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Greathouse KL, Stone JK, Vargas AJ, Choudhury A, Padgett RN, White JR, Jung A, Harris CC. Co-enrichment of cancer-associated bacterial taxa is correlated with immune cell infiltrates in esophageal tumor tissue. Sci Rep 2024; 14:2574. [PMID: 38296990 PMCID: PMC10831118 DOI: 10.1038/s41598-023-48862-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/30/2023] [Indexed: 02/02/2024] Open
Abstract
Esophageal carcinoma (ESCA) is a leading cause of cancer-related death worldwide, and certain oral and intestinal pathogens have been associated with cancer development and progression. We asked if esophageal microbiomes had shared alterations that could provide novel biomarkers for ESCA risk. We extracted DNA from tumor and non-tumor tissue of 212 patients in the NCI-MD case control study and sequenced the 16S rRNA gene (V3-4), with TCGA ESCA RNA-seq (n = 172) and WGS (n = 123) non-human reads used as validation. We identified four taxa, Campylobacter, Prevotella, Streptococcus, and Fusobacterium as highly enriched in esophageal cancer across all cohorts. Using SparCC, we discovered that Fusobacterium and Prevotella were also co-enriched across all cohorts. We then analyzed immune cell infiltration to determine if these dysbiotic taxa were associated with immune signatures. Using xCell to obtain predicted immune infiltrates, we identified a depletion of megakaryocyte-erythroid progenitor (MEP) cells in tumors with presence of any of the four taxa, along with enrichment of platelets in tumors with Campylobactor or Fusobacterium. Taken together, our results suggest that intratumoral presence of these co-occurring bacterial genera may confer tumor promoting immune alterations that allow disease progression in esophageal cancer.
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Affiliation(s)
- K L Greathouse
- Department of Biology, Baylor University, Waco, TX, USA.
- Nutrition Division, Human Sciences and Design, Baylor University, Waco, TX, USA.
| | - J K Stone
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - A J Vargas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - A Choudhury
- Department of Biology, Baylor University, Waco, TX, USA
| | - R N Padgett
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - J R White
- Resphera Biosciences, LLC, Baltimore, MD, USA
| | - A Jung
- Department of Biology, Baylor University, Waco, TX, USA
| | - C C Harris
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
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Vargas AJ. Human Milk Composition: An Atlas for Child Health Recommendations. Adv Nutr 2024; 15:100151. [PMID: 37979694 PMCID: PMC10831946 DOI: 10.1016/j.advnut.2023.100151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 11/20/2023] Open
Affiliation(s)
- Ashley J Vargas
- Division of Extramural Research and Training, National Institute of Environmental Health Sciences, Durham, NC, United States.
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Casavale KO, Anderson-Villaluz D, Ahuja JK, Chakrabarti S, Gibbs K, Hopperton K, Parnel S, Pehrsson PR, Stanton M, Vargas AJ. Perspective: The Human Milk Composition Initiative - Filling Crucial Gaps in Data on and Related to Human Milk in the United States and Canada. Adv Nutr 2023; 14:1253-1254. [PMID: 37499981 PMCID: PMC10721460 DOI: 10.1016/j.advnut.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023] Open
Affiliation(s)
- Kellie O Casavale
- Center for Food Safety and Applied Nutrition, Food and Drug Administration, United States Department of Health and Human Services, College Park, MD, United States
| | - Dennis Anderson-Villaluz
- Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, United States Department of Health and Human Services, Rockville, MD, United States
| | - Jaspreet K Ahuja
- Methods and Application of Food Composition Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Services, United States Department of Agriculture, Beltsville, MD, United States
| | - Subhadeep Chakrabarti
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Kimberlea Gibbs
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Kathryn Hopperton
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Sophie Parnel
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Pamela R Pehrsson
- Methods and Application of Food Composition Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Services, United States Department of Agriculture, Beltsville, MD, United States
| | - Melanie Stanton
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Ashley J Vargas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States.
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Evans ME, Herrick KA, Regan KS, Shams-White MM, Vargas AJ, Reedy J. A Decade of Dietary Assessment Methodology Research at the National Institutes of Health, 2012-2021. J Nutr 2023; 153:1627-1635. [PMID: 36921805 PMCID: PMC10196585 DOI: 10.1016/j.tjnut.2023.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/10/2023] [Accepted: 02/23/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Assessment of individual and population-level dietary intake is critical for public health surveillance, epidemiology, and dietary intervention research. In recognition of that need, the National Insitutes of Health (NIH) has a history of funding research projects designed to support the development, implementation, and refinement of tools to assess dietary intake in humans. OBJECTIVES This report provides data and information on NIH-funded dietary intake assessment methodological research over the period of 2012-2021. METHODS Data were extracted from an internal NIH data system using the Research, Condition, and Disease Categorization (RCDC) spending category for Nutrition. Data were then examined to identify research focused on dietary assessment tools or methods to capture or analyze dietary intake. RESULTS Over the decade of 2012-2021, NIH supported 46 grants and 2 large contracts specific to dietary assessment methods development. The top 6 Institutes and Offices funding dietary assessment methods research were identified. Most projects were limited to adults. Projects ranged from novel methods to capture dietary intake, and refinement of analytical methods, to biomarkers of dietary intake. One key contract supported the automated self-administered 24-h dietary assessment tool (ASA24), a widely used, free tool available to the research community for assessing dietary intake. CONCLUSIONS NIH's support for dietary assessment methods development over this 10-y period was small but grew over time with an expanding number and variety of methods, data sources, and technological advancements in the assessment of dietary intake. NIH remains committed to supporting research seeking to advance the field of dietary assessment methods research.
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Affiliation(s)
- Mary E Evans
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States.
| | - Kirsten A Herrick
- National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Karen S Regan
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD, United States
| | - Marissa M Shams-White
- National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Ashley J Vargas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Jill Reedy
- National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
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Vargas AJ, Assar C, Bremer AA, Carlson SJ, Fasano J, Gahche J, Gibbs K, Hansen PA, Lotze A, McKinnon RA, Morissette R, Potischman N, Kaneko K. Science surrounding the safe use of bioactive ingredients in infant formula: federal comment. Pediatr Res 2023:10.1038/s41390-023-02512-6. [PMID: 36759748 PMCID: PMC10382303 DOI: 10.1038/s41390-023-02512-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/10/2023] [Accepted: 01/17/2023] [Indexed: 02/11/2023]
Affiliation(s)
- Ashley J Vargas
- Eunice Kennedy Shrive National Institute of Child Health and Human Development, Bethesda, MD, USA.
| | - Carrie Assar
- Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Andrew A Bremer
- Eunice Kennedy Shrive National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - Susan J Carlson
- Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Jeremiah Fasano
- Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Jaime Gahche
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD, USA
| | - Kimberlea Gibbs
- Eunice Kennedy Shrive National Institute of Child Health and Human Development, Bethesda, MD, USA
| | | | - Andrea Lotze
- Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Robin A McKinnon
- Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | | | - Nancy Potischman
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD, USA
| | - Kotaro Kaneko
- Center for Food Safety and Applied Nutrition, College Park, MD, USA
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Hamner HC, Nelson JM, Sharma AJ, Jefferds MED, Dooyema C, Flores-Ayala R, Bremer AA, Vargas AJ, Casavale KO, de Jesus JM, Stoody EE, Scanlon KS, Perrine CG. Improving Nutrition in the First 1000 Days in the United States: A Federal Perspective. Am J Public Health 2022; 112:S817-S825. [PMID: 36122314 PMCID: PMC9612192 DOI: 10.2105/ajph.2022.307028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2022] [Indexed: 11/04/2022]
Abstract
The first 1000 days begins with pregnancy and ends at the child's second birthday. Nutrition throughout the life course, and especially during the first 1000 days, supports maternal health and optimal growth and development for children. We give a high-level summary of the state of nutrition in the first 1000 days in the United States. We provide examples where continued efforts are needed. We then discuss select opportunities to strengthen federal research and surveillance, programs, and communication and dissemination efforts aimed at improving nutrition and positively, and equitably, influencing the health and well-being of mothers and children. (Am J Public Health. 2022;112(S8):S817-S825. https://doi.org/10.2105/AJPH.2022.307028).
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Affiliation(s)
- Heather C Hamner
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Jennifer M Nelson
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Andrea J Sharma
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Maria Elena D Jefferds
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Carrie Dooyema
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Rafael Flores-Ayala
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Andrew A Bremer
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Ashley J Vargas
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Kellie O Casavale
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Janet M de Jesus
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Eve E Stoody
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Kelley S Scanlon
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Cria G Perrine
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
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7
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Ahuja JKC, Casavale KO, Li Y, Hopperton KE, Chakrabarti S, Hines EP, Brooks SPJ, Bondy GS, MacFarlane AJ, Weiler HA, Wu X, Borghese MM, Ahluwalia N, Cheung W, Vargas AJ, Arteaga S, Lombo T, Fisher MM, Hayward D, Pehrsson PR. Perspective: Human Milk Composition and Related Data for National Health and Nutrition Monitoring and Related Research. Adv Nutr 2022; 13:2098-2114. [PMID: 36084013 PMCID: PMC9776678 DOI: 10.1093/advances/nmac099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/18/2022] [Accepted: 09/07/2022] [Indexed: 01/28/2023] Open
Abstract
National health and nutrition monitoring is an important federal effort in the United States and Canada, and the basis for many of their nutrition and health policies. Understanding of child exposures through human milk (HM) remains out of reach due to lack of current and representative data on HM's composition and intake volume. This article provides an overview of the current national health and nutrition monitoring activities for HM-fed children, HM composition (HMC) and volume data used for exposure assessment, categories of potential measures in HM, and associated variability factors. In this Perspective, we advocate for a framework for collection and reporting of HMC data for national health and nutrition monitoring and programmatic needs, including a shared vision for a publicly available Human Milk Composition Data Repository (HMCD-R) to include essential metadata associated with HMC. HMCD-R can provide a central, integrated platform for researchers and public health officials for compiling, evaluating, and sharing HMC data. The compiled compositional and metadata in HMCD-R would provide pertinent measures of central tendency and variability and allow use of modeling techniques to approximate compositional profiles for subgroups, providing more accurate exposure assessments for purposes of monitoring and surveillance. HMC and related metadata could facilitate understanding the complexity and variability of HM composition, provide crucial data for assessment of infant and maternal nutritional needs, and inform public health policies, food and nutrition programs, and clinical practice guidelines.
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Affiliation(s)
- Jaspreet K C Ahuja
- Methods and Application of Food Composition Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Services, US Department of Agriculture, Beltsville, Maryland, USA.
| | - Kellie O Casavale
- Center for Food Safety and Applied Nutrition, Food and Drug Administration, US Department of Health and Human Services, College Park, Maryland, USA
| | - Ying Li
- Methods and Application of Food Composition Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Services, US Department of Agriculture, Beltsville, Maryland, USA
| | - Kathryn E Hopperton
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Subhadeep Chakrabarti
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Erin P Hines
- Reproductive and Developmental Toxicology Branch, Public Health and Integrated Toxicology Division, US Environmental Protection Agency, Chapel Hill, North Carolina, USA
| | - Stephen P J Brooks
- Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Genevieve S Bondy
- Bureau of Chemical Safety, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Amanda J MacFarlane
- Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Hope A Weiler
- Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Xianli Wu
- Methods and Application of Food Composition Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Services, US Department of Agriculture, Beltsville, Maryland, USA
| | - Michael M Borghese
- Environmental Health Sciences and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Namanjeet Ahluwalia
- National Center for Health Statistics, Centers for Disease Control and Prevention, Department of Health and Human Services, Hyattsville, Maryland, USA
| | - Winnie Cheung
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Ashley J Vargas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Sonia Arteaga
- Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health, Bethesda, Maryland, USA
| | - Tania Lombo
- Maternal Adolescent Pediatric Research Branch, Prevention Science Program, Division of AIDS, National Institute of Allergy and Infectious Diseases (NIAID), Bethesda, Maryland, USA
| | - Mandy M Fisher
- Environmental Health Sciences and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Deborah Hayward
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Pamela R Pehrsson
- Methods and Application of Food Composition Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Services, US Department of Agriculture, Beltsville, Maryland, USA
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Landry MJ, Ruiz LD, Gibbs K, Radtke MD, Lerman J, Vargas AJ. Perspective: Early-Life Nutrition Research Supported by the US National Institutes of Health from 2018 to 2020. Adv Nutr 2022; 13:1395-1401. [PMID: 35438148 PMCID: PMC9526875 DOI: 10.1093/advances/nmac044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 01/28/2023] Open
Abstract
The Dietary Guidelines for Americans, 2020-2025, included guidelines for pregnancy, lactation, and children from birth to age 24 mo (B-24) to reflect the growing body of evidence about appropriate nutrition during the earliest stages of life. Guidelines were based on a thorough review of the existing scientific evidence by the 2020 Dietary Guidelines Advisory Committee (DGAC). This study's objective was to enumerate early-life (pregnancy, lactation, and B-24) nutrition research needs that are already being addressed by the scientific community and to identify remaining research gaps. The Scientific Report of the 2020 Dietary Guidelines Advisory Committee was reviewed, and 138 research gaps relevant to early life were identified. Research gaps were consolidated into 13 topic areas. A total of 1632 nutrition- and early-life-focused research projects funded by the NIH between 2018 and 2020 were manually coded using title, abstract, and public health relevance statement available on NIH RePORTER. Projects were coded as affirmative if they addressed a research gap within 1 of the 13 research gap topic areas. Of coded projects, 235 (14.4%) addressed any early-life nutrition research gap. Between fiscal years 2018 to 2020, total costs of projects addressing any gap represented only 15% of total costs for all projects reviewed. Complementary foods, breastfeeding (never vs. ever), and frequency of eating were research gap areas most frequently coded as being addressed by a funded project. Iron supplementation, seafood consumption, and maternal diet food allergens were research gap areas least frequently coded as being potentially addressed by a funded project. This analysis highlights opportunities for changes in the federal government investment in maternal and child nutrition research to support development of effective, evidence-based dietary guidelines for improvement in early-life nutrition practices and overall public health.
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Affiliation(s)
| | - Lyndsey D Ruiz
- Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - Kimberlea Gibbs
- Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Marcela D Radtke
- Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - Jennifer Lerman
- Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ashley J Vargas
- Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
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9
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O'Connor LE, Gahche JJ, Herrick KA, Davis CD, Potischman N, Vargas AJ. Nonfood Prebiotic, Probiotic, and Synbiotic Use Has Increased in US Adults and Children From 1999 to 2018. Gastroenterology 2021; 161:476-486.e3. [PMID: 33895169 DOI: 10.1053/j.gastro.2021.04.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/06/2021] [Accepted: 04/15/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS Public interest in pre-, pro-, and synbiotic products is increasing because of interactions between gut microbiota and human health. Our aim was to describe nonfood (from dietary supplements or medication) pre-, pro-, and synbiotic use by US adults and children and reported reasons. METHODS Using data from the National Health and Nutrition Examination Survey (NHANES), we text-mined dietary supplement and prescription medication labels and ingredients to identify pre-, pro-, and synbiotic products used in the past 30 days. We describe trends in use from 1999 to 2018 (n = 101,199) and prevalence in 2015-2016 and 2017-2018 (n = 19,215) by age groups, sex, ethnicity/race, education, income, self-reported diet and health quality, and prescription gastrointestinal medication use stratified by children (<19 years) and adults (19+ years). RESULTS Nonfood pre-, pro-, and synbiotic use increased up to 3-fold in recent cycles. Prevalence of use for all ages for prebiotics was 2.4% (95% confidence interval [CI], 2.0-2.9), for probiotics was 4.5% (95% CI, 3.5-5.6), and for synbiotics was 1.1% (95% CI, 0.8-1.5). Use was highest among older adults (8.8% [95% CI, 5.4-13.3] among those aged 60-69 years for probiotics), non-Hispanic Whites, those with higher educational attainment and income, those with more favorable self-reported diet or health quality, and those with concurrent prescription gastrointestinal medication use. The top reasons for use were for digestive health and to promote/maintain general health. Less than 30% reported using these products based on a health care provider's recommendation. CONCLUSIONS One in 20 US adults or children use nonfood pre-, pro-, or synbiotic products, and use has sharply increased in recent years. Most individuals voluntarily take these products for general digestive or overall health reasons.
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Affiliation(s)
- Lauren E O'Connor
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Jaime J Gahche
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland
| | - Kirsten A Herrick
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Cindy D Davis
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland
| | - Nancy Potischman
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland
| | - Ashley J Vargas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
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Murray DM, Ganoza LF, Vargas AJ, Ellis EM, Oyedele NK, Schully SD, Liggins CA. New NIH Primary and Secondary Prevention Research During 2012-2019. Am J Prev Med 2021; 60:e261-e268. [PMID: 33745818 DOI: 10.1016/j.amepre.2021.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION This manuscript characterizes primary and secondary prevention research in humans and related methods research funded by NIH in 2012‒2019. METHODS The NIH Office of Disease Prevention updated its prevention research taxonomy in 2019‒2020 and applied it to a sample of 14,523 new extramural projects awarded in 2012-2019. All projects were coded manually for rationale, exposures, outcomes, population focus, study design, and type of prevention research. All results are based on that manual coding. RESULTS Taxonomy updates resulted in a slight increase, from an average of 16.7% to 17.6%, in the proportion of prevention research awards for 2012‒2017; there was a further increase to 20.7% in 2019. Most of the leading risk factors for death and disability in the U.S. were observed as an exposure or outcome in <5% of prevention research projects in 2019 (e.g., diet, 3.7%; tobacco, 3.9%; blood pressure, 2.8%; obesity, 4.4%). Analysis of existing data became more common (from 36% to 46.5%), whereas randomized interventions became less common (from 20.5% to 12.3%). Randomized interventions addressing a leading risk factor in a minority health or health disparities population were uncommon. CONCLUSIONS The number of new NIH awards classified as prevention research increased to 20.7% in 2019. New projects continued to focus on observational studies and secondary data analysis in 2018 and 2019. Additional research is needed to develop and test new interventions or develop methods for the dissemination of existing interventions, which address the leading risk factors, particularly in minority health and health disparities populations.
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Affiliation(s)
- David M Murray
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland.
| | - Luis F Ganoza
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
| | - Ashley J Vargas
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
| | - Erin M Ellis
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
| | - Natasha K Oyedele
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
| | - Sheri D Schully
- All of Us Research Program, Office of the Director, NIH, Bethesda, Maryland
| | - Charlene A Liggins
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
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Christian P, Smith ER, Lee SE, Vargas AJ, Bremer AA, Raiten DJ. The need to study human milk as a biological system. Am J Clin Nutr 2021; 113:1063-1072. [PMID: 33831952 PMCID: PMC8106761 DOI: 10.1093/ajcn/nqab075] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/25/2021] [Indexed: 12/24/2022] Open
Abstract
Critical advancement is needed in the study of human milk as a biological system that intersects and interacts with myriad internal (maternal biology) and external (diet, environment, infections) factors and its plethora of influences on the developing infant. Human-milk composition and its resulting biological function is more than the sum of its parts. Our failure to fully understand this biology in a large part contributes to why the duration of exclusive breastfeeding remains an unsettled science (if not policy). Our current understanding of human-milk composition and its individual components and their functions fails to fully recognize the importance of the chronobiology and systems biology of human milk in the context of milk synthesis, optimal timing and duration of feeding, and period of lactation. The overly simplistic, but common, approach to analyzing single, mostly nutritive components of human milk is insufficient to understand the contribution of either individual components or the matrix within which they exist to both maternal and child health. There is a need for a shift in the conceptual approach to studying human milk to improve strategies and interventions to support better lactation, breastfeeding, and the full range of infant feeding practices, particularly for women and infants living in undernourished and infectious environments. Recent technological advances have led to a rising movement towards advancing the science of human-milk biology. Herein, we describe the rationale and critical need for unveiling the multifunctionality of the various nutritional, nonnutritional, immune, and biological signaling pathways of the components in human milk that drive system development and maturation, growth, and development in the very early postnatal period of life. We provide a vision and conceptual framework for a research strategy and agenda to change the field of human-milk biology with implications for global policy, innovation, and interventions.
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Affiliation(s)
| | - Emily R Smith
- Milken Institute School of Public Health, The George Washington University, Departments of Global Health and Exercise and Nutrition Sciences, Washington, DC, USA
| | - Sun Eun Lee
- The Bill and Melinda Gates Foundation, Seattle, WA, USA
| | - Ashley J Vargas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Andrew A Bremer
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Daniel J Raiten
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
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12
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Robinson K, Rozga M, Braakhuis A, Ellis A, Monnard CR, Sinley R, Wanner A, Vargas AJ. Effect of Incorporating Genetic Testing Results into Nutrition Counseling and Care on Dietary Intake: An Evidence Analysis Center Systematic Review-Part I. J Acad Nutr Diet 2020; 121:553-581.e3. [PMID: 32624394 DOI: 10.1016/j.jand.2020.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Indexed: 12/15/2022]
Abstract
Consumer interest in personalized nutrition based on nutrigenetic testing is growing. Recently, multiple, randomized controlled trials have sought to understand whether incorporating genetic information into dietary counseling alters dietary outcomes. The objective of this systematic review was to examine how incorporating genetic information into nutrition counseling and care, compared to an alternative intervention or control group, impacts dietary outcomes. This is the first of a 2-part systematic review series. Part II reports anthropometric, biochemical, and disease-specific outcomes. Peer-reviewed randomized controlled trials were identified through a systematic literature search of multiple databases, screened for eligibility, and critically reviewed and synthesized. Conclusion statements were graded to determine quality of evidence for each dietary outcome reported. Reported outcomes include intake of total energy and macronutrients, micronutrients, foods, food groups, food components (added sugar, caffeine, and alcohol), and composite diet scores. Ten articles representing 8 unique randomized controlled trials met inclusion criteria. Of 15 conclusion statements (evidence grades: Weak to Moderate), 13 concluded there was no significant effect of incorporating genetic information into nutrition counseling/care on dietary outcomes. Limited data suggested that carriers of higher-risk gene variants were more likely than carriers of low-risk gene variants to significantly reduce intake of sodium and alcohol in response to nutrition counseling that incorporated genetic results. Included studies differed in quality, selected genetic variants, timing and intensity of intervention, sample size, dietary assessment tools, and population characteristics. Therefore, strong conclusions could not be drawn. Collaboration between the Academy of Nutrition and Dietetics and professional nutrigenetic societies would likely prove valuable in prioritizing which genetic variants and targeted nutrition messages have the most potential to alter dietary outcomes in a given patient subpopulation and, thus, should be the targets of future research.
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Affiliation(s)
- Katie Robinson
- Scientific and Medical Affairs, Abbott Nutrition, Columbus, OH
| | - Mary Rozga
- Academy of Nutrition and Dietetics, Evidence Analysis Center, Chicago, IL.
| | - Andrea Braakhuis
- Faculty of Medical and Health Science, Discipline of Nutrition, The University of Auckland, Grafton, Auckland, New Zealand
| | - Amy Ellis
- University of Alabama, Tuscaloosa, AL
| | | | | | | | - Ashley J Vargas
- National Institutes of Health, Office of Disease Prevention, Rockville, MD
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13
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Ellis A, Rozga M, Braakhuis A, Monnard CR, Robinson K, Sinley R, Wanner A, Vargas AJ. Effect of Incorporating Genetic Testing Results into Nutrition Counseling and Care on Health Outcomes: An Evidence Analysis Center Systematic Review-Part II. J Acad Nutr Diet 2020; 121:582-605.e17. [PMID: 32624396 DOI: 10.1016/j.jand.2020.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Indexed: 02/06/2023]
Abstract
In recent years, literature examining implementation of nutritional genomics into clinical practice has increased, including publication of several randomized controlled trials (RCTs). This systematic review addressed the following question: In children and adults, what is the effect of incorporating results of genetic testing into nutrition counseling and care compared with an alternative intervention or control group, on nutrition-related health outcomes? A literature search of MEDLINE, Embase, PsycINFO, CINAHL, and other databases was conducted for peer-reviewed RCTs published from January 2008 until December 2018. An international workgroup consisting of registered dietitian nutritionists, systematic review methodologists, and evidence analysts screened and reviewed articles, summarized data, conducted meta-analyses, and graded conclusion statements. The second in a two-part series, this article specifically summarizes evidence from RCTs that examined health outcomes (ie, quality of life, disease incidence and prevention of disease progression, or mortality), intermediate health outcomes (ie, anthropometric measures, body composition, or relevant laboratory measures routinely collected in practice), and adverse events as reported by study authors. Analysis of 11 articles from nine RCTs resulted in 16 graded conclusion statements. Among participants with nonalcoholic fatty liver disease, a diet tailored to genotype resulted in a greater reduction of percent body fat compared with a customary diet for nonalcoholic fatty liver disease. However, meta-analyses for the outcomes of total cholesterol, low-density lipoprotein cholesterol, body mass index, and weight yielded null results. Heterogeneity between studies and low certainty of evidence precluded development of strong conclusions about the incorporation of genetic information into nutrition practice. Although there are still relatively few well-designed RCTs to inform integration of genetic information into the Nutrition Care Process, the field of nutritional genomics is evolving rapidly, and gaps in the literature identified by this systematic review can inform future studies.
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14
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Villani J, Ganoza L, Sims BE, Crump AD, Godette DC, Hilton ME, Vargas AJ. Substance use prevention research funded by the NIH. Drug Alcohol Depend 2020; 206:107724. [PMID: 31753731 DOI: 10.1016/j.drugalcdep.2019.107724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/02/2019] [Accepted: 11/04/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Substance use is a leading preventable cause of death in the U.S. The National Institutes of Health (NIH) provides public funding to advance understanding on the causes of substance use disorders and apply that knowledge to improve public health through research that develops new and improved strategies to prevent substance use. The purpose of this study was to characterize substance use prevention research funded by the NIH. METHODS Leveraging a dataset of NIH-funded prevention research, we identified grants studying substance use during 2012-2017. We coded the substances and types of prevention research studied in these grants. We generated descriptive statistics and estimated trends using weighted data representing the entire NIH substance use prevention research portfolio. RESULTS Approximately 2.4% of all NIH research awards focused on substance use prevention during 2012-2017, with most focused on Epidemiologic Research. Alcohol and Nicotine were the top two substance categories studied. Marijuana prevention research showed a significant upward trend in funding over time (p = 0.002). Among studies of College Students and Military/Veterans, over three-quarters focused on Alcohol. Studies of Pregnant/Port-partum Women mostly focused on Nicotine. CONCLUSIONS While substance use is a leading cause for morbidity and mortality, substance use prevention grants comprised a small portion of NIH's research portfolio during 2012-2017. These grants demonstrated breadth in the substances studied and the types of prevention research. Opportunities for further study are discussed.
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Affiliation(s)
- Jennifer Villani
- Office of Disease Prevention, National Institutes of Health, Rockville, MD, 20892, United States.
| | - Luis Ganoza
- Office of Disease Prevention, National Institutes of Health, Rockville, MD, 20892, United States
| | - Belinda E Sims
- Prevention Research Branch, Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Rockville, MD, 20892, United States
| | - Aria D Crump
- Prevention Research Branch, Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Rockville, MD, 20892, United States
| | - Dionne C Godette
- Office of Disease Prevention, National Institutes of Health, Rockville, MD, 20892, United States
| | - Michael E Hilton
- Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, Rockville, MD, 20892, United States
| | - Ashley J Vargas
- Office of Disease Prevention, National Institutes of Health, Rockville, MD, 20892, United States
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15
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Vargas AJ, Sprow K, Lerman JL, Villani J, Regan KS, Ballard RM. Diet and Physical Activity Prevention Research Supported by the U.S. NIH From 2012-2017. Am J Prev Med 2019; 57:818-825. [PMID: 31753263 PMCID: PMC6894494 DOI: 10.1016/j.amepre.2019.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Poor diet and inadequate physical activity are common contributors to preventable death in the U.S. This paper provides a summary of the NIH-sponsored research on disease prevention that underlies public health and clinical recommendations to improve diet and physical activity. METHODS A representative sample (n=11,082) of research grants and cooperative agreements (research projects) representing the NIH prevention research portfolio between 2012 and 2017 were hand coded by trained analysts in 2017-2018. This manuscript describes the rationale(s), exposure(s), outcome(s), population(s), and study design(s) in prevention research focused on diet and physical activity and compares this research to identified research gaps in the field. RESULTS A relatively stable 7.8% (95% CI=7.0%, 8.8%) and 5.0% (95% CI=4.4%, 5.7%) of the NIH prevention research projects were focused on diet and physical activity, respectively, during 2012-2017. These projects often explored diet and physical activity together in the context of obesity, included observational studies, and focused on a general adult population. Few of these projects focused on development of improved assessment methods. Approximately 50% of these studies were related to research gaps identified by the 2015 Dietary or 2018 Physical Activity Guidelines Advisory Committee Scientific Reports. CONCLUSIONS Opportunities exist for more engagement by NIH and scientific investigators in diet- and physical activity-focused prevention research, particularly around assessment and known research gaps.
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Affiliation(s)
| | - Kyle Sprow
- National Cancer Institute, NIH, Rockville, Maryland
| | - Jennifer L Lerman
- National Cancer Institute, NIH, Rockville, Maryland; ICF International, Fairfax, Virginia
| | | | - Karen S Regan
- National Institute of Diabetes, Digestive and Kidney Diseases, Bethesda, Maryland; Office of Dietary Supplements, NIH, Rockville, Maryland
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16
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Vargas AJ, Schully SD, Villani J, Ganoza Caballero L, Murray DM. Assessment of Prevention Research Measuring Leading Risk Factors and Causes of Mortality and Disability Supported by the US National Institutes of Health. JAMA Netw Open 2019; 2:e1914718. [PMID: 31702797 PMCID: PMC6902772 DOI: 10.1001/jamanetworkopen.2019.14718] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE No studies to date have examined support by the National Institutes of Health (NIH) for primary and secondary prevention research in humans and related methods research that measures the leading risk factors or causes of death or disability as outcomes or exposures. OBJECTIVE To characterize NIH support for such research. DESIGN AND SETTING This serial cross-sectional study randomly sampled NIH grants and cooperative agreements funded during fiscal years 2012 through 2017. For awards with multiple subprojects, each was treated as a separate project. Study characteristics, outcomes, and exposures were coded from October 2015 through February 2019. Analyses weighted to reflect the sampling scheme were completed in March through June 2019. Using 2017 data from the Centers for Disease Control and Prevention and 2016 data from the Global Burden of Disease project, the leading risk factors and causes of death and disability in the United States were identified. MAIN OUTCOMES AND MEASURES The main outcome was the percentage of the NIH prevention research portfolio measuring a leading risk factor or cause of death or disability as an outcome or exposure. RESULTS A total of 11 082 research projects were coded. Only 25.9% (95% CI, 24.0%-27.8%) of prevention research projects measured a leading cause of death as an outcome or exposure, although these leading causes were associated with 74.0% of US mortality. Only 34.0% (95% CI, 32.2%-35.9%) measured a leading risk factor for death, although these risk factors were associated with 57.3% of mortality. Only 31.4% (95% CI, 29.6%-33.3%) measured a leading risk factor for disability-adjusted life-years lost, although these risk factors were associated with 42.1% of disability-adjusted life-years lost. Relatively few projects included a randomized clinical trial (24.6%; 95% CI, 22.5%-26.9%) or involved more than 1 leading cause (3.3%; 95% CI, 2.6%-4.1%) or risk factor (8.8%; 95% CI, 7.9%-9.8%). CONCLUSIONS AND RELEVANCE In this cross-sectional study, the leading risk factors and causes of death and disability were underrepresented in the NIH prevention research portfolio relative to their burden. Because so much is already known about these risk factors and causes, and because randomized interventions play such a vital role in the development of clinical and public health guidelines, it appears that greater attention should be given to develop and test interventions that address these risk factors and causes, addressing multiple risk factors or causes when possible.
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Affiliation(s)
- Ashley J. Vargas
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
| | - Sheri D. Schully
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
| | - Jennifer Villani
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
| | - Luis Ganoza Caballero
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
- Scientific Consulting Group, Inc, Gaithersburg, Maryland
| | - David M. Murray
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
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17
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Murray DM, Villani J, Vargas AJ, Lee JA, Myles RL, Wu JY, Mabry PL, Schully SD. NIH Primary and Secondary Prevention Research in Humans During 2012-2017. Am J Prev Med 2018; 55:915-925. [PMID: 30458950 PMCID: PMC6251492 DOI: 10.1016/j.amepre.2018.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/30/2018] [Accepted: 08/08/2018] [Indexed: 12/19/2022]
Abstract
INTRODUCTION This paper provides the first detailed analysis of the NIH prevention research portfolio for primary and secondary prevention research in humans and related methods research. METHODS The Office of Disease Prevention developed a taxonomy of 128 topics and applied it to 11,082 projects representing 91.7% of all new projects and 84.1% of all dollars used for new projects awarded using grant and cooperative agreement activity codes that supported research in fiscal years 2012-2017. Projects were coded in 2016-2018 and analyzed in 2018. RESULTS Only 16.7% of projects and 22.6% of dollars were used for primary and secondary prevention research in humans or related methods research. Most of the leading risk factors for death and disability in the U.S. were selected as an outcome in <5% of the projects. Many more projects included an observational study, or an analysis of existing data, than a randomized intervention. These patterns were consistent over time. CONCLUSIONS The appropriate level of support for primary and secondary prevention research in humans from NIH will differ by field and stage of research. The estimates reported here may be overestimates, as credit was given for a project even if only a portion of that project addressed prevention research. Given that 74% of the variability in county-level life expectancy across the U.S. is explained by established risk factors, it seems appropriate to devote additional resources to developing and testing interventions to address those risk factors.
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Affiliation(s)
| | | | | | - Jocelyn A Lee
- Office of Disease Prevention, NIH, Rockville, Maryland
| | | | - Jessica Y Wu
- University of California Research Initiatives, University of California, Office of the President, Oakland, California
| | - Patricia L Mabry
- Indiana University Network Science Institute and School of Public Health-Bloomington, Indiana University, Bloomington, Indiana
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18
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Villani J, Schully SD, Meyer P, Myles RL, Lee JA, Murray DM, Vargas AJ. A Machine Learning Approach to Identify NIH-Funded Applied Prevention Research. Am J Prev Med 2018; 55:926-931. [PMID: 30458951 PMCID: PMC6251715 DOI: 10.1016/j.amepre.2018.07.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/20/2018] [Accepted: 07/20/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION To fulfill its mission, the NIH Office of Disease Prevention systematically monitors NIH investments in applied prevention research. Specifically, the Office focuses on research in humans involving primary and secondary prevention, and prevention-related methods. Currently, the NIH uses the Research, Condition, and Disease Categorization system to report agency funding in prevention research. However, this system defines prevention research broadly to include primary and secondary prevention, studies on prevention methods, and basic and preclinical studies for prevention. A new methodology was needed to quantify NIH funding in applied prevention research. METHODS A novel machine learning approach was developed and evaluated for its ability to characterize NIH-funded applied prevention research during fiscal years 2012-2015. The sensitivity, specificity, positive predictive value, accuracy, and F1 score of the machine learning method; the Research, Condition, and Disease Categorization system; and a combined approach were estimated. Analyses were completed during June-August 2017. RESULTS Because the machine learning method was trained to recognize applied prevention research, it more accurately identified applied prevention grants (F1 = 72.7%) than the Research, Condition, and Disease Categorization system (F1 = 54.4%) and a combined approach (F1 = 63.5%) with p<0.001. CONCLUSIONS This analysis demonstrated the use of machine learning as an efficient method to classify NIH-funded research grants in disease prevention.
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Affiliation(s)
| | | | - Payam Meyer
- Office of Portfolio Analysis, NIH, Bethesda, Maryland
| | | | - Jocelyn A Lee
- Office of Disease Prevention, NIH, Rockville, Maryland
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Emenaker NJ, Vargas AJ. The Mediterranean Diet, the OGG1 Gene, and Disease Risk: Early Evidence. J Acad Nutr Diet 2018; 118:547-549. [PMID: 29305132 PMCID: PMC5869136 DOI: 10.1016/j.jand.2017.09.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 09/27/2017] [Indexed: 12/22/2022]
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20
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Emenaker NJ, Vargas AJ. Nutrition and Cancer Research: Resources for the Nutrition and Dietetics Practitioner. J Acad Nutr Diet 2018; 118:550-554. [PMID: 29289548 DOI: 10.1016/j.jand.2017.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/13/2017] [Indexed: 11/17/2022]
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Vargas AJ, Sittadjody S, Thangasamy T, Mendoza EE, Limesand KH, Burd R. Exploiting Tyrosinase Expression and Activity in Melanocytic Tumors. Integr Cancer Ther 2017; 10:328-40. [DOI: 10.1177/1534735410391661] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Melanoma is an aggressive tumor that expresses the pigmentation enzyme tyrosinase. Tyrosinase expression increases during tumorigenesis, which could allow for selective treatment of this tumor type by strategies that use tyrosinase activity. Approaches targeting tyrosinase would involve gene transcription or signal transduction pathways mediated by p53 in a direct or indirect manner. Two pathways are proposed for exploiting tyrosinase expression: ( a) a p53-dependent pathway leading to apoptosis or arrest and ( b) a reactive oxygen species–mediated induction of endoplasmic reticulum stress in p53 mutant tumors. Both strategies could use tyrosinase-mediated activation of quercetin, a dietary polyphenol that induces the expression of p53 and modulates reactive oxygen species. In addition to antitumor signaling properties, activation of quercetin could complement conventional cancer therapy by the induction of phase II detoxification enzymes resulting in p53 stabilization and transduction of its downstream targets. In conclusion, recent advances in tyrosinase enzymology, prodrug chemistry, and modern chemotherapeutics present an intriguing and selective multitherapy targeting system where dietary bioflavonoids could be used to complement conventional cancer treatments.
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Alexander DD, Miller PE, Vargas AJ, Weed DL, Cohen SS. Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke. J Am Coll Nutr 2016; 35:704-716. [DOI: 10.1080/07315724.2016.1152928] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Vargas AJ, Quackenbush J, Glass K. Diet-induced weight loss leads to a switch in gene regulatory network control in the rectal mucosa. Genomics 2016; 108:126-133. [PMID: 27524493 PMCID: PMC5121035 DOI: 10.1016/j.ygeno.2016.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 08/09/2016] [Accepted: 08/10/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Weight loss may decrease risk of colorectal cancer in obese individuals, yet its effect in the colorectum is not well understood. We used integrative network modeling, Passing Attributes between Networks for Data Assimilation, to estimate transcriptional regulatory network models from mRNA expression levels from rectal mucosa biopsies measured pre- and post-weight loss in 10 obese, pre-menopausal women. RESULTS We identified significantly greater regulatory targeting of glucose transport pathways in the post-weight loss regulatory network, including "regulation of glucose transport" (FDR=0.02), "hexose transport" (FDR=0.06), "glucose transport" (FDR=0.06) and "monosaccharide transport" (FDR=0.08). These findings were not evident by gene expression analysis alone. Network analysis also suggested a regulatory switch from NFΚB1 to MAX control of MYC post-weight loss. CONCLUSIONS These network-based results expand upon standard gene expression analysis by providing evidence for a potential mechanistic alteration caused by weight loss.
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Affiliation(s)
- Ashley J Vargas
- Harvard School of Public Health, Harvard University, Boston, MA, USA; Cancer Prevention Fellowship Program, National Cancer Institute, Rockville, MD, USA
| | - John Quackenbush
- Harvard School of Public Health, Harvard University, Boston, MA, USA; Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Kimberly Glass
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.
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Abstract
Goldenberg JZ, Lytvyn L, Steurich J, Parkin P, Mahant S, Johnston BC. Probiotics for the prevention of pediatric antibiotic-associated diarrhea.Cochrane Database Syst Rev2015, Issue 12. Art. No.: CD004827. http://dx.doi.org/10.1002/14651858.CD004827.pub4. BACKGROUND Antibiotics are frequently prescribed in children. They alter the microbial balance within the gastrointestinal tract, commonly resulting in antibiotic-associated diarrhea (AAD). Probiotics may prevent AAD via restoration of the gut microflora. OBJECTIVES The primary objectives were to assess the efficacy and safety of probiotics (any specified strain or dose) used for the prevention of AAD in children. SEARCH METHODS MEDLINE, EMBASE, CENTRAL, CINAHL, AMED, and the Web of Science (inception to November 2014) were searched along with specialized registers including the Cochrane IBD/FBD review group, CISCOM (Centralized Information Service for Complementary Medicine), NHS Evidence, the International Bibliographic Information on Dietary Supplements, as well as trial registries. Letters were sent to authors of included trials, nutraceutical and pharmaceutical companies, and experts in the field requesting additional information on ongoing or unpublished trials. Conference proceedings, dissertation abstracts, and reference lists from included and relevant articles were also searched. SELECTION CRITERIA Randomized, parallel, controlled trials in children (0-18 years) receiving antibiotics, that compare probiotics to placebo, active alternative prophylaxis, or no treatment and measure the incidence of diarrhea secondary to antibiotic use were considered for inclusion. DATA COLLECTION AND ANALYSIS Study selection, data extraction, and methodological quality assessment using the risk of bias instrument were conducted independently and in duplicate by two authors. Dichotomous data (incidence of diarrhea and adverse events) were combined using a pooled risk ratio (RR) or risk difference (RD), and continuous data (mean duration of diarrhea and mean daily stool frequency) as mean difference (MD), along with their corresponding 95% confidence interval (95% CI). For overall pooled results on the incidence of diarrhea, sensitivity analyses included available case versus extreme-plausible analyses and random- versus fixed-effect models. To explore possible explanations for heterogeneity, a priori subgroup analysis was conducted on probiotic strain, dose, definition of antibiotic-associated diarrhea, and risk of bias. We also conducted post hoc subgroup analyses by patient diagnosis, single versus multi-strain, industry sponsorship, and inpatient status. The overall quality of the evidence supporting the outcomes was evaluated using the GRADE criteria. MAIN RESULTS Overall, 23 studies (3938 participants) met the inclusion criteria. Trials included treatment with either Bacillus spp., Bifidobacterium spp., Clostridium butyricum, Lactobacilli spp., Lactococcus spp., Leuconostoc cremoris, Saccharomyces spp., or Streptococcus spp., alone or in combination. Eleven studies used a single-strain probiotic, four combined two probiotic strains, three combined three probiotic strains, one combined four probiotic strains, two combined seven probiotic strains, one included ten probiotic strains, and one study included two probiotic arms that used three and two strains, respectively. The risk of bias was determined to be high or unclear in 13 studies and low in 10 studies. Available case (patients who did not complete the studies were not included in the analysis) results from 22/23 trials reporting on the incidence of diarrhea show a precise benefit from probiotics compared to active, placebo, or no treatment control. The incidence of AAD in the probiotic group was 8% (163/1992) compared to 19% (364/1906) in the control group (RR = 0.46; 95% CI: 0.35-0.61; I2 = 55%, 3898 participants). A GRADE analysis indicated that the overall quality of the evidence for this outcome was moderate. This benefit remained statistically significant in an extreme-plausible (60% of children lost to follow-up in probiotic group and 20% lost to follow-up in the control group had diarrhea) sensitivity analysis, where the incidence of AAD in the probiotic group was 14% (330/2294) compared to 19% (426/2235) in the control group (RR = 0.69; 95% CI: 0.54-0.89; I2 = 63%, 4529 participants). None of the 16 trials (n = 2455) that reported on adverse events documented any serious adverse events attributable to probiotics. Meta-analysis excluded all but an extremely small non-significant difference in adverse events between treatment and control (RD = 0.00, 95% CI: -0.01 to 0.01). The majority of adverse events were in placebo, standard care, or no treatment group. Adverse events reported in the studies include rash, nausea, gas, flatulence, abdominal bloating, abdominal pain, vomiting, increased phlegm, chest pain, constipation, taste disturbance, and low appetite. AUTHORS׳ CONCLUSIONS: Moderate quality evidence suggests a protective effect of probiotics in preventing AAD. Our pooled estimate suggests a precise (RR 0.46; 95% CI: 0.35-0.61) probiotic effect with an NNT of 10. Among the various probiotics evaluated, Lactobacillus rhamnosus or Saccharomyces boulardii at 5-40 billion colony-forming units/day may be appropriate given the modest NNT and the likelihood that adverse events are very rare. It is premature to draw conclusions about the efficacy and safety of other probiotic agents for pediatric AAD. Although no serious adverse events were observed among otherwise healthy children, serious adverse events have been observed in severely debilitated or immunocompromised children with underlying risk factors including central venous catheter use and disorders associated with bacterial/fungal translocation. Until further research has been conducted, probiotic use should be avoided in pediatric populations at risk for adverse events. Future trials would benefit from a standard and valid outcomes to measure AAD.
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Affiliation(s)
- Shelby R Hayes
- National Cancer Institute, 6100 Executive Bldv, Rockville, MD 20852
| | - Ashley J Vargas
- National Cancer Institute, 6100 Executive Bldv, Rockville, MD 20852.
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Abstract
Precision medicine relies on validated biomarkers with which to better classify patients by their probable disease risk, prognosis and/or response to treatment. Although affordable 'omics'-based technology has enabled faster identification of putative biomarkers, the validation of biomarkers is still stymied by low statistical power and poor reproducibility of results. This Review summarizes the successes and challenges of using different types of molecule as biomarkers, using lung cancer as a key illustrative example. Efforts at the national level of several countries to tie molecular measurement of samples to patient data via electronic medical records are the future of precision medicine research.
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Affiliation(s)
- Ashley J Vargas
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Room 3068A, MSC 425, 837 Convent Drive, Bethesda, Maryland 20892-4258, USA
- Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland 20850, USA
| | - Curtis C Harris
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Room 3068A, MSC 425, 837 Convent Drive, Bethesda, Maryland 20892-4258, USA
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Vargas AJ, Neuhouser ML, George SM, Thomson CA, Ho GYF, Rohan TE, Kato I, Nassir R, Hou L, Manson JE. Diet Quality and Colorectal Cancer Risk in the Women's Health Initiative Observational Study. Am J Epidemiol 2016; 184:23-32. [PMID: 27267948 DOI: 10.1093/aje/kwv304] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/29/2015] [Indexed: 02/07/2023] Open
Abstract
Diet quality index scores on Healthy Eating Index 2010 (HEI-2010), Alternative HEI-2010, alternative Mediterranean Diet Index, and the Dietary Approaches to Stop Hypertension (DASH) index have been inversely associated with all-cause and cancer-specific death. This study assessed the association between these scores and colorectal cancer (CRC) incidence as well as CRC-specific mortality in the Women's Health Initiative Observational Study (1993-2012), a US study of postmenopausal women. During an average of 12.4 years of follow-up, there were 938 cases of CRC and 238 CRC-specific deaths. We estimated multivariate hazard ratios and 95% confidence intervals for relationships between quintiles of diet scores (from baseline food frequency questionnaires) and outcomes. HEI-2010 score (hazard ratios were 0.81, 0.77, and 0.73 with P values of 0.04, 0.01, and <0.01 for quintiles 3-5 vs. quintile 1, respectively) and DASH score (hazard ratios were 0.72, 0.74, and 0.78 with P values of <0.01, <0.01, and 0.03 for quintiles 3-5 vs. quintile 1, respectively), but not other diet scores, were associated with a lower risk of CRC in adjusted models. No diet scores were significantly associated with CRC-specific mortality. Closer adherence to HEI-2010 and DASH dietary recommendations was inversely associated with risk of CRC in this large cohort of postmenopausal women.
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Ruiz-Juretschke F, Vargas AJ, Gonzalez-Quarante LH, Gil de Sagredo OL, Montalvo A, Fernandez-Carballal C. Microsurgical treatment of trigeminal neuralgia in patients older than 70 years: An efficacy and safety study. Neurologia 2016; 32:424-430. [PMID: 26968821 DOI: 10.1016/j.nrl.2016.01.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 01/25/2016] [Accepted: 01/26/2016] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION The increasing incidence of trigeminal neuralgia (TN) with age together with population ageing call for reexamination of surgical treatment options for refractory TN in elderly patients. METHODS Retrospective review of a consecutive series of patients older than 70 who underwent microvascular decompression (MVD) for refractory TN between 1997 and 2015. Outcomes based on the Barrow Neurological Institute pain intensity score (BNI score) and surgical complications were compared to those of patients younger than 70 undergoing MVD in the same period. RESULTS Forty patients older than 70 (mean = 74.8 years) underwent interventions. At a mean follow-up time of 34 months, 73% of the patients presented complete absence of pain without medication (BNI I) and 85% had good pain control with or without medication (BNI I-III). A comparison of these patients with the 85 patients younger than 70 treated surgically during the same period did not find a significant association between age and achievement of pain control (BNI I-II). However, there was a significant association between age older than 70 and complete pain relief (BNI I; P=.03). The mean hospital stay in patients over 70 was also significantly longer (P=.04), although the postsurgical complication rate was similar to that in younger patients. CONCLUSIONS Elderly patients with refractory TN may benefit from treatment with MVD and the probability of success and surgical risk are comparable to those in younger patients.
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Affiliation(s)
- F Ruiz-Juretschke
- Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | - A J Vargas
- Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - L H Gonzalez-Quarante
- Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - O L Gil de Sagredo
- Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - A Montalvo
- Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - C Fernandez-Carballal
- Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España
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Vargas AJ, Ashbeck EL, Wertheim BC, Wallace RB, Neuhouser ML, Thomson CA, Thompson PA. Dietary polyamine intake and colorectal cancer risk in postmenopausal women. Am J Clin Nutr 2015; 102:411-9. [PMID: 26135350 PMCID: PMC4515861 DOI: 10.3945/ajcn.114.103895] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 06/01/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Putrescine, spermidine, and spermine (i.e., polyamines) are small cationic amines synthesized by cells or acquired from the diet or gut bacteria. Polyamines are required for both normal and colorectal cancer (CRC) cell growth. OBJECTIVE We investigated the association between dietary polyamines and risk of CRC incidence and mortality. DESIGN The study was a prospective analysis in 87,602 postmenopausal women in the Women's Health Initiative Observational Study. Multivariate Cox regression was used to calculate HRs and 95% CIs. RESULTS Total dietary polyamine intake (mean ± SD: 289.2 ± 127.4 μmol/d) was not positively associated with CRC in fully adjusted models. Instead, intake ≥179.67 μmol/d was associated with reduced risk of CRC [HR (95% CI): 0.82 (0.68, 1.00), 0.81 (0.66, 0.99), 0.91 (0.74, 1.12), and 0.80 (0.62, 1.02) for quintiles 2-5, respectively, compared with quintile 1]. Reduced risk was not significant across all quintiles. Polyamines were not significantly associated with CRC-specific mortality in fully adjusted models. When stratified by risk factors for CRC, only body mass index (BMI) and fiber intake significantly modified the association between polyamine intake and CRC. In women with BMI (in kg/m²) ≤25 or fiber consumption above the median, polyamine intake was associated with significantly lower risk of CRC. CONCLUSIONS No positive association between dietary polyamines and CRC or CRC-specific mortality risk in women was observed. Instead, a protective effect of dietary polyamines was suggested in women with some CRC risk-lowering behaviors in particular. These results are consistent with emerging evidence that exogenous polyamines may be beneficial in colon health and warrant additional study.
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Affiliation(s)
| | | | | | - Robert B Wallace
- University of Iowa College of Public Health, University of Iowa, Iowa City, IA; and
| | - Marian L Neuhouser
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Cynthia A Thomson
- Departments of Nutritional Sciences, College of Public Health, The University of Arizona, Tucson, AZ; The University of Arizona Cancer Center, Tucson, AZ
| | - Patricia A Thompson
- Departments of Nutritional Sciences, Molecular and Cellular Biology, and The University of Arizona Cancer Center, Tucson, AZ
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Abstract
Dietary polyamines have recently been associated with increased risk of pre-malignant colorectal lesions. Because polyamines are synthesized in cells and taken up from dietary sources, development of a biomarker of exposure is challenging. Excess polyamines are primarily excreted in the urine. This pilot study seeks to identify dietary correlates of excreted urinary polyamines as putative biomarkers of exposure. Dietary polyamines/other nutrients were estimated from a food frequency questionnaire (FFQ) and correlated with urinary levels of acetylated polyamines in 36 men using 24-h urine samples. Polyamines, abundant in cheese and citrus, were highly positively correlated with urinary N(8)-acetylspermidine (correlation coefficient; r = 0.37, P = 0.03), but this correlation was attenuated after adjustment for total energy intake (r = 0.07, P = 0.68). Dietary energy intake itself was positively correlated with urinary total acetylated polyamine output (r = .40, P = 0.02). In energy-adjusted analyses, folic acid and folate from food were associated with urinary N(1),N(12)-diacetylspermine (r = 0.34, P = 0.05 and r = -0.39, P = 0.02, respectively). Red meat negatively correlated with total urinary acetylated polyamines (r = -0.42, P = 0.01). Our findings suggest that energy, folate, folic acid, saturated fat, and red meat intake, as opposed to FFQ-estimated dietary polyamines, are correlated with urinary polyamines.
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Affiliation(s)
- Ashley J Vargas
- a Department of Nutritional Sciences , University of Arizona , Tucson , Arizona , USA
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Abstract
Diet and nutrition are estimated to explain as much as 30%-50% of the worldwide incidence of colorectal cancer. In 2007, the World Cancer Research Fund (WCRF), in conjunction with the American Institute for Cancer Research (AICR), released the second expert report that summarizes the current scientific evidence linking diet to the prevention of cancer. This text provides an expert summary and level of evidence of the research relating diet/nutrients to factors that influence cancers of multiple organs, including colon and rectum, with an important emphasis on global patterns. Specific examples include dietary fat, red and processed meat, and dairy, as well effects of nutrients such as calcium, folate, and vitamin D. Evidence is obtained from ongoing systematic literature reviews conducted by experts in both the United States and Europe. The expert panel applies standard practices to evaluate the strength and quality of individual studies to draw summary conclusions. In 2011, the report was updated to include findings from a series of meta-analyses published in 2010. To complement the WCRF/AICR report, the authors review the evidence favoring the role for diet and nutrition in the etiology of colorectal cancer. Specifically, they have integrated information gained from more recent meta-analyses and high-quality, prospective study findings, some of which have been included in the 2011 updated WCRF/AICR summary.
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Affiliation(s)
- Ashley J Vargas
- Department of Nutritional Sciences, University of Arizona Cancer Center, Tucson, Arizona, USA
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Vargas AJ, Wertheim BC, Gerner EW, Thomson CA, Rock CL, Thompson PA. Dietary polyamine intake and risk of colorectal adenomatous polyps. Am J Clin Nutr 2012; 96:133-41. [PMID: 22648715 PMCID: PMC3374737 DOI: 10.3945/ajcn.111.030353] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Putrescine, spermidine, and spermine are the polyamines required for human cell growth. The inhibition of ornithine decarboxylase (ODC), which is the rate-limiting enzyme of polyamine biosynthesis, decreases tumor growth and the development of colorectal adenomas. A database was developed to estimate dietary polyamine exposure and relate exposure to health outcomes. OBJECTIVE We hypothesized that high polyamine intake would increase risk of colorectal adenoma and that the allelic variation at ODC G>A +316 would modify the association. DESIGN Polyamine exposure was estimated in subjects pooled (n = 1164) from the control arms of 2 randomized trials for colorectal adenoma prevention [Wheat Bran Fiber low-fiber diet arm (n = 585) and Ursodeoxycholic Acid placebo arm (n = 579)] by using baseline food-frequency questionnaire data. All subjects had to have a diagnosis of colorectal adenoma to be eligible for the trial. RESULTS A dietary intake of polyamines above the median amount in the study population was associated with 39% increased risk of colorectal adenoma at follow-up (adjusted OR: 1.39; 95% CI: 1.06, 1.83) in the pooled sample. In addition, younger participants (OR: 1.94; 95% CI: 1.23, 3.08), women (OR: 2.43; 95% CI: 1.48, 4.00), and ODC GG genotype carriers (OR: 1.59; 95% CI: 1.00, 2.53) had significantly increased odds of colorectal adenoma if they consumed above-median polyamine amounts. CONCLUSIONS This study showed a role for dietary polyamines in colorectal adenoma risk. Corroboration of these findings would confirm a previously unrecognized, modifiable dietary risk factor for colorectal adenoma.
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Affiliation(s)
- Ashley J Vargas
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA.
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Abstract
Quercetin is a unique dietary polyphenol because it can exert biphasic dose-responses on cells depending on its concentration. Cancer preventative effects of quercetin are observed at concentrations of approximately 1-40 microM and are likely mediated by quercetin's antioxidant properties. Pro-oxidant effects are present at cellular concentrations of 40-100 microM. However, at higher concentrations, many novel pathways in addition to ROS contribute to its effects. The potent bioactivity of quercetin has led to vigorous study of this compound and revealed numerous pathways that could interact synergistically to prevent or treat cancer. The effect of intake and concentration on emerging pathways and how they may interact are discussed in this review.
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Affiliation(s)
- Ashley J Vargas
- Department of Nutritional Sciences at the University of Arizona, Tucson, Arizona 85721, USA
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Vargas AJ, Geremias DS, Provensi G, Fornari PE, Reginatto FH, Gosmann G, Schenkel EP, Fröde TS. Passiflora alata and Passiflora edulis spray-dried aqueous extracts inhibit inflammation in mouse model of pleurisy. Fitoterapia 2007; 78:112-9. [PMID: 17215089 DOI: 10.1016/j.fitote.2006.09.030] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2004] [Accepted: 09/27/2006] [Indexed: 11/18/2022]
Abstract
The aqueous leaves extracts of Passiflora alata (100-300 mg/kg, i.p.) and Passiflora edulis (100-1000 mg/kg, i.p.) possess a significant antiinflammatory activity on carrageenan-induced pleurisy in mice. Treatment with the extracts inhibited leukocyte migration and reduced the formation of exudate. Moreover, a significant inhibition of myeloperoxidase and adenosine-deaminase activities was observed at the doses tested (100 or 250 mg/kg, i.p.). At the same doses, a significant decrease of serum C-reactive protein was observed.
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Affiliation(s)
- A J Vargas
- Departamento de Análises Clínicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Campus Universitário-Trindade, 88040-970, Florianópolis, SC, Brazil
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