Nutrition

MedicalResearch.com Interview with: [caption id="attachment_21402" align="alignleft" width="120"] Dr. Martha Morris[/caption] Dr. Martha Clare Morris ScD Section on Nutrition and Nutritional Epidemiology Department of Internal Medicine Rush University Medical Center Chicago, Illinois Medical Research: What is the background for this study? What are the main findings? Dr. Morris: We examined seafood consumption in a cohort of older residents of the...

MedicalResearch.com Interview with: Lea Borgi, MD Joint Fellowship Program in Nephrology Brigham and Women’s/ Massachusetts General Medical Research: What is the background for this study? What are the main findings? Dr. Borgi: Hypertension is one of the most common diseases in the United States and in the world. It is a known risk factor for cardiovascular disease. Even when hypertension is well-controlled with anti-hypertensives, these individuals are at an increased cardiovascular risk. Therefore, a healthy lifestyle is critical for normotensive individuals. This usually includes dietary patterns. However, if we could restrict dietary patterns to specific foods, then we would be able to provide better advice to our patients. In this study, we analyzed the association of fruits and vegetables with the incidence of hypertension. We were also interested in studying the change in consumption of fruits and vegetables over time and the incidence of hypertension. We used data from 3 large prospective cohort studies: the Nurses’ Health Study, the Nurses’ Health Study II and the Health Professional Follow-up study (total of 187,453 participants). Information about health and food intake was updated every 2 and 4 years, respectively. We found that participants who consumed ≥4 servings/day of fruits (not including fruit juice) had a lower risk of developing hypertension (follow-up was more than 20 years), when compared to participants whose consumption was ≤4 servings/weeks (Hazard ratio=0.92; 95%CI= 0.87-0.97). However, the association of vegetable intake with hypertension was different; indeed, we found no significant association with a HR of 0.95(0.86-1.04). To better understand these associations, we further analyzed individual fruits and vegetables with the incidence of hypertension. We found lower risks of developing hypertension when these individual fruits and vegetables were consumed ≥4 servings/week as compared to <1 serving/month: broccoli, carrots, tofu or soybeans, raisins and apples. In contrast, we found that eating more string beans or brussel sprouts was associated with an increased risk of hypertension with HRs of 1.11(1.05-1.17) and 1.23(1.04-1.46), respectively. In all of our analyses, we adjusted for potential cofounders (such as age, gender, body mass index and more). Finally, we also found that increasing total fruit (but not total vegetable) consumption by ≥7servings/week in the preceding 8 years was associated with a lower risk of hypertension with a pooled HR 0.94(0.90-0.97).

MedicalResearch.com Interview with: [caption id="attachment_21216" align="alignleft" width="144"]Dr. Maryam S. Farvid, PhD Takemi Fellow Harvard T.H. Chan School of Public Health Dr. Maryam Farvid[/caption] Dr. Maryam S. Farvid, PhD Takemi Fellow Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Farvid: Previous studies of fiber intake and breast cancer have almost all been non-significant, but none of them examined diet during adolescence or early adulthood, a period when breast cancer risk factors appear to be particularly important. Current study supports protective role of dietary fiber intake on breast cancer. The women who reported the highest amount of fiber consumed during high school, about 28 grams daily, had a 16% lower risk of overall breast cancer compared with those who said they consumed an about 15 grams a day. Also highest verses lowest intake of fiber during early adulthood was associated with a 19% lower risk of overall breast cancer. The associations were more apparent for premenopausal breast cancer than postmenopausal breast cancer. Each 10 grams increase in adolescent fiber intake may lead to a 20% lower risk of premenopausal breast cancer, as was a 15% for overall breast cancer.

MedicalResearch.com Interview with: [caption id="attachment_21145" align="alignleft" width="133"]Simin Nikbin Meydani, D.V.M., Ph.D. Director, JM USDA-HNRCA at Tufts University Professor of Nutrition and Immunology Friedman School of Nutrition Science and Policy and Sackler Graduate School at Tufts University Boston, MA 02111 Dr. Simin Meydani[/caption] Simin Nikbin Meydani, D.V.M., Ph.D. Director, JM USDA-HNRCA at Tufts University Professor of Nutrition and Immunology Friedman School of Nutrition Science and Policy and Sackler Graduate School at Tufts University Boston, MA 02111 Medical Research: What is the background for this study? Dr. Meydani: A significant number of older people are zinc deficient which can result in a compromised immune system which weakens as the body ages, making older adults more susceptible to infections and higher incidence and morbidity from pneumonia. Older adults with impaired immune response, particularly T cell-mediated function, have a higher susceptibility to infections and cancer. Our research team from the Jean Mayer USDA Human Nutrition Research Center on Aging created a small double-blind, placebo-controlled trial involved adults age 65 or older from three Boston-area nursing homes to determine the feasibility of increasing serum zinc concentrations in older adults. The full findings are published in The American Journal of Clinical Nutrition. These results have a significant public health implication for the older adults because it shows directly that correction of a nutrient deficiency can improve immune response in older adult (a biological function which consistently has been shown to be impaired with aging).

MedicalResearch.com Interview with: [caption id="attachment_21138" align="alignleft" width="189"]Rajan Anthony Sonik Lurie Institute for Disability Policy Heller School for Social Policy and Management Brandeis University Waltham, MA Rajan Anthony Sonik[/caption] Rajan Anthony Sonik Lurie Institute for Disability Policy Heller School for Social Policy and Management Brandeis University Waltham, MA Medical Research: What is the background for this study? What are the main findings? Response: We know that food insecurity (experiencing hunger, insufficient food, or concerns about having enough food) is associated with a host of health problems, ranging from behavior health conditions to iron deficiencies. However, understanding the relationship between food insecurity and healthcare utilization and cost patterns has been more difficult to assess with available data. Presumably, rises in food insecurity should worsen health, which in turn should increase healthcare utilization and ultimately costs. To examine this topic, I actually looked at this in the opposite way by asking if a decrease in food insecurity might lead to decrease in costs. The opportunity to do so arose in the form of the April 2009 increase in benefit levels for the Supplemental Nutrition Assistance Program (SNAP; formerly the Food Stamps Program) that were part of the American Recovery and Reinvestment Act (commonly referred to as the “stimulus package”). SNAP has been shown to alleviate food insecurity, and so this increase in benefits created the chance to explore my question. I analyzed Massachusetts data from October 2006 to August 2012 using interrupted time series models and found that inpatient Medicaid cost growth in Massachusetts fell by 73% (p = 0.003) after the increase in SNAP benefits. Moreover I found that decreased admissions were the primary driver of this outcome rather any patterns in health care inflation. In addition, I found that, for people with selected chronic illnesses that create heightened sensitivity to food insecurity, the drop in cost growth was even greater (the diseases studied were sickle cell disease, diabetes, malnutrition/failure to thrive, inflammatory bowel disease, asthma, and cystic fibrosis).

MedicalResearch.com Interview with: [caption id="attachment_21118" align="alignleft" width="80"]Helmut Schröder, Ph.D. Head Cardiovascular Epidemiology and Nutrition Research Group, CIBER Epidemiology and Public Health Senior Research Scientist Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC) IMIM-Hospital del Mar Medical Research Institute Parc de Recerca Biomèdica de Barcelona Barcelona,Spain Dr. Helmut Schröder[/caption] Helmut Schröder,  Ph.D. Head Cardiovascular Epidemiology and Nutrition Research Group, CIBER Epidemiology and Public Health Senior Research Scientist Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC) IMIM-Hospital del Mar Medical Research Institute Parc de Recerca Biomèdica de Barcelona Barcelona,Spain Medical Research: What is the background for this study? What are the main findings? Dr. Schröder: A healthy diet is paramount for physical and mental health. Healthy dietary patterns are more expensive than unhealthy choices. But it is unknown how increases in individual diet cost, driven by rising food prices, affects consumers’ food choices and, consequently, overall diet quality. It is of particular concern that low diet quality is more often found in segments of the population with the lowest socioeconomic status. The he aim of our research was to determine the prospective association between changes in individual diet cost and changes in diet quality in the REGICOR (Registre Gironí del Cor) cohort, a representative Spanish population. Additionally, we determined the impact of changes in diet cost on body weight. We have found that an increase in the energy-adjusted diet cost predicted a shift to a healthier diet and to better weight management. Diet quality strongly increased if money previously spent on unhealthy food choices such as fast food and pastry is instead spent on vegetables and fruits. Furthermore, we have seen that a 1.4€ increase in average spending on food is associated with the consumption of 74 grams more vegetables and 52 grams more fruit, per person per day, for a 1000 kcal diet. Conversely, a reduction of 0.06€ in average spending is linked to a decrease of 121 grams of vegetables and 94 grams of fruit, as well as increased consumption of foodstuffs like fast food and baked goods.

MedicalResearch.com Interview with: [caption id="attachment_21101" align="alignleft" width="200"]Professor Stuart M. Phillips Ph.D., FACSM, FACN Department of Kinesiology, McMaster University, CANADA Exercise Metabolism Research Group – Protein Metabolism Research Lab Director, Physical Activity Centre for Excellence Prof. Stuart Phillips[/caption] Professor Stuart M. Phillips Ph.D., FACSM, FACN Department of Kinesiology, McMaster University, Canada Exercise Metabolism Research Group – Protein Metabolism Research Lab Director, Physical Activity Centre for Excellence Medical Research: What is the background for this study? What are the main findings? Prof. Phillips: During weight loss with diet only people lose both muscle and fat and muscle. The long-term health consequences of losing metabolically active muscle versus fat are not likely to be beneficial. In the context of this study we thought perhaps the preservation of muscle would also be important in very active young men. We wanted to see whether when men were in a very large energy deficit (40% less energy than they required) higher protein (2.4 g/kg/d) could preserve muscle mass and still result in increased function (strength) and fitness. Our results show that during a marked energy deficit that consumption of 2.4 g protein/kg/d was more effective than consumption of a diet containing 1.2 g protein/kg/d in promoting increases in LBM (1.2 vs 0.1kg increase) and losses of fat mass (-4.8kg vs. -3.5kg) when combined with a high volume of resistance and anaerobic exercise.

[caption id="attachment_21010" align="alignleft" width="148"]Dr. Monica L. Bertoia, MPH, PhD Instructor in Medicine, Channing Division of Network Medicine Brigham and Women’s Hospital & Harvard Medical School Research Associate, Department of Nutrition Harvard T. H. Chan School of Public Health Boston, MA 02115 Dr. Monica Bertoia[/caption] MedicalResearch.com Interview with: Monica L. Bertoia, MPH, PhD Instructor in Medicine, Channing Division of Network Medicine Brigham and Women’s Hospital & Harvard Medical School Research Associate, Department of Nutrition Harvard T. H. Chan School of Public Health Boston, MA 02115 Medical Research: What is the background for this study? What are the main findings? Response: Most weight loss studies have focused on one type of flavonoid, the flavan-3-ols found in green tea, and are limited to small numbers of overweight and obese study participants. We examined 7 subclasses of flavonoids and weight change in 124,086 healthy adults who reported their diet and weight repeatedly over up to 24 years.

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[caption id="attachment_21025" align="alignleft" width="176"]JONATHAN WELBURN PHD STUDENT AND RESEARCH ASSISTANT DEPARTMENT OF INDUSTRIAL AND SYSTEMS ENGINEERING UNIVERSITY OF WISCONSIN, MADISON Jonathan Welburn[/caption] Jonathan Welburn PhD Student and Research Assistant Department of Industrial and Systems Engineering University of Wisconsin, Madison Medical Research: What is the background for this study? What are the main findings? Response: This study addresses rising concerns associated with increasing levels of food imported into the United States.  We use data on FDA import violations to quantify risks to food safety.  Using this data, we provide insight on food safety risks that are not easy to obtain by other means.   Our results suggest that the risk level of imported food is higher for foods from low-GDP countries.  High-GDP countries, on the other hand, may be better able to reduce risks through standards and regulations.  Consequently, importers may wish to pay a little more for products from high-GDP countries or work closely with suppliers from low-GDP countries to ensure good safety practices.

[caption id="attachment_20859" align="alignleft" width="122"]Dr. Refaat Hegazi, MD, PhD MS MPH Abbott medical director and study author Dr. Refaat Hegazi[/caption] MedicalResearch.com Interview with: Dr. Refaat Hegazi, MD, PhD MS MPH Abbott medical director and study author MedicalResearch: What is the background for this study? What are the main findings? Dr. Hegazi: The NOURISH study that was recently published in Clinical Nutrition showed that a specialized oral nutrition supplement (with high protein, HMB and Vitamin D) was associated with a 50 percent lower death rate in older, malnourished patients with a heart or lung disease, 90 days after leaving the hospital. The study was conducted with the utmost scientific rigor and is one of the largest nutrition clinical studies of its kind. In the study, we evaluated the effects of this specialized nutrition supplement compared to a placebo supplement on the incidence of hospital readmission or death through 90-days after leaving the hospital. The population studied has never been evaluated before in this way. Results showed no significant differences between the two groups for the primary composite (i.e. combined) endpoint of hospital readmissions or death. However, the study individual components and additional analyses showed:
  • A significantly lower (50 percent) death rate for those who received the specialized nutrition supplement. This lower incidence of death began at 30 days after participants left the hospital, and continued for 90 days.
  • Similar rates of hospital readmissions between the two groups.
  • Improvements in other health outcomes including body weight, nutritional status and Vitamin D levels at 30 and 60 days after leaving the hospital, and continued body weight and nutritional status improvements at 90 days for the group taking the specialized nutrition supplement. 

More on Sleep on MedicalResearch.com MedicalResearch.com Interview with: [caption id="attachment_20750" align="alignleft" width="150"]Marie-Pierre St-Onge, Ph.D, FAHA Assistant Professor, Department of Medicine New York Obesity Nutrition Research Center Institute of Human Nutrition College of Physicians & Surgeons, Columbia University New York, NY 10032 Dr. Marie St-Onge[/caption] Marie-Pierre St-Onge, Ph.D, FAHA Assistant Professor, Department of Medicine New York Obesity Nutrition Research Center Institute of Human Nutrition College of Physicians & Surgeons, Columbia University New York, NY 10032   Medical Research: What is the background for this study? What are the main findings? Dr. St-Onge: We have shown that sleep affects food intake: restricting sleep increases energy intake, particularly from fat (others also find increased sugar intake).  We wanted to know if the reverse was also true: does diet affect sleep at night? Medical Research: What should clinicians and patients take away from your report? Dr. St-Onge: Diet quality can play an important role in sleep quality.  Sleep can be affect after only a single day of poor dietary intakes (high saturated fat and low fiber intakes).  It is possible that improving one’s diet can also improve their sleep.

[caption id="attachment_20719" align="alignleft" width="200"]Dr. Lindsey Taillie PhD Research Assistant Professor Department of Nutrition University of North Carolina at Chapel Hill Dr. Lindsey Taillie[/caption] More on Nutrition on MedicalResearch.com MedicalResearch.com Interview with: Dr. Lindsey Taillie PhD Research Assistant Professor Department of Nutrition University of North Carolina at Chapel Hill Medical Research: What is the background for this study? Dr. Taillie: Walmart is the US’ biggest grocer retailer. With over 50% more sales than the next largest grocery retailer, Kroger, Walmart has a major influence on what Americans buy and eat. Previous research suggests this growing dominance of Walmart could also contributing to our growing waistlines: Walmart has been linked to less healthy food purchases and higher levels of obesity. At the same time, public health scientists and advocates are also increasingly concerned about ensuring that everyone—and especially the poor—have access to healthy food stores to buy fruits, vegetables and other nutritious foods. But what’s a healthy store? Typically we think of these as traditional grocery stores and supermarkets, but not massive supercenters like Walmart (or convenience or drug stores). However, it’s very difficult to actually test how stores affect the healthfulness of our diets. For example, the reason why some food store purchases seem healthier is because more health-conscious consumers shop there to begin with, not necessarily because the food is actually healthier. Where stores choose to locate is not random, either—stores like Walmart might choose to open a store in a certain neighborhood because of other characteristics (low rent, more space, etc.), which themselves can be associated with poor diets and more obesity. People also shop at more than one type of food store, so unhealthy foods at one store might offset healthier foods purchased at another.

More on Ophthalmology on MedicalResearch.com MedicalResearch.com Interview with: Jae Hee Kang, MSc, SC Associate Epidemiologist, Brigham and Women's Hospital Assistant Professor of Medicine, Harvard Medical School Brigham and Women's Hospital Department of Medicine Channing Division of Network Medicine Boston, MA 02115 Medical Research: What is the background for this study? What are the main findings? Dr. Kang: Glaucoma is a leading cause of irreversible blindness worldwide, and primary open-angle glaucoma (POAG) is the most common form of the disease. Little is known on the causes of glaucoma but dysfunction in the regulation of blood flow to the optic nerve, which transmits visual information to the brain, may be involved. Nitric oxide is important for maintenance of blood flow and its signaling may be impaired in glaucoma. We were interested in whether dietary nitrates, an exogenous source of nitric oxide mostly found in green-leafy vegetables, may be related to lower risk of POAG. Medical Research: What is the background for this study? What are the main findings? Dr. Kang: We (Brigham and Women’s Hospital / Harvard Medical School and Massachusetts Eye and Ear researchers) used 25+ years of data from over 100,000 participants in the Nurses' Health Study (63,893 women) and the Health Professionals Follow-up Study (41,094 men). Participants were nurses or other health professionals and were aged 40 years or older and reported eye exams. We collected information on their diet and other health information every two years with questionnaires. During follow-up, 1,483 new cases of primary open-angle glaucoma with visual field loss were identified and confirmed with medical record review. Participants were divided into quintiles (one of five groups) of dietary nitrate intake (quintile 5, approximately 240 mg/day; quintile 1, approximately 80 mg/day) and of green leafy vegetables (quintile 5, approximately 1.5 servings/day; quintile 1, approximately one-third of a serving/day). We observed that greater intake of dietary nitrate and green leafy vegetables (e.g., romaine and iceberg lettuce and kale/chard/mustard greens) was associated with a 20 percent to 30 percent lower POAG risk; the association was particularly strong (40 percent-50 percent lower risk) for POAG with early paracentral visual field loss (a subtype of POAG most linked to dysfunction in blood flow autoregulation).

Click Here for More on Salt/Sodium on MedicalResearch.com [caption id="attachment_20641" align="alignleft" width="200"]Sandra L Jackson PhD Epidemic Intelligence Service, CDC Division for Heart Disease and Stroke Prevention National Center for Chronic Disease Prevention and Health Promotion Atlanta, Georgi Dr. Sandra Jackson[/caption] MedicalResearch.com Interview with: Sandra L Jackson PhD Epidemic Intelligence Service, CDC Division for Heart Disease and Stroke Prevention National Center for Chronic Disease Prevention and Health Promotion Atlanta, Georgia Medical Research: What is the background for this study? What are the main findings? Dr. Jackson: Sodium reduction is an important public health strategy to reduce cardiovascular disease, and this study was the latest in CDC’s ongoing effort to monitor U.S. sodium intake. These findings reveal that nearly all Americans – regardless of age, race and gender – consume more sodium than is recommended for a healthy diet. Specifically, over 90 percent of children (2 to 18) and 89 percent of adults (19 and up) eat more than the recommended limits in the 2015-2020 Dietary Guidelines for Americans, and that doesn’t even include salt added at the table. The newly released guidelines recommend limiting sodium to less than 2,300 mg per day for people over the age of 14, and less for those younger. The analysis also examined specific populations. Among adults, a larger proportion of men (98 percent) than women (80 percent) consume too much sodium. Among people at greater risk of developing heart disease or stroke – such as people age 51 and older, African Americans and individuals with high blood pressure or pre-hypertension (blood pressure higher than normal but not in the “high” range) – more than three out of four exceed 2,300 mg per day. Adults with hypertension consume slightly less sodium than other adults, and may be trying to follow physician’s advice to reduce sodium. However, 86 percent of adults with hypertension still consume too much.

[caption id="attachment_20483" align="alignleft" width="70"]Dr. Caroline Fox, MD MPH National Heart, Lung, and Blood Institute Assistant Clinical Professor of Medicine Harvard Medical School Dr. Fox[/caption] MedicalResearch.com Interview with: Dr. Caroline Fox, MD MPH National Heart, Lung, and Blood Institute Assistant Clinical Professor of Medicine Harvard Medical School Medical Research: What is the background for this study? What are the main findings? Dr. Fox: There is evidence linking sugar sweetened beverages with obesity and type 2 diabetes. There is also evidence suggesting that specific adipose tissue depots may play a role in the pathogenesis of these diseases. We found that higher levels of sugar sweetened beverage (SSB) intake was associated with more visceral fat (fat in the stomach cavity) over 6 years.

[caption id="attachment_20555" align="alignleft" width="132"]Prof. Peter Lay PhD Professor of Inorganic Chemistry School of Chemistry | Faculty of Science Director, Vibrational Spectroscopy Core Facility Research Portfolio The University of Sydney Prof. Peter Lay[/caption] MedicalResearch.com Interview with: Prof. Peter Lay PhD Professor of Inorganic Chemistry School of Chemistry | Faculty of Science Director, Vibrational Spectroscopy Core Facility Research Portfolio The University of Sydney Medical Research: What is the background for this study? What are the main findings? Response: My group has been studying the molecular mechanisms of chromium(VI)-induced cancers and the biochemistry of vanadium over the last three decades. Vanadium drugs have been in clinical trials for their anti-diabetic effects that occur via species with very similar chemistry to chromium(VI).  The more we understood the biochemistry of each, the more we questioned whether the efficacies of anti-diabetic chromium(III) supplements were associated with the generation of carcinogenic chromium(VI) and chromium(V). To test this, we conducted experiments to either provide evidence for our hypothesis or disprove it.  This work commenced some 15 years ago with studies on the changes in the nature of chromium(III) supplements exposed to simulated gastrointestinal juices, as well as in human and animal blood serum over times that mimicked the residence time of the supplements in the human body. We discovered that all supplements were changed to a range of different Cr(III) species in both the GI tract and the blood.1,2  Common species were observed, but the rates at which they formed were dependent on the nature of the chromium(III) supplement.  Both the supplements themselves and the chromium(III) species that formed in blood serum were partially oxidised to Cr(VI) at concentrations of the oxidant, hydrogen peroxide (a type of bleach), found in the blood of people with type II diabetes.1,2 One of the clinical features of patients with type II diabetes is increased levels of oxidants, such as hydrogen peroxide, in their blood and cells. These oxidants are associated with many of the side-effects of type II diabetes that are associated with reduced life expectancy. These transformed chromium(III) species bound to blood proteins were more easily oxidised to chromium(VI) than the administered Cr(III) supplements.  The faster a particular chromium(III) supplement reacted with blood proteins to form these easily oxidised chromium(III)-protein species, the more active was the Cr(III) supplement in its anti-diabetic activity in animal and human studies reported by other groups.1-5  According to many health and regulatory bodies, chromium(III) has minimal or no efficacy in glucose metabolism and no other beneficial effects, such as weight loss or muscle building, in well conducted human and animal trials with non-diabetic subjects. This is consistent with our proposed mechanism of action. It is only under oxidising physiological conditions associated with type II diabetes that chromium(III) can be partially transformed to sufficient concentrations of carcinogenic chromium(VI) to enable significant biological activity.  In a large clinical trial where diabetic patients were treated with high doses of chromium(III) picolinate (one of the least efficacious supplements in animal studies), there was no efficacy in patients with controlled type II diabetes. Only those patients with uncontrolled type II diabetes exhibited improved glucose metabolism.  These patients, who have the highest concentrations of oxidants with the ability to transform chromium(III) to chromium(VI) in blood, are therefore at the greatest risk of developing Cr-induced cancers. Even where efficacy was observed, glucose metabolism was only reduced to the levels in patients with controlled type II diabetes; i.e., no patients exhibited a return to normal glucose metabolism.4,5 Coupled with all of this information our separate studies showed that chromium(VI) and chromium(V), but not chromium(III), are strong inhibitors of protein tyrosine phosphatase (PTP) enzymes.  The relevance of this is that drugs that inhibit PTPs activate circulating insulin in people with type II diabetes.  That is, it causes insulin to bind more strongly to cells involved in glucose metabolism (such as fat cells) to bring about the cascade of biochemical reactions that import glucose into cells and metabolise it.1-5 Thus we were able to link all of the animal, human and in vitro studies to show that physiological conditions under which chromium(III) had the highest probability of being transformed to chromium(VI) were also those in which chromium(III) supplements were most active.1-5 Moreover, we were able to provide a mechanism of activity that required chromium(VI) and chromium(V) to be generated for insulin enhancing activity.1-5  What remained was to establish whether we could observe Cr(VI) and Cr(V) in cells treated with chromium(III) supplements. This has now been established in our most recent study6 that have just been published. Contrary to the press releases of the dietary supplement industry, the published paper was carefully planned to mimic those conditions found in vivo.  The chromium(III) supplement chosen was that which had a chemical structure most closely resembling those generated in blood plasma. Thus we were able to complete the circle in linking our extensive studies on the biochemistry of chromium(III) species generated from chromium(III) supplements in the blood and show that such species were absorbed by the relevant cells and partially oxidised to chromium(VI) and chromium(V).

[caption id="attachment_20494" align="alignleft" width="132"]Russell Keast Ph.D., CFS Professor Centre for Advanced Sensory Science (CASS) School of Exercise and Nutrition Sciences, Faculty of Health Deakin University Melbourne Burwood Campus Burwood, VIC 3125 Prof. Keast[/caption] MedicalResearch.com Interview with: Russell Keast Ph.D., CFS Professor Centre for Advanced Sensory Science (CASS) School of Exercise and Nutrition Sciences, Faculty of Health Deakin University Melbourne Burwood Campus Burwood, VIC 3125 Medical Research: What is the background for this study? What are the main findings? Dr. Keast: Fatty acids are detected at various stages of food consumption and digestion via interactions with nutrient receptors upon the tongue and within the gastrointestinal (GI) tract. This chemoreception initiates functional responses, i.e., taste perception, peptide secretion and alterations in GI motility that play a fundamental role in food consumption, hedonics and satiety. In obesity, both GI and taste detection of fatty acids is attenuated and this may predispose individuals to increased consumption of high-fat foods, or foods containing greater concentrations of fat.  In other word overweight and obese people are less sensitive to fat and this is associated with overconsumption of fatty foods leading to weight gain.

[caption id="attachment_20446" align="alignleft" width="144"]Kawther Hashem MSc RNutr (Public Health) Nutritionist and Researcher Action on Sugar Wolfson Institute of Preventive Medicine, Queen Mary, University of London London UK Kawther Hashem[/caption] MedicalResearch.com Interview with: Kawther Hashem MSc RNutr (Public Health) Nutritionist and Researcher Action on Sugar Wolfson Institute of Preventive Medicine, Queen Mary, University of London London UK Medical Research: What is the background for this study? What are the main findings? Response: The calculations showed that a 40% reduction in free sugars added to Sugar Sweetened Beverages (SSBs) over five years would lead to an average reduction in energy intake of 38 kcal per day by the end of the fifth year. This would lead to an average reduction in body weight of 1.20kg in adults,  resulting in a reduction in overweight and obese adults by approximately half a million and 1 million respectively. This would in turn prevent between 274,000-309,000 obesity-related type 2 diabetes over the next two decades. Policies such as this will reduce cases of overweight and obesity and type 2 diabetes, this will have a major clinical impact and reduce healthcare costs.

[caption id="attachment_20421" align="alignleft" width="117"]Dalane W. Kitzman, M.D. Professor, Cardiology Sticht Center on Aging Gerontology and Geriatric Medicine Translational Science Institute Wake-Forest Baptist Health Winston-Salem, NC Dr. Dalane Kitzman[/caption] MedicalResearch.com Interview with: Dalane W. Kitzman, M.D. Professor, Cardiology Sticht Center on Aging Gerontology and Geriatric Medicine Translational Science Institute Wake-Forest Baptist Health Winston-Salem, NC Medical Research: What is the background of the research? Dr. Kitzman: Heart Failure With Preserved Ejection Fraction (HFPEF) is a relatively recently recognized disorder.  It used to be thought that it was rare.  However, we now realize that HFPEF is the dominant form of heart failure in America.  It is also the fastest growing cardiovascular disorder.  Interestingly, this disorder occurs almost exclusively among older persons, particularly women.  The need is great because outcomes in persons with HFPEF (death, rehospitalization, health care costs) are worsening.  This stands in contrast to most other cardiovascular disorders which are on the decline and / or are experiencing greatly improved outcomes.  Remarkably, all of the large studies that have used medications in HFPEF that seemed they should be ‘sure bets’ showed no benefit for their primary outcomes.  Thus, this is also the only major cardiovascular disorder where there is no proven medication treatment.  That means physicians take ‘educated guesses’ in choosing treatment for this large group of patients. The main symptom in patients with chronic HFPEF is shortness of breath and and fatigue with exertion.  We showed in 2002 in JAMA that when we objectively measured this symptom with expired gas analysis (Peak VO2), this was as severely decreased in HFPEF as in patients with HFREF (severely reduced EF), the classic, well accepted form of heart failure.  That and other studies helped lead to acceptance of HFPEF as a true Heart Failure disorder. We first showed 5 years ago that 4 months of exercise training improves peak VO2 and quality of life in patients with HFPEF.  In fact, exercise remains the only proven means to improve these patients’ chronic symptoms. The goal of our study was to determine if weight loss diet also improved peak VO2 and quality of life in HFPEF patients, alone and in combination with exercise training.  This was based on the under-recognized fact that over 80% of Heart Failure With Preserved Ejection Fraction patients are overweight or obese.  It was already known that weight loss diet in other groups of older persons improves peak VO2 and quality of life.  And small studies of weight loss surgery in the other form of HF (HFREF) suggested that weight loss can improves symptoms, peak VO2, and quality of life.  However, there had never been a study of weight loss, by diet or other means, in HFPEF.  In fact, it had been thought, based on observational data, that weight loss diet might be contraindicated in HFPEF. So we recruited 100 overweight / obese patients age 60 years and older with this disorder from our community; 80% were women.  The exercise was standard exercise training that we’d previously shown was effective.  The meals for the weight loss diet were prepared in our metabolic kitchen by a regisered dietition.  Patients made out menus selecting preferred foods.  Well balanced, healthy, nutritious, but very palatable.  The portions were controlled so that there was a 350 caloric deficit per day deficit, on average.  Pateints made their own breakfast with guidance, unlimited of certain fruits and vegetables, and occasional “free days”, such as for holidays.  Patients loved the meals and wanted to continue after the 5 month study.

[caption id="attachment_20297" align="alignleft" width="110"]Philipp Schuetz, MD, MPH University Department of Medicine Clinic for Endocrinology/Metabolism/Clinical Nutrition, Kantonsspital Aarau, Aarau, Switzerland Medical Faculty of the University of Basel Basel, Switzerland Dr. Schuetz[/caption] MedicalResearch.com Interview with: Philipp Schuetz, MD, MPH University Department of Medicine Clinic for Endocrinology/Metabolism/Clinical Nutrition, Kantonsspital Aarau, Aarau, Switzerland Medical Faculty of the University of Basel Basel, Switzerland Medical Research: What is the background for this study? What are the main findings? Dr. Schuetz: Malnutrition is common in hospitalised patients and associated with detrimental metabolic consequences. The current clinical approach is to provide at risk patients nutritional support as a strategy to tackle malnutrition and its associated adverse outcomes. Yet, whether this strategy is effective and improves clinical outcomes in the medical inpatient population is unclear. In addition, recent trials from critical care have shown adverse outcomes when nutritional therapy was used too aggressively. Herein, our metaanalysis is the first to systematically investigate effects of nutritional support in medical inpatients. Our analysis shows that nutritional support is highly effective in increasing energy and protein intake and helps to stabilize weight loss. Also, risk for unplanned readmission after discharge from the hospital was reduced and length of stay was shorter in the patient population with established malnutrition. Yet, for other important clinical outcomes such as mortality and functional outcomes effects of nutritional support remained uncertain. Also, the quality of evidence was found to be moderate to low.

[caption id="attachment_1583" align="alignleft" width="200"]Qi Sun, MD ScD Assistant Professor of Medicine Channing Division of Network Medicine Brigham and Women's Hospital and Harvard Medical School Assistant Professor Department of Nutrition, Harvard School of Public Health 665 Huntington Avenue, Boston, MA 02115 Dr. Qi Sun[/caption] MedicalResearch.com Interview with: Dr. Qi Sun Sc.D Assistant Professor Department of Nutrition Harvard T.H. Chan School of Public Health Boston, Massachusetts  Medical Research: What is the background for this study? What are the main findings? Dr. Qi Sun: Potato is considered as a vegetable in certain dietary recommendations, such as in the U.S. MyPlate food guide, whereas in the U.K. national food guide, potato is grouped with cereal as sources of carbohydrates. Potato foods are typically higher in glycemic index and glycemic load, but data are rare regarding whether individual and total potato foods are associated with chronic diseases. In this analysis, we focused on diabetes and found that a higher consumption of total potato foods and individual potato foods, especially french fries, was associated with an increased risk of developing type 2 diabetes in three large cohort studies of ~200 thousand U.S. men and women. In addition, we found that increased potato food consumption over time was associated with a subsequent increased risk of developing diabetes.

[caption id="attachment_20204" align="alignleft" width="200"]Zoltan Sarnyai, M.D., Ph.D. Associate Professor of Pharmacology Head, Laboratory of Psychiatric Neuroscience Australian Institute of Tropical Health and Medicine (AITHM) Comparative Genome Centre Centre for Biodiscovery and Molecular Development of Therapeutics James Cook University Townsville, Australia Dr. Zoltan Sarnyai[/caption] MedicalResearch.com Interview with: Zoltan Sarnyai, M.D., Ph.D. Associate Professor of Pharmacology Head, Laboratory of Psychiatric Neuroscience Australian Institute of Tropical Health and Medicine (AITHM) Comparative Genome Centre Centre for Biodiscovery and Molecular Development of Therapeutics James Cook University Townsville, Australia Medical Research: What is the background for this study? Dr. Sarnyai: Schizophrenia has long been conceptualized as a disease contributed by the increased activity of the neurotransmitter system that provides dopamine for the brain. All clinically used antipsychotic drugs inhibit dopamine transmission in the brain by blocking dopamine receptors. These drugs have only a limited efficacy on a certain set of symptoms associated with schizophrenia. More recent research has uncovered that abnormal glucose and energy metabolism in the brain may contribute in the development of schizophrenia. This is not altogether surprising considering that our brain is using a disproportionately high amount of glucose to fuel neurotransmission (cell-to-cell communication in the brain), to maintain normal electrical activity of nerve cells and to deal with damaging free oxygen radicals. Therefore, even relatively small changes in the machinery that is required to provide energy for the brain cells can have very significant impact on brain function. In fact, recent studies have identified altered expression of genes and proteins that are responsible for enzymatic breakdown of glucose and proper handling of the metabolites to create the energy-rich molecule ATP. In addition, recent research shows decreased number and impaired function of the mitochondria, the powerhouses of the cell, in the brain of individuals with schizophrenia.  These recent results that show abnormal energy metabolism in schizophrenia raise the possibility of targeting metabolic pathways for therapeutic benefit in this condition. Ketogenic diet provides and alternative source of energy to the brain through fatty acids. Furthermore, since this diet is very low in carbohydrates, almost all the energy needs of the cells comes from breaking down fat (fatty acids) as opposed to glucose. This can circumvent the classic glucose metabolic pathways that maybe impaired in the disease. Also, breaking down fatty acids produces 40% more of the energy-rich molecule ATP than breaking down the carbohydrate glucose. Altogether, ketogenic diet may provide extra energy and can help neurotransmission in the brain, leading to the improvement of neurobiological processes underlying schizophrenia.

[caption id="attachment_20091" align="alignleft" width="180"]Néstor Vicente Salar Dr. Vicente Salar[/caption] MedicalResearch.com Interview with: Néstor Vicente Salar, PhD. Profesor Asociado UMH/ UMH Part-time Assistant Professor Doctor en Biología Diplomado en Nutrición Humana y Dietética (CV00195) Miembro del GE-NuDAFD (AEDN)  Medical Research: What is the background for this study? What are the main findings? Response: Nowadays, the practising of endurance sport is increasing, running being the sport chosen by many people who decide to start doing exercise. Distances and time are important factors to take in account in amateur as well as in professional runners. Among others, these factors are directly related to the risk of oxidative damage. In fact, oxidative stress has two faces: beneficial and deleterious. Helpful effects include the defence against infectious agents or the function as intracellular signaling molecules in many processes. On the other hand, high and persistent levels of oxidative stress can produce harmful effects if the antioxidant defences are overwhelmed, resulting in structural damage. Antioxidants from diet, for example pomegranate juice, seem to control oxidative stress disorders. However, the studies about the role of pomegranate juice in oxidative stress modulation in athletes are scarce. We have demonstrated that the intake of this kind of juice during 22 days in endurance athletes is capable to modulate the structural damage in macromolecules as proteins and lipids.

[caption id="attachment_19942" align="alignleft" width="90"]Maria T. Chao, DrPH, MPA Assistant Professor of Medicine Osher Center for Integrative Medicine & Division of General Internal Medicine - SFGH UCSF San Francisco, CA 94143-1726 Dr. Chao[/caption] MedicalResearch.com Interview with: Maria T. Chao, DrPH, MPA Assistant Professor of Medicine Osher Center for Integrative Medicine & Division of General Internal Medicine - SFGH UCSF San Francisco, CA 94143-1726 Medical Research: What is the background for this study? What are the main findings? Dr. Chao: Many Americans use complementary and integrative health (CIH) approaches to help them manage the symptoms of chronic diseases. To date, most of these treatments are only available in outpatient clinics. In this study, we asked oncology inpatients which of 12 different CIH approaches they currently use or have tried in the past, and also which approaches they would like to be available in the hospital. We found that 95% of patients had tried at least one  complementary and integrative health approach in the past, and that a similarly high number were interested in accessing these services as an inpatient. More than three quarters of our sample expressed interest in receiving nutritional counseling and massage during their hospital stay, and approximately half were interested in acupuncture, biofeedback, and mindfulness meditation.

[caption id="attachment_19771" align="alignleft" width="177"]Wenji Li, MMed, PhD Postdoc Associate Department of Pharmaceutics Ernest Mario School of Pharmacy Rutgers, The State University of New Jersey Dr. Wenji Li[/caption] MedicalResearch.com Interview with: Wenji Li, MMed, PhD Postdoc Associate Department of Pharmaceutics Ernest Mario School of Pharmacy Rutgers, The State University of New Jersey Medical Research: What is the background for this study? What are the main findings? Dr. Li: Hypertension is a vital risk factor for many serious disorders. Male and age ≥40 years were found to be highly associated with more severe hypertension. In Singapore, the prevalence of hypertension increased markedly from age 40 years onwards. Tea, a popular beverage in Chinese people, has been approved to possess many beneficial pharmacological effects including antihypertension. However, no clinical studies on the correlation between tea drinking and its effect on lowering blood pressure among Singaporeans have been conducted. To find out the potential link, we are the first to investigate the correlation of hypertension and consumption of tea, health supplements, living habits and socio-demographic factors among Singaporean Chinese residents. By the large scale cross-sectional epidemiology study (N = 1184), we found the prevalence of hypertension among the whole investigated population was 49.73% and the prevalence increased to 66.47% in the sub-population aged ⩾60 years. High risk of hypertension was associated with age ⩾60 years, obesity, family history of hypertension, diabetes history, hyperlipidemia history, male and coffee intake. In contrast, drinking green tea at least 150 ml per week was associated with lower hypertension risk. Drinking combination of green tea and British tea was associated with higher reduction in the risk of hypertension. This study suggests that consumption of tea, especially green tea and British tea, is beneficial for lowering the risk of hypertension while the consumption of coffee may have the opposite effect. 

[caption id="attachment_19591" align="alignleft" width="200"]David L. Katz, MD, MPH, FACPM, FACP, FACLM Director, Yale University Prevention Research Center Griffin Hospital President, American College of Lifestyle Medicine Founder, True Health Initiative Dr. David Katz[/caption] MedicalResearch.com Interview with: David L. Katz, MD, MPH, FACPM, FACP, FACLM Director, Yale University Prevention Research Center Griffin Hospital President, American College of Lifestyle Medicine Founder, True Health Initiative Medical Research: What is the background for this study? What are the main findings? Dr. Katz: the evidence that nuts in general, and walnuts in particular, have health promoting properties is vast and conclusive.  In our own prior research, we have shown that daily ingestion of walnuts ameliorates overall cardiac risk in type 2 diabetics (http://www.ncbi.nlm.nih.gov/pubmed/19880586) and that the same intervention improves cardiac risk and body composition in adults at risk for diabetes (http://www.ncbi.nlm.nih.gov/pubmed/23756586).  Our prior studies, and work by others, suggest that despite their energy density, walnuts may exert a favorable influence on calorie intake and weight, because of their very high satiety factor.  We also know that walnuts are highly nutritious overall, and suspect that those who add walnuts to their diets are apt to 'bump' something less nutritious out, thereby improving the overall quality of their diets as measured objectively. Accordingly, we designed the new study to look at the effects of daily walnut ingestion on diet quality, weight, and cardiac risk measures in a larger cohort of adults at risk for type 2 diabetes (ie, central obesity, indications of insulin resistance) over a longer period of time.  We also wondered whether the addition of some 350 daily calories from walnuts would result in the displacement of a comparable number of calories from other sources, so we compared the effects of the intervention with, and without, counseling to help people 'make room' for the walnut calories. We found again that walnuts improved overall cardiac risk status, as measured by endothelial function- essentially, a direct measure of blood vessel health and blood flow.  We also found that adding walnuts to the diet significantly improved overall diet quality, and did not lead to weight gain.  Walnuts also improved the lipid profile.  When walnut intake was combined with counseling for overall calorie intake, there was a significant decline in waist circumference.

[caption id="attachment_19533" align="alignleft" width="145"]Mark A. Klebanoff, MD Center for Perinatal Research The Research Institute Nationwide Children's Hospital Dr. Klebanoff[/caption] MedicalResearch.com Interview with: Mark A. Klebanoff, MD Center for Perinatal Research The Research Institute Nationwide Children's Hospital Medical Research: What is the background for this study? What are the main findings? Dr. Klebanoff: Caffeine is among the substances most commonly consumed by pregnant women.  There are numerous sources of caffeine in the diet—regular (non-decaf) coffee, regular tea, many soft drinks, energy drinks, and some power bars. Even chocolate contains some caffeine.  It’s also included in some over the counter pain relievers, and in over the counter ‘keep awake’ pills such as No-Doz.  As a result of its wide availability, most pregnant women consume at least some caffeine.  In spite of over 30 years of research, whether moderate amounts of caffeine (up to 200 milligrams, the amount contained in about 2 normal-sized cups of coffee, per day) during pregnancy are harmful is uncertain.  However almost all previous research has been about events related to pregnancy, such as difficulty becoming pregnant, miscarriage, birth defects, and the size of the newborn.  Whether maternal caffeine use during pregnancy has an impact on things later in childhood, such as obesity and neurologic development, has hardly been studied. We used a biomarker, measured in the mother’s blood during pregnancy, for caffeine use, and found that more caffeine use was not associated with the child’s body mass index at either 4 or 7 years of age, and that at blood levels of the marker that we saw in the vast majority, caffeine was not associated with the child’s IQ, nor with behavioral abnormalities at those ages.

[caption id="attachment_19373" align="alignleft" width="300"]Bo (Bonnie) Qin, PhD Postdoctoral associate at Rutgers Cancer Institute of New Jersey Dr. Qin[/caption] MedicalResearch.com Interview with: Bo (Bonnie) Qin, PhD Postdoctoral associate at Rutgers Cancer Institute of New Jersey Medical Research: What is the background for this study? What are the main findings? Response:  Ovarian cancer is among the top five causes of cancer death among women in the US. Compared to white women, African-American women tend to have a worse 5-year survival rate of ovarian cancer. It highlights a critical need for identifying preventive factors in African Americans, particularly through dietary modification, which is relatively low cost and low risk compared to medical treatments. We found that adherence to an overall healthy dietary pattern i.e. Alternate Healthy Eating Index (AHEI)-2010 may reduce ovarian cancer risk in African-American women, and particularly among postmenopausal women. Adherence to the current Dietary Guidelines for Americans i.e. Healthy Eating Index-2010, were also strongly associated with reduced risk of ovarian cancer among postmenopausal African-American women.

[caption id="attachment_19362" align="alignleft" width="200"]Suzan Wopereis, Ph.D. TNO, Microbiology and Systems Biology Group Zeist, The Netherlands Dr. Wopereis[/caption] MedicalResearch.com Interview with: Suzan Wopereis, Ph.D. TNO, Microbiology and Systems Biology Group Zeist, The Netherlands Medical Research: What is the background for this study? What are the main findings? Dr. Wopereis: For the first time we could demonstrate the very subtle start of negative health effects caused by a high calorie snack diet in healthy men. We already knew about the negative consequences of such diets from so called epidemiologic studies. In such studies, scientists compare large populations (thousands of people) to better understand disease development. For example, by comparing  obese populations to a lean population, scientists could define various steps in the disease development related to obesity, like high cholesterol, onset of inflammation, high blood pressure, high glucose, etc. Yet, the early deviations from health  were difficult to study because human metabolism (the way we digest and metabolize our meals from a biochemical viewpoint)  is very flexible and able to efficiently deal with all kinds of daily stressors, such as a meal or intensive exercise. So, at TNO we decided to exploit  this flexibility by giving our healthy volunteers a ‘challenge test’, in the form of a high-fat milkshake. Next, we studied how multiple aspects of their metabolism react to such a challenge test. We showed that a snack diet for 4 weeks reduced many aspects of  flexibility of our healthy men, thus indicating very early changes in health. Both the high-fat challenge test and the integral study of many different outcomes form a novel approach of what “healthy” really means. In the study we used two groups of male volunteers. One group of 10 healthy male volunteers and one group of 9 male volunteers with Metabolic Syndrome, who had a combination of 2 or more risk factors that raises your risk for heart disease and other health problems (unhealthy cholesterol levels, high blood pressure, high blood sugar, high blood lipids, and abdominal fat). In other words, subjects with Metabolic Syndrome have a suboptimal health condition. Both groups received a high-fat milk-shake, and before and up to 8 hours after consumption of this metabolic challenge-test, blood samples were taken. In these blood samples, 61 different biomarkers were measured, such as cholesterol and blood sugar. These 61 biomarkers were used for a thorough health assessment of these 2 groups in response to the challenge test. We noted that biochemical processes related to sugar metabolism, fat metabolism and inflammation function abnormal in subjects with Metabolic Syndrome. The next step was to provide the 10 healthy male volunteers with a snack diet for 4 weeks. On top of their normal diet they had to consume an additional 1300 kcal per day, in the form of sweets and savory products such as candy bars, tarts, peanuts, and crisps. After these 4 weeks the response of the same 61 biomarkers to the challenge test was evaluated. Here, we observed that signaling molecules such as hormones regulating the control of sugar and fat metabolism and inflammation were changed, resembling the very subtle start of negative health effects. Without the use of the challenge test, we would not have been able to observe that even this short period of overfeeding induces changes in the metabolism of healthy people that resemble what happens in people with metabolic syndrome.

[caption id="attachment_19359" align="alignleft" width="183"]Audry H. Garcia PhD Scientist Department of Epidemiology Erasmus MC, University Medical Center Rotterdam Rotterdam, The Netherlands Dr. Garcia[/caption] MedicalResearch.com Interview with: Audry H. Garcia PhD Scientist Department of Epidemiology Erasmus MC, University Medical Center Rotterdam Rotterdam, The Netherlands Medical Research: What is the background for this study? What are the main findings? Dr. Garcia: Mild and chronic metabolic acidosis as a result of a diet rich in acid-forming nutrients, such as cheese, fish, meat and grain products, may interfere with optimal bone mineralization and indirectly increase the risk of osteoporosis later in life. Previous observational studies in adults have reported inverse associations between dietary acid load and bone mass. However, the evidence in younger populations is scarce; only a few studies have been performed in healthy children and adolescents with inconsistent results, and not much is known on the effects of dietary acid load on bone mass in younger children or in children with a non-European background. In a prospective multiethnic population-based cohort study of 2,850 children from the city of Rotterdam, the Netherlands, we found that dietary acid load estimated as dietary potential renal acid load (dPRAL), and as protein intake to potassium intake ratio (Pro:K) at 1 year of age, was not consistently associated with childhood bone health. Furthermore, associations did not differ by sex, ethnicity, weight status, or vitamin D supplementation.