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.
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.
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.
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.
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.
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.
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.
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.
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.
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!!
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.
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.
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:
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.
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.
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.
For MedicalResearch.com
Jyrki 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.
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.
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.”
MedicalResearch.com Interview with:
Sharon G. Curhan, MD, ScM
Channing Division of Network Medicine
Department of Internal Medicine
Brigham and Women's Hospital
Harvard Medical School
Boston, MA 02115
Medical Research: What are the main findings of the study?
Dr. Curhan: We followed more than 65,000 women who were participants in the Nurses’ Health Study II over 18 years and found that eating 2 or more servings of fish per week was associated with a lower risk of hearing loss. For example, after adjusting for potential confounders in multivariable analyses, in comparison with women who rarely or never ate fish, women who consumed 2 or more servings of fish per week had a 20% lower risk of hearing loss. Eating any type of fish (tuna, dark fish, light fish or shellfish) tended to be associated with lower risk. Also, we found that higher intake of long-chain omega-3 polyunsaturated fatty acids (PUFAs) was inversely associated with risk. For example, in comparison with women with the lowest intake, women with the highest intake of long-chain omega-3 PUFAs had a 22% lower risk of hearing loss.
MedicalResearch.com Interview with:
Vanessa Er PhD
School of Social and Community Medicine
University of Bristol and Bristol Nutrition BRU
Medical Research: What are the main findings of the study?
Dr. Er: We found that men who had optimal intake of three nutrients- calcium, selenium and foods rich in lycopene- had a lower risk of prostate cancer. Mainly, men who ate over 10 servings/week of tomatoes and tomato-based products had 18% reduction in risk of developing prostate cancer. We also found that the risk of prostate cancer was lower in men who had high intake of fruits and vegetables.
MedicalResearch.com Interview with:
Prof. Peter B. Marko
Department of Biology
University of Hawaii at Mānoa,
Honolulu, Hawaii
Medical Research: What are the main findings of the study
Prof. Marko: The main finding of the study was that species substitutions and fishery stock substitutions together obscure a complex pattern of mercury contamination in Chilean sea bass (or Patagonian toothfish) that can put consumers unknowingly at risk of ingesting greater levels of mercury than the labeling would suggest. Although it is well appreciated that mercury levels vary dramatically among different species of fish, and that species substitutions have the potential to expose consumers to unwanted mercury, our study shows that for Chilean sea bass, fish mislabeled as to their country or region of origin (but labeled as the correct species) have a high potential to expose consumers to unexpectedly high levels of mercury.
MedicalResearch.com Interview with:
Professor Clodagh O'Gorman
MB BCh BAO MSc MD FRCPI FPAEDS
Foundation Chair & Professor of Paediatrics,
Graduate Entry Medical School,
University of Limerick, Ireland.
Medical Research: What are the main findings of the study?
Professor O'Gorman: 1155 cues for food and beverages (BBC=450; RTE=705), were recorded over 82.5 hours; thus, on average one cue was recorded every 4.2 minutes. The total recorded time for food and beverage cues was 3.94 hours, equating to 4.8% of the total recording time, and averaging 13.2 seconds per cue.
If these results are representative of all children’s television broadcast on RTE and BBC, then if your child watches 82.5 hours of television, your child will see 3.94 hours of food and beverages during this time. Unhealthy foods account for 47.5% of specified food cues, and sugar-sweetened beverages for 25% of specified beverage cues, with an average time of 13.8 s for healthy cues and 11.4 s for unhealthy cues (p=0.17).
88.2% of all food and beverage cues involved a major character and 95.3% involved a character ‘goodie’. Male characters were more common than female (45.3% vs 14.0%), adults more common than teens or children (46.3% vs 23.8% and 14.2%). Overweight characters were depicted in 4.7%. The most common ethnic group was white Caucasian (88.5%).
The commonest motivating factor for consuming/depiction of food and beverage was celebratory/social (25.2%), followed by hunger/thirst (25.0%), reward (4.5%), health-related (2.2%) and punishment (1.2%). Motivating factors were positive (30.5%), negative (1.5%) and health-related (25.8%). Cue outcomes were positive (32.6%), negative (19.8%) and neutral (47.5%).
MedicalResearch.com Interview with:
James T. Becker, Ph.D.
Professor of Psychiatry, Psychology, and Neurology
University of Pittsburgh
Medical Research: What are the main findings of the study?
Dr. Becker: We found that people who eat baked or broiled (but not fried) fish at least once every week had significantly larger brain volumes in areas critical for memory and cognition, namely, hippocampus, precuneus, posterior cingulate cortex, and orbital frontal cortex.
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 Discovery
Columbia, SC 29208
Medical Research: What are the main findings of the study?
Dr. Turner-McGrievy: This study assessed how closely crowdsourced ratings of foods and beverages contained in 450 pictures from the Eatery mobile app as rated by peer users using a simple “healthiness” scale were related to the ratings of the same pictures by trained observers. Our trained observers used a rating scale based on the U.S. Dietary Guidelines to assess the healthiness of the foods and beverages in each picture. Crowdsourcing uses the input of several users to provide feedback and information. We found that all three trained raters’ scores was highly correlated with the peer healthiness score for all the photos. In addition, we found that peer ratings were in the expected direction for both foods/beverages the Dietary Guidelines say to increase and ones to limit. Photos with fruit, vegetables, whole grains, and legumes, nuts, and seeds were all associated with higher peer healthiness scores and processed, food from fast food restaurants, refined grains, red meat, cheese, savory snacks, sweets/desserts, and sugar sweetened beverages were associated with lower peer healthiness scores.