MedicalResearch.com Interview with:
James J. DiNicolantonio, PharmD
Associate Editor BMJ Open Heart
Cardiovascular Research Scientist
Saint Luke's Mid America Heart Institute
Medical Research: What is the background for this study? What are the main findings?Dr. DiNicolantonio: Cardiovascular disease is the leading cause of premature mortality in the developed world, and hypertension is its most important risk factor. Controlling hypertension is a major focus of public health initiatives, and dietary approaches have historically focused on sodium.
A reduction in the intake of added sugars, particularly fructose, and specifically in the quantities and context of industrially-manufactured consumables, would help not only curb hypertension rates, but would also help address broader problems related to cardiometabolic disease.
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MedicalResearch.com Interview with:
Refaat Hegazi, MD, PhD, MS, MPH
Medical Director at Abbott Nutrition and an author of the FeedM.E. study. Affiliate Research Associate Professor
Department of Internal Medicine, Division of Gastroenterology
Brody School of Medicine at East Carolina UniversityMedical Research: What is the background for this study? What are the main findings?
Dr. Hegazi: When we think about malnutrition, we don’t believe it can impact us and our families. But malnutrition is a widespread condition that can affect anyone, especially when sick or injured, and exists in every country of the world - both in emerging and developed nations. In fact, an estimated one in three patients who enter a hospital are malnourished and up to one out of two older adults are at risk for malnutrition.
The consequences of malnutrition are serious and include increased complications, (pressure ulcers, infections, falls), longer hospital stays, frequent readmissions, increased cost of care and higher risk of mortality. However, the condition often goes undiagnosed despite being preventable and treatable if identified early.
This is why we authored “Evidence-Based Recommendations for Addressing Malnutrition in Health Care: An Updated Strategy From the feedM.E. Global Study Group”. It aims to create a call to action for clinicians worldwide and provides a simple clinical nutrition care pathway that can be implemented in any health care setting, in any part of the world.
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MedicalResearch.com Interview with:
Immaculata De Vivo PhD
Associate Professor Harvard Medical School
Director, Dana Farber/Harvard Cancer Center High Throughput Genotyping Core
Facility. Channing Division of Network Medicine
Boston, MA 02115
MedicalResearch:What is the background for this study? What are the main findings?Dr. De Vivo: Our study found that greater adherence to the Mediterranean diet is associated with longer telomeres. Following a diet closer to the Mediterranean diet, can prevent accelerated telomere shortening. Our unique contribution to the literature is that we provide a potential molecular mechanism, preventing telomere shortening. Telomeres are bits of DNA that protect your chromosomes.
MedicalResearch: Is telomere shortening reversible?Dr. De Vivo: Telomere shortening is a biological process, the shorten with age.
However, lifestyle choices can help to prevent accelerated shortening.
Fruits, vegetables, olive oil and nuts – key components of the Mediterranean diet have well known antioxidant and anti-inflammatory effects that could balance out the “bad effects” of smoking and obesity.
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MedicalResearch.com Interview with:
Joana Alves Dias, MPH
Department of Clinical Sciences in Malmö,
Lund University Malmö, SwedenMedical Research: What is the background for this study? What are the main findings?Response:The evidence that chronic inflammation may be in the genesis of diseases such as cardiovascular disease, type-II diabetes, and certain types of cancer is increasing. It is suggested that lifestyle factors such as diet, physical activity, smoking, and alcohol consumption could influence the inflammatory state. Instead of focusing on single nutrient effects, we used a hypothesis-driven approach to food pattern studies, and constructed a diet quality index based on the Swedish Nutrition Recommendations and Swedish Dietary guidelines (DQI-SNR). The DQI-SNR consisted of 6 components. Individuals were assigned 0 when not adhering to a recommendation and 1 when adhering, resulting in total scores ranging from 0 to 6. We classified individuals in low (0 or 1 points), medium (2 or 3) and high (4-6 points) diet quality. We explored the association between the index scores and low-grade inflammation.
Our study indicates that adherence to a high quality diet is associated with lower systemic inflammation, as measured by several soluble and cellular biomarkers of inflammation, in middle-aged individuals. In other words, adherence to the general nutrition recommendations could help prevent the development of diseases associated with chronic inflammation. The anti-inflammatory effects of Mediterranean-like diets have been studied extensively, but this study focused on the Swedish dietary habits and recommendations for the Swedish population, and reached similar conclusions. (more…)
Medicalresearch.com with:
Frank B. Hu, MD, PhD
Professor of Nutrition and Epidemiology
Harvard School of Public Health
Professor of Medicine Harvard Medical School
Boston, MA 02115
Medical Research: What is the background for this study?
Dr. Hu: Type 2 diabetes (T2D) affects approximately 26 million people in the United States and 366 million people worldwide, and thus primary prevention of T2D has become a public health imperative. The relation between consumption of different types of dairy and risk of type 2 diabetes remains uncertain. (more…)
MedicalResearch.com Interview with:
Refaat Hegazi, MD, PhD, MS, MPH
Medical Director, Abbott Nutrition
Affiliate Research Associate Professor,
The Brody School of Medicine at East Carolina University
Medical Research: What is the background for this study? What are the main findings?Dr. Hegazi: This study stems from the need to address the financial and health burdens that Chronic Obstructive Pulmonary Disease (COPD) places on the United States. It is the third leading cause of death in the U.S. and costs us about $50 billion a year. It’s a devastating and chronic condition that plagues patients on a daily basis, and previous studies have shown that proper nutrition is essential for proper pulmonary function and rehabilitation.
In a retrospective study of inpatient medical records, we found that by ensuring the nutritional needs of COPD patients were met with oral nutritional supplements (ONS), we were able to tackle the issue of cost, as well as better health outcomes. Specifically, the COPD patients that received oral nutritional supplements, experienced reduced length of hospitalization, lower average hospital costs, and lower readmission rates within 30 days, compared to those that did not.
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MedicalResearch.com Interview with:Sheila E. Harvey, Ph.D.
CTU Manager/Senior Research Fellow
ICNARC
Napier House London
Medical Research: What is the background for this study? Dr. Harvey: The CALORIES trial was set-up in the context of concerns about malnutrition in critically ill patients in NHS hospitals and conflicting evidence as to the optimal route for delivery of early nutritional support to critically ill patients. The enteral route is the mainstay of nutritional support in the critically ill but it is frequently associated with gastrointestinal intolerance and underfeeding. In contrast, the parenteral route, though more invasive and expensive, is more likely to secure delivery of the intended nutrition but has been associated with more risks and complications (e.g. infectious complications) compared with the enteral route.
In light of the uncertainty surrounding the most effective route for delivery of early nutritional support and, given recent improvements in the delivery, formulation and monitoring of parenteral nutrition, the UK National Institute of Health Research (NIHR) Health Technology Assessment (HTA) Programme put out a “call” for a large pragmatic randomised controlled trial to be conducted in critically ill patients to determine the optimal route of delivery of early nutritional support. CALORIES was set up to test the hypothesis that early nutritional support delivered via the parenteral route is superior to early nutritional support delivered via the enteral route in adults who had an unplanned admission to an intensive care unit and who could be fed via either route.
The primary outcome was all-cause mortality at 30 days. The secondary outcomes included infectious and non-infectious complications (hypoglycaemia, elevated liver enzymes, nausea requiring treatment, abdominal distension, vomiting, new or substantially worsened pressure ulcers).
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MedicalResearch.com Interview with:James J. DiNicolantonio, PharmD
Associate Editor BMJ Open Heart
Cardiovascular Research Scientist
Saint Luke's Mid America Heart Institute
Medical Research:What is the background for this study? What are the main findings?Dr. DiNicolantonio: Focusing on calories misdirects eating away from healthy foods (that are higher in calories - such as nuts, salmon, and avocados) and towards harmful foods (e.g. rapidly absorbable carbohydrates - including added sugars such as table sugar and high fructose corn syrup).
Treating obesity should not focus on decreasing caloric intake, rather, it should focus on eating quality foods. Lower calorie foods - that are high in rapidly absorbable carbohydrates - drive increased hunger throughout the day, whereas higher calorie foods (such as full-fat milk and eggs) leads to satiety. Consuming rapidly absorbable carbohydrates leads to increased total caloric intake throughout the day (driven by insulin resistance and leptin resistance). These metabolic consequences derived from overconsuming these types of foods leads us to eat more and exercise less. In essence, eating more and exercising less doesn't cause obesity, overconsuming rapidly absorbable carbohydrates causes us to eat more and exercise less, which then causes obesity - a subtle but important distinction.
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MedicalResearch.com Interview with:Wenjie Ma MS Doctoral Student
Harvard School of Public Health
Medical Research:What is the background for this study? What are the main findings?Response: De novo lipogenesis (DNL) is the process whereby excess carbohydrate and protein are converted into saturated fatty acids (SFAs) and monounsaturated fatty acids (MUFAs). Emerging animal and in vitro evidence suggests that DNL might play an important role in metabolic regulation and influence the pathogenesis of type 2 diabetes. We used circulating biomarkers SFAs and MUFAs to investigate the prospective associations with incident diabetes in the Cardiovascular Health Study, a community-based cohort of older US adults. We found that circulating palmitic acid and stearic acid were associated with higher risk of incident diabetes, whereas vaccenic acid was associated with lower risk. In contrast, dietary intakes of saturated fatty acids and monounsaturated fatty acids were not associated with diabetes risk.
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MedicalResearch.com Interview with:
Yvonne M. Terry-McElrath, MSA
Research Associate, Survey Research Center, Institute of Social Research
University of Michigan Tobacco Research Center
Medical Research: What is the background for this study? What are the main findings?Dr. Terry-McElrath: The United States Department of Agriculture (USDA) recently improved nutrition standards for federally-reimbursable school lunch and breakfast programs. Most lunch standards were implemented at the beginning of the 2012-13 school year and changes in breakfast began with the 2013-14 school year. Beginning in 2014, schools participating in federally-reimbursable meal programs were also required to improve nutrition standards for foods and beverages sold in vending machines, stores/snack bars/carts, and à la carte cafeteria lines. The new standards limit fats, sodium, sugar, and calories; and will eventually remove candy; regular-fat salty snacks/sugary treats; higher-fat milks; high-fat, high-calorie savory foods; and sugar-sweetened beverages, like regular soda, fruit drinks and high calorie sports drinks. They were developed in response to rising overweight/obesity among US children and adolescents.
This study uses five years of data from nationally-representative samples of middle and high school students—and their school administrators—to examine three research questions: What percentage of US secondary students attended schools in 2008-2012 where foods and beverages met at least some of the USDA standards that were to begin phased implementation starting in 2012-13? Is there evidence that those standards were associated with student overweight/obesity? Is there evidence of the effect of those standards on racial/ethnic minorities and students from lower income families? Using data from schools even before the new USDA standards went into effect can indicate potential effect of the standards once they have been in effect for several years. The research was conducted through two studies: The Monitoring the Future study, supported by a grant from the National Institute on Drug Abuse, and the Youth, Education and Society study, part of a larger research initiative funded by the Robert Wood Johnson Foundation, titled “Bridging the Gap: Research Informing Policy and Practice for Healthy Youth Behavior.”
Study findings show that from 2008-2012, few middle or high school students attended schools where food and beverage standards would be judged to meet at least some of the USDA school nutrition standards that began to be implemented in 2012-13. Significant increases in the number of standards over time were seen for middle but not high school students. Among high school students, having fruits and vegetables available wherever foods were sold, the absence of higher-fat milks, and increasing the number of positive nutrition standards were associated with significantly lower odds of overweight/obesity. Not having sugar-sweetened beverages was associated with lower overweight/obesity for middle and high school minority students.
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MedicalResearch.com Interview with:Dr. Patrice Carter
Diabetes, Nutrition & Lifestyle Research Associate
Diabetes Research Centre (Broadleaf) University of Leicester
Leicester General Hospital Leicester UK
Medical Research: What is the background for this study? What are the main findings?Dr. Carter: Type 2 diabetes is a growing concern, worldwide prevalence is expected to increase to 552million by 2030. Prevalence is closely linked to increasing obesity rates which are associated to environmental changes that have led to more sedentary lifestyles and poor-quality dietary intake. Consumption of fast food has previously been linked to the obesity epidemic and consumption is associated with low adherence to dietary recommendations.
We analysed data of over 10,000 individuals to investigate the association between screen detected type 2 diabetes and the number of fast food outlets in their neighbourhood.
In summary we found the mean number of fast food outlets in areas with high social deprivation as compared to low social deprivation; mean number of outlets was 3.53 (SD 4.83) and 0.91 (1.89) respectively. The number of fast food outlets was positively associated with screen-detected type 2 diabetes (OR=1.05; 95% CI 1.04, 1.07; p<0.001). In addition, we used these data to calculate that for every additional two outlets we would expect to see one more diabetes case, assuming a 7% prevalence of undiagnosed type 2 diabetes in neighbourhoods with no outlets and approximately 200 residents in a 500m radius, and assuming a causal relationship.
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MedicalResearch.com Interview with: Jill Kanaley, PhD
Professor and Associate Ahair
Department of Nutrition and Exercise Physiology
University of Missouri
Abstract: Background: Adolescents consume more sugar-sweetened beverages than do individuals in any other age group, but it is unknown how the type of sugar-sweetened beverage affects metabolic health in this population.
Objective: The objective was to compare the metabolic health effects of short-term (2-wk) consumption of high-fructose (HF) and high-glucose (HG)–sweetened beverages in adolescents (15–20 y of age).
Design: In a counterbalanced, single-blind fashion, 40 male and female adolescents completed two 2-wk trials that included 1) an HF trial in which they consumed 710 mL of a sugar-sweetened beverage/d (equivalent to 50 g fructose/d and 15 g glucose/d) for 2 wk and 2) an HG trial in which they consumed 710 mL of a sugar-sweetened beverage/d (equivalent to 50 g glucose/d and 15 g fructose/ d) for 2 wk in addition to their normal ad libitum diet. In addition, the participants maintained similar physical activity levels during each trial. The day after each trial, insulin sensitivity and resistance [assessed via Quantitative Insulin Sensitivity Check Index (QUICKI) and homeostatic model assessment of insulin resistance (HOMA-IR) index] and fasting and postprandial glucose, lactate, lipid, cholesterol, insulin, C-peptide, insulin secretion, and clearance responses to HF or HG mixed meals were assessed.
Results: Body weight, QUICKI (whole-body insulin sensitivity), HOMA-IR (hepatic insulin resistance), and fasting lipids, cholesterol, glucose, lactate, and insulin secretion or clearance were not different between trials. Fasting HDL- and HDL3-cholesterol concentrations were w10–31% greater (P , 0.05) in female adolescents than in male adolescents. Postprandial triacylglycerol, HDL-cholesterol, HDL3-cholesterol, and glucose concentrations were not different between HF and HG trials. The lactate incremental area under the curve was w3.7-fold greater during the HF trial (P , 0.05), whereas insulin secretion was 19% greater during the HG trial (P , 0.05).
Conclusions: Moderate amounts of HF- or HG-sweetened beverages for 2 wk did not have differential effects on fasting or postprandial cholesterol, triacylglycerol, glucose, or hepatic insulin clearance in weight-stable, physically active adolescents.
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MedicalResearch.com Interview with:James J. DiNicolantonio, PharmD
Associate Editor BMJ Open Heart
Cardiovascular Research Scientist
Saint Luke's Mid America Heart Institute
Medical Research: What is the background for this study? What are the main findings?
Dr. DiNicolantonio: Daily low-dose aspirin has been shown to decrease the risk for cancer in a meta-analysis of randomized controlled trials, which is likely attributable to its ability to modestly decrease the activity of cyclooxygenase-2 (cox-2), an enzyme which contributes importantly to the genesis and progression of adenocarcinomas. Adenocarcinomas are cancer of the glands, the most common type of breast cancer (invasive ductal carcinoma) is an adenocarcinoma, additionally many cancers of the lung, intestine, esophagus, colon are adenocarcinomas.
We show that an ample dietary intake of long-chain omega-3 fats—the type prominent in fatty fish—would oppose cox-2 activity. Additionally, we cite numerous evidence that a higher intake of long-chain omega-3 fats has been found to reduce the risk for numerous types of cancer - especially when looking at trials that excluded fried or preserved fish (or fish high in omega-6), excluded trials with a high background intake of omega-6, and included trials where the "high" intake group - actually ate 2 servings of fish or more per week. Additionally, basic science as well as randomized data showing that long-chain omega-3s can reduce the number and size of colon polyps supports this argument.
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MedicalResearch.com Interview with: Dr. Markos Klonizakis
Centre for Sports and Exercise Science
Sheffield Hallam University, UK
Medical Research:What is the background for this study? What are the main findings?Dr. Klonizakis: It is widely accepted that populations in the Eastern Mediterranean sea have historical lower rates of cardiovascular disease, diabetes and cancer. This has been attributed to a great extent, at following a diet based on dishes and ingredients, which are common in this region and are collectively known as “Mediterranean diet”. Taking into consideration that cardiovascular disease is on the rise, particularly in the Western world, it did make sense to see if such a diet can be adapted for a population that has a largely different culinary tradition and what the results would be if this is combined with exercise of moderate-intensity. We therefore, designed and implemented an 8-week intervention, aiming at older, healthy but previously untrained people, comparing an exercise-only group vs one where exercise was combined with Mediterranean diet. Our work has shown that benefits of this intervention are still evident in the vascular function (measured by the function of the inner vein lining, called the endothelium) and the cardiopulmonary fitness, one year after the end of the intervention.
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MedicalResearch.com Interview with:
Brie Turner-McGrievy, Ph.D., M.S., R.D.
Assistant Professor
University of South Carolina; Arnold School of Public Health
Department of Health Promotion, Education, and Behavior
Columbia, SC 29208
Medical Research: What is the background for this study? What are the main findings?Dr. Turner-McGrievy: Several observational studies have examined differences in weight-related outcomes among individuals following vegan, vegetarian, pesco-vegetarian, semi-vegetarian, or omnivorous diets. These studies have found lower body weights and less weight gain over time among vegans as compared to other groups. However, no randomized controlled trials have tested the relationship between these diets and body weight. So the goal of our study was to determine the effect of varying plant-based diets on weight loss. Our study found that a similar relationship of weight loss was found among the five diet groups that has been observed in epidemiological studies, with weight loss going from greatest in the vegan group followed by vegetarian, pesco-vegetarian, semi-vegetarian, and omnivorous. At six months, the vegan group lost significantly more weight (-7.5 ± 4.5%) than the omnivorous (-3.1 ± 3.6%, P=0.03), semi-vegetarian (-3.2 ± 3.8%, P=0.03), and pesco-vegetarian (-3.2 ± 3.4%, P=0.03) groups. (more…)
MedicalResearch.com Interview with: Susanne Rautiainen, PhD
From the Department of Institute of Environmental Medicine
Karolinska Institutet, Stockholm, Sweden
Divisions of Preventive Medicine Department of Medicine,
Brigham and Women's Hospital and Harvard Medical School, Boston, MA
Medical Research: What is the background for this study? What are the main findings?Dr. Rautiainen: Multivitamins are the most commonly used dietary supplement in the US and other developed countries and it has been shown that many take them with the goal of maintaining or improving their health. Multivitamins typically provide low-doses of essential vitamins and minerals to prevent deficiency. Yet many people who take multivitamins are not deficient. Despite the widespread use, limited number of studies have investigated how multivitamins are associated with major chronic diseases, including cardiovascular disease. We therefore examined how self-reported multivitamin use was associated with both short- and long-term risk of cardiovascular diseases in the Women’s Health Study which is a prospective cohort of 37,193 women aged ≥45 years and free of CVD and cancer at baseline.
In this study of middle-aged and elderly women who were apparently healthy at baseline and followed for an average of 16.2 years, we observed that multivitamin use was not associated with neither short- nor long-term risk risk of major CVD events, including MI, stroke, or CVD death. Moreover, there was no significant association observed for women who had taken multivitamins for ≥10 years at baseline. There were some important indications that the association between multivitamin use and long-term risk of major CVD events may be modified by age and fruit and vegetable intake, suggesting that women who were older and had low fruit and vegetable intake may benefit more from multivitamin supplement use. However, these results should be interpreted with caution. Moreover, relying on self-reports of multivitamin use may be subject to misclassification, plus other unmeasured factors may have biased the results despite our best effort to account for everything.
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MedicalResearch.com Interview with Punam Ohri-Vachaspati, Ph.D.,R.D
Associate Professor, Nutrition
Arizona State University
School of Nutrition and Health Promotion
College of Health Solutions Phoenix, AZ 85004
Medical Research: What is the background for this study? What are the main findings?Dr. Ohri-Vachaspati: Fast food is heavily marketed to kids -- with the food industry spending over $700 million each year to market their products specifically to children and adolescents. About half of this money goes towards premiums like toys given away with kids meals. And marketing works --exposure to food marketing is associated with higher fast food consumption among children. Research has shown us that 2-18 year olds consume 13% of their total calories at fast food restaurants. Children who eat at fast food restaurants are likely to have poor diets and worse health outcomes.
In this study we wanted to examine which communities are more vulnerable to child-directed marketing on the interior and exterior of fast food restaurants. Over a three year period (2010, 2011, and 2012) we sampled nearly 7000 restaurants from a whole spectrum of communities across the US. Child-directed marketing measured inside fast food restaurants included indoor play area and display of kids’ meal toys, and on the exterior included advertisements with cartoon characters, advertisements with movie, TV or sports figures, and advertisements for kids’ meal toys among others.We found that more than a fifth of fast food restaurants used child-directed marketing on the inside or on the exterior of their premises. Middle-income communities, majority black communities and rural areas were disproportionately exposed to this type of child-directed marketing.
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MedicalResearch.com Interview with:Mary Ann Honors, Ph.D.
Postdoctoral Research Fellow
Division of Epidemiology and Community Health
University of Minnesota
Medical Research:What are the main findings of the study?Dr. Honors: The American Heart Association and USDA have made recommendations on what we should and should not eat in order in reduce our cardiovascular disease risk. We wanted to know whether Americans are currently meeting these recommendations, as well as how our diets have changed over time. In particular, we were interested in several specific nutrients, including trans fats, saturated fats, and the omega-3 fatty acids, DHA and EPA. We examined trends in fatty acid intake in participants from the Minnesota Heart Survey. The Minnesota Heart Survey is a an ongoing, cross-sectional study of adults in the Minneapolis-St. Paul metro area that was designed to monitor cardiovascular disease risk factors, including diet.
We found that intake of trans fats and saturated fats has declined substantially over the last 30 years. However, intake levels are still above current recommendations. With DHA and EPA, we found that levels of intake were pretty steady over time and below what is recommended. Overall, while we saw some encourage trends, there is still some room for improvement in our diets. (more…)
MedicalResearch.com Interview with:Georg Loss, PhD
Dr. von Hauner Children’s Hospital
Ludwig Maximilians University of Munich
Munich, Germany
Medical Research: What are the main findings of the study?Dr. Loss:In this large population based cohort study we observed that consumption of fresh unprocessed cow’s milk protected from respiratory infections, febrile illness and inflammation of the middle ear during the first year of life. The risk of developing these conditions was reduced by up to 30%, and the effect was diminished if the milk was heated at home before consumption. Conventionally pasteurized milk retained the ability to reduce the risk of febrile illness, while exposure to the higher temperatures used in UHT (Ultra-heat-treatment) processing eliminated the effect altogether. Importantly, the positive impact of fresh milk could be clearly separated from the confounding effects of other elements of the children’s nutrition. Furthermore, infants fed on unprocessed milk were found to have lower levels of the C-reactive protein, which is a measure of inflammation status.
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MedicalResearch.com Interview with: Sara N. Bleich, Ph.D.
Associate Professor Department of Health Policy and Management
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD 21205
Medical Research: What are the main findings of the study?Dr. Bleich: Providing easily understandable calorie information — particularly in the form of miles of walking — makes adolescents more likely to buy a beverage with fewer calories, a healthier beverage or a smaller size beverage. Adolescents were also more likely to not buy any drink at all after seeing the signs with calorie information.
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MedicalResearch.com Interview with: Deborah Clegg, PhD
Research Scientist, Diabetes and Obesity Research Institute
Associate Professor, Department of Biomedical Science
Cedars-Sinai Medical Center
Los Angeles, CA 90048
Medical Research: What are the main findings of the study?Dr. Clegg:The main findings are that males and females differ with respect to how they process and respond to diets high in fat!!!! Males following consumption of a diet that is 42% of the calories coming from saturated fat (it would be analogous to eating a big mac and having a coke), gained the same amount of weight as did the females BUT the males had increased markers of inflammation in their brains and the females did not. With the elevated markers of inflammation, the males had dysregulation in glucose homeostasis and alteration in cardiovascular function – yet the females did not!!
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MedicalResearch.com Interview Invitation Sara N. Bleich, Ph.D.
Associate Professor
Department of Health Policy and Management
Johns Hopkins Bloomberg School of Public Health
Baltimore, MD 21205
Medical Research: What are the main findings of the study?Dr. Bleich: Large chain restaurants appear to be voluntarily reducing the calories in their newly introduced menu items which contain an average of 60 fewer calories than items only on the menu in the prior year. This decline is primarily driven by new lower calorie salads and sandwiches.
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MedicalResearch.com Interview with: Jordi Salas-Salvadó Professor of Nutrition
Human Nutrition Unit Department of Biochemistry & Biotechnology
IISPV School of Medicine.
Rovira i Virgili University CIBERobn, Instituto Carlos III
Medical Research: What are the main findings of the study?Response: In this large, multicenter, randomized clinical trial conducted in Mediterranean individuals at high cardiovascular risk, Mediterranean-diet supplemented with extra-virgin olive oil was associated to a lower increase in the prevalence of metabolic syndrome compared to the advice on a control low-fat diet. However, no beneficial effect of Mediterranean-diet on the incidence of metabolic syndrome among participants free of this condition at baseline was observed. Therefore, the lower increase in prevalence was especially due to the reversion of metabolic syndrome in those individuals with metabolic syndrome at baseline.
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MedicalResearch.com Interview with:
Daniel (Dong) Wang MD, MSc
Department of Nutrition, Harvard School of Public Health
Boston, MA 02115
Medical Research: What are the main findings of the study?Dr. Wang:
The overall dietary quality in US adults improved modestly from 1999 to 2010, but the quality of US diet remains far from optimal and huge room exists for further improvements.
The improvement in dietary quality was greater among adults with higher socioeconomic status and healthier body weight, thus disparities that existed in 1999 increased over the next decade.
More than half of the improvement in diet quality was due to a large reduction in consumption of trans fat.
MedicalResearch.com Interview with: Dr. Wenjun Li PhD
Associate Professor of Medicine (Biostatistics)
University of Massachusetts Medical School of Medicine
University of Massachusetts Medical School
Medical Research: What are the main findings of the study?Dr. Li: The study discovered that the effectiveness of dietary interventions is significantly influenced by the presence of a supportive community nutrition environment.
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MedicalResearch.com Interview with: Pietro Manuel Ferraro, MD PhD Candidate
Division of Nephrology
Catholic University of the Sacred Heart
Rome Italy
Medical Research: What are the main findings of the study?Dr. Ferraro: We analyzed the association between caffeine intake and the risk of developing kidney stones in three large cohorts of U.S. health professionals. The 217,883 participants included did not have any history of kidney stones when follow-up began. During 20 years of follow-up, 4,982 of them developed a kidney stone. In all three cohorts, participants with higher intakes of caffeine had a reduced risk of developing kidney stones. Intake of caffeine from sources other than coffee was also associated with reduced risk of kidney stones. Among 6,033 participants with 24-hour urine data, intake of caffeine was associated with higher excretion of calcium but also higher urine volume and lower likelihood of calcium and uric acid stone formation. (more…)
MedicalResearch.com Interview with: Dr. Anil Nigam MD MSc FRCPC
Director, Research Program in Preventive Cardiology at ÉPIC Centre
Montreal Heart Institute
Associate Professor, Department of Medicine at Université de Montréal
Medical Research: What are the main findings of the study?Dr. Nigam: The main finding is that high-dose fish oil rich in marine omega-3 fatty acids did not reduce recurrence of atrial fibrillation in individuals with paroxysmal or persistent atrial fibrillation not receiving conventional anti-arrhythmic therapy.
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For MedicalResearch.comJyrki Virtanen, PhD
Adjunct Professor of Nutritional Epidemiology
University of Eastern Finland
Kuopio, Finland
Medical Research: What are the main findings of the study?Dr. Virtanen: The main finding was that saturated fat intake was not an independent risk factor for Coronary Heart Disease even in a population with relatively high average saturated fat intake, like in this population with middle-aged and older men from Eastern Finland. In other words, intake of carbohydrates in place of saturated fat was not associated with lower risk, not even when the quality of carbohydrates was taken into account. Only when polyunsaturated fat replaced saturated fat in the diet, was the risk of Coronary Heart Disease, especially Coronary Heart Disease mortality, lower. In fact, also replacing trans fat or carbohydrates with polyunsaturated fat was associated with lower risk. The associations were similar with both n-6 and n-3 polyunsaturated fatty acids.
Trans fat intake was not associated with the Coronary Heart Disease risk, but that is most likely explained by the low intake of trans fat in Finland already in mid-1980s.
We also investigated the associations of the fatty acid intake with carotid artery atherosclerosis, and the results were generally similar to the findings with incident Coronary Heart Disease events.
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MedicalResearch.com Interview with: Lynn L. Moore, DSc, MPH
Co-Director, Nutrition and Metabolism
Assoc Prof of Medicine
Preventive Medicine & Epidemiology Department of Medicine
Boston University School of Medicine
Boston, MA 02118
Medical Research: What are the main findings of the study?Response: Our data were derived from 1,361 adults (aged 30-54 years) enrolled in the Framingham Offspring Study and showed that men and women who consumed higher amounts of protein had lower blood pressures (both systolic and diastolic blood pressures) after four years of follow-up. We then followed them for an average of about 11 years and found that those who consumed the most protein (approximately 103 g/day) had about a 40% lower risk of developing high blood pressure than those consuming about half that amount. These beneficial effects were even more pronounced when higher protein intakes were combined with high fiber intakes.
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MedicalResearch.com Interview with: Professor Aubrey Sheiham
Emeritus Professor of Dental Public Health
Department of Epidemiology & Public Health,
University College London, WC1E 6BT. UK.
Medical Research: What are the main findings of the study?Prof Sheiham: There is a robust log-linear relationship of caries to sugar intakes from zero to 10% of sugars as a proportion of total energy intake. Furthermore our analyses showed that sugar intakes of 10%E sugars intake that is currently recommended as an upper limit for free sugars by the WHO and the Scientific Advisory Committee on Nutrition in England would induce a very costly burden of caries in most populations. Second, we found that free sugars* in the diet should make up no more than 3% of total energy intake. Above that level they cause a significant level of tooth decay across the lifecourse of most people in the developed world. Third, we were able to show that despite widescale fluoride use from both toothpastes and drinking water the mean numbers of decayed, missing and filled teeth (DMFT) and decayed and filled surfaces (DFS) for adults increased with sugar use despite the presence of fluoride.
*Free sugars are defined by the World Health Organisation Nutrition Guidance Adivisory Group as follows: “Free sugars include monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit concentrates.” (more…)
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MedicalResearch.com Interview with:
James J. DiNicolantonio, PharmD
Associate Editor BMJ Open Heart
Cardiovascular Research Scientist
Saint Luke's Mid America Heart Institute
Medical Research: What is the background for this study? What are the main findings?
Dr. DiNicolantonio: Cardiovascular disease is the leading cause of premature mortality in the developed world, and hypertension is its most important risk factor. Controlling hypertension is a major focus of public health initiatives, and dietary approaches have historically focused on sodium.
A reduction in the intake of added sugars, particularly fructose, and specifically in the quantities and context of industrially-manufactured consumables, would help not only curb hypertension rates, but would also help address broader problems related to cardiometabolic disease.
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