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Sequeira-Bisson IR, Lu LW, Silvestre MP, Plank LD, Middleditch N, Acevedo-Fani A, Parry-Strong A, Hollingsworth KG, Tups A, Miles-Chan JL, Krebs JD, Foster M, Poppitt SD. Glycaemic Response to a Nut-Enriched Diet in Asian Chinese Adults with Normal or High Glycaemia: The Tū Ora RCT. Nutrients 2024; 16:2103. [PMID: 38999851 PMCID: PMC11243085 DOI: 10.3390/nu16132103] [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: 05/30/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
Nut-based products are a good source of high-quality plant protein in addition to mono- and polyunsaturated fatty acids, and may aid low-glycaemic dietary strategies important for the prevention of type 2 diabetes (T2D). In particular, they may be advantageous in populations susceptible to dysglycaemia, such as Asian Chinese. The present study aimed to compare effects of a higher-protein nut bar (HP-NB, also higher in total fibre and unsaturated fats, comprising mixed almonds and peanuts) vs. an isoenergetic higher-carbohydrate cereal bar (HC-CB) within the diet of 101 Chinese adults with overweight and normo- or hyperglycaemia. Ectopic pancreas and liver fat were characterised using magnetic resonance imaging and spectroscopy (MRI/S) as a secondary outcome. Participants were randomized to receive HP-NB or HC-CB daily as a 1 MJ light meal or snack replacement, in addition to healthy eating advice. Anthropometry and clinical indicators of T2D risk were assessed fasted and during an oral glucose tolerance test (OGTT), pre- and post-intervention. No significant difference was observed between diet groups for body weight, body mass index, waist or hip circumference, blood pressure, glucoregulatory markers, lipid profile or inflammatory markers over 12 weeks (all, p > 0.05). No difference was observed between glycaemic subgroups or those with normal versus high ectopic organ fat. Although HP-NB can attenuate postprandial glycaemia following a meal, no effects were observed for either fasting or glucose-mediated outcomes following longer-term inclusion in the habitual diet of Chinese adults with overweight, including at-risk subgroups.
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Affiliation(s)
- Ivana R. Sequeira-Bisson
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland 1024, New Zealand; (I.R.S.-B.); (L.W.L.); (M.P.S.); (J.L.M.-C.)
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- Riddet Institute, Massey University, Palmerston North 4442, New Zealand
| | - Louise W. Lu
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland 1024, New Zealand; (I.R.S.-B.); (L.W.L.); (M.P.S.); (J.L.M.-C.)
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
| | - Marta P. Silvestre
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland 1024, New Zealand; (I.R.S.-B.); (L.W.L.); (M.P.S.); (J.L.M.-C.)
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), NOVA University of Lisbon, 1169-056 Lisbon, Portugal
| | - Lindsay D. Plank
- Department of Surgery, University of Auckland, Auckland 1023, New Zealand;
| | - Nikki Middleditch
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- School of Food and Advanced Technology, Massey University, Palmerston North 4442, New Zealand
| | - Alejandra Acevedo-Fani
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- Riddet Institute, Massey University, Palmerston North 4442, New Zealand
| | - Amber Parry-Strong
- Department of Medicine, University of Otago, Dunedin 9054, New Zealand;
- Centre for Endocrine, Diabetes and Obesity Research (CEDOR), Te Whatu Ora, Capital and Coast Health, Wellington 6242, New Zealand
| | - Kieren G. Hollingsworth
- Translational and Clinical Research Institute, Faculty of Medical Science, Newcastle University, Newcastle-upon-Tyne NE1 7RU, UK
| | - Alexander Tups
- Centre for Neuroendocrinology, University of Otago, Dunedin 9054, New Zealand;
| | - Jennifer L. Miles-Chan
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland 1024, New Zealand; (I.R.S.-B.); (L.W.L.); (M.P.S.); (J.L.M.-C.)
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- Riddet Institute, Massey University, Palmerston North 4442, New Zealand
| | - Jeremy D. Krebs
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- Department of Medicine, University of Otago, Dunedin 9054, New Zealand;
- Centre for Endocrine, Diabetes and Obesity Research (CEDOR), Te Whatu Ora, Capital and Coast Health, Wellington 6242, New Zealand
| | - Meika Foster
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- Edible Research Ltd., Ohoka, Christchurch 7475, New Zealand
| | - Sally D. Poppitt
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland 1024, New Zealand; (I.R.S.-B.); (L.W.L.); (M.P.S.); (J.L.M.-C.)
- High Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (N.M.); (A.A.-F.); (J.D.K.); (M.F.)
- Riddet Institute, Massey University, Palmerston North 4442, New Zealand
- Department of Medicine, University of Auckland, Auckland 1023, New Zealand
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Faraj S, Sequeira-Bisson IR, Lu L, Miles-Chan JL, Hoggard M, Barnett D, Parry-Strong A, Foster M, Krebs JD, Poppitt SD, Taylor MW, Mathrani A. Effect of a Higher-Protein Nut versus Higher-Carbohydrate Cereal Enriched Diet on the Gut Microbiomes of Chinese Participants with Overweight and Normoglycaemia or Prediabetes in the Tū Ora Study. Nutrients 2024; 16:1971. [PMID: 38931324 PMCID: PMC11206330 DOI: 10.3390/nu16121971] [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: 05/30/2024] [Revised: 06/11/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
Global increases in metabolic disorders such as type 2 diabetes (T2D), especially within Asian populations, highlight the need for novel approaches to dietary intervention. The Tū Ora study previously evaluated the effects on metabolic health of including a nut product into the diet of a New Zealand cohort of Chinese participants with overweight and normoglycaemia or prediabetes through a 12-week randomised, parallel-group clinical trial. In this current study, we compared the impact of this higher-protein nut bar (HP-NB) versus a higher-carbohydrate cereal bar (HC-CB) on the faecal microbiome by employing both 16S rRNA gene amplicon and shotgun metagenomic sequencing of pre- and post-intervention pairs from 84 participants. Despite the higher fibre, protein, and unsaturated fat content of nuts, there was little difference between dietary groups in gut microbiome composition or functional potential, with the bacterial phylum Firmicutes dominating irrespective of diet. The lack of observed change suggests the dietary impact of the bars may have been insufficient to affect the gut microbiome. Manipulating the interplay between the diet, microbiome, and metabolic health may require a more substantial and/or prolonged dietary perturbation to generate an impactful modification of the gut ecosystem and its functional potential to aid in T2D risk reduction.
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Affiliation(s)
- Saif Faraj
- Human Nutrition Unit, University of Auckland, Auckland 1024, New Zealand; (S.F.); (I.R.S.-B.); (L.L.); (J.L.M.-C.); (S.D.P.)
- High-Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (A.P.-S.); (M.F.); (J.D.K.)
- School of Biological Sciences, University of Auckland, Auckland 1010, New Zealand;
| | - Ivana R. Sequeira-Bisson
- Human Nutrition Unit, University of Auckland, Auckland 1024, New Zealand; (S.F.); (I.R.S.-B.); (L.L.); (J.L.M.-C.); (S.D.P.)
- High-Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (A.P.-S.); (M.F.); (J.D.K.)
- School of Biological Sciences, University of Auckland, Auckland 1010, New Zealand;
| | - Louise Lu
- Human Nutrition Unit, University of Auckland, Auckland 1024, New Zealand; (S.F.); (I.R.S.-B.); (L.L.); (J.L.M.-C.); (S.D.P.)
- High-Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (A.P.-S.); (M.F.); (J.D.K.)
- School of Biological Sciences, University of Auckland, Auckland 1010, New Zealand;
| | - Jennifer L. Miles-Chan
- Human Nutrition Unit, University of Auckland, Auckland 1024, New Zealand; (S.F.); (I.R.S.-B.); (L.L.); (J.L.M.-C.); (S.D.P.)
- High-Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (A.P.-S.); (M.F.); (J.D.K.)
- School of Biological Sciences, University of Auckland, Auckland 1010, New Zealand;
| | - Michael Hoggard
- School of Biological Sciences, University of Auckland, Auckland 1010, New Zealand;
| | - Daniel Barnett
- Department of Statistics, University of Auckland, Auckland 1010, New Zealand;
| | - Amber Parry-Strong
- High-Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (A.P.-S.); (M.F.); (J.D.K.)
- Department of Medicine, University of Otago, Dunedin 9054, New Zealand
- Centre for Endocrine, Diabetes and Obesity Research (CEDOR), Te Whatu Ora, Capital and Coast Health, Wellington P.O. Box 7902, New Zealand
| | - Meika Foster
- High-Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (A.P.-S.); (M.F.); (J.D.K.)
- Edible Research, Ohoka, Christchurch 7475, New Zealand
| | - Jeremy D. Krebs
- High-Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (A.P.-S.); (M.F.); (J.D.K.)
- Department of Medicine, University of Otago, Dunedin 9054, New Zealand
- Centre for Endocrine, Diabetes and Obesity Research (CEDOR), Te Whatu Ora, Capital and Coast Health, Wellington P.O. Box 7902, New Zealand
| | - Sally D. Poppitt
- Human Nutrition Unit, University of Auckland, Auckland 1024, New Zealand; (S.F.); (I.R.S.-B.); (L.L.); (J.L.M.-C.); (S.D.P.)
- High-Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (A.P.-S.); (M.F.); (J.D.K.)
- School of Biological Sciences, University of Auckland, Auckland 1010, New Zealand;
| | - Michael W. Taylor
- High-Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (A.P.-S.); (M.F.); (J.D.K.)
- School of Biological Sciences, University of Auckland, Auckland 1010, New Zealand;
| | - Akarsh Mathrani
- High-Value Nutrition National Science Challenge, Auckland 1023, New Zealand; (A.P.-S.); (M.F.); (J.D.K.)
- School of Biological Sciences, University of Auckland, Auckland 1010, New Zealand;
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Rondanelli M, Barrile GC, Cavioni A, Donati P, Genovese E, Mansueto F, Mazzola G, Patelli Z, Pirola M, Razza C, Russano S, Sivieri C, Tartara A, Valentini EM, Perna S. A Narrative Review on Strategies for the Reversion of Prediabetes to Normoglycemia: Food Pyramid, Physical Activity, and Self-Monitoring Innovative Glucose Devices. Nutrients 2023; 15:4943. [PMID: 38068801 PMCID: PMC10707766 DOI: 10.3390/nu15234943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
In 2019, "Nutrition Therapy for Adults with Diabetes or Prediabetes: A Consensus Report" was published. This consensus report, however, did not provide an easy way to illustrate to subjects with prediabetes (SwPs) how to follow a correct dietary approach. The purpose of this review is to evaluate current evidence on optimum dietary treatment of SwPs and to provide a food pyramid for this population. The pyramid built shows that everyday consumption should consist of: whole-grain bread or potatoes eaten with their skins (for fiber and magnesium) and low glycemic index carbohydrates (GI < 55%) (three portions); fruit and vegetables (5 portions), in particular, green leafy vegetables (for fiber, magnesium, and polyphenols); EVO oil (almost 8 g); nuts (30 g, in particular, pistachios and almonds); three portions of dairy products (milk/yogurt: 300-400 g/day); mineral water (almost 1, 5 L/day for calcium intake); one glass of wine (125 mL); and three cups of coffee. Weekly portions should include fish (four portions), white meat (two portions), protein plant-based food (four portions), eggs (egg portions), and red/processed meats (once/week). At the top of the pyramid, there are two pennants: a green one means that SwPs need some personalized supplementation (if daily requirements cannot be satisfied through diet, vitamin D, omega-3, and vitamin B supplements), and a red one means there are some foods and factors that are banned (simple sugar, refined carbohydrates, and a sedentary lifestyle). Three to four times a week of aerobic and resistance exercises must be performed for 30-40 min. Finally, self-monitoring innovative salivary glucose devices could contribute to the reversion of prediabetes to normoglycemia.
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Affiliation(s)
- Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Gaetan Claude Barrile
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Alessandro Cavioni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Paolo Donati
- AICUBE srl, 20090 Trezzano sul Naviglio, Italy; (P.D.); (S.R.)
| | - Elisa Genovese
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Francesca Mansueto
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Giuseppe Mazzola
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Zaira Patelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Martina Pirola
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Claudia Razza
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Stefano Russano
- AICUBE srl, 20090 Trezzano sul Naviglio, Italy; (P.D.); (S.R.)
| | - Claudia Sivieri
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Alice Tartara
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Eugenio Marzio Valentini
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Simone Perna
- Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, University of Milan, 20133 Milan, Italy;
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Gayathri R, Abirami K, Kalpana N, Manasa VS, Sudha V, Shobana S, Jeevan RG, Kavitha V, Parkavi K, Anjana RM, Unnikrishnan R, Gokulakrishnan K, Beatrice DA, Krishnaswamy K, Pradeepa R, Mattes RD, Salas-Salvadó J, Willett W, Mohan V. Effect of almond consumption on insulin sensitivity and serum lipids among Asian Indian adults with overweight and obesity- A randomized controlled trial. Front Nutr 2023; 9:1055923. [PMID: 36704786 PMCID: PMC9873375 DOI: 10.3389/fnut.2022.1055923] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/07/2022] [Indexed: 01/12/2023] Open
Abstract
Background Asian Indians have an increased susceptibility to type 2 diabetes and premature coronary artery disease. Nuts, like almonds, are rich in unsaturated fat and micronutrients with known health benefits. Objectives This study aimed to assess the efficacy of almonds for reduction of insulin resistance and improving lipid profile in overweight Asian Indian adults. Methods This parallel-arm, randomized, controlled trial was conducted in Chennai, India on 400 participants aged 25-65 years with a body mass index ≥ 23 kg/m2. The intervention group received 43 g of almonds/day for 12 weeks, while the control group was advised to consume a customary diet but to avoid nuts. Anthropometric, clinical, and dietary data were assessed at periodic intervals. Glucose tolerance, serum insulin, glycated hemoglobin, C-peptide and lipid profile were assessed at baseline and end of the study. Insulin resistance (homeostasis assessment model-HOMA IR) and oral insulin disposition index (DIo) were calculated. Results A total of 352 participants completed the study. Significant improvement was seen in DIo [mean (95% CI) = + 0.7 mmol/L (0.1, 1.3); p = 0.03], HOMA IR (-0.4 (-0.7, -0.04; p = 0.03) and total cholesterol (-5.4 mg/dl (-10.2, -0.6); p = 0.03) in the intervention group compared to the control group. Incremental area under the curve (IAUC) and mean amplitude of glycemic excursion (MAGE) assessed using continuous glucose monitoring systems were also significantly lower in the intervention group. Dietary 24-h recalls showed a higher significant reduction in carbohydrate and increase in mono unsaturated fatty acid (MUFA) and polyunsaturated fatty acids (PUFA) intake in the intervention group compared to the control group. Conclusion Daily consumption of almonds increased the intake of MUFA with decrease in carbohydrate calories and decreases insulin resistance, improves insulin sensitivity and lowers serum cholesterol in Asian Indians with overweight/obesity. These effects in the long run could aid in reducing the risk of diabetes and other cardiometabolic disease.
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Affiliation(s)
- Rajagopal Gayathri
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India,Department of Biochemistry, University of Madras, Chennai, Tamil Nadu, India
| | - Kuzhandhaivelu Abirami
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Natarajan Kalpana
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Valangaiman Sriram Manasa
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Vasudevan Sudha
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Shanmugam Shobana
- Department of Diabetes Food Technology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Raman Ganesh Jeevan
- Department of Diabetes Food Technology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Vasudevan Kavitha
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Karthikeyan Parkavi
- Department of Diabetes Food Technology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Ranjit Mohan Anjana
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Ranjit Unnikrishnan
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Kuppan Gokulakrishnan
- Department of Neurochemistry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - D. Annette Beatrice
- Department of Home Science, Women’s Christian College, Chennai, Tamil Nadu, India
| | - Kamala Krishnaswamy
- Department of Foods Nutrition and Dietetics Research, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Rajendra Pradeepa
- Department of Research Operations, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India
| | - Richard D. Mattes
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, IN, United States
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Institut d’Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain,Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Walter Willett
- Department of Nutrition, Harvard School of Public Health, Boston, MA, United States,Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States
| | - Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India,*Correspondence: Viswanathan Mohan, , www.drmohansdiabetes.com
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Dhillon J, Jacobs AG, Ortiz S, Diaz Rios LK. A Systematic Review of Literature on the Representation of Racial and Ethnic Minority Groups in Clinical Nutrition Interventions. Adv Nutr 2022; 13:1505-1528. [PMID: 35108358 PMCID: PMC9526835 DOI: 10.1093/advances/nmac002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/29/2021] [Accepted: 01/10/2022] [Indexed: 02/04/2023] Open
Abstract
The racial and ethnic disparities in diet-related chronic diseases are major concerns. This systematic review examines the extent to which diet-induced changes in health outcomes, such as cardiometabolic, inflammation, cancer, bone health, and kidney function outcomes, etc., have been reported and discussed by race or ethnicity in randomized trials with 2 or more diet arms that recruited both minority and non-Hispanic White groups. Databases (i.e., PubMed, Cochrane Library, and Web of Science) were searched up to August 2021. Thirty-four studies that discussed effects of defined dietary interventions on health outcomes by racial or ethnic minority group compared with non-Hispanic Whites were included in the systematic review (PROSPERO registration number: CRD42021229256). Acute trials and those with 1 diet arm that accounted for race or ethnicity in their analyses and studies that focused on a single racial or ethnic group were discussed separately. Most studies were conducted in Black compared with White adults testing effects of energy restriction, macronutrient modification, sodium reduction, or variations of the Dietary Approaches to Stop Hypertension (DASH) diet on cardiometabolic outcomes. There was limited focus on other minority groups. Evidence suggests greater blood pressure reduction for Black adults compared with Whites particularly with DASH (or similar) diets. Overall, there was limited consideration for group-specific eating patterns and diet acceptability. Overall risk of bias was low. With emerging precision nutrition initiatives that aim to optimize metabolic responses in population subgroups through tailored approaches, it is imperative to ensure adequate representation of racial and ethnic subgroups for addressing health disparities. Factors that help explain variability in responses such as socioecological context should be included and adequately powered. Given the racial and ethnic disparities in chronic diseases, studying the adoption, maintenance, and effectiveness of dietary interventions on health outcomes among different groups is critical for developing approaches that can mitigate diet-related health disparities.
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Affiliation(s)
| | | | - Sigry Ortiz
- Department of Molecular & Cell Biology, School of Natural Sciences, University of California Merced, Merced, CA, USA
| | - L Karina Diaz Rios
- Division of Agriculture and Natural Resources, University of California Merced, Merced, CA, USA
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