Association between dietary fiber intake and risk of coronary heart disease: A meta-analysis

Healthful plant-based diet and incidence of hypertension in Brazilian adults: A six-year follow-up of the CUME study

BACKGROUND

Studies demonstrate that consuming plant-based diets has beneficial effects on several health outcomes. However, the evaluation of the healthiness of plant-based diets and the incidence of hypertension has still been little explored in the literature.

OBJECTIVES

Thus, this study aimed to evaluate the association between plant-based diet indices and the incidence of hypertension in Brazilian adults and test whether the interaction between hPDI, sociodemographic, and lifestyle variables modifies this association.

METHODS

This longitudinal study included 3192 (F = 2125, average age 34 years) participants from the Cohort of Universities of Minas Gerais (CUME Study, Brazil, 2016-2022). Dietary intakes were assessed using a validated food frequency questionnaire. We measured three plant-based diet indices: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). Participants were classified as new cases of hypertension if they were free of this disease at baseline, had a systolic blood pressure ≥ 140 mmHg, a diastolic blood pressure ≥90 mmHg, were using antihypertensive medications, or had a diagnosis of hypertension by a physician in at least one of the follow-ups. Crude and adjusted Cox regression models were used to evaluate the relationship between plant-based diet indices and hypertension incidence and a multiplicative interaction was tested.

RESULTS

The incidence of hypertension was 19,8/1000 person-years total. The mean follow-up time was 3.36 years. There was an inverse association between the highest quintiles of hPDI (HR = 0.56, 95% CI = 0.37-0.86; HR = 0.55, 95% CI = 0.35-0.88) and hypertension. In subgroup analysis, inverse associations between hPDI and hypertension risk were stronger in participants who were insufficiently active and overweight (p-interaction < 0.05).

CONCLUSION

Greater consumption of healthful plant foods, reduced consumption of animal-source foods, and less consumption of unhealthful plant foods are important for hypertension prevention in the Brazilian population.

Associations of dietary riboflavin intake with coronary heart disease in US adults: a cross-sectional study of NHANES 2007-2018

Objective

There is currently little study on the relationship between dietary riboflavin intake and coronary heart disease (CHD) risk.

Methods

Using information from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018, we carried out a cross-sectional study. Dietary riboflavin intake and CHD risk were examined using weighted univariate and multivariable logistic regression. To learn more about the connection between dietary riboflavin intake and CHD risk, subgroup analyses and interactions were conducted. Next, the potential non-linear association was visually described using restricted cubic spline (RCS).

Results

The risk of CHD was inversely correlated with dietary riboflavin consumption. The multivariable odds ratio (OR) with 95% confidence interval (CI) for the risk of CHD was 0.52 (95%Cl: 0.34-0.81, Ptrend = 0.009) for the highest vs. lowest tertiles of riboflavin. This protective effect of dietary riboflavin on CHD was influenced by gender, drinking status and serum folate concentration. A non-linear inverse connection (Pfor nonlinearity ≤ 0.001) was shown using RCS analysis between riboflavin intake and the risk of CHD.

Conclusion

Our research suggested that consuming more riboflavin in your diet may lessen the risk of CHD. The results improved the current knowledge base and supplied potential implications for dietary recommendations and health policy.

Assessing and Monitoring Nutrition Security in the United States: A Narrative Review of Current Measures and Instruments

PURPOSE OF REVIEW

Because nutrition plays a crucial role in the development of chronic diseases, ensuring nutrition security is important for promoting population health. Nutrition security is defined as having consistent and equitable access to healthy, safe, affordable foods essential to optimal health and well-being. Distinguished from food security, nutrition security consists of two constructs: healthy diets and nutritional status. The study aimed to identify population measures that reflect the important constructs of nutrition security (i.e., healthy diets and nutritional status) to inform U.S. nutrition security assessment and monitoring.

RECENT FINDINGS

Through a narrative review conducted across multiple databases, associations between subconstructs of healthy diets and nutritional status were identified. Of the six subconstructs that constitute healthy diets, nutrient adequacy and moderation were most often used to assess and monitor healthfulness of U.S. population diets and were associated with health outcomes. There is little evidence of an association between health outcomes and macronutrient balance or diversity in the U.S. Thirteen instruments were identified as potentially suitable for measuring at least one subconstruct of healthy diet in the population. This review highlights the importance of nutrition security in addressing population health challenges. It emphasizes the potential use of multiple instruments and measures to comprehensively monitor population nutrition security and inform intervention strategies. Identifying feasible and practical measures for assessing and monitoring nutrition security is imperative for advancing population health and mitigating the burden of chronic diseases.

Technological Evaluation of Fiber Effects in Wheat-Based Dough and Bread

Dietary fiber incorporation in bread offers potential health benefits but poses challenges due to its impact on dough rheology and bread quality. This study evaluated the effects of pea, cocoa, and apple fiber on wheat-based dough and bread properties using rheological methods (farinograph, alveograph, pasting, and proofing) and baking trials. Substituting flour with fiber at 1%, 5%, or 10% increased water absorption and affected dough development, stability, and extensibility, particularly at high fiber concentrations. Pasting properties showed varying gelatinization behaviors influenced by fiber type and concentration. Principal component analysis (PCA) highlighted the clustering of dough and bread characteristics based on fiber concentration and type. At low fiber concentrations (up to 5% of flour replacement), negative effects were minimal, suggesting no need for comprehensive compositional analysis. However, high fiber concentrations (10%) introduced significant variability and complexity in dough properties. New farinographic parameters (FU4, FU6, FU8, FU10, and FU12) improved the explanatory power of PCA, enhancing the understanding of fiber-rich dough dynamics. The significant alterations in moisture content and texture underscore the intricate relationship between type of fiber, concentration, and dough functionality. Optimizing rheological parameters for fiber-enriched flour is crucial for adapting the bread-making process to produce high-quality bread with desired characteristics and enhanced nutritional benefits.

Dietary Survey of Japanese Individuals with Type 2 Diabetes Mellitus on a Low-Carbohydrate Diet: An Observational Study

The nutrient intake of persons with diabetes placed on a low-carbohydrate diet remains unclear. This study aimed to assess nutrient intake in persons with type 2 diabetes mellitus treated with a low-carbohydrate diet. The brief-type self-administered diet history questionnaire was used to collect the dietary information of 335 outpatients at Kitasato Institute Hospital, while their clinical characteristics were collected from their electronic medical records. The median age, HbA1c level, and body mass index of the participants were 68 (60-74) years, 49 (45-55) mmol/mol [6.7 (6.3-7.2)%], and 24.0 (21.8-26.7) kg/m2, respectively; median energy intake was 1457 (1153-1786) kcal/day; and protein-energy, fat-energy, and available carbohydrate-energy ratios were 18.6 (15.7-21.4)%E, 36.8 (31.6-43.2)%E, and 34.6 (26.0-42.4)%E, respectively. As the available carbohydrate-energy ratio decreased, the fat-energy ratio increased significantly. The total dietary fibre and salt intake were 7.1 (5.6-8.4) g/1000 kcal and 6.5 (5.6-7.5) g/1000 kcal, respectively. Japanese individuals with type 2 diabetes mellitus placed on a low-carbohydrate diet had a fat-to-energy ratio exceeding 30%, while the fat-energy ratio increased as the carbohydrate-energy ratio decreased.

Association between plant-based diets and the risk of coronary heart disease predicted using the Framingham Risk Score in Korean men: data from the HEXA cohort study

OBJECTIVES

This study investigated the potential correlation between 4 plant-based diet indices and the predicted risk of coronary heart disease (CHD) in Korean men using the Framingham Risk Score.

METHODS

The study included 12,356 men participants (aged ≥40 years) from the Health Examinees Study. Dietary intake was estimated using a validated food frequency questionnaire. Four plant-based diet indices were measured, including the overall plant-based diet index, the healthy plant-based diet index (hPDI), the unhealthy plant-based diet index (uPDI), and the pro-vegetarian diet index. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for the predicted 10-year risk of CHD.

RESULTS

The study found that individuals in the highest hPDI quintile had a 19% lower risk score for CHD based on the Framingham Risk Score (model 3: HR, 0.80; 95% CI, 0.69 to 0.93; p for trend=0.010). In stratified analyses, the highest pro-vegetarian diet index was associated with a lower risk score for CHD in physically active individuals (HR, 0.74; 95% CI, 0.59 to 0.93; p for interaction=0.020). Conversely, the highest uPDI was associated with the highest risk score for CHD in those with a body mass index of ≥25 kg/m2 and a waist circumference ≥90 cm.

CONCLUSIONS

This prospective cohort study highlights the positive role of adhering to a high hPDI diet in the prevention of CHD in Korean men. Further prospective studies are needed to determine the association between various plant-based diet indices and the risk of CHD in Asian populations with different dietary habits.

Physiologic Effects of Isolated or Synthetic Dietary Fiber in Children: A Scoping Review

Background

Fiber is an integral part of a healthy diet. Studies have shown that the fiber intake in children is below adequate amounts, leading to adverse health outcomes.

Objectives

This study aimed to perform a scoping review to assess the available evidence for the impact of isolated and synthetic dietary fiber on children's health outcomes.

Methods

A systematic literature search was conducted in Ovid Medline, Ovid Global Health, Embase, and Cochrane Library via Wiley to identify randomized controlled trials (RCTs) in healthy children aged 1-18 y at baseline who consumed added, isolated, or synthetic dietary fiber. The outcomes of interest were categorized based on the Food and Drug Administration's guidance for industry on nondigestible carbohydrates and the Vahouny Fiber Symposium criteria, which included reduced fasting blood, glucose, total and/or LDL cholesterol concentrations, attenuation of postprandial glycemia/insulinemia, increased fecal bulk/laxation, reduced transit time, weight loss/reduction in adiposity, reduced energy intake from food consumption, increased satiety, bone health/enhanced mineral absorption, and blood pressure. We also cataloged additional reported outcomes.

Results

Of 3837 randomized controlled parallel or crossover trials screened at the abstract level, 160 were eligible for full-text review, and 32 included for data extraction. This scoping review presents analysis of data from 32 RCTs in children who were healthy, overweight/obese or had mild hypercholesterolemia. Inulin-type fructans (41%) and psyllium (22%) were the most frequently administered fiber types, with weight/adiposity, markers of lipid metabolism (41%), and bone-related markers (38%) being the most frequently reported health outcomes. Only a few RCTs have investigated the effects of laxation (9%), and none specifically studied the impact of fiber on reducing postprandial glycemia/insulinemia.

Conclusions

This scoping review demonstrates sufficient evidence for conducting systematic reviews and meta-analyses for several outcomes. Evidence gaps remain on the impact of isolated fibers on outcomes such as laxation, colonic transit time, and postprandial glycemia/insulinemia in children.

Association between ischemic heart disease and dietary intake of lycopene: a case-control study

Aim

The effect of dietary lycopene on ischemic heart disease (IHD) is not clear. Hence, this study aimed to determine the association between dietary lycopene and IHD.

Methods

This case-control study was conducted on 443 patients with physician confirmed diagnosis of IHD as the case group and 443 healthy individuals as the control group. Data on demographic, medical history, anthropometric, and physical activity of the participants were collected. Food intake was evaluated using a 237-item semi-quantitative food frequency questionnaire (FFQ). The dietary intake of lycopene was assessed using Nutritionist IV software.

Results

A negative association was found between IHD and lycopene (OR: 0.98, CI 95%: 0.963-0.996, p = 0.02). The results remained significant after adjustment for age and sex, additional adjustment for dietary intake of calorie and fat, further adjustments for BMI, and additional adjustment for smoking, drinking alcohol, and physical activity. The risk of IHD in people with the highest quartile of dietary intake of lycopene was significantly lower than those with the lowest quartile (OR = 0.67, CI 95%: 0.46-0.97, p = 0.036).

Conclusion

There was a significant inverse relationship between intake of lycopene and IHD. Further prospective studies in different populations are required to elucidate the roles of lycopene against IHD.

Dietary fiber intake and all-cause and cause-specific mortality: An updated systematic review and meta-analysis of prospective cohort studies

BACKGROUND

Accumulating evidence supports the effects of dietary fiber on the risk of non-communicable diseases (NCDs). However, there is no updated systematic review and meta-analysis that compares and pools the effect of different types of fiber on mortality.

METHODS

In this systematic review and meta-analysis, all prospective cohort studies that evaluated the relationship between dietary fiber intake and all-cause or cause-specific mortality were included. The PubMed, SCOPUS, and Web of Science databases were searched up to October 2022. Data extraction and quality assessment were performed by two researchers independently. Heterogeneity between studies was assessed using Chi-square based test. Random/fixed effect meta-analysis was used to pool the hazard ratios (HR) or relative risks (RR) and 95 % confidence intervals (CI) for the association between different types of fiber and mortality.

RESULTS

This systematic review included 64 eligible studies, with a total sample size of 3512828 subjects, that investigated the association between dietary fiber intake and mortality from all-cause, cardiovascular disease (CVD), and cancer. Random-effect meta-analysis shows that higher consumption of total dietary fiber, significantly decreased the risk of all-cause mortality, CVD-related mortality, and cancer-related mortality by 23, 26 and 22 % (HR:0.77; 95%CI (0.73,0.82), HR:0.74; 95%CI (0.71,0.77) and HR:0.78; 95%CI (0.68,0.87)), respectively. The consumption of insoluble fiber tended to be more effective than soluble fiber intake in reducing the risk of total mortality and mortality due to CVD and cancer. Additionally, dietary fiber from whole grains, cereals, and vegetables was associated with a reduced risk of all-cause mortality, while dietary fiber from nuts and seeds reduced the risk of CVD-related death by 43 % (HR:0.57; 95 % CI (0.38,0.77)).

CONCLUSION

This comprehensive meta-analysis provides additional evidence supporting the protective association between fiber intake and all-cause and cause-specific mortality rates.

Total and different dietary fiber subtypes and the risk of all-cause, cardiovascular, and cancer mortality: a dose-response meta-analysis of prospective cohort studies

We aimed to conduct a comprehensive review of the association between dietary fiber and the risk of mortality. We did a systematic search in PubMed, Scopus, and Web of Science up to November 2022 to find prospective cohort studies of the relationship between total and subtypes of dietary fiber and the risk of all-cause, cardiovascular (CVD), and cancer mortality in the general population. The hazard ratios (HRs) and 95% CIs were calculated using a random-effects model. A total of 28 studies with 1 613 885 participants were included. Higher intake of total and subtypes of dietary fiber including cereal, vegetable, legume, soluble, and insoluble fiber, but not fruit fiber, was associated with a lower risk of all-cause mortality, with HRs ranging from 0.77 for insoluble fiber to 0.93 for legume fiber. Similar findings were observed for CVD mortality, where higher intake of total and all subtypes of dietary fiber was each associated with a lower risk. Higher intake of total, cereal, vegetable, and insoluble fiber was also associated with a lower risk of cancer mortality. No association was found between the intake of fruit, legume, and soluble fiber and cancer mortality. Dose-response meta-analyses suggested an inverse association between total fiber intake and the risk of all-cause, CVD, and cancer mortality. The certainty of evidence was rated moderate for the association of total fiber with all-cause, CVD, and cancer mortality. In conclusion, our findings highlight the potential advantages of consuming a wide range of dietary fiber subtypes against all-cause, CVD, and cancer mortality. Registry and registry number: PROSPERO (CRD42021226816).

Role of diet and exercise in aging, Alzheimer's disease, and other chronic diseases

Alzheimer's disease (AD) is a progressive neurodegenerative disease, characterized by memory loss and multiple cognitive impairments. Genetic mutations cause a small proportion (1-2%) of early-onset AD, with mutations in amyloid precursor protein (APP), presenilin 1 (PS1) and presenilin 2 (PS2). Major contributing factors of late-onset AD are ApoE4 genotype, traumatic brain injury, diabetes, obesity, hypertension, cardiovascular conditions, in addition to lifestyle factors, such as unhealthy diet and lack of physical exercise. Disease progression can be delayed and/or prevented to a greater extent by adopting healthy lifestyle with balanced and antioxidant enriched diet and daily exercise. The interaction and interplay of diet, exercise, age, and pharmacological interventions holds a crucial role in the progression, pathogenesis and management of AD and its comorbidities, including diabetes, obesity, hypertension and cardiovascular conditions. Antioxidant enriched diet contributes to brain health, glucose control, weight management, and cardiovascular well-being. Regular exercise removes toxins including free radicals and enhances insulin sensitivity, and supports cardiovascular function. In the current article, we discussed, the role of diet, and exercise in aging, AD and other conditions including diabetes, obesity, hypertension, cardiovascular conditions. This article also highlights the impact of medication, socioeconomic and lifestyle factors, and pharmacological interventions. These aspects were discussed in different races and ethnic groups in Texas, and the US.

Determination of the level of evidence for the association between different food groups/items and dietary fiber intake and the risk of cardiovascular diseases and hypertension: An umbrella review

Evidence has suggested that nutrition is a preventive factor against cardiovascular disease (CVD) risk. Because of a sharp growth in published meta-analyses and pooled analyses in recent years, a reassessment of old evidence is needed. We aimed to determine the level of evidence for the association between the consumption of different food groups/items and dietary fiber and the incidence risk of CVDs, hypertension, and atrial fibrillation from meta-analyses and pooled analyses of observational studies. Databases Scopus, PubMed/Medline, and Web of Science were searched for related studies. Fifty-eight articles met the inclusion criteria for evidence grading. In summary, grading the level of evidence showed a suggestive inverse association between the higher consumption of fruits, whole grains, fish, legumes, nuts, and dietary fibers with the incidence risk of hypertension and different types of CVD. Also, there was a probable inverse association between the higher consumption of total and low-fat dairy products and the risk of hypertension. Higher red meat consumption had a probable association with the increased risk of ischemic stroke. Higher consumption of processed meat and poultry also had a suggestive direct association with the incidence risk of stroke and hypertension. We have tried to present a comprehensive and useful overview of the level of evidence based on the most updated findings. The summary of results in the current umbrella review can be a helpful tool for nutritionists, dietitians, and researchers to establish new studies and identify research gaps in related issues.

Effects of paramylon-rich Euglena gracilisEOD-1 powder on visceral fat obesity in moderately obese Japanese adults: A randomized, double-blind, placebo-controlled, parallel-group trial

To investigate whether supplementation of paramylon (PM)-rich Euglena gracilis EOD-1 powder (EOD-1) reduces visceral fat obesity in moderately obese Japanese subjects. A randomized, double-blind, placebo-controlled intervention study was conducted involving 36 Japanese adults with a body mass index (BMI) ≥25 and <30 kg/m2. Subjects were randomly assigned into two groups to consume EOD-1 capsules (EOD-1 group, 2.6 g PM/day) or cellulose capsules (placebo group) for a 12-week period. Anthropometric measurements including visceral fat area (VFA) and blood samples were measured at baseline and throughout the trial. There was no significant difference in VFA between the two groups, although subgroup analysis by gender showed a significant decrease in VFA in the male EOD-1 group compared with the placebo group. Serum adiponectin levels in all subjects from the EOD-1 group were significantly higher than in the placebo group. By comparison with the placebo group, the subjects in the EOD-1 group showed a significant reduction in serum HbA1c levels. EOD-1 intake led to a significant reduction in VFA in male subjects with moderate obesity (BMI 25-30 kg/m2). PM in EOD-1 may contribute to preventing visceral fat obesity in male Japanese subjects. Moreover, PM may also contribute to improving glucose homeostasis in moderately obese Japanese adults.

High fiber diet attenuate the inflammation and adverse remodeling of myocardial infarction via modulation of gut microbiota and metabolites

Introduction

High intake of dietary fiber is associated with lower incidence of cardiovascular diseases. Dietary fiber, functions as a prebiotic, has a significant impact on intestinal bacteria composition and diversity. The intestinal flora and metabolites generated by fermentation of dietary fiber not only affect the health of intestine but also play a role in many extra-intestinal diseases, such as obesity, diabetes and atherosclerosis. However, the role and the mechanism by which a high fiber diet contributes to the development of myocardial infarction is still unclear.

Methods and results

Here we used an in vivo mouse model to investigate whether dietary fiber intake could protect against myocardial infarction. Our study demonstrated high fiber diet significantly improved cardiac function, reduced infarct size and prevented adverse remodeling following myocardial infarction. The protective effects of high fiber diet had a strong relation with its attenuation of inflammation. Moreover, we observed that high fiber diet could modulate the composition of intestinal flora and differentially impacted metabolites production, including the biosynthesis of bile acids and linoleic acid metabolism.

Conclusion

Overall, the findings of this study provided mechanistic insights into the curative effect of dietary fiber on myocardial infarction with a specific emphasis on the potential role of microbiota-metabolism-immunity interactions.

The combination of isomalto-oligosaccharides (IMO)-based dietary fiber and hypocaloric high-protein diet could improve the anthropometric profile and fasting plasma glucose of healthy adults: A repeated single-arm clinical trial

Background and aims

Meals with high protein and fiber could reduce weight and improve diabetes risk factors. Isomalto-oligosaccharide (IMO), a form of dietary fiber, could induce the afferent signal that causes appetite suppression. However, the direct effect of fiber supplementation in the form of IMO combined with a high-protein diet (HPF) on those parameters is still unknown. This study aims to investigate the effect of HPF on anthropometric parameters and blood glucose regulation of healthy subjects. 
.

Methods

Thirteen healthy subjects were given a hypocaloric high protein diet (HPD) mixed with their prepared meals for two weeks. Followed by the HPF diet for another two weeks. Their anthropometric parameters, such as body composition (total body weight, body fat percentage, and fat-free mass), BMI and waist circumference, and fasting plasma glucose, were measured.

Results

Compared to pre-intervention, HPF could significantly (p ≤ 0.004) reduce the anthropometric parameters and fasting plasma glucose. Compared to HPD, HPF could significantly (p ≤ 0.005) reduce more total body weight, body fat percentage, and BMI. In addition, HPF could induce more satiety than HPD (higher VAS score).

Conclusion

HPF could improve the subject's anthropometric parameters which is obviously beneficial in preventing the risk of developing diabetes.

Fibre intake for optimal health: how can healthcare professionals support people to reach dietary recommendations?

Nicola M McKeown and colleagues advocate for the importance of translating the health impact of high fibre diets to patients and clients, with emphasis placed on incorporating a variety of plant based foods to achieve dietary fibre recommendations

US Consumer Identification of the Health Benefits of Dietary Fiber and Consideration of Fiber When Making Food Choices

The purposes of this study were to (1) determine beliefs in the health benefits of dietary fiber, an under-consumed nutrient of public health concern, and (2) determine the relationship between beliefs about dietary fiber and consideration of fiber when making food choices. We conducted a nationally representative within-subject randomized online survey of 42,018 US primary shoppers in May–June 2021. Participants selected health benefits they believed were associated with consumption of fiber from a list of six benefits recognized by the Food and Drug Administration (FDA), one indirect benefit, and one unrelated benefit. Respondents then indicated which nutrients, if any, they considered when making food choices. Respondents selected 1.77 (95% CI = 1.76–1.77) FDA-recognized benefits out of a total six; half (50.6%) of respondents identified zero or one FDA-recognized benefit. The most-cited benefit was “improving bowel movements” (64.4%). Older participants perceived significantly more FDA-recognized fiber benefits. Identification of FDA-recognized benefits increased odds ratios for consideration of fiber during food choice (relative to zero benefits) from 3.0 for one benefit (95% CI = 2.8–3.3) to 14.3 for six benefits (95% CI = 12.4–16.6). Consumers are largely unaware of the many health benefits of dietary fiber, which dramatically decreases the likelihood that they consider this important, under-consumed nutrient during food choice.

Association Between Dietary Fiber Intake and Heart Failure Among Adults: National Health and Nutrition Examination Survey 2009–2018

Objective

To explore the association between dietary fiber and heart failure (HF).

Methods

Data were collected from the 2009–2018 National Health and Nutrition Examination Survey. Dietary fiber intake data were obtained from two 24-h dietary recall interviews. Logistic regression and restricted cubic spline models were used to explore the association of dietary intakes of total, cereal, fruit, and vegetable fiber with HF prevalence.

Results

A total of 21869 adults were included in this study. After adjusting for multiple confounding factors, the odds ratios (OR) and 95% confidence intervals (CI) for HF was 0.49 (0.28 to 0.87, P for trend = 0.016) for the highest tertile versus lowest tertile of total fiber intake. Similar results were observed for cereal but not fruit and vegetable fiber intake. Dose-response analysis indicated that dietary intake of total and cereal fiber were inversely associated with HF in a linear manner.

Conclusion

Intakes of total and cereal fiber were inversely associated with HF in adults.

Effects of Daily Kelp (Laminaria japonica) Intake on Body Composition, Serum Lipid Levels, and Thyroid Hormone Levels in Healthy Japanese Adults: A Randomized, Double-Blind Study

To investigate whether supplementation with iodine-reduced kelp (Laminaria japonica) powder decreases body fat composition in overweight Japanese subjects, a randomized, double-blind, placebo-controlled intervention study was conducted in 50 Japanese subjects with body mass index (BMI) ≥25 and <30 kg/m2. Subjects were randomly assigned to consume thirty tablets/d (10 tablets orally, 3 times/d) containing either iodine-reduced kelp powder (test, 6 g kelp powder corresponding to 3 g alginate/d) or kelp-free powder (placebo) for 8 weeks. Anthropometric measurements, blood lipids, and serum thyroid hormone levels were obtained before and after the trial. Body fat percentage was significantly decreased in male subjects from the test group compared with the placebo group. The same tendency was observed for body weight (p = 0.065) and BMI (p = 0.072) in male subjects. No significant changes in anthropometric measurements or visceral fat area were observed in female subjects. Serum thyroid hormone concentrations did not increase after 1.03 mg/d of iodine supplementation through kelp intake. The intake of iodine-reduced kelp powder led to significant and safe reductions in body fat percentage in overweight male subjects. The consumption of kelp high in alginate may contribute to preventing obesity without influencing thyroid function in Japanese subjects with a relatively high intake of iodine from seaweed.

High-quality intake of carbohydrates is associated with lower prevalence of subclinical atherosclerosis in femoral arteries: The AWHS study

BACKGROUND AND AIMS

High-quality of the carbohydrates consumed, apart from their total amount, appear to protect from cardiovascular disease (CVD). However, the relationship between the quality of carbohydrates and the early appearance of atherosclerosis has not yet been described. Our objective was to estimate the association between the quality of dietary carbohydrates and subclinical atherosclerosis in femoral and carotid arteries.

METHODS

Cross-sectional study of femoral and carotid atherosclerosis assessed using ultrasounds of 2074 middle-aged males, 50.9 (SD 3.9) years old, with no previous CVD, and pertaining to the Aragon Workers' Health Study (AWHS) cohort. Food frequency questionnaires were used to calculate a carbohydrate quality index (CQI) defined as: consumption of dietary fiber, a lower glycemic index, the ratio of whole grains/total grains, and the ratio of solid carbohydrates/total carbohydrates. The presence of plaques across four CQI intervals was studied using adjusted logistic regression models.

RESULTS

The CQI showed a direct inverse association with subclinical atherosclerosis in femoral territories. Participants with a higher consumption of high-quality carbohydrates (13-15 points) were less likely to have femoral plaques when compared with participants in the lowest index interval (4-6 points) (OR = 0.59; 95% CI = 0.39, 0.89; p = 0.005). No association was found between the CQI and the presence of subclinical atherosclerosis in carotid territories. A lower consumption of high-quality carbohydrates tended to be associated with a greater atherosclerosis extension, considered as the odds for having more affected territories (p = 0.011).

CONCLUSIONS

Among middle-aged males, a high-quality intake of carbohydrates is associated with a lower prevalence of femoral artery subclinical atherosclerosis when compared with a lower consumption. Thus, indicating an early relationship between the quality of carbohydrates and the development of CVD.

Physicochemical properties and microstructure of corn flour-cellulose fiber extrudates

In this study, corn flour with 24% w/w moisture content was extruded, and cellulose at varied weight ratios was added in order to investigate its effect on the extrudate's physicochemical properties. Twin-screw extrusion was divided into five temperature zones, and the screw temperature profile was 60℃, 120℃, 140℃, 120℃, and 110℃, respectively, and screw speed was 150 rpm. The cellulose content was 1%-15% w/w. Results showed that the addition of cellulose led to an increase in hardness, L* and b* of the extruded samples, and a decrease in degree of expansion, a*, thermal enthalpy of the sample paste. The sample paste exhibited a solid-like characteristic. Microscopic morphology analysis showed that surface wrinkles of the sample increased with the increase of cellulose addition. The addition of cellulose can effectively increase the degree of puffing of corn flour-cellulose fiber extrudates.

Predictive value of inflammatory factors on coronary restenosis after percutaneous coronary intervention in patients with coronary heart disease: A protocol for systematic review and meta-analysis

BACKGROUND

Evidence reveals that inflammatory factors can predict coronary restenosis in patients suffering from coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Perhaps, inflammatory factors are promising biomarkers for the diagnosis of coronary restenosis after PCI. However, the accuracy of inflammatory factors has not been systematically evaluated. Therefore, it is necessary to perform a meta-analysis to certify the diagnostic values of inflammatory factors on coronary restenosis after PCI.

METHODS

China National Knowledge Infrastructure (CNKI), Wanfang, VIP, China Biology Medicine disc (CBM), PubMed, EMBASE, Cochrane Library and Web of Science were searched for relevant studies to explore the potential diagnostic values of inflammatory factors on coronary restenosis after PCI from inception to January 2021. All data were extracted by 2 experienced researchers independently. The risk of bias about the meta-analysis was confirmed by the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The data extracted were synthesized and heterogeneity was investigated as well. All of the above statistical analyses were carried out with Stata 16.0.

RESULTS

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

CONCLUSION

This study clarified confusions about the specificity and sensitivity of inflammatory factors on coronary restenosis after PCI, thus further guiding their promotion and application.

ETHICS AND DISSEMINATION

Ethical approval will not be necessary since this systematic review and meta-analysis will not contain any private information of participants or violate their human rights.

TRIAL REGISTRATION NUMBER

DOI 10.17605/OSF.IO/N28JX.

Plant foods, dietary fibre and risk of ischaemic heart disease in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

BACKGROUND

Epidemiological evidence indicates that diets rich in plant foods are associated with a lower risk of ischaemic heart disease (IHD), but there is sparse information on fruit and vegetable subtypes and sources of dietary fibre. This study examined the associations of major plant foods, their subtypes and dietary fibre with risk of IHD in the European Prospective Investigation into Cancer and Nutrition (EPIC).

METHODS

We conducted a prospective analysis of 490 311 men and women without a history of myocardial infarction or stroke at recruitment (12.6 years of follow-up, n cases = 8504), in 10 European countries. Dietary intake was assessed using validated questionnaires, calibrated with 24-h recalls. Multivariable Cox regressions were used to estimate hazard ratios (HR) of IHD.

RESULTS

There was a lower risk of IHD with a higher intake of fruit and vegetables combined [HR per 200 g/day higher intake 0.94, 95% confidence interval (CI): 0.90-0.99, P-trend = 0.009], and with total fruits (per 100 g/day 0.97, 0.95-1.00, P-trend = 0.021). There was no evidence for a reduced risk for fruit subtypes, except for bananas. Risk was lower with higher intakes of nuts and seeds (per 10 g/day 0.90, 0.82-0.98, P-trend = 0.020), total fibre (per 10 g/day 0.91, 0.85-0.98, P-trend = 0.015), fruit and vegetable fibre (per 4 g/day 0.95, 0.91-0.99, P-trend = 0.022) and fruit fibre (per 2 g/day 0.97, 0.95-1.00, P-trend = 0.045). No associations were observed between vegetables, vegetables subtypes, legumes, cereals and IHD risk.

CONCLUSIONS

In this large prospective study, we found some small inverse associations between plant foods and IHD risk, with fruit and vegetables combined being the most strongly inversely associated with risk. Whether these small associations are causal remains unclear.

Association between food and nutrients intakes and coronary plaque vulnerability in patients with coronary heart disease: An optical coherence tomography study

BACKGROUND AND AIMS

Dietary intakes play important roles in the prevention and treatment of coronary heart disease (CHD). Coronary plaque vulnerability is the key mechanism leading to CHD progression. We aimed to explore the association between dietary intakes and plaque vulnerability via optical coherence tomography (OCT).

METHODS AND RESULTS

A total of 314 CHD patients were included in this study. Dietary intake status was assessed by semi-quantitative food frequency questionnaire and plaque vulnerability was measured by OCT. The results showed that vegetables were negatively associated with macrophage infiltration, thin cap fibroatheroma (TCFA) and thrombus [odds ratio (OR) = 0.48, 0.38, 0.38, 95% confidence interval (95% CI) = 0.24-0.93, 0.17-0.84, 0.15-0.94, all P < 0.05]; fruits were negatively associated with lipid plaque, TCFA, rupture and thrombus (OR = 0.17, 0.11, 0.12, 0.20, 95% CI = 0.07-0.39, 0.04-0.29, 0.05-0.28, 0.08-0.55, all P < 0.05); salt was positively associated with lipid plaque and TCFA (OR = 2.59, 2.83, 95% CI = 1.14-5.90, 1.23-6.51, all P < 0.05). Regarding nutrients intakes, dietary fiber was negatively associated with macrophage infiltration (OR = 0.34, 95% CI = 0.14-0.85, P = 0.021); folate was negatively associated with lipid plaque, TCFA and rupture (OR = 0.22, 0.16, 0.20, 95% CI = 0.09-0.58, 0.06-0.41, 0.08-0.51, all P < 0.05); vitamin C was negatively associated with TCFA, rupture and thrombus (OR = 0.26, 0.22, 0.05, 95% CI = 0.07-0.95, 0.07-0.65, 0.01-0.25, all P < 0.05); sodium was positively associated with lipid plaque, TCFA, rupture and thrombus (OR = 3.43, 3.96, 2.73, 4.84, 95% CI = 1.51-7.80, 1.66-9.45, 1.18-6.27, 1.76-9.28, all P < 0.05).

CONCLUSION

Salt and sodium were dietary risk factors for plaque vulnerability, whereas vegetables, fruits, dietary fiber, folate and vitamin C were dietary protective factors for plaque vulnerability.

C. S, Basnet R, Neupane B. Dietary nutrients of relative importance associated with coronary artery disease: Public health implication from random forest analysis

Dietary nutrients have significant effects on the risk of cardiovascular diseases. However, the results were not uniform across different countries. The study aims to determine the relative importance of dietary nutrients associated with coronary artery disease (CAD) among the Nepalese population. A hospital-based matched case-control study was carried out at Shahid Gangalal National Heart Center in Nepal. In the present study, patients with more than seventy percent stenosis in any main coronary artery branch in angiography were defined as cases, while those presenting normal coronary angiography or negative for stressed exercise test were considered controls. Dietary intakes of 612 respondents over the past 12 months were evaluated using a semi-quantitative customized food frequency questionnaire. In conditional regression model, the daily average dietary intake of β-carotene (OR: 0.54; 95%CI: 0.34, 0.87), and vitamin C (OR: 0.96; 95%CI: 0.93, 0.99) were inversely, whereas dietary carbohydrate (OR: 1.16; 95%CI: 1.1, 1.24), total fat/oil (OR: 1.47; 95%CI: 1.27, 1.69), saturated fatty acid (SFA) (OR: 1.2; 95%CI: 1.11, 1.3), cholesterol (OR: 1.01; 95%CI: 1.001, 1.014), and iron intakes (OR: 1.11; 95%CI: 1.03, 1.19) were positively linked with CAD. Moreover, in random forest analysis, the daily average dietary intakes of SFA, vitamin A, total fat/oil, β-carotene, and cholesterol were among the top five nutrients (out of 12 nutrients variables) of relative importance associated with CAD. The nutrients of relative importance imply a reasonable preventive measure in public health nutrients specific intervention to prevent CAD in a resource-poor country like Nepal. The findings are at best suggestive of a possible relationship between these nutrients and the development of CAD, but prospective cohort studies and randomized control trials will need to be performed in the Nepalese population.

Associations between consumption of dietary fibers and the risk of cardiovascular diseases, cancers, type 2 diabetes, and mortality in the prospective NutriNet-Santé cohort

BACKGROUND

Mounting evidence, yet with varying levels of proof, suggests that dietary fibers (DFs) may exert a protective role against various chronic diseases, but this might depend on the DF type and source.

OBJECTIVES

Our objectives were to assess the associations between the intake of DFs of different types [total (TDF), soluble (SF), insoluble (IF)] and from different sources (fruits, vegetables, whole grains, legumes, potatoes and tubers) and the risk of cardiovascular diseases (CVDs), cancer, type 2 diabetes (T2D), and mortality in the large-scale NutriNet-Santé prospective cohort (2009-2019).

METHODS

Overall, 107,377 participants were included. Usual DF intake was estimated from validated repeated 24-h dietary records over the first 2 y following inclusion in the cohort. Associations between sex-specific quintiles of DF intake and the risk of chronic diseases and mortality were assessed using multiadjusted Cox proportional hazards models.

RESULTS

T2D risk was inversely associated with TDFs [HR for quintile 5 compared with quintile 1: 0.59 (95% CI: 0.42, 0.82), P-trend <0.001], SFs [HR: 0.77 (0.56, 1.08); P-trend = 0.02], and IFs [HR: 0.69 (0.50, 0.96); P-trend = 0.004]. SFs were associated with a decreased risk of CVD [HR: 0.80 (0.66, 0.98); P-trend = 0.01] and colorectal cancer [HR: 0.41 (0.21, 0.79); P-trend = 0.01]. IFs were inversely associated with mortality from cancer or CVDs [HR: 0.65 (0.45, 0.94); P-trend = 0.02]. TDF intake was associated with a decreased risk of breast cancer [HR:: 0.79 (0.54, 1.13); P-trend = 0.04]. DF intake from fruit was associated with the risk of several chronic diseases.

CONCLUSIONS

Our results suggest that DF intake, especially SFs and DFs from fruits, was inversely associated with the risk of several chronic diseases and with mortality. Further studies are needed, involving different types and sources of fiber. Meanwhile, more emphasis should be put on DFs in public health nutrition policies, as DF intake remains below the recommended levels in many countries. This trial was registered at clinicaltrials.gov as NCT03335644.

Whole grain intake compared with cereal fibre intake in association to CVD risk factors: a cross-sectional analysis of the National Diet and Nutrition Survey (UK)

Objective:

To investigate how intakes of whole grains and cereal fibre were associated to risk factors for CVD in UK adults.

Design:

Cross-sectional analyses examined associations between whole grain and cereal fibre intakes and adiposity measurements, serum lipid concentrations, C-reactive protein, systolic blood pressure, fasting glucose, HbA1c, homocysteine and a combined CVD relative risk score.

Setting:

The National Diet and Nutrition Survey (NDNS) Rolling Programme 2008–2014.

Participants:

A nationally representative sample of 2689 adults.

Results:

Participants in the highest quartile (Q4) of whole grain intake had lower waist–hip ratio (Q1 0·872; Q4 0·857; P = 0·04), HbA1c (Q1 5·66 %; Q4 5·47 %; P = 0·01) and homocysteine (Q1 9·95 µmol/l; Q4 8·76 µmol/l; P = 0·01) compared with participants in the lowest quartile (Q1), after adjusting for dietary and lifestyle factors, including cereal fibre intake. Whole grain intake was inversely associated with C-reactive protein using multivariate analysis (P = 0·02), but this was not significant after final adjustment for cereal fibre. Cereal fibre intake was also inversely associated with waist–hip ratio (P = 0·03) and homocysteine (P = 0·002) in multivariate analysis.

Conclusions:

Similar inverse associations between whole grain and cereal fibre intakes to CVD risk factors suggest the relevance of cereal fibre in the protective effects of whole grains. However, whole grain associations often remained significant after adjusting for cereal fibre intake, suggesting additional constituents may be relevant. Intervention studies are needed to compare cereal fibre intake from non-whole grain sources to whole grain intake.

Application of nutrient essentiality criteria to dietary carbohydrates

The purpose of the present review is to describe how human physiology at very low carbohydrate intakes relates to the criteria for nutritional essentiality. Although we did not limit ourselves to one particular type or function of carbohydrates, we did primarily focus on glucose utilisation as that function was used to determine the recommended daily allowance. In the general population, the human body is able to endogenously synthesise carbohydrates, and does not show signs of deficiency in the absence of dietary carbohydrates. However, in certain genetic defects, such as glycogen storage disease type I, absence of dietary carbohydrates causes abnormalities that are resolved with dietary supplementation of carbohydrates. Therefore, dietary carbohydrates may be defined as conditionally essential nutrients because they are nutrients that are not required in the diet for the general population but are required for specific subpopulations. Ketosis may be considered a physiological normal state due to its occurrence in infants in addition to at very low carbohydrate intakes. Although sources of dietary carbohydrates can provide beneficial micronutrients, no signs of micronutrient deficiencies have been reported in clinical trials of low-carbohydrate ketogenic diets. Nonetheless, more research is needed on how micronutrient requirements can change depending on the dietary and metabolic context. More research is also needed on the role of dietary fibre during a low-carbohydrate ketogenic diet as the beneficial effects of dietary fibre were determined on a standard diet and several studies have shown beneficial effects of decreasing non-digestible carbohydrates.

Nutritional adequacy and dietary disparities in an adult Caribbean population of African descent with a high burden of diabetes and cardiovascular disease

The Caribbean island of Barbados has a high burden of diabetes and cardiovascular disease. Dietary habits were last described in 2005. A representative population-based sample (n = 363, aged 25-64 years) provided two nonconsecutive 24-hr dietary recalls in this cross-sectional study. Mean daily nutrient intakes were compared with the Dietary Guidelines for Americans. Subgroup differences by age, sex, and educational level were examined using logistic regression. High sugar intakes exist for both sexes with 24% (95% CIs 18.9, 30.0) consuming less than the recommended <10% of energy from added sugars (men 22%; 15.0, 31.6; women 26%; 18.9, 33.7). Sugar-sweetened beverages provide 43% (42.2%, 44.4%) of total sugar intake. Inadequate dietary fiber intakes (men 21 g, 18.2, 22.8; women 18 g, 16.7, 18.9) exist across all age groups. Inadequate micronutrient intake was found in women for calcium, folate, thiamine, zinc, and iron. Older persons (aged 45-64 years) were more likely to report adequacy of dietary fiber (OR = 2.7, 1.5, 4.8) and iron (OR = 3.0, 1.7, 5.3) than younger persons (aged 25-44). Older persons (aged 45-64 years) were less likely to have an adequate supply of riboflavin (OR = 0.4, 0.2, 0.6) than younger persons. Men were more likely to have adequate intakes of iron (OR = 13.0, 6.1, 28.2), folate (OR = 2.4, 1.3, 4.6), and thiamine (OR = 3.0, 1.5, 5.0) than women. Education was not associated with nutrient intake. The Barbadian diet is characterized by high sugar intakes and inadequate dietary fiber; a nutrient profile associated with an increased risk of obesity, type 2 diabetes, and related noncommunicable diseases.

Structural and sensory analysis of compositionally optimized apple jellies enriched with dietary fibre compared to commercial apple jams

The objective of this work was to optimize the formulation of apple jellies enriched with 3 g/100 g of dietary fibre and to compare them with commercial apple jams in terms of structural and organoleptic properties. With that aim, a fibre mix with one part of psyllium and three parts of other fibre variety (apple, bamboo or wheat) was added to apple jelly, and the rheological, mechanical and sensory properties, as well as colour and syneresis (water loss) of the samples at different storage times were studied, and compared to two commercial apple jams. Those properties did not suffer significant changes during 30 days of cold storage, meaning that the product was stable. The reduction of psyllium proportion in the fibre mix (from 1:1 to 1:3) reduced the gumminess of the fibre enriched jellies, keeping the syneresis at 0 g/100 g. The jelly enriched with apple and psyllium fibre was the most similar to commercial apple jams in terms of rheological and mechanical properties. Consumers acceptability of fibre enriched jellies was higher than 72%, being the jelly enriched with bamboo and psyllium fibre the closest to a commercial apple jam, which was the consumer's favourite.

Dietary fiber intake and mortality in a Mediterranean population: the "Seguimiento Universidad de Navarra" (SUN) project

PURPOSE

To prospectively assess the association of dietary fiber intake (from different dietary sources) with all-cause mortality in a Mediterranean cohort.

METHODS

We assessed 19,703 participants of the SUN (Seguimiento Universidad de Navarra) cohort (mean follow-up: 10.1 years). A validated 136-item FFQ was administered at baseline. We used Cox proportional hazards models adjusted for multiple socio-demographic, anthropometric, lifestyle factors, and prevalent conditions at baseline.

RESULTS

We observed 323 deaths during 198,341 person-years of follow-up. A significantly inverse linear trend in Cox models was observed for the association of total dietary fiber intake and all-cause mortality after adjustment for confounders (p for trend 0.017). Each additional intake of 5 g/1000 kcal of dietary fiber was associated with a 9% relative reduction in all-cause mortality risk (HR 0.91, 95% CI 0.84-0.99). Considering separate dietary sources in separate models, a significant inverse trend was apparent for fiber derived from vegetables (p for trend 0.001), but it was non-significant for fiber derived from fruit, legumes, cereals, or other sources. Soluble fiber was significantly inversely associated with all-cause mortality in the fully adjusted model (p for trend 0.007), and insoluble fiber was marginally significant (p for trend 0.08).

CONCLUSIONS

A higher intake of total dietary fiber, and particularly fiber from vegetables, was related to a reduced all-cause mortality in our Mediterranean cohort. Dietary messages to increase the consumption of dietary patterns rich in fiber-rich foods should be broadly disseminated to decrease the alarming rate of chronic diseases and its derived mortality.

Deciphering the Riddles in Nutrition and Cardiovascular Disease

Cardiovascular disease is the leading global cause of death in Western countries, and its development is largely associated with unhealthy dietary patterns. A large body of scientific evidence has reported that nutrition might be the most preventive factor of cardiovascular disease death and could even reverse heart disease. Processes of chronic inflammation and oxidative distress share triggers that are modifiable by nutrition. This review aimed to identify potential targets (food patterns, single foods or individual nutrients) for cardiovascular disease prevention, and analyse the mechanisms implicated in their cardioprotective effects.

Influence of daily fresh pear consumption on biomarkers of cardiometabolic health in middle-aged/older adults with metabolic syndrome: a randomized controlled trial

Previous research suggests potential for fresh pears as a functional food for promoting cardiometabolic health. The purpose of this randomized, open-label, placebo-controlled, crossover clinical trial was to evaluate the influence of daily fresh pear consumption on blood pressure (primary outcome) and other biomarkers of cardiometabolic health in middle-aged/older adults with metabolic syndrome (MetS). Forty men and women aged 45-65 years with MetS were included and randomly assigned to receive either two medium-sized fresh pears (Pear) or a calorie-matched control drink (Control) per day for each 12-week treatment period, each separated by a 4-week washout period. After 12 weeks of daily fresh pear consumption, systolic blood pressure tended to be reduced (130 ± 2 mmHg vs. 134 ± 2 mmHg at baseline, P = 0.07) and pulse pressure was significantly reduced (51 ± 1 vs. 54 ± 1 at baseline, P < 0.05). At 12 weeks, leptin concentrations were lower in the Pear group than Control (52.5 [7.6, 120.5] ng dL-1vs. 53.4 [5.0, 120.5] ng dL-1, respectively, P < 0.05), and there was a significant group by time interaction (P < 0.05). Leptin concentrations were significantly reduced at 12 weeks compared to baseline in the Pear group (52.5 [7.6, 120.5] ng dL-1vs. 54.8 [6.4, 120.5] ng dL-1 at baseline, P < 0.05) but not in the Control group. Waist circumference was significantly reduced at 12 weeks in the Pear group (107.7 ± 2.0 cm vs. 108.4 ± 2 cm at baseline, P < 0.05) with a trend for a group by time interaction (P < 0.1), and significantly lower in the Pear group than Control (108.1 ± 2.0 cm vs. 108.8 ± 2 cm, P < 0.05) at 6 weeks with a significant group by time interaction (P < 0.05). Conversely, values were significantly increased at 6 weeks (108.8 ± 2 cm vs. 108.3 ± 2.0 cm at baseline, P < 0.05) in the Control group and sustained at 12 weeks. Waist-to-hip ratio was significantly reduced (0.92 ± 0.01 vs. 0.93 ± 0.01 at baseline, P < 0.05) at 12 weeks in the Pear group, and significantly lower than Control at 6 weeks (0.93 ± 0.01 vs. 0.93 ± 0.01, respectively, P < 0.05) and 12 weeks (0.92 ± 0.01 vs. 0.93 ± 0.01, P < 0.05). These findings suggest that daily fresh pear consumption may promote modest improvements in cardiometabolic health in middle-aged/older adults with MetS. This trial was registered at clinicaltrials.gov as NCT02228837.

Traditional v. modern dietary patterns among a population in western Austria: associations with body composition and nutrient profile

OBJECTIVE

The present study aimed to identify dietary patterns, compare dietary patterns regarding nutrient profile and investigate the association between dietary patterns and body composition in a population in western Austria.

DESIGN

In a cross-sectional study, eating habits, anthropometric measurements and body composition were assessed. Food intake was collected by two non-consecutive 24 h recalls. Factor analysis (principal component analysis) with complementary cluster analysis was applied to identify dietary patterns. Associations of dietary patterns with body composition and nutrient profile were examined by the t test, one-way ANOVA and ANCOVA with Bonferroni's correction. The χ 2 test was used for categorical variables.

SETTING

Tyrol, western Austria, 2014-2015.ParticipantsAdults (n 463) aged 18-64 years.

RESULTS

Three dietary patterns were derived, labelled as the 'health-conscious', the 'western' and the 'traditional' dietary pattern. After adjustment for confounding variables, individuals following the traditional and western patterns were more likely to be overweight/obese (P <0·001) and to have a higher body fat percentage (P <0·05). Individuals following the traditional dietary pattern consumed significantly more SFA and less PUFA and dietary fibre (P <0·001) than those in the other groups.

CONCLUSIONS

Individuals who mostly eat in a traditional way should be encouraged to increase their consumption of vegetables, fruits, whole grains and healthy fats. It is important to know local eating habits not only for planning individual nutritional therapy, but also for well-directed public health actions.

Impact of plant extracts upon human health: A review

With the increase in evidences directly linking diet and health, several foodstuffs, such as phenolic rich fruits and vegetables, have emerged as possessing potential health benefits. Plants, given their fiber and phenolic content (and their intrinsic biological potential), have long been considered as contributing to health promotion. Therefore, the present work aimed to review the existing evidences regarding the various potential benefits of plant extracts' and plant extract-based products' consumption, with emphasis on in vivo works and epidemiological studies whenever available. Overall, the information available supports that, while there are indications of the potential benefits of plant extracts' consumption, further human-based studies are still needed to establish a true cause-effect.

Influence of Bioactive Nutrients on the Atherosclerotic Process: A Review

The protective effects of a dietary intervention as a useful tool in the prevention of atherosclerosis disease has gained greater attention in recent years. Several epidemiological studies have demonstrated the importance of diet in reducing expensive treatments or possible undesirable side effects. The main aim of this review is to examine the effects of specific nutrients on the development and progression of atherosclerosis in patients with cardiovascular disease. Various mechanisms have been proposed to explain the cardioprotective effect of different nutrients. In this sense, results have shown stabilization of vulnerable atherosclerotic plaques or downregulation of biomarkers related to inflammation through nutrients such as Omega-3 polyunsaturated fatty acids, hydroxytyrosol of extra virgin olive oil, lycopen, phytosterols of plants, or flavonols of fruits and vegetables, among others. The accumulated evidence on the anti-inflammatory effects related to these nutrients is summarized in the present review.

Dietary interventions in cardiac rehabilitation - The gap between guidelines and clinical practice

BACKGROUND & AIMS

An unhealthy diet is a risk factor for ischemic heart disease (IHD) and therefore cardiac rehabilitation (CR) should include dietary interventions. In 2007, CR became a shared responsibility between Danish hospitals and municipalities. Later, a national clinical guideline including recommendations on dietary interventions was developed to facilitate implementation of CR. The aim of the present study is: 1) To describe provision of dietary interventions in CR for IHD patients in Denmark in 2013 and 2015 emphasizing differences between hospitals and municipalities, and 2) To evaluate the implementation of the national clinical guideline in clinical practice.

METHODS

A repeated nationwide cross-sectional electronic survey was carried out in 2013 and 2015. Participation was mandatory for all Danish hospital departments offering CR (n = 36), but voluntary for municipalities (n = 98) reaching response rates of 82% and 89% in 2013 and 2015, respectively. The electronic survey covered the core components of dietary interventions in CR as described in the national clinical guideline.

RESULTS

In 2015, 72% of municipalities provided dietary interventions. This proportion was significantly higher in hospitals (94%, p = 0.007). 26% and 38% of hospitals screened systematically for dietary intervention needs in 2013 and 2015, respectively. Corresponding results from municipalities were 26% and 29%. No significant differences were seen in clinical practice over time.

CONCLUSIONS

The results of this study identified a major gap between recommendations in the national clinical guideline and actual clinical practice on dietary interventions in CR in Danish hospitals and municipalities. The study confirmed that implementation of guidelines in clinical practice takes time and requires an intensive effort.

Dietary Fibre as a Unifying Remedy for the Whole Spectrum of Obesity-Associated Cardiovascular Risk

Obesity is a pandemic carrying the heavy burden of multiple and serious co-morbidities including metabolic syndrome, type 2 diabetes and cardiovascular diseases. The pathophysiological processes leading to the accumulation of body fat slowly evolve to fat accumulation in other body compartments than subcutaneous tissue. This abnormal fat deposition determines insulin resistance which in turn causes blood glucose and lipid metabolism derangement, non-alcoholic fatty liver disease, hypertension, and metabolic syndrome. All these conditions contribute to increase the cardiovascular risk of obese people. Several randomized clinical trials demonstrated that moderate weight loss (5⁻10%) in obese patients improves obesity-related metabolic risk factors and coexisting disorders. Therefore, nutritional strategies able to facilitate weight management, and in the meantime positively influence obesity-associated cardiovascular risk factors, should be implemented. To this aim, a suitable option could be dietary fibres that may also act independently of weight loss. The present narrative review summarizes the current evidence about the effects of dietary fibres on weight management in obese people. Moreover, all of the different cardiovascular risk factors are individually considered and evidence on cardiovascular outcomes is summarized. We also describe the plausible mechanisms by which different dietary fibres could modulate cardio-metabolic risk factors. Overall, despite both epidemiological and intervention studies on weight loss that show statistically significant but negligible clinical effects, dietary fibres seem to have a beneficial impact on main pathophysiological pathways involved in cardiovascular risk (i.e., insulin resistance, renin-angiotensin, and sympathetic nervous systems). Although the evidence is not conclusive, this suggests that fibre would be a suitable option to counteract obesity-related cardio-metabolic diseases also independently of weight loss. However, evidence is not consistent for the different risk factors, with clear beneficial effects shown on blood glucose metabolism and Low Density Lipoprotein (LDL) cholesterol while there is fewer, and less consistent data shown on plasma triglyceride and blood pressure. Ascribing the beneficial effect of some foods (i.e., fruits and vegetables) solely to their fibre content requires more investigation on the pathophysiological role of other dietary components, such as polyphenols.

Both the intratumoral immune and microbial microenvironment are linked to recurrence in human colon cancer: results from a prospective, multicenter nodal ultrastaging trial

Colon cancer (CC) is the third most common cancer diagnosed in the United States and the incidence has been rising among young adults. We and others have shown a relationship between the immune infiltrate and prognosis, with improved disease-free survival (DFS) being associated with a higher expression of CD8⁺ T cells. We hypothesized that a microbial signature might be associated with intratumoral immune cells as well as DFS. We found that the relative abundance of one Operational Taxonomic Unit (OTU), OTU_104, was significantly associated with recurrence even after applying false discovery correction (HR 1.21, CI 1.08 to 1.36). The final multivariable model showed that DFS was influenced by three parameters: N-stage, CD8⁺ labeling, as well as this OTU_104 belonging to the order Clostridiales. Not only were CD8⁺ labeling and OTU_104 significant contributors in the final DFS model, but they were also inversely correlated to each other (p=0.022). Interestingly, CD8⁺ was also significantly associated with the microbiota composition in the tumor: CD8⁺ T cells was inversely correlated with alpha diversity (p=0.027) and significantly associated with the beta diversity. This study is the first to demonstrate an association among the intratumoral microbiome, CD8⁺ T cells, and recurrence in CC. An increased relative abundance of a specific OTU_104 was inversely associated with CD8⁺ T cells and directly associated with CC recurrence. The link between this microbe, CD8⁺ T cells, and DFS has not been previously shown.

Dietary Fiber and Telomere Length in 5674 U.S. Adults: An NHANES Study of Biological Aging

The relationship between fiber intake and telomere length was evaluated using a cross-sectional design and an NHANES sample of 5674 U.S. adults. Another purpose was to test the impact of potential confounders on the association. Fiber consumption was measured using a 24 h recall and telomere length was indexed using the quantitative polymerase chain reaction method. Overall, the U.S. adults had low fiber intake (median: 6.6 g per 1000 kcal)—less than one-half the recommendation of the Dietary Guidelines for Americans. With age, gender, race, housing status, and misreported energy intake controlled, the relationship between fiber intake per 1000 kcal and telomere length was linear (F = 9.5, p = 0.0045). Specifically, for each 1 g increment in fiber intake per 1000 kcal, telomeres were 8.3 base pairs longer. Because each additional year of chronological age was associated with telomeres that were 15.5 base pairs shorter, results suggest that a 10 g increase in fiber intake per 1000 kcal would correspond with telomeres that are 83 base pairs longer. On average, this would equate to 5.4 fewer years of biologic aging (83 ÷ 15.5). With smoking, BMI, alcohol use, and physical activity controlled, as well as the other covariates, each 10 g increment in fiber accounted for telomeres that were 67 base pairs longer (F = 7.6, p = 0.0101), a biologic aging difference of about 4.3 years. In conclusion, significant fiber consumption accounts for longer telomeres and less biologic aging than lower levels of fiber intake.

Diet and Cardiovascular Disease: Advances and Challenges in Population-Based Studies

In this Minireview, we provide an epidemiologist's perspective on the debate and recent advances in determining the relationship between diet and cardiovascular health. We conclude that, in order to reduce the global burden of cardiovascular disease, there should be a greater emphasis on improving overall diet quality and food sources of macronutrients, such as dietary fats and carbohydrates. In addition, building a strong evidence base through high-quality intervention and observational studies is crucial for effective policy changes, which can greatly improve the food environment and population health.

Dietary fiber and health outcomes: an umbrella review of systematic reviews and meta-analyses

Background

Several studies have suggested that higher consumption of dietary fiber is beneficial for a variety of health outcomes. However, many results have been inconclusive and, to our knowledge, there has been no attempt to systematically capture the breadth of outcomes associated with dietary fiber intake or to systematically assess the quality and the strength of the evidence on the associations of dietary fiber intake and different health outcomes or medical conditions.

Objective

The aim of this study was to describe the diverse health outcomes convincingly associated with dietary fiber consumption.

Design

This was an umbrella review of systematic reviews with meta-analysis of observational studies. For each association, random-effects summary effect size, 95% CIs, and 95% prediction intervals were estimated. We also assessed heterogeneity, evidence for small-study effect, and evidence for excess significance bias. We used these metrics to evaluate the credibility of the identified evidence.

Results

Our literature search identified 1351 abstracts. Of these, 18 meta-analyses including a total of 298 prospective observational studies and 21 outcomes were included. Outcomes studied included cancer and precancer lesions (n = 12), cardiovascular diseases (CVDs; n = 3), all-cause and specific-cause mortality (n = 4), type 2 diabetes (n = 1), and Crohn disease (n = 1). Overall, 6 (29%) of the 21 eligible outcomes reported highly significant summary results (P < 1 × 10-6); these included CVD and CVD mortality, coronary artery disease, pancreatic cancer, and gastric cancer. Overall, 3 of 21 (14%) outcomes presented convincing evidence (pancreatic cancer, CVD mortality, and all-cause mortality), but only CVD and all-cause mortality were based on prospective studies. Two other outcomes (10%), CVD and coronary artery disease, presented highly suggestive evidence based on prospective studies.

Conclusion

Our results support dietary recommendations that promote higher fiber intake as part of a healthy diet.