Eating a Mostly Plant Based Diet Linked To Lower Risk of Heart Failure

MedicalResearch.com Interview with:
“Fresh Food” by Sonny Side Up! is licensed under CC BY 2.0

 

Dr. Kyla M Lara
Icahn School of Medicine at Mount Sinai

 

 

 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This was the first study to evaluate whether dietary patterns of black and white adults living in the United States were associated with developing heart failure. We’re hearing a lot in the news about specific diets like low-fat, high protein, low carb, and other diets that decrease cardiovascular risk. We would love it, as physicians, if we could prescribe a specific diet to limit cardiovascular risk in our patients. I’m really excited about our study because instead of examining patterns of what we already know are healthy, we looked at foods people were regularly consuming in the United States and developed dietary patterns from this. This study is similar to other work we have done with stroke and heart attack.

We used data from the NIH funded REGARDS study, also known as the Reasons for Geographic and Racial Differences in Stroke. More than 30,000 white and African-American adults were recruited from 2003-2007. From this group, we studied over 18,000 adults who successfully completed a dietary assessment called the Food Frequency Questionnaire. This was a really great group to study because people who live in this particular geographic area of the Southeastern United States, also known as the stroke belt, suffer from a higher risk of death from stroke. It’s extremely important for us to better understand the major risk factors that contribute to this and also cardiovascular disease.

We used statistical techniques to derive 5 dietary patterns based on the types of foods participants tended to eat.
• Convenience – Mexican and Chinese food, mixed dishes (both meat and bean)
• Sweets – added fats, bread, chocolate, desserts, sweet breakfast foods
• Southern – added fats, fried food, organ and processed meat, fatty milk
• Alcohol/Salads – beer, wine, liquor, green leafy vegetables, salad dressings, nuts and seeds, coffee
• Plant Based- fruit, vegetables, fruit juice, cereal, fish, poultry

Each participant received a score for each pattern that reflected how closely their diet resembled that dietary pattern. This approach reflects the real world and how people eat.

Over the 3135 days (8.6 years) of median follow up, 594 participants were hospitalized for incident HF. Greatest adherence to the plant-based dietary pattern during the study period was associated with a 28% risk reduction of developing heart failure.
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Chocolate Milk May Promote Weight Gain in Children and Adolescents

MedicalResearch.com Interview with:

Jorge E. Chavarro, M.D., Sc.D. Assistant Professor of Nutrition and Epidemiology Harvard T.H. Chan School of Public Health Assistant Professor of Medicine Harvard Medical School Boston, MA 02113

Dr. Chavarro

Jorge E. Chavarro, MD, ScD
Associate Professor
Departments of Nutrition and Epidemiology
Harvard T.H. Chan School of Public Health
Channing Division of Network Medicine
Department of Medicine
Brigham and Women’s Hospital and Harvard Medical School
Boston, MA 02115

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It is well known that sugared sweetened beverages (SSBs) promote excessive weight gain and obesity in children. The excess sugars in chocolate milk and other flavored milks puts them in a category that may be closer to sugared sweetened beverages than to plain milk. However, data on whether flavored milks promote weight gain is scarce.

We followed a cohort of 5,321 children and adolescents over a four year period to evaluate whether intake of chocolate milks was related to weight gain. We found that children who increased their intake of flavored milk gained more weight than children whose intake of flavored milk remained stable over this period. Moreover, among those children who did not drink any chocolate milk at baseline, those who started drinking chocolate milk over the course of the study gained substantially more weight than children who remained non-consumers of chocolate milk.

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Salt Content in Restaurant Food Remains High

MedicalResearch.com Interview with:

Julia Wolfson, PhD MPP Assistant Professor Department of Health Management and Policy Department of Nutritional Sciences University of Michigan School of Public Health Ann Arbor, MI 48109

Dr. Wolfson

Julia Wolfson, PhD MPP
Assistant Professor
Department of Health Management and Policy
Department of Nutritional Sciences
University of Michigan School of Public Health
Ann Arbor, MI 48109

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Over the past several years, Large chain restaurants in the United States have made some progress in introducing new lower calorie items on their menus. Since 2012, calories of items consistently on restaurant menus in all years have not significantly change. In this study, we examined the sodium content of restaurant menu items among 66 of the 100 largest restaurants in the US. We examined sodium content among items on the menu in all years (2012-2016) and among newly introduced items in 2013, 2014, 2015 and 2016 compared to items on the menu in 2012 only.

We found that sodium content of menu items on the menu in all years did not change, but that restaurants were introducing new, lower sodium menu items. However, sodium content of restaurant menu items remains high. This is important because diets high in sodium are associated with serious adverse health outcomes including hypertension, stroke and cardiovascular disease.

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Multivitamins in Pregnancy May Be Associated With Lower Autism Risk

MedicalResearch.com Interview with:
Elizabeth DeVilbiss, PhD MPH
Dornsife School of Public Health
Drexel University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Unfortunately, not much is known about how diet during pregnancy affects autism risk.  There have been studies in recent years about varied aspects of diet during pregnancy and autism risk involving multivitamins, iron, folic acid, vitamin D, and more, but the evidence is still inconclusive.

After adjusting for several potentially influencing factors in both mothers and children, we found that multivitamin use, with or without additional iron and/or folic acid, was associated with a lower likelihood of child autism spectrum disorder with intellectual disability relative to mothers who did not use folic acid, iron, and multivitamins.

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Participation in SNAP Food Assistance Linked To Lower Health Care Costs

MedicalResearch.com Interview with:

Seth A. Berkowitz, MD, MPH Division of General Internal Medicine Diabetes Population Health Unit Harvard Medical School Massachusetts General Hospital, Boston

Dr. Berkowitz

Seth A. Berkowitz, MD, MPH
Division of General Internal Medicine
Diabetes Population Health Unit
Harvard Medical School
Massachusetts General Hospital, Boston

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There is ever growing pressure to contain healthcare costs in the US. Increasingly, attention is turning to programs that address social determinants of health–that is, those factors which affect health but lie outside the realm of clinical medicine.

Prior research has highlighted food insecurity as having a clear association with poor health and higher healthcare costs. SNAP is the nation’s largest program to combat food insecurity. However, we did not know whether SNAP participation would be associated with any difference in healthcare costs, compared with eligible non-participants.

This study found that participating in SNAP was associated with approximately $1400 lower healthcare expenditures per year in low-income adults.

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High Carbohydrate Diet Associated With Increased Risk of Mortality

MedicalResearch.com Interview with:

Dr. Mahshid Dehghan, PhD Investigator- Nutrition Epidemiology Program Population Health Research Institute Senior Research Associate – Department of Medicine McMaster University

Dr. Dehghan

Dr. Mahshid Dehghan, PhD
Investigator- Nutrition Epidemiology Program
Population Health Research Institute
Senior Research Associate – Department of Medicine
McMaster University

MedicalResearch.com: What is the background for this study?

Response: For decades, dietary guidelines have largely focused on reducing total fat and saturated fat intake based on the idea that reducing fat consumption should reduce the risk of CVD. But this did not take into account what nutrients replace saturated fats in the diet. Given that carbohydrates are relatively inexpensive, reducing fats (especially saturated fat) is often accompanied by increased carbohydrate consumption. This approach continues to influence health policy today. The guidelines were developed some 4 decades back mainly using data from some Western countries (such as Finland) where fat and saturated fat intakes were very high (eg total fat intake was >40% of caloric intake and saturated fats was >20% of caloric intake). It is not clear whether the harms seen at such high levels applies to current global intakes or countries outside North America and Europe where fat intakes are much lower.

The PURE (Prospective Urban Rural Epidemiology) study is a large international cohort study of more than 157,000 people aged 35 to 70 years from 18 low-income, middle-income, and high-income countries on 5 continents. In this study, 135,335 individuals with dietary information and without cardiovascular disease at baseline were included in the study. Standardized questionnaires were used to collect information about demographics, socio-economic factors, lifestyle behaviors, health history and medication use. Standardized case-report forms were used to record data on major cardiovascular events and mortality during follow-up, which were adjudicated centrally in each country by trained physicians using standard definitions. The participants were followed-up for 7.5 years, during which time 4784 major cardiovascular events and 5796 deaths were recorded.

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3-4 Servings Fruits, Vegetables and Legumes Sufficient To Reduce Cardiovascular Mortality

MedicalResearch.com Interview with:
Ms Victoria Miller
Population Health Research Institute
DBCVS Research Institut
McMaster University, Hamilton, ON
Canada

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: PURE study is prospective urban rural epidemiology study that included aged 35 to 70 years from 26 low-income, middle-income, and high-income countries on 5 continents. Data were collected at the community, household, and individual levels. Standardized questionnaires were used to collect information about demographic factors, socio-economic status (education, income, and employment), lifestyle (smoking, physical activity, and alcohol intake), health history and medication use. Standardized case-report forms were used to record data on major cardiovascular events and mortality during follow-up, which were adjudicated centrally in each country by trained physicians using standard definitions. Participants’ habitual food intake was recorded using country-specific (or region specific in India) validated food frequency questionnaires (FFQs) at baseline. The median follow up is 7.4 years and we are aiming for follow up people at least for 15 years. During 7.4 years of follow up more than 6000 CVD and 7000 mortality recorded.

Higher fruit, vegetable and legume intake is associated with a lower risk of cardiovascular, non-cardiovascular and total mortality. Our findings show the lowest risk of death in those who consume three to four servings (equivalent to 375-500 grams per day) of fruits, vegetables and legumes per day, with little additional benefit for intake beyond that range.

When examined separately, fruit intake is associated with lower risk of cardiovascular, non-cardiovascular and total mortality, while legume intake is inversely associated with non-cardiovascular and total mortality. For vegetables, raw vegetable intake is more strongly associated with lower risk of total mortality compared to cooked vegetable intake.

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Loss of Sense of Smell, Malnutrition Common in Kidney Disease Patients

MedicalResearch.com Interview with:

Dr. Nigwekar and Dr. Paunescu

Dr. Nigwekar and                 Dr. Paunescu

Teodor Paunescu, PhD and
Sagar Nigwekar, MD
Division of Nephrology
Massachusetts General Hospital

 MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Over 25 million people in the U.S. have chronic kidney disease, and the number of deaths caused by this disease has doubled between 1990 and 2010. It is projected that by 2030 more than 1 in 3 adults over 65 years old will be diagnosed with chronic kidney disease.

Many patients with kidney disease are also malnourished, which negatively impacts their quality of life, overall health, and even survival. However, no effective treatments are currently available to address malnutrition in these patients.

The sense of smell plays an important role in determining food flavor. If a patient’s ability to smell is impaired, this could affect the taste of food, for example, foods that used to appeal to the patient may no longer do so. Given the relation between the sense of smell and appetite, we set out to investigate the loss of smell in patients with kidney disease, and to test an intervention aimed at alleviating their smell deficits.

Our first goal was to determine if patients with various degrees of kidney disease suffer smell losses and whether smell issues might affect their nutritional status. We found that, while most kidney disease patients do not perceive a problem with their sense of smell, deficits in the ability to smell are actually common among these patients, and the severity of these deficits increases with the severity of their kidney disease. Moreover, our study found that reductions in several markers of nutrition (such as cholesterol and albumin levels) correlate with the impairment in these patients’ sense of smell.

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Artificial Sweeteners May Be Bad For Your Waistline and Your Heart

MedicalResearch.com Interview with:

Dr. Azad

Dr. Azad

Meghan Azad PhD
Assistant Professor, Department of Pediatrics & Child Health and Community Health Sciences, University of Manitoba; Associate Investigator, Canadian Healthy Infant Longitudinal Development (CHILD) Study
Research Scientist, Children’s Hospital Research Institute of Manitoba; co-Lead, Population Health Pillar, Developmental Origins of Chronic Diseases in Children Network

MedicalResearch.com: What is the background for this study?

Response: Consumption of artificial sweeteners, such as aspartame, sucralose and stevia, is widespread and increasing.  Emerging data indicate that artificial, or non-nutritive, sweeteners may have negative effects on metabolism, gut bacteria and appetite, although the evidence is conflicting.

MedicalResearch.com: What are the main findings?

Response: We conducted a systematic review of 37 studies that collectively followed over 400,000 people for an average of 10 years.

Only 7 of these studies were randomized clinical trials (the gold standard in clinical research), involving 1003 people followed for 6 months on average. The trials did not show a consistent effect of artificial sweeteners on weight loss, and the longer observational studies showed a link between consumption of artificial sweeteners and relatively higher risks of weight gain and obesity, high blood pressure, diabetes, heart disease and other health issues.

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Study Finds Diet Not Connected to GI Problems in Children With Autism

MedicalResearch.com Interview with:

Bradley James Ferguson, PhD University of Missouri School of Medicine

Dr. Ferguson

Bradley James Ferguson, PhD
University of Missouri School of Medicine 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Many individuals with autism spectrum disorder (ASD) have gastrointestinal problems, such as constipation, irritable bowel syndrome and abdominal pain, but the cause of these GI issues is not currently known. Previous research from our laboratory showed a significant positive relationship between cortisol levels and GI problems, especially for constipation. However, it is possible that other factors such as diet may affect GI functioning, especially since many children have altered diets. This study examined 32 different nutrients in the children’s diets, as assessed by a food frequency questionnaire that assessed the participant’s diet over the past month, and how each nutrient was related to upper and lower GI tract symptom scores over the past month created from the Questionnaire on Pediatric Gastrointestinal Symptoms – Rome III. The results showed no significant relationships between any of the nutrients and GI symptoms, suggesting that diet was not associated with GI symptoms in this sample.

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Moderate Coffee Drinking Linked To Lower Risk of Death

MedicalResearch.com Interview with:
Marc J. Gunter, PhD 

From International Agency for Research on Cancer
Lyon, France

MedicalResearch.com: What is the background for this study?

Response: U.S. and Japanese studies have previously found that drinking more coffee was related with a lower risk of death. However, in European populations, where coffee consumption and preparation methods are more varied, the relationship was less certain as relatively small studies had previously been conducted. Our analysis was undertaken in ~500,000 men and women from 10 European countries, the largest study to date investigating the coffee and mortality relationship.

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Fewer Refined Grains During Pregnancy May Reduce Obesity Risk In Kids

MedicalResearch.com Interview with:

Cuilin Zhang MD, PhD Senior Investigator, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Bethesda, MD 20817 

Dr. Zhang

Cuilin Zhang MD, PhD
Senior Investigator, Epidemiology Branch
Division of Intramural Population Health Research
NICHD/National Institutes of Health
Bethesda, MD 20817 

MedicalResearch.com: What is the background for this study?

Response: Refined grains with a high glycemic index and reduced fiber and nutrient content have been linked to increased adiposity and higher risk of metabolic syndrome among adults. Despite these differences and the growing body of literature on the link between maternal diet/nutrition during pregnancy and subsequent offspring health consequences throughout the lifespan, little is known about the intergenerational impact of refined-grain intake during pregnancy on long-term cardio-metabolic outcomes in the offspring.

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When Should Babies Be Introduced To Peanuts, Eggs and Cow’s Milk?

MedicalResearch.com Interview with:

Dr. Malcolm Sears, Professor  MB, ChB, FRACP, FRCPC, FAAAAI Co-director of the CHILD Study Division of Respirology, Department of Medicine, McMaster Universi

Dr. Sears

Dr. Malcolm Sears, Professor
MB, ChB, FRACP, FRCPC, FAAAAI
Co-director of the CHILD Study
Division of Respirology, Department of Medicine,
McMaster University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Canadian Healthy Infant Longitudinal Development (CHILD) Study is a longitudinal birth cohort study commenced in 2008 with 3,495 families across Canada.  We recruited the mothers during pregnancy and are following their children to age 5 with the intent of determining the underlying developmental causes of allergy and asthma.

In the current analysis, we have looked at the relationship between the timing of first introduction of three “allergenic” foods (milk products, egg and peanut) and the likelihood of sensitization to these foods at age 1 year.  We found that earlier introduction was associated with a reduced risk of sensitization, which is consistent with some recent randomized controlled trials.  For instance, infants who avoided cow’s milk product in their first year of life were nearly four times as likely to be sensitized to cow’s milk compared with infants who did consume cow’s milk products before age 12 months.  Similarly, infants who avoided egg or peanut in the first year were nearly twice as likely to be sensitized to those foods compared to infants who consumed them before 12 months of age.

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Which Diet Is Best For You? It Depends On Your Genes

MedicalResearch.com Interview with:

Kaixiong (Calvin) Ye, PhD Post-doctoral Associate Dept. of Biological Statistics & Computational Biology Cornell University thaca, NY

Dr. Kaixong Ye

Kaixiong (Calvin) Ye, PhD
Post-doctoral Associate
Dept. of Biological Statistics & Computational Biology
Cornell University
thaca, NY

MedicalResearch.com: What is the background for this study?

Response: Omega-6 and omega-3 fatty acids are critical for human brain development, cognitive function, immune response, and cardiovascular health. Physiologically active forms of omega-6 and omega-3 fatty acids, such as AA, EPA, and DHA, are readily available in meat and seafood, but are absent in most plant-based foods (e.g. fruits and vegetables). Instead, plant-based foods contain two precursor fatty acids, LA and ALA, which could be metabolized in our body and converted into physiologically active forms. Fatty acid desaturase (FADS) genes encode key enzymes for this biosynthesis.

We hypothesized that genetic variations in FADS genes that enhance the biosynthesis efficiency were adaptive to plant-based diets in traditional farming populations and thus became more frequent over time. Our study compiled a huge data set of genetic information (DNA) from both present-day and ancient individuals. For the first time, we examined the action of natural selection on humans for the past 30,000 years in Europe.

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Elegant Descriptions of Healthy Foods Encourages Consumption

MedicalResearch.com Interview with:

Bradley P. Turnwald

Bradley Turnwald

Bradley P. Turnwald MS
Stanford University, Department of Psychology
Stanford, California

MedicalResearch.com: What is the background for this study?

Response: This study tested an intervention to encourage people to consume healthier foods. Encouraging healthy eating is difficult because many people think that healthy foods do not taste good, and most people prioritize taste over health when choosing what to eat. In fact, lab studies suggest that people rate foods as less tasty, less enjoyable, and less filling when they are labeled as healthy compared to when the same foods are not labeled as healthy. A recent study from the Stanford Mind & Body Lab published last month in Health Psychology showed that healthy foods are even described with less tasty, exciting, and indulgent descriptions compared to standard items on the menus of top-selling chain restaurants in America. This led us to ask the question, what if healthy foods were described with the tasty and indulgent descriptions that are typically reserved for the more classic, unhealthy foods?

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Healthy Diet and Exercise Reduce Colon Cancer Recurrence

MedicalResearch.com Interview with:
Dr. Erin Van Blarigan, ScD
Assistant Professor, Department of Epidemiology and Biostatistics
UC San Francisco

MedicalResearch.com: What is the background for this study?

Response: There are over 1.3 million colorectal cancer survivors in the United States. Cancer survivors often seek guidance on what they can do to lower their risk of cancer recurrence and death. In response to patient interest and the need for improved survivorship care, the American Cancer Society (ACS) published guidelines on nutrition and physical activity for cancer survivors.

The guidelines are to:
1) achieve and maintain a healthy body weight;
2) engage in regular physical activity; and
3) achieve a dietary pattern that is high in vegetables, fruits, and whole grains.

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Salt Intake From Packaged Foods Decreasing But Still Too High

MedicalResearch.com Interview with:

Jennifer Poti, PhD Research Assistant Professor Nutritional Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill

Dr. Poti

Jennifer Poti, PhD
Research Assistant Professor
Nutritional Epidemiology
Gillings School of Global Public Health
University of North Carolina at Chapel Hill

MedicalResearch.com: What is the background for this study?

Response: Although strong evidence links excessive sodium intake to hypertension, a leading risk factor for cardiovascular disease, the majority of American children and adults have sodium intake that exceeds the recommended upper limit for daily sodium intake.

To lower sodium intake at the population-level, the Institute of Medicine has recommended that reducing sodium in packaged foods will be essential and has emphasized the need to monitor sodium in the US food supply. However, little is known about whether sodium in packaged foods has changed during the past 15 years.

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Fatty Acids From Fish During Infancy May Lower Risk of Type 1 Diabetes

MedicalResearch.com Interview with:

Sari Niinistö, PhD Senior Researcher, Public Health Solutions, Nutrition Unit National Institute for Health and Welfare Helsinki, Finland

Dr. Niinistö

Sari Niinistö, PhD
Senior Researcher,
Public Health Solutions, Nutrition Unit
National Institute for Health and Welfare
Helsinki, Finland

MedicalResearch.com: What is the background for this study?

Response: Previous prospective studies have observed protective association between fish-derived fat and type 1 diabetes related autoimmunity in older children. Also some other fatty acids have been associated with the risk for type 1 diabetes associated autoimmunity. We wanted to study very young children, because type 1 diabetes associated autoimmunity often begins early, already in infancy. Therefore, we investigated whether serum fatty acid levels during infancy or the main dietary sources of fatty acids (breast milk and infant formula) were related to the development of autoimmunity responses among children at increased genetic risk of developing type 1 diabetes.

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Food Costs Can Lead To Less Protein and Phosphorous in Indigent Kidney Transplant Patients

MedicalResearch.com Interview with:

Ms. Shifra Mincer Medical Student in the class of 2019 SUNY Downstate Medical School

Shifra Mincer

Ms. Shifra Mincer
Medical Student in the class of 2019
SUNY Downstate Medical School

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Hypophosphatemia is commonly encountered in the post-transplant setting. Early post-transplant hypophosphatemia has been ascribed to excess FGF23 and hyperphosphaturia.

Many patients remain hypohosphatemic months or even years after their transplant and the mechanism was assumed to be the same, however, our group recently reported that patients with late post-transplant hypophosphatemia had very little phosphorous in their urine (Wu S, Brar A, Markell, MS. Am J Kidney Dis. 2016,67(5): A18). We hypothesized that they were not eating enough phosphorous to compensate for the acute phosphorous losses they experienced immediately post-transplant.

In this study, using both 3-day diet journals and 24-hour diet recall questionnaires, we found that mean intake of phosphorous and protein was barely at the Recommended Daily Allowance, and that despite 70% of the patients using EBT, 30% of those patients still reported concerns regarding food security. Patients who reported that the cost of food influenced their dietary choices ate 43% less protein (average 48,5 gms vs. 85.8 gms) and 29% less phosphorous (average 887 mg vs 1257 mg). When ability to rise from a chair over a 30 second period was evaluated, only patients who expressed food cost concerns were unable to complete the test.

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Spermidine in Foods Such As Aged Cheese Prevents Liver Damage and Extends Life — in Mice

MedicalResearch.com Interview with:

Leyuan Liu, Ph.D., Assistant Professor Center for Translational Cancer Research Institute of Biosciences and Technology Texas A&M University Houston, Texas 77030

Dr. Liu

Leyuan Liu, Ph.D., Assistant Professor
Center for Translational Cancer Research
Institute of Biosciences and Technology
Texas A&M University
Houston, Texas 77030

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our research team has been working on the question why people develop cancers and how we can prevent or cure them. In contrast to public views, we concluded from our studies that cancers, similar to our age-related diseases, originate from inefficiencies of our body to clean up cellular wastes accumulated during our lifespan. The most important pathway to clean up those wastes is called autophagy, or cellular self-eating behavior. We study how autophagy is regulated, how autophagy causes cancers, and whether we can control autophagy to prevent or cure cancers.

Previously we found autophagy is regulated by a protein called MAP1S and mice without MAP1S are more likely to develop liver cancer. We have been seeking ways to improve MAP1S-mediated autophagy to prevent liver cancer. Our current study show that spermidine, a natural component existing in many foods, can increase the stability of MAP1S proteins and activate MAP1S-mediated autophagy. Concurrent with the benefits of expand mouse lifespans ours also reported, spermidine can suppress the development of liver fibrosis and liver cancer specifically through MAP1S if we add spermidine into the daily drinking water of mice.

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Fresh Fruit Consumption May Lower Risk of Diabetes and Vascular Complications

MedicalResearch.com Interview with:
Huaidong Du

Senior Research Fellow
China Kadoorie Biobank
Medical Research Council Population Health Research Unit
Clinical Trial Service Unit & Epidemiological Studies Unit
Nuffield Department of Population Health
Oxford UK

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This research article describes findings from the China Kadoorie Biobank study which is a large population based prospective cohort study including about 0.5 million adults recruited from 10 areas in China.

The main reason for us to perform this study is because previous evidence on potential benefit of fruit consumption in diabetes prevention and management is very limited. The sugar content of fruit has led to concerns in many parts of the world (e.g. China and several other Asian countries) about its potential harm for people with (high risk of) diabetes. This has consequently Chinese people diagnosed with diabetes tend to restrict their fruit intake. With the rapid increase of diabetes incidence in China and many other Asian countries, it is critically important to investigate the associations of fruit consumption with the incidence diabetes and, among those with diabetes already, diabetic macro- and microvascular complications.

Through analysing data collected during 7 years of follow-up, the study found that people who eat fresh fruit more frequently are at lower risk of developing diabetes and diabetes related vascular complications. Compared with non-consumers, those who ate fresh fruit daily had a 12% lower risk of developing diabetes. Among participants with diabetes at the start of the study, higher fresh fruit consumption also showed health benefits, with a 100g portion of fruit per day associated with 17% lower overall mortality, 13% lower risk of developing diabetes-related complications affecting large blood vessels (e.g. ischaemic heart disease and stroke) and 28% lower risk of developing complications affecting small blood vessels (e.g. kidney and eye diseases).

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Fewer Heart Attacks and Strokes After Trans-Fat Restriction Laws in New York

MedicalResearch.com Interview with:

Eric J. Brandt, MD Yale University Cardiovascular Disease Fellow

Dr. Eric Brandt

Eric J. Brandt, MD
Yale University
Cardiovascular Disease Fellow

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: From previous studies we know that industrial trans fatty acid (trans fat) consumption is linked to elevated risk for cardiovascular disease. Even small amounts of consumption can be deleterious to cardiovascular health. In New York state, there were 11 counties that restricted the use of trans fatty acids in eateries. We compared hospitalization for heart attacks and stroke from 2002 through 2013 in counties that did and did not have restrictions.

Our study found that when comparing populations within New York state that restricted the use of trans fat, compared to those that did not, there was an associated additional decline beyond temporal trends for heart attacks and stroke events combined by 6.2%.

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How Does Fruit Juice Affect Weight Gain in Children?

MedicalResearch.com Interview with:

Brandon Auerbach, MD, MPH Acting Instructor Division of General Internal Medicine University of Washington

Dr. Auerbach

Brandon Auerbach, MD, MPH
Acting Instructor
Division of General Internal Medicine
University of Washington

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The question of whether 100% fruit juice causes poor health outcomes in children, such as weight gain, has been a subject of controversy. On one hand, 100% fruit juice contains vitamins and nutrients that many children lack, is often cheaper than whole fruit, and may help kids with limited access to healthy food meet their daily fruit requirements.

On the other hand, leading nutrition experts have expressed concern that fruit juice contains amounts of sugar equal to or greater than those of sugary drinks like regular soda. Guidelines from the American Academy of Pediatrics warn that 100% juice can be a significant source of calories and contribute to obesity if consumed excessively.

Our main finding was that consuming 1 serving/day of 100% fruit juice was not associated with weight gain in children. Children ages 1 to 6 years gained a small amount of weight, but not enough to negatively impact health. Children ages 7 and older gained no weight. We did not study amounts of 100% fruit juice higher than 1 serving/day.

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For Access To Nutritious Food, It Comes Down To Price

MedicalResearch.com Interview with:
Lillian MacNell PhD

Assistant Professor
Department of Public Health
Campbell University

MedicalResearch.com: What is the background for this study?

Response: There’s been a lot of research done on how to define and measure food deserts (areas with limited access to supermarkets), and some other studies on the dietary and related health effects of living in a food desert. But there’s been a lot less attention paid to how the people who live in those food deserts deal with this—how do they feel it affects them? How and where do they shop for food? In this study, we wanted to get a better understanding of the daily reality of living in a food desert and the strategies that people use to respond to low access to food. We interviewed 42 low-income mothers and grandmothers of young children in one urban food desert about this, and we also profiled the available food stores in the neighborhood to get a sense of what’s available for these families.

One thing we found is that most of the food stores in the neighborhood were small corner and convenience stores; these rarely offered fresh fruits and vegetables, and only a few carried canned produce or other nutritious options like low-fat milk and wheat bread. When we did see those items in the neighborhood, they cost about 25% more than they did at the nearest supermarkets. So in terms of the environment, these women were working with fewer options at a higher price, unless they traveled outside of their neighborhoods to reach large supermarkets.

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Better-Beverage Campaign Reduced Sugary Drink Consumption

MedicalResearch.com Interview with:

Marlene B. Schwartz PhD Director, Rudd Center for Obesity & Food Policy (Principal Investigator) Professor, Department of Human Development and Family Studies University of Connecticut Hartford, CT 06103

Dr. Schwartz

Marlene B. Schwartz PhD
Director, Rudd Center for Obesity & Food Policy (Principal Investigator)
Professor, Department of Human Development and Family Studies
University of Connecticut
Hartford, CT 06103

MedicalResearch.com: What is the background for this study? 

Response: The aim of this study was to evaluate the impact of a community-wide campaign to reduce consumption of sugary beverages in Howard County, Maryland. We measured the retail sales of sugary drinks in supermarkets in the target community and a set of matched control supermarkets in another state. The campaign included multiple components over three years, including television advertising, digital marketing, direct mail, outdoor advertising, social media and earned media, creating 17 million impressions. The community partners successfully advocated for public policies to encourage healthy beverage consumption in schools, child care, health care and government settings.

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Late Risers Eat More Fat and Sugar In Evening

MedicalResearch.com Interview with:
Mirkka Maukonen

MSc (nutrition), PhD Candidate
the National Institute for Health and Welfare, Department of Public Health Solutions
Helsinki, Finland

MedicalResearch.com: What is the background for this study?

Response: Recent literature has highlighted the importance of sleep and circadian rhythms in development of obesity and metabolic dysfunctions. Furthermore, it has been suggested that in addition to quality of the diet also meal timing may play role in development of obesity. For example, skipping breakfast and eating at later times in the evening have been associated with higher BMI. However, little is known about how the timing of circadian rhythms (chronotype) affects timing of energy intake and its association with metabolic health.

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Food Insecurity Common Among Inner City Stroke Patients

MedicalResearch.com Interview with:

Dr. Lakshmi Warrior MD Assistance Professor, Neurology Cook County Health & Hospitals System Chicago

Dr. Lakshmi Warrior

Dr. Lakshmi Warrior MD
Assistance Professor, Neurology
Cook County Health & Hospitals System
Chicago

MedicalResearch.com: What is the background for this study?

Response: In 2015, 42.2 million Americans lived in food insecure households. Food insecurity is defined as “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways”. Previous work has demonstrated associations between food insecurity and chronic diseases such as hypertension, diabetes, hyperlipidemia.

Cook County Health and Hospitals System serves a population of largely uninsured and underinsured patients. This pilot study sought determine the prevalence of food insecurity in our population of patients who were recently discharged home from the hospital with the diagnosis of stroke.

MedicalResearch.com: What are the main findings?

Response: We found that food insecurity is a prevalent problem in our patient population with more than 1 in 5 identifying as food insecure. It also appears that food insecure stroke patients had a higher prevalence of diabetes (54% vs 28%)and hypertension (86% vs. 67%) as compared to food secure patients.

MedicalResearch.com: What should readers take away from your report?

Response: Food insecurity is a prevalent issue in our patient population. There should be consideration for food insecurity screening in high-risk populations as food insecurity can complicate the management of diet-related diseases such as hypertension and diabetes. For patients with food insecurity, a multi-disciplinary approach using case and social workers in addition to medical management should be considered.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Further study of this topic is needed. A larger, retrospective review of our stroke patients is currently underway. We are also planning for a prospective study of our inpatient stroke patients to evaluate if these patients are at higher risk for not only vascular risk factors but also re-hospitalization and poor outcomes.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation: Abstract presented at the  AHA/ASA International Stroke Conference February 2017

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on MedicalResearch.com

Lifestyle Modifications May Improve Health and Prognosis in Breast Cancer Patients

MedicalResearch.com Interview with:
Ellen Warner, MD, FRCPC, FACP, M.Sc.
Affiliate scientist
Sunnybrook Health Sciences Centre
Toronto, ON

MedicalResearch.com: What is the background for this review?

Response: As a medical oncologist who has treated breast cancer patients for over 30 years, I have found that most of the women in my practice are desperately looking for things they can do beyond standard surgery, radiation, chemotherapy, etc. to increase their chance of cure.  Unfortunately, many fall prey to false claims they read over the Internet or hear from well-meaning friends and relatives.  As a result they turn to absurdly restrictive diets (eg. No meat, dairy or sugar) or to ‘supplements’ with unproven effectiveness or even safety. So I thought it would be helpful to review the literature to determine what evidence-based lifestyle changes these women could make that would at least improve their overall health and, ideally, reduce their risk of dying of recurrent breast cancer.  For this review I thought it would be great to team up with Julia Hamer, a pre-med student with a degree in nutrition who just happens to also be an Olympic level athlete!
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Cardioprotective Effect of Soy in Japanese May Be Mediated Through Equol

MedicalResearch.com Interview with:

Akira Sekikawa, Ph.D.</strong> Associate professor of epidemiology University of Pittsburgh Graduate School of Public Health

Dr. Sekikawa

Akira Sekikawa, Ph.D.
Associate professor of epidemiology
University of Pittsburgh Graduate School of Public Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We found that Japanese men who are able to produce equol—a substance made by some types of “good” gut bacteria when they metabolize isoflavones (micronutrients found in dietary soy)—have lower levels of a risk factor for heart disease than their counterparts who cannot produce it. All monkeys can produce equol, as can 50 to 70 percent of people in Asian countries. However, only 20 to 30 percent of people in Western countries can.

Scientists have known for some time that isoflavones protect against the buildup of plaque in arteries, known as atherosclerosis, in monkeys, and are associated with lower rates of heart disease in people in Asian countries. It was surprising when a large trial of isoflavones in the U.S. didn’t show the beneficial effects on atherosclerosis.

My colleagues and I recruited 272 Japanese men aged 40 to 49 and performed blood tests to find out if they were producing equol. After adjusting for other heart disease risk factors such as high blood pressure, cholesterol, smoking and obesity as well as dietary intake of isoflavones, we found that the equol-producers had 90-percent lower odds of coronary artery calcification, a predictor of heart disease, than the equol non-producers.

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Calorie Restriction Extends Life Through Protein Regulation

MedicalResearch.com Interview with:

John C. Price, Ph.D Asst. Professor Chemistry and Biochemistry Brigham Young University Provo, Utah

Dr. John Price

John C. Price, Ph.D
Asst. Professor Chemistry and Biochemistry
Brigham Young University
Provo, Utah

MedicalResearch.com: What is the background for this study?

Response: Since 1930 it has been known that the rate of biological aging could be modified by the diet.  In mice for example if you let them eat as much as they want they will live almost 3 years.  Providing essentially the same diet but controlling the number of total calories, there is an almost linear increase in lifespan as you restrict calories.  The studies in mice and rats have been repeated hundreds of times since that time.  There have been a lot of somewhat conflictive observations, like increased formation of new mitochondria, and increased autophagy which targets organelles for degradation, during stable reduced calorie intake. This expectation, that a restricted diet with fewer calories available to the animal could support increased protein synthesis and degradation and result in increased lifespan, is what got us interested in studying Calorie Restriction.  So we measured the relative synthesis rates for several hundred proteins in 18 month old calorie restricted mice which were experiencing the benefits of improved health and lifespan.  We found overwhelmingly that the calorie restricted mice had reduced synthesis rates down to as low as 25% of the age matched control group.  This observation has now been independently confirmed by multiple groups.

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Link Between Soy Consumption and Breast Cancer Remains Complicated

MedicalResearch.com Interview with:
Xiyuan Zhang PhD
and Leena Hilakivi-Clarke, PhD
Professor of Oncology
Georgetown University
Research Building, Room E407
Washington, DC 20057

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Breast cancer is the most common cancer type in women and it also is the second leading cause of death by cancer in the United States. Every year, over 200,000 new cases of breast cancer are diagnosed in the US and this number reached over 1.5 million worldwide in 2012.

Asian women exhibit much lower risk of breast cancer than Caucasian women, accounting for about one fifth of the breast cancer incidence in Western women. Therefore, researchers have been intensively studying and aiming to decipher the difference between these two populations. Results of previous research from our laboratory and by others, in animal models and humans, indicate that higher intake of soy foods or soy isoflavone genistein during childhood is associated with reduced breast cancer risk. However, findings done using human breast cancer cells indicate that soy isoflavones stimulate growth of breast cancer cells. Thus, there is an apparent controversy regarding soy isoflavones and breast cancer.

70% of all breast cancer cases are estrogen receptor positive (ER+) and are therefore treated with endocrine therapy, including with tamoxifen. Although these treatments effectively prevent recurrence in half of the ER+ breast cancer patients, the other half are resistant or develop resistance to the endocrine therapy and recur. Intriguingly, several studies done using human breast cancer cells in culture or in mice found that soy isoflavone genistein negates tamoxifen’s effects. However, observational studies in women suggest that those patients who consume most soy foods have the lowest risk of breast cancer recurrence. The present study was designed to address these conflicting findings using a preclinical animal model and to determine if lifetime isoflavone intake has different effect on tamoxifen’s ability to treat breast cancer than intake that starts when cancer is detected.

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How Many Calories Do You Add To Your Coffee or Tea?

MedicalResearch.com Interview with:

Ruopeng An, PhD Assistant Professor Department of Kinesiology and Community Health College of Applied Health Sciences University of Illinois at Urbana-Champaign Champaign, IL 61820

Dr. Ruopeng An

Ruopeng An, PhD
Assistant Professor
Department of Kinesiology and Community Health
College of Applied Health Sciences
University of Illinois at Urbana-Champaign
Champaign, IL 61820

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Coffee and tea are among the most widely consumed beverages in U.S. adults.1,2 Unlike other popular beverages including alcohol and sugar-sweetened beverages that are typically consumed in isolation, many people prefer drinking coffee and tea with add-ins like sugar or cream. These add-in items are often dense in energy and fat but low in nutritional value. Drinking coffee and tea with add-ins on a regular basis might impact an individual’s daily energy/nutrient intake and diet quality.3 The 2015-2020 Dietary Guidelines for Americans suggests that “coffee, tea, and flavored waters also can be selected, but calories from cream, added sugars, and other additions should be accounted for within the eating pattern.”4

To our knowledge, no study has been conducted to assess consumption of coffee and tea with add-ins in relation to daily energy and nutrient intake at the population level. Bouchard et al. examined the association between coffee and tea consumption with add-ins and body weight status rather than energy/nutrient intake, and consumption was measured by a few frequency-related questions instead of a 24-hour dietary recall.5

The purpose of this study was to examine consumption of coffee and tea with add-ins (e.g., sugar, cream) in relation to energy, sugar, and fat intake among U.S. adults 18 years of age and above. Data came from 2001-2012 National Health and Nutrition Examination Survey (NHANES), comprising a nationally-representative (biennially) repeated cross-sectional sample of 13,185 and 6,215 adults who reported coffee and tea consumption in in-person 24-hour dietary recalls, respectively.

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Type of Sugar, Not Just Amount, Influences Metabolic Effects

MedicalResearch.com Interview with:
Dr. Marta Alegret

Department of Pharmacology, Toxicology and Therapeutic Chemistry
Pharmacology Section
School of Pharmacy and Food Sciences
University of Barcelona

MedicalResearch.com: What is the background for this study?

Response: In humans, an excessive intake of sugars has been linked to the development of metabolic disturbances, and therefore to an increase in the risk for cardiovascular diseases. Specifically, increased consumption of simple sugars in liquid form, as beverages sweetened with high fructose corn syrup or sucrose, has been linked to obesity, insulin resistance and type 2 diabetes. However, two questions remain unresolved: what is/are the underlying molecular mechanism(s) linking these metabolic alterations to cardiovascular diseases? Are the adverse cardiovascular and metabolic effects of sugar-sweetened beverages merely the consequence of the increase in caloric intake caused by their consumption?

To answer to these questions, we performed a study in female rats, which were randomly assigned to three groups: a control group, without any supplementary sugar; a fructose-supplemented group, which received a supplement of 20% weight/volume fructose in drinking water; and a glucose-supplemented group, supplemented with 20% weight/volume glucose in drinking water.

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Government Endorsed DASH Diet Voted Best Overall

MedicalResearch.com Interview with:

Janet M. de Jesus, M.S., R.D. Program Officer, Implementation Science Center for Translation Research and Implementation Science (CTRIS) National Heart, Lung, and Blood Institute

Janet de Jesus

Janet M. de Jesus, M.S., R.D.
Program Officer, Implementation Science
Center for Translation Research and Implementation Science (CTRIS)
National Heart, Lung, and Blood Institute

MedicalResearch.com: What is the background for the DASH diet? What are the main components?

Response: The DASH eating plan was created for a clinical trial funded by the National Heart, Lung, and Blood Institute (NHLBI). DASH stands for Dietary Approaches to Stop Hypertension. The goal of the original DASH trial was to test the eating plan compared to a typical American diet (at the time in the 1990s) on the effect of blood pressure.

The DASH eating plan is rich in fruits, vegetables, and whole grains. It includes low-fat dairy products, poultry, fish, legumes, vegetable oils, and nuts; and limits intake of sweets and sugar-sweetened beverages and high-fat meats. The eating plan is a good source of potassium, magnesium, and calcium. The DASH eating plan was shown to reduce blood pressure and improve lipid profiles.

A second DASH trial, “DASH-sodium,” showed that adding sodium reduction to the DASH eating plan reduced blood pressure even more.

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Endocannabinoids Link Overeating a Western Diet to Obesity

MedicalResearch.com Interview with:

Nicholas V. DiPatrizio, Ph.D. Assistant Professor of Biomedical Sciences University of California, Riverside School of Medicine Riverside, California, 92521

Dr. Nicholas DiPatrizio

Nicholas V. DiPatrizio, Ph.D.
Assistant Professor of Biomedical Sciences
University of California, Riverside School of Medicine
Riverside, California, 92521

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Endocannabinoids are a group of lipid signaling molecules that serve many physiological roles, including the control of food intake, energy balance, and reward. Previous research by my group found that tasting specific dietary fats drives production of the endocannabinoids in the upper small intestine of rats, and inhibiting this signaling event blocked feeding of fats (DiPatrizio et al., Endocannabinoid signaling in the gut controls dietary fat intake, Proceedings of the National Academy of Sciences, 2011). Thus, gut-brain endocannabinoid signaling is thought to generate positive feedback to the brain that promotes the intake of foods containing high levels of fats.

We now asked the question of what role peripheral endocannabinoid signaling plays in promoting obesity caused by chronic consumption of a western diet (i.e., high levels of fats and sugar), as well as the role for endocannabinoids in overeating that is associated with western diet-induced obesity. When compared to mice fed a standard low-fat/sugar diet, mice fed a western diet for 60 days rapidly gained body weight and became obese, consumed significantly more calories, and consumed significantly larger meals at a much higher rate of intake (calories per minute). These hyperphagic responses to western diet were met with greatly elevated levels of endocannabinoids in the small intestine and circulation. Importantly, blocking elevated endocannabinoid signaling with pharmacological inhibitors of cannabinoid receptors in the periphery completely normalized food intake and meal patterns in western diet-induced obese mice to levels found in control lean mice fed standard chow. This work describes for the first time that overeating associated with chronic consumption of a Western Diet is driven by endocannabinoid signals generated in the periphery.

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Does Red Meat Really Increase Risk of Heart Disease?

MedicalResearch.com Interview with:

Wayne W. Campbell PhD Center on Aging and the Life Course Purdue University

Dr. Wayne Campbell

Wayne W. Campbell PhD
Center on Aging and the Life Course
Purdue University

MedicalResearch.com: What is the background for this study?

Response: Organizations that promote healthy eating often recommend consuming no more than 3.5-4.5 2-3 ounce servings of red meat per week. This recommendation is mainly based on data from epidemiological studies that observe a cohort of peoples’ eating habits over time and relate those habits to whether or not they experience a cardiovascular event, such as a heart attack or stroke, or cardiovascular-related death.

These studies show associations between dietary choices and health but are unable to determine if a dietary choice is actually causing the disease. Randomized controlled clinical trials are able to determine causality by isolating one dietary variable to see the effects of that variable on certain health risk factors. Therefore, our lab compiled data from randomized controlled trials assessing the consumption of ≤ vs >3.5 servings of total red meat per week on blood lipids and lipoproteins and blood pressures, since these are common measures taken by clinicians to determine the risk for developing cardiovascular disease.

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Resistant Starches in Diet May Help Reduce Body Weight

MedicalResearch.com Interview with:

Dr Stacey Lockyer BSc(hons) MSc PhD RNutr Nutrition Scientist British Nutrition Foundation Imperial House 6th Floor London

Dr Stacey Lockyer

Dr Stacey Lockyer BSc(hons) MSc PhD RNutr
Nutrition Scientist
British Nutrition Foundation
Imperial House 6th Floor
London

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This in depth review examines the potential health benefits of resistant starch, a form of starch that is not digested in the small intestine and is therefore considered a type of dietary fibre. Some forms of resistant starch occur naturally in foods such as bananas, potatoes, grains, and pulses, and some are produced or modified commercially and incorporated into food products as a functional ingredient.

There has been increasing research interest in resistant starch, with a large number of human studies published over the last 10 years looking at a variety of different health outcomes such as postprandial glycaemia, satiety and gut health. The review summarises reported effects and explores the potential mechanisms of action that underpin them.

There is consistent evidence that consumption of resistant starch in place of digestible carbohydrates can aid blood glucose control and this has resulted in an approved health claim in the European Union. There is also some evidence that resistant starch can support gut health and enhance satiety, though much more research is needed in these areas.

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Byproduct of Sweet Potato Waste Offers Clue To Lipid Metabolism

MedicalResearch.com Interview with:
Dr. Koji Ishiguro

National Agriculture and Food Research Organization
Japan

MedicalResearch.com: What is the background for this study?

Response: -Sweet potato (Ipomoea batatas L.) roots are not only used for human consumption, they are used to make starch materials, processed foods, and distilled spirits in Japan. Starch use accounts for about 15% (131,500 tons) of total sweet potato production. Starch residues are discharged during starch production and are mainly used in animal feed and compost. Large amounts of the wastewater, which can cause serious environmental problems, are discarded after clarification. Investigation into the uses of the by-products of the sweet potato starch industry would benefit both the environment and industry.

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Handful of Nuts a Day Can Reduce Chronic Diseases

MedicalResearch.com Interview with:

Dr. Dagfinn Aune Department of Epidemiology and Biostatistics School of Public Health Imperial College London St. Mary's Campus London  UK

Dr. Dagfinn Aune

Dr. Dagfinn Aune
Department of Epidemiology and Biostatistics
School of Public Health
Imperial College London
St. Mary’s Campus London  UK

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There is a growing body of evidence suggesting that intake of nuts may reduce the risk of coronary heart disease, but the relation between nut intake and other diseases like cancer and stroke, and the relation with mortality and less common causes of death is not clear. Also it is not clear how much nuts are needed to reduce the risk.

So our current meta-analysis reviewed the data from 20 studies (29 publications) on nut intake and different health outcomes. We found that a nut intake of approximately one serving per day (28 g/d or a handful) was associated with a reduced risk of coronary heart disease (by 30%), total cancer (15%), all-cause mortality (22%) and mortality from respiratory disease (50%), diabetes (40%), and infections (75%), although there were few studies in the latter three analyses. We found that most of the benefit was observed up to an intake of around 20 grams per day. Similar results were found for total nuts, tree nuts and peanuts (which are botanically defined as legumes), but peanuts were also associated with reduced risk of stroke, while only tree nuts were associated with reduced cancer risk. We also calculated the number of deaths that potentially could be avoided, under the assumption that the observed associations are causal, and arrived at 4.4 million deaths in North and South America, Europe, Southeast Asia and the Western Pacific (unfortunately we did not have data on nut intake from West Asia and Africa so we were not able to include those areas).

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Some Saturated Fatty Acids Linked To Risk of Coronary Artery Disease

MedicalResearch.com Interview with:

Dr. Qi Sun Sc.D, M.D., M.M.S. Assistant Professor in the Department of Nutrition Harvard T.H. Chan School of Public Heath Boston

Dr. Qi Sun

Dr. Qi Sun Sc.D, M.D., M.M.S.
Assistant Professor in the Department of Nutrition
Harvard T.H. Chan School of Public Heath
Boston

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Interpretation of existing human study data regarding saturated fat intake in relation to heart disease risk is quite confusing and distorted in certain publications. It is a fact that, depending on data analysis strategies, the effects of saturated fats may depend on which macronutrients they replace. For example, substituting saturated fats for refined carbohydrates will not lead to an elevated risk of heart disease because both nutrients are harmful whereas replacing saturated fats with good polyunsaturated fats results in risk reduction. In our current analysis, we clearly demonstrated that when total saturated fatty acids were replaced by polyunsaturated fatty acids, monounsaturated fatty acids, whole grain carbohydrates, and plant-based proteins, the diabetes risk would decrease.

Furthermore, we showed that major individual saturated fatty acids were all associated with an elevated heart disease risk.

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Difficulty Smelling May Lead to Malnutrition In Chronic Kidney Disease Patients

MedicalResearch.com Interview with:

Dr. Teodor G. Paunescu PhD Assistant Professor of Medicine Harvard Medical School Boston

Dr. Teodor G. Paunescu

Dr. Teodor G. Paunescu PhD
Assistant Professor of Medicine
Harvard Medical School
Boston

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Patients with kidney disease frequently report food aversion and poor dietary intake leading to malnutrition, a complication associated with high morbidity and mortality. However, there are no effective treatments currently available to address this complication, and the mechanisms underlying anorexia and food aversion in these patients remain unclear.
Because of the critical role of olfaction in flavor appreciation and dietary intake, we decided to quantify olfactory (smelling) deficits in advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients.

We found that patients with kidney disease have significant olfactory deficits that need objective assessments for accurate characterization. Our results also indicate that olfactory deficits likely attribute to nutritional impairment in patients with kidney disease.

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Americans Aware of Threat of Excessive Sugar Intake, But Aren’t Doing Much About It

MedicalResearch.com Interview with:

Healthline Sugar Survey

Healthline Sugar Survey

Tracy Stickler, Editor in Chief
Healthline

Ms. Stickler discusses a Healthline survey of over 3000 Americans, regarding “their knowledge of sugar and how it affects the body to gauge their relationship about their own sugar consumption and the effects it has on them”.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our company surveyed over 3,000 Americans from across the country about their sugar consumption habits and awareness about added sugar in food.

What we learned is that while many people are aware of the threat overconsumption of sugar is to their health, they aren’t doing much about it. Why not? They don’t know how and quite often they don’t know how much sugar is contained in certain foods they eat. We have an awareness issue. Two out of 3 respondents answered incorrectly to our questions related to which food item contained more sugar.

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Children Eating Too Much Salt At Every Meal

MedicalResearch.com Interview with:

Zerleen S. Quader, MPH CDC

Zerleen S. Quader

Zerleen S. Quader, MPH
CDC

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Sodium reduction is considered a key public health strategy to reduce cardiovascular disease nationwide, and this study is the latest in ongoing CDC efforts to monitor U.S. sodium intake.

Eating habits and taste for salt are established early in life by what children eat. Eating too much sodium can set them up for high blood pressure now and health problems later. Previous evidence suggests that one in nine children already has blood pressure above the normal range, and strong evidence has shown that reducing sodium intake reduces blood pressure – and lowering blood pressure lowers the risk of cardiovascular disease among adults. With voluntary efforts already underway by some manufacturers to lower the sodium and added sugar content in some of their products, these findings help provide a baseline to monitor changes in the food industry, as well as sodium intake among U.S. youth.

We examined data from the 2011-2012 National Health and Nutrition Examination Survey (NHANES) to determine sodium intake by major food category, place and eating occasion. We found that average sodium intake among participants was 3,256 mg, and that doesn’t include salt added at the table. On the day of assessment, nearly 90 percent exceeded the upper level of sodium recommended for a healthy diet.

• There were some variations based on age and gender. For example:
o Average intake was highest among high school-aged children
o Girls had significantly lower daily intake than boys (for example, 2,919 mg versus 3,584 mg)
• In addition, we found that ten types of food make up nearly half of youth sodium intake nationwide, including pizza, bread, lunch meats and snack foods.

We also analyzed where the foods were obtained and found that approximately 58 percent of sodium comes from store foods, 16 percent from fast food and pizza restaurants and 10 percent from school cafeteria foods. And when we looked at occasion, we discovered that 39 percent of sodium intake was consumed at dinner, 31 percent at lunch, 16 percent from snacks and 14 percent from breakfast.
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Low Carb Meals Reduce Insulin Resistance

MedicalResearch.com Interview with>
Katarina Borer, Ph.D. Professor
Po-Ju Lin,PhD
School of Kinesiology
The University of Michigan
Ann Arbor, MI

MedicalResearch.com: What is the background for this study?

Response: This study was part of the doctoral dissertation of Po-Ju Lin, who is now a post-doctoral fellow at the University of Rochester. With this study, we wanted to answer three questions:

(1) Is daily carbohydrate load responsible for evening glucose intolerance and post-meal insulin resistance. (Evening glucose intolerance represents well-documented higher glucose and insulin responses in the evening than in the morning when the same quantity of glucose is eaten or infused intravenously) To answer this question we offered two daily meals containing about 800 Kcal and either 30% or 60% of carbohydrates.

(2) Will exercise before the meals improve glucose tolerance (glucose clearance from the blood and insulin response) after eating? (Exercise is a well-known means of increasing glucose uptake by the muscle and of increasing muscle sensitivity to insulin action for a number of hours after exercise). To answer this question we had the subjects exercise for two hours walking on a treadmill at 45% of their maximal aerobic effort one hour before each meal.

(3) Is the upper-intestinal hormone GIP involved in any effects associated with variation in dietary carbohydrate? (GIP or glucose-dependent insulinotropic peptide, stimulates insulin secretion in advance of absorbed glucose).

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Association Between Dietary Intake and Function in Amyotrophic Lateral Sclerosis

MedicalResearch.com Interview with:

Dr. Jeri Nieves PhD Director of bone density testing New York's Helen Hayes Hospital

Dr. Jeri Nieves

Dr. Jeri Nieves PhD
Director of bone density testing
New York’s Helen Hayes Hospital

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Amyotrophic lateral sclerosis (ALS) is a devastating severe neurodegenerative disorder that causes progressive muscle atrophy, paralyses, and eventual respiratory failure.

Our objective was to evaluate the associations between nutrition and severity of ALS around the time of diagnosis. This was a cross-sectional analysis of data from a multicenter cohort of 302 patients with ALS. We assessed nutrient intake using a modified Block Food Frequency Questionnaire. The outcomes were respiratory function (measured using percentage forced vital capacity; FVC%) and functional performance measured by ALS Functional Rating Scale–Revised (ALSFRS-R), both considered important indicators of the severity of ALS. Results of the regression analysis were that higher intakes of antioxidants and carotenes from vegetable intake were associated with higher ALSFRS-R scores or better %FVC.

We used a novel analysis to evaluate the diet as a whole and found that higher intakes of antioxidants, fiber from grains, vegetables, fruit, eggs, fish, and poultry were all associated with higher function in patients with ALS. However, milk and lunch meats were associated with lower measures of function. These consistent results from two different statistical analyses indicate that diet may help minimize the severity of ALS. Perhaps these findings point to the role of oxidative stress in ALS severity.

In summary, increased consumption of antioxidant nutrients, foods high in carotenoids and fiber, vegetables and fruits, poultry and fish are associated with better function around the time of ALS diagnosis.

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Balancing Omega 6 to Omega 3 To Prevent and Manage Obesity

MedicalResearch.com Interview with:

Artemis P. Simopoulos, M.D. FACN President, The Center for Genetics Nutrition and Health Washington, DC 20016

Dr. Artemis P. Simopoulos

Artemis P. Simopoulos, M.D. FACN
President, The Center for Genetics
Nutrition and Health
Washington, DC 20016

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: I have written extensively on the evolutionary aspects of diet, the diet of Crete prior to 1960 in which I pointed to the misinterpretation of the data of the Seven Countries Study by Keys et al. A major characteristic of these diets is a balanced omega-6/omega-3 ratio.

The recommendation to substitute saturated fats with omega-6 rich oils (sunflower, corn, soybean) increases inflammation and coronary heart disease. It has been shown in a number of studies that a high omega-6/omega-3 (20/1 instead of a balanced ratio) leads to an increase in white adipose tissue and prevents the formation of brown adipose tissue leading to obesity. The changes in the diet-high in omega-6 oils depletion of omega-3 and high fructose along with highly refined carbohydrates in processed foods and a sedentary lifestyle lead to obesity, diabetes, coronary heart disease and cancer.

The scientific evidence from the FAT-1 mouse and recent cohort studies clearly show that the current dietary guidelines as the previous ones are not based on science that takes into consideration genetics, metabolism, the concept that a calorie is not a calorie. It is important to consider that nutrients influence the expression of genes, the omega-6 fatty acids are the most pro-inflammatory nutrients, and inflammation is at the base of all chronic non-communicable diseases.

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Inverse Association Between Mediterranean Diet and Cardiovascular Disease

MedicalResearch.com Interview with:
Dr Nita Forouhi, MRCP, PhD, FFPHM
Programme Leader
MRC Epidemiology Unit
University of Cambridge School of Clinical Medicine
Institute of Metabolic Science
Cambridge Biomedical Campus

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The benefits of the Mediterranean diet for cardiovascular health are well documented in countries of the Mediterranean region and some other countries, but there is little such evidence in the UK general population. Our work fills this research gap.

In our study we followed up 23,902 initially healthy Britons living in Norfolk (Eastern England) for an average of 12 to 17 years, and determined the occurrence of new cases of cardiovascular diseases (CVD) and deaths due to CVD during that time period. Our results showed that those adults who adhered to a Mediterranean diet had 6% to 16% lower risk of developing CVD, compared to those who had dietary habits further away from the Mediterranean-type diet pattern. This was the case even when we accounted for several important risk factors and correlates of CVD, including as age, sex, body mass index, lifestyle habits such as smoking, alcohol intake and physical activity, and socio-economic factors.

We also modelled what would happen in the study population if all the participants increased their adherence to the Mediterranean-type diet. From this we estimated that nearly 4% of all new cardiovascular disease cases, or 12.5% of cardiovascular deaths in the population could potentially be avoided. This is novel information about the potential health benefit of a Mediterranean-type diet in a UK context. However, we should remember that our study was an observational study, not a clinical trial with a dietary intervention, and thus we cannot imply a cause and effect relationship between increasing adherence to the Mediterranean diet and reduction in cardiovascular disease.

We defined the Mediterranean diet using a 15 point score based on guideline recommendations from a Mediterranean dietary pyramid published by the Mediterranean Diet Foundation. The recommendations had not previously been specifically tested for their associations with health, so our findings, for the first time, show the utility of the Mediterranean dietary pyramid.

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Early Introduction May Reduce Peanut and Egg, But Not Gluten, Allergies in Children

MedicalResearch.com Interview with:

Dr Robert Boyle Senior lecturer in paediatric allergy honorary consultant, Paediatric allergist Imperial College Healthcare NHS Trust

Dr. Robert Boyle

Dr Robert Boyle
Senior lecturer in paediatric allergy
honorary consultant, Paediatric allergist
Imperial College Healthcare NHS Trust

MedicalResearch.com: What is the background for this study? What are the main findings?

 
Editors’ note: Please discuss food introduction with your child’s pediatrician before embarking on any new foods.

Response: Food allergy is a common problem which may be getting more common.

We have known for over 100 years that feeding egg to animals such as guinea pigs can prevent egg allergy. However randomised trials of allergenic food introduction for preventing food allergy in human infants have not been done until the past 5 years, and have so far yielded mixed results. One trial for peanut allergy was positive, with less peanut allergy in infants who were fed the food from early in life compared with infants who avoided it for 5 years. Other trials have yielded null findings, but may have been too small to yield a conclusive result. We used a technique called meta-analysis to combine the results of all previous trials of timing of allergenic food introduction and risk of food allergy. We also evaluated other allergic and autoimmune diseases.

Our analysis yielded conclusive results for both egg and peanut – that early introduction of these foods into an infant’s diet might reduce their risk of egg and peanut allergy by around 40-70%. We were surprised to see null findings in our meta-analysis of timing of gluten or wheat introduction and risk of coeliac disease (gluten intolerance) which is a different type of allergy to egg and peanut allergy. This suggests that early introduction of allergenic foods does not reduce risk of all types of food allergy.

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Combination of Restrictions and Incentives May Lead To Better Food Choices By SNAP Beneficiaries

MedicalResearch.com Interview with:

Lisa Harnack, DrPH, RD | Professor and Director Nutrition Coordinating Center Division of Epidemiology and Community Health School of Public Health, University of Minnesota Minneapolis, MN 55454-1087

Dr. Lisa Harnack

Lisa Harnack, DrPH, RD | Professor and Director
Nutrition Coordinating Center
Division of Epidemiology and Community Health
School of Public Health, University of Minnesota
Minneapolis, MN 55454-1087

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There is interest in considering ways to reshape SNAP so that it better meets meet its objective to help families buy the food they need for good health. Prohibiting the purchase of foods such as soft drinks with SNAP benefits is one of the proposed program changes. Offering an incentive for the purchase of fruits and vegetables is another program change that is being discussed.

Little is known about the effects of prohibitions and restrictions on food purchasing and consumption. Consequently, we carried out an experimental trial to evaluate effects.

In our study we found that a food benefit program that includes both prohibitions on the purchase of less nutritious foods and incentives for purchasing nutritious foods may lead to a number of favorable changes in diet.

To elaborate, we found those enrolled in a food benefit program that prohibited the purchase of sugar sweetened beverages, sweet bakes goods, and candies with food program benefits and provided a 30% financial incentive for fruit and vegetable purchases had a number of favorable dietary changes that were significantly different from changes among those enrolled in a food benefit program that had neither prohibitions or incentives. These favorable changes included reduced consumption of calories, sugar sweetened beverages, sweet baked goods, and candies; and increased consumption of fruit. The overall nutritional quality of the diet also improved.

Fewer nutritional improvements were observed among those enrolled in food benefit programs that included prohibitions or incentives only.

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Healthy Eating in Adolescence Sets Pattern For Less Weight Gain As Young Adult

MedicalResearch.com Interview with:

David R. Jacobs, Jr., PhD Mayo Professor of Public Health Division of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN 55454-1075

Dr. David R. Jacobs, Jr.

David R. Jacobs, Jr., PhD
Mayo Professor of Public Health
Division of Epidemiology and Community Health, School of Public Health
University of Minnesota
Minneapolis MN 55454-1075

MedicalResearch.com: What is the background for this study?

Response: Project EAT (Eating and Activity in Teens and Young Adults) is on ongoing longitudinal study which began by screening middle and secondary school students in the Minneapolis and St Paul Metropolitan are. Students were the 11-18 years old (average age 15), then followed up at average ages 20 and 25. We had devised an eating pattern in about 2006, which
a) predicts a lot of things in several different studies (including total mortality in the Iowa Women’s Health Study) and b) looks a great deal like the recently released 2015 Dietary Guidelines for Americans (DGA).

We call our diet pattern A Priori Diet Quality Score (APDQS) and think of it as close to or in the style of a Mediterranean/prudent/healthy diet.

We hypothesized that this pattern would be associated with lower weight (in general with better long term health, but the focus in Project EAT was weight and BMI), probably least so at age 15. The minimal hypothesized effect in adolescence relates to the very large energy expenditure in adolescent growth years; we thought that diet composition would be less important for body weight at that time than energy intake (and APDQS is about diet composition).

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