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Walsh K, Kiosa A, Olupot-Olupot P, Alaroker F, Okiror W, Nakuya M, Tssenyondo T, Aromut D, Okalebo BC, Muhindo R, Mpoya A, George EC, Frost GS, Maitland K. Legume-supplemented feed for children hospitalised with severe malnutrition: a phase II trial. Br J Nutr 2024:1-10. [PMID: 38831516 PMCID: PMC7616506 DOI: 10.1017/s0007114524000837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Children hospitalised with severe malnutrition have high mortality and readmission rates post-discharge. Current milk-based formulations target restoring ponderal growth but not the modification of gut barrier integrity or microbiome which increases the risk of gram-negative sepsis and poor outcomes. We propose that legume-based feeds rich in fermentable carbohydrates will promote better gut health and improve overall outcomes. We conducted an open-label phase II trial at Mbale and Soroti Regional Referral Hospitals, Uganda, involving 160 children aged 6 months to 5 years with severe malnutrition (mid-upper arm circumference (MUAC) < 11·5 cm and/or nutritional oedema). Children were randomised to a lactose-free, chickpea-enriched legume paste feed (LF) (n 80) v. WHO standard F75/F100 feeds (n 80). Co-primary outcomes were change in MUAC and mortality to day 90. Secondary outcomes included weight gain (> 5 g/kg/d), de novo development of diarrhoea, time to diarrhoea and oedema resolution. Day 90 MUAC increase was marginally lower in LF v. WHO arm (1·1 cm (interquartile range (IQR) 1·1) v. 1·4 cm (IQR 1·40), P = 0·09); day 90 mortality was similar (11/80 (13·8 %) v. 12/80 (15 %), respectively, OR 0·91 (95 % CI 0·40, 2·07), P = 0·83). There were no differences in any of the other secondary outcomes. Owing to initial poor palatability of the LF, ten children switched to WHO feeds. Per-protocol analysis indicated a trend to lower day 90 mortality and readmission rates in the LF (6/60 (10 %) and 2/60(3 %)) v. WHO feeds (12/71(17·5 %) and 4/71(6 %)). Further refinement of LF and clinical trials are warranted, given the poor outcomes in children with severe malnutrition.
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Affiliation(s)
- Kevin Walsh
- Division of Diabetes, Endocrinology and Metabolism, Imperial College, 6th Floor Commonwealth Building, Hammersmith Campus, DuCane Road, LondonW12, UK
- Department of Nutritional Sciences, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College, LondonSE1 9NH, UK
| | - Akglinta Kiosa
- Division of Diabetes, Endocrinology and Metabolism, Imperial College, 6th Floor Commonwealth Building, Hammersmith Campus, DuCane Road, LondonW12, UK
| | - Peter Olupot-Olupot
- Mbale Clinical Research Institute, Busitema University Faculty of Health Sciences, Mbale Campus, Palissa Road, PO Box 1966, Mbale, Uganda
| | - Florence Alaroker
- Soroti Regional Referral Hospital, Hospital Road, PO Box 289, Soroti, Uganda
| | - William Okiror
- Mbale Clinical Research Institute, Busitema University Faculty of Health Sciences, Mbale Campus, Palissa Road, PO Box 1966, Mbale, Uganda
| | - Margaret Nakuya
- Soroti Regional Referral Hospital, Hospital Road, PO Box 289, Soroti, Uganda
| | - Tonny Tssenyondo
- Mbale Clinical Research Institute, Busitema University Faculty of Health Sciences, Mbale Campus, Palissa Road, PO Box 1966, Mbale, Uganda
| | - Denis Aromut
- Soroti Regional Referral Hospital, Hospital Road, PO Box 289, Soroti, Uganda
| | - Bernard Charles Okalebo
- Mbale Clinical Research Institute, Busitema University Faculty of Health Sciences, Mbale Campus, Palissa Road, PO Box 1966, Mbale, Uganda
| | - Rita Muhindo
- Mbale Clinical Research Institute, Busitema University Faculty of Health Sciences, Mbale Campus, Palissa Road, PO Box 1966, Mbale, Uganda
| | - Ayub Mpoya
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Elizabeth C George
- Medical Research Council Clinical Trials Unit (MRC CTU) at University College London, London, UK
| | - Gary S Frost
- Division of Diabetes, Endocrinology and Metabolism, Imperial College, 6th Floor Commonwealth Building, Hammersmith Campus, DuCane Road, LondonW12, UK
| | - Kathryn Maitland
- Mbale Clinical Research Institute, Busitema University Faculty of Health Sciences, Mbale Campus, Palissa Road, PO Box 1966, Mbale, Uganda
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Kilifi, Kenya
- Imperial College, Department of Infectious Disease and Institute of Global Health and Innovation, Faculty of Medicine, Imperial College, London, UK
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Li A, Li M, Guo J, Yun W, He Q. Efficacy of oats for dyslipidaemia: protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e058291. [PMID: 35487520 PMCID: PMC9052058 DOI: 10.1136/bmjopen-2021-058291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 03/01/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Dyslipidaemia is a critical factor in the development of atherosclerotic cardiovascular disease. Concerning dyslipidaemia regulation, we advocate for lifestyle interventions such as diet to complement drug treatment. Numerous studies have confirmed that oat β-glucan, a critical component of oats, can help lower cholesterol. However, there is no conclusive evidence for the efficacy of oats and their products in the treatment of dyslipidaemia. As a result, we have developed this protocol to serve as a guide for future research on oat intervention for dyslipidaemias. METHODS AND ANALYSIS We will conduct a search of eight databases or websites (PubMed, Web of Science, Cochrane Library, EMBASE, CNKI, SinoMed, VIP and Wanfang) to identify studies on oats' ability to regulate blood lipid levels. Two authors will screen articles independently, extract data based on inclusion and exclusion criteria, and assess the quality and bias of included studies. To assess and quantify heterogeneity, Q and I2 statistics will be used. If there is significant heterogeneity between studies, the source of the heterogeneity will be investigated using subgroup analysis and sensitivity analysis. We will analyse potential publication bias using the Begg funnel plot and Egger's weighted regression statistics. To assess the quality of evidence for the primary outcomes, the Grades of Recommendations, Assessment, Development and Evaluation method will be used. ETHICS AND DISSEMINATION This study is based on the existing literature and data in the databases. It is not subject to ethical review. The findings, on the other hand, will be published in a peer-reviewed journal. These findings may aid in the management of dyslipidaemia on a daily basis. PROSPERO REGISTRATION NUMBER CRD42021226751.
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Affiliation(s)
- Anqi Li
- Department of Cardiology, China Academy of Traditional Chinese Medicine Guanganmen Hospital, Beijing, China
- Beijing University of Traditional Chinese Medicine, Beijing, China
| | - Min Li
- Department of Cardiology, China Academy of Traditional Chinese Medicine Guanganmen Hospital, Beijing, China
| | - Jianbo Guo
- Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wingyan Yun
- Department of Cardiology, China Academy of Traditional Chinese Medicine Guanganmen Hospital, Beijing, China
- Beijing University of Traditional Chinese Medicine, Beijing, China
| | - Qingyong He
- Department of Cardiology, China Academy of Traditional Chinese Medicine Guanganmen Hospital, Beijing, China
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The Impact of Addition Oats (Avena sativa) and Cinnamon on Cookies and their Biological Effects on Rats Treated with Cirrhosis by CCL4. Saudi J Biol Sci 2021; 28:7142-7151. [PMID: 34867017 PMCID: PMC8626240 DOI: 10.1016/j.sjbs.2021.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/01/2021] [Accepted: 08/02/2021] [Indexed: 02/08/2023] Open
Abstract
Oats are represented an important source for nutrition, and it have attracted a lot of attention in recent years. In this study we produced oatmeal cookies and oats was added to formula wheat by 50% and 75%. Also, we added cinnamon to treatments 3 and 4 by 5% to increase nutrition value of oatmeal cookies, improvement sensory evaluation and increase antioxidant properties. All the cookies treatments were storage at room temperature. The purposes of this study were to study antioxidant activity for oats and cinnamon. Also determined the chemical composition include (moisture content, protein, ash, total lipids, crude fibers, carbohydrates and total calories) for oats, white flour and oatmeal cookies treatments. In addition evaluated all of sensory evaluation contain (appearance, color, texture, taste and odor) and microbiological evaluation such as (total bacterial count, spore forming bacteria and mold and yeasts count) for oatmeal cookies treatments. Also, biological assays were preformed to measure level of GPT, GOT, urea, creatinine, total cholesterol, triglycerides, HDL, LDL, and glucose. Furthermore, histopathological examination of both liver and kidneys was analyzed. The obtained results were clarified that the antioxidant activity for oats and cinnamon were 52.91% and 87.91%. Moreover, addition of oats and cinnamon to the cookies improve sensory evaluation as made it more acceptable, decreasing microbial load principally treatments 4 (prepared by 75% oats + 5% cinnamon). Biochemical assays were improved in rats with cirrhosis of carbon tetrachloride and their histopathological examination of liver and kidneys. It was clear that the additions ground whole grain oats and cinnamon to wheat flour based cookies improve its nutritional, chemical, and biological functions properties.
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Sawicki CM, Jacques PF, Lichtenstein AH, Rogers GT, Ma J, Saltzman E, McKeown NM. Whole- and Refined-Grain Consumption and Longitudinal Changes in Cardiometabolic Risk Factors in the Framingham Offspring Cohort. J Nutr 2021; 151:2790-2799. [PMID: 34255848 PMCID: PMC8417925 DOI: 10.1093/jn/nxab177] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/20/2021] [Accepted: 05/11/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Greater whole grain (WG) consumption is associated with reduced risk of cardiovascular disease (CVD); however, few prospective studies have examined WG or refined grain (RG) intake and intermediate cardiometabolic risk factors. OBJECTIVES We examined the longitudinal association between WG and RG intake on changes in waist circumference (WC); fasting HDL cholesterol, triglyceride, and glucose concentrations; and blood pressure. METHODS Subjects were participants in the Framingham Offspring cohort study [n = 3121; mean ± SD baseline age: 54.9 ± 0.2 y; BMI (kg/m2) 27.2 ± 0.1]. FFQ, health, and lifestyle data were collected approximately every 4 y over a median 18-y follow-up. Repeated measure mixed models were used to estimate adjusted mean changes per 4-y interval in risk factors across increasing categories of WG or RG intake. RESULTS Greater WG intake was associated with smaller increases in WC (1.4 ± 0.2 compared with 3.0 ± 0.1 cm in the highest compared with the lowest category, respectively; P-trend < 0.001), fasting glucose concentration (0.7 ± 0.4 compared with 2.6 ± 0.2 mg/dL; P-trend < 0.001), and systolic blood pressure (SBP; 0.2 ± 0.5 compared with 1.4 ± 0.3 mm Hg; P-trend < 0.001) per 4-y interval. When stratified by sex, a stronger association with WC was observed among females than males. Higher intake of WG was associated with greater increases in HDL cholesterol and declines in triglyceride concentrations; however, these differences did not remain significant after adjustment for change in WC. Conversely, greater RG intake was associated with greater increases in WC (2.7 ± 0.2 compared with 1.8 ± 0.1 cm, P-trend < 0.001) and less decline in triglyceride concentration (-0.3 ± 1.3 compared with -7.0 ± 0.7 mg/dL, P-trend < 0.001). CONCLUSIONS Among middle- to older-age adults, replacing RG with WG may be an effective dietary modification to attenuate abdominal adiposity, dyslipidemia, and hyperglycemia over time, thereby reducing the risk of cardiometabolic diseases.
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Affiliation(s)
- Caleigh M Sawicki
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Paul F Jacques
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Alice H Lichtenstein
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Gail T Rogers
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston MA, USA
| | - Jiantao Ma
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Edward Saltzman
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Nicola M McKeown
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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Quarta S, Massaro M, Chervenkov M, Ivanova T, Dimitrova D, Jorge R, Andrade V, Philippou E, Zisimou C, Maksimova V, Smilkov K, Ackova DG, Miloseva L, Ruskovska T, Deligiannidou GE, Kontogiorgis CA, Sánchez-Meca J, Pinto P, García-Conesa MT. Persistent Moderate-to-Weak Mediterranean Diet Adherence and Low Scoring for Plant-Based Foods across Several Southern European Countries: Are We Overlooking the Mediterranean Diet Recommendations? Nutrients 2021; 13:nu13051432. [PMID: 33922771 PMCID: PMC8145023 DOI: 10.3390/nu13051432] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 01/15/2023] Open
Abstract
The Mediterranean diet (MD) has been sponsored worldwide as a healthy and sustainable diet. Our aim was to update and compare MD adherence and food choices across several Southern European countries: Spain (SP), Portugal (PT), Italy (IT), Greece (GR), and Cyprus (CY) (MED, Mediterranean), and Bulgaria (BG) and the Republic of North Macedonia (NMK) (non-MED, non-Mediterranean). Participants (N = 3145, ≥18 y) completed a survey (MeDiWeB) with sociodemographic, anthropometric, and food questions (14-item Mediterranean Diet Adherence Screener, 14-MEDAS). The MED and non-MED populations showed moderate (7.08 ± 1.96) and weak (5.58 ± 1.82) MD adherence, respectively, with significant yet small differences across countries (SP > PT > GR > IT > CY > BG > NMK, p-value < 0.001). The MED participants scored higher than the non-MED ones for most of the Mediterranean-typical foods, with the greatest differences found for olive oil (OO) and white meat preference. In most countries, ≥70% of the participants reported quantities of red meat, butter, sweet drinks, and desserts below the recommended cutoff points, whereas <50% achieved the targets for plant-based foods, OO, fish, and wine. Being a woman and increasing age were associated with superior adherence (p-value < 0.001), but differences were rather small. Our results suggest that the campaigns carried out to support and reinforce the MD and to promote plant-based foods have limited success across Southern Europe, and that more hard-hitting strategies are needed.
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Affiliation(s)
- Stefano Quarta
- Laboratory of Biochemistry and Molecular Biology, Department of Biological and Environmental Sciences and Technologies, University of Salento, 73100 Lecce, Italy;
| | - Marika Massaro
- National Research Council (CNR), Institute of Clinical Physiology, 73100 Lecce, Italy;
| | - Mihail Chervenkov
- Faculty of Veterinary Medicine, University of Forestry, 1797 Sofia, Bulgaria;
- Slow Food in Bulgaria, 9 Pierre De Geytre St. bl. 3, 1113 Sofia, Bulgaria; (T.I.); (D.D.)
| | - Teodora Ivanova
- Slow Food in Bulgaria, 9 Pierre De Geytre St. bl. 3, 1113 Sofia, Bulgaria; (T.I.); (D.D.)
- Department of Plant and Fungal Diversity and Resources, Institute of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Dessislava Dimitrova
- Slow Food in Bulgaria, 9 Pierre De Geytre St. bl. 3, 1113 Sofia, Bulgaria; (T.I.); (D.D.)
- Department of Plant and Fungal Diversity and Resources, Institute of Biodiversity and Ecosystem Research, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
| | - Rui Jorge
- Instituto Politécnico de Santarém, Escola Superior Agraria, 2001-904 Santarém, Portugal; (R.J.); (V.A.)
- Life Quality Research Centre (CIEQV), IPSantarém/IPLeiria, 2040-413 Rio Maior, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, 2829-511 Monte de Caparica, Portugal
| | - Vanda Andrade
- Instituto Politécnico de Santarém, Escola Superior Agraria, 2001-904 Santarém, Portugal; (R.J.); (V.A.)
| | - Elena Philippou
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia 1700, Cyprus; (E.P.); (C.Z.)
- Department of Nutritional Sciences, King’s College London, London SE1 9NH, UK
| | - Constantinos Zisimou
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia 1700, Cyprus; (E.P.); (C.Z.)
| | - Viktorija Maksimova
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Katarina Smilkov
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Darinka Gjorgieva Ackova
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Lence Miloseva
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Tatjana Ruskovska
- Faculty of Medical Sciences, University Goce Delcev, str. Krste Misirkov, No. 10-A, POB 201, 2000 Stip, North Macedonia; (V.M.); (K.S.); (D.G.A.); (L.M.); (T.R.)
| | - Georgia Eirini Deligiannidou
- Laboratory of Hygiene and Environmental Protection, School of Medicine, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece; (G.E.D.); (C.A.K.)
| | - Christos A. Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, School of Medicine, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Greece; (G.E.D.); (C.A.K.)
| | - Julio Sánchez-Meca
- Department of Basic Psychology & Methodology, Faculty of Psychology, University of Murcia, 30100 Murcia, Spain;
| | - Paula Pinto
- Instituto Politécnico de Santarém, Escola Superior Agraria, 2001-904 Santarém, Portugal; (R.J.); (V.A.)
- Life Quality Research Centre (CIEQV), IPSantarém/IPLeiria, 2040-413 Rio Maior, Portugal
- Correspondence: (P.P.); (M-T.G.-C.); Tel.: +34-(968)396-276 (M-T.G.-C.)
| | - María-Teresa García-Conesa
- Research Group on Quality, Safety and Bioactivity of Plant Foods, Centro de Edafología y Biología Aplicada del Segura-Consejo Superior de Investigaciones Científicas (CEBAS-CSIC), Campus de Espinardo, P.O. Box 164, 30100 Murcia, Spain
- Correspondence: (P.P.); (M-T.G.-C.); Tel.: +34-(968)396-276 (M-T.G.-C.)
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Effect of Coarse and Superfine-ground Wheat Brans on the Microstructure and Quality Attributes of Dried White Noodle. FOOD BIOPROCESS TECH 2021. [DOI: 10.1007/s11947-021-02621-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tosh SM, Bordenave N. Emerging science on benefits of whole grain oat and barley and their soluble dietary fibers for heart health, glycemic response, and gut microbiota. Nutr Rev 2021; 78:13-20. [PMID: 32728756 DOI: 10.1093/nutrit/nuz085] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The aim of this work is to review the major mechanisms by which consumption of whole grain oats and barley, and β-glucans, reduces the risk of coronary heart disease, type 2 diabetes, and other noncommunicable chronic conditions. These effects have been predominantly explained by the role of soluble dietary fibers and smaller bioactive compounds, such as phenolic compounds, in oats and barley. These help to reduce the level of serum low-density lipoprotein cholesterol, decreasing postprandial blood glucose and modulating gut microbiota. In the present review, the role of viscosity development of the intestinal content by β-glucans in these mechanisms is discussed, as well as the impact of processing conditions altering the composition or the physicochemical characteristics of β-glucans.
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Affiliation(s)
- Susan M Tosh
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Nicolas Bordenave
- School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Soltani S, Jayedi A. Adherence to healthy dietary pattern and risk of kidney disease: a systematic review and meta-analysis of observational studies. INT J VITAM NUTR RES 2020; 92:267-279. [PMID: 32138628 DOI: 10.1024/0300-9831/a000647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Epidemiological studies show that adherence to healthy dietary patterns may be associated with a lower risk of decline in kidney function. However, existing evidence has not been quantitatively gathered. Pertinent observational studies investigating the association of adherence to a healthy dietary pattern, either priori-defined dietary pattern/indices or data-driven dietary patterns, with risk of kidney disease in the general population were identified by searching Medline and Scopus databases to May 28, 2018. A random-effects meta-analysis was applied. The analysis included eight prospective cohorts (5734 cases among 569,688 participants) and five cross-sectional studies (1955 cases among 16,614 participants). Higher adherence to a healthy dietary pattern (either priori-defined or data-driven dietary patterns) was associated with a 28% lower risk of kidney disease in the analysis of prospective cohort studies (RR = 0.72, 95 % CI = 0.58, 0.86; I2 = %71, n = 8). A subgroup analysis based on definition of healthy dietary pattern resulted in significant inverse association only in the subgroup of Dietary Approaches to Stop Hypertension dietary pattern (RR: 0.74, 95 % CI: 0.54, 0.93; I2 = 73%, n = 5). A dose-response analysis indicated a monotonic inverse association between adherence to the Dietary Approaches to Stop Hypertension dietary pattern with risk of kidney disease. A 32% lower risk was observed in the analysis of cross-sectional studies (OR: 0.68, 95 %CI: 0.53, 0.83, I2 = 0%, n = 5). The findings suggest that higher adherence to a healthy dietary pattern is associated with a lower risk of kidney disease.
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Affiliation(s)
- Sepideh Soltani
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ahmad Jayedi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran.,Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Sawicki CM, Livingston KA, Ross AB, Jacques PF, Koecher K, McKeown NM. Evaluating Whole Grain Intervention Study Designs and Reporting Practices Using Evidence Mapping Methodology. Nutrients 2018; 10:nu10081052. [PMID: 30096913 PMCID: PMC6115963 DOI: 10.3390/nu10081052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/04/2018] [Accepted: 08/06/2018] [Indexed: 01/15/2023] Open
Abstract
Consumption of whole grains have been associated with reduced risk of chronic diseases in many observational studies; yet, results of intervention studies are mixed. We aimed to use evidence mapping to capture the methodological and reporting variability in whole grain intervention studies that may contribute to this inconsistency. We conducted a reproducible search in OVID Medline for whole grain human intervention studies (published 1946 to February 2018). After screening based on a priori criteria, we identified 202 publications describing a total of 213 unique trials. Over half (55%) were acute trials, lasting ≤1 day, 30% were moderate duration studies (up to 6 weeks) and 15% were of longer duration (more than 6 weeks). The majority of acute trials (75%) examined measures of glycaemia and/or insulinemia, while most of the longer trials included measures of cardiometabolic health (71%), appetite/satiety (57%) and weight/adiposity (56%). Among the moderate and long duration trials, there was a wide range of how whole grains were described but only 10 publications referenced an established definition. Only 55% of trials reported the actual amount of whole grains (in grams or servings), while 36% reported the amount of food/product and 9% did not report a dose at all. Of the interventions that provided a mixture of whole grains, less than half (46%) reported the distribution of the different grain types. Reporting of subject compliance also varied and only 22% used independent biomarkers of whole grain intake. This evidence map highlights the need to standardize both study protocols and reporting practices to support effective synthesis of study results and provide a stronger foundation to better inform nutrition scientists and public health policy.
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Affiliation(s)
- Caleigh M Sawicki
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA.
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
| | - Kara A Livingston
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA.
| | - Alastair B Ross
- Department of Biology and Biological Engineering, Chalmers University of Technology, 41296 Gothenburg, Sweden.
| | - Paul F Jacques
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA.
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
| | - Katie Koecher
- Bell Institute of Health, Nutrition and Food Safety, General Mills, Inc., Minneapolis, MN 55427, USA.
| | - Nicola M McKeown
- Nutritional Epidemiology, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA.
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
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Dinu M, Whittaker A, Pagliai G, Benedettelli S, Sofi F. Ancient wheat species and human health: Biochemical and clinical implications. J Nutr Biochem 2017; 52:1-9. [PMID: 29065353 DOI: 10.1016/j.jnutbio.2017.09.001] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/17/2017] [Accepted: 09/05/2017] [Indexed: 12/13/2022]
Abstract
Wheat is the major staple food in many diets. Based on the increase in worldwide mortality attributable to diet-related chronic diseases, there is an increasing interest in identifying wheat species with greater health potential, more specifically for improved anti-oxidant and anti-inflammatory properties. In particular, ancient varieties (defined as those species that have remained unchanged over the last hundred years) are gaining interest since several studies suggested that they present a healthier nutritional profile than modern wheats. This manuscript reviews the nutritional value and health benefits of ancient wheats varieties, providing a summary of all in vitro, ex vivo, animal and human studies that have thus far been published. Differences in chemical composition, and biochemical and clinical implications of emmer, einkorn, spelt, khorasan and various regional Italian varieties are discussed. Although many studies based on in vitro analyses of grain components provide support to the premise of a healthier nutritional and functional potential of ancient wheat, other in vitro studies performed are not in support of an improved potential of ancient varieties. In the light of existing evidence derived from in vivo experiments, the ancient wheat varieties have shown convincing beneficial effects on various parameters linked to cardio-metabolic diseases such as lipid and glycaemic profiles, as well as the inflammatory and oxidative status. However, given the limited number of human trials, it is not possible to definitively conclude that ancient wheat varieties are superior to all modern counterparts in reducing chronic disease risk.
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Affiliation(s)
- Monica Dinu
- Department of Experimental and Clinical Medicine, School of Human Health Sciences, University of Florence, Italy; Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy
| | - Anne Whittaker
- Department of Agrifood Production and Environmental Sciences, University of Florence, Italy
| | - Giuditta Pagliai
- Department of Experimental and Clinical Medicine, School of Human Health Sciences, University of Florence, Italy; Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy
| | - Stefano Benedettelli
- Department of Agrifood Production and Environmental Sciences, University of Florence, Italy
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, School of Human Health Sciences, University of Florence, Italy; Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy; Don Carlo Gnocchi Foundation Italy, Onlus IRCCS, Florence, Italy.
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Kelly SA, Hartley L, Loveman E, Colquitt JL, Jones HM, Al-Khudairy L, Clar C, Germanò R, Lunn HR, Frost G, Rees K. Whole grain cereals for the primary or secondary prevention of cardiovascular disease. Cochrane Database Syst Rev 2017; 8:CD005051. [PMID: 28836672 PMCID: PMC6484378 DOI: 10.1002/14651858.cd005051.pub3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND There is evidence from observational studies that whole grains can have a beneficial effect on risk for cardiovascular disease (CVD). Earlier versions of this review found mainly short-term intervention studies. There are now longer-term randomised controlled trials (RCTs) available. This is an update and expansion of the original review conducted in 2007. OBJECTIVES The aim of this systematic review was to assess the effect of whole grain foods or diets on total mortality, cardiovascular events, and cardiovascular risk factors (blood lipids, blood pressure) in healthy people or people who have established cardiovascular disease or related risk factors, using all eligible RCTs. SEARCH METHODS We searched CENTRAL (Issue 8, 2016) in the Cochrane Library, MEDLINE (1946 to 31 August 2016), Embase (1980 to week 35 2016), and CINAHL Plus (1937 to 31 August 2016) on 31 August 2016. We also searched ClinicalTrials.gov on 5 July 2017 and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) on 6 July 2017. We checked reference lists of relevant articles and applied no language restrictions. SELECTION CRITERIA We selected RCTs assessing the effects of whole grain foods or diets containing whole grains compared to foods or diets with a similar composition, over a minimum of 12 weeks, on cardiovascular disease and related risk factors. Eligible for inclusion were healthy adults, those at increased risk of CVD, or those previously diagnosed with CVD. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies. Data were extracted and quality-checked by one review author and checked by a second review author. A second review author checked the analyses. We assessed treatment effect using mean difference in a fixed-effect model and heterogeneity using the I2 statistic and the Chi2 test of heterogeneity. We assessed the overall quality of evidence using GRADE with GRADEpro software. MAIN RESULTS We included nine RCTs randomising a total of 1414 participants (age range 24 to 70; mean age 45 to 59, where reported) to whole grain versus lower whole grain or refined grain control groups. We found no studies that reported the effect of whole grain diets on total cardiovascular mortality or cardiovascular events (total myocardial infarction, unstable angina, coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, total stroke). All included studies reported the effect of whole grain diets on risk factors for cardiovascular disease including blood lipids and blood pressure. All studies were in primary prevention populations and had an unclear or high risk of bias, and no studies had an intervention duration greater than 16 weeks.Overall, we found no difference between whole grain and control groups for total cholesterol (mean difference 0.07, 95% confidence interval -0.07 to 0.21; 6 studies (7 comparisons); 722 participants; low-quality evidence).Using GRADE, we assessed the overall quality of the available evidence on cholesterol as low. Four studies were funded by independent national and government funding bodies, while the remaining studies reported funding or partial funding by organisations with commercial interests in cereals. AUTHORS' CONCLUSIONS There is insufficient evidence from RCTs of an effect of whole grain diets on cardiovascular outcomes or on major CVD risk factors such as blood lipids and blood pressure. Trials were at unclear or high risk of bias with small sample sizes and relatively short-term interventions, and the overall quality of the evidence was low. There is a need for well-designed, adequately powered RCTs with longer durations assessing cardiovascular events as well as cardiovascular risk factors.
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Affiliation(s)
- Sarah Am Kelly
- Institute of Public Health, University of Cambridge, Forvie Site, School of Clinical Medicine, Box 113 Cambridge Biomedical Campus, Cambridge, UK, CB2 0SR
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Abstract
Consumption of dietary soluble fibers has been associated with health benefits such as reduced lipid levels, lower blood pressure, improved blood glucose control, weight loss, improved immune function, and reduced inflammation. Many of these health benefits relate to a reduced risk of developing cardiovascular disease. In this paper, we have reviewed recent studies on the hypocholesterolemic effects of dietary soluble fibers as well as fiber-rich foods. Findings include the following: (a) consumption of water-soluble, viscous-forming fibers can reduce total and low-density lipoprotein cholesterol levels by about 5-10 %; (b) minimal changes of high-density lipoprotein cholesterol or triglyceride levels were observed; (c) cholesterol-lowering properties of soluble fibers depend on their physical and chemical properties; and (d) medium to high molecular weight fibers are more effective in reducing lipid levels. Hypocholesterolemic benefits were also observed with some fiber-rich foods, such as whole oats, whole barley, legumes, peas, beans, flax seeds, apples, and citrus foods.
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Affiliation(s)
- Prasanth Surampudi
- Department of Internal Medicine, University of California, Davis, CA, USA
| | - Byambaa Enkhmaa
- Department of Internal Medicine, University of California, Davis, CA, USA
| | - Erdembileg Anuurad
- Department of Internal Medicine, University of California, Davis, CA, USA
| | - Lars Berglund
- Department of Internal Medicine, University of California, Davis, CA, USA. .,2UC Davis Medical Center, CTSC, 2921 Stockton Blvd, Suite 1400, Sacramento, CA, 95817, USA.
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Marventano S, Vetrani C, Vitale M, Godos J, Riccardi G, Grosso G. Whole Grain Intake and Glycaemic Control in Healthy Subjects: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2017; 9:nu9070769. [PMID: 28753929 PMCID: PMC5537883 DOI: 10.3390/nu9070769] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/08/2017] [Accepted: 07/13/2017] [Indexed: 02/07/2023] Open
Abstract
Backgrounds: There is growing evidence from both observational and intervention studies that Whole Grain (WG) cereals exert beneficial effects on human health, especially on the metabolic profile. The aim of this study was to perform a meta-analysis of randomised controlled trials (RCT) to assess the acute and medium/long-term effect of WG foods on glycaemic control and insulin sensitivity in healthy individuals. Methods: A search for all the published RCT on the effect of WG food intake on glycaemic and insulin response was performed up to December 2016. Effect size consisted of mean difference (MD) and 95% CI between the outcomes of intervention and the control groups using the generic inverse-variance random effects model. Results: The meta-analysis of the 14 studies testing the acute effects of WG foods showed significant reductions of the post-prandial values of the glucose iAUC (0–120 min) by −29.71 mmol min/L (95% CI: −43.57, −15.85 mmol min/L), the insulin iAUC (0–120 min) by −2.01 nmol min/L (95% CI: −2.88, −1.14 nmol min/L), and the maximal glucose and insulin response. In 16 medium- and long-term RCTs, effects of WG foods on fasting glucose and insulin and homeostatic model assessment-insulin resistance values were not significant. Conclusions: The consumption of WG foods is able to improve acutely the postprandial glucose and insulin homeostasis compared to similar refined foods in healthy subjects. Further research is needed to better understand the long-term effects and the biological mechanisms.
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Affiliation(s)
- Stefano Marventano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Claudia Vetrani
- Department of Clinical Medicine and Surgery, "Federico II" University, 80131 Naples, Italy.
| | - Marilena Vitale
- Department of Clinical Medicine and Surgery, "Federico II" University, 80131 Naples, Italy.
| | - Justyna Godos
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliero-Universitaria Policlinico Vittorio Emanuele, 95124 Catania, Italy.
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, "Federico II" University, 80131 Naples, Italy.
| | - Giuseppe Grosso
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliero-Universitaria Policlinico Vittorio Emanuele, 95124 Catania, Italy.
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Health Benefits of Dietary Whole Grains: An Umbrella Review of Meta-analyses. J Chiropr Med 2016; 16:10-18. [PMID: 28228693 DOI: 10.1016/j.jcm.2016.08.008] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 08/11/2016] [Accepted: 08/11/2016] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE The purpose of this study is to review the effectiveness of the role of whole grain as a therapeutic agent in type 2 diabetes, cardiovascular disease, cancer, and obesity. METHODS An umbrella review of all published meta-analyses was performed. A PubMed search from January 1, 1980, to May 31, 2016, was conducted using the following search strategy: (whole grain OR whole grains) AND (meta-analysis OR systematic review). Only English language publications that provided quantitative statistical analysis on type 2 diabetes, cardiovascular disease, cancer, and weight loss were retrieved. RESULTS Twenty-one meta-analyses were retrieved for inclusion in this umbrella review, and all the meta-analyses reported statistically significant positive benefits for reducing the incidence of type 2 diabetes (relative risk [RR] = 0.68-0.80), cardiovascular disease (RR = 0.63-0.79), and colorectal, pancreatic, and gastric cancers (RR = 0.57-0.94) and a modest effect on body weight, waist circumference, and body fat mass. Significant reductions in cardiovascular and cancer mortality were also observed (RR = 0.82 and 0.89, respectively). Some problems of heterogeneity, publication bias, and quality assessment were found among the studies. CONCLUSION This review suggests that there is some evidence for dietary whole grain intake to be beneficial in the prevention of type 2 diabetes, cardiovascular disease, and colorectal, pancreatic, and gastric cancers. The potential benefits of these findings suggest that the consumption of 2 to 3 servings per day (~45 g) of whole grains may be a justifiable public health goal.
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Kromhout D, Spaaij CJK, de Goede J, Weggemans RM. The 2015 Dutch food-based dietary guidelines. Eur J Clin Nutr 2016; 70:869-78. [PMID: 27049034 PMCID: PMC5399142 DOI: 10.1038/ejcn.2016.52] [Citation(s) in RCA: 244] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 02/09/2016] [Accepted: 02/10/2016] [Indexed: 02/08/2023]
Abstract
The objective of this study was to derive food-based dietary guidelines for the Dutch population. The dietary guidelines are based on 29 systematic reviews of English language meta-analyses in PubMed summarizing randomized controlled trials and prospective cohort studies on nutrients, foods and food patterns and the risk of 10 major chronic diseases: coronary heart disease, stroke, heart failure, diabetes, breast cancer, colorectal cancer, lung cancer, chronic obstructive pulmonary disease, dementia and depression. The committee also selected three causal risk factors for cardiovascular diseases or diabetes: systolic blood pressure, low-density lipoprotein cholesterol and body weight. Findings were categorized as strong or weak evidence, inconsistent effects, too little evidence or effect unlikely for experimental and observational data separately. Next, the committee selected only findings with a strong level of evidence for deriving the guidelines. Convincing evidence was based on strong evidence from the experimental data either or not in combination with strong evidence from prospective cohort studies. Plausible evidence was based on strong evidence from prospective cohort studies only. A general guideline to eat a more plant food-based dietary pattern and limit consumption of animal-based food and 15 specific guidelines have been formulated. There are 10 new guidelines on legumes, nuts, meat, dairy produce, cereal products, fats and oils, tea, coffee and sugar-containing beverages. Three guidelines on vegetables, fruits, fish and alcoholic beverages have been sharpened, and the 2006 guideline on salt stayed the same. A separate guideline has been formulated on nutrient supplements. Completely food-based dietary guidelines can be derived in a systematic and transparent way.
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Affiliation(s)
- D Kromhout
- The Health Council of the Netherlands, The Hague, The Netherlands
| | - C J K Spaaij
- The Health Council of the Netherlands, The Hague, The Netherlands
| | - J de Goede
- The Health Council of the Netherlands, The Hague, The Netherlands
| | - R M Weggemans
- The Health Council of the Netherlands, The Hague, The Netherlands
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Comino I, Moreno MDL, Sousa C. Role of oats in celiac disease. World J Gastroenterol 2015; 21:11825-11831. [PMID: 26557006 PMCID: PMC4631980 DOI: 10.3748/wjg.v21.i41.11825] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 09/02/2015] [Accepted: 09/15/2015] [Indexed: 02/06/2023] Open
Abstract
A gluten-free diet is currently the only effective means of treating individuals with celiac disease. Such a diet enables celiac patients to control their symptoms and avoid various complications associated with this condition. However, while the quality of gluten-free foods has significantly improved during recent decades, maintenance of a gluten-free diet does not necessarily ensure adequate nutritional intake. Because oats are an important source of proteins, lipids, vitamins, minerals, and fibre, their inclusion in a gluten-free diet might improve the nutritional status of a celiac patient. Although oats are included in the list of gluten-free ingredients specified in European regulations, their safety when consumed by celiac patients remains debatable. Some studies claim that pure oats are safe for most celiac people, and contamination with other cereal sources is the main problem facing people with this disease. However, it is necessary to consider that oats include many varieties, containing various amino acid sequences and showing different immunoreactivities associated with toxic prolamins. As a result, several studies have shown that the immunogenicity of oats varies depending on the cultivar consumed. Thus, it is essential to thoroughly study the variety of oats used in a food ingredient before including it in a gluten-free diet.
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Total, insoluble and soluble dietary fibre intake in relation to blood pressure: the INTERMAP Study. Br J Nutr 2015; 114:1480-6. [PMID: 26328746 DOI: 10.1017/s0007114515003098] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Prospective cohort studies have shown inverse associations between fibre intake and CVD, possibly mediated by blood pressure (BP). However, little is known about the impact of types of fibre on BP. We examined cross-sectional associations with BP of total, insoluble and soluble fibre intakes. Data were used from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP) study, including 2195 men and women aged between 40 and 59 years from the USA. During four visits, eight BP, four 24 h dietary recalls and two 24 h urine samples were collected. Linear regression models adjusted for lifestyle and dietary confounders to estimate BP differences per 2 sd higher intakes of total and individual types of fibre were calculated. After multivariable adjustment, total fibre intake higher by 6·8 g/4184 kJ (6·8 g/1000 kcal) was associated with a 1·69 mmHg lower systolic blood pressure (SBP; 95% CI -2·97, -0·41) and attenuated to -1·01 mmHg (95% CI -2·35, 0·34) after adjustment for urinary K. Insoluble fibre intake higher by 4·6 g/4184 kJ (4·6 g/1000 kcal) was associated with a 1·81 mmHg lower SBP (95% CI -3·65, 0·04), additionally adjusted for soluble fibre and urinary K excretion, whereas soluble fibre was not associated with BP. Raw fruit was the main source of total and insoluble fibre, followed by whole grains and vegetables. In conclusion, higher intakes of fibre, especially insoluble, may contribute to lower BP, independent of nutrients associated with higher intakes of fibre-rich foods.
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Whole-grain products and whole-grain types are associated with lower all-cause and cause-specific mortality in the Scandinavian HELGA cohort. Br J Nutr 2015. [DOI: 10.1017/s0007114515001701] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
No study has yet investigated the intake of different types of whole grain (WG) in relation to all-cause and cause-specific mortality in a healthy population. The aim of the present study was to investigate the intake of WG products and WG types in relation to all-cause and cause-specific mortality in a large Scandinavian HELGA cohort that, in 1992–8, included 120 010 cohort members aged 30–64 years from the Norwegian Women and Cancer Study, the Northern Sweden Health and Disease Study, and the Danish Diet Cancer and Health Study. Participants filled in a FFQ from which data on the intake of WG products were extracted. The estimation of daily intake of WG cereal types was based on country-specific products and recipes. Mortality rate ratios (MRR) and 95 % CI were estimated using the Cox proportional hazards model. A total of 3658 women and 4181 men died during the follow-up (end of follow-up was 15 April 2008 in the Danish sub-cohort, 15 December 2009 in the Norwegian sub-cohort and 15 February 2009 in the Swedish sub-cohort). In the analyses of continuous WG variables, we found lower all-cause mortality with higher intake of total WG products (women: MRR 0·89 (95 % CI 0·86, 0·91); men: MRR 0·89 (95 % CI 0·86, 0·91) for a doubling of intake). In particular, intake of breakfast cereals and non-white bread was associated with lower mortality. We also found lower all-cause mortality with total intake of different WG types (women: MRR 0·88 (95 % CI 0·86, 0·92); men: MRR 0·88 (95 % CI 0·86, 0·91) for a doubling of intake). In particular, WG oat, rye and wheat were associated with lower mortality. The associations were found in both women and men and for different causes of deaths. In the analyses of quartiles of WG intake in relation to all-cause mortality, we found lower mortality in the highest quartile compared with the lowest for breakfast cereals, non-white bread, total WG products, oat, rye (only men), wheat and total WG types. The MRR for highest v. lowest quartile of intake of total WG products was 0·68 (95 % CI 0·62, 0·75, Ptrend over quartiles< 0·0001) for women and 0·75 (95 % CI 0·68, 0·81, Ptrend over quartiles< 0·0001) for men. The MRR for highest v. lowest quartile of intake of total WG types was 0·74 (95 % CI 0·67, 0·81, Ptrend over quartiles< 0·0001) for women and 0·75 (95 % CI 0·68, 0·82, Ptrend over quartiles< 0·0001) for men. Despite lower statistical power, the analyses of cause-specific mortality according to quartiles of WG intake supported these results. In conclusion, higher intake of WG products and WG types was associated with lower mortality among participants in the HELGA cohort. The study indicates that intake of WG is an important aspect of diet in preventing early death in Scandinavia.
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Zhou Q, Wu J, Tang J, Wang JJ, Lu CH, Wang PX. Beneficial Effect of Higher Dietary Fiber Intake on Plasma HDL-C and TC/HDL-C Ratio among Chinese Rural-to-Urban Migrant Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:4726-38. [PMID: 25938914 PMCID: PMC4454936 DOI: 10.3390/ijerph120504726] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 04/20/2015] [Accepted: 04/23/2015] [Indexed: 12/05/2022]
Abstract
Research has shown that high-dose supplemental dietary fiber intake has beneficial effects on cardiovascular risk factors. To clarify such a relationship, we examined the association between daily dietary fiber intake and plasma lipids using a cross-sectional design including 1034 (M 502, F 532) rural-to-urban workers in China. We found a dose-response relationship between increased dietary fiber intakes and increase of HDL cholesterol in male workers. There was also a dose-response relationship between increased dietary fiber intake and decreased total cholesterol to HDL cholesterol (TC/HDL-C) ratio in both male and female workers, after adjusting for potential confounders (p for trend, all p < 0.05). When the average dietary fiber intake increased from less than 18 g/day to over 30 g/day, the average HDL cholesterol level increased by 10.1%, and the TC/HDL-C ratio decreased by 14.4% for males (p = 0.020) and by 11.1% for females (p = 0.048). In conclusion, higher daily dietary fiber consumption is associated with beneficial effect on cholesterol for rural-to-urban workers in China, suggesting its potential beneficial effect on decreasing the risk of cardiovascular diseases.
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Affiliation(s)
- Quan Zhou
- Faculty of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 195# West Dongfeng Road, Guangzhou 510182, China.
| | - Jiang Wu
- Shenzhen Baoan City Center Hospital, 6 Xiyuan Road, Baoan District, Shenzhen 518102, China.
| | - Jie Tang
- Faculty of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 195# West Dongfeng Road, Guangzhou 510182, China.
| | - Jia-Ji Wang
- Faculty of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 195# West Dongfeng Road, Guangzhou 510182, China.
| | - Chu-Hong Lu
- Faculty of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 195# West Dongfeng Road, Guangzhou 510182, China.
| | - Pei-Xi Wang
- Faculty of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, 195# West Dongfeng Road, Guangzhou 510182, China.
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Whitehead A, Beck EJ, Tosh S, Wolever TMS. Cholesterol-lowering effects of oat β-glucan: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2014; 100:1413-21. [PMID: 25411276 PMCID: PMC5394769 DOI: 10.3945/ajcn.114.086108] [Citation(s) in RCA: 217] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Health claims regarding the cholesterol-lowering effect of soluble fiber from oat products, approved by food standards agencies worldwide, are based on a diet containing ≥3 g/d of oat β-glucan (OBG). Given the number of recently published randomized controlled trials (RCTs), it is important to update the findings of previous meta-analyses. OBJECTIVE The objective was to quantify the effect of ≥3 g OBG/d on serum cholesterol concentrations in humans and investigate potential effect modifiers. DESIGN A meta-analysis was performed on 28 RCTs comparing ≥3 g OBG/d with an appropriate control. Systematic searches were undertaken in PubMed, AGRICOLA, and Scopus between 1 January 1966 and 6 June 2013, plus in-house study reports at CreaNutrition AG. Studies were assessed with regard to inclusion/exclusion criteria, and data were extracted from included studies by reviewers working independently in pairs, reconciling differences by consensus. Estimates of the mean reduction in serum cholesterol from baseline between the OBG and control diets were analyzed by using random-effects meta-analysis models and meta-regression. RESULTS OBG in doses of ≥3 g/d reduced low-density lipoprotein (LDL) and total cholesterol relative to control by 0.25 mmol/L (95% CI: 0.20, 0.30; P < 0.0001) and 0.30 mmol/L (95% CI: 0.24, 0.35; P < 0.0001), respectively, with some indication of heterogeneity (P = 0.13 and P = 0.067). There was no significant effect of OBG on high-density lipoprotein (HDL) cholesterol or triglycerides and no evidence that dose (range across trials: 3.0-12.4 g/d) or duration of treatment (range: 2-12 wk) influenced the results. LDL cholesterol lowering was significantly greater with higher baseline LDL cholesterol. There was a significantly greater effect for both LDL and total cholesterol in subjects with diabetes compared with those without (although based on few studies). CONCLUSIONS Adding ≥3 g OBG/d to the diet reduces LDL and total cholesterol by 0.25 mmol/L and 0.30 mmol/L, respectively, without changing HDL cholesterol or triglycerides.
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Affiliation(s)
- Anne Whitehead
- From the Medical & Pharmaceutical Statistics Research Unit, Department of Mathematics and Statistics, Lancaster University, Lancaster, United Kingdom (AW); the School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia (EJB); Agriculture and Agri-Food Canada, Guelph, Canada (ST); and the Department of Nutritional Sciences, University of Toronto, Toronto, Canada (TMSW)
| | - Eleanor J Beck
- From the Medical & Pharmaceutical Statistics Research Unit, Department of Mathematics and Statistics, Lancaster University, Lancaster, United Kingdom (AW); the School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia (EJB); Agriculture and Agri-Food Canada, Guelph, Canada (ST); and the Department of Nutritional Sciences, University of Toronto, Toronto, Canada (TMSW)
| | - Susan Tosh
- From the Medical & Pharmaceutical Statistics Research Unit, Department of Mathematics and Statistics, Lancaster University, Lancaster, United Kingdom (AW); the School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia (EJB); Agriculture and Agri-Food Canada, Guelph, Canada (ST); and the Department of Nutritional Sciences, University of Toronto, Toronto, Canada (TMSW)
| | - Thomas M S Wolever
- From the Medical & Pharmaceutical Statistics Research Unit, Department of Mathematics and Statistics, Lancaster University, Lancaster, United Kingdom (AW); the School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia (EJB); Agriculture and Agri-Food Canada, Guelph, Canada (ST); and the Department of Nutritional Sciences, University of Toronto, Toronto, Canada (TMSW)
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Williams PG. The benefits of breakfast cereal consumption: a systematic review of the evidence base. Adv Nutr 2014; 5:636S-673S. [PMID: 25225349 PMCID: PMC4188247 DOI: 10.3945/an.114.006247] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
There have been no comprehensive reviews of the relation of breakfast cereal consumption to nutrition and health. This systematic review of all articles on breakfast cereals to October 2013 in the Scopus and Medline databases identified 232 articles with outcomes related to nutrient intake, weight, diabetes, cardiovascular disease, hypertension, digestive health, dental and mental health, and cognition. Sufficient evidence was available to develop 21 summary evidence statements, ranked from A (can be trusted to guide practice) to D (weak and must be applied with caution). Breakfast cereal consumption is associated with diets higher in vitamins and minerals and lower in fat (grade B) but is not associated with increased intakes of total energy or sodium (grade C) or risk of dental caries (grade B). Most studies on the nutritional impact are cross-sectional, with very few intervention studies, so breakfast cereal consumption may be a marker of an overall healthy lifestyle. Oat-, barley-, or psyllium-based cereals can help lower cholesterol concentrations (grade A), and high-fiber, wheat-based cereals can improve bowel function (grade A). Regular breakfast cereal consumption is associated with a lower body mass index and less risk of being overweight or obese (grade B). Presweetened breakfast cereals do not increase the risk of overweight and obesity in children (grade C). Whole-grain or high-fiber breakfast cereals are associated with a lower risk of diabetes (grade B) and cardiovascular disease (grade C). There is emerging evidence of associations with feelings of greater well-being and a lower risk of hypertension (grade D), but more research is required.
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22
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Soare A, Khazrai YM, Del Toro R, Roncella E, Fontana L, Fallucca S, Angeletti S, Formisano V, Capata F, Ruiz V, Porrata C, Skrami E, Gesuita R, Manfrini S, Fallucca F, Pianesi M, Pozzilli P. The effect of the macrobiotic Ma-Pi 2 diet vs. the recommended diet in the management of type 2 diabetes: the randomized controlled MADIAB trial. Nutr Metab (Lond) 2014; 11:39. [PMID: 25302069 PMCID: PMC4190933 DOI: 10.1186/1743-7075-11-39] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 08/17/2014] [Indexed: 01/06/2023] Open
Abstract
Background Diet is an important component of type 2 diabetes therapy. Low adherence to current therapeutic diets points out to the need for alternative dietary approaches. This study evaluated the effect of a different dietary approach, the macrobiotic Ma-Pi 2 diet, and compared it with standard diets recommended for patients with type 2 diabetes. Methods A randomized, controlled, open-label, 21-day trial was undertaken in patients with type 2 diabetes comparing the Ma-Pi 2 diet with standard (control) diet recommended by professional societies for treatment of type 2 diabetes. Changes in fasting blood glucose (FBG) and post-prandial blood glucose (PPBG) were primary outcomes. HbA1c, insulin resistance (IR), lipid panel and anthropometrics were secondary outcomes. Results After correcting for age, gender, BMI at baseline, and physical activity, there was a significantly greater reduction in the primary outcomes FBG (95% CI: 1.79; 13.46) and PPBG (95% CI: 5.39; 31.44) in those patients receiving the Ma-Pi 2 diet compared with those receiving the control diet. Statistically significantly greater reductions in the secondary outcomes, HbA1c (95% CI: 1.28; 5.46), insulin resistance, total cholesterol, LDL cholesterol and LDL/HDL ratio, BMI, body weight, waist and hip circumference were also found in the Ma-Pi 2 diet group compared with the control diet group. The latter group had a significantly greater reduction of triglycerides compared with the Ma-Pi 2 diet group. Conclusions Intervention with a short-term Ma-Pi 2 diet resulted in significantly greater improvements in metabolic control in patients with type 2 diabetes compared with intervention with standard diets recommended for these patients. Trial registration Current Controlled Trials ISRCTN10467793.
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Affiliation(s)
- Andreea Soare
- Department of Endocrinology and Diabetes, University Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Yeganeh M Khazrai
- Department of Endocrinology and Diabetes, University Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Rossella Del Toro
- Department of Endocrinology and Diabetes, University Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Elena Roncella
- Department of Endocrinology and Diabetes, University Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Lucia Fontana
- Unit of Dietology and Diabetology, Sandro Pertini Hospital, Via dei Monti Tiburtini 385, 00157 Rome, Italy
| | - Sara Fallucca
- Department of Endocrinology and Diabetes, University Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Silvia Angeletti
- Department of Laboratory Medicine, University Campus Bio-Medico, Rome, Italy
| | - Valeria Formisano
- Department of Endocrinology and Diabetes, University Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Francesca Capata
- Department of Endocrinology and Diabetes, University Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Vladimir Ruiz
- Department of Biochemistry and Physiology, Institute of Nutrition and Food Hygiene, Infanta 1158, 10300 Havana, Cuba
| | - Carmen Porrata
- Clinical Assay Direction, Finlay Institute, Avenue 27, No. 19805, La Coronela, La Lisa 11600, Havana, Cuba
| | - Edlira Skrami
- Center of Epidemiology, Biostatistics and Medical Information Technology, Polytechnic Marche University, Via Tronto 10A, 60020 Ancona, Italy
| | - Rosaria Gesuita
- Center of Epidemiology, Biostatistics and Medical Information Technology, Polytechnic Marche University, Via Tronto 10A, 60020 Ancona, Italy
| | - Silvia Manfrini
- Department of Endocrinology and Diabetes, University Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Francesco Fallucca
- Department of Clinical Sciences, La Sapienza University II Faculty, Via di Grottarossa 1035/1039, 00189 Rome, Italy
| | - Mario Pianesi
- International Study Center for Environment, Agriculture, Food, Health and Economics, Via San Nicola, 62029 Rome, Italy
| | - Paolo Pozzilli
- Department of Endocrinology and Diabetes, University Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy
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23
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Harris Jackson K, West SG, Vanden Heuvel JP, Jonnalagadda SS, Ross AB, Hill AM, Grieger JA, Lemieux SK, Kris-Etherton PM. Effects of whole and refined grains in a weight-loss diet on markers of metabolic syndrome in individuals with increased waist circumference: a randomized controlled-feeding trial. Am J Clin Nutr 2014; 100:577-86. [PMID: 24944054 PMCID: PMC4095661 DOI: 10.3945/ajcn.113.078048] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Higher whole-grain (WG) intake is associated with a lower prevalence of metabolic syndrome (MetS); however, there is inconsistent clinical evidence with regard to the benefit of WGs compared with refined grains (RGs) on MetS. OBJECTIVE We hypothesized that consuming WGs in the place of RGs would improve MetS criteria in individuals with or at risk of MetS. DESIGN A randomized, controlled, open-label parallel study was conducted in 50 overweight and obese individuals with increased waist circumference and one or more other MetS criteria. Participants consumed a controlled weight-loss diet containing either WG or RG (control) products for 12 wk. Body composition, MetS criteria and related markers, and plasma alkylresorcinols (compliance marker of WG intake) were measured at baseline and at 6 and 12 wk. A subgroup (n = 28) underwent magnetic resonance imaging to quantify subcutaneous and visceral adipose tissue (AT). RESULTS Baseline variables were not significantly different between groups; however, the RG group tended to have higher triglycerides and lower high-density lipoprotein (HDL) cholesterol (P = 0.06). Alkylresorcinols increased with consumption of the WG diet and did not change with consumption of the RG diet (time × treatment, P < 0.0001), which showed dietary compliance. There were no differences in anthropometric changes between groups; however, weight, body mass index, and percentage of body AT decreased at both 6 and 12 wk (P < 0.05), and reductions in percentage of abdominal AT occurred by 6 wk and did not change between 6 and 12 wk (P = 0.09). Both glucose (P = 0.02) and HDL cholesterol (P = 0.04) were lower with the consumption of the WG compared with the RG diet. However, when noncompliant individuals (n = 3) were removed, the glucose effect was stronger (P = 0.01) and the HDL-cholesterol effect was no longer significant (P = 0.14). CONCLUSIONS Replacing RGs with WGs within a weight-loss diet does not beneficially affect abdominal AT loss and has modest effects on markers of MetS. WGs appear to be effective at normalizing blood glucose concentrations, especially in those individuals with prediabetes.
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Affiliation(s)
- Kristina Harris Jackson
- From the Departments of Nutritional Sciences (KHJ, SGW, AMH, JAG, and PMK-E), Biobehavioral Health (SGW), and Veterinary and Biomedical Science (JPVH); the Center of Excellence in Nutrigenomics (JPVH and PMK-E); and the Social, Life, and Engineering Sciences Imaging Center (SKL), Pennsylvania State University, University Park, PA; the Bell Institute of Health and Nutrition, General Mills Inc, Minneapolis, MN (SSJ); the Nestlé Research Center, Lausanne, Switzerland (ABR); the Chalmers University of Technology, Gothenburg, Sweden (ABR); the Nutritional Physiology Research Centre, University of South Australia, Adelaide, Australia (AMH); and the Robinson Institute, Adelaide University, Adelaide, Australia (JAG)
| | - Sheila G West
- From the Departments of Nutritional Sciences (KHJ, SGW, AMH, JAG, and PMK-E), Biobehavioral Health (SGW), and Veterinary and Biomedical Science (JPVH); the Center of Excellence in Nutrigenomics (JPVH and PMK-E); and the Social, Life, and Engineering Sciences Imaging Center (SKL), Pennsylvania State University, University Park, PA; the Bell Institute of Health and Nutrition, General Mills Inc, Minneapolis, MN (SSJ); the Nestlé Research Center, Lausanne, Switzerland (ABR); the Chalmers University of Technology, Gothenburg, Sweden (ABR); the Nutritional Physiology Research Centre, University of South Australia, Adelaide, Australia (AMH); and the Robinson Institute, Adelaide University, Adelaide, Australia (JAG)
| | - John P Vanden Heuvel
- From the Departments of Nutritional Sciences (KHJ, SGW, AMH, JAG, and PMK-E), Biobehavioral Health (SGW), and Veterinary and Biomedical Science (JPVH); the Center of Excellence in Nutrigenomics (JPVH and PMK-E); and the Social, Life, and Engineering Sciences Imaging Center (SKL), Pennsylvania State University, University Park, PA; the Bell Institute of Health and Nutrition, General Mills Inc, Minneapolis, MN (SSJ); the Nestlé Research Center, Lausanne, Switzerland (ABR); the Chalmers University of Technology, Gothenburg, Sweden (ABR); the Nutritional Physiology Research Centre, University of South Australia, Adelaide, Australia (AMH); and the Robinson Institute, Adelaide University, Adelaide, Australia (JAG)
| | - Satya S Jonnalagadda
- From the Departments of Nutritional Sciences (KHJ, SGW, AMH, JAG, and PMK-E), Biobehavioral Health (SGW), and Veterinary and Biomedical Science (JPVH); the Center of Excellence in Nutrigenomics (JPVH and PMK-E); and the Social, Life, and Engineering Sciences Imaging Center (SKL), Pennsylvania State University, University Park, PA; the Bell Institute of Health and Nutrition, General Mills Inc, Minneapolis, MN (SSJ); the Nestlé Research Center, Lausanne, Switzerland (ABR); the Chalmers University of Technology, Gothenburg, Sweden (ABR); the Nutritional Physiology Research Centre, University of South Australia, Adelaide, Australia (AMH); and the Robinson Institute, Adelaide University, Adelaide, Australia (JAG)
| | - Alastair B Ross
- From the Departments of Nutritional Sciences (KHJ, SGW, AMH, JAG, and PMK-E), Biobehavioral Health (SGW), and Veterinary and Biomedical Science (JPVH); the Center of Excellence in Nutrigenomics (JPVH and PMK-E); and the Social, Life, and Engineering Sciences Imaging Center (SKL), Pennsylvania State University, University Park, PA; the Bell Institute of Health and Nutrition, General Mills Inc, Minneapolis, MN (SSJ); the Nestlé Research Center, Lausanne, Switzerland (ABR); the Chalmers University of Technology, Gothenburg, Sweden (ABR); the Nutritional Physiology Research Centre, University of South Australia, Adelaide, Australia (AMH); and the Robinson Institute, Adelaide University, Adelaide, Australia (JAG)
| | - Alison M Hill
- From the Departments of Nutritional Sciences (KHJ, SGW, AMH, JAG, and PMK-E), Biobehavioral Health (SGW), and Veterinary and Biomedical Science (JPVH); the Center of Excellence in Nutrigenomics (JPVH and PMK-E); and the Social, Life, and Engineering Sciences Imaging Center (SKL), Pennsylvania State University, University Park, PA; the Bell Institute of Health and Nutrition, General Mills Inc, Minneapolis, MN (SSJ); the Nestlé Research Center, Lausanne, Switzerland (ABR); the Chalmers University of Technology, Gothenburg, Sweden (ABR); the Nutritional Physiology Research Centre, University of South Australia, Adelaide, Australia (AMH); and the Robinson Institute, Adelaide University, Adelaide, Australia (JAG)
| | - Jessica A Grieger
- From the Departments of Nutritional Sciences (KHJ, SGW, AMH, JAG, and PMK-E), Biobehavioral Health (SGW), and Veterinary and Biomedical Science (JPVH); the Center of Excellence in Nutrigenomics (JPVH and PMK-E); and the Social, Life, and Engineering Sciences Imaging Center (SKL), Pennsylvania State University, University Park, PA; the Bell Institute of Health and Nutrition, General Mills Inc, Minneapolis, MN (SSJ); the Nestlé Research Center, Lausanne, Switzerland (ABR); the Chalmers University of Technology, Gothenburg, Sweden (ABR); the Nutritional Physiology Research Centre, University of South Australia, Adelaide, Australia (AMH); and the Robinson Institute, Adelaide University, Adelaide, Australia (JAG)
| | - Susan K Lemieux
- From the Departments of Nutritional Sciences (KHJ, SGW, AMH, JAG, and PMK-E), Biobehavioral Health (SGW), and Veterinary and Biomedical Science (JPVH); the Center of Excellence in Nutrigenomics (JPVH and PMK-E); and the Social, Life, and Engineering Sciences Imaging Center (SKL), Pennsylvania State University, University Park, PA; the Bell Institute of Health and Nutrition, General Mills Inc, Minneapolis, MN (SSJ); the Nestlé Research Center, Lausanne, Switzerland (ABR); the Chalmers University of Technology, Gothenburg, Sweden (ABR); the Nutritional Physiology Research Centre, University of South Australia, Adelaide, Australia (AMH); and the Robinson Institute, Adelaide University, Adelaide, Australia (JAG)
| | - Penny M Kris-Etherton
- From the Departments of Nutritional Sciences (KHJ, SGW, AMH, JAG, and PMK-E), Biobehavioral Health (SGW), and Veterinary and Biomedical Science (JPVH); the Center of Excellence in Nutrigenomics (JPVH and PMK-E); and the Social, Life, and Engineering Sciences Imaging Center (SKL), Pennsylvania State University, University Park, PA; the Bell Institute of Health and Nutrition, General Mills Inc, Minneapolis, MN (SSJ); the Nestlé Research Center, Lausanne, Switzerland (ABR); the Chalmers University of Technology, Gothenburg, Sweden (ABR); the Nutritional Physiology Research Centre, University of South Australia, Adelaide, Australia (AMH); and the Robinson Institute, Adelaide University, Adelaide, Australia (JAG)
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24
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Mullan B, Wong C, Kothe E, O'Moore K, Pickles K, Sainsbury K. An examination of the demographic predictors of adolescent breakfast consumption, content, and context. BMC Public Health 2014; 14:264. [PMID: 24645936 PMCID: PMC4000053 DOI: 10.1186/1471-2458-14-264] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 03/14/2014] [Indexed: 12/22/2022] Open
Abstract
Background Breakfast consumption is important to health; however, adolescents often skip breakfast, and an increased understanding of the breakfast consumption patterns of adolescents is needed. The purpose of this study was to identify the predictors of breakfast eating, including the content and context, in an adolescent sample from Australia and England. Methods Four-hundred and eighty-one students completed an online questionnaire measuring breakfast skipping, and breakfast content (what was eaten) and context (who they ate with, involvement in preparation). Logistic regression was conducted to investigate the predictors of skipping breakfast, breakfast context, and consumption of the ten most commonly consumed foods. Chi-square analyses were used to examine differences in breakfast content according to context. Results Most students (88%) had consumed breakfast on the day of the survey; breakfast skipping was more common in England (18%) than in Australia (8%). Country, gender, socioeconomic status, and body mass index (BMI) were all predictors of breakfast content and context. Whether adolescents ate with others and/or were involved in breakfast preparation predicted the content of breakfast consumed. Conclusions This study provides a comprehensive examination of the factors underlying breakfast consumption (content and context) and has important implications for the development of evidence-based interventions to improve rates of breakfast consumption and the quality of food consumed amongst adolescents.
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Affiliation(s)
| | | | - Emily Kothe
- School of Psychology, Deakin University, Melbourne, VIC, 3125, Australia.
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25
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Rees K, Dyakova M, Wilson N, Ward K, Thorogood M, Brunner E. Dietary advice for reducing cardiovascular risk. Cochrane Database Syst Rev 2013; 2013:CD002128. [PMID: 24318424 PMCID: PMC9993221 DOI: 10.1002/14651858.cd002128.pub5] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Changes in population diet are likely to reduce cardiovascular disease and cancer, but the effect of dietary advice is uncertain. This review is an update of a previous review published in 2007. OBJECTIVES To assess the effects of providing dietary advice to achieve sustained dietary changes or improved cardiovascular risk profile among healthy adults. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials, the Database of Abstracts of Reviews of Effects (DARE) and the HTA database on The Cochrane Library (Issue 4, 2010). We searched MEDLINE (Ovid) (1950 to week 2 October 2010) and EMBASE (Ovid) (1980 to Week 42 2010). Additional searches were done on CAB Health (1972 to December 1999), CVRCT registry (2000), CCT (2000) and SIGLE (1980 to 2000). Dissertation abstracts and reference lists of articles were checked and researchers were contacted. SELECTION CRITERIA Randomised studies with no more than 20% loss to follow-up, lasting at least three months and involving healthy adults comparing dietary advice with no advice or minimal advice. Trials involving children, trials to reduce weight or those involving supplementation were excluded. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial quality and extracted data. Study authors were contacted for additional information. MAIN RESULTS Forty-four trials with 52 intervention arms (comparisons) comparing dietary advice with no advice were included in the review; 18,175 participants or clusters were randomised. Twenty-nine of the 44 included trials were conducted in the USA. Dietary advice reduced total serum cholesterol by 0.15 mmol/L (95% CI 0.06 to 0.23) and LDL cholesterol by 0.16 mmol/L (95% CI 0.08 to 0.24) after 3 to 24 months. Mean HDL cholesterol levels and triglyceride levels were unchanged. Dietary advice reduced blood pressure by 2.61 mm Hg systolic (95% CI 1.31 to 3.91) and 1.45 mm Hg diastolic (95% CI 0.68 to 2.22) and 24-hour urinary sodium excretion by 40.9 mmol (95% CI 25.3 to 56.5) after 3 to 36 months but there was heterogeneity between trials for the latter outcome. Three trials reported plasma antioxidants, where small increases were seen in lutein and β-cryptoxanthin, but there was heterogeneity in the trial effects. Self-reported dietary intake may be subject to reporting bias, and there was significant heterogeneity in all the following analyses. Compared to no advice, dietary advice increased fruit and vegetable intake by 1.18 servings/day (95% CI 0.65 to 1.71). Dietary fibre intake increased with advice by 6.5 g/day (95% CI 2.2 to 10.82), while total dietary fat as a percentage of total energy intake fell by 4.48% (95% CI 2.47 to 6.48) with dietary advice, and saturated fat intake fell by 2.39% (95% CI 1.4 to 3.37).Two trials analysed incident cardiovascular disease (CVD) events (TOHP I/II). Follow-up was 77% complete at 10 to 15 years after the end of the intervention period and estimates of event rates lacked precision but suggested that sodium restriction advice probably led to a reduction in cardiovascular events (combined fatal plus non-fatal events) plus revascularisation (TOHP I hazards ratio (HR) 0.59, 95% CI 0.33 to 1.08; TOHP II HR 0.81, 95% CI 0.59 to 1.12). AUTHORS' CONCLUSIONS Dietary advice appears to be effective in bringing about modest beneficial changes in diet and cardiovascular risk factors over approximately 12 months, but longer-term effects are not known.
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Affiliation(s)
- Karen Rees
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryUKCV4 7AL
| | - Mariana Dyakova
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryUKCV4 7AL
| | - Nicola Wilson
- Warwick Medical School, University of WarwickDivision of Health SciencesCoventryUKCV4 7AL
| | - Kirsten Ward
- King's College LondonDepartment of Twin Research & Genetic EpidemiologySt. Thomas' Hospital Campus4th Floor, South Wing, Block DLondonUKSE1 7EH
| | - Margaret Thorogood
- Division of Health SciencesPublic Health and EpidemiologyWarwick Medical School, University of WarwickGibbet HillCoventryUKCV4 7AL
| | - Eric Brunner
- University College London Medical SchoolDepartment of Epidemiology and Public Health1‐19 Torrington PlaceLondonUKWC1E 6BT
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26
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Eilat-Adar S, Sinai T, Yosefy C, Henkin Y. Nutritional recommendations for cardiovascular disease prevention. Nutrients 2013; 5:3646-83. [PMID: 24067391 PMCID: PMC3798927 DOI: 10.3390/nu5093646] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 08/26/2013] [Accepted: 08/27/2013] [Indexed: 02/07/2023] Open
Abstract
Lifestyle factors, including nutrition, play an important role in the etiology of Cardiovascular Disease (CVD). This position paper, written by collaboration between the Israel Heart Association and the Israel Dietetic Association, summarizes the current, preferably latest, literature on the association of nutrition and CVD with emphasis on the level of evidence and practical recommendations. The nutritional information is divided into three main sections: dietary patterns, individual food items, and nutritional supplements. The dietary patterns reviewed include low carbohydrate diet, low-fat diet, Mediterranean diet, and the DASH diet. Foods reviewed in the second section include: whole grains and dietary fiber, vegetables and fruits, nuts, soy, dairy products, alcoholic drinks, coffee and caffeine, tea, chocolate, garlic, and eggs. Supplements reviewed in the third section include salt and sodium, omega-3 and fish oil, phytosterols, antioxidants, vitamin D, magnesium, homocysteine-reducing agents, and coenzyme Q10.
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Affiliation(s)
- Sigal Eilat-Adar
- Zinman College for Physical Education & Sports, Wingate Institute, Netanya 42902, Israel
| | - Tali Sinai
- School of Nutritional Sciences, Institute of Biochemistry, Food Science and Nutrition, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel; E-Mail:
| | - Chaim Yosefy
- Cardiology Department, Barzilai Medical Center Campus, Ashkelon 78000, Israel; E-Mail:
- Ben-Gurion University of the Negev, Beer Sheva 84105, Israel; E-Mail:
| | - Yaakov Henkin
- Ben-Gurion University of the Negev, Beer Sheva 84105, Israel; E-Mail:
- Cardiology Department, Soroka University Medical Center, Beer-Sheva 84101, Israel
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27
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Tighe P, Duthie G, Brittenden J, Vaughan N, Mutch W, Simpson WG, Duthie S, Horgan GW, Thies F. Effects of wheat and oat-based whole grain foods on serum lipoprotein size and distribution in overweight middle aged people: a randomised controlled trial. PLoS One 2013; 8:e70436. [PMID: 23940575 PMCID: PMC3734251 DOI: 10.1371/journal.pone.0070436] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 06/17/2013] [Indexed: 11/18/2022] Open
Abstract
Introduction Epidemiological studies suggest three daily servings of whole-grain foods (WGF) might lower cardiovascular disease risk, at least partly by lowering serum lipid levels. We have assessed the effects of consuming three daily portions of wholegrain food (provided as wheat or a mixture of wheat and oats) on lipoprotein subclass size and concentration in a dietary randomised controlled trial involving middle aged healthy individuals. Methods After a 4-week run-in period on a refined diet, volunteers were randomly allocated to a control (refined diet), wheat, or wheat + oats group for 12 weeks. Our servings were determined in order to significantly increase the intakes of non starch polysaccharides to the UK Dietary Reference Value of 18 g per day in the whole grain groups (18.5 g and 16.8 g per day in the wheat and wheat + oats groups respectively in comparison with 11.3 g per day in the control group). Outcome measures were serum lipoprotein subclasses' size and concentration. Habitual dietary intake was assessed prior and during the intervention. Of the 233 volunteers recruited, 24 withdrew and 3 were excluded. Results At baseline, significant associations were found between lipoprotein size and subclasses' concentrations and some markers of cardiovascular risk such as insulin resistance, blood pressure and serum Inter cellular adhesion molecule 1 concentration. Furthermore, alcohol and vitamin C intake were positively associated with an anti-atherogenic lipoprotein profile, with regards to lipoprotein size and subclasses' distribution. However, none of the interventions with whole grain affected lipoprotein size and profile. Conclusion Our results indicate that three portions of wholegrain foods, irrelevant of the type (wheat or oat-based) do not reduce cardiovascular risk by beneficially altering the size and distribution of lipoprotein subclasses. Trial Registration www.Controlled-Trials.com ISRCTN 27657880.
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Affiliation(s)
- Paula Tighe
- Division of Applied Medicine, University of Aberdeen, Aberdeen, United Kingdom
| | - Garry Duthie
- Rowett Institute of Nutrition & Health, University of Aberdeen, Aberdeen, United Kingdom
| | - Julie Brittenden
- Division of Applied Medicine, University of Aberdeen, Aberdeen, United Kingdom
| | - Nicholas Vaughan
- Division of Applied Medicine, University of Aberdeen, Aberdeen, United Kingdom
| | - William Mutch
- Clinical Biochemistry, National Health Service Grampian, Aberdeen, United Kingdom
| | - William G. Simpson
- Clinical Biochemistry, National Health Service Grampian, Aberdeen, United Kingdom
| | - Susan Duthie
- Rowett Institute of Nutrition & Health, University of Aberdeen, Aberdeen, United Kingdom
| | - Graham W. Horgan
- Biomathematics and Statistics Scotland, Rowett Institute of Nutrition & Health, Aberdeen, United Kingdom
| | - Frank Thies
- Division of Applied Medicine, University of Aberdeen, Aberdeen, United Kingdom
- Rowett Institute of Nutrition & Health, University of Aberdeen, Aberdeen, United Kingdom
- * E-mail:
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28
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Abstract
BACKGROUND Changes in population diet are likely to reduce cardiovascular disease and cancer, but the effect of dietary advice is uncertain. This review is an update of a previous review published in 2007. OBJECTIVES To assess the effects of providing dietary advice to achieve sustained dietary changes or improved cardiovascular risk profile among healthy adults. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials, the Database of Abstracts of Reviews of Effects (DARE) and the HTA database on The Cochrane Library (Issue 4, 2010). We searched MEDLINE (Ovid) (1950 to week 2 October 2010) and EMBASE (Ovid) (1980 to Week 42 2010). Additional searches were done on CAB Health (1972 to December 1999), CVRCT registry (2000), CCT (2000) and SIGLE (1980 to 2000). Dissertation abstracts and reference lists of articles were checked and researchers were contacted. SELECTION CRITERIA Randomised studies with no more than 20% loss to follow-up, lasting at least three months and involving healthy adults comparing dietary advice with no advice or minimal advice. Trials involving children, trials to reduce weight or those involving supplementation were excluded. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial quality and extracted data. Study authors were contacted for additional information. MAIN RESULTS Forty-four trials with 52 intervention arms (comparisons) comparing dietary advice with no advice were included in the review; 18,175 participants or clusters were randomised. Twenty-nine of the 44 included trials were conducted in the USA. Dietary advice reduced total serum cholesterol by 0.15 mmol/L (95% CI 0.06 to 0.23) and LDL cholesterol by 0.16 mmol/L (95% CI 0.08 to 0.24) after 3 to 24 months. Mean HDL cholesterol levels and triglyceride levels were unchanged. Dietary advice reduced blood pressure by 2.61 mm Hg systolic (95% CI 1.31 to 3.91) and 1.45 mm Hg diastolic (95% CI 0.68 to 2.22) and 24-hour urinary sodium excretion by 40.9 mmol (95% CI 25.3 to 56.5) after 3 to 36 months but there was heterogeneity between trials for the latter outcome. Three trials reported plasma antioxidants, where small increases were seen in lutein and β-cryptoxanthin, but there was heterogeneity in the trial effects. Self-reported dietary intake may be subject to reporting bias, and there was significant heterogeneity in all the following analyses. Compared to no advice, dietary advice increased fruit and vegetable intake by 1.18 servings/day (95% CI 0.65 to 1.71). Dietary fibre intake increased with advice by 6.5 g/day (95% CI 2.2 to 10.82), while total dietary fat as a percentage of total energy intake fell by 4.48% (95% CI 2.47 to 6.48) with dietary advice, and saturated fat intake fell by 2.39% (95% CI 1.4 to 3.37).Two trials analysed incident cardiovascular disease (CVD) events (TOHP I/II). Follow-up was 77% complete at 10 to 15 years after the end of the intervention period and estimates of event rates lacked precision but suggested that sodium restriction advice probably led to a reduction in cardiovascular events (combined fatal plus non-fatal events) plus revascularisation (TOHP I hazards ratio (HR) 0.59, 95% CI 0.33 to 1.08; TOHP II HR 0.81, 95% CI 0.59 to 1.12). AUTHORS' CONCLUSIONS Dietary advice appears to be effective in bringing about modest beneficial changes in diet and cardiovascular risk factors over approximately 12 months, but longer-term effects are not known.
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Affiliation(s)
- Karen Rees
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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29
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Damsgaard CT, Dalskov SM, Petersen RA, Sørensen LB, Mølgaard C, Biltoft-Jensen A, Andersen R, Thorsen AV, Tetens I, Sjödin A, Hjorth MF, Vassard D, Jensen JD, Egelund N, Dyssegaard CB, Skovgaard I, Astrup A, Michaelsen KF. Design of the OPUS School Meal Study: a randomised controlled trial assessing the impact of serving school meals based on the New Nordic Diet. Scand J Public Health 2012; 40:693-703. [PMID: 23108477 DOI: 10.1177/1403494812463173] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Danish children consume too much sugar and not enough whole grain, fish, fruit, and vegetables. The Nordic region is rich in such foods with a strong health-promoting potential. We lack randomised controlled trials that investigate the developmental and health impact of serving school meals based on Nordic foods. AIM This paper describes the rationale, design, study population, and potential implications of the Optimal well-being, development and health for Danish children through a healthy New Nordic Diet (OPUS) School Meal Study. METHODS In a cluster-randomised cross-over design, 1021 children from 3rd and 4th grades (8-11 years old) at nine Danish municipal schools were invited to participate. Classes were assigned to two 3-month periods with free school meals based on the New Nordic Diet (NND) or their usual packed lunch (control). Dietary intake, nutrient status, physical activity, cardiorespiratory fitness, sleep, growth, body composition, early metabolic and cardiovascular risk markers, illness, absence from school, wellbeing, cognitive function, social and cultural features, food acceptance, waste, and cost were assessed. RESULTS In total, 834 children (82% of those invited) participated. Although their parents were slightly better educated than the background population, children from various socioeconomic backgrounds were included. The proportion of overweight and obese children (14%) resembled that of earlier examinations of Danish school children. Drop out was 8.3%. CONCLUSIONS A high inclusion rate and low drop out rate was achieved. This study will be the first to determine whether school meals based on the NND improve children's diet, health, growth, cognitive performance, and early disease risk markers.
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Affiliation(s)
- Camilla T Damsgaard
- Department of Human Nutrition, Faculty of Science, University of Copenhagen, Denmark.
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Rautiainen S, Levitan EB, Orsini N, Åkesson A, Morgenstern R, Mittleman MA, Wolk A. Total antioxidant capacity from diet and risk of myocardial infarction: a prospective cohort of women. Am J Med 2012; 125:974-80. [PMID: 22998880 DOI: 10.1016/j.amjmed.2012.03.008] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 03/28/2012] [Accepted: 03/28/2012] [Indexed: 12/31/2022]
Abstract
BACKGROUND There are no previous studies investigating the effect of all dietary antioxidants in relation to myocardial infarction. The total antioxidant capacity of diet takes into account all antioxidants and synergistic effects between them. The aim of this study was to examine how total antioxidant capacity of diet and antioxidant-containing foods were associated with incident myocardial infarction among middle-aged and elderly women. METHODS In the population-based prospective Swedish Mammography Cohort of 49-83-year-old women, 32,561 were cardiovascular disease-free at baseline. Women completed a food-frequency questionnaire, and dietary total antioxidant capacity was calculated using oxygen radical absorbance capacity values. Information on myocardial infarction was identified from the Swedish Hospital Discharge and the Cause of Death registries. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazard models. RESULTS During the follow-up (September 1997-December 2007), we identified 1114 incident cases of myocardial infarction (321,434 person-years). In multivariable-adjusted analysis, the HR for women comparing the highest quintile of dietary total antioxidant capacity to the lowest was 0.80 (95% CI, 0.67-0.97; P for trend=0.02). Servings of fruit and vegetables and whole grains were nonsignificantly inversely associated with myocardial infarction. CONCLUSIONS These data suggest that dietary total antioxidant capacity, based on fruits, vegetables, coffee, and whole grains, is of importance in the prevention of myocardial infarction.
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Affiliation(s)
- Susanne Rautiainen
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Zhang J, Li L, Song P, Wang C, Man Q, Meng L, Cai J, Kurilich A. Randomized controlled trial of oatmeal consumption versus noodle consumption on blood lipids of urban Chinese adults with hypercholesterolemia. Nutr J 2012; 11:54. [PMID: 22866937 PMCID: PMC3489577 DOI: 10.1186/1475-2891-11-54] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 06/28/2012] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death in China and worldwide. Whole grain oats can reduce risk of CVD by reducing total and LDL-cholesterol, major risk factors for CVD. While this association has been established in many populations, data from Asian populations is limited. Thus, this study investigated the impact of oat consumption on cholesterol levels in Chinese adults. Male and female data from this work were previously published separately in mandarin in two Chinese journals. The combined male and female data were reanalyzed and are presented here. METHODS A randomized, controlled, parallel-arm study was conducted at Beijing Hospital, Beijing china. Subjects were adults (men and women) with mild to moderate hypercholesterolemia. The oat group (n=85) consumed 100 grams of instant oat cereal versus the control group (n=81) who consumed 100 grams of wheat flour-based noodles daily for 6 weeks. Laboratory and anthropometric measurements were conducted at baseline and at the end of the 6-week intervention. RESULTS Dietary fiber intake increased significantly in the oat group compared to the control group at the end of the 6-week intervention. Total-, LDL-cholesterol and waist circumference decreased significantly in the oat group compared to the control. HDL-cholesterol decreased significantly in the control group versus the oat group. There were no significant changes in blood pressure, other anthropometric or laboratory measures between the two groups at the end of the intervention. CONCLUSIONS Instant oatmeal consumed daily for 6 weeks significantly increased fiber intake and decreased major risk factors for CVD in Chinese adults with hypercholesterolemia. Increased consumption of whole grains, including oats, should continue to be encouraged.
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Affiliation(s)
- Jian Zhang
- Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Lixiang Li
- Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Pengkun Song
- Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Chunrong Wang
- Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Qingqing Man
- Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Liping Meng
- Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Jenny Cai
- PepsiCo China Foods, 168 Xizhangmiddle Road, Shanghai, 200001, China
| | - Anne Kurilich
- Long Term Research, PepsiCo Inc, 617w.main St, Barrington, IL, 60010, USA
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Landberg R, Townsend MK, Neelakantan N, Sun Q, Sampson L, Spiegelman D, van Dam RM. Alkylresorcinol metabolite concentrations in spot urine samples correlated with whole grain and cereal fiber intake but showed low to modest reproducibility over one to three years in U.S. women. J Nutr 2012; 142:872-7. [PMID: 22437553 PMCID: PMC3327746 DOI: 10.3945/jn.111.156398] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Two alkylresorcinol (AR) metabolites, 3, 5-dihydroxybenzoic acid (DHBA) and 3-(3,5-dihydroxyphenyl)-1-propanoic acid (DHPPA), in urine have been suggested as biomarkers of whole grain (WG) and cereal fiber intake but the long-term reproducibility and correlation with habitual intake has not been determined. Therefore, we evaluated the long-term reproducibility of AR metabolites in spot urine samples and investigated their correlation with habitual WG and cereal fiber intake in U.S. women. AR metabolites were analyzed in 104 women participating in the Nurses' Health Study II and WG and fiber intakes were assessed using a FFQ. Long-term reproducibility was assessed by calculating the intra-class correlation coefficients (ICC) using samples taken 1-3 y (mean 1.8 y) apart. The observed Spearman correlation coefficients (r(s)) and r(s) adjusted for within-participant variation in the biomarker were calculated between WG and fiber intake and biomarkers. The long-term reproducibility was poor for DHBA [ICC = 0.17 (95% CI: 0.05, 0.43)] and modest for DHPPA [ICC = 0.31 (95% CI: 0.17, 0.51)]. The correlation between WG intake in 1995 and DHPPA measured 2 y later was 0.37 (P < 0.0001); the adjusted correlation was 0.60 (95% CI: 0.37, 0.76). Cereal fiber and WG intake were similarly correlated to the biomarkers. DHPPA in spot urine samples reflected WG intake despite relatively low intake of food sources of AR. The poor to modest reproducibility may limit the use of single measurements of these biomarkers in cohort studies in the US, where WG intake is relatively low and has changed over time. But DHPPA in repeated samples may be useful for validating WG intake and assessing compliance in WG intervention studies.
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Affiliation(s)
- Rikard Landberg
- Department of Food Science, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - Mary K. Townsend
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Harvard University, Boston; MA
| | - Nithya Neelakantan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Qi Sun
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Harvard University, Boston; MA,Department of Nutrition, and
| | | | - Donna Spiegelman
- Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, MA; and
| | - Rob M. van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,Department of Nutrition, and,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Evaluation of the effect of wheat aleurone-rich foods on markers of antioxidant status, inflammation and endothelial function in apparently healthy men and women. Br J Nutr 2012; 108:1644-51. [DOI: 10.1017/s0007114511007070] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Observational data show an inverse association between the consumption of wholegrain foods, and inflammation and related diseases. Although the underlying mechanisms are unclear, wholegrains, and in particular the aleurone layer, contain a wide range of components with putative antioxidant and anti-inflammatory effects. We evaluated the effects of a diet high in wheat aleurone on plasma antioxidants status, markers of inflammation and endothelial function. In this parallel, participant-blinded intervention, seventy-nine healthy, older, overweight participants (45–65 years, BMI>25 kg/m2) incorporated either aleurone-rich cereal products (27 g aleurone/d), or control products balanced for fibre and macronutrients, into their habitual diets for 4 weeks. Fasting blood samples were taken at baseline and on day 29. Results showed that, compared to control, consumption of aleurone-rich products provided substantial amounts of micronutrients and phytochemicals which may function as antioxidants. Additionally, incorporating these products into a habitual diet resulted in significantly lower plasma concentrations of the inflammatory marker, C-reactive protein (P = 0·035), which is an independent risk factor for CVD. However, no changes were observed in other markers of inflammation, antioxidant status or endothelial function. These results provide a possible mechanism underlying the beneficial effects of longer-term wholegrain intake. However, it is unclear whether this effect is owing to a specific component, or a combination of components in wheat aleurone.
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Abstract
Elevated total and low-density lipoprotein (LDL) cholesterol levels are considered major risk factors for cardiovascular disease. Oat β-glucan, a soluble dietary fiber that is found in the endosperm cell walls of oats, has generated considerable interest due to its cholesterol-lowering properties. The United States Food and Drug Administration (FDA) approved a health claim for β-glucan soluble fiber from oats for reducing plasma cholesterol levels and risk of heart disease in 1997. Similarly, in 2004 the United Kingdom Joint Health Claims Initiative (JHCI) allowed a cholesterol-lowering health claim for oat β-glucan. The present review aims to investigate if results from more recent studies are consistent with the original conclusions reached by the FDA and JHCI. Results of this analysis show that studies conducted during the past 13 years support the suggestion that intake of oat β-glucan at daily doses of at least 3 g may reduce plasma total and low-density lipoprotein (LDL) cholesterol levels by 5-10% in normocholesterolemic or hypercholesterolemic subjects. Studies described herein have shown that, on average, oat consumption is associated with 5% and 7% reductions in total and LDL cholesterol levels, respectively. Significant scientific agreement continues to support a relationship between oat β-glucan and blood cholesterol levels, with newer data being consistent with earlier conclusions made by the FDA and JHCI.
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Affiliation(s)
- Rgia A Othman
- Department of Human Nutritional Sciences and Canadian Centre for Agri-food Research in Health and Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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Flock MR, Kris-Etherton PM. Dietary Guidelines for Americans 2010: Implications for Cardiovascular Disease. Curr Atheroscler Rep 2011; 13:499-507. [DOI: 10.1007/s11883-011-0205-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Huang J, Frohlich J, Ignaszewski AP. The Impact of Dietary Changes and Dietary Supplements on Lipid Profile. Can J Cardiol 2011; 27:488-505. [DOI: 10.1016/j.cjca.2010.12.077] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 12/26/2010] [Indexed: 01/24/2023] Open
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Affiliation(s)
- Dariush Mozaffarian
- Division of Cardiovascular Medicine and Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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Abstract
Cereal fibre and whole-grain intakes have been consistently associated in the epidemiological literature with reduced mortality and risk of chronic disease including obesity, CVD and type 2 diabetes. The present review focuses on intervention trials with three primary aims: (1) understanding the mechanisms through which fibre consumption improves health (for example, examination of intermediate endpoints reflecting improved lipid, glucose and energy metabolism); (2) close evaluation of qualitative factors which modify fibre's effectiveness including physiochemical properties (for example, solubility, fermentability and viscosity), fibre extract molecular weight, fibre particle size and botanical structure of the fibre source grain; and (3) identification of areas in which additional research is needed. The first two aims typify the goals of nutrition research, in that improved understanding of the specific factors which determine fibre's health benefits has critical implications for dietary recommendations as well as improving understanding of physiological mechanisms. The third aim acknowledges the substantial gap between recommended and actual fibre intakes in many developed countries including the USA and the UK. In recognition of this deficit in total fibre intake, food manufacturing processes increasingly utilise fibre extracts and concentrates as food additives. However, whether fibre extracts provide similar health benefits to the fibre supplied in the constituents of whole grain is largely unexplored. The relative benefits of fibre extracts compared with whole-grain fibre sources therefore represent a critical area in which additional research is needed.
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Affiliation(s)
- Caren E. Smith
- Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Katherine L. Tucker
- Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
- Department of Health Sciences, Northeastern University, Boston, MA, USA
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Jonnalagadda SS, Harnack L, Hai Liu R, McKeown N, Seal C, Liu S, Fahey GC. Putting the whole grain puzzle together: health benefits associated with whole grains--summary of American Society for Nutrition 2010 Satellite Symposium. J Nutr 2011; 141:1011S-22S. [PMID: 21451131 PMCID: PMC3078018 DOI: 10.3945/jn.110.132944] [Citation(s) in RCA: 181] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The symposium "Putting the Whole Grain Puzzle Together: Health Benefits Associated with Whole Grains" sponsored by the ASN brought together researchers to review the evidence regarding the health benefits associated with whole grains. Current scientific evidence indicates that whole grains play an important role in lowering the risk of chronic diseases, such as coronary heart disease, diabetes, and cancer, and also contribute to body weight management and gastrointestinal health. The essential macro- and micronutrients, along with the phytonutrients present in whole grains, synergistically contribute to their beneficial effects. Current evidence lends credence to the recommendations to incorporate whole grain foods into a healthy diet and lifestyle program. The symposium also highlighted the need for further research to examine the role of whole grain foods in disease prevention and management to gain a better understanding of their mechanisms of action.
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Affiliation(s)
- Satya S. Jonnalagadda
- General Mills Bell Institute of Health and Nutrition, Golden Valley, MN, 55427,To whom correspondence should be addressed. E-mail:
| | - Lisa Harnack
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454
| | - Rui Hai Liu
- Department of Food Science, Cornell University, Ithaca, NY 14853
| | - Nicola McKeown
- Nutrition Epidemiology Program, Jean Mayer USDA HNRCA at Tufts University, Boston, MA 02111
| | - Chris Seal
- Human Nutrition Research Centre, New Castle University, Newcastle upon Tyne, NE17RU UK
| | - Simin Liu
- Program on Genomics and Nutrition, University of California, Los Angeles, CA, 90095
| | - George C. Fahey
- Department of Animal Sciences, University of Illinois, Urbana, IL 61801
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Harris KA, Kris-Etherton PM. Effects of whole grains on coronary heart disease risk. Curr Atheroscler Rep 2011; 12:368-76. [PMID: 20820954 DOI: 10.1007/s11883-010-0136-1] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Characterizing which types of carbohydrates, including whole grains, reduce the risk for coronary heart disease (CHD) is challenging. Whole grains are characterized as being high in resistant carbohydrates as compared with refined grains, meaning they typically are high in fiber, nutrients, and bound antioxidants. Whole grain intake consistently has been associated with improved cardiovascular disease outcomes, but also with healthy lifestyles, in large observational studies. Intervention studies that assess the effects of whole grains on biomarkers for CHD have mixed results. Due to the varying nutrient compositions of different whole grains, each could potentially affect CHD risk via different mechanisms. Whole grains high in viscous fiber (oats, barley) decrease serum low-density lipoprotein cholesterol and blood pressure and improve glucose and insulin responses. Grains high in insoluble fiber (wheat) moderately lower glucose and blood pressure but also have a prebiotic effect. Obesity is inversely related to whole grain intake, but intervention studies with whole grains have not produced weight loss. Visceral fat, however, may be affected favorably. Grain processing improves palatability and can have varying effects on nutrition (e.g., the process of milling and grinding flour increases glucose availability and decreases phytochemical content whereas thermal processing increases available antioxidants). Understanding how individual grains, in both natural and processed states, affect CHD risk can inform nutrition recommendations and policies and ultimately benefit public health.
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Affiliation(s)
- Kristina A Harris
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA 16802, USA
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Peacock E, Stanley J, Calder PC, Jebb SA, Thies F, Seal CJ, Woodside JV, Sanders TAB. UK Food Standards Agency Workshop Report: carbohydrate and cardiovascular risk. Br J Nutr 2010; 103:1688-94. [PMID: 20236556 PMCID: PMC3359681 DOI: 10.1017/s0007114510000735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This report summarises a workshop convened by the UK Food Standards Agency (FSA) on 14 October 2008 to discuss current FSA-funded research on carbohydrates and cardiovascular health. The objective of this workshop was to discuss the results of recent research and to identify any areas which could inform future FSA research calls. This workshop highlighted that the FSA is currently funding some of the largest, well-powered intervention trials investigating the type of fat and carbohydrate, whole grains and fruit and vegetables, on various CVD risk factors. Results of these trials will make a substantive contribution to the evidence on diet and cardiovascular risk.
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Affiliation(s)
- Emma Peacock
- Nutrition Division, Food Standards Agency, London, UK.
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Markers of cardiovascular risk are not changed by increased whole-grain intake: the WHOLEheart study, a randomised, controlled dietary intervention. Br J Nutr 2010; 104:125-34. [PMID: 20307353 DOI: 10.1017/s0007114510000644] [Citation(s) in RCA: 162] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Recommendations for whole-grain (WG) intake are based on observational studies showing that higher WG consumption is associated with reduced CVD risk. No large-scale, randomised, controlled dietary intervention studies have investigated the effects on CVD risk markers of substituting WG in place of refined grains in the diets of non-WG consumers. A total of 316 participants (aged 18-65 years; BMI>25 kg/m2) consuming < 30 g WG/d were randomly assigned to three groups: control (no dietary change), intervention 1 (60 g WG/d for 16 weeks) and intervention 2 (60 g WG/d for 8 weeks followed by 120 g WG/d for 8 weeks). Markers of CVD risk, measured at 0 (baseline), 8 and 16 weeks, were: BMI, percentage body fat, waist circumference; fasting plasma lipid profile, glucose and insulin; and indicators of inflammatory, coagulation, and endothelial function. Differences between study groups were compared using a random intercepts model with time and WG intake as factors. Although reported WG intake was significantly increased among intervention groups, and demonstrated good participant compliance, there were no significant differences in any markers of CVD risk between groups. A period of 4 months may be insufficient to change the lifelong disease trajectory associated with CVD. The lack of impact of increasing WG consumption on CVD risk markers implies that public health messages may need to be clarified to consider the source of WG and/or other diet and lifestyle factors linked to the benefits of whole-grain consumption seen in observational studies.
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Albertson AM, Thompson D, Franko DL, Holschuh NM, Bauserman R, Barton BA. Prospective associations among cereal intake in childhood and adiposity, lipid levels, and physical activity during late adolescence. ACTA ACUST UNITED AC 2009; 109:1775-80. [PMID: 19782178 DOI: 10.1016/j.jada.2009.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Accepted: 03/30/2009] [Indexed: 10/20/2022]
Abstract
Cereal consumption is a common dietary behavior that has been associated with positive health outcomes. The objective of this study was to examine prospective associations between cereal intake in childhood and percent body fat, waist-to-hip ratio, lipid levels, and physical activity during late adolescence. In this longitudinal investigation (data collected 1987-1997), data were analyzed for the 2,379 girls who participated in the 10-year National Heart, Lung, and Blood Institute Growth and Health Study. The cumulative percent of days that each girl consumed cereal during childhood (based on 3-day food diaries collected during six study visits between ages 11.5 and 18.6 years) was examined in relation to percent body fat, waist-to-hip ratio, lipid levels, and physical activity measured at age 18.6 years. Results indicated that nearly all girls (90.1%) reported eating cereal and 18.7% reported eating cereal on half or more of the days reported in the food diaries. Girls who ate cereal on a greater percentage of days during childhood had lower percent body fat and total cholesterol, and were more likely to exhibit high levels of physical activity and less television viewing during Study Year 10 (P values<0.05). Further research should explore lifestyle issues related to cereal consumption.
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Affiliation(s)
- Ann M Albertson
- Bell Insititute of Health and Nutrition, General Mills, Inc., Minneapolis, MN, USA
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Effects of oats on plasma cholesterol and lipoproteins in C57BL/6 mice are substrain specific. Br J Nutr 2009; 103:513-21. [DOI: 10.1017/s000711450999211x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cholesterol-lowering effects of oats have been demonstrated in both animals and human subjects. However, the crucial properties of oat-containing diets that determine their health effects need to be further investigated to optimise their use. A mouse model would be a valuable tool, but few such studies have been published to date. We investigated the effects of oat bran on plasma cholesterol and lipoproteins in two substrains of C57BL/6 mice. Western diet was made atherogenic by the addition of 0·8 % cholesterol and 0·1 % cholic acid. After 4 weeks on atherogenic diet, total plasma cholesterol had increased from 1·86–2·53 to 3·77–4·40 mmol/l. In C57BL/6NCrl mice, inclusion of 27 and 40 % oat bran reduced total plasma cholesterol by 19 and 24 %, respectively, reduced the shift from HDL to LDL+VLDL and caused increased faecal cholesterol excretion. There was no effect of oat bran on plasma levels of the inflammatory markers fibrinogen, serum amyloid A or TNF-α. Contrary to findings in C57BL/6NCrl mice, there was no sustained effect of oat bran (27 or 40 %) on plasma cholesterol in C57BL/6JBomTac mice after 4 weeks of feeding. Thus, C57BL/6NCrl mice fed an atherogenic diet are a good model for studies of physiological effects of oats, whereas a substrain derived from C57BL/6J, raised in a different breeding environment and likely possessing functional genetic differences from C57BL/6N, is considerably less responsive to oats. The present finding that two substrains of mice respond differently to oats is of practical value, but can also help to elucidate mechanisms of the cholesterol-lowering effect of oats.
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Kamal-Eldin A, Lærke HN, Knudsen KEB, Lampi AM, Piironen V, Adlercreutz H, Katina K, Poutanen K, Åman P. Physical, microscopic and chemical characterisation of industrial rye and wheat brans from the Nordic countries. Food Nutr Res 2009. [DOI: 10.3402/fnr.v52i0.1912] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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47
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Kamal-Eldin A, Lærke HN, Knudsen KEB, Lampi AM, Piironen V, Adlercreutz H, Katina K, Poutanen K, Ɨman P. Physical, microscopic and chemical characterisation of industrial rye and wheat brans from the Nordic countries. Food Nutr Res 2009; 53:1912. [PMID: 19412350 PMCID: PMC2675562 DOI: 10.3402/fnr.v53i0.1912] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Revised: 03/13/2009] [Accepted: 03/25/2009] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Epidemiological studies show inverse relationship between intake of wholegrain cereals and several chronic diseases. Components and mechanisms behind possible protective effects of wholegrain cereals are poorly understood. OBJECTIVE To characterise commercial rye bran preparations, compared to wheat bran, regarding structure and content of nutrients as well as a number of presumably bioactive compounds. DESIGN Six different rye brans from Sweden, Denmark and Finland were analysed and compared with two wheat brans regarding colour, particle size distribution, microscopic structures and chemical composition including proximal components, vitamins, minerals and bioactive compounds. RESULTS Rye brans were generally greener in colour and smaller in particle size than wheat brans. The rye brans varied considerably in their starch content (13.2-;28.3%), which reflected variable inclusion of the starchy endosperm. Although rye and wheat brans contained comparable levels of total dietary fibre, they differed in the relative proportions of fibre components (i.e. arabinoxylan, beta-glucan, cellulose, fructan and Klason lignin). Generally, rye brans contained less cellulose and more beta-glucan and fructan than wheat brans. Within small variations, the rye and wheat brans were comparable regarding the contents of tocopherols/tocotrienols, total folate, sterols/stanols, phenolic acids and lignans. Rye bran had less glycine betaine and more alkylresorcinols than wheat brans. CONCLUSIONS The observed variation in the chemical composition of industrially produced rye brans calls for the need of standardisation of this commodity, especially when used as a functional ingredient in foods.
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Affiliation(s)
- Afaf Kamal-Eldin
- Department of Food Science, Swedish University of Agricultural Sciences (SLU), Uppsala, Sweden
| | - Helle Nygaard Lærke
- Department of Animal Health, Welfare and Nutrition, Faculty of Agricultural Sciences, Aarhus University, Tjele, Denmark
| | - Knud-Erik Bach Knudsen
- Department of Animal Health, Welfare and Nutrition, Faculty of Agricultural Sciences, Aarhus University, Tjele, Denmark
| | - Anna-Maija Lampi
- Department of Chemistry and Applied Microbiology, University of Helsinki, Helsinki, Finland
| | - Vieno Piironen
- Department of Chemistry and Applied Microbiology, University of Helsinki, Helsinki, Finland
| | - Herman Adlercreutz
- Folkhalsan Research Centre and Division of Clinical Chemistry, University of Helsinki, Finland
| | - Kati Katina
- VTT Technical Research Centre of Finland, Finland
| | | | - Per Ɨman
- Department of Food Science, Swedish University of Agricultural Sciences (SLU), Uppsala, Sweden
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48
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A rapid gas chromatography–mass spectrometry method for quantification of alkylresorcinols in human plasma. Anal Biochem 2009; 385:7-12. [DOI: 10.1016/j.ab.2008.10.031] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Revised: 10/24/2008] [Accepted: 10/26/2008] [Indexed: 11/27/2022]
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Landberg R, Aman P, Friberg LE, Vessby B, Adlercreutz H, Kamal-Eldin A. Dose response of whole-grain biomarkers: alkylresorcinols in human plasma and their metabolites in urine in relation to intake. Am J Clin Nutr 2009; 89:290-6. [PMID: 19056600 DOI: 10.3945/ajcn.2008.26709] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Alkylresorcinols (ARs), phenolic lipids almost exclusively present in the outer parts of wheat and rye grains in commonly consumed foods, have been proposed as specific dietary biomarkers of whole-grain wheat and rye intakes. OBJECTIVE The objective was to assess the dose response of plasma ARs and the excretion of 2 recently discovered AR metabolites in 24-h urine samples in relation to AR intake and to establish a pharmacokinetic model for predicting plasma AR concentration. DESIGN Sixteen subjects were given rye bran flakes containing 11, 22, or 44 mg total ARs 3 times daily during week-long intervention periods separated by 1-wk washout periods in a nonblinded randomized crossover design. Blood samples were collected at baseline, after the 1-wk run-in period, and after each treatment and washout period. Two 24-h urine samples were collected at baseline and after each treatment period. RESULTS Plasma AR concentrations and daily excretion of 2 urinary AR metabolites increased with increasing AR dose (P < 0.001). Recovery of urinary metabolites in 24-h samples decreased with increasing doses from approximately 90% to approximately 45% in the range tested. A one-compartment model with 2 absorption compartments with different lag times and absorption rate constants adequately predicted plasma AR concentrations at the end of each intervention period. CONCLUSION Both plasma AR concentrations and urinary metabolites in 24-h samples showed a dose-response relation to increased AR intake, which strongly supports the hypothesis that ARs and their metabolites may be useful as biomarkers of whole-grain wheat and rye intakes.
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Affiliation(s)
- Rikard Landberg
- Department of Food Science, Swedish University of Agriculture Science, Uppsala, Sweden.
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50
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Poli A, Marangoni F, Paoletti R, Mannarino E, Lupattelli G, Notarbartolo A, Aureli P, Bernini F, Cicero A, Gaddi A, Catapano A, Cricelli C, Gattone M, Marrocco W, Porrini M, Stella R, Vanotti A, Volpe M, Volpe R, Cannella C, Pinto A, Del Toma E, La Vecchia C, Tavani A, Manzato E, Riccardi G, Sirtori C, Zambon A. Non-pharmacological control of plasma cholesterol levels. Nutr Metab Cardiovasc Dis 2008; 18:S1-S16. [PMID: 18258418 DOI: 10.1016/j.numecd.2007.10.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2007] [Revised: 10/24/2007] [Accepted: 10/25/2007] [Indexed: 01/25/2023]
Abstract
The importance of non-pharmacological control of plasma cholesterol levels in the population is increasing, along with the number of subjects whose plasma lipid levels are non-optimal, or frankly elevated, according to international guidelines. In this context, a panel of experts, organized and coordinated by the Nutrition Foundation of Italy, has evaluated the nutritional and lifestyle interventions to be adopted in the control of plasma cholesterol levels (and specifically of LDL cholesterol levels). This Consensus document summarizes the view of the panel on this topic, with the aim to provide an updated support to clinicians and other health professionals involved in cardiovascular prevention.
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