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Mahajan A, Duncan AM, Darlington G, Haines J, Ma DWL, Buchholz AC. Dietary Sugar and Anthropometrics among Young Children in the Guelph Family Health Study: Longitudinal Associations. CAN J DIET PRACT RES 2024; 85:132-139. [PMID: 38836464 DOI: 10.3148/cjdpr-2024-001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Purpose: Our understanding of the influence of sugar intake on anthropometrics among young children is limited. Most existing research is cross-sectional and has focused on sugar-sweetened beverages. The study objective was to investigate longitudinal associations between young children's total, free, and added sugar intake from all food sources at baseline with anthropometric measures at baseline and 18 months.Methods: The Guelph Family Health Study (GFHS) is an ongoing randomized controlled trial and a family-based health promotion study. Food records and anthropometric data were collected at baseline (n = 109, 55 males; 3.7 ± 1.1 y, mean ± SD) and 18 months (n = 109, 55 males; 5.1 ± 1.1 y) of the GFHS pilots. Associations between sugar intakes and anthropometrics were estimated using linear regression models with generalized estimating equations adjusted for age, sex, household income, and intervention status.Results: Total sugar intake was inversely associated with body weight at 18 months (P = 0.01). There was no effect of time on any other associations between total, free, and added sugar intakes and anthropometrics.Conclusions: Early life dietary sugar intakes may not relate to anthropometric measures in the short term. Further investigation into potential associations between dietary sugar intakes and anthropometric variables over longer time periods is warranted.
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Affiliation(s)
- Anisha Mahajan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
| | - Alison M Duncan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
| | - Gerarda Darlington
- Department of Mathematics and Statistics, University of Guelph, Guelph ON
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph ON
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
| | - Andrea C Buchholz
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph ON
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Cho M, Park H, Lee SH, Kim MJ, Jang M. Phyllodulcin from the hexane fraction of Hydrangea macrophylla inhibits glucose-induced lipid accumulation and reactive oxygen species generation in Caenorhabditis elegans. Biosci Biotechnol Biochem 2024; 88:789-797. [PMID: 38599627 DOI: 10.1093/bbb/zbae043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/25/2024] [Indexed: 04/12/2024]
Abstract
We confirmed that the hexane layer of Hydrangea macrophylla leaf extract (HLH) is rich in phyllodulcin (PD), an alternative sweetener, through high performance liquid chromatography (HPLC) analysis. To investigate in vivo activity of HLH and its PD, acute toxicity and growth rate of Caenorhabditis elegans were tested and there are no clinical abnormalities at 125-500 µg/mL of HLH. HLH decreased the total lipid and triglyceride contents dose-dependently in glucose-induced obese worms. Also, HLH increased survival rates under oxidative and thermal stress and decreased body reactive oxygen species (ROS) contents significantly. Such antioxidant properties of HLH were attributed to the enhanced activity of the antioxidant enzyme catalase. To determine whether the effect of HLH was due to PD, worms were treated with PD (concentration contained in HLH), and inhibitory effects on total lipids and ROS were observed. Our results suggest that HLH and its PD as a natural alternative sweetener can be used as materials to improve metabolic diseases.
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Affiliation(s)
- Myogyeong Cho
- Department of Smart Food & Drug, Inje University, Gimhae, Korea
| | - Harin Park
- Department of Digital Anti-aging Healthcare, Inje University, Gimhae, Korea
| | - Sang Hyun Lee
- Department of Smart Food & Drug, Inje University, Gimhae, Korea
- Department of Food Technology and Nutrition, Inje University, Gimhae, Korea
| | - Myo-Jeong Kim
- Department of Smart Food & Drug, Inje University, Gimhae, Korea
- Department of Digital Anti-aging Healthcare, Inje University, Gimhae, Korea
| | - Miran Jang
- Department of Smart Food & Drug, Inje University, Gimhae, Korea
- Department of Digital Anti-aging Healthcare, Inje University, Gimhae, Korea
- Department of Food Technology and Nutrition, Inje University, Gimhae, Korea
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3
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Gutiérrez-Esparza G, Martinez-Garcia M, Ramírez-delReal T, Groves-Miralrio LE, Marquez MF, Pulido T, Amezcua-Guerra LM, Hernández-Lemus E. Sleep Quality, Nutrient Intake, and Social Development Index Predict Metabolic Syndrome in the Tlalpan 2020 Cohort: A Machine Learning and Synthetic Data Study. Nutrients 2024; 16:612. [PMID: 38474741 DOI: 10.3390/nu16050612] [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] [Received: 01/10/2024] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
This study investigated the relationship between Metabolic Syndrome (MetS), sleep disorders, the consumption of some nutrients, and social development factors, focusing on gender differences in an unbalanced dataset from a Mexico City cohort. We used data balancing techniques like SMOTE and ADASYN after employing machine learning models like random forest and RPART to predict MetS. Random forest excelled, achieving significant, balanced accuracy, indicating its robustness in predicting MetS and achieving a balanced accuracy of approximately 87%. Key predictors for men included body mass index and family history of gout, while waist circumference and glucose levels were most significant for women. In relation to diet, sleep quality, and social development, metabolic syndrome in men was associated with high lactose and carbohydrate intake, educational lag, living with a partner without marrying, and lack of durable goods, whereas in women, best predictors in these dimensions include protein, fructose, and cholesterol intake, copper metabolites, snoring, sobbing, drowsiness, sanitary adequacy, and anxiety. These findings underscore the need for personalized approaches in managing MetS and point to a promising direction for future research into the interplay between social factors, sleep disorders, and metabolic health, which mainly depend on nutrient consumption by region.
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Affiliation(s)
- Guadalupe Gutiérrez-Esparza
- Researcher for Mexico CONAHCYT, National Council of Humanities, Sciences and Technologies, Mexico City 08400, Mexico
- Clinical Research, National Institute of Cardiology 'Ignacio Chávez', Mexico City 14080, Mexico
| | - Mireya Martinez-Garcia
- Department of Immunology, National Institute of Cardiology 'Ignacio Chávez', Mexico City 14080, Mexico
| | - Tania Ramírez-delReal
- Center for Research in Geospatial Information Sciences, Aguascalientes 20313, Mexico
| | | | - Manlio F Marquez
- Department of Electrocardiology, National Institute of Cardiology 'Ignacio Chavez', Mexico City 14080, Mexico
| | - Tomás Pulido
- Cardiopulmonary Department, National Institute of Cardiology 'Ignacio Chávez', Mexico City 14080, Mexico
| | - Luis M Amezcua-Guerra
- Department of Immunology, National Institute of Cardiology 'Ignacio Chávez', Mexico City 14080, Mexico
| | - Enrique Hernández-Lemus
- Computational Genomics Division, National Institute of Genomic Medicine, Mexico City 14610, Mexico
- Center for Complexity Sciences, Universidad Nacional Autónoma de Mexico, Mexico City 04510, Mexico
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Mahajan A, Yu J, Hogan JL, Jewell K, Carriero A, Annis A, Sadowski A, Darlington G, Buchholz AC, Duncan AM, Haines J, Ma DWL. Dietary sugar intake among preschool-aged children: a cross-sectional study. CMAJ Open 2021; 9:E855-E863. [PMID: 34521651 PMCID: PMC8445636 DOI: 10.9778/cmajo.20200178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Excessive intake of sugar in young children is a public health concern. Our study objectives were to examine intakes of total, free and added sugar among preschool-aged children and to investigate their associations with body weight, body mass index Z-scores, percent fat mass and waist circumference. METHODS The cross-sectional cohort study included preschool-aged children between 1.5 and 5 years of age, enrolled in pilot studies of the Guelph Family Health Study, Guelph, Ontario, from 2014 to 2016. Daily intake of total sugar was determined using a food processor software; daily intakes of free and added sugar, and food sources were determined through manual inspection of 3-day food records. Anthropometric measures were completed by trained research staff. We used linear regression models with generalized estimating equations to estimate associations between sugar intakes and anthropometric measures. RESULTS We included 109 children (55 girls and 54 boys) in 77 families. Mean daily intakes were 86 (standard deviation [SD] 26) g for total sugar, 31 (SD 15) g for free sugar and 26 (SD 13) g for added sugar. Of participants, 80% (n = 87) had intakes of free sugar greater than 5% of their daily energy intake. The most frequent food sources of free and added sugar were bakery products. A weak inverse association between free sugar intake (kcal/1000 kcal) and waist circumference (cm) (β = -0.02, 95% confidence interval -0.04 to -0.0009) was found, but no significant associations were noted between sugar intake and other anthropometric measures. INTERPRETATION Most of the preschool-aged children in this study had free sugar intakes greater than current recommendations; overall, their total, free and added sugar intakes were not associated with the anthropometric measures. This study can be used to inform policy development for sugar intake in young children and apprise early intervention programs.
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Affiliation(s)
- Anisha Mahajan
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Jessica Yu
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Jaimie L Hogan
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Kira Jewell
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Alex Carriero
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Angela Annis
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Adam Sadowski
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Gerarda Darlington
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Andrea C Buchholz
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Alison M Duncan
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Jess Haines
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - David W L Ma
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont.
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Chang CP, Meyers TJ, Fu A, Zhang MY, Tashkin DP, Rao JY, Cozen W, Mack TM, Hashibe M, Morgenstern H, Zhang ZF. Dietary glycemic index, glycemic load, and lung cancer risk: A case-control study in Los Angeles County. Cancer Epidemiol 2020; 69:101824. [PMID: 33039726 PMCID: PMC7734880 DOI: 10.1016/j.canep.2020.101824] [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] [Received: 05/11/2020] [Revised: 09/03/2020] [Accepted: 09/14/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although there is some evidence of positive associations between both the glycemic index (GI) and glycemic load (GL) with cancer risk, the relationships with lung cancer risk remain largely unexplored. We evaluated the associations between GI and GL with lung cancer. METHODS The analyses were performed using data from a population-based case-control study recruited between 1999 and 2004 in Los Angeles County. Dietary factors were collected from 593 incident lung cancer cases and 1026 controls using a modified food frequency questionnaire. GI and GL were estimated using a food composition table. Adjusted odds ratios (ORs) and 95 % confidence intervals (CI) were estimated using unconditional logistic regression adjusting for potential confounders. RESULTS Dietary GI was positively associated with lung cancer (OR for upper vs. lower tertile = 1.62; 95 % CI: 1.17, 2.25). For histologic subtypes, positive associations were observed between GI and adenocarcinoma (OR for upper vs. lower tertile = 1.82; 95 % CI: 1.22, 2.70) and small cell carcinoma (OR for upper vs. lower tertile = 2.68; 95 % CI: 1.25, 5.74). No clear association between GL and lung cancer was observed. CONCLUSION These findings suggest that high dietary GI was associated with increased lung cancer risk, and the positive associations were observed for both lung adenocarcinoma and small cell lung carcinoma. Replication in an independent dataset is merited for a broader interpretation of our results.
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Affiliation(s)
- Chun-Pin Chang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States; Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Travis J Meyers
- Department of Epidemiology and Biostatistics, University of California, San Francisco (UCSF), San Francisco, CA, United States
| | - Alan Fu
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States
| | - Ming-Yan Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States
| | - Donald P Tashkin
- Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Jian-Yu Rao
- Department of Pathology, Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States
| | - Wendy Cozen
- Departments of Preventive Medicine and Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States
| | - Thomas M Mack
- Departments of Preventive Medicine and Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Department of Urology, Medical School, University of Michigan, Ann Arbor, MI, United States
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, United States.
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Zupanič N, Hristov H, Gregorič M, Blaznik U, Delfar N, Koroušić Seljak B, Ding EL, Fidler Mis N, Pravst I. Total and Free Sugars Consumption in a Slovenian Population Representative Sample. Nutrients 2020; 12:nu12061729. [PMID: 32526954 PMCID: PMC7352580 DOI: 10.3390/nu12061729] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 01/09/2023] Open
Abstract
Excessive free sugars consumption is associated with poor health outcomes. Thus, the World Health Organization (WHO) recommends limiting free sugars intake to no more than 10% of total energy intake. To evaluate current intakes of dietary sugars and monitor the adherence to the guidelines, the objective of this study was to comprehensively assess total and free sugars consumption of different age groups within the Slovenian population. The Slovenian national food consumption survey SI.Menu 2017/18 was conducted on representative samples of adolescents (10–17 years), adults (18–64 years), and the elderly (65–74 years) using two non-consecutive 24-h dietary recalls. The analyses were carried out on a sample of 1248 study participants. Free sugars content in food was estimated based on previously established databases. The population weighted median free sugars intake accounted for 10.1% of total energy intake (TEI) among adolescents, 6.4% among adults, and 6.5% in the elderly population. Both total and free sugars consumption in the percentage of TEI were higher among women than men, in participants with lower education, and those with higher family net income. The main sources of free sugars in adolescents were beverages, cakes, muffins, pastry, and dairy products; for adults and the elderly, the key sources of free sugars were beverages, cakes, muffins, pastry, and sugars, honey, and related products. A total of 56% of adolescents, 84% of adults, and 81% of the elderly population adhered to the WHO free sugars guidelines. Additional measures will be required to further decrease free sugars consumption among the teenage population, in which dietary patterns are still of greatest concern.
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Affiliation(s)
- Nina Zupanič
- Nutrition Institute, Tržaška cesta 40, SI-1000 Ljubljana, Slovenia; (N.Z.); (H.H.)
- Department of Food Science and Technology, Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, 1000 Ljubljana, Slovenia
| | - Hristo Hristov
- Nutrition Institute, Tržaška cesta 40, SI-1000 Ljubljana, Slovenia; (N.Z.); (H.H.)
| | - Matej Gregorič
- National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana, Slovenia; (M.G.); (U.B.); (N.D.)
| | - Urška Blaznik
- National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana, Slovenia; (M.G.); (U.B.); (N.D.)
| | - Nataša Delfar
- National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana, Slovenia; (M.G.); (U.B.); (N.D.)
| | | | - Eric L. Ding
- Department of Nutrition, Harvard Chan School of Public Health, Boston, MA 02115, USA;
| | - Nataša Fidler Mis
- Department of Gastroenterology, Hepatology and Nutrition, University Children’s Hospital, University Medical Centre Ljubljana, Bohoričeva ulica 22a, SI-1000 Ljubljana, Slovenia;
| | - Igor Pravst
- Nutrition Institute, Tržaška cesta 40, SI-1000 Ljubljana, Slovenia; (N.Z.); (H.H.)
- Department of Food Science and Technology, Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, 1000 Ljubljana, Slovenia
- VIST—Higher School of Applied Sciences, Gerbičeva cesta 51A, SI-1000 Ljubljana, Slovenia
- Correspondence: ; Tel.: +386-590-68871; Fax: +386-310-07981
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Alexander Bentley R, Ruck DJ, Fouts HN. U.S. obesity as delayed effect of excess sugar. ECONOMICS AND HUMAN BIOLOGY 2020; 36:100818. [PMID: 31540873 DOI: 10.1016/j.ehb.2019.100818] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 08/13/2019] [Accepted: 09/02/2019] [Indexed: 06/10/2023]
Abstract
In the last century, U.S. diets were transformed, including the addition of sugars to industrially-processed foods. While excess sugar has often been implicated in the dramatic increase in U.S. adult obesity over the past 30 years, an unexplained question is why the increase in obesity took place many years after the increases in U.S. sugar consumption. To address this, here we explain adult obesity increase as the cumulative effect of increased sugar calories consumed over time. In our model, which uses annual data on U.S. sugar consumption as the input variable, each age cohort inherits the obesity rate in the previous year plus a simple function of the mean excess sugar consumed in the current year. This simple model replicates three aspects of the data: (a) the delayed timing and magnitude of the increase in average U.S. adult obesity (from about 15% in 1970 to almost 40% by 2015); (b) the increase of obesity rates by age group (reaching 47% obesity by age 50) for the year 2015 in a well-documented U.S. state; and (c) the pre-adult increase of obesity rates by several percent from 1988 to the mid-2000s, and subsequent modest decline in obesity rates among younger children since the mid-2000s. Under this model, the sharp rise in adult obesity after 1990 reflects the delayed effects of added sugar calories consumed among children of the 1970s and 1980s.
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Affiliation(s)
- R Alexander Bentley
- Anthropology Department, University of Tennessee, 1621 Cumberland Avenue, Knoxville, TN 37996, USA.
| | - Damian J Ruck
- Anthropology Department, University of Tennessee, 1621 Cumberland Avenue, Knoxville, TN 37996, USA
| | - Hillary N Fouts
- Department of Child and Family Studies, University of Tennessee, 1215 W. Cumberland Ave, Knoxville, TN 37996, USA
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Food sources of free sugars in children's diet and identification of lifestyle patterns associated with free sugars intake: the GRECO (Greek Childhood Obesity) study. Public Health Nutr 2018; 19:2326-35. [PMID: 27515790 DOI: 10.1017/s1368980015003146] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Excessive free sugars consumption has a possible role in health issues, diet quality and obesity development. The present cross-sectional study aimed to identify the major food sources of free sugars in Greek children's diet and investigate possible associations of dietary patterns with free sugars intake. DESIGN Anthropometric measurements and information on dietary and physical activity habits were obtained. Energy and free sugars intake coming from foods were estimated and principal components analysis was applied to identify dietary patterns. SETTING The GRECO (Greek Childhood Obesity) study. SUBJECTS Nationwide sample of 3089 children (aged 10-12 years). RESULTS Adopting WHO criteria, 44·2 % of participants were categorized as having free sugars intake above 10 % of total energy intake. Mean contribution of free sugars to energy intake was 11·2 %, and the major food sources of free sugars differed from those of other childhood populations. Free sugars intake was not associated with overweight/obesity. Multiple linear regression analysis revealed that two lifestyle and dietary patterns, characterized by higher consumption of sweets, fast foods, fries, sugared drinks, frequently ordering/eating outside home and having meals in front of a screen (pattern 1) and higher consumption of whole fruits, 100 % fruit juices, vegetables, legumes and honey/jam (pattern 2), were positively associated with free sugars intake. CONCLUSIONS A large proportion of children exceeded the recommended cut-off and free sugars intake was associated with lifestyle patterns rather than single foods. Public health programmes aiming to reduce free sugars consumption should be tailored on promoting the correct dietary habits of specific childhood populations.
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9
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Bentley RA, Ross CN, O'Brien MJ. Obesity, Metabolism, and Aging: A Multiscalar Approach. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2018; 155:25-42. [PMID: 29653680 DOI: 10.1016/bs.pmbts.2017.11.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Obesity contributes to the aging process through the alteration of metabolic pathways evidenced biochemically in the relationship between caloric restriction and longevity. Humans have entered into an era of metabolism and aging entirely unprecedented in their evolution, with a diet that, for many, contains a majority of calories as sugar and yields an expected lifespan of over 80years in industrialized nations. Deeply embedded in the complex issue of obesity are questions of behavior, causality versus correlation, and appropriate models. For example, are primates a better reference than mice for studying metabolic connections between obesity and aging? We consider those issues from the standpoint of life-history theory, especially implications of the interplay of refined sugar and socioeconomic disparities for the future of human health.
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Affiliation(s)
| | - Corinna N Ross
- Texas A&M University-San Antonio, San Antonio, TX, United States
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10
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Block JM, Arisseto-Bragotto AP, Feltes MMC. Current policies in Brazil for ensuring nutritional quality. FOOD QUALITY AND SAFETY 2017. [DOI: 10.1093/fqsafe/fyx026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Vos MB, Kaar JL, Welsh JA, Van Horn LV, Feig DI, Anderson CAM, Patel MJ, Cruz Munos J, Krebs NF, Xanthakos SA, Johnson RK. Added Sugars and Cardiovascular Disease Risk in Children: A Scientific Statement From the American Heart Association. Circulation 2017; 135:e1017-e1034. [PMID: 27550974 PMCID: PMC5365373 DOI: 10.1161/cir.0000000000000439] [Citation(s) in RCA: 349] [Impact Index Per Article: 49.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Poor lifestyle behaviors are leading causes of preventable diseases globally. Added sugars contribute to a diet that is energy dense but nutrient poor and increase risk of developing obesity, cardiovascular disease, hypertension, obesity-related cancers, and dental caries. METHODS AND RESULTS For this American Heart Association scientific statement, the writing group reviewed and graded the current scientific evidence for studies examining the cardiovascular health effects of added sugars on children. The available literature was subdivided into 5 broad subareas: effects on blood pressure, lipids, insulin resistance and diabetes mellitus, nonalcoholic fatty liver disease, and obesity. CONCLUSIONS Associations between added sugars and increased cardiovascular disease risk factors among US children are present at levels far below current consumption levels. Strong evidence supports the association of added sugars with increased cardiovascular disease risk in children through increased energy intake, increased adiposity, and dyslipidemia. The committee found that it is reasonable to recommend that children consume ≤25 g (100 cal or ≈6 teaspoons) of added sugars per day and to avoid added sugars for children <2 years of age. Although added sugars most likely can be safely consumed in low amounts as part of a healthy diet, few children achieve such levels, making this an important public health target.
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Abstract
ABSTRACT Objective: To identify attributes that promote healthy eating in order to support a study for the Quality Index for School Meal Menus content validity. Methods: This study used the Delphi technique to consult school nutrition experts in Brazil. These experts were selected among the authors of articles published between 2010 and 2015 that were identified by searching the Web of Science database, using the keywords 'school feeding', 'school nutrition program', and 'school food program', as well as the authors of official documents on this topic. The Likert method was used to record respondent perceptions in two analytical dimensions: foods that are part of a healthy menu for school feeding, and composition of an indicator of nutritional quality for school feeding menus. Results: Most respondents (n=27) were affiliated with public institutions (92.59%) and had over six years of experience in the area (70.36%). Assertions resulted in consensus according to the analysis criteria. A consensus was established for fresh food, fruits and vegetables, dairy products, beans, meat and eggs, and a schedule compatible with the meal as promoters of healthy eating, and processed foods, sweets, and fat excess as risk attributes. Conclusion: Since a consensus was not reached in the first round, there is a need to broaden the debate on issues related to foods rich in sugar, replacement of meals by sweets, and foods rich in fat.
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13
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Pointer SD, Rickstrew J, Slaughter C, Vaezi MF, Silver HJ. Dietary carbohydrate intake, insulin resistance and gastro-oesophageal reflux disease: a pilot study in European- and African-American obese women. Aliment Pharmacol Ther 2016; 44:976-988. [PMID: 27582035 PMCID: PMC5048546 DOI: 10.1111/apt.13784] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 04/11/2016] [Accepted: 08/05/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although obesity rates are higher in African-American than European-American women, gastro-oesophageal reflux disease (GERD) and its comorbidities are more prevalent in European-American women. A common denominator for increased adiposity, and consequent insulin resistance, is excess dietary macronutrient intake - which may promote greater prevalence and severity of GERD in women. AIM To investigate whether GERD is more robustly associated with dietary carbohydrate intake, particularly dietary simple carbohydrate intake, and insulin resistance in European-American women. METHODS About 144 obese women were assessed at baseline and 16 weeks after consuming a high-fat/low-carbohydrate diet. GERD diagnosis and medication usage was confirmed in medical records with symptoms and medications assessed weekly. RESULTS About 33.3% (N = 33) of European-American and 20.0% (N = 9) of African-American women had GERD at baseline. Total carbohydrate (r = 0.34, P < 0.001), sugars (r = 0.30, P = 0.005), glycaemic load (r = 0.34, P = 0.001) and HOMAIR (r = 0.30, P = 0.004) were associated with GERD, but only in European-American women. In response to high-fat/low-carbohydrate diet, reduced intake of sugars was associated with reduced insulin resistance. By the end of diet week 10, all GERD symptoms and medication usage had resolved in all women. CONCLUSIONS GERD symptoms and medication usage was more prevalent in European-American women, for whom the relationships between dietary carbohydrate intake, insulin resistance and GERD were most significant. Nevertheless, high-fat/low-carbohydrate diet benefited all women with regard to reducing GERD symptoms and frequency of medication use.
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Affiliation(s)
- Stephanie D. Pointer
- Vanderbilt University Medical Center, Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Nashville, TN, USA
| | - Jace Rickstrew
- University of Kansas, School of Medicine, Kansas City, MO, USA
| | - Chris Slaughter
- Vanderbilt University Medical Center, Department of Biostatistics, Nashville, TN, USA
| | - Michael F. Vaezi
- Vanderbilt University Medical Center, Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Nashville, TN, USA
| | - Heidi J. Silver
- Vanderbilt University Medical Center, Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Nashville, TN, USA
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14
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Clemens RA, Jones JM, Kern M, Lee SY, Mayhew EJ, Slavin JL, Zivanovic S. Functionality of Sugars in Foods and Health. Compr Rev Food Sci Food Saf 2016; 15:433-470. [DOI: 10.1111/1541-4337.12194] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 12/21/2015] [Accepted: 12/31/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Roger A. Clemens
- USC School of Pharmacy; Intl. Center for Regulatory Science; 1540 Alcazar St., CHP 140 Los Angeles CA 90089 U.S.A
| | - Julie M. Jones
- St. Catherine Univ; 4030 Valentine Court; Arden Hills Minnesota 55112 U.S.A
| | - Mark Kern
- San Diego State Univ; School of Exercise and Nutritional Sciences; 5500 Campanile Dr. San Diego CA 92182-7251 U.S.A
| | - Soo-Yeun Lee
- Univ. of Illinois at Urbana Champaign; 351 Bevier Hall MC-182, 905 S Goodwin Ave. Urbana IL 61801 U.S.A
| | - Emily J. Mayhew
- Univ. of Illinois at Urbana Champaign; 399A Bevier Hall; 905 S Goodwin Ave. Urbana IL 61801 U.S.A
| | - Joanne L. Slavin
- Univ. of Minnesota; 166 Food Science & Nutrition; 1354 Eckles Ave. Saint Paul MN 55108-1038 U.S.A
| | - Svetlana Zivanovic
- Mars Petcare; Global Applied Science and Technology; 315 Cool Springs Boulevard Franklin TN 37067 U.S.A
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15
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Murray EK, Auld G, Inglis-Widrick R, Baker S. Nutrition Content in a National Nutrition Education Program for Low-Income Adults: Content Analysis and Comparison With the 2010 Dietary Guidelines for Americans. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2015; 47:566-573.e1. [PMID: 26566098 DOI: 10.1016/j.jneb.2015.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 08/28/2015] [Accepted: 09/02/2015] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to identify nutrition-related content employed nationally by the Expanded Food and Nutrition Education Program (EFNEP) with adult participants. A content analysis was used to assess the type, frequency, and depth of nutrition content in adult curricula most used by EFNEP nationally compared with the 2010 Dietary Guidelines for Americans (2010 DGA). All EFNEP curricula reviewed employed the vast majority of the 2010 DGA nutrition recommendations, with differences in the frequency and depth of nutrition content. Further research is needed to determine which 2010 DGA recommendations are most important to teach and evaluate within a low-income population.
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Affiliation(s)
- Erin K Murray
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Ruth Inglis-Widrick
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Susan Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
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16
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Crino M, Sacks G, Vandevijvere S, Swinburn B, Neal B. The Influence on Population Weight Gain and Obesity of the Macronutrient Composition and Energy Density of the Food Supply. Curr Obes Rep 2015; 4:1-10. [PMID: 26627085 DOI: 10.1007/s13679-014-0134-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Rates of overweight and obesity have increased dramatically in all regions of the world over the last few decades. Almost all of the world's population now has ubiquitous access to low-cost, but highly-processed, energy-dense, nutrient-poor food products. These changes in the food supply, rather than decreases in physical activity, are most likely the primary driver of population weight gain and obesity. To-date, the majority of prevention efforts focus on personalised approaches targeting individuals. Population-wide food supply interventions addressing sodium and trans fat reduction have proven highly effective and comparable efforts are now required to target obesity. The evidence suggests that strategies focusing upon reducing the energy density and portion size of foods will be more effective than those targeting specific macronutrients. Government leadership, clearly specified targets, accountability and transparency will be the key to achieving the food supply changes required to address the global obesity epidemic.
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Affiliation(s)
- Michelle Crino
- The George Institute for Global Health, University of Sydney, Level 10, King George V Building, 83-117 Missenden Rd, Camperdown, NSW, 2050, Sydney, Australia.
| | - Gary Sacks
- WHO Collaborating Centre for Obesity Prevention, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Stefanie Vandevijvere
- School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand.
| | - Boyd Swinburn
- WHO Collaborating Centre for Obesity Prevention, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
- School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland, 1142, New Zealand.
| | - Bruce Neal
- The George Institute for Global Health, University of Sydney, Level 10, King George V Building, 83-117 Missenden Rd, Camperdown, NSW, 2050, Sydney, Australia.
- The Royal Prince Alfred Hospital, Sydney, Australia.
- Imperial College, London, UK.
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17
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A systematic methodology to estimate added sugar content of foods. Eur J Clin Nutr 2014; 69:154-61. [PMID: 25514896 DOI: 10.1038/ejcn.2014.256] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 10/09/2014] [Accepted: 10/15/2014] [Indexed: 01/14/2023]
Abstract
BACKGROUND/OBJECTIVES The effect of added sugar on health is a topical area of research. However, there is currently no analytical or other method to easily distinguish between added sugars and naturally occurring sugars in foods. This study aimed to develop a systematic methodology to estimate added sugar values on the basis of analytical data and ingredients of foods. SUBJECTS/METHODS A 10-step, stepwise protocol was developed, starting with objective measures (six steps) and followed by more subjective estimation (four steps) if insufficient objective data are available. The method developed was applied to an Australian food composition database (AUSNUT2007) as an example. RESULTS Out of the 3874 foods available in AUSNUT2007, 2977 foods (77%) were assigned an estimated value on the basis of objective measures (steps 1-6), and 897 (23%) were assigned a subjectively estimated value (steps 7-10). Repeatability analysis showed good repeatability for estimated values in this method. CONCLUSIONS We propose that this method can be considered as a standardised approach for the estimation of added sugar content of foods to improve cross-study comparison.
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18
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O'Charoen S, Hayakawa S, Matsumoto Y, Ogawa M. Effect ofd-Psicose Used as Sucrose Replacer on the Characteristics of Meringue. J Food Sci 2014; 79:E2463-9. [DOI: 10.1111/1750-3841.12699] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 09/30/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Siwaporn O'Charoen
- Dept. of Applied Biological Science; Faculty of Agriculture; Kagawa Univ; 2393 Ikenobe Miki Kagawa 761-0795 Japan
| | - Shigeru Hayakawa
- Dept. of Applied Biological Science; Faculty of Agriculture; Kagawa Univ; 2393 Ikenobe Miki Kagawa 761-0795 Japan
| | - Yoshiki Matsumoto
- Dept. of Applied Biological Science; Faculty of Agriculture; Kagawa Univ; 2393 Ikenobe Miki Kagawa 761-0795 Japan
| | - Masahiro Ogawa
- Dept. of Applied Biological Science; Faculty of Agriculture; Kagawa Univ; 2393 Ikenobe Miki Kagawa 761-0795 Japan
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19
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O'Charoen S, Hayakawa S, Ogawa M. Food properties of egg white protein modified by rare ketohexoses through Maillard reaction. Int J Food Sci Technol 2014. [DOI: 10.1111/ijfs.12607] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Siwaporn O'Charoen
- Department of Applied Biological Science; Faculty of Agriculture; Kagawa University; 2393 Ikenobe Miki Kagawa 761-0795 Japan
| | - Shigeru Hayakawa
- Department of Applied Biological Science; Faculty of Agriculture; Kagawa University; 2393 Ikenobe Miki Kagawa 761-0795 Japan
| | - Masahiro Ogawa
- Department of Applied Biological Science; Faculty of Agriculture; Kagawa University; 2393 Ikenobe Miki Kagawa 761-0795 Japan
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20
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Nash SH, Kristal AR, Hopkins SE, Boyer BB, O’Brien DM. Stable isotope models of sugar intake using hair, red blood cells, and plasma, but not fasting plasma glucose, predict sugar intake in a Yup'ik study population. J Nutr 2014; 144:75-80. [PMID: 24198311 PMCID: PMC3861795 DOI: 10.3945/jn.113.182113] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 08/21/2013] [Accepted: 10/16/2013] [Indexed: 11/14/2022] Open
Abstract
Objectively measured biomarkers will help to resolve the controversial role of sugar intake in the etiology of obesity and related chronic diseases. We recently validated a dual-isotope model based on RBC carbon (δ(13)C) and nitrogen (δ(15)N) isotope ratios that explained a large percentage of the variation in self-reported sugar intake in a Yup'ik study population. Stable isotope ratios can easily be measured from many tissues, including RBCs, plasma, and hair; however, it is not known how isotopic models of sugar intake compare among these tissues. Here, we compared self-reported sugar intake with models based on RBCs, plasma, and hair δ(13)C and δ(15)N in Yup'ik people. We also evaluated associations of sugar intake with fasting plasma glucose δ(13)C. Finally, we evaluated relations between δ(13)C and δ(15)N values in hair, plasma, RBCs, and fasting plasma glucose to allow comparison of isotope ratios across tissue types. Models using RBCs, plasma, or hair isotope ratios explained similar amounts of variance in total sugar, added sugar, and sugar-sweetened beverage intake (∼53%, 48%, and 34%, respectively); however, the association with δ(13)C was strongest for models based on RBCs and hair. There were no associations with fasting plasma glucose δ(13)C (R(2) = 0.03). The δ(13)C and δ(15)N values of RBCs, plasma, and hair showed strong, positive correlations; the slopes of these relations did not differ from 1. This study demonstrates that RBC, plasma, and hair isotope ratios predict sugar intake and provides data that will allow comparison of studies using different sample types.
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Affiliation(s)
- Sarah H. Nash
- Center for Alaska Native Health Research, Institute of Arctic Biology, and
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK; and
| | | | | | - Bert B. Boyer
- Center for Alaska Native Health Research, Institute of Arctic Biology, and
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK; and
| | - Diane M. O’Brien
- Center for Alaska Native Health Research, Institute of Arctic Biology, and
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK; and
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21
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Isotopic estimates of sugar intake are related to chronic disease risk factors but not obesity in an Alaska native (Yup'ik) study population. Eur J Clin Nutr 2013; 68:91-6. [PMID: 24219893 PMCID: PMC3947290 DOI: 10.1038/ejcn.2013.230] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 09/26/2013] [Accepted: 09/27/2013] [Indexed: 11/09/2022]
Abstract
Background Sugar intake may be causally associated with chronic disease risk, either directly or by contributing to obesity. However, evidence from observational studies is mixed, in part due to the error and bias inherent in self-reported measures of sugar intake. Objective biomarkers may clarify the relationship between sugar intake and chronic disease risk. We have recently validated a biomarker of sugar intake in an Alaska Native (Yup’ik) study population that incorporates red blood cell carbon and nitrogen isotope ratios in a predictive model. Objective This study tested associations of isotopic estimates of sugar intake with BMI, waist circumference (WC), and a broad array of other physiological and biochemical measures of chronic disease risk in Yup’ik people. Subjects/Methods In a cross-sectional sample of 1076 Yup’ik people, multiple linear regression was used to examine associations of sugar intake with BMI, WC and other chronic disease risk factors. Results Isotopic estimates of sugar intake were not associated with BMI (P = 0.50) or WC (P = 0.85). They were positively associated with blood pressure, triglycerides, and leptin, and inversely associated with total-, HDL- and LDL-cholesterol and adiponectin. Conclusions Isotopic estimates of sugar intake were not associated with obesity, but were adversely associated with other chronic disease risk factors in this Yup’ik study population. This first use of stable isotope markers of sugar intake may influence recommendations for sugar intake by Yup’ik people; however, longitudinal studies are required to understand associations with chronic disease incidence.
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22
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Shankar P, Ahuja S, Sriram K. Non-nutritive sweeteners: review and update. Nutrition 2013; 29:1293-9. [PMID: 23845273 DOI: 10.1016/j.nut.2013.03.024] [Citation(s) in RCA: 145] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 03/02/2013] [Accepted: 03/31/2013] [Indexed: 11/27/2022]
Abstract
Obesity has become an epidemic, not just in the United States, but also across the globe. Obesity is a result of many factors including poor dietary habits, inadequate physical activity, hormonal issues, and sedentary lifestyle, as well as many psychological issues. Direct and indirect costs associated with obesity-related morbidity and mortality have been estimated to be in the billions of dollars. Of the many avenues for treatment, dietary interventions are the most common. Numerous diets have been popularized in the media, with most being fads having little to no scientific evidence to validate their effectiveness. Amidst this rise of weight loss diets, there has been a surge of individual products advertised as assuring quick weight loss; one such product group is non-nutritive sweeteners (NNS). Sugar, a common component of our diet, is also a major contributing factor to a number of health problems, including obesity and increased dental diseases both in adults and children. Most foods marketed towards children are sugar-laden. Obesity-related health issues, such as type 2 diabetes mellitus, cardiovascular diseases, and hypertension, once only commonly seen in older adults, are increasing in youth. Manufacturers of NNS are using this as an opportunity to promote their products, and are marketing them as safe for all ages. A systematic review of several databases and reliable websites on the internet was conducted to identify literature related to NNS. Keywords that were used individually or in combination included, but were not limited to, artificial sweeteners, non-nutritive sweeteners, non-caloric sweeteners, obesity, sugar substitutes, diabetes, and cardiometabolic indicators. The clinical and epidemiologic data available at present are insufficient to make definitive conclusions regarding the benefits of NNS in displacing caloric sweeteners as related to energy balance, maintenance or decrease in body weight, and other cardiometabolic risk factors. Although the FDA and most published (especially industry-funded) studies endorse the safety of these additives, there is a lack of conclusive evidence-based research to discourage or to encourage their use on a regular basis. While moderate use of NNS may be useful as a dietary aid for someone with diabetes or on a weight loss regimen, for optimal health it is recommended that only minimal amounts of both sugar and NNS be consumed.
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Affiliation(s)
- Padmini Shankar
- Department of Health and Kinesiology, Georgia Southern University, Statesboro, GA, USA.
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23
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Abstract
PURPOSE OF REVIEW The assumption that fructose may be toxic and involved in the pathogenesis of noncommunicable diseases such as obesity, diabetes mellitus, dyslipidemia, and even cancer has resulted in the call for public health action, such as introducing taxes on sweetened beverages. This review evaluates the scientific basis for such action. RECENT FINDINGS Although some studies hint towards some potential adverse effects of excessive fructose consumption especially when combined with excess energy intake, the results from clinical trials do not support a significant detrimental effect of fructose on metabolic health when consumed as part of a weight-maintaining diet in amounts consistent with the average-estimated fructose consumption in Western countries. However, definitive studies are missing. SUMMARY Public health policies to eliminate or limit fructose in the diet should be considered premature. Instead, efforts should be made to promote a healthy lifestyle that includes physical activity and nutritious foods while avoiding intake of excess calories until solid evidence to support action against fructose is available. Public health is almost certainly to benefit more from policies that are aimed at promoting what is known to be good than from policies that are prohibiting what is not (yet) known to be bad.
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Affiliation(s)
- Luc Tappy
- Department of Physiology, University of Lausanne, Lausanne, Switzerland.
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