SUBJECT: AJCN Dec 2014 from Roc Nutrition Investigator

Research from the December American Journal of Clinical Nutrition:

In the past week I have spoken with people with high blood pressure and kidney stones. Reading these bimonthly headlines and searching my website may provide simple nutritional steps to reduce your suffering. Happy Holidays from Roc.

An apple a day could keep the doctor away (free abstract)- The subjects in this study are elderly and all are at “high risk” of cardiovascular disease (CVD; having hypertension or type 2 diabetes or other risk factors). Fiber intake tracked with fruit consumption and both showed a significantly lower total all-cause mortality (∼37% risk reduction with fiber and ∼42% risk reduction with fruit consumption).  In contrast, neither vegetable intake nor intake of whole grains showed a significant trend toward decreased all-cause mortality. Although the public and many scientists seem to consider the beneficial effect of a high-fiber diet to be on the colon and colon cancer, the major clinical trials attempting to link intake of a particular fiber, or increasing the amount of total fiber in the diet, have not shown a beneficial effect of fiber intervention on decreased colon polyp reoccurrence after polyp removal (considered the gold standard for a beneficial effect against colon cancer). This was based on decreased risk of CVD, because they found a significant risk reduction for CVD with both high-fiber diets (54% risk reduction) and fruit consumption (56% reduction). This is probably one of the most differentiating factors between the current study and others, because the current study focuses on older individuals who are at high risk of contracting CVD, not healthy individuals. One medium apple (which is the most commonly eaten fruit in this cohort) contains 182 g of fruit and has 4.4 g of fiber, which would mean that adding 1 medium apple to the diet would put an individual from the lowest quintile (not protective) into quintile 2 (the protective category) for both fruit and fiber. It also shows that it is never too late to switch to a higher-fiber diet, and even if one already has a predisposition to heart disease it still will be possible to decrease the risk by having a higher intake of fiber/fruit.

Flavonoid intake at midllife increases wellbeing when older – (Further news why you might join the teaberry study) – Higher intake of flavonoids at midlife, specifically flavones, flavanones, anthocyanins, and flavonols, is associated with greater likelihood of health and wellbeing in individuals surviving to older ages. flavonoids and flavonoid-containing foods have been associated with lower risks of fatal or nonfatal cardiovascular disease, hypertension, stroke, cancer, diabetes and neurodegenerative diseases. Hence, overall, there is a strong biological and epidemiologic rationale for a role of flavonoids in healthy aging, despite the limited research in this area.

Caffeine intake lowers risk of kidney stones by about 30% – and 500mg of vitamin C twice a day lowers it about 22% more – The analysis included 217,883 participants; participants in the highest quintile of caffeine intake had a 26% lower risk of developing stones in the HPFS cohort, a 29% lower risk in the NHS I cohort, and a 31% lower risk in the NHS II cohort. Caffeine intake is independently associated with a lower risk of incident kidney stones.

Reducing salt intake lowers blood pressure – This meta-analysis showed that salt-substitution strategies are effective at lowering systolic BP and diastolic BP, which supports a nutritional approach to preventing hypertension.

Vitamin K intake reduces risk for many chronic diseases – Poor vitamin K status is linked to greater risk of several chronic diseases.Vitamin K insufficiency recently has been linked to a higher risk of several chronic diseases, including low bone mineral density, hip fractures, osteoarthritis, insulin resistance, and coronary calcium progression. Good sources of K are greens like spinach and broccoli.

Dairy is safe to enjoy – A dose-response meta-analysis of prospective studies indicates that milk intake is not associated with total mortality but may be inversely associated with overall CVD risk, from 2 large U.S. cohorts (Health Professionals Follow-Up Study: 51,529 men; Nurses’ Health Study: 121,700 women).There was a modest but significant inverse relation between intakes of total dairy products, low-fat dairy products, and cheese and risk of type 2 diabetes . The totality of evidence does not support that dairy SFAs increase the risk of coronary artery disease or stroke or CVD mortality. In contrast, lean dairy is clearly associated with decreased risk of type 2 diabetes, and this effect is partly independent of any effect of body fat loss. In addition, lean dairy does not increase body fatness but tends to preserve lean body tissue. Dairy does not increase stroke risk

Reduce undernutrition and obesity worldwide by feeding just the first thousand days from conception (see symposium index at the bottom of TOC) – Latin American children are getting taller, but they are also becoming fatter. These changes are not restricted to Latin America. With the possible exception of sub-Saharan Africa, the prevalence of stunting is rapidly decreasing. Child overweight is increasing in all regions, including Africa, at a faster rate than adult overweight. Whereas only a few years ago the major concern was with undernutrition, in particular with its impact on morbidity, mortality, and child development, the nutrition transition has shifted the focus to the risk of adult noncommunicable diseases (NCDs) related to early growth patterns. These analyses showed that rapid weight gain during the 1000-d window is associated with greater human capital, expressed in terms of intelligence, productivity, adult height, or next-generation reproductive outcomes. Contrary to what may have been expected, rapid gains in this period showed variable associations with NCD markers measured in young adults, which somewhat increased risks for some markers and no associations or protection against others. Rapid weight gains after the first couple of years, however, were consistently associated with higher concentrations of markers for NCDs, and did not contribute to improving human capital. These findings have programmatic implications. Programs aimed at promoting weight gains in children >2 y—except of course in populations in whom wasting is prevalent—may do more harm than good.