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Sood V, Alam S, Nagral A, Srivastava A, Deshmukh A, Bavdekar A, Acharyya BC, Geetha SM, Gupte G, Bhatia I, Tiwari K, Bharadia L, Sathiyasekaran M, Kaur P, Khanna R, Shrivastava R, Poyekar S, Pandey S, Ramakrishna SH, Kinjawadekar U, Borkar V, Sivaramakrishnan VM, Kohli R, Matthai J, Dhawan A. Practice Recommendations for Metabolic Dysfunction-Associated Steatotic Liver Disease by the Indian Society of Pediatric Gastroenterology, Hepatology and Nutrition (ISPGHAN). Indian Pediatr 2024; 61:919-934. [PMID: 39297398 DOI: 10.1007/s13312-024-3290-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Accepted: 09/03/2024] [Indexed: 01/06/2025]
Abstract
JUSTIFICATION There has been an alarming increase in metabolic dysfunction-associated steatotic liver disease (MASLD) and it is now the most common chronic liver disease worldwide, in both adult and pediatric populations. The lack of regional guidelines has hampered the formulation of national policies for prevention and management of MASLD in children. Therefore, we formulated recommendations for steatotic liver disease in children. OBJECTIVES To review the existing literature on the burden and epidemiology of pediatric MASLD and formulate recommendations for diagnostic evaluation, prevention, and management strategies. PROCESS The Indian Society of Pediatric Gastroenterology, Hepatology, and Nutrition invited national and international stakeholders to participate in a consensus meeting held on April 20, 2024, in Mumbai, Maharashtra, India. Various aspects of pediatric steatotic liver disease were deliberated upon and a consensus document and recommendations were formulated after several rounds of discussion. RECOMMENDATIONS Metabolic dysfunction-associated steatotic liver disease (MASLD) should be used as the preferred term in place of non-alcoholic fatty liver disease (NAFLD). There is a high prevalence of steatotic liver disease (SLD) among Indian children and adolescents, especially those who are overweight or obese. This condition may be progressive in childhood and associated with increased morbidity and mortality in adulthood. Various lifestyle, dietary, and genetic factors may predispose individuals to MASLD, including an increased intake of calorie-dense processed foods, sweetened sugar beverages, excessive screen time, higher sedentary time and lack of moderate to vigorous physical activity. MASLD is usually asymptomatic or presents with mild, non-specific symptoms and therefore, a high degree of suspicion is required for early diagnosis. MASLD is usually associated with cardiometabolic factors (hypertension, insulin resistance/diabetes mellitus, and/or dyslipidemia) and secondary causes should be excluded in all cases, particularly in the presence of red flag signs. Screening for MASLD should be considered in all obese children (body mass index or BMI ≥95th percentile) and in all overweight children (BMI ≥ 85th and <95thpercentile) with additional risk factors, such as prediabetes/diabetes, dyslipidemia, positive family history of metabolic syndrome, obstructive sleep apnea, and hypopituitarism. Abdominal ultrasound in combination with alanine aminotransferase (ALT) levels should be used as a screening test for MASLD in Indian children as per the proposed algorithm. Diet (any hypocaloric diet) and exercise (aerobic, resistance, or a combination of both; moderate to high intensity; regular in frequency) remain the cornerstones of pediatric MASLD management. Pharmacotherapy and/or endoscopic/surgical techniques for obesity should be considered as adjuncts and should be considered only after a failed adequate trial of lifestyle modifications.
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Affiliation(s)
- Vikrant Sood
- Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Seema Alam
- Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India. Correspondence to: Dr Seema Alam, Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
| | - Aabha Nagral
- Department of Gastroenterology, Jaslok Hospital and Research Center and Apollo Hospital, Mumbai, Maharashtra, India
| | - Anshu Srivastava
- Department of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Aniket Deshmukh
- Department of Pediatric Hepatology and Liver Transplant, Gleneagles Hospital, Mumbai, Maharashtra, India
| | - Ashish Bavdekar
- Department of Pediatrics, KEM Hospital and Research Centre, Pune, Maharashtra, India
| | - Bhaswati C Acharyya
- Department of Pediatric Hepatology and Gastroenterology, Institute of Child Health, Kolkata, West Bengal, India
| | - S M Geetha
- Department of Pediatric Gastroenterology, Aster Medcity, Kochi, Kerala, India
| | - Girish Gupte
- Liver Unit (Including Small Bowel Transplantation), Birmingham Women's and Children's Hospital, Birmingham, UK
| | - Ishitaa Bhatia
- Department of Nutrition, The Nutrition Project and Wellfed Children's Nutrition Clinic, Mumbai, Maharashtra, India
| | - Kritika Tiwari
- Department of Pediatrics and Adolescent Medicine, Matushree Gomati Hospital, Mumbai, Maharashtra, India
| | - Lalit Bharadia
- Department of Pediatric Gastroenterology, Neoclinic Children Hospital, Jaipur, Rajasthan, India
| | - Malathi Sathiyasekaran
- Department of Pediatric Gastroenterology, Rainbow Children's Hospital, Chennai, Tamil Nadu, India
| | - Prabhsaran Kaur
- Department of Pediatrics, Seth G.S Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Rajeev Khanna
- Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rimjhim Shrivastava
- Pediatric Gastroenterology and Hepatology Clinic, Raipur, Chhattisgarh, India
| | - Samriddhi Poyekar
- Department of Gastroenterology, Jagjivan Ram Hospital, Mumbai, Maharashtra, India
| | - Snehavardhan Pandey
- Department of Pediatric Hepatology and Liver Transplantation, Sahyadri Superspeciality Hospital Pvt Ltd, Pune, Maharashtra, India
| | | | - Upendra Kinjawadekar
- Department of Pediatrics, Kamlesh Mother and Child Hospital, Nerul, Navi Mumbai, Maharashtra, India
| | - Vibhor Borkar
- Department of Pediatric Hepatology and Gastroenterology, Nanavati Max Super Specialty Hospital, Mumbai, Maharashtra, India
| | | | - Rohit Kohli
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - John Matthai
- Department of Pediatrics, Masonic Medical Centre for Children, Coimbatore, Tamil Nadu, India
| | - Anil Dhawan
- Pediatric Liver, GI and Nutrition Centre, and Mowat Labs, King's College Hospital, London, UK
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Jannati N, Mohammadi-Faez R, Mahmoodi MR, Azadbakht L. Association between quality and quantity of carbohydrate intake with selected anthropometric indices among primary school girls in Kerman city, Iran: a cross-sectional study. BMC Pediatr 2024; 24:267. [PMID: 38658854 PMCID: PMC11040773 DOI: 10.1186/s12887-024-04739-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/04/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND The school-age is a crucial period of physical and cognitive growth, which requires an assessment of dietary intake and its influence on body weight and height. This study aims to determine the association between the quality and quantity of carbohydrate intake with selected anthropometric indices in primary school girls in Kerman City, Iran. METHODS This cross-sectional study was conducted on 330 primary school girls ages 6-12 years in Kerman. We used a validated and reliable dish-based 185-item food frequency questionnaire to evaluate people's food intake. We assessed the amount of carbohydrates in children's diets as the percentage of daily calories and grams per day. We used dietary fiber intake (grams/day), the glycemic load, the ratio of whole grain to total grain, and the ratio of solid carbohydrates to total carbohydrates to assess carbohydrate quality. Height, weight, and arm circumference were measured. We calculated body mass index (BMI) by dividing the weight in kilograms by the height in centimeters squared. We used the World Health Organization z-scores charts for girls 5 to 19 years old to assess z-scores for BMI-for-age (BAZ), height-for-age (HAZ), and weight-for-age (WAZ). Socioeconomic status and physical activity were assessed. We used ANOVA and ANCOVA statistical tests to assess the association between anthropometric indices and carbohydrate quantity and quality parameters. RESULTS Participants with the highest amount of carbohydrate intake had significantly higher anthropometric indices, including arm circumference, BMI-for-age z score (BAZ), and Height-for-age z score (HAZ) (p < 0.001, p < 0.001, and p = 0.009, respectively). With the increase in glycemic load (GL) and dietary fiber intake, anthropometric indices including arm circumference (GL: p < 0.001, Fiber: p < 0.001), BAZ (GL: p < 0.001, Fiber: P < 0.001), and HAZ (GL: P = 0.009, Fiber: p < 0.001) increased significantly. CONCLUSIONS We concluded that there was a positive association between the amount of carbohydrate intake and anthropometric indices (MUAC, BAZ, and HAZ). Also, with the increase in glycemic load and dietary fiber intake, the anthropometric indices including MUAC, BAZ, and HAZ increased.
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Affiliation(s)
- Nooshin Jannati
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Reyhaneh Mohammadi-Faez
- Department of Nutrition, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Mahmoodi
- Physiology Research Center, Institute of Neuropharmacology & Department of Nutrition, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran.
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Mohebati S, Shakeri M, Ranjbar S, Jalali M, Nouri M, Faghih S. The association of dietary carbohydrate quality and quantity with obesity among Iranian adolescents: a case-control study. BMC Pediatr 2024; 24:176. [PMID: 38461264 PMCID: PMC10924309 DOI: 10.1186/s12887-024-04671-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 02/24/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND Adolescent obesity is considered as a major health concern worldwide which is closely linked to the quality of diet. The purpose of the present study was to assess the carbohydrate quality and quantity in relation to odds of overweight and obesity in adolescents. METHODS This case-control study with a 1:1 ratio was conducted on 406 adolescents (14 to 18 years old) matched for age and gender. Participants were selected by multistage cluster random sampling method from March to October 2019 in Shiraz, Iran. Dietary intakes of the study population were assessed by a validated semi-quantitative food frequency questionnaire. Also anthropometric indices were measured using standard methods and demographic information was recorded via face to face interview. The relation between low carbohydrate diet score (LCDS) and carbohydrate quality index (CQI), and odds of obesity was evaluated by multiple Logistic regression. RESULTS After adjusting the role of potential confounders, the participants in the third tertiles of LCDS (OR = 0.443, 95% CI = (0.260 to 0.755)) and CQI (OR = 0.005, 95% CI = (0.001 to 0.025)) had less odds of being overweight and obese compared to the first tertile. CONCLUSION The present study found an inverse relationship between dietary quantity and quality of carbohydrate intake and the odds of overweight and obesity in a sample of Iranian adolescents.
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Affiliation(s)
- Shabnam Mohebati
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahboobeh Shakeri
- Endoocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sara Ranjbar
- Department of Nutritional sciences, Texas Tech University, Lubbock, TX, USA
| | - Mohammad Jalali
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehran Nouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Iatcu CO, Gal AM, Covasa M. Dietary Patterns of Patients with Prediabetes and Type 2 Diabetes. Metabolites 2023; 13:metabo13040532. [PMID: 37110190 PMCID: PMC10142065 DOI: 10.3390/metabo13040532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/30/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
Given the worldwide high prevalence of type 2 diabetes, the prevention and control of this disease has become an urgent priority. In this research, we report the results from a cross-sectional study conducted in the counties of Suceava and Iasi, northeast of Romania, on 587 patients with type 2 diabetes and 264 patients with prediabetes. By employing a factor analysis (principal component) on 14 food groups followed by varimax orthogonal rotation, three dietary patterns were identified for each group. In prediabetes, a low adherence to a specific dietary pattern (1 and 2) was associated with lower fasting plasma glucose, blood pressure and serum insulin, compared to increased adherence. In patients with diabetes, a low adherence to Pattern 1 was associated with lower systolic blood pressures, while a low adherence to Pattern 3 was associated with a lower HbA1c, compared to high adherence. Statistically significant differences between the groups were observed for fats and oils, fish and fish products, fruit, potatoes, sugars, preserves and snacks intake. The study demonstrated that certain food patterns are associated with increased blood pressure, fasting blood glucose and serum insulin.
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Affiliation(s)
- Camelia Oana Iatcu
- College of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- College of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Ana-Maria Gal
- College of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- College of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Mihai Covasa
- College of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA 91766, USA
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Triffoni-Melo ADT, Castro MD, Jordão AA, Leandro-Merhi VA, Dick-DE-Paula I, Diez-Garcia RW. HIGH-FIBER DIET PROMOTES METABOLIC, HORMONAL, AND SATIETY EFFECTS IN OBESE WOMEN ON A SHORT-TERM CALORIC RESTRICTION. ARQUIVOS DE GASTROENTEROLOGIA 2023; 60:163-171. [PMID: 37556741 DOI: 10.1590/s0004-2803.202302022-96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 12/08/2022] [Indexed: 08/11/2023]
Abstract
•Body weight and BMI decrease in both the EG and CG groups during the period of caloric restriction. •For both the EG and CG groups, fat-free mass decreases during food restriction. •Subjects on a high-fiber diet have reduced fasting glucose and basal insulin as well as improved insulin resistance, as attested by the lower HOMA-IR index. •Obese women on a high-fiber diet have suppressed postprandial (after 60 min) acylated ghrelin, confirming that the diet composition influences ghrelin levels from the first day. •In the present study, it was possible to verify that fasting leptin concentration diminishes in obese women on a high-fiber diet. Background - Several mechanisms, including excessive hunger, account for patients' difficulties in maintaining weight loss and dietary changes after caloric restriction. Objective - To evaluate the effect of short-term high-fiber calorie-restricted diet in appetite-regulating hormones, and hunger and satiety sensations in women with obesity. In a randomized controlled trial study, thirty women with body mass index (BMI) higher than 30 kg/m2, and aged from 20 to 50 years were hospitalized following a calorie-restricted diet (1000 kcal/day) for three days. The experimental group (n=15) received high-fiber diet and the control group (n=15), conventional diet. Results - Body weight, BMI, resting energy expenditure (REE), acylated and total ghrelin, leptin, insulin and glucose, and hunger and satiety sensations were evaluated. Linear regression models with mixed effects (fixed and random effects) helped to assess the variables between the two groups and within the groups. Body weight and BMI decreased in both the experimental and control groups (P<0.001). After the high-fiber diet, postprandial acylated ghrelin (P=0.04), glucose (P<0.001), insulin (P=0.04), and leptin (P=0.03) levels as well as the HOMA-IR index (P=0.01) decreased, whereas satiety improved (P=0.02). Obese women that followed the conventional diet had increased body fat percentage (P=0.04) and lower REE (P=0.02). The two diets did not differ in terms of hunger sensation. Conclusion - A short-term high-fiber diet improves satiety sensations and metabolic parameters while suppressing postprandial acylated ghrelin (60 minutes) and maintaining the resting energy expenditure.
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Affiliation(s)
| | - Margaret de Castro
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Clínica Médica - Endocrinologia, Ribeirão Preto, SP, Brasil
| | - Alceu Afonso Jordão
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Ciências da Saúde - Nutrição e Metabolismo, Ribeirão Preto, SP, Brasil
| | | | - Ingrid Dick-DE-Paula
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Rosa Wanda Diez-Garcia
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Departamento de Ciências da Saúde - Nutrição e Metabolismo, Ribeirão Preto, SP, Brasil
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Sun Y, Zhang J, Zhang H, Hou H. Effects of long-term intake of whole wheat and aleurone-enriched Chinese steamed bread on gut microbiome and liver metabolome in mice fed high-fat diet. J Cereal Sci 2023. [DOI: 10.1016/j.jcs.2022.103614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Chopp-Hurley JN, Wiebenga EG, Keller HH, Maly MR. Nutrition risk, physical activity and fibre intake are associated with body composition in OA: analysis of the Canadian Longitudinal Study on Aging. BMJ Nutr Prev Health 2022; 5:191-200. [PMID: 36619336 PMCID: PMC9813624 DOI: 10.1136/bmjnph-2021-000319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 05/31/2022] [Indexed: 01/11/2023] Open
Abstract
Objective Sarcopenic obesity is a key feature in osteoarthritis (OA). While ideal OA treatment involves physical activity and diet, how diet influences OA pathophysiology is unclear. We explored the associations between diet, nutrition risk and physical activity with body composition in older adults with OA. Methods Baseline data from the Canadian Longitudinal Study on Aging data set were analysed. Participants with hip, knee, hand or multiple forms of OA were included in this cross-sectional analysis. Body composition measures (lean, fat and total masses (kg) and body fat percentage) were separate dependent variables. Regression analyses were conducted to explore associations between body composition with dietary intake (high calorie snack, fibre), nutrition risk (SCREEN II) and physical activity (Physical Activity Scale for the Elderly). Results 1596 participants were 66.5 (9.0) years old with a body mass index of 28.2 (5.3) kg/m2. Higher fibre cereal intake was associated with higher lean mass (unstandardised beta coefficient 0.5 (0.1, 0.9), p=0.02) and lower body fat percentage (-0.3 (-0.6, 0.0), p=0.046). Lower nutrition risk was associated with higher lean mass (0.1 (0.0, 0.1), p=0.03), lower fat mass (-0.05 (-0.1, 0.0), p=0.009) and lower body fat percentage (-0.1 (-0.1, 0.0), p<0.001). Higher physical activity was associated with higher lean mass (0.01 (0.01, 0.02), p<0.001), lower fat mass (-0.01 (0.0, 0.0), p=0.005) and lower body fat percentage (-0.01 (0.0, 0.0), p<0.001). Conclusion Greater physical activity and lower nutrition risk were associated with better body composition. While fibre intake was also associated body composition, the CIs were wide suggesting weak associations.
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Affiliation(s)
- Jaclyn N Chopp-Hurley
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Emily G Wiebenga
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Heather H Keller
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada,Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada
| | - Monica R Maly
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada,Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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The contribution of intact structure and food processing to functionality of plant cell wall-derived dietary fiber. Food Hydrocoll 2022. [DOI: 10.1016/j.foodhyd.2022.107511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Garutti M, Nevola G, Mazzeo R, Cucciniello L, Totaro F, Bertuzzi CA, Caccialanza R, Pedrazzoli P, Puglisi F. The Impact of Cereal Grain Composition on the Health and Disease Outcomes. Front Nutr 2022; 9:888974. [PMID: 35711559 PMCID: PMC9196906 DOI: 10.3389/fnut.2022.888974] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/26/2022] [Indexed: 12/21/2022] Open
Abstract
Whole grains are a pivotal food category for the human diet and represent an invaluable source of carbohydrates, proteins, fibers, phytocompunds, minerals, and vitamins. Many studies have shown that the consumption of whole grains is linked to a reduced risk of cancer, cardiovascular diseases, and type 2 diabetes and other chronic diseases. However, several of their positive health effects seem to disappear when grains are consumed in the refined form. Herein we review the available literature on whole grains with a focus on molecular composition and health benefits on many chronic diseases with the aim to offer an updated and pragmatic reference for physicians and nutrition professionals.
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Affiliation(s)
- Mattia Garutti
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Gerardo Nevola
- Department of Anaesthesia and Intensive Care - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Roberta Mazzeo
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Linda Cucciniello
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Fabiana Totaro
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Carlos Alejandro Bertuzzi
- Department of Anaesthesia and Intensive Care - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - Paolo Pedrazzoli
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Fabio Puglisi
- Department of Medical Oncology - CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
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Defining whole-grain foods - does it change estimations of intakes and associations with CVD risk factors: an Australian and Swedish perspective. Br J Nutr 2021; 126:1725-1736. [PMID: 33526150 DOI: 10.1017/s0007114521000453] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Historically, there are inconsistencies in the calculation of whole-grain intake, particularly through use of highly variable whole-grain food definitions. The current study aimed to determine the impact of using a whole-grain food definition on whole-grain intake estimation in Australian and Swedish national cohorts and investigate impacts on apparent associations with CVD risk factors. This utilised the Australian National Nutrition and Physical Activity Survey 2011-2012, the Swedish Riksmaten adults 2010-2011 and relevant food composition databases. Whole-grain intakes and associations with CVD risk factors were determined based on consumption of foods complying with the Healthgrain definition (≥30 % whole grain (dry weight), more whole than refined grain and meeting accepted standards for 'healthy foods' based on local regulations) and compared with absolute whole-grain intake. Compliance of whole-grain containing foods with the Healthgrain definition was low in both Sweden (twenty-nine of 155 foods) and Australia (214 of 609 foods). Significant mean differences of up to 24·6 g/10 MJ per d of whole-grain intake were highlighted using Swedish data. Despite these large differences, application of a whole-grain food definition altered very few associations with CVD risk factors, specifically, changes with body weight and blood glucose associations in Australian adults where a whole-grain food definition was applied, and some anthropometric measures in Swedish data where a high percentage of whole-grain content was included. Use of whole-grain food definitions appears to have limited impact on measuring whole-grain health benefits but may have greater relevance in public health messaging.
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Sawicki CM, Jacques PF, Lichtenstein AH, Rogers GT, Ma J, Saltzman E, McKeown NM. Whole- and Refined-Grain Consumption and Longitudinal Changes in Cardiometabolic Risk Factors in the Framingham Offspring Cohort. J Nutr 2021; 151:2790-2799. [PMID: 34255848 PMCID: PMC8417925 DOI: 10.1093/jn/nxab177] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/20/2021] [Accepted: 05/11/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Greater whole grain (WG) consumption is associated with reduced risk of cardiovascular disease (CVD); however, few prospective studies have examined WG or refined grain (RG) intake and intermediate cardiometabolic risk factors. OBJECTIVES We examined the longitudinal association between WG and RG intake on changes in waist circumference (WC); fasting HDL cholesterol, triglyceride, and glucose concentrations; and blood pressure. METHODS Subjects were participants in the Framingham Offspring cohort study [n = 3121; mean ± SD baseline age: 54.9 ± 0.2 y; BMI (kg/m2) 27.2 ± 0.1]. FFQ, health, and lifestyle data were collected approximately every 4 y over a median 18-y follow-up. Repeated measure mixed models were used to estimate adjusted mean changes per 4-y interval in risk factors across increasing categories of WG or RG intake. RESULTS Greater WG intake was associated with smaller increases in WC (1.4 ± 0.2 compared with 3.0 ± 0.1 cm in the highest compared with the lowest category, respectively; P-trend < 0.001), fasting glucose concentration (0.7 ± 0.4 compared with 2.6 ± 0.2 mg/dL; P-trend < 0.001), and systolic blood pressure (SBP; 0.2 ± 0.5 compared with 1.4 ± 0.3 mm Hg; P-trend < 0.001) per 4-y interval. When stratified by sex, a stronger association with WC was observed among females than males. Higher intake of WG was associated with greater increases in HDL cholesterol and declines in triglyceride concentrations; however, these differences did not remain significant after adjustment for change in WC. Conversely, greater RG intake was associated with greater increases in WC (2.7 ± 0.2 compared with 1.8 ± 0.1 cm, P-trend < 0.001) and less decline in triglyceride concentration (-0.3 ± 1.3 compared with -7.0 ± 0.7 mg/dL, P-trend < 0.001). CONCLUSIONS Among middle- to older-age adults, replacing RG with WG may be an effective dietary modification to attenuate abdominal adiposity, dyslipidemia, and hyperglycemia over time, thereby reducing the risk of cardiometabolic diseases.
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Affiliation(s)
- Caleigh M Sawicki
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Paul F Jacques
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Alice H Lichtenstein
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Gail T Rogers
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston MA, USA
| | - Jiantao Ma
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Edward Saltzman
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Nicola M McKeown
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston MA, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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12
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Gaesser GA. Whole grain intake and pancreatic cancer risk. Hepatobiliary Surg Nutr 2021; 10:530-533. [PMID: 34430536 DOI: 10.21037/hbsn-21-221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/25/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Glenn A Gaesser
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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13
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Guo H, Ding J, Liang J, Zhang Y. Associations of Whole Grain and Refined Grain Consumption With Metabolic Syndrome. A Meta-Analysis of Observational Studies. Front Nutr 2021; 8:695620. [PMID: 34277690 PMCID: PMC8280517 DOI: 10.3389/fnut.2021.695620] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/07/2021] [Indexed: 12/26/2022] Open
Abstract
Background: The associations of whole grain and refined grain consumption with metabolic syndrome (MetS) has been evaluated in several epidemiological studies with conflicting results. This meta-analysis was therefore employed to further investigate the above associations. Method: We searched the PubMed, Web of Science and Embase database until March 2021 (without restriction for inclusion time), for observational studies on the associations of whole grain and refined grain consumption with MetS. The pooled relative risk (RR) of MetS for the highest vs. lowest category of whole grain and refined grain consumption, as well as their corresponding 95% confidence interval (CI) were calculated. Results: A total of 14 observational studies, which involved seven cross-sectional and seven prospective cohort studies, were identified. Specifically, nine studies were related to whole grain consumption, and the overall multi-variable adjusted RR demonstrated that the whole grain consumption was inversely associated with MetS (RR = 0.80, 95%CI: 0.67-0.97; P = 0.021). With regard to refined grain consumption, 13 studies were included. The overall multi-variable adjusted RR indicated that refined grain consumption was positively associated with MetS (RR = 1.37, 95%CI: 1.02-1.84; P = 0.036). Conclusions: The existing evidence suggests that whole grain consumption is negatively associated with MetS, whereas refined grain consumption is positively associated with MetS. Our result might be helpful to better consider the diet effect on MetS. However, more well-designed prospective cohort studies are needed to elaborate the concerned issues further.
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Affiliation(s)
- Hongbin Guo
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Jun Ding
- Changsha Social Work College, Changsha, China
| | - Jieyu Liang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Yi Zhang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
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14
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Comparison of Indices of Carbohydrate Quality and Food Sources of Dietary Fiber on Longitudinal Changes in Waist Circumference in the Framingham Offspring Cohort. Nutrients 2021; 13:nu13030997. [PMID: 33808767 PMCID: PMC8003409 DOI: 10.3390/nu13030997] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 01/01/2023] Open
Abstract
The long-term impact of carbohydrate quality on abdominal weight gain is not fully understood. We aimed to examine the prospective relation of a carbohydrate quality index (CQI; defined by four criteria: dietary fiber, glycemic index, whole grain-to-total grain ratio, and solid-to-total carbohydrate ratio), total, cereal grain, vegetable, and fruit fiber, carbohydrate-to-total fiber ratio, and carbohydrate-to-cereal fiber ratio with changes in waist circumference (WC). Subjects were middle-aged to older, mostly white, participants in the Framingham Offspring cohort (n = 3101 subjects), with mean baseline age 54.9 ± 0.2 years (mean ± SE) and body mass index (BMI) 27.2 ± 0.1 kg/m2. Food frequency questionnaire (FFQ), health, and lifestyle data were collected approximately every four years over a median total follow-up of 18 years. Repeated measure mixed models were used to estimate adjusted mean change in WC per four-year interval across quartiles of carbohydrate variables. In the most adjusted model, a higher CQI was marginally associated with a smaller increase in WC (2.0 ± 0.1 vs. 2.4 ± 0.1 cm in highest vs. lowest quartile, p-trend = 0.04). Higher ratios of carbohydrate-to-fiber and carbohydrate-to-cereal fiber were associated with greater increases in WC per four-year interval (2.6 ± 0.1 vs. 2.0 ± 0.1 cm, p-trend < 0.001, and 2.5 ± 0.1 vs. 2.1 ± 0.1 cm in highest versus lowest categories, p-trend = 0.007, respectively); whereas higher intake of total fiber (1.8 ± 0.1 vs. 2.7 ± 0.1 cm, p-trend < 0.001), cereal fiber (2.0 ± 0.1 vs. 2.5 ± 0.1 cm, p-trend = 0.001), and fruit fiber (2.0 ± 0.1 vs. 2.7 ± 0.1 cm, p-trend < 0.001) were associated with smaller increases in WC compared to lower intakes. There was a significant interaction between total fiber and total carbohydrate (as % of total energy intake). After stratification, the association between fiber intake and change in WC was not maintained in the context of a high carbohydrate diet. Better carbohydrate quality, primarily higher fiber intake and lower carbohydrate-to-fiber ratios, may help attenuate increases in abdominal adiposity over time.
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15
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Whole Grains, Refined Grains, and Cancer Risk: A Systematic Review of Meta-Analyses of Observational Studies. Nutrients 2020; 12:nu12123756. [PMID: 33297391 PMCID: PMC7762239 DOI: 10.3390/nu12123756] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/21/2022] Open
Abstract
PubMed, Web of Science, and the Cochrane Database of Systematic Reviews were searched for meta-analyses that provided risk estimates (±95% confidence intervals) for associations between intakes of whole and refined grains and risk of total and site-specific cancer. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were followed. Only meta-analyses that included whole grains and refined grains as separate food groups, and not as part of dietary patterns, were included. A total of 17 publications were identified that met inclusion criteria. Within these, results from a total of 54 distinct meta-analyses were reported for whole grains and 5 meta-analyses for refined grains. For total cancer mortality, 7 meta-analyses of cohort studies indicated that whole grain intake was associated with 6% to 12% lower risk in comparison of highest vs. lowest intake groups, and 3% to 20% lower risk for doses ranging from 15 to 90 g/day. For site-specific cancers, meta-analyses indicated that whole grain intake was consistently associated with lower risks of colorectal, colon, gastric, pancreatic, and esophageal cancers. Limited data were available for refined grains, with only 4 publications providing risk estimates, and only 1 of the meta-analyses included more than 3 studies. High intake of refined grains was associated with increased risk of colon and gastric cancer. By contrast, in the only dose-response meta-analysis, each 90 g/day consumption of refined grains was associated with a 6% lower risk of total cancer. In addition to the limited number of published meta-analyses on refined grains, results were also weakened due to the fact that refined grains were frequently defined to include both staple grain foods and indulgent grain foods, and the majority of studies included in the meta-analyses provided no specific definition of refined grains. Overall, meta-analyses of cohort and case-control studies consistently demonstrate that whole grain intake is associated with lower risk of total and site-specific cancer, and support current dietary recommendations to increase whole grain consumption. By contrast, the relationship between refined grain intake and cancer risk is inconclusive.
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16
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Kissock KR, Neale EP, Beck EJ. Whole Grain Food Definition Effects on Determining Associations of Whole Grain Intake and Body Weight Changes: A Systematic Review. Adv Nutr 2020; 12:693-707. [PMID: 33070194 PMCID: PMC8166549 DOI: 10.1093/advances/nmaa122] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/21/2020] [Accepted: 09/04/2020] [Indexed: 02/06/2023] Open
Abstract
Within epidemiological and intervention studies, whole grain consumption has generally shown positive associations with reductions in markers of overweight and obesity. However, studies use varied methods of determining whole grain intake, including different definitions of a whole grain food, which may explain varied results. This systematic review aimed to identify how different methods of reporting and calculating whole grain intake, including whole grain food definitions, affect reported associations between whole grain intake and body weight measures in adults. Systematic searching of PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register for Controlled Trials (CENTRAL), and MEDLINE (all years to 11 June, 2020) identified eligible studies. Cohort and cross-sectional studies assessing whole grain intake and body weight measures in adults were included. Studies that did not specify methods used to calculate whole grain intake were excluded. Twenty-one cross-sectional studies (from 24 articles) and 9 prospective cohort studies (from 7 articles) were included in the review. Many cross-sectional studies showed whole grain intake was, to some degree, significantly associated with body weight measures, whereas associations varied greatly among cohort studies. Studies calculating whole grain intake using total grams of intake, USDA databases, or ≥25% whole grain in combination with listing specific foods, showed consistent beneficial effects of increasing whole grain intake on body weight. Studies with general lists of foods included as "whole grain foods" or lower cut-offs for whole grain content were inconsistent. The majority of studies reported whole grain intake as servings/day or grams whole grain/day. This review suggests that an association between whole grain and body weight measures remains likely, although precise associations are difficult to determine due to heterogeneity in methodologies and an inability to formally compare studies. Moving forward, application of a standardized methodology to calculate whole grain intake is essential.
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Affiliation(s)
| | - Elizabeth P Neale
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Eleanor J Beck
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
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17
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Papanikolaou Y, Slavin JL, Clemens R, Brenna JT, Hayes D, Gaesser GA, Fulgoni VL. Do Refined Grains Have a Place in a Healthy Dietary Pattern: Perspectives from an Expert Panel Consensus Meeting. Curr Dev Nutr 2020; 4:nzaa125. [PMID: 33062912 PMCID: PMC7538308 DOI: 10.1093/cdn/nzaa125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 06/17/2020] [Accepted: 07/14/2020] [Indexed: 11/14/2022] Open
Abstract
Although dietary guidance recommends increasing consumption of whole grains and concurrently limiting consumption of refined and/or enriched grain foods, emerging research suggests that certain refined grains may be part of a healthy dietary pattern. A scientific expert panel was convened to review published data since the release of 2015 dietary guidance in defined areas of grain research, which included nutrient intakes, diet quality, enrichment/fortification, and associations with weight-related outcomes. Based on a 1-d roundtable discussion, the expert panel reached consensus that 1) whole grains and refined grains can make meaningful nutrient contributions to dietary patterns, 2) whole and refined grain foods contribute nutrient density, 3) fortification and enrichment of grains remain vital in delivering nutrient adequacy in the American diet, 4) there is inconclusive scientific evidence that refined grain foods are linked to overweight and obesity, and 5) gaps exist in the scientific literature with regard to grain foods and health.
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Affiliation(s)
| | - Joanne L Slavin
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN, USA
| | - Roger Clemens
- USC School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - J Thomas Brenna
- Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | | | - Glenn A Gaesser
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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18
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Favari E, Angelino D, Cipollari E, Adorni MP, Zimetti F, Bernini F, Ronda N, Pellegrini N. Functional pasta consumption in healthy volunteers modulates ABCG1-mediated cholesterol efflux capacity of HDL. Nutr Metab Cardiovasc Dis 2020; 30:1768-1776. [PMID: 32605885 DOI: 10.1016/j.numecd.2020.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 04/17/2020] [Accepted: 05/05/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUNDS AND AIMS Prevention of cardiovascular (CV) disease is considered a central issue in public health and great attention is payed to nutritional approaches, including consumption of functional foods to reduce CV risk in individuals without indications for anti-atherosclerotic drugs. Cholesterol efflux capacity (CEC) is an important anti-atherogenic property of HDL and a marker of CV risk. We evaluated the effect of a daily consumption of an innovative whole-wheat synbiotic pasta, compared to a control whole-wheat pasta, on serum ATP binding cassette G1 (ABCG1)-mediated CEC in healthy overweight or obese individuals. METHODS AND RESULTS Study participants (n = 41) were randomly allocated to either innovative or control pasta, consumed daily for twelve weeks. Serum CEC was measured before and after the dietary intervention, by a well-established radioisotopic technique on Chinese Hamster Ovary Cells transfected with human ABCG1. The innovative synbiotic pasta consumption was associated to a significantly higher post treatment/baseline ratio of ABCG1-mediated CEC values with respect to control pasta (mean ratio 1.05 ± 0.037 and 0.95 ± 0.042 respectively, p < 0.05). Analysis of the relationship between ABCG1-mediated CEC and glycemia, homocysteine, total folates and interleukin-6 showed specific changes in the correlations between HDL function and glycemia, oxidative and inflammatory markers only after synbiotic pasta consumption. CONCLUSION This is the first report on serum CEC improvement obtained by a new synbiotic functional pasta consumption, in absence of lipid profile modifications, in overweight/obese participants. This pilot study suggests that a simple dietary intervention can be a promising approach to CV preservation through improving of athero-protective HDL function.
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Affiliation(s)
- Elda Favari
- Department of Food and Drug, University of Parma, Parma, Italy
| | - Donato Angelino
- Department of Food and Drug, University of Parma, Parma, Italy
| | | | | | | | - Franco Bernini
- Department of Food and Drug, University of Parma, Parma, Italy
| | - Nicoletta Ronda
- Department of Food and Drug, University of Parma, Parma, Italy.
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19
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Fuglsang-Nielsen R, Rakvaag E, Langdahl B, Knudsen KEB, Hartmann B, Holst JJ, Hermansen K, Gregersen S. Effects of whey protein and dietary fiber intake on insulin sensitivity, body composition, energy expenditure, blood pressure, and appetite in subjects with abdominal obesity. Eur J Clin Nutr 2020; 75:611-619. [PMID: 32948867 DOI: 10.1038/s41430-020-00759-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 08/12/2020] [Accepted: 09/08/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Recently, we demonstrated that whey protein (WP) combined with low dietary fiber improved lipemia, a risk factor for cardiovascular disease in subjects with abdominal obesity. In the present study, we investigated the effects of intake of WP and dietary fiber from enzyme-treated wheat bran on other metabolic parameters of the metabolic syndrome. METHODS The study was a 12-week, double-blind, randomized, controlled, parallel intervention study. We randomized 73 subjects with abdominal obesity to 1 of 4 iso-energetic dietary interventions: 60 g per day of either WP hydrolysate or maltodextrin (MD) combined with high-fiber (HiFi; 30 g dietary fiber/day) or low-fiber (LoFi; 10 g dietary fiber/day) cereal products. We assessed changes in insulin sensitivity, gut hormones (GLP-1, GLP-2, GIP, and peptide YY), body composition, 24-h BP, resting energy expenditure and respiratory exchange ratio (RER), and appetite. RESULTS Sixty-five subjects completed the trial. Subjective hunger ratings were lower after 12 weeks of WP compared with MD, independent of fiber content (P = 0.02). We found no effects on ratings of satiety, fullness or prospective food consumption for either of the interventions. Intake of WP combined with LoFi increased the postprandial peptide YY response. There were no effects of WP or fiber on insulin sensitivity, body composition, energy expenditure, incretins, or 24-h BP. CONCLUSIONS WP consumption for 12 weeks reduced subjective ratings of hunger in subjects with abdominal obesity. Neither WP nor dietary fiber from wheat bran affected insulin sensitivity, 24-h BP, gut hormone responses, body composition, or energy expenditure compared with MD and low dietary fiber.
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Affiliation(s)
- Rasmus Fuglsang-Nielsen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark. .,Department of Internal Medicine, Regional Hospital Horsens, Horsens, Denmark. .,Steno Diabetes Center Aarhus, Aarhus, Denmark.
| | - Elin Rakvaag
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.,Clinical Pharmacology, Novo Nordisk A/S, Søborg, Denmark
| | - Bente Langdahl
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | - Bolette Hartmann
- Novo Nordisk Foundation Center for Basic Metabolic Research, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Juul Holst
- Novo Nordisk Foundation Center for Basic Metabolic Research, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kjeld Hermansen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Søren Gregersen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.,Steno Diabetes Center Aarhus, Aarhus, Denmark
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20
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Flor-Alemany M, Marín-Jiménez N, Nestares T, Borges-Cosic M, Aranda P, Aparicio VA. Mediterranean diet, tobacco consumption and body composition during perimenopause. The FLAMENCO project. Maturitas 2020; 137:30-36. [PMID: 32498934 DOI: 10.1016/j.maturitas.2020.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 03/16/2020] [Accepted: 04/02/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To study the association of the adherence to the Mediterranean diet (MD) and tobacco consumption with body composition during perimenopause. STUDY DESIGN AND METHODS A cross-sectional study in 176 perimenopausal women from the FLAMENCO project. A food frequency questionnaire and the Mediterranean Diet Score were assessed. Body composition was measured using dual-energy X-ray absorptiometry. MAIN OUTCOMES MEASURES Body mass index (BMI), fat mass (FM), ratio of gynecoid to total fat mass (G/T), ratio of android to gynecoid fat mass (A/G), visceral adipose tissue (VAT) and waist circumference (WC). RESULTS Intake of whole-grain cereals was associated with lower WC, FM percentage, android FM, VAT and higher G/T (all p < 0.05). Intake of nuts was associated with lower BMI and FM percentage and intake of fruits with lower BMI, WC, total and android FM, FM percentage, A/G, VAT and higher G/T (all p < 0.05). Intake of pulses was associated with lower weight, BMI and android FM. Intake of whole dairy products was associated with lower weight, BMI, WC, total and android FM and VAT (all p < 0.05). Intake of olive oil was associated with lower WC and FM percentage (all p < 0.05). Intake of sweetened beverages was associated with higher weight, BMI, WC, FM percentage, android FM, VAT and total FM (all, p < 0.05). Smokers had a lower MD adherence (p < 0.05). Finally, a greater MD adherence was associated with higher G/T (p < 0.01) and lower A/G (p < 0.05). CONCLUSIONS A higher MD adherence, avoiding tobacco, an increased consumption of whole-grain cereals, nuts, fruits, pulses, whole dairy products and olive oil, and a lower consumption of sweetened beverages might contribute to a healthier body composition during perimenopause.
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Affiliation(s)
- M Flor-Alemany
- Department of Physiology, Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Spain; Sport and Health University Research Institute (IMUDS), Granada, Spain.
| | - N Marín-Jiménez
- Sport and Health University Research Institute (IMUDS), Granada, Spain; Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - T Nestares
- Department of Physiology, Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Spain
| | - M Borges-Cosic
- Sport and Health University Research Institute (IMUDS), Granada, Spain; Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - P Aranda
- Department of Physiology, Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Spain; Sport and Health University Research Institute (IMUDS), Granada, Spain
| | - V A Aparicio
- Department of Physiology, Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Spain; Sport and Health University Research Institute (IMUDS), Granada, Spain
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21
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Malinowski B, Fajardo Leighton RI, Hill CG, Szandorowski P, Wiciński M. Bioactive Compounds and Their Effect on Blood Pressure-A Review. Nutrients 2020; 12:E1659. [PMID: 32503160 PMCID: PMC7352988 DOI: 10.3390/nu12061659] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 12/14/2022] Open
Abstract
Elevated blood pressure affects a great part of the elderly population and is the leading risk factor for cardiovascular disease. New approaches have been taken in the fight against this growing problem, in the form of diets (Mediterranean, Dietary Approaches to Stop Hypertension (DASH) and intermittent fasting). Recent research has shown the promising results regarding diets and their effect on the prevention and improvement of elevated blood pressure. This review attempts to take this a step further, reviewing 26 studies in the search for dietary elements that may be causing this improvement. Although good evidence was found in favor of lycopene, Docosahexaenoic acid (DHA), fiber and anthocyanin, further evidence is needed before any conclusions can be made. In contrast, the evidence shows that licorice increases blood pressure.
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Affiliation(s)
- Bartosz Malinowski
- Department of Pharmacology and Therapeutics, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie 9, 85–090 Bydgoszcz, Poland; (R.I.F.L.); (C.G.H.); (P.S.); (M.W.)
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22
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Whole grain intake compared with cereal fibre intake in association to CVD risk factors: a cross-sectional analysis of the National Diet and Nutrition Survey (UK). Public Health Nutr 2020; 23:1392-1403. [DOI: 10.1017/s1368980019004221] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AbstractObjective:To investigate how intakes of whole grains and cereal fibre were associated to risk factors for CVD in UK adults.Design:Cross-sectional analyses examined associations between whole grain and cereal fibre intakes and adiposity measurements, serum lipid concentrations, C-reactive protein, systolic blood pressure, fasting glucose, HbA1c, homocysteine and a combined CVD relative risk score.Setting:The National Diet and Nutrition Survey (NDNS) Rolling Programme 2008–2014.Participants:A nationally representative sample of 2689 adults.Results:Participants in the highest quartile (Q4) of whole grain intake had lower waist–hip ratio (Q1 0·872; Q4 0·857; P = 0·04), HbA1c (Q1 5·66 %; Q4 5·47 %; P = 0·01) and homocysteine (Q1 9·95 µmol/l; Q4 8·76 µmol/l; P = 0·01) compared with participants in the lowest quartile (Q1), after adjusting for dietary and lifestyle factors, including cereal fibre intake. Whole grain intake was inversely associated with C-reactive protein using multivariate analysis (P = 0·02), but this was not significant after final adjustment for cereal fibre. Cereal fibre intake was also inversely associated with waist–hip ratio (P = 0·03) and homocysteine (P = 0·002) in multivariate analysis.Conclusions:Similar inverse associations between whole grain and cereal fibre intakes to CVD risk factors suggest the relevance of cereal fibre in the protective effects of whole grains. However, whole grain associations often remained significant after adjusting for cereal fibre intake, suggesting additional constituents may be relevant. Intervention studies are needed to compare cereal fibre intake from non-whole grain sources to whole grain intake.
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Suara SB, Siassi F, Saaka M, Rahimi Foroshani A, Sotoudeh G. Association between Carbohydrate Quality Index and general and abdominal obesity in women: a cross-sectional study from Ghana. BMJ Open 2019; 9:e033038. [PMID: 31874884 PMCID: PMC7008417 DOI: 10.1136/bmjopen-2019-033038] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES The relationships between carbohydrate intake and risk of obesity have been widely investigated. However, there are limited data on the associations between their relative proportions and quality contained in the same diet on risk of obesity, especially in low-income and middle-income countries. The aim of this study was to assess the relationship between an overall Carbohydrate Quality Index (CQI) and general and abdominal obesity in women. SETTING AND PARTICIPANTS In this cross-sectional study, data from 277 women in Ghana were analysed. Dietary information was obtained from 2-day 24 hours dietary recalls. CQI was calculated from the four indices dietary fibre, Glycaemic Index, whole grains/total grains ratio and solid carbohydrates/total carbohydrates ratio. OUTCOME MEASURES Body mass index, waist circumference (WC), waist-to-height ratio (WHtR) and Conicity Index were measured. RESULTS After adjusting for covariates, the chance for general obesity (OR 0.25, 95% CI 0.10 to 0.65) and abdominal obesity measured by WC (OR 0.22, 95% CI 0.08 to 0.58) were significantly lower in the topmost quintile of CQI in comparison with the lowest quintile. In addition, the OR for higher WHtR (OR 0.27, 95% CI 0.11 to 0.69) was significantly lower among participants in the fifth quintile of CQI compared with those in the first quintile. CONCLUSIONS The present study demonstrates that there is an inverse association between dietary CQI and both general and abdominal obesity. These findings suggest that CQI may be used for the improvement of dietary intake to prevent obesity.
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Affiliation(s)
- Sufyan Bakuri Suara
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, International College, Tehran University of Medical Sciences, Tehran, Iran, Tehran, Iran (the Islamic Republic of)
| | - Fereydoun Siassi
- Department of Community Nutrition, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Mahama Saaka
- Community Nutrition, University for Development Studies, Tamale, Ghana
| | - Abbas Rahimi Foroshani
- Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
| | - Gity Sotoudeh
- Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran, Iran (the Islamic Republic of)
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The Relationship between Whole Grain Intake and Body Weight: Results of Meta-Analyses of Observational Studies and Randomized Controlled Trials. Nutrients 2019; 11:nu11061245. [PMID: 31159235 PMCID: PMC6627338 DOI: 10.3390/nu11061245] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/16/2019] [Accepted: 05/27/2019] [Indexed: 12/11/2022] Open
Abstract
Results from some observational studies suggest that higher whole grain (WG) intake is associated with lower risk of weight gain. Ovid Medline was used to conduct a literature search for observational studies and randomized controlled trials (RCTs) assessing WG food intake and weight status in adults. A meta-regression analysis of cross-sectional data from 12 observational studies (136,834 subjects) and a meta-analysis of nine RCTs (973 subjects) was conducted; six prospective cohort publications were qualitatively reviewed. Cross-sectional data meta-regression results indicate a significant, inverse correlation between WG intake and body mass index (BMI): weighted slope, −0.0141 kg/m2 per g/day of WG intake (95% confidence interval (CI): −0.0207, −0.0077; r = −0.526, p = 0.0001). Prospective cohort results generally showed inverse associations between WG intake and weight change with typical follow-up periods of five to 20 years. RCT meta-analysis results show a nonsignificant pooled standardized effect size of −0.049 kg (95% CI −0.297, 0.199, p = 0.698) for mean difference in weight change (WG versus control interventions). Higher WG intake is significantly inversely associated with BMI in observational studies but not RCTs up to 16 weeks in length; RCTs with longer intervention periods are warranted.
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25
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Gaesser GA. Perspective: Refined Grains and Health: Genuine Risk, or Guilt by Association? Adv Nutr 2019; 10:361-371. [PMID: 30947337 PMCID: PMC6520038 DOI: 10.1093/advances/nmy104] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 10/24/2018] [Accepted: 11/01/2018] [Indexed: 01/07/2023] Open
Abstract
Refined grain intake is widely assumed to be associated with adverse health outcomes, including increased risk for cardiovascular disease (CVD), type 2 diabetes (T2D), and obesity. The 2015 Dietary Guidelines Advisory Committee recommended that to improve dietary quality, the US population should replace most refined grains with whole grains. This recommendation was based largely on results from studies that examined dietary patterns, not separate food groups. A Western dietary pattern typically includes red and processed meat, sugar-sweetened foods and beverages, French fries, and high-fat dairy products, as well as refined grains, and has been linked to increased risk of many chronic diseases. However, when evaluated as a distinct food category, 11 meta-analyses of prospective cohort studies, which included a total of 32 publications with data from 24 distinct cohorts, demonstrated that refined grain intake was not associated with all-cause mortality, T2D, CVD, coronary heart disease (CHD), stroke, hypertension, or cancer. By contrast, consumption of red and processed meat was consistently associated with increased risk of these same health outcomes. Refined grain consumption up to 6-7 servings/d (1 serving = 30 g) was not associated with higher risk of CHD, T2D, hypertension, or all-cause mortality. Moreover, total grain intake was not associated with risk of CVD, CHD, stroke, or cancer, but was associated with lower risk of all-cause mortality. Consequently, the recommendation to reduce refined grain intake based on results from studies linking a Western dietary pattern to numerous adverse health outcomes is contrary to a substantial body of published scientific evidence. Future research needs to better define refined grain intake to distinguish between staple grain foods and indulgent grain foods, and to better design randomized controlled trials to resolve discrepancies between results from observational studies and such trials with regard to determining the benefits of whole grains compared with refined grains.
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Affiliation(s)
- Glenn A Gaesser
- College of Health Solutions, Arizona State University, Phoenix, AZ,Address correspondence to GAG (e-mail: )
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26
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Abstract
Whole grain intake is associated with lower CVD risk in epidemiological studies. It is unclear to what extent cereal fibre, located primarily within the bran, is responsible. This review aimed to evaluate association between intake of whole grain, cereal fibre and bran and CVD risk. Academic databases were searched for human studies published before March 2018. Observational studies reporting whole grain and cereal fibre or bran intake in association with any CVD-related outcome were included. Studies were separated into those defining whole grain using a recognised definition (containing the bran, germ and endosperm in their natural proportions) (three studies, seven publications) and those using an alternative definition, such as including added bran as a whole grain source (eight additional studies, thirteen publications). Intake of whole grain, cereal fibre and bran were similarly associated with lower risk of CVD-related outcomes. Within the initial analysis, where studies used the recognised whole grain definition, results were less likely to show attenuation after adjustment for cereal fibre content. The fibre component of grain foods appears to play an important role in protective effects of whole grains. Adjusting for fibre content, associations remained, suggesting that additional components within the whole grain, and the bran component, may contribute to cardio-protective association. The limited studies and considerable discrepancy in defining and calculating whole grain intake limit conclusions. Future research should utilise a consistent definition and methodical approach of calculating whole grain intake to contribute to a greater body of consistent evidence surrounding whole grains.
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27
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Sandberg JC, Björck IME, Nilsson AC. Impact of rye-based evening meals on cognitive functions, mood and cardiometabolic risk factors: a randomized controlled study in healthy middle-aged subjects. Nutr J 2018; 17:102. [PMID: 30400947 PMCID: PMC6220522 DOI: 10.1186/s12937-018-0412-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 10/28/2018] [Indexed: 12/25/2022] Open
Abstract
Background Whole grain (WG) intake is associated with reduced risk of obesity, type 2 diabetes and cardiovascular disease, whereas type 2 diabetes increases the risk of cognitive decline and dementia. The purpose of this study was to investigate the effects of short-term intervention with WG rye on cognitive functions, mood and cardiometabolic risk markers in middle-aged test subjects. Method Rye-based breads were provided to 38 healthy test subjects (aged 52-70y) during three consecutive days in a crossover study design, using white wheat flour bread (WWB) as a reference. The rye-based bread consisted of a WG rye kernel/flour mixture (1:1 ratio) supplemented with resistant starch type 2 (RS2) (RB + RS2). The last bread portion was ingested at 2100 h, and cognitive function, mood and cardiometabolic risk markers were determined the following morning, 11 − 14 h post intake. Results In comparison to WWB, the RB + RS2 product increased ratings of mood parameters (valance, P < 0.001; activation P < 0.05). No differences were seen in the cognitive tests depending on intervention (P > 0.05). RB + RS2 increased insulin sensitivity (P < 0.05), fasting levels of gut hormones (PYY, P < 0.05; GLP-2, P < 0.01) and fasting concentrations of plasma acetate, butyrate and total SCFA (P < 0.001). In contrast, fasting levels of IL − 1β were decreased (P < 0.05). Insulin sensitivity was positively correlated with working memory test performance (P < 0.05). Conclusions This study display novel findings regarding effects of WG rye products on mood, and glucose and appetite regulation in middle-aged subjects, indicating anti-diabetic properties of WG rye. The beneficial effects are suggested to be mediated through gut fermentation of dietary fiber in the RB + RS2 product. Trial registration The study was retrospectively registered at ClinicalTrials.gov, register number NCT03275948. Registered September 8 2017.
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Affiliation(s)
- Jonna C Sandberg
- Department of Food Technology, Engineering and Nutrition, Lund University, P.O. Box 124, SE-221 00, Lund, Sweden.,Food for Health Science Centre, Lund University, P.O. Box 124, SE-221 00, Lund, Sweden
| | - Inger M E Björck
- Food for Health Science Centre, Lund University, P.O. Box 124, SE-221 00, Lund, Sweden
| | - Anne C Nilsson
- Department of Food Technology, Engineering and Nutrition, Lund University, P.O. Box 124, SE-221 00, Lund, Sweden. .,Food for Health Science Centre, Lund University, P.O. Box 124, SE-221 00, Lund, Sweden.
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Raptou E, Papastefanou G. An empirical investigation of the impact of smoking on body weight using an endogenous treatment effects model approach: the role of food consumption patterns. Nutr J 2018; 17:101. [PMID: 30396350 PMCID: PMC6217773 DOI: 10.1186/s12937-018-0408-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 10/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study explored the influence of cigarette smoking and food consumption patterns on BMI after adjusting for various socio-demographic characteristics. Since weight-based stereotypes may have an impact on smoking behaviour and both obesity and smoking have been associated with detrimental health effects, an interdependency between them is quite possible. METHODS Cross-sectional data were collected via a formal standardized questionnaire administered in personal interviews and two additional self-completion questionnaires from a random sample of 3471 German adults. The empirical framework considered potential endogeneity between smoking and body weight by employing an endogenous treatment effects model with an ordered outcome. The estimations derived from the endogenous treatment effects approach were also compared to the univariate ordered probit model results. RESULTS Our findings showed that ignoring potential endogeneity may affect both the statistical significance of the smoking estimate and the direction of the influence of smoking on BMI. Smoking was positively associated with BMI in both male (β = 1.236, p < 0.01) and female (β = 0.634, p < 0.10) participants. Smokers presented a 23.1% higher risk of obesity and a 24.3% lower likelihood of being within a healthy weight range. Male smokers also appeared to have a considerably augmented probability of being obese compared to their female counterparts (23.6% vs 15.1%). The relationship between smoking and BMI may be attributed to dietary practices, since smoking was correlated with poor dietary habits characterized by the frequent intake of more energy-dense foods (meat products and white-toasted bread) and less frequent consumption of healthy food items, such as whole-grain bread, vegetables and fruits. Concerning the impact of eating habits on body weight, frequent consumption of meat products and confectionery was found to have a direct association with BMI in both genders. Furthermore, white-toasted bread consumption was negatively linked with body weight in males (β = - 0.337, p < 0.01). CONCLUSIONS Our findings raised questions about the general belief that smoking is an effective weight control tool. Health interventions should be oriented toward a simultaneous decrease in smoking and obesity, since both behaviours seem to be interdependent. Nutrition programmes should also be designed according to the characteristics of different target groups in order to promote a healthy lifestyle.
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Affiliation(s)
- Elena Raptou
- Department of Agricultural Development, Laboratory of Management and Marketing, Democritus University of Thrace, Orestiada, Greece
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Wholegrain Intake and Risk of Type 2 Diabetes: Evidence from Epidemiological and Intervention Studies. Nutrients 2018; 10:nu10091288. [PMID: 30213062 PMCID: PMC6163785 DOI: 10.3390/nu10091288] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/03/2018] [Accepted: 09/10/2018] [Indexed: 12/27/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is one of the most common metabolic diseases and represents a leading cause of morbidity and mortality because of its related complications. The alarming rise in T2DM prevalence worldwide poses enormous challenges in relation to its social, economic, and a clinical burden requiring appropriate preventive strategies. Currently, lifestyle modifications—including approaches to promote a moderate body weight reduction and to increase regular physical exercise—are the first crucial intervention for T2DM prevention. In the light of the difficulty in reducing body weight and in long-term maintenance of weight loss, quality changes in dietary patterns—in terms of macro and micronutrient composition—can also strongly affect the development of T2DM. This may provide a more practical and suitable preventative approach than simply implementing caloric restriction. Along this line, there is increasing evidence that wholegrain consumption in substitution of refined grains is associated with a reduction of the incidence of several non-communicable chronic diseases. The aim of the present review is to summarize the current evidence from observational and randomized controlled clinical trials on the benefits of wholegrain on T2DM prevention and treatment. Plausible mechanisms by which wholegrain could act on glucose homeostasis and T2DM prevention are also evaluated. Altogether, the totality of the available evidence supports present dietary recommendations promoting wholegrain foods for the prevention and treatment of T2DM.
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Kikuchi Y, Nozaki S, Makita M, Yokozuka S, Fukudome SI, Yanagisawa T, Aoe S. Effects of Whole Grain Wheat Bread on Visceral Fat Obesity in Japanese Subjects: A Randomized Double-Blind Study. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2018; 73:161-165. [PMID: 29671172 DOI: 10.1007/s11130-018-0666-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Metabolic syndrome is a risk factor for cardiovascular diseases and has become increasingly common in Japan. Epidemiological studies show inverse associations between intake of whole wheat grains and metabolic syndrome, but few dietary intervention trials have investigated the effect of whole wheat grain consumption. It was investigated whether a diet in which refined wheat bread (RW diet) was substituted by whole grain wheat bread (WW diet) would reduce visceral fat obesity in Japanese subjects. A randomized double-blind placebo-controlled intervention study was conducted in 50 Japanese subjects with body mass index (BMI) ≥ 23 kg/m2. Subjects were randomly assigned WW (WW group) or RW diets (RW group) for 12 weeks. Blood samples and computed tomography scans were obtained every 6th week. The WW group showed decrease (-4 cm2) in visceral fat area (VFA) (p < 0.05), whereas the RW group showed no significant changes. These time-dependent changes were significantly different between the groups. WW diet led to significant and safe reductions in VFA in subjects with BMI ≥ 23 kg/m2. WW diet may contribute to preventing visceral fat obesity.
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Affiliation(s)
- Yosuke Kikuchi
- Research Center for Basic Science, Research and Development, Quality Assurance Division, Nisshin Seifun Group Inc., 5-3-1, Tsurugaoka, Fujimino, Saitama, 356-8511, Japan
| | - Satomi Nozaki
- Research Center for Basic Science, Research and Development, Quality Assurance Division, Nisshin Seifun Group Inc., 5-3-1, Tsurugaoka, Fujimino, Saitama, 356-8511, Japan
| | - Miki Makita
- Research Center for Basic Science, Research and Development, Quality Assurance Division, Nisshin Seifun Group Inc., 5-3-1, Tsurugaoka, Fujimino, Saitama, 356-8511, Japan
| | - Shoji Yokozuka
- Research and Development, Quality Assurance Division, Nisshin Seifun Group Inc., 1-25, Kandanishiki-cho, Chiyoda-ku, Tokyo, 101-8441, Japan
| | - Shin-Ichi Fukudome
- Research Center for Basic Science, Research and Development, Quality Assurance Division, Nisshin Seifun Group Inc., 5-3-1, Tsurugaoka, Fujimino, Saitama, 356-8511, Japan
| | - Takashi Yanagisawa
- Institute of Crop Science, National Agriculture and Food Research Organization (NARO), 2-1-18, Kannondai, Tsukuba, Ibaraki, 305-8642, Japan
| | - Seiichiro Aoe
- Faculty of Home Economics, Department of Food Science, Otsuma Women's University, 12 Sanban-cho, Chiyoda-ku, Tokyo, 102-8357, Japan.
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Bozzetto L, Costabile G, Della Pepa G, Ciciola P, Vetrani C, Vitale M, Rivellese AA, Annuzzi G. Dietary Fibre as a Unifying Remedy for the Whole Spectrum of Obesity-Associated Cardiovascular Risk. Nutrients 2018; 10:E943. [PMID: 30037123 PMCID: PMC6073249 DOI: 10.3390/nu10070943] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/15/2018] [Accepted: 07/18/2018] [Indexed: 02/07/2023] Open
Abstract
Obesity is a pandemic carrying the heavy burden of multiple and serious co-morbidities including metabolic syndrome, type 2 diabetes and cardiovascular diseases. The pathophysiological processes leading to the accumulation of body fat slowly evolve to fat accumulation in other body compartments than subcutaneous tissue. This abnormal fat deposition determines insulin resistance which in turn causes blood glucose and lipid metabolism derangement, non-alcoholic fatty liver disease, hypertension, and metabolic syndrome. All these conditions contribute to increase the cardiovascular risk of obese people. Several randomized clinical trials demonstrated that moderate weight loss (5⁻10%) in obese patients improves obesity-related metabolic risk factors and coexisting disorders. Therefore, nutritional strategies able to facilitate weight management, and in the meantime positively influence obesity-associated cardiovascular risk factors, should be implemented. To this aim, a suitable option could be dietary fibres that may also act independently of weight loss. The present narrative review summarizes the current evidence about the effects of dietary fibres on weight management in obese people. Moreover, all of the different cardiovascular risk factors are individually considered and evidence on cardiovascular outcomes is summarized. We also describe the plausible mechanisms by which different dietary fibres could modulate cardio-metabolic risk factors. Overall, despite both epidemiological and intervention studies on weight loss that show statistically significant but negligible clinical effects, dietary fibres seem to have a beneficial impact on main pathophysiological pathways involved in cardiovascular risk (i.e., insulin resistance, renin-angiotensin, and sympathetic nervous systems). Although the evidence is not conclusive, this suggests that fibre would be a suitable option to counteract obesity-related cardio-metabolic diseases also independently of weight loss. However, evidence is not consistent for the different risk factors, with clear beneficial effects shown on blood glucose metabolism and Low Density Lipoprotein (LDL) cholesterol while there is fewer, and less consistent data shown on plasma triglyceride and blood pressure. Ascribing the beneficial effect of some foods (i.e., fruits and vegetables) solely to their fibre content requires more investigation on the pathophysiological role of other dietary components, such as polyphenols.
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Affiliation(s)
- Lutgarda Bozzetto
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy.
| | - Giuseppina Costabile
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy.
| | - Giuseppe Della Pepa
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy.
| | - Paola Ciciola
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy.
| | - Claudia Vetrani
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy.
| | - Marilena Vitale
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy.
| | - Angela A Rivellese
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy.
| | - Giovanni Annuzzi
- Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy.
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Makarem N, Bandera EV, Lin Y, McKeown NM, Hayes RB, Parekh N. Associations of Whole and Refined Grain Intakes with Adiposity-Related Cancer Risk in the Framingham Offspring Cohort (1991-2013). Nutr Cancer 2018; 70:776-786. [PMID: 29781707 PMCID: PMC7236605 DOI: 10.1080/01635581.2018.1470647] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Case-control studies suggest that higher whole grain and lower refined grain intakes are associated with reduced cancer risk, but longitudinal evidence is limited. The objective of this prospective cohort study is to evaluate associations between whole and refined grains and their food sources in relation to adiposity-related cancer risk. Participants were adults from the Framingham Offspring cohort (N = 3,184; ≥18 yr). Diet, measured using a food frequency questionnaire, medical and lifestyle data were collected at exam 5 (1991-95). Between 1991 and 2013, 565 adiposity-related cancers were ascertained using pathology reports. Cox proportional hazards models were used to estimate adjusted hazard ratios and 95% confidence intervals for associations of whole and refined grains with risk of adiposity-related cancers combined and with risk of breast and prostate cancers in exploratory site-specific analyses. Null associations between whole and refined grains and combined incidence of adiposity-related cancers were observed in multivariable-adjusted models (HR: 0.94; 95% CI: 0.71-1.23 and HR: 0.98; 95% CI: 0.70-1.38, respectively). In exploratory analyses, higher intakes of whole grains (oz eq/day) and whole grain food sources (servings/day) were associated with 39% and 47% lower breast cancer risk (HR: 0.61; 95% CI: 0.38-0.98 and HR: 0.53; 95% CI: 0.33-0.86, respectively). In conclusion, whole and refined grains were not associated with adiposity-related cancer risk. Whole grains may protect against breast cancer, but findings require confirmation within a larger sample and in other ethnic groups.
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Affiliation(s)
- Nour Makarem
- Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Elisa V. Bandera
- Department of Epidemiology, Rutgers School of Public Health, Rutgers the State University of New Jersey, Piscataway, New Jersey, USA
| | - Yong Lin
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Nicola M. McKeown
- Jean Mayer USDA Human Nutrition Research Center on Aging, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Richard B. Hayes
- Department of Population Health, NYU Langone School of Medicine, New York, NY, USA
| | - Niyati Parekh
- Department of Public Health Nutrition, College of Global Public Health, New York University, New York, NY, USA
- Department of Population Health, NYU Langone School of Medicine, New York, NY, USA
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Costabile G, Griffo E, Cipriano P, Vetrani C, Vitale M, Mamone G, Rivellese AA, Riccardi G, Giacco R. Subjective satiety and plasma PYY concentration after wholemeal pasta. Appetite 2018; 125:172-181. [PMID: 29427691 DOI: 10.1016/j.appet.2018.02.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 02/02/2018] [Accepted: 02/04/2018] [Indexed: 12/20/2022]
Abstract
Dietary fiber and whole grain foods may contribute to the regulation of appetite; however, evidence has produced inconclusive findings. The objective was to evaluate the effects of an experimental wholemeal pasta on appetite ratings, plasma concentrations of gastrointestinal hormones involved in appetite control, and postprandial glucose/insulin responses in healthy adults. Fourteen healthy adults (7M/7F), mean age 30±2 yrs (mean±SEM), participated in a randomized, controlled, crossover trial. Participants consumed on two different days, at one week interval, 117g of wholemeal pasta or 100g of refined wheat pasta (control pasta), similar in energy and macronutrient composition except for fiber amount, which was higher in wholemeal pasta (11 vs 3 g). Appetite ratings, glucose/insulin/lipid and gastrointestinal hormone responses were measured at fasting and for 4-h after the ingestion of the pasta tests, after which self-reported energy intake for 8-h was evaluated. After the wholemeal pasta, the desire to eat and the sensation of hunger were lower (-16%, p=0.04 and -23%, p=0.004, respectively) and satiety was higher (+13%; p=0.08) compared with the control pasta; no effect on self-reported energy intake at subsequent meal was observed. After wholemeal pasta, glucose, triglyceride increased and GLP-1 responses were not different compared to control pasta but insulin response at 30 min (p<0.05) and ghrelin at 60 min (p=0.03) were lower and PYY levels higher (AUC=+44%, p=0.001). The appetite rating changes correlated with PYY plasma levels (p<0.03). In conclusion, consumption of whole grain instead of refined wheat pasta contributed to appetite control but did not seem to influence acute energy balance. Appetite ratings were associated with modifications in PYY hormone concentrations.
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Affiliation(s)
- Giuseppina Costabile
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Ettore Griffo
- Institute of Food Science, National Research Council, Avellino, Italy
| | - Paola Cipriano
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Claudia Vetrani
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Marilena Vitale
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Gianfranco Mamone
- Institute of Food Science, National Research Council, Avellino, Italy
| | - Angela A Rivellese
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy; Institute of Food Science, National Research Council, Avellino, Italy
| | - Rosalba Giacco
- Institute of Food Science, National Research Council, Avellino, Italy.
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Evaluating the ≤10:1 wholegrain criterion in identifying nutrient quality and health implications of UK breads and breakfast cereals. Public Health Nutr 2017; 21:1186-1193. [PMID: 29277169 DOI: 10.1017/s1368980017003718] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate the nutrient quality of breads and breakfast cereals identified using the wholegrain definition of ≤10:1 carbohydrate:fibre ratio. DESIGN Following a cross-sectional study design, nutritional information was systematically gathered from food labels of breads and breakfast cereals that met the ≤10:1 carbohydrate:fibre criterion. The median nutrient content was compared with the UK Food Standards Agency's nutrient profiling standards and the associations between carbohydrate:fibre ratio and other nutrients were analysed. Subgroup analyses were undertaken for products with and without fruit, nuts and/or seeds. SETTING Products from four major supermarket stores in the UK. SUBJECTS Breads (n 162) and breakfast cereals (n 266). RESULTS Breads which met the ≤10:1 criterion typically contained medium fat, low saturated fat, low sugar and medium Na. Breakfast cereals typically contained medium fat, low saturated fat, high sugar and low Na. In both groups, as the carbohydrate:fibre ratio decreased, fat content increased (bread: P=0·029, r=-0·171; breakfast cereal: P=0·033, r=-0·131) and, in breakfast cereals, as the ratio increased, sugar content increased (P<0·0005, r=0·381). Breakfast cereals with fruit, nuts and/or seeds contained, per 100 g, more energy (P=0·002), fat, saturated fat and sugar (all P<0·0005), while seeded breads had more energy, fat and saturated fat (all P<0·0005). CONCLUSIONS Overall, breads and breakfast cereals meeting the ≤10:1 criterion have good nutritional quality, suggesting that the criterion could be useful in public health and/or food labelling. The utility of applying the ≤10:1 criterion to products containing fruit, nuts and/or seeds is less clear and requires further research.
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Celis-Morales C, Livingstone KM, Affleck A, Navas-Carretero S, San-Cristobal R, Martinez JA, Marsaux CFM, Saris WHM, O'Donovan CB, Forster H, Woolhead C, Gibney ER, Walsh MC, Brennan L, Gibney M, Moschonis G, Lambrinou CP, Mavrogianni C, Manios Y, Macready AL, Fallaize R, Lovegrove JA, Kolossa S, Daniel H, Traczyk I, Drevon CA, Mathers JC. Correlates of overall and central obesity in adults from seven European countries: findings from the Food4Me Study. Eur J Clin Nutr 2017; 72:207-219. [PMID: 29242527 DOI: 10.1038/s41430-017-0004-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 07/25/2017] [Accepted: 08/16/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES To identify predictors of obesity in adults and investigate to what extent these predictors are independent of other major confounding factors. SUBJECTS/METHODS Data collected at baseline from 1441 participants from the Food4Me study conducted in seven European countries were included in this study. A food frequency questionnaire was used to measure dietary intake. Accelerometers were used to assess physical activity levels (PA), whereas participants self-reported their body weight, height and waist circumference via the internet. RESULTS The main factors associated (p < 0.05) with higher BMI per 1-SD increase in the exposure were age (β:1.11 kg/m2), intakes of processed meat (β:1.04 kg/m2), red meat (β:1.02 kg/m2), saturated fat (β:0.84 kg/m2), monounsaturated fat (β:0.80 kg/m2), protein (β:0.74 kg/m2), total energy intake (β:0.50 kg/m2), olive oil (β:0.36 kg/m2), sugar sweetened carbonated drinks (β:0.33 kg/m2) and sedentary time (β:0.73 kg/m2). In contrast, the main factors associated with lower BMI per 1-SD increase in the exposure were PA (β:-1.36 kg/m2), intakes of wholegrains (β:-1.05 kg/m2), fibre (β:-1.02 kg/m2), fruits and vegetables (β:-0.52 kg/m2), nuts (β:-0.52 kg/m2), polyunsaturated fat (β:-0.50 kg/m2), Healthy Eating Index (β:-0.42 kg/m2), Mediterranean diet score (β:-0.40 kg/m2), oily fish (β:-0.31 kg/m2), dairy (β:-0.31 kg/m2) and fruit juice (β:-0.25 kg/m2). CONCLUSIONS These findings are important for public health and suggest that promotion of increased PA, reducing sedentary behaviours and improving the overall quality of dietary patterns are important strategies for addressing the existing obesity epidemic and associated disease burden.
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Affiliation(s)
- Carlos Celis-Morales
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK.,BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Katherine M Livingstone
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - Alexander Affleck
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | | | - Rodrigo San-Cristobal
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain
| | - J Alfredo Martinez
- Department of Nutrition, Food Science and Physiology, University of Navarra, Pamplona, Spain
| | - Cyril F M Marsaux
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Wim H M Saris
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Clare B O'Donovan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Hannah Forster
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Clara Woolhead
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Eileen R Gibney
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Marianne C Walsh
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Lorraine Brennan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Mike Gibney
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - George Moschonis
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | | | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Anna L Macready
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Rosalind Fallaize
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, UK
| | - Silvia Kolossa
- ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Technische Universität München, Munchen, Germany
| | - Hannelore Daniel
- ZIEL Research Center of Nutrition and Food Sciences, Biochemistry Unit, Technische Universität München, Munchen, Germany
| | - Iwona Traczyk
- Human Nutrition Department, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Christian A Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle Upon Tyne, UK.
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Violette C, Kantor MA, Ferguson K, Reicks M, Marquart L, Laus MJ, Cohen N. Package Information Used by Older Adults to Identify Whole Grain Foods. J Nutr Gerontol Geriatr 2017; 35:146-60. [PMID: 27153253 DOI: 10.1080/21551197.2016.1168759] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
A structured interview protocol was used to investigate the ability of older adults (n = 89, age ≥ 65 years) to accurately determine whether three common food items were whole grain, and to assess the package information used in their decision process. Cereal and crackers, which were both whole grain products, were correctly identified by 63% and 66% of participants, respectively. Bread (a refined product), was correctly identified by only 19% of participants, while 46% of participants misidentified the bread as being whole grain. The ingredient list was the information most frequently cited in deciding if a food was whole grain, but participants varied in their ability to accurately interpret it. Package information considered nonpertinent (e.g., the Nutrition Facts label) in identifying a whole grain product was used almost as often as the ingredient list. Older adults would benefit from whole grain education programs that focus on accurately interpreting package information.
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Affiliation(s)
- Catherine Violette
- a University of New Hampshire Cooperative Extension, University of New Hampshire , Durham , New Hampshire , USA
| | - Mark A Kantor
- b US Food and Drug Administration and Department of Nutrition and Food Science , University of Maryland , College Park , Maryland , USA
| | - Katharine Ferguson
- c Department of Molecular, Cellular and Biomedical Sciences , University of New Hampshire , Durham , New Hampshire , USA
| | - Marla Reicks
- d Department of Food Science and Nutrition , University of Minnesota , St. Paul , Minnesota , USA
| | - Len Marquart
- d Department of Food Science and Nutrition , University of Minnesota , St. Paul , Minnesota , USA
| | - Mary Jane Laus
- e Department of Nutrition , University of Massachusetts , Amherst , Massachusetts , USA
| | - Nancy Cohen
- e Department of Nutrition , University of Massachusetts , Amherst , Massachusetts , USA
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Vatanparast H, Whiting S, Hossain A, Mirhosseini N, Merchant AT, Szafron M. National pattern of grain products consumption among Canadians in association with body weight status. BMC Nutr 2017; 3:59. [PMID: 32153839 PMCID: PMC7050848 DOI: 10.1186/s40795-017-0183-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 07/06/2017] [Indexed: 11/18/2022] Open
Abstract
Background Obesity in Canadian adults is showing upward trends. Consumption of whole-grains is one recommendation for the prevention of obesity. Despite the apparent nutritional and energy content differences between whole and refined grains, knowledge relating refined grains to weight gain in Canadian adults is scarce. The aim of this study was to assess the consumption of specific grain-based foods at the regional and national levels, and to evaluate the association between grain consumption with overweight or obesity in Canadian adults. Methods We used the 2004 Canadian Community Health Survey data. The association between type of grain product consumed and Body Mass Index (BMI) in adults aged ≥19y was evaluated by logistic regression. Results The mean daily intake of whole grains (86 ± 1.9 g/day) was significantly less than refined grains (276.6 ± 3.8 g/day), which was different across provinces. After adjustment for caloric needs, male consumers showed significantly lower intake of whole grains than females. Accordingly, the incidence of overweight or obesity was higher in males than in females. Also, in comparison to whole grains, the consumption of refined grains was associated with a higher risk of overweight or obesity among adults. Conclusion Canadians’ preference was refined grain products consumption, based on 2004 Health Survey, which was significantly associated with overweight/obesity. Hence, consumption of whole grains should be more effectively promoted rather than refined grain products to prevent obesity and its complications such as cardiovascular diseases and type 2 diabetes. Electronic supplementary material The online version of this article (doi:10.1186/s40795-017-0183-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hassan Vatanparast
- 1College of Pharmacy and Nutrition, University of Saskatchewan, 110 Science Place, Saskatoon, SK S7N 5C9 Canada.,College of Pharmacy and Nutrition, 104 Clinic Place (E3332 Health Sciences), Saskatoon, SK S7N 2Z4 Canada
| | - Susan Whiting
- 1College of Pharmacy and Nutrition, University of Saskatchewan, 110 Science Place, Saskatoon, SK S7N 5C9 Canada
| | - Alomgir Hossain
- 2University of Ottawa Heart Institute, Ottawa, Canada.,3Department of Community Health and Epidemiology, Health Science Building, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5 Canada
| | | | - Anwar T Merchant
- 5Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Columbia, SC 29208 USA
| | - Michael Szafron
- 6School of Public Health, University of Saskatchewan, 110 Science Place, Saskatoon, SK S7N 5C9 Canada
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Karl JP, Meydani M, Barnett JB, Vanegas SM, Goldin B, Kane A, Rasmussen H, Saltzman E, Vangay P, Knights D, Chen CYO, Das SK, Jonnalagadda SS, Meydani SN, Roberts SB. Substituting whole grains for refined grains in a 6-wk randomized trial favorably affects energy-balance metrics in healthy men and postmenopausal women. Am J Clin Nutr 2017; 105:589-599. [PMID: 28179223 PMCID: PMC5320410 DOI: 10.3945/ajcn.116.139683] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 12/27/2016] [Indexed: 12/23/2022] Open
Abstract
Background: The effect of whole grains on the regulation of energy balance remains controversial.Objective: We aimed to determine the effects of substituting whole grains for refined grains, independent of body weight changes, on energy-metabolism metrics and glycemic control.Design: The study was a randomized, controlled, parallel-arm controlled-feeding trial that was conducted in 81 men and postmenopausal women [49 men and 32 women; age range: 40-65 y; body mass index (in kg/m2): <35.0]. After a 2-wk run-in period, participants were randomly assigned to consume 1 of 2 weight-maintenance diets for 6 wk. Diets differed in whole-grain and fiber contents [mean ± SDs: whole grain-rich diet: 207 ± 39 g whole grains plus 40 ± 5 g dietary fiber/d; refined grain-based diet: 0 g whole grains plus 21 ± 3 g dietary fiber/d] but were otherwise similar. Energy metabolism and body-composition metrics, appetite, markers of glycemic control, and gut microbiota were measured at 2 and 8 wk.Results: By design, body weight was maintained in both groups. Plasma alkylresorcinols, which are biomarkers of whole-grain intake, increased in the whole grain-rich diet group (WG) but not in the refined grain-based diet group (RG) (P-diet-by-time interaction < 0.0001). Beta ± SE changes (ΔWG compared with ΔRG) in the resting metabolic rate (RMR) (43 ± 25 kcal/d; P = 0.04), stool weight (76 ± 12 g/d; P < 0.0001), and stool energy content (57 ± 17 kcal/d; P = 0.003), but not in stool energy density, were higher in the WG. When combined, the favorable energetic effects in the WG translated into a 92-kcal/d (95% CI: 28, 156-kcal/d) higher net daily energy loss compared with that of the RG (P = 0.005). Prospective consumption (P = 0.07) and glycemia after an oral-glucose-tolerance test (P = 0.10) trended toward being lower in the WG than in the RG. When nonadherent participants were excluded, between-group differences in stool energy content and glucose tolerance increased, and between-group differences in the RMR and prospective consumption were not statistically significant.Conclusion: These findings suggest positive effects of whole grains on the RMR and stool energy excretion that favorably influence energy balance and may help explain epidemiologic associations between whole-grain consumption and reduced body weight and adiposity. This trial was registered at clinicaltrials.gov as NCT01902394.
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Affiliation(s)
- J Philip Karl
- Jean Mayer USDA Human Nutrition Research Center on Aging
| | - Mohsen Meydani
- Jean Mayer USDA Human Nutrition Research Center on Aging
| | | | | | - Barry Goldin
- School of Medicine, Tufts University, Boston, MA
| | - Anne Kane
- School of Medicine, Tufts University, Boston, MA
| | | | | | - Pajau Vangay
- Biomedical Informatics and Computational Biology
| | - Dan Knights
- Department of Computer Science and Engineering, University of Minnesota,
Minneapolis, MN
| | | | - Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging
| | | | | | - Susan B Roberts
- Jean Mayer USDA Human Nutrition Research Center on Aging and
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Fayet-Moore F, Petocz P, McConnell A, Tuck K, Mansour M. The Cross-Sectional Association between Consumption of the Recommended Five Food Group "Grain (Cereal)", Dietary Fibre and Anthropometric Measures among Australian Adults. Nutrients 2017; 9:E157. [PMID: 28218715 PMCID: PMC5331588 DOI: 10.3390/nu9020157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/07/2017] [Accepted: 02/13/2017] [Indexed: 12/20/2022] Open
Abstract
The Australian Dietary Guidelines recommended "grain (cereal)" core food group includes both refined and whole grain foods, but excludes those that are discretionary (i.e., cakes). We investigated the association between daily serves from the "grain (cereal)" group and its effect on fibre and adiposity. Data from Australian adults in the 2011-2012 National Nutrition and Physical Activity Survey were used (n = 9341). Participants were categorised by serves of core grain foods and general linear models were used to investigate the effect of demographic, socioeconomic, and dietary covariates on waist circumference, body mass index (BMI) and fibre intake. Compared to core grain avoiders (0 serves), high consumers (6+ serves/day) were: more likely male and socially advantaged, had a healthier dietary pattern, less likely dieting, overweight or obese, and were at lower risk of metabolic complications. After adjustment for age, sex and energy intake, there was an inverse relationship between core grain serves intake and BMI (p < 0.001), waist circumference (p = 0.001) and a positive relationship with fibre (p < 0.001). Model adjustments for diet and lifestyle factors resulted in a smaller difference in waist circumference (p = 0.006) and BMI (p = 0.006). Core grain serves was significantly associated with higher fibre, but marginally clinically significant for lower adiposity.
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Affiliation(s)
- Flavia Fayet-Moore
- Nutrition Research Australia, Level 13, 167 Macquarie St, Sydney NSW 2000, Australia.
| | - Peter Petocz
- Department of Statistics, Macquarie University, Sydney NSW 2000, Australia.
| | - Andrew McConnell
- Nutrition Research Australia, Level 13, 167 Macquarie St, Sydney NSW 2000, Australia.
| | - Kate Tuck
- Nutrition Research Australia, Level 13, 167 Macquarie St, Sydney NSW 2000, Australia.
| | - Marie Mansour
- Nutrition Research Australia, Level 13, 167 Macquarie St, Sydney NSW 2000, Australia.
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Golpour-Hamedani S, Mohammadifard N, Khosravi A, Feizi A, Safavi SM. Dietary approaches to stop hypertension diet and obesity: A cross-sectional study of Iranian children and adolescents. ARYA ATHEROSCLEROSIS 2017; 13:7-13. [PMID: 28761449 PMCID: PMC5515185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Few studies have investigated the effects of dietary approaches to stop hypertension (DASH) diet on obesity in children. The present study was conducted to examine adherence to the DASH diet in relation to obesity in children and adolescents, Isfahan, Iran. METHODS A cross-sectional study was carried out among 456 children aged 11-18 years who were selected by random cluster sampling method. Dietary intakes were assessed using a validated Food Frequency Questionnaire (FFQ). The DASH score was constructed based on food items emphasized or minimized in the DASH diet. Anthropometric measurements were conducted based on standard protocols. General and abdominal obesity were defined based on body mass index ≥ 95th percentiles and waist: height ratio of more than 0.5, respectively. RESULTS Higher adherence to DASH diet was inversely associated with general obesity (odds ratioT1 vs. T3 3.34, 95% confidence interval 1.28-8.75); however, after controlling for confounding factors, this association disappeared. Furthermore, higher adherence to DASH diet was negatively associated with central obesity in children, but the relation was not statistically significant. CONCLUSION We concluded that there was an inverse nonsignificant association between adherence to DASH diet and general obesity indices after adjustment for potential confounders. Further, well-designed randomized clinical trial studies are suggested to find out the effect of DASH diet on obesity obviously.
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Affiliation(s)
- Sahar Golpour-Hamedani
- Food Security Research Center AND Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute AND Department of Biostatistics and Epidemiology, School of Health and Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sayyed Morteza Safavi
- Food Security Research Center AND Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran,Correspondence to: Sayyed Morteza Safavi,
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Biskup I, Kyrø C, Marklund M, Olsen A, van Dam RM, Tjønneland A, Overvad K, Lindahl B, Johansson I, Landberg R. Plasma alkylresorcinols, biomarkers of whole-grain wheat and rye intake, and risk of type 2 diabetes in Scandinavian men and women. Am J Clin Nutr 2016; 104:88-96. [PMID: 27281306 DOI: 10.3945/ajcn.116.133496] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/10/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Studies that use dietary biomarkers to investigate the association between whole-grain intake and the risk of developing type 2 diabetes (T2D) are lacking. OBJECTIVE We examined the association between plasma total alkylresorcinols and the alkylresorcinol C17:0-to-C21:0 ratio, biomarkers of whole-grain wheat and rye intake and relative whole-grain rye over whole-grain wheat intake, respectively, and the risk of T2D among Scandinavian men and women. DESIGN A nested case-control study was established within the Northern Sweden Health and Disease Study and the Danish Diet, Cancer and Health cohort. Alkylresorcinol concentrations and the ratios of C17:0 to C21:0 were determined in plasma samples from 931 case-control pairs. ORs for T2D were calculated for plasma total alkylresorcinol concentration or C17:0-to-C21:0 ratio in quartiles with the use of conditional logistic regression that was adjusted for potential confounders. Additional analyses with whole-grain wheat and rye intake estimated from food-frequency questionnaires (FFQs) as exposures were also performed. RESULTS The plasma total alkylresorcinol concentration was not associated with T2D risk (OR: 1.34; 95% CI: 0.95, 1.88) for the highest compared with the lowest quartiles in multivariable adjusted models. However, the C17:0-to-C21:0 ratio was associated with a lower diabetes risk (OR: 0.54; 95% CI: 0.37, 0.78). Analyses with whole-grain intake estimated from FFQs yielded similar results. CONCLUSIONS Total whole-grain wheat and rye intake, reflected by alkylresorcinols in plasma, was not associated with a lower risk of T2D in a population with high whole-grain intake. In contrast, the proportion of whole-grain rye to whole-grain wheat intake, indicated by the plasma C17:0-to-C21:0 ratio, was inversely associated with T2D. This suggests that whole-grain intake dominated by rye may be favorable for T2D prevention.
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Affiliation(s)
- Izabela Biskup
- Department of Food Science, BioCenter, Swedish University of Agricultural Sciences, Uppsala, Sweden; Department of Pharmacognosy, Wroclaw Medical University, Wroclaw, Poland
| | - Cecilie Kyrø
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Matti Marklund
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Rob M van Dam
- Saw Swee Hock School of Public Health and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore; Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA
| | | | - Kim Overvad
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Bernt Lindahl
- Departments of Public Health and Clinical Medicine and
| | | | - Rikard Landberg
- Department of Food Science, BioCenter, Swedish University of Agricultural Sciences, Uppsala, Sweden; Nutritional Epidemiology Unit, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
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Koo HC, Poh BK, Ruzita AT. Intervention on whole grain with healthy balanced diet to manage childhood obesity (GReat-Child™trial): study protocol for a quasi-experimental trial. SPRINGERPLUS 2016; 5:840. [PMID: 27386289 PMCID: PMC4917502 DOI: 10.1186/s40064-016-2431-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 05/26/2016] [Indexed: 11/21/2022]
Abstract
Background The rapid increase in childhood obesity is a serious public health problem, and has led to the development of many interventions. However, no intervention has emphasized whole grains as a strategy to manage childhood obesity. Therefore, this article describes the protocol of a 12-week multi-component, family-based intervention on whole grain, using a healthy balanced diet for managing childhood obesity. Methods The GReat-Child trial utilize a quasi-experimental method in which two schools in Kuala Lumpur are assigned to intervention and control groups. The eligibility criteria are overweight/obese children, aged 9 through 11 years, who has no serious co-morbidities. The children who report consuming whole-grain foods in their 3-day diet-recall during the screening will be excluded. The study sample is characterized by anthropometric measurements (weight, height, percentage of body fat and waist circumference), whole grain and nutrient intakes (3-day 24-h diet recalls), and their knowledge, attitudes and practices towards whole grain. The 12-week intervention is comprised of three components addressing behaviour, personal and environmental factors, based on social cognitive theory: (1) individual diet counselling for the parents; (2) six 30-min nutrition education classes and (3) school delivery of whole-grain foods; The control school does not receive any interventions, however, for ethical purposes, a health talk is conducted after the entire GReat-Child Trial is completed. Conclusion The GReat-Child trial represents a novel approach to examining the effectiveness of the intervention of whole grain in a healthy balanced diet on managing childhood obesity. We anticipate that this trial will reveal not only whether whole grain intervention will be effective in managing childhood obesity, but also provide greater insights into the acceptance of whole grain among Malaysian children.
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Affiliation(s)
- H C Koo
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia ; Department of Healthcare Professional, Faculty of Health and Life Sciences, Management & Science University, Shah Alam, Malaysia
| | - B K Poh
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Abd Talib Ruzita
- Nutritional Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
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Exploratory and confirmatory factory analysis of the Willingness to Eat Whole Grains Questionnaire: A measure of young adults' attitudes toward consuming whole grain foods. Appetite 2016; 105:460-7. [PMID: 27328099 DOI: 10.1016/j.appet.2016.06.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 06/15/2016] [Accepted: 06/16/2016] [Indexed: 11/20/2022]
Abstract
Whole grains are recommended by dietary guidelines because of their health-promoting properties, yet attitudes toward consuming these foods have not been examined. This study developed and validated a questionnaire to estimate willingness to consume whole grain foods. Focus group interviews with high school students and input from nutrition educators produced a list of 10 whole grain items that were included in the "Willingness to Eat Whole Grains Questionnaire". Young adult university students 18-29 years of age indicated their willingness to consume each of the whole grain foods using a 4-point, Likert-type scale with responses ranging from "always unwilling" to "always willing" and a fifth option of "never eaten". Participants' age, race/ethnicity, and gender were collected. Data were examined using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and test-retest reliability. The EFA test (n = 266; 65% female; 69% white) using principal axis factoring returned a single factor that included all survey items and explained 58.3% of the variance. The CFA (n = 252; 62% female, 74% white) supported a single-factor solution: χ(2) = 80.57 (35); RMSEA = 0.07; Comparative Fit Index = 0.92; Tucker-Lewis Index = 0.90; and SRMR = 0.05. The questionnaire, administered on two occasions separated by two weeks to 36 university students, demonstrated good testretest reliability (r = 0.87, p < 0.0001). The "Willingness to Eat Whole Grains Questionnaire" had good face validity when used with a young adult population and will be a useful tool to help nutrition educators examine attitudes toward consuming nutrient-rich whole grain foods.
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Azadbakht L, Haghighatdoost F, Esmaillzadeh A. White Rice Consumption, Body Mass Index, and Waist Circumference among Iranian Female Adolescents. J Am Coll Nutr 2016; 35:491-499. [DOI: 10.1080/07315724.2015.1113902] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Makarem N, Nicholson JM, Bandera EV, McKeown NM, Parekh N. Consumption of whole grains and cereal fiber in relation to cancer risk: a systematic review of longitudinal studies. Nutr Rev 2016; 74:353-73. [PMID: 27257283 DOI: 10.1093/nutrit/nuw003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 11/03/2015] [Indexed: 02/07/2023] Open
Abstract
CONTEXT Evidence from previous reviews is supportive of the hypothesis that whole grains may protect against various cancers. However, the reviews did not report risk estimates for both whole grains and cereal fiber and only case-control studies were evaluated. It is unclear whether longitudinal studies support this conclusion. OBJECTIVE To evaluate associations between whole grains and cereal fiber in relation to risk of lifestyle-related cancers data from longitudinal studies was evaluated. DATA SOURCES The following 3 databases were systematically searched: PubMed, EMBASE, and Cochrane CENTRAL. STUDY SELECTION A total of 43 longitudinal studies conducted in Europe and North America that reported multivariable-adjusted risk estimates for whole grains (n = 14), cereal fiber (n = 23), or both (n = 6) in relation to lifestyle-related cancers were included. DATA EXTRACTION Information on study location, cohort name, follow-up duration, sample characteristics, dietary assessment method, risk estimates, and confounders was extracted. DATA SYNTHESIS Of 20 studies examining whole grains and cancer, 6 studies reported a statistically significant 6%-47% reduction in risk, but 14 studies showed no association. Of 29 studies examining cereal fiber intake in relation to cancer, 8 showed a statistically significant 6%-49% reduction in risk, whereas 21 studies reported no association. CONCLUSIONS This systematic review concludes that most studies were suggestive of a null association. Whole grains and cereal fiber may protect against gastrointestinal cancers, but these findings require confirmation in additional studies.
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Affiliation(s)
- Nour Makarem
- N. Makarem is with the Department of Nutrition, Food Studies and Public Health, New York University, New York, New York, USA. J.M. Nicholson is with the Department of Medical Library, New York University School of Medicine, New York, New York, USA. E.V. Bandera is with the Rutgers School of Public Health, Rutgers-The State University of New Jersey, and the Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA. N.M. McKeown is with the Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA. N. Parekh is with the College of Global Public Health, Department of Nutrition, Food Studies and Public Health, and Department of Population Health, New York University, New York, New York, USA
| | - Joseph M Nicholson
- N. Makarem is with the Department of Nutrition, Food Studies and Public Health, New York University, New York, New York, USA. J.M. Nicholson is with the Department of Medical Library, New York University School of Medicine, New York, New York, USA. E.V. Bandera is with the Rutgers School of Public Health, Rutgers-The State University of New Jersey, and the Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA. N.M. McKeown is with the Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA. N. Parekh is with the College of Global Public Health, Department of Nutrition, Food Studies and Public Health, and Department of Population Health, New York University, New York, New York, USA
| | - Elisa V Bandera
- N. Makarem is with the Department of Nutrition, Food Studies and Public Health, New York University, New York, New York, USA. J.M. Nicholson is with the Department of Medical Library, New York University School of Medicine, New York, New York, USA. E.V. Bandera is with the Rutgers School of Public Health, Rutgers-The State University of New Jersey, and the Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA. N.M. McKeown is with the Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA. N. Parekh is with the College of Global Public Health, Department of Nutrition, Food Studies and Public Health, and Department of Population Health, New York University, New York, New York, USA
| | - Nicola M McKeown
- N. Makarem is with the Department of Nutrition, Food Studies and Public Health, New York University, New York, New York, USA. J.M. Nicholson is with the Department of Medical Library, New York University School of Medicine, New York, New York, USA. E.V. Bandera is with the Rutgers School of Public Health, Rutgers-The State University of New Jersey, and the Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA. N.M. McKeown is with the Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA. N. Parekh is with the College of Global Public Health, Department of Nutrition, Food Studies and Public Health, and Department of Population Health, New York University, New York, New York, USA
| | - Niyati Parekh
- N. Makarem is with the Department of Nutrition, Food Studies and Public Health, New York University, New York, New York, USA. J.M. Nicholson is with the Department of Medical Library, New York University School of Medicine, New York, New York, USA. E.V. Bandera is with the Rutgers School of Public Health, Rutgers-The State University of New Jersey, and the Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA. N.M. McKeown is with the Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA. N. Parekh is with the College of Global Public Health, Department of Nutrition, Food Studies and Public Health, and Department of Population Health, New York University, New York, New York, USA
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Abstract
Body fat distribution, especially visceral fat accumulation, may contribute more than total fat mass per se to the development of metabolic and cardiovascular disorders. Early prevention highly improves health outcomes later in life, especially when considering such cumulative conditions as atherosclerosis. However, as these processes emerge to be partly reversible, dietary and lifestyle interventions at any age and health condition are greatly beneficial. Given the worldwide abundance of metabolic and cardiovascular disorders, the identification and implementation of strategies for preventing or reducing the accumulation of morbid fat tissues is of great importance for preventing and regressing atherosclerosis. This review focuses on dietary strategies and specific food components that were demonstrated to alter body fat distribution and regression of atherosclerosis. Different properties of various adipose depots (superficial subcutaneous, deep subcutaneous and visceral fat depots) and their contribution to metabolic and cardiovascular disorders are briefly discussed. Visceral obesity and atherosclerosis should be approached as modifiable rather than ineluctable conditions.
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47
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Rusu E, Enache G, Jinga M, Dragut R, Nan R, Popescu H, Parpala C, Homentcovschi C, Nitescu M, Stoian M, Costache A, Posea M, Rusu F, Jinga V, Mischianu D, Radulian G. Medical nutrition therapy in non-alcoholic fatty liver disease--a review of literature. J Med Life 2015; 8:258-62. [PMID: 26351523 PMCID: PMC4556902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/29/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND AIM Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease worldwide, with a prevalence of 20%-40% in Western populations. The purpose of this article is to review data related to lifestyle changes in patients with NAFLD. METHOD We searched a public domain database (PubMed) with the following categories: disease (NAFLD, fatty liver, and non-alcoholic steatohepatitis [NASH]) and intervention (lifestyle intervention, diet, nutrition) with each possible combination through 25 September 2014, for relevant articles. Review of articles was restricted to those published in English. We selected the studies involving adult patients only. CONCLUSION There is no consensus as to what diet or lifestyle approach is the best for NAFLD patients. However, patients with NAFLD may benefit from a moderate- to low-carbohydrate (40%-45% of total calories) diet, coupled with increased dietary MUFA and n-3 PUFAs, reduced SFAs. More CRT are needed to clarify the specific effects of different diets and dietary components on the health of NAFLD patients. ABBREVIATIONS NAFL = Non-alcoholic fatty liver, NAFLD = non-alcoholic fatty liver disease, NASH = non-alcoholic steatohepatitis, HCC = hepatocarcinoma, BEE = basal energy expenditure, CRT = A small clinical randomized trial showed that short-term carbohydrate restriction is more efficacious in reducing intrahepatic triglyceride, IHT = intrahepatic triglyceride, VLCD = Very low calorie diets, AST = aspartate aminotransferases, SFAs = saturated fatty acids.
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Affiliation(s)
- E Rusu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - G Enache
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - M Jinga
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - R Dragut
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - R Nan
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - H Popescu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - C Parpala
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - C Homentcovschi
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - M Nitescu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - M Stoian
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - A Costache
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - M Posea
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - F Rusu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - V Jinga
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - D Mischianu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - G Radulian
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Bellissimo N, Akhavan T. Effect of macronutrient composition on short-term food intake and weight loss. Adv Nutr 2015; 6:302S-8S. [PMID: 25979503 PMCID: PMC4424768 DOI: 10.3945/an.114.006957] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The purpose of this review is to describe the role of macronutrient composition on the suppression of short-term food intake (FI) and weight loss. The effects of macronutrient composition on short-term FI will be reviewed first, followed by a brief examination of longer-term clinical trials that vary in effects of dietary macronutrient composition on weight loss. The objectives were: 1) to examine the effect of macronutrient composition on the suppression of short-term FI, 2) to determine whether some macronutrient sources suppress FI beyond their provision of energy, 3) to assess the combined effects of macronutrients on FI and glycemic response, and 4) to determine whether knowledge of the effect of macronutrients on short-term FI has led to greater success in spontaneous weight loss, adherence to energy-restricted diets, and better weight maintenance after weight loss. Although knowledge of macronutrient composition on short-term FI regulation has advanced our understanding of the role of diet composition on energy balance, it has yet to lead to greater success in long-term weight loss and weight maintenance. It is clear from this review that many approaches based on manipulating dietary macronutrient composition can help people lose weight as long as they follow the diets. However, only by evaluating the interaction between the physiologic systems that govern FI and body weight may the benefits of dietary macronutrient composition be fully realized.
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Affiliation(s)
- Nick Bellissimo
- Ryerson University, Faculty of Community Services, School of Nutrition, Toronto, Canada
| | - Tina Akhavan
- Ryerson University, Faculty of Community Services, School of Nutrition, Toronto, Canada
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Plasma alkylresorcinols, biomarkers of whole-grain intake, are not associated with progression of coronary artery atherosclerosis in postmenopausal women with coronary artery disease. Public Health Nutr 2015; 19:326-31. [DOI: 10.1017/s1368980015001123] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveThe objective of the present study was to examine the relationship between plasma alkyresorcinol (AR) concentrations, which are biomarkers of whole-grain intake, and atherosclerotic progression over 3 years in postmenopausal women with coronary artery disease.DesignPlasma AR concentrations were measured by a validated GC–MS method in fasting plasma samples. Atherosclerosis progression was assessed using change in mean minimal coronary artery diameter (MCAD) and percentage diameter stenosis (%ST), based on mean proximal vessel diameter across up to ten coronary segments. Dietary intake was estimated using a 126-item interviewer-administered FFQ.SettingA prospective study of postmenopausal women participating in the Estrogen Replacement and Atherosclerosis trial.SubjectsFor the analysis of plasma AR concentrations and atherosclerotic progression, plasma samples and follow-up data on angiography were available for 182 women.ResultsMean whole-grain intake was 9·6 (se 0·6) servings per week. After multivariate adjustment, no significant associations were observed between plasma AR concentrations and change in mean MCAD or progression of %ST. Plasma AR concentrations were significantly correlated with dietary whole grains (r=0·35, P<0·001), cereal fibre (r=0·33, P<0·001), bran (r=0·15, P=0·05), total fibre (r=0·22, P=0·003) and legume fibre (r=0·15, P=0·04), but not refined grains, fruit fibre or vegetable fibre.ConclusionsPlasma AR concentrations were not significantly associated with coronary artery progression over a 3-year period in postmenopausal women with coronary artery disease. A moderate association was observed between plasma AR concentrations and dietary whole grains and cereal fibre, suggesting it may be a useful biomarker in observational studies.
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Barak F, Falahi E, Keshteli AH, Yazdannik A, Esmaillzadeh A. Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet in relation to obesity among Iranian female nurses. Public Health Nutr 2015; 18:705-712. [PMID: 24810207 PMCID: PMC10271762 DOI: 10.1017/s1368980014000822] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 12/18/2013] [Accepted: 04/03/2014] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Limited observational studies have considered habitual consumption of the general population to examine the relationship between the Dietary Approaches to Stop Hypertension (DASH) diet and obesity. The aim of the present study was to investigate adherence to the DASH diet in relation to general and central obesity among female nurses in Isfahan, Iran. DESIGN Cross-sectional study carried out among 293 female nurses aged >30 years who were selected by a multistage, cluster random sampling method. Usual dietary intakes were assessed using a validated FFQ. We constructed the DASH score based on foods and nutrients emphasized or minimized in the DASH diet, focusing on eight components: high intake of fruits, vegetables, nuts and legumes, low-fat dairy products and whole grains and low intakes of sodium, sweetened beverages, and red and processed meats. General and abdominal obesity were defined as BMI ≥ 25 kg/m2 and waist circumference ≥ 88 cm, respectively. SETTING Isfahan, Iran. SUBJECTS Female nurses (n 293) aged >30 years. RESULTS Increased adherence to the DASH diet was associated with older age (P<0.01) and lower waist circumference (P=0.04). There was no statistically significant difference in the prevalence of general obesity between extreme quartiles of the DASH diet score. After adjustment for age, energy intake and other confounding factors, DASH diet score was not significantly associated with obesity. However, with further controlling for other dietary factors, those in the highest quartile of DASH diet score were 71 % less likely to have general obesity compared with those in the lowest quartile. In addition, following a DASH diet was inversely associated with central obesity after adjustment for potential confounders (OR=0.37; 95 % CI 0.14, 0.96). CONCLUSIONS We found that adherence to the DASH diet was inversely related to central obesity among Iranian adult females. This association remained significant even after adjustment for potential confounders.
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Affiliation(s)
- Farzaneh Barak
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, PO Box 81745-151, Islamic Republic of Iran
| | - Ebrahim Falahi
- Department of Nutrition, Faculty of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Islamic Republic of Iran
| | - Ammar Hassanzadeh Keshteli
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
| | - Ahmadreza Yazdannik
- Department of Critical Care Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
| | - Ahmad Esmaillzadeh
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, PO Box 81745-151, Islamic Republic of Iran
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