Alcohol consumption and the risk of alcohol related cirrhosis in women.

The risks in women of cirrhosis with a likely primary alcohol aetiology were estimated for various levels of alcohol consumption in a case-control study. Data were obtained from 41 women with a first diagnosis of cirrhosis who had no evidence of non-alcohol-related cirrhosis; three matched controls were interviewed for each case. Significant increases in the risk of cirrhosis were detected at levels of consumption between 41 and 60 g daily; above this level a dose-response relation was observed. The risk of cirrhosis did not appear to be influenced by other nutritional factors or history of liver disease or use of hepatotoxic drugs. One per cent of Australian women consume more than 40 g alcohol daily, yet more than 90% of women identified with cirrhosis consumed alcohol at this level. Preventive interventions to reduce alcohol consumption in the small group of women who consume more than 40 g daily have the potential to reduce substantially the incidence of alcohol related cirrhosis.     

The Fat-Sucrose Seesaw in Relation to Age and Dietary Variety of French Adults

DREWNOWSKI, ADAM, SUSAN AHLSTROM HENDERSON, AMY BETH SHORE, CLAUDE FISCHLER, PAUL PREZIOSI, SERGE HERCBERG. The fatsucrose seesaw in relation to age and dietary variety of French adults. Guidelines for a healthy diet often recommend limiting dietary sugars and fats. Some researchers have called these aims mutually incompatible, suggesting that fat and sugar intakes, when expressed as percent dietary energy, are inversely linked. Others have argued that sugar, more specifically sucrose, acts as a vehicle for dietary fat and serves to suppress the overall quality of the diet. This study examined the relationship between age, sucrose and fat intakes, body mass index (BMI), and measures of dietary diversity and variety in a communitybased sample of 837 French adults. Consistent with other studies, high consumption of added sucrose (in g/day or g/1000 kcal per day) was associated with higher consumption of energy and fat and lower consumption of vegetables and fruit. However, eating patterns were strongly influenced by age. High-sucrose consumers were significantly younger and had lower BMI values than did low-sucrose consumers, who were both older and had higher BMIs. High-sucrose diets had minimal effect on the diet diversity score and were associated with more varied diets, as evidenced by a higher dietary variety score.     

Chromium,selenium, and other trace element intakes of a selected sample of Canadian premenopausal women

Daily Cr, Se, Ag, Cs, Rb, Sb, and Sc intakes of 84 Canadian women aged 30.3±6.1 yr (mean±SD) living in a University community and consuming self-selected diets were determined by analyses of 1-d food composites collected by the subjects. Aliquots of the homogenized food composites were freeze-dried and then analyzed by instrumental neutron activation procedures following irradiation for 72h. In all cases, trace element concentrations in the food composites were non-Gaussian. Median daily intakes were: Cr, 47 μg; Se, 74 μg; Ag, 7.1 μg; Cs, 4.4 μg; Rb, 1.5 mg; Sb 2.0 μg; and Sc, 0.38 μg. Sixty percent and 24% of the subjects received daily Cr and Se intakes, respectively, below the US Food and Nutrition Board safe and adequate range. High Cr density diets were associated with a significantly higher consumption of cheese and dry legumes and nuts (p<0.05). In the high Se density diets, intakes of grain products and breakfast cereals were significantly higher (p<0.05), and intakes of potatoes, table fats, total fat, saturated fat, and oleic acid were significantly lower (p<0.05) compared to the low Se density diets. The low daily Cr intakes evident in this study may be cause for concern in view of the increasing evidence that women may be at greater risk for deficiency of Cr than men because of Cr depletion during pregnancy.     

Whole Grain Intakes in the Diets Of Malaysian Children and Adolescents – Findings from the MyBreakfast Study

Background

Diets rich in whole grain are associated with several health benefits. Little is known however, about whole grain consumption patterns in Malaysia. The aim of this study was to assess whole grain intakes and dietary source in Malaysian children and adolescents.

Methods

This analysis is from the MyBreakfast study, a national cross sectional study investigating eating habits among primary and secondary school children throughout Malaysia, conducted in 2013. Children (n = 5,165) and adolescents (n = 2,947) who completed two days of dietary assessment using a food record or recall respectively were included. The whole grain content of foods was estimated mainly through the use of quantitative ingredient declarations on food labels. All wholegrain foods were considered irrespective of the amount of whole grain they contained.

Results

Overall, only 25% of children and 19% of adolescents were wholegrain consumers. Mean daily intakes in the total sample were 2.3g/d (SD 5.8g/d) in children and 1.7g/d (SD 4.7g/d) in adolescents and in the consumer’s only sample, mean intakes reached 9.1g/d (SD 8.6) and 9.2g/d (SD 7.1g/d) respectively. Wheat was the main grain source of whole grain while ready to eat breakfast cereals and hot cereals were the main food contributors. Less than 3% of the children and adolescents reached the US quantitative whole grain recommendation of 48g/day.

Conclusion

Whole grain is consumed by only a minority of Malaysian children and adolescents and even among consumers, intakes are well below recommendations. Efforts are needed to firstly understand the barriers to whole grain consumption among Malaysian children in order to design effective health promotion initiatives to promote an increase in whole grain consumption.     

Sugar,fat, and the risk of colorectal cancer.

The habitual diet of 50 patients with large bowel cancer, as assessed by a dietary history method, was compared with that of 50 closely matched controls. Patients were included only if their symptoms were unlikely to have changed previous eating habits. The mean daily intakes of all major nutrient classes and of dietary fibre were estimated. Patients with large bowel cancer consumed 16% more energy than controls (mean (SEM) daily intake 9.92 (0.41) v 8.56 (0.32) MJ (2370 (98) v 2046 (76) kcal), respectively; p less than 0.0001), mainly in the form of carbohydrate (21% more; 282.6 (13.7) v 233.4 (10.5) g; p less than 0.0001) and fat (14% more; 100.8 (4.3) v 88.4 (3.2) g; p less than 0.001). The extra carbohydrate was largely in the form of sugars depleted in fibre and the extra fat as combinations of fat and such sugars. As the selection criteria used make it unlikely that this eating pattern was caused by the disease the data suggest that a high intake of sugars depleted in fibre and fat predisposes to the development of large bowel cancer.     

Severity of alcohol dependence in patients with alcoholic liver disease.

To determine the severity of dependence on alcohol in patients with alcoholic liver disease the severity of alcohol dependence questionnaire was administered to 193 patients with various types of alcoholic liver disease established histologically, in whom a detailed history of lifetime alcohol consumption was also obtained. Only 34 patients (18%) were classified as being severely dependent compared with 56% of patients without overt liver disease who were attending a neighbouring alcohol treatment unit. There was a significant correlation between the severity of dependence and mean daily alcohol consumption (r = 0.45 and 0.39 for men and women, respectively) but not duration of drinking. Dependence scores tended to be lower in patients with cirrhosis than in those with precirrhotic liver disease, but this difference reached significance only in women. These findings confirm that patients who develop chronic alcoholic liver disease are usually only mildly dependent on alcohol and support the hypothesis that patients who escape florid symptoms of alcohol dependence are at greater risk of developing liver damage because they are able to sustain a continual consumption of alcohol over many years.     

EPA and DHA--protein, not fat is "where it's at"?

Guidelines and recommendations for the dietary intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are topics of debate. Recently, EPA and DHA intakes have been demonstrated to be associated with dietary protein intakes and not dietary fat intakes that are distinct from α-linolenic acid. We presently confirm these observations in a secondary analysis of baseline dietary intake data for the validation of a food frequency questionnaire (n=99). DHA intakes measured by both 3 d dietary record and food frequency questionnaire and EPA intakes measured by food frequency questionnaire were positively correlated with protein intakes. EPA and DHA were not associated with fat intakes in either assessment, while ?-linolenic acid was positively correlated with fat intakes. Future recommendations regarding the intake of omega-3 polyunsaturated fatty acids, and EPA and DHA specifically, should consider these associations that provide insight on dietary sources of EPA and DHA in the food supply.     

Dietary recommendations for the community towards the postponement of coronary heart disease.

The public has recently been confronted with many, often conflicting, recommendations about diet and reducing the risk of coronary heart disease (CHD). Dietary recommendations to the community designed to lower the risk of CHD should be specific, clear, and brief. People should be advised to reduce their intake of foods that are high in saturated fats and replace these partially with foods that are relatively high in polyunsaturated fats. This will lower both total fat and dietary cholesterol intakes and will also change the ratio of polyunsaturated to saturated fats.     

Fat intake and the risk of gastroschisis

BACKGROUND: Young age has been associated with an increased risk of gastroschisis. It has been suggested that the pathogenesis of gastroschisis may be related to vascular disruption. Nutrients that may be associated with vasoconstriction include dietary fat and its subtypes. The objective of this study was to examine the association between dietary fats and gastroschisis and whether maternal age modified this association. METHODS: Data came from the National Birth Defects Prevention Study (NBDPS), which included 304 isolated gastroschisis cases and 3313 controls. Dietary intake in the year prior to conception was ascertained using a food frequency questionnaire, and included total, saturated, monosaturated, and polyunsaturated fat and cholesterol. Unconditional logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for confounders. Age and smoking were tested as effect modifiers. RESULTS: Higher mean intakes of total energy, total fat, and cholesterol as well as the subtypes of fats were found for gastroschisis cases compared to controls. Cases were more likely to be in the middle (adjusted OR [AOR], 1.3; 95% CI, 0.9-1.9) and highest (AOR, 1.2; 95% CI, 0.8-1.7) tertile of total fat intake compared to controls. This pattern was also true for saturated fat intake. No association was found for mono or polyunsaturated fat. Cases were less likely to be in the middle (AOR, 0.6; 95% CI, 0.4-0.9) and highest (AOR, 0.8; 95% CI, 0.6-1.2) tertiles for cholesterol. There was no evidence of effect modification. CONCLUSIONS: A possible weak effect of increased risk of gastroschisis associated with higher intakes of total fat or saturated fat was found in the NBDPS; however, this did not help to explain why younger aged women are at greater risk of having an infant with this type of birth defect.     

Dietary analysis of young professional soccer players for 1 week during the competitive season

Limited data exist concerning the dietary practices of young professional soccer players that compete within the United Kingdom. Therefore, the purpose of this study was to investigate the nutritional and activity habits of professional male soccer players (n = 10; age: 17 ± 1 years, height: 1.72 ± 0.01 m, mass: 67.5 ± 1.8 kg, estimated maximal aerobic capacity: 57.8 ± 0.9 ml·kg·min) who played for the youth team of a UK-based Championship club. All players recorded their 7-day dietary intake and activity habits during a competitive week that included a match day, 4- training days, and 2 rest days in the first half of the 2009/2010 playing season. The intake of carbohydrates (5.9 ± 0.4 g·kg·d), proteins (1.7 ± 0.1 g·kg·d), and fats (1.5 ± 0.1 g·kg·d) represented 56 ± 1, 16 ± 1, and 31 ± 1% of the mean daily energy intake respectively. The intake of fiber was found to be significantly lower than Recommended Nutrient Intake (RNI) values (67% of RNI, p < 0.001), whereas all other analyzed micronutrients met or exceeded recommended values. A mean daily energy deficit of 788 ± 174 kcal existed because daily energy expenditures exceeded that of intake (3,618 ± 61 vs. 2831 ± 164 kcal, p = 0.001). The mean daily fluid intake was 3.2 ± 0.3 L. Consequently, the nutritional practices of the sampled group of professional youth soccer players were inadequate to sustain optimized performance throughout training and match play. Youth soccer players should therefore seek to ensure that their diets contain adequate energy through increased total caloric intake, while also optimizing the proportion of energy derived from carbohydrates and ensuring that enough fiber-rich foods are consumed.     

Comparison of demography, diet, lifestyle, and serum lipid levels between the Guangxi Bai Ku Yao and Han populations

Bai Ku Yao is an isolated subgroup of the Yao minority in China. Little is known about dyslipidemia in this population. The aim of this study was to compare the effects of demography, diet, and lifestyle on serum lipid levels between the Bai Ku Yao and Han populations. A total of 1,170 subjects of Bai Ku Yao and 1,173 subjects of Han Chinese aged 15-89 years were surveyed by a stratified randomized cluster sampling. The levels of total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, apolipoprotein A-I (apoA-I), and apoB were significantly lower in Bai Ku Yao than in Han. Physical activity level and total dietary fiber intake were higher, whereas body mass index (BMI), waist circumference, total energy intake, and total fat intake were lower in Bai Ku Yao than in Han. Hyperlipidemia was positively correlated with BMI, waist circumference, and total energy and total fat intakes and negatively associated with physical activity level and total dietary fiber intake in both populations, but it was positively associated with age and alcohol consumption only in Han. The differences in the lipid profiles between the two ethnic groups were associated with different dietary habits, lifestyle choices, and levels of physical activities.     

Fatty liver: Role of inflammation and fatty acid nutrition

Nonalcoholic fatty liver disease (NAFLD) refers to a wide spectrum of liver damage, ranging from simple steatosis to nonalcoholic steatohepatitis (NASH), advanced fibrosis, and cirrhosis. NAFLD is strongly associated with insulin resistance and is defined by accumulation of liver fat >5% per liver weight in the presence of <10 g of daily alcohol consumption. The exact prevalence of NAFLD is uncertain because of the absence of simple noninvasive diagnostic tests to facilitate an estimate of prevalence but in subgroups of people such as those with type 2 diabetes, the prevalence may be as high as 70%. NASH is an important subgroup within the spectrum of NAFLD that progresses over time with worsening fibrosis and cirrhosis, and NASH is associated with increased risk for cardiovascular disease. It is, therefore, important to understand the pathogenesis of NASH specifically, to develop strategies for interventions to treat this condition. The purpose of this review is to discuss the roles of inflammation, fatty acids and fatty acids in nutrition, in the pathogenesis and potential treatment of NAFLD.     

Relation between consumption of alcohol and fatty acids esterifying serum cholesterol in healthy men.

The relation between consumption of alcohol (established by interview), two of its typical markers (gamma-glutamyltransferase activity and mean corpuscular volume), and the composition of fatty acids in plasma cholesterol esters was investigated in an epidemiological study of 1467 actively employed men aged 35-45. In this group of subjects mean consumption of alcohol was 34.6 (SD 25.2) g/day. Palmitoleic acid and oleic acid were positively correlated with consumption of alcohol, gamma-glutamyltransferase activity, and mean corpuscular volume, while linoleic acid was negatively correlated with these variables. When these three fatty acids, gamma-glutamyltransferase activity, mean corpuscular volume, and the fat content of the diet were introduced into a multivariate regression analysis, with consumption of alcohol as the dependent variable, only palmitoleic acid, gamma-glutamyltransferase activity, mean corpuscular volume, and the monounsaturated fat content of the diet remained significant. Palmitoleic acid seems to be an independent correlate of consumption of alcohol and could be useful in epidemiological and clinical studies as a variable of consumption.     

Cancer and cardiovascular diseases nutrition knowledge and dietary intake of medical students

The aims of this study were to determine medical students' knowledge regarding the association between dietary factors and the risk of cancer and cardiovascular diseases and to investigate if this knowledge has an impact on their dietary intakes. Three hundred and ninety medical students (males and females) were included in a study and grouped according to their daily fibre and fat intakes. For diet-disease knowledge, questions from the General Nutrition Knowledge Questionnaire for Adults were used and dietary assessment was done with Food Frequency Questionnaire. The obtained results showed that the students' diet-disease knowledge was generally inadequate. Higher level of diet-disease knowledge was among those with high dietary fibre intake, with slightly better scores for dietary factors and risk for cardiovascular diseases than the risk for cancer. Better diet-disease knowledge positively correlated with higher intake of fish (p = 0.027, p = 0.001) and vegetables (p = 0.019, p = 0.001) in high fibre groups of both gender, and in females additionally with fruit intake (p = 0.038, p = 0.007). A higher dietary fibre intake among studied students seems to be a factor that ensures lower obesity rates, lower intake of energy and lower consumption of coffee, sweets and alcoholic drinks. On the basis of the results of this study, it is clear that medical schools should provide in their nutrition programs the opportunity for students to learn about their own dietary and lifestyle behaviours, in order to more knowledgably and convincingly counsel their future patients.     

Intake of dietary fats and fatty acids and the incidence of type 2 diabetes: A systematic review and dose-response meta-analysis of prospective observational studies

BackgroundThe role of fat quantity and quality in type 2 diabetes (T2D) prevention is controversial. Thus, this systematic review and meta-analysis aimed to investigate the associations between intake of dietary fat and fatty acids and T2D, and to evaluate the certainty of evidence.Methods and findingsWe systematically searched PubMed and Web of Science through 28 October 2019 for prospective observational studies in adults on the associations between intake of dietary fat and fatty acids and T2D incidence. The systematic literature search and data extraction were conducted independently by 2 researchers. We conducted linear and nonlinear random effects dose–response meta-analyses, calculated summary relative risks (SRRs) with their corresponding 95% confidence intervals (95% CIs), and assessed the certainty of evidence. In total, 15,070 publications were identified in the literature search after the removal of duplicates. Out of the 180 articles screened in full text, 23 studies (19 cohorts) met our inclusion criteria, with 11 studies (6 cohorts) conducted in the US, 7 studies (7 cohorts) in Europe, 4 studies (5 cohorts) in Asia, and 1 study (1 cohort) in Australia. We mainly observed no or weak linear associations between dietary fats and fatty acids and T2D incidence. In nonlinear dose–response meta-analyses, the protective association for vegetable fat and T2D was steeper at lower levels up to 13 g/d (SRR [95% CI]: 0.81 [0.76; 0.88], p_nonlinearity = 0.012, n = 5 studies) than at higher levels. Saturated fatty acids showed an apparent protective association above intakes around 17 g/d with T2D (SRR [95% CI]: 0.95 [0.90; 1.00], p_nonlinearity = 0.028, n = 11). There was a nonsignificant association of a decrease in T2D incidence for polyunsaturated fatty acid intakes up to 5 g/d (SRR [95% CI]: 0.96 [0.91; 1.01], p_nonlinearity = 0.023, n = 8), and for alpha-linolenic acid consumption up to 560 mg/d (SRR [95% CI]: 0.95 [0.90; 1.00], p_nonlinearity = 0.014, n = 11), after which the curve rose slightly, remaining close to no association. The association for long-chain omega-3 fatty acids and T2D was approximately linear for intakes up to 270 mg/d (SRR [95% CI]: 1.10 [1.06; 1.15], p_nonlinearity < 0.001, n = 16), with a flattening curve thereafter. Certainty of evidence was very low to moderate. Limitations of the study are the high unexplained inconsistency between studies, the measurement of intake of dietary fats and fatty acids via self-report on a food group level, which is likely to lead to measurement errors, and the possible influence of unmeasured confounders on the findings.ConclusionsThere was no association between total fat intake and the incidence of T2D. However, for specific fats and fatty acids, dose–response curves provided insights for significant associations with T2D. In particular, a high intake of vegetable fat was inversely associated with T2D incidence. Thus, a diet including vegetable fat rather than animal fat might be beneficial regarding T2D prevention.

Manuela Neuenschwander and colleagues study associations between intake of different types of fat and incidence of type 2 diabetes.     

Adiposity and dietary intake in cardiovascular risk in an obese population from a Mediterranean area

The aim of the study was to determine the particular relevance of android fat distribution and dietary intake in cardiovascular risk in an obese Mediterranean population with high intake of monounsaturated fatty acids (MUFA) and to compare the findings with those from normal-weight subjects. For the study, 193 subjects aged 25-60 were selected: 118 obese (BMI > or = 27 kg/m2), and 75 normal-weight (BMI < 25 kg/m2). Cardiovascular risk factors including hypertension, dyslipidaemia, glucose intolerance and insulin resistance were assessed. Nutrient intake and body fat distribution were determined. Results show that MUFA were highly consumed in the total population (21% of total energy). The obese population was normolipidemic and normoinsulinemic. However, cardiovascular risk factors (CVRF) were significantly higher than in normal-weight (P < 0.05). Obese subjects derived a greater percentage of their energy intake from total fat and lower from carbohydrates and saturated fats (P < 0.05). BMI and waist-hip ratio positively correlated with fat percentage of total energy intake and with MUFA (g/100 g fatty acids) in men, indicating that the excess of fat intake in obesity is due to a larger consumption of olive oil. CVRF were significantly and positively associated to waist circumference and WHR, both in obese and in normal-weight subjects. In conclusion, not only obesity but also android fat in normal-weight subjects are important factors in cardiovascular disease even in the Mediterranean population, with a high intake of MUFA, where these factors seem to be more relevant to cardiovascular risk than dietary composition.     

Infrequent Breakfast Consumption Is Associated with Higher Body Adiposity and Abdominal Obesity in Malaysian School-Aged Adolescents

Unhealthy dietary pattern increases the risk of obesity and metabolic disorders in growing children and adolescents. However, the way the habitual pattern of breakfast consumption influences body composition and risk of obesity in adolescents is not well defined. Thus, the aim of the present study was to assess any associations between breakfast consumption practices and body composition profiles in 236 apparently healthy adolescents aged 12 to 19 years. A self-administered questionnaire on dietary behaviour and lifestyle practices and a dietary food frequency questionnaire were used. Body composition and adiposity indices were determined using standard anthropometric measurement protocols and dual energy χ-ray absorptiometry (DXA). Mean age of the participants was 15.3±1.9 years. The majority of participants (71.2%) fell in the normal body mass index (BMI) ranges. Breakfast consumption patterns showed that only half of the participants (50%) were consuming breakfast daily. Gender-specific multivariate analyses (ANCOVA) showed that in both boys and girls, those eating breakfast at least 5 times a week had significantly lower body weight, body mass index (BMI), BMI z-scores, waist circumference, body fat mass and percent body fat (%BF) compared to infrequent breakfast eaters, after adjustment for age, household income, pubertal status, eating-out and snacking practices, daily energy intakes, and daily physical activity levels. The present findings indicate that infrequent breakfast consumption is associated with higher body adiposity and abdominal obesity. Therefore, daily breakfast consumption with healthy food choices should be encouraged in growing children and adolescents to prevent adiposity during these critical years of growth.     

Physical activity,muscle strength,and calcium intake in fracture of the proximal femur in Britain.

Regular exercise and high calcium intake possibly help to preserve bone mass. Little is known, however, about their role in preventing hip fracture. The physical activity and calcium intake of 300 elderly men and women with hip fractures were compared with those of 600 controls matched for age and sex. In both sexes increased daily activity, including standing, walking, climbing stairs, carrying, housework, and gardening protected against fracture. This was independent of other known risk factors, including body mass, cigarette smoking, and alcohol consumption. Strength of grip correlated with activity and was inversely related to the risk of fracture. Calcium intake was not related to the risk of fracture in women. Men with daily calcium intakes above 1g had lower risks. These findings point to the importance of elderly people in Britain maintaining physical activity in their day to day lives.     

Assessment of iron and zinc intake and related biochemical parameters in an adult Mediterranean population from southern Spain: influence of lifestyle factors

This study assessed factors influencing iron and zinc intake and associated biochemical parameters in an adult population from southern Spain to identify patterns of intake and groups at risk for deficiency. A cross-sectional survey was done in Andalusia (southern Spain) to study nutrient intakes in a random sample of 3421 subjects (1747 men, 1674 women, age between 25 and 60 years). Blood samples were obtained for biochemical assays in a random subsample of 354 subjects (170 men, 184 women). Food consumption was assessed by 48-h recall. In blood samples, we measured red blood cells, haemoglobin (Hb), haematocrit, total iron binding capacity (TIBC) and plasma concentration of Fe and Zn. Information about educational level, smoking habit, alcohol consumption and physical exercise was collected with a structured questionnaire. Intakes were below two thirds of the recommended dietary allowances (RDA) in 22.45% of the sample for Fe and in 56.45% for Zn. Iron deficiency [two or more abnormal values for plasma Fe, TIBC, transferrin saturation and mean cell volume (MCV)] was found in 12.7% of the sample, and iron-deficient anaemia (low values for Hb, MCV, mean cell Hb and mean corpuscular Hb concentration) was found in 2.1%. In smokers, plasma levels of Fe were higher, and MCV was lower than in nonsmokers. Plasma Zn concentrations were below the reference value in 17.8% of the persons. Age and body mass index correlated inversely with plasma Zn (P<.01). Gender, age, obesity, smoking, alcohol consumption and physical activity were associated with differences in nutrient intakes. Logistic regression analysis showed that female gender and older age were associated with the risk of low intakes of Fe and Zn.