHODS

Patients with chronic congestive heart failure presenting to the Emergency Department for either acute decompensated heart failure (cases) or for other reasons (controls) were included in a case-control study. Cases and controls were compared with respect to age, smoking, recent sodium intake, medication nonadherence, coronary artery disease, and hypertension. A food frequency questionnaire was utilized to estimate recent sodium intake, defined as the number of food types consumed in the previous 3 days from the 12 highest-sodium food categories.

RESULTS

There were 182 patients enrolled. One patient was excluded due to uncertainty about the primary diagnosis. When adjusted for age, smoking, medication nonadherence, coronary artery disease, and hypertension, acute decompensated heart failure was not associated with short-term dietary sodium intake. The odds ratio for acute decompensated heart failure for each increase in the number of high-sodium food types consumed was 1.1 (95% confidence interval 0.9-1.3; p = 0.3). Acute decompensated heart failure was associated with medication nonadherence, with an odds ratio for decompensation of 2.5 (95% confidence interval 1.2-5.1; p = 0.01).

CONCLUSIONS

Patients with chronic congestive heart failure who presented to the Emergency Department with acute decompensated heart failure were no more likely to report consuming a greater number of high-sodium foods in the 3 days before than were patients with chronic congestive heart failure who presented with unrelated symptoms. On the other hand, those who presented with acute decompensated heart failure were significantly more likely to report nonadherence with medications.

Negative effect of a low-carbohydrate, high-protein, high-fat diet on small peripheral artery reactivity in patients with increased cardiovascular risk

Low-carbohydrate diets have become increasingly popular for weight loss. Although they may improve some metabolic markers, particularly in type 2 diabetes mellitus (T2D) or the metabolic syndrome (MS), their net effect on arterial wall function remains unclear. The objective was to evaluate the relation between dietary macronutrient composition and the small artery reactive hyperaemia index (saRHI), a marker of small artery endothelial function, in a cohort of patients at increased cardiovascular (CV) risk. The present cross-sectional study included 247 patients. Diet was evaluated by a 3-d food-intake register and reduced to a novel low-carbohydrate diet score (LCDS). Physical examination, demographic, biochemical and anthropometry parameters were recorded, and the saRHI was measured in each patient. Individuals in the lowest LCDS quartile (Q1, 45 % carbohydrate; 20 % protein; 32 % fat) had higher saRHI values than those in the top quartile (Q4, 29 % carbohydrate, 24 % protein, 40 % fat; 1·66 (sd 0·41) v. 1·52 (sd 0·22), P= 0·037). These results were particularly strong in patients with the MS (Q1 = 1·82 (sd 0·32) v. Q4 = 1·61 (sd 027); P= 0·021) and T2D (Q1 = 1·78 (sd 0·31) v. Q4 = 1·62 (sd 0·35); P= 0·011). Multivariate analysis demonstrated that individuals in the highest LCDS quartile had a significantly negative coefficient of saRHI, which was independent of confounders (OR − 0·85; 95 % CI 0·19, 0·92; P= 0·031). These findings suggest that a dietary pattern characterised by a low amount of carbohydrate, but high amounts of protein and fat, is associated with a poorer small artery vascular reactivity in patients with increased CV risk.

Effects of plant sterols and stanols on intestinal cholesterol metabolism: suggested mechanisms from past to present

Plant sterols and stanols are natural food ingredients found in plants. It was already shown in 1950 that they lower serum low-density lipoprotein cholesterol (LDL-C) concentrations. Meta-analysis has reported that a daily intake of 2.5 g plant sterols/stanols reduced serum LDL-C concentrations up to 10%. Despite many studies, the underlying mechanism remains to be elucidated. Therefore, the proposed mechanisms that have been presented over the past decades will be described and discussed in the context of the current knowledge. In the early days, it was suggested that plant sterols/stanols compete with intestinal cholesterol for incorporation into mixed micelles as well as into chylomicrons. Next, the focus shifted toward cellular processes. In particular, a role for sterol transporters localized in the membranes of enterocytes was suggested. All these processes ultimately lowered intestinal cholesterol absorption. More recently, the existence of a direct secretion of cholesterol from the circulation into the intestinal lumen was described. First results in animal studies suggested that plant sterols/stanols activate this pathway, which also explains the increased fecal neutral sterol content and as such could explain the cholesterol-lowering activity of plant sterols/stanols.

How significant is the 'significant other'? Associations between significant others' health behaviors and attitudes and young adults' health outcomes

Background

Having a significant other has been shown to be protective against physical and psychological health conditions for adults. Less is known about the period of emerging young adulthood and associations between significant others’ weight and weight-related health behaviors (e.g. healthy dietary intake, the frequency of physical activity, weight status). This study examined the association between significant others’ health attitudes and behaviors regarding eating and physical activity and young adults’ weight status, dietary intake, and physical activity.

Methods

This study uses data from Project EAT-III, a population-based cohort study with emerging young adults from diverse ethnic and socioeconomic backgrounds (n = 1212). Logistic regression models examining cross-sectional associations, adjusted for sociodemographics and health behaviors five years earlier, were used to estimate predicted probabilities and calculate prevalence differences.

Results

Young adult women whose significant others had health promoting attitudes/behaviors were significantly less likely to be overweight/obese and were more likely to eat ≥ 5 fruits/vegetables per day and engage in ≥ 3.5 hours/week of physical activity, compared to women whose significant others did not have health promoting behaviors/attitudes. Young adult men whose significant other had health promoting behaviors/attitudes were more likely to engage in ≥ 3.5 hours/week of physical activity compared to men whose significant others did not have health promoting behaviors/attitudes.

Conclusions

Findings suggest the protective nature of the significant other with regard to weight-related health behaviors of young adults, particularly for young adult women. Obesity prevention efforts should consider the importance of including the significant other in intervention efforts with young adult women and potentially men.

Family meals. Associations with weight and eating behaviors among mothers and fathers

Few studies have looked at the relationship between family meals and adult weight and health behaviors. The current study investigates the association between frequency of family meals and mothers' and fathers' body mass index (BMI), dietary intake, dieting behaviors and binge eating. Data from Project F-EAT (Families and Eating and Activity in Teens) were used for the current analysis. Socio-economically and racially/ethnically diverse mothers and fathers (n=3488) of adolescents participating in a multi-level population-based study (EAT 2010) completed surveys mailed to their homes. Predicted means or probabilities were calculated for each outcome variable at each level of family meal frequency. Interactions between race/ethnicity and marital status with family meals were evaluated in all models. Overall, results indicated that having more frequent family meals was associated with increased consumption of fruits and vegetables for mothers and fathers, after adjusting for age, educational attainment, marital status and race/ethnicity. Other findings including less fast food intake for fathers and fewer dieting and binge eating behaviors for mothers were significantly associated with family meal frequency, but not consistently across all family meal categories or with BMI. Interactions by race/ethnicity and marital status were non-significant, indicating that family meals may be important for more healthful dietary intake across race and marital status. Future research should confirm findings in longitudinal analyses to identify temporality and strength of associations.

Differences in food intake among obese and nonobese women and men with type 2 diabetes

OBJECTIVE

Weight reduction is a key goal for the prevention of vascular complications in obese individuals with type 2 diabetes, but a nutritionally balanced intake is also important in this regard. We compared dietary intakes and vitamin supplement use between obese and nonobese women and men with type 2 diabetes to identify gaps in adherence to nutritional management guidelines.

METHODS

We analyzed data from a longitudinal study of adults with type 2 diabetes, wherein participants were assessed once per season over 1 year. Dietary data were collected using a validated semiquantitative, self-administered food-frequency questionnaire. Given the absence of seasonal variations in anthropometric variables and dietary intake, data from multiple visits were averaged for each individual. Associations of both intake of fruit and vegetables and nutrients related to cardiovascular disease risk were compared between obese (body mass index ≥ 30 kg/m²) and nonobese individuals through multivariable linear regression with adjustments for age, education, and energy intake.

RESULTS

Among the 200 participants (93 women and 107 men), 53% of women and 43% of men were obese. Compared with nonobese women, obese women consumed more saturated fat (mean difference, 1.2% of total energy intake; 95% confidence interval [CI], 3% to 2.2%) and sodium (mean difference, 0.3 g; 95% CI, 0.04 to 0.5 g), and they had a lower intake of fiber (mean difference, -2.7 g; 95% CI, -4.4 to -0.9 g) and magnesium (mean difference, -33.6 mg; 95% CI, -55.2 to -12.0 g). No differences in dietary intake were observed between obese and nonobese men, but the intakes of men overall were similar to those of obese women. Compared with nonobese participants, fewer obese individuals used vitamin/mineral supplements (women: 37% vs 48%, men: 26% vs 38%).

CONCLUSIONS

Obese women and both obese and nonobese men appeared to have poorer dietary quality compared with nonobese women. Our findings support the need to emphasize dietary composition in addition to weight control in diabetes.

Antioxidant capacity of different fractions of vegetables and correlation with the contents of ascorbic acid, phenolics, and flavonoids

The antioxidant capacity of different fractions of 17 vegetables were analyzed using ferric reducing antioxidant power assay (FRAP assay) after water and acetone extractions. The contents of ascorbic acid, phenolics, and flavonoids were determined and their correlations with FRAP value were investigated. The results showed that the peel or leaf fractions of vegetables were stronger than the pulp or stem fractions in antioxidant capacity based on total FRAP value. Lotus root peel was the highest and cucumber pulp the lowest in total FRAP value among the vegetable fractions analyzed. All water extracts were higher in FRAP value than the acetone extracts. The FRAP value was significantly correlated with the contents of ascorbic acid, phenolics, or flavonoids in water extracts, in which the phenolics contributed most based on multivariate regression analysis. We conclude that different vegetable fractions were remarkably different in antioxidant capacity. The phenolics are responsible mostly for the antioxidant capacity of vegetables in vitro.

Type of dietary fat is associated with the 25-hydroxyvitamin D3 increment in response to vitamin D supplementation

CONTEXT

Mono- and polyunsaturated fats may have opposing effects on vitamin D absorption.

OBJECTIVE

The purpose of this study was to determine whether intakes of different dietary fats are associated with the increase in serum 25-hydroxyvitamin D (25OHD) after supplementation with vitamin D(3).

DESIGN, SETTING, AND PARTICIPANTS

This analysis was conducted in the active treatment arm of a randomized, double-blind, placebo-controlled trial of vitamin D and calcium supplementation to prevent bone loss and fracture. Subjects included 152 healthy men and women age 65 and older who were assigned to 700 IU/d vitamin D(3) and 500 mg/d calcium. Intakes of monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), and saturated fatty acids (SFA) were estimated by food frequency questionnaire.

MAIN OUTCOME MEASURE

The change in plasma 25OHD during 2 yr vitamin D and calcium supplementation was assessed.

RESULTS

The change in plasma 25OHD (nanograms per milliliter) during vitamin D supplementation was positively associated with MUFA, (β = 0.94; P = 0.016), negatively associated with PUFA, (β = -0.93; P = 0.038), and positively associated with the MUFA/PUFA ratio (β = 6.46; P = 0.014).

CONCLUSION

The fat composition of the diet may influence the 25OHD response to supplemental vitamin D(3). Diets rich in MUFA may improve and those rich in PUFA may reduce the effectiveness of vitamin D(3) supplements in healthy older adults. More studies are needed to confirm these findings.

Weight gain since menopause and its associations with weight loss maintenance in obese postmenopausal women

Objective

To examine the association between weight gain since menopause and weight regain after a weight loss program.

Methods

Participants were 19 obese women who participated in a 15-week weight loss program and a 12-month follow-up. Main outcomes were: body composition, resting metabolic rate, energy intake, energy expenditure, and weight regain at follow-up.

Results

All body composition measures significantly decreased after intervention (all P ≤ 0.01) while all measures of fatness increased significantly after the 12-month follow-up (P ≤ 0.01). Body weight gain since menopause was associated with body weight regain (r = 0.65; P = 0.003) after follow-up even after adjustment for confounders.

Conclusion

Weight gain since menopause is associated with body weight regain following the weight loss program. Therefore, weight gain since menopause should be considered as a factor influencing weight loss maintenance in older women.

Energy and macronutrient intake and dietary pattern among school children in Bahrain: a cross-sectional study

BACKGROUND

Obesity is increasing in Bahrain and there is lack of information on the energy and macronutrient intake of children. The objective of this research was to study the energy and macronutrient intake as well as food frequency pattern of Bahraini school children.

METHODS

This is a cross-sectional descriptive study conducted on Bahraini school boys and girls aged 6-18 years from all the 11 populated regions of the country. Data on food intake consisted of a 24-hour dietary recall and was obtained by interviewing a sub-sample of the study population. Information was also obtained through a self-administered questionnaire for the entire sample on the weekly frequency of food items that were grouped into 7 categories based on similarity of nutrient profiles. Dietary analysis was performed using the Nutritionist 5 (First Data Bank Version 1.6 1998).

RESULTS

While the average energy intake of students was close to the Estimated Average Requirements of the UK Reference standards, protein intake substantially exceeded the Reference Nutrient Intake values as did daily sugar consumption. Dietary fiber fell short of the Dietary Recommended Values (UK) and 36%-50% students exceeded the Energy % limits for total fat, saturated fat and cholesterol. The Polyunsaturated: Saturated fat ratio remained at an unacceptable level of 0.6 for girls and boys. While sweets, snacks and regular soda drinks were popular, milk, fruits and vegetables were not commonly consumed.

CONCLUSIONS

High sugar consumption, low intake of dietary fiber and high energy % of saturated fat and dietary cholesterol by many Bahraini children, is likely to increase their risk of obesity and cardiovascular diseases in later life. Nutrition education programs in schools should emphasize the importance of healthy balanced diets for growth and health maintenance of children as well as dietary prevention of diseases.

Consumption of Purple/Blue Produce Is Associated With Increased Nutrient Intake and Reduced Risk for Metabolic Syndrome: Results From the National Health and Nutrition Examination Survey 1999-2002

To determine the effect of consuming purple/blue fruit and vegetables (P/B) on nutrient intakes and physiological parameters, a secondary analysis of National Health and Nutrition Examination Survey (NHANES) 1999-2002 data for children aged 5 to 18 years (n = 6345) and adults 19+ years (n = 8827) was conducted. Compared with nonconsumers (n = 13 304), P/B consumers (n = 1559) had increased intakes of total fruit (P < .0001), dietary fiber (P ≤ .0001), vitamin C (P < .001), and potassium (P < .0001) and decreased intakes of added sugar (P < .0001). P/B consumers had higher energy intakes (P < .001), but among children, there were no differences in weight or body mass index (BMI) for age between groups; among adults, lower weight and BMI (P < .0001) were found as compared with nonconsumers. Adult P/B consumers had significantly reduced risk for 3 of the 5 risk factors that define the metabolic syndrome (MetS): elevated blood pressure, low HDL cholesterol, and increased waist circumference. An additional analysis for the subgroup of 100% grape juice (GJ) consumers was conducted. GJ consumers (n = 270) also had higher intakes of fruit (P < .001), vitamin C (P < .001), and potassium (P < .005) and lower intakes of added sugar (P < .01) compared with GJ nonconsumers (n = 14 902), with no differences in weight, BMI, or waist circumference. Consumption of P/B produce was associated with increased fruit and nutrient intakes and with reduced risk for MetS. GJ consumption was also associated with increased nutrient intake.

Subcutaneous and intramuscular adipose tissue stearoyl-coenzyme A desaturase gene expression and fatty acid composition in calf- and yearling-fed Angus steers

We proposed that stearoyl-CoA desaturase (SCD) activity dictates fatty acid composition of adipose tissue and muscle in beef cattle, regardless of ruminal or hepatic fatty acid hydrogenation or desaturation. Twelve Angus steers were assigned to a calf-fed (CF) group and slaughtered at weaning (8 mo of age; n=4), 12 mo of age (n=4), or 16 mo of age (n=4). Twelve steers were assigned to a yearling-fed (YF) group and slaughtered at 12 mo of age (n=4), 16 mo of age (n=4), and 17.5 mo of age (n=4; 525 kg, market weight). Data were analyzed based on time on the corn-based finishing diet, with terminal age as a covariate, and orthogonal polynomial contrasts were tested on the main effects of treatment group and time on the finishing diet. Fatty acids from duodenal digesta, plasma, liver, LM, and subcutaneous and intramuscular adipose tissue were measured, and SCD gene expression was measured in intramuscular and subcutaneous adipose tissues. In duodenal digesta, palmitic and linoleic acids increased by 100% over the sampling period, α-linolenic acid decreased over the sampling period, and trans-vaccenic acid was greater in YF than in CF steers (all P < 0.01). The proportion of α-linolenic acid decreased over time in all tissues, including liver. The SCD index (ratio of SCD fatty acid products to SCD fatty acid substrates) increased over time in LM and in intramuscular and subcutaneous adipose tissues. The SCD:glyceraldehyde 3-phosphate dehydrogenase mRNA ratio was virtually undetectable at the initial sampling periods in subcutaneous adipose tissue of YF and CF steers, and it increased over time (P < 0.01). The SCD index and SCD:glyceraldehyde 3-phosphate dehydrogenase ratio were greater in intramuscular adipose tissue of CF steers than in that of YF steers. The SCD index did not change over time in liver and decreased over time in duodenal digesta. We conclude that, unlike essential fatty acids, the SFA and MUFA composition of adipose tissue is regulated by adipose tissue fatty acid desaturation, with little contribution from hepatic or duodenal fatty acids.

Nutrition and human health from a sex-gender perspective

Nutrition exerts a life-long impact on human health, and the interaction between nutrition and health has been known for centuries. The recent literature has suggested that nutrition could differently influence the health of male and female individuals. Until the last decade of the 20th century, research on women has been neglected, and the results obtained in men have been directly translated to women in both the medicine and nutrition fields. Consequently, most modern guidelines are based on studies predominantly conducted on men. However, there are many sex-gender differences that are the result of multifactorial inputs, including gene repertoires, sex steroid hormones, and environmental factors (e.g., food components). The effects of these different inputs in male and female physiology will be different in different periods of ontogenetic development as well as during pregnancy and the ovarian cycle in females, which are also age dependent. As a result, different strategies have evolved to maintain male and female body homeostasis, which, in turn, implies that there are important differences in the bioavailability, metabolism, distribution, and elimination of foods and beverages in males and females. This article will review some of these differences underlying the impact of food components on the risk of developing diseases from a sex-gender perspective.

Dietary monounsaturated fatty acids are protective against metabolic syndrome and cardiovascular disease risk factors

Over 50 years of research has sought to define the role dietary fat plays in cardiovascular disease (CVD) risk. Although optimal dietary fat quantity has been keenly pursued over past decades, attention has recently centered on the value of dietary fat quality. The purpose of the present review is to provide a critical assessment of the current body of evidence surrounding efficacy of dietary monounsaturated fatty acids (MUFA) for reduction of traditional risk factors defining metabolic syndrome (MetS) and CVD. Due to existing and emerging research on health attributes of MUFA rich diets, and to the low prevalence of chronic disease in populations consuming MUFA rich Mediterranean diets, national dietary guidelines are increasingly recommending dietary MUFA, primarily at the expense of saturated fatty acids (SFA). Consumption of dietary MUFA promotes healthy blood lipid profiles, mediates blood pressure, improves insulin sensitivity and regulates glucose levels. Moreover, provocative newer data suggest a role for preferential oxidation and metabolism of dietary MUFA, influencing body composition and ameliorating the risk of obesity. Mounting epidemiological and human clinical trial data continue to demonstrate the cardioprotective activity of the MUFA content of dietary fat. As the debate on the optimal fatty acid composition of the diet continues, the benefit of increasing MUFA intakes, particularly as a substitute for dietary SFA, deserves considerable attention.

Persistent organic pollutants in food items collected in Hong Kong

This study aims to investigate levels of POPs in meat, edible oils, nuts, milk and wine collected from Hong Kong. Naphthalene, pp-DDE, beta-, gamma-HCH and PBDE 47 were detected in most of the food items. Goose liver accumulated the highest PAHs (47.9ngg(-1) wet wt), DDTs (25.6), HCHs (13.0), PCBs (4.17), PBDEs (468pgg(-1) wet wt) among all the selected food. Meat and nut groups had significant (p<0.01 or 0.05) correlations between lipid contents and concentrations of PAHs (meat: r=0.878), HCHs (meat: r=0.753), DDTs (meat: r=0.937; nuts: r=0.968) and PCBs (meat: r=0.832; nut: r=0.946). The concentrations of DDTs, HCHs and PCBs in vegetable oil were lower, but HCHs in fish oil were higher, when compared with other countries. The concentrations of PAHs, DDTs, PCBs and PBDEs in food tested in the present study were all below various safety guidelines.

The neuroprotective effect of olive leaf extract is related to improved blood-brain barrier permeability and brain edema in rat with experimental focal cerebral ischemia

Recent studies suggest that olive extracts suppress inflammation and reduce stress oxidative injury. We sought to extend these observations in an in vivo study of rat cerebral ischemia-reperfusion injury. Four groups, each of 18 Wister rats, were studied. One (control) group received distilled water, while three treatment groups received oral olive leaf extract (50, 75 and 100mg/kg/day respectively). After 30 days, blood lipid profiles were determined, before a 60 min period of middle cerebral artery occlusion (MCAO). After 24h reperfusion, neurological deficit scores, infarct volume, brain edema, and blood-brain barrier permeability were each assessed in subgroups of six animals drawn from each main group. Olive leaf extract reduced the LDL/HDL ratio in doses 50, 75, and 100mg/kg/day in comparison to the control group (P<0.001), and offered cerebroprotection from ischemia-reperfusion. For controls vs. doses of 50mg/kg/day vs. 75 mg/kg/day vs. 100mg/kg/day, attenuated corrected infarct volumes were 209.79 ± 33.05 mm(3) vs. 164.36 ± 13.44 mm(3) vs. 123.06 ± 28.83 mm(3) vs. 94.71 ± 33.03 mm(3); brain water content of the infarcted hemisphere 82.33 ± 0.33% vs. 81.33 ± 0.66% vs. 80.75 ± 0.6% vs. 80.16 ± 0.47%, and blood-brain barrier permeability of the infarcted hemisphere 11.22 ± 2.19 μg/g vs. 9.56 ± 1.74 μg/g vs. 6.99 ± 1.48 μg/g vs. 5.94 ± 1.73 μg/g tissue (P<0.05 and P<0.01 for measures in doses 75 and 100mg/kg/day vs. controls respectively). Oral administration of olive leaf extract reduces infarct volume, brain edema, blood-brain barrier permeability, and improves neurologic deficit scores after transient middle cerebral artery occlusion in rats.

A reusable framework for health counseling dialogue systems based on a behavioral medicine ontology

Automated approaches to promoting health behavior change, such as exercise, diet, and medication adherence promotion, have the potential for significant positive impact on society. We describe a theory-driven computational model of dialogue that simulates a human health counselor who is helping his or her clients to change via a series of conversations over time. Applications built using this model can be used to change the health behavior of patients and consumers at low cost over a wide range of media including the web and the phone. The model is implemented using an OWL ontology of health behavior change concepts and a public standard task modeling language (ANSI/CEA-2018). We demonstrate the power of modeling dialogue using an ontology and task model by showing how an exercise promotion system developed in the framework was re-purposed for diet promotion with 98% reuse of the abstract models. Evaluations of these two systems are presented, demonstrating high levels of fidelity to best practices in health behavior change counseling.

Nonmeat Protein Alternatives as Meat Extenders and Meat Analogs

  The direct consumption of vegetable proteins in food products has been increasing over the years because of animal diseases, global shortage of animal protein, strong demand for wholesome and religious (halal) food, and economic reasons. The increasing importance of legume and oilseed proteins in the manufacturing of various functional food products is due to their high-protein contents. However, the greatest obstacle to utilizing these legumes and oilseeds is the presence of antinutrients; but these antinutrients can be successfully removed or inactivated by employing certain processing methods. In contrast, the potential negative impact of the antinutrients is partially balanced by the fact that they may have a health-promoting role. Legumes and oilseeds provide well-balanced amino acid profiles when consumed with cereals. Soybean proteins, wheat gluten, cottonseed proteins, and other plant proteins have been used for texturization. Texturized vegetable proteins can extend meat products while providing an economical, functional, and high-protein food ingredient or can be consumed directly as a meat analog. Meat analogs are successful because of their healthy image (cholesterol free), meat-like texture, and low cost. Mycoprotein is fungal in origin and is used as a high-protein, low-fat, health-promoting food ingredient. Mycoprotein has a good taste and texture. Texturized vegetable proteins and a number of mycoprotein products are accepted as halal foods. This article summarizes information regarding the molecular, nutritional, and functional properties of alternative protein sources to meat and presents current knowledge to encourage further research to optimize the beneficial effects of alternative protein sources.

HDL-C and LDL-C: their role in stroke pathogenesis and implications for treatment

Elevated serum low-density lipoprotein cholesterol (LDL-C) and low serum high-density lipoprotein cholesterol (HDL-C) are risk factors for atherosclerotic ischemic stroke. The National Cholesterol Education Panel and the American Heart Association have released guidelines for the treatment of dyslipidemia that stress LDL-C reduction using HMG CoA (3-hydroxy-3-methylglutaryl coenzyme A) reductase inhibitors (statins) and are applicable to individuals who have had or are at a high risk of having a stroke. Treatment of low HDL-C is a secondary goal of these guidelines and can be best achieved by using extended-release niacin (alone or in combination with statins) and fibrates. Early and aggressive treatment of dyslipidemia is an important component of a multimodality approach to stroke prevention.

Dyslipidemia after allogeneic hematopoietic stem cell transplantation: evaluation and management

Currently, approximately 15,000 to 20,000 patients undergo allogeneic hematopoietic stem cell transplantation (HSCT) annually throughout the world, with the number of long-term survivors increasing rapidly. In long-term follow-up after transplantation, the focus of care moves beyond cure of the original disease to the identification and treatment of late effects after HSCT. One of the more serious complications is therapy-related cardiovascular disease. Long-term survivors after HSCT probably have an increased risk of premature cardiovascular events. Cardiovascular complications related to dyslipidemia and other risk factors account for a significant proportion of late nonrelapse morbidity and mortality. This review addresses the risk and causes of dyslipidemia and impact on cardiovascular complications after HSCT. Immunosuppressive therapy, chronic graft-versus-host disease, and other long-term complications influence the management of dyslipidemia. There are currently no established guidelines for evaluation and management of dyslipidemia in HSCT patients; in this review, we have summarized our suggested approach in the HSCT population.

Interindividual variations in resting metabolic rate during weight loss in obese postmenopausal women A pilot study

The objective of the study was to examine if decreases in resting metabolic rate (RMR) take place early in the weight loss process and if they remain throughout the duration of the weight loss intervention. Twenty obese postmenopausal women (61.8 +/- 5.9 years) participated in a 15-week weight loss program. After the fifth week, subjects were characterized as having an increased (>5%) or a decreased (<5%) RMR based on baseline values. Afterward, they were followed for an additional 10 weeks. Outcome measures were as follows: fat mass ([FM] total, trunk), lean body mass (total, trunk), RMR, resting heart rate (RHR), and physical activity level. After 5 weeks, significant decreases were observed for lean body mass, FM, and RHR (P < .05), whereas no overall changes in physical activity level and RMR were observed. However, on an individual basis, large variations in RMR were observed (ranging from -320 to +330 kcal/d). Analyses showed that subjects characterized as either having an increased or a decreased RMR after the fifth week maintained these adaptations at the end of intervention. Finally, subjects displaying a decreased RMR during weight loss had a significantly higher RMR and lower FM accumulations at baseline (total and trunk) compared with those with an increased RMR. Interindividual variations in RMR took place early in the weight loss process and were maintained over the duration of the weight loss program in our cohort of obese postmenopausal women. Baseline RMR, changes in RHR, and FM accumulations (total and trunk) seem to be important factors to consider when studying the effects of weight loss on RMR.

Legume consumption and severe depressed mood, the modifying roles of gender and menopausal status

OBJECTIVE

Legumes have been recommended as staple foods in the anticipation of disease prevention. However, the scientific evidence of their benefits, particularly on mental well-being, remains preliminary. We longitudinally assessed the association between legume consumption and the risk of severe depressed mood (SDM) among a national cohort.

DESIGN

The study included adults aged 25-74 years who were examined in 1971-1975 as a part of the National Health and Nutrition Examination Survey. Legume consumption at baseline was obtained from a 3-month FFQ and categorised as infrequent (<1 time/week), moderate (1-2 times/week) and frequent (> or = 3 times/week). SDM was defined as Center for Epidemiologic Studies Depression Scale score > or = 22 or taking anti-depression medication after an average of 10.6 years of follow-up (from 8.0 to 12.5 years).

RESULTS

Among women, the proportion of individuals with SDM was 17.75 %. For premenopausal women (n 1778), a significant linear trend of deleterious effect from legume consumption was observed (P for trend = 0.0148). The relative risks (RR) for infrequent, moderate and frequent consumptions were 1 (reference), 1.24 (95 % CI = 0.91, 1.70) and 1.75 (1.12, 2.75), respectively. However, moderate consumption showed a significant protective effect (RR = 0.52 (0.27, 1.00)) among women undergoing the menopausal transition (n 454). No association was obtained from either postmenopausal women (n 601) or men (n 2036).

CONCLUSIONS

These findings suggest that gender and menopausal status were effect modifiers of the association between legume consumption and SDM. Detrimental effects of frequent consumption of legumes may exist among premenopausal women; moderate consumption, however, may protect perimenopausal women against SDM.

Early and sustained enrichment of serum n-3 long chain polyunsaturated fatty acids in dogs fed a flaxseed supplemented diet

A study was conducted in dogs to assess n-3 long chain polyunsaturated fatty acid incorporation after feeding an alpha-linolenic (ALA)-rich flaxseed supplemented diet (FLX) for 84 days. Serum total phospholipids (PL), triacylglycerol (TG), and cholesteryl esters (CE) were isolated at selected times and fatty acid methyl esters were analyzed. Increased LA was seen in the FLX-PL fraction after 28 days and an expected decrease in PL-AA. Enrichment of ALA, eicosapentaenoic acid (EPA) and docosapentaenoic acid n-3 (DPAn-3) in the FLX-group occurred early on (day 4) in both PL and TG fractions but no docosahexaenoic acid (DHA) was found, consistent with data from other species including humans. In contrast, no accumulation of DPAn-3 was seen in serum-CE, suggesting that this fatty acid does not participate in reverse-cholesterol transport. The accumulation of DPAn-3 in fasting PL and TG fractions is likely due to post-absorptive secretion after tissue synthesis. Because conversion of DPAn-3 to DHA occurs in canine neurologic tissues, this DPAn-3 may provide a circulating reservoir for DHA synthesis in such tissues. The absence of DPAn-3 in serum-CE suggests that such transport may be unidirectional. Although conversion of DPAn-3 to DHA is slow in most species, one-way transport of DPAn-3 in the circulation may help conserve this fatty acid as a substrate for DHA synthesis in brain and retinal tissues especially when dietary intakes of DHA are low.

Are energy-dense foods really cheaper? Reexamining the relation between food price and energy density

BACKGROUND

The inverse relation between energy density (kcal/g) and energy cost (price/kcal) has been interpreted to suggest that produce (fruit, vegetables) is more expensive than snacks (cookies, chips).

OBJECTIVE

The objective of this study was to show the methodologic weakness of comparing energy density with energy cost.

DESIGN

The relation between energy density and energy cost was replicated in a random-number data set. Additionally, observational data were collected for produce and snacks from an online supermarket. Variables included total energy (kcal), total weight (g), total number of servings, serving size (g/serving), and energy density (kcal/g). Price measures included energy cost ($/kcal), total price ($), unit price ($/g), and serving price ($/serving). Two-tailed t tests were used to compare price measures by food category. Relations between energy density and price measures within food categories were examined with the use of Spearman rank correlation analysis.

RESULTS

The relation between energy density and energy cost was shown to be driven by the algebraic properties of these variables. Food category was strongly correlated with both energy density and food price measures. Energy cost was higher for produce than for snacks. However, total price and unit price were lower for produce. Serving price and serving size were greater for produce than for snacks. Within food categories, energy density was uncorrelated with most measures of food price, except for a weak positive correlation with serving price within the produce category.

CONCLUSION

The findings suggest the relation between energy density and food price is confounded by food category and depends on which measure of price is used.

Effect of daily fiber intake on reproductive function: the BioCycle Study

BACKGROUND

High-fiber diets have been associated with decreased breast cancer risk, likely mediated by the effect of fiber on lowering circulating estrogen concentrations. The influence of fiber on aspects of reproduction, which include ovulation, has not been well studied in premenopausal women.

OBJECTIVE

The objective was to determine if fiber consumption is associated with hormone concentrations and incident anovulation in healthy, regularly menstruating women.

DESIGN

The BioCycle Study was a prospective cohort study conducted from 2004 to 2006 that followed 250 women aged 18-44 y for 2 cycles. Dietary fiber consumption was assessed < or =4 times/cycle by using 24-h recall. Outcomes included concentrations of estradiol, progesterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH), which were measured < or =8 times/cycle, and incident anovulation.

RESULTS

Dietary fiber consumption was inversely associated with hormone concentrations (estradiol, progesterone, LH, and FSH; P < 0.05) and positively associated with the risk of anovulation (P = 0.003) by using random-effects models with adjustment for total calories, age, race, and vitamin E intake. Each 5-g/d increase in total fiber intake was associated with a 1.78-fold increased risk (95% CI: 1.11, 2.84) of an anovulatory cycle. The adjusted odds ratio of 5 g fruit fiber/d was 3.05 (95% CI: 1.07, 8.71).

CONCLUSIONS

These findings suggest that a diet high in fiber is significantly associated with decreased hormone concentrations and a higher probability of anovulation. Further study of the effect of fiber on reproductive health and of the effect of these intakes in reproductive-aged women is warranted.

Characteristics and nutritional and cardiovascular-health properties of seaweeds

While marine algae have traditionally formed part of the Oriental diet, their major use in Western countries has been in the phytocolloid industry. Only a few coastal communities outside Asia have customarily used seaweeds as components of special dishes. Of late, however, seaweeds have gained importance as foodstuffs in Western countries and most recently as components of functional foods because of their high dietary fiber, mineral, vitamin, and phytochemical content, low energy levels, and high concentrations of certain polyunsaturated fatty acids. The present paper reviews the available data for some of the components of the major edible algae and studies several factors that can affect their physiochemical properties (e.g., hydration, water and oil-holding capacity, fermentability, binding capacity, etc.) and, in turn, their nutritional importance. The effects of marine alga consumption on growth and body weight, mineral availability, lipid metabolism, blood pressure, and antioxidant properties are reviewed, together with preliminary data on the effects of some functional foods containing seaweeds on lipid metabolism and gene expression of enzymes engaged in antioxidant protection. This review concludes with some remarks regarding the danger of the improper use of seaweeds in herbal medications. In addition, as the properties of algae are highly dependent on their individual composition, any generalization regarding these properties may be considered misleading and scientifically inappropriate.

It is time for a positive approach to dietary guidance using nutrient density as a basic principle

The consumption of nutrient-dense foods and beverages, which would ultimately be identified by a scientifically validated nutrient density profiling system, should be instituted as a nutrition platform in the Dietary Guidelines as a part of a larger educational effort to help people choose more nutrient-dense foods and as the guiding principle for consumers to plan healthful diets. By consciously choosing more nutrient-dense foods and beverages, Americans will be in a better position to meet their nutrient requirements without overconsuming energy. An objective, science-based, and validated nutrient density profiling system is needed to characterize foods based on their nutrient composition and this concept should be integrated into the Dietary Guidelines. This article sets forth guiding principles for the development and implementation of a nutrient density profiling system based on the current knowledge of diet and health and recommends that the development of a nutrient density profiling system include testing for effectiveness against accepted measures of diet quality, such as the Healthy Eating Index, and measurable public health markers, such as blood lipids and blood pressure.

Criteria for the evaluation of large cohort studies: an application to the nurses' health study

Evaluating the success of major funding programs from the National Institutes of Health (NIH) remains a vexing challenge. We propose a set of criteria to evaluate epidemiological studies that fit within the discovery, development, and delivery paradigm introduced by the NIH. We apply these criteria to the Nurses' Health Study (NHS), a large epidemiological cohort study initiated in the 1970s to evaluate the associations between oral contraceptives and risk of breast cancer and between diet and other lifestyle factors and risk of cancer overall. Our evaluation suggests that the NHS has led to important changes in health practice, and it underscores the need to develop metrics that are suitable to the evaluation of large epidemiological cohort studies.