Nutrition

AJCN Aug, 2006

[Eat well when pregnant] Early nutritional determinants of coronary artery disease: a question of timing? Am J Clin Nutr 2006 84: 271-272 ” Since its proposal nearly 2 decades ago, the hypothesis that suboptimal maternal and fetal nutrition can have a profound and sustained effect on the health of a person later in life (1) has gained support from human epidemiologic and animal studies. ..persons undernourished in the first trimester were reported to have a greater prevalence of CAD and obesity, those undernourished during early gestation to midgestation were reported to have an increased risk of obstructive lung disease, and those undernourished during mid-to-late gestation were reported to be more insulin resistant and more likely to have impaired renal function.”

[Get at least 2,000IU vitamin D when pregnant] Vitamin D deficiency during pregnancy: an ongoing epidemic Am J Clin Nutr 2006 84: 273 “They defined deficiency as circulating 25-hydroxyvitamin D [25(OH)D] concentrations <25 nmol/L (10 ng/mL). As far as we are concerned, this is an old definition of vitamin D deficiency, and many investigators now define deficiency as < 80 nmol (32 ng/mL) circulating 25(OH)D/L (2, 3). This deficiency cutoff is now based on an array of biomarkers that are adversely affected by nutritional vitamin D deficiency rather than on Gaussian distributions of 25(OH)D concentrations in populations, as were used in the past (2)… the function of vitamin D is now known to extend well beyond skeletal integrity (2, 4-7), and thus it would be a tragedy to ignore this information. The next question is, how much vitamin D is required to correct this deficiency and achieve circulating 25(OH)D concentrations of >80 nmol/L? It is certain that, in the absence of meaningful sun exposure, the current adequate intake of 200 IU vitamin D/d is far less than enough. Such an intake will do nothing to maintain nutritional vitamin D status, let alone increase it (2, 8). To increase nutritional vitamin D to meaningful concentrations, dietary intakes of 2000 IU/d may be required (2, 8)…The same may well be true for the risks of developing autoimmune diseases, such as multiple sclerosis (which has recently been linked to seasonality of birth; 10) and rheumatoid arthritis, or of conditions such as malignancy (4, 11). Most important is the role of nutritional vitamin D status in activating the human innate immune system that is reported by Liu et al (7). ..Who would have thought that a “simple nutrient” could possess such global health potential?”

[sugar-sweetened beverages make you fat] Intake of sugar-sweetened beverages and weight gain: a systematic review Am J Clin Nutr 2006 84: 274-288 ” Consumption of sugar-sweetened beverages (SSBs), particularly carbonated soft drinks, may be a key contributor to the epidemic of overweight and obesity, by virtue of these beverages’ high added sugar content, low satiety, and incomplete compensation for total energy… The weight of epidemiologic and experimental evidence indicates that a greater consumption of SSBs is associated with weight gain and obesity. Although more research is needed, sufficient evidence exists for public health strategies to discourage consumption of sugary drinks as part of a healthy lifestyle.”

[entire world is getting fat, therefore ill] Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases Am J Clin Nutr 2006 84: 289-298 ” Global energy imbalances and related obesity levels are rapidly increasing. The world is rapidly shifting from a dietary period in which the higher-income countries are dominated by patterns of degenerative diseases (whereas the lower- and middle-income countries are dominated by receding famine) to one in which the world is increasingly being dominated by degenerative diseases…Dietary changes appear to be shifting universally toward a diet dominated by higher intakes of animal and partially hydrogenated fats and lower intakes of fiber. Activity patterns at work, at leisure, during travel, and in the home are equally shifting rapidly toward reduced energy expenditure. ..Limited documentation of the extent of the increased effects of the fast food and bottled soft drink industries on this nutrition shift is available,..” The article goes on to explain that national policies to reduce obesity work well when done earnestly. Finland is held up as an example where intersectoral collaboration works through price policy, package labelling, and education have succeeded.

[kids need intense exercise to control weight] Relations of total physical activity and intensity to fitness and fatness in children: the European Youth Heart Study Am J Clin Nutr 2006 84: 299-303 ” Conclusions: The results suggest that physical activity of vigorous intensity may have a greater effect on preventing obesity in children than does physical activity of lower intensity, whereas both total and at least moderate to vigorous physical activity may improve children’s cardiovascular fitness.”

[Diet for 6 weeks before obesity surgery] Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging Am J Clin Nutr 2006 84: 304-311 “Conclusions: Given the observed early reduction in liver volume and the progressive reduction in visceral adipose tissue, we suggest that the minimum duration for a preoperative very-low-energy diet be 2 wk. Ideally, the duration should be 6 wk to achieve maximal liver volume reduction and significant reductions in visceral adipose tissue and body weight without compromising compliance and acceptability. ”

[Eat nuts, alcohol, whole grains] Adherence to the Mediterranean dietary pattern is positively associated with plasma adiponectin concentrations in diabetic women Am J Clin Nutr 2006 84: 328-335 “Conclusions: Our data suggest that, of the several components of the Mediterranean dietary pattern score, alcohol, nuts, and whole grains show the strongest association with adiponectin concentrations. Close adherence to a Mediterranean-type diet is associated with higher adiponectin concentrations.” Adiponectin is secreted by fatty tissue. It improves sugar and fat metabolism, improves insulin sensitivity, and has antiatherosclerotic effects.

[Olive oil is great] Ratio of oleic to palmitic acid is a dietary determinant of thrombogenic and fibrinolytic factors during the postprandial state in men Am J Clin Nutr 2006 84: 342-349 “Objective: We investigated whether the ratio of oleic to palmitic acid [and that of monounsaturated to saturated fatty acids (MUFA:SFA)] in the diet affects postprandial concentrations of triacylglycerols, tissue factor (TF), fibrinogen, tissue-type plasminogen activator (t-PA), and plasminogen activator inhibitor 1 (PAI-1)…Design: We studied the effects of diets enriched in olive oil (ROO), high-palmitic sunflower oil (HPSO), butter, or a mixture of vegetable and fish oils (VEFO) on circulating concentrations of the aforementioned factors in 14 healthy men. The fats had ratios of oleic to palmitic acid (MUFA:SFA) of 6.83 (5.43), 2.36 (2.42), 0.82 (0.48), and 13.81 (7.08)…Conclusions: Postprandial concentrations of TF, fibrinogen, and PAI-1 are associated with the ratio of oleic to palmitic acid (MUFA:SFA) in dietary fats. The postprandial t-PA response is related to postprandial concentrations of triacylglycerol.”

[To burn fat, eat foods with low glycemic index] Influence of high-carbohydrate mixed meals with different glycemic indexes on substrate utilization during subsequent exercise in women Am J Clin Nutr 2006 84: 354-360 “Conclusion: Altering the glycemic index of the carbohydrate within a meal significantly changes the postprandial hyperglycemic and hyperinsulinemic responses in women. A low glycemic index preexercise meal resulted in a higher rate of fat oxidation during exercise than did a high glycemic index meal”

[check calcium content of mineral water you drink] Absorbability and utility of calcium in mineral waters Am J Clin Nutr 2006 84: 371-374 “Conclusion: High-calcium mineral waters could provide useful quantities of bioavailable calcium. ”

[Natural mixed vitamin E is likely to be safer] Distribution of serum concentrations of -tocopherol and -tocopherol in the US population Am J Clin Nutr 2006 84: 375-383 “Objective:Our aim was to describe the distribution of serum concentrations of -tocopherol and -tocopherol in a nationally representative sample of US adults…Concentrations of -tocopherol increased significantly (P for trend < 0.001) with age and were significantly (P = 0.015) lower in men than in women. African Americans and Mexican Americans had significantly (P < 0.001) lower concentrations of -tocopherol than did whites. The median concentrations of -tocopherol showed a trend with respect to age, did not differ significantly between men and women, and were slightly but nonsignificantly lower in white participants than in African American or Mexican American participants.” Article explains vitamin E intake is inversely associated with Alzheimer disease, macular degeneration, and heart disease. But there are 8 forms of vitamin E: alpha, beta, gamma, and delta-tocopherol and alpha, beta, gamma, and delta-tocotrienol. Figure 3 shows those taking supplements have higher serum levels of alpha-tocopherol. But most supplement users have a much lower ratio of gamma-tocopherol, because most supplements, even those labeled natural, are just alpha-tocopherol. As gamma-tocopherol is especially useful in trapping free radicals produced by cigarette smoke, it may be important to maintain the gamma-tocopherol level.

[boys benefit from 1140mg calcium/day] Calcium retention in adolescent boys on a range of controlled calcium intakes Am J Clin Nutr 2006 84: 414-418 “Background: National calcium requirements in the United States for boys are based on data from girls…Results: Maximal calcium retention in boys was achieved at an intake of 1140 mg/d. …Conclusion: The higher calcium retention in boys than in girls was attained through higher net calcium absorption and lower urinary excretion than in girls.” Previous article in AJCN shows girls need 800 mg calcium/day.

[Mature adults need magnesium] Magnesium and muscle performance in older persons: the InCHIANTI study Am J Clin Nutr 2006 84: 419-426 “Background: The role of magnesium in maintaining muscle integrity and function in older adults is largely unknown. Objective: We aimed to investigate the relation between serum magnesium concentrations and muscle performance in older subjects…Conclusions: The serum magnesium concentration is an independent correlate of muscle performance in older persons. Whether magnesium supplementation improves muscle function remains to be shown.”

[Weight gain before age 40 is most hazardous] Body mass index history and risk of type 2 diabetes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam Study Am J Clin Nutr 2006 84: 427-433 “Conclusion: Weight gain in early adulthood is related to a higher risk and earlier onset of type 2 diabetes than is weight gain between 40 and 55 y of age.”

[Quality of diet prevents obesity and metabolic syndrome] Nutritional risk and the metabolic syndrome in women: opportunities for preventive intervention from the Framingham Nutrition Study Am J Clin Nutr 2006 84: 434-441 The metabolic syndrome affects 29% of women in the United States. “Conclusions: Higher composite nutritional risk predicts the development of abdominal obesity and Metabolic Syndrome during long-term follow-up in healthy women, independent of lifestyle and ischemic heart disease risk factors. Preventive nutrition interventions for obesity and Metabolic Syndrome risk reduction should focus on the overall nutritional quality of women’s dietary profiles. ”

[Saturated fats contribute to metabolic syndrome, unsaturated fats prevent it] Factor analysis of fatty acids in serum lipids as a measure of dietary fat quality in relation to the metabolic syndrome in men Am J Clin Nutr 2006 84: 442-448 ” Conclusions: The generated fatty acid factors, which presumably represent dietary fat quality and endogenous fatty acid metabolism, may be important in the development of Metabolic Syndrome. This finding supports current dietary recommendations to increase polyunsaturated fatty acid intakes and restrict saturated fatty acid intakes.”

[Lower Waist-hip ratio is more important to survivial than BMI] Weight, shape, and mortality risk in older persons: elevated waist-hip ratio, not high body mass index, is associated with a greater risk of death Am J Clin Nutr 2006 84: 449-460 “Objective: We investigated the association of BMI (in kg/m2), waist circumference, and waist-hip ratio (WHR) with mortality and cause-specific mortality…Conclusions: Current guidelines for BMI-based risk categories overestimate risks due to excess weight in persons aged 75 y. Increased mortality risk is more clearly indicated for relative abdominal obesity as measured by high WHR.”