Total Dietary Fat Intake, Fat Quality, and Health Outcomes: A Scoping Review of Systematic Reviews of Prospective Studies

Regio-specific lipid fingerprinting of edible sea cucumbers using LC/MS

Sea cucumbers are a rich source of bioactive compounds and are gaining popularity as nutrient-rich seafood. They are consumed as a whole organism in Pacific regions. However, limited data are available on the comparison of their lipid composition and nutritional value. In this study, untargeted liquid chromatography/mass spectrometry was applied to comprehensively profile lipids in the skin, meat, and intestinal contents of three color-distinct edible sea cucumbers. Multivariate principal component analysis revealed that the lipid composition of the intestinal contents of red, black, and blue sea cucumbers differs from that of skin, and meats. Polyunsaturated fatty acids (PUFAs) are abundant in the intestinal contents, followed by meats of sea cucumber. Lipid nutritional quality assessments based on fatty acid composition revealed a high P:S ratio, low index of atherogenicity, and high health promotion indices for the intestinal contents of red sea cucumber, suggesting its potential health benefits. In addition, hierarchical cluster analysis revealed that the intestinal contents of sea cucumbers were relatively high in PUFA-enriched phospholipids and lysophospholipids. Ceramides are abundant in black skin, blue meat, and red intestinal content samples. Overall, this study provides the first insights into a comprehensive regio-specific profile of the lipid content of sea cucumbers and their potential use as a source of lipid nutrients in food and nutraceuticals.

Secular trends in dietary energy, carbohydrate, fat, and protein intake among Korean adults, 2010-2020 KHANES

OBJECTIVES

The composition and balance of macronutrient intake play key roles in promoting a longer lifespan. In this study, we aimed to investigate the secular trends in carbohydrate, fat, and protein intakes in South Koreans from 2010 to 2020.

METHODS

We examined the dietary nutritional intake of South Koreans using data from the Korean National Health and Nutrition Examination Survey. A total of 60,190 adults aged ≥19 y who completed the 24-h dietary recall interviews in a single day on all survey periods were included in this study. The outcomes included changes in macronutrient intake according to subgroups, such as age; sex; and the presence of diabetes, dyslipidemia, stroke, or heart disease, as well as energy intake from macronutrients.

RESULTS

The study population showed a significant decrease in total energy intake from 2010 to 2020, with a corresponding decrease in the percentage of energy intake from carbohydrates (p-values for trend < 0.001). Conversely, the proportions of energy intake from proteins and fats increased during the same period (p < 0.001). Subgroup analyses revealed variations in macronutrient intake trends according to age, sex, obesity status, and underlying diseases. The analysis of trends in energy intake from various fat subtypes, total sugar, and fiber revealed a decrease in the energy intake percentage of total sugar from 2016 to 2020 and an increase in the energy intake percentage of all fat subtypes and fiber from 2013 to 2020.

CONCLUSIONS

In the past 10 y, the dietary patterns in Korea have shifted toward the consumption of high-fat and high-protein diets with reduced carbohydrate intake.

Association of postoperative dietary macronutrient content and quality with total weight loss and fat-free mass loss at midterm after sleeve gastrectomy

OBJECTIVES

This study aimed to investigate the associations of macronutrient quantities and qualities with percentage total weight loss and percentage of fat-free mass loss relative to total weight loss in adults undergoing sleeve gastrectomy.

METHODS

This cross-sectional study included 146 patients on postoperative time since sleeve gastrectomy of 2 to 4 y. Diet was assessed using a food frequency questionnaire. Macronutrient quality index, carbohydrate quality index, fat quality index, and healthy plate protein quality index were calculated. The associations of dietary variables with percentage total weight loss and percentage of fat-free mass loss relative to total weight loss were determined using linear regression. Logistic regression was used to estimate the odds of non-response (percentage total weight loss < 25%) and excessive fat-free mass loss (percentage of fat-free mass loss relative to total weight loss > 28%) based on dietary intakes.

RESULTS

Forty-six (31.5%) were non-responders, and 49 (33.6%) experienced excessive fat-free mass loss. The fully adjusted model showed a 0.75 decrease in percentage total weight loss per 5% carbohydrate increase (95% CI, -1.45 to -0.05). The odds of non-response were 53% lower per 5% increase in protein (95% CI, 0.23-0.94). Each 5-g higher intake of fat was associated with 0.29 higher percentage of fat-free mass loss relative to total weight loss (95% CI, 0.03-0.55). The odds of excessive fat-free mass loss were reduced by 5% per gram of fiber intake (95% CI, 0.90-0.99). Each 5% increment in energy intake from protein that was isocalorically substituted for either carbohydrate or fat was associated with lower odds of nonresponse. Macronutrient quality indices had no significant associations.

CONCLUSIONS

Adherence to a high-protein, high-fiber diet after sleeve gastrectomy may enhance surgical success by improving total weight loss and preventing excessive fat-free mass loss.

Designing healthier and more sustainable ultraprocessed foods

The food industry has been extremely successful in creating a broad range of delicious, affordable, convenient, and safe food and beverage products. However, many of these products are considered to be ultraprocessed foods (UPFs) that contain ingredients and are processed in a manner that may cause adverse health effects. This review article introduces the concept of UPFs and briefly discusses food products that fall into this category, including beverages, baked goods, snacks, confectionary, prepared meals, dressings, sauces, spreads, and processed meat and meat analogs. It then discusses correlations between consumption levels of UPFs and diet-related chronic diseases, such as obesity and diabetes. The different reasons for the proposed ability of UPFs to increase the risk of these chronic diseases are then critically assessed, including displacement of whole foods, high energy densities, missing phytochemicals, contamination with packaging chemicals, hyperpalatability, harmful additives, rapid ingestion and digestion, and toxic reaction products. Then, potential strategies to overcome the current problems with UPFs are presented, including reducing energy density, balancing nutritional profile, fortification, increasing satiety response, modulating mastication and digestion, reengineering food structure, and precision processing. The central argument is that it may be possible to reformulate and reengineer many UPFs to improve their healthiness and sustainability, although this still needs to be proved using rigorous scientific studies.

Chemical and Nutritional Fat Profile of Acheta domesticus, Gryllus bimaculatus, Tenebrio molitor and Rhynchophorus ferrugineus

The use of edible insects in the human diet is gaining importance because they are characterized by high nutritional value, and their cultivation is much more environmentally friendly than traditional livestock farming. The objective of this study was to determine the chemical and nutritional fat profile of selected edible insects as follows: house cricket (Acheta domesticus adult), field cricket (Gryllus bimaculatus adult), mealworm (Tenebrio molitor larvae), and palm weevil (Rhynchophorus ferrugineus larvae) which are now commercially available worldwide. Additionally, the degree of implementation of nutrition standards for selected nutrients by these insects was assessed. Freeze-dried insects were studied using infrared-attenuated total reflectance mid-infrared spectroscopy for basic differentiation. The content of fat and fatty acids was determined, and dietary indicators were calculated. The spectroscopic findings align with biochemical data, revealing that Rhynchophorus ferrugineus larvae contain the highest fat content and the least protein. Unsaturated fatty acids (UFAs) predominated in the fat of the assessed insects. The highest content of saturated fatty acids (SFAs), along with the lowest content of polyunsaturated fatty acids (PUFAs), was observed in the larvae of the Rhynchophorus ferrugineus species. From a nutritional standpoint, Tenebrio molitor larvae exhibit the most favorable indicators, characterized by minimal athero- and thrombogenic effects, along with an optimal balance of hypo- and hypercholesterolemic acids. Knowledge of the composition and quantities of fats in different insect species is valuable for planning and preparing meals with accurate nutritional profiles, among other applications.

Changes of trans and saturated fatty acid content in savory baked goods from 2015 to 2021 and their effect on consumers' intake using substitution models: A study conducted in Greece

BACKGROUND

In Greece, nearly a third of savory baked goods (SBGs) exceeded the limit of 2 g of nonruminant or industrial trans fatty acids (i-TFA) per 100 g fat in 2015. The impact of the Commission Regulation (European Union) 2019/649 on exposure to trans fatty acids (TFA), i-TFA, and saturated fatty acid (SFA) from SBGs has not been previously evaluated.

OBJECTIVES

The study aimed to explore fatty acid reformulation of SBG products and assess differences in TFA, i-TFA, and SFA intakes using a sample of Greek SBG consumers from a nationally representative survey.

METHODS

In 2021, 140 samples of SBGs were collected in the greater metropolitan area of Athens, and their fat profile and content were compared to those from 2015. Based on these measurements, food consumption substitution models were employed to examine TFA and SFA intake differences, and the percent contribution from SBG among consumers was calculated (N = 1008). Nutrient densities were calculated by adjusting all fat intakes by individual mean energy intake (percentage of daily total energy intake).

RESULTS

The 2% i-TFA legislative limit/100 g of fat in measured SBGs was exceeded by 11.4% in 2021 compared to 31.1% in 2015 (19.7% increase in compliance). Median i-TFA and TFA intakes from SBGs were reduced from 0.05 (0.01, 0.12)% and 0.13 (0.03, 0.27)% in 2015 to 0.03 (0.01, 0.09) and 0.06 (0.03, 0.13)% in 2021, respectively. In terms of SFA, a mean increase/100 g was calculated, resulting in an increased intake in 2021 compared to 2015 [5.18% (2.78, 8.37) and 3.55 (1.99, 5.73), respectively].

CONCLUSIONS

Despite the reductions seen in i-TFA content of SBGs, food product reformulation efforts in Greece should focus not only on TFA content but also on SFA reduction to improve public health.

Saturated fat, the estimated absolute risk and certainty of risk for mortality and major cancer and cardiometabolic outcomes: an overview of systematic reviews

OBJECTIVE

To assess the impact of reducing saturated fat or fatty foods, or replacing saturated fat with unsaturated fat, carbohydrate or protein, on the risk of mortality and major cancer and cardiometabolic outcomes in adults.

METHODS

We searched MEDLINE, EMBASE, CINAHL, and references of included studies for systematic reviews and meta-analyses (SRMAs) of randomized controlled trials (RCTs) and observational studies in adults published in the past 10 years. Eligible reviews investigated reducing saturated fat or fatty foods or replacing saturated fat with unsaturated fat, carbohydrate or protein, on the risk of cancer and cardiometabolic outcomes and assessed the certainty of evidence for each outcome using, for example, the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach. We assessed the quality of SRMAs using a modified version of AMSTAR-2. Results were summarized as absolute estimates of effect together with the certainty of effects using a narrative synthesis approach.

RESULTS

We included 17 SRMAs (13 reviews of observational studies with follow-up 1 to 34 years; 4 reviews of RCTs with follow-up 1 to 17 years). The quality of two-thirds of the SRMAs was critically low to moderate; the main limitations included deficient reporting of study selection, absolute effect estimates, sources of funding, and a priori subgroups to explore heterogeneity. Our included reviews reported > 100 estimates of effect across 11 critically important cancer and cardiometabolic outcomes. High quality SRMAs consistently and predominantly reported low to very low certainty evidence that reducing or replacing saturated fat was associated with a very small risk reduction in cancer and cardiometabolic endpoints. The risk reductions where approximately divided, some being statistically significant and some being not statistically significant. However, based on 2 moderate to high quality reviews, we found moderate certainty evidence for a small but important effect that was statistically significant for two outcomes (total mortality events [20 fewer events per 1000 followed] and combined cardiovascular events [16 fewer per 1000 followed]). Conversely, 4 moderate to high quality reviews showed very small effects on total mortality, with 3 of these reviews showing non-statistically significant mortality effects.

CONCLUSION

Systematic reviews investigating the impact of SFA on mortality and major cancer and cardiometabolic outcomes almost universally suggest very small absolute changes in risk, and the data is based primarily on low and very low certainty evidence.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42020172141.

Macronutrient quality and the incidence of metabolically unhealthy phenotypes in adults with normal weight and overweight/obesity

OBJECTIVE

We aimed to investigate the associations of macronutrient quality indices with the incident metabolically unhealthy normal weight (MUNW) and metabolically unhealthy overweight/obesity (MUO) phenotypes.

METHODS

This prospective study included 512 metabolically healthy normal weight and 787 metabolically healthy overweight/obese adults from the third study examination of the Tehran Lipid and Glucose Study. The participants were followed through the sixth study examination. Diet was measured with a food frequency questionnaire. The macronutrient quality index (MQI), carbohydrate quality index (CQI), fat quality index (FQI), and healthy plate quality index (HPPQI) were calculated. Hazard ratio (HR) and 95 % confidence interval (95 % CI) were estimated for incident unhealthy phenotypes using Cox regression.

RESULTS

After controlling all possible confounding factors, a one-point higher HPPQI was linked to a 28 % lower risk of MUNW (HR = 0.72; 95 % CI = 0.59, 0.87). Compared to the lowest quartile, the incident MUNW was also lower in the two last quartiles of the HPPQI. A one-unit increase in MQI was associated with a 5 % lower incident MUO (HR = 0.95; 95 % CI = 0.92, 0.99). The incident MUO was also higher for the highest compared to the lowest MQI quartile. In quartiles 2-4 of the HPPQI, incident MUO was lower with respective HRs (95 % CI) of 0.71 (0.54, 0.93), 0.60 (0.45, 0.80), and 0.66 (0.50, 0.86) in the fully-adjusted model.

CONCLUSIONS

A higher overall macronutrient quality was independently associated with a lower incident MUO. A higher dietary protein quality was related to a lower risk for MUNW and MUO.

Dairy foods and cardiometabolic diseases: an update and a reassessment of the impact of SFA

Type 2 diabetes (T2D) and CVD are major causes of mortality and chronic morbidity. Whilst mortality from CVD has decreased they remain the largest cause of death in Europe and the prevalence of T2D is increasing rapidly. A consistent component of public health advice is to reduce intake of SFA to reduce CVD in particular, which implies limiting dairy food consumption. The prospective studies and randomised controlled trials included in this review show that for dairy foods at least, SFA are not consistently associated with CVD or T2D risk. For CVD the association with dairy foods is generally neutral despite dairy foods being the major source of SFA in many diets. This creates considerable doubt, at least for dairy foods, concerning the validity of the traditional diet-heart hypothesis which positively relates SFA intake to increased serum LDL-cholesterol and subsequent increased CVD. There is now emerging evidence to explain this which is highly relevant to dairy foods. These include the potentially counterbalancing effect of SFA-stimulated HDL-cholesterol and specific food matrix factors. In addition, SFA are associated with the less atherogenic large buoyant LDL particles and possible counterbalancing hypotensive effects of dairy proteins. Overall, dairy foods have either a neutral or beneficial association with CVD and T2D. Beneficial associations are seen for blood pressure and the reduced T2D risk linked to yoghurt consumption, a subject that needs urgent attention given the sharp rise in T2D prevalence in many countries.

Fat Intake and Fat Quality in Pregnant and Lactating Women, Infants, Children, and Adolescents and Related Health Outcomes: A Scoping Review of Systematic Reviews of Prospective Studies

INTRODUCTION

Dietary fat intake during pregnancy and childhood is important for health. However, several health aspects are inconclusive.

METHODS

We systematically searched Medline, Cochrane Library, and Epistemonikos for systematic reviews (SRs) of randomized controlled trials (RCTs) and/or prospective cohort studies published from January 01, 2015, to December 31, 2019, assessing the association of dietary fat intake (including dietary supplements) during pregnancy and across childhood with pregnancy, perinatal, and child health outcomes.

RESULTS

Thirty-one SRs, mainly of RCTs, were included. Omega-3 fatty acids supplementation during pregnancy reduced the risk of early preterm birth, and in some SRs also any preterm birth, increased gestation length and birth weight, but mostly was not associated with other pregnancy/perinatal outcomes. Pre- and postnatal polyunsaturated fatty acids (PUFAs) intake was not consistently associated with growth, neurological, visual and cognitive outcomes, allergic diseases, cardiovascular, and metabolic health in childhood. Reduced saturated fatty acids (SFAs) intake and its replacement with PUFA/monounsaturated fatty acids had favourable effects on blood pressure and blood lipids in children. No apparent effects of total or trans fat on health outcomes across target groups were observed.

CONCLUSION

Omega-3 PUFA supplementation during pregnancy and SFA intake reduction in childhood require further consideration in dietary recommendations targeting these populations.

Dietary Patterns Associated with Abnormal Glucose Tolerance following Gestational Diabetes Mellitus: The MyNutritype Study

Abnormal glucose tolerance (AGT), which includes type 2 diabetes and pre-diabetes, is highly prevalent in women post gestational diabetes mellitus (post-GDM). Dietary patterns have been associated with the risk of developing AGT in women post-GDM, but evidence in Asian populations is sparse. This study aimed to determine the association between a posteriori dietary patterns and AGT in women post-GDM. This cross-sectional study recruited 157 women post-GDM (mean age 34.8 years) from Seri Kembangan Health Clinic and Universiti Putra Malaysia. AGT was diagnosed according to the Malaysian Clinical Practice Guidelines using a 75 g 2 h oral glucose tolerance test or HbA1c. Food intake was assessed using the 2014 Malaysian Adult Nutrition Survey food frequency questionnaire. Five dietary patterns were derived using principal component analysis: 'Unhealthy', 'Fish-eggs-fruits-vegetables', 'Cereals-confectionaries', 'Legumes-dairy', and 'Meat-sugar-sweetened-beverages'. After adjusting for sociodemographic characteristics and total energy intake, the 'Cereals-confectionaries' dietary pattern was significantly associated with AGT (adjusted odds ratio 1.536, p = 0.049). Targeted lifestyle modification, including dietary intervention, for women post-GDM is warranted to reduce their risk of AGT and its complications.

A Plant-Based Animal Fat Analog Produced by an Emulsion Gel of Alginate and Pea Protein

As the market for plant-based meat analogs grows, the development of plant-based animal fat analogs has become increasingly important. In this study, we propose an approach by developing a gelled emulsion based on sodium alginate, soybean oil (SO), and pea protein isolate. Formulations containing 15% to 70% (w/w) SO were successfully produced without phase inversion. The addition of more SO resulted in pre-gelled emulsions with a more elastic behavior. After the emulsion was gelled in the presence of calcium, the color of the gelled emulsion changed to light yellow, and the formulation containing 70% SO exhibited a color most similar to actual beef fat trimming. The lightness and yellowness values were greatly influenced by the concentrations of both SO and pea protein. Microscopic images revealed that pea protein formed an interfacial film around the oil droplets, and the oil was more tightly packed at higher oil concentrations. Differential scanning calorimetry showed that lipid crystallization of the gelled SO was influenced by the confinement of the alginate gelation, but the melting behavior was like that of free SO. FTIR spectrum analysis indicated a potential interaction between alginate and pea protein, but the functional groups of SO were unchanged. Under mild heating conditions, gelled SO exhibited an oil loss similar to that observed in actual beef trims. The developed product has the potential to mimic the appearance and slow-rendering melting attribute of real animal fat.

Emulsion-Templated Liquid Oil Structuring with Egg White Protein Microgel- Xanthan Gum

In this study, oleogels were prepared by the emulsion-template method using egg-white protein microgel as a gelator and xanthan gum (XG) as thickener. The physicochemical properties of the emulsion and oleogels were investigated. The adsorption of protein on the surface of the oil droplet reached saturation when the protein microgel concentration reached 2%. The excess protein combined with XG and accumulated on the outer layer of the oleogel, which prevented the emulsion from flocculation, enhanced the oil-holding capacity of the oleogel, and had a positive effect on preventing the oxidation of oil. When the concentration of XG was less than 0.4%, the EWP microgel, combined with the XG, stabilized the emulsion. As the concentration of XG was greater than 0.4%, excessive XG in the emulsion improved the viscosity and mechanical properties of the emulsion to prevent the aggregation of oil droplets. However, the change in XG concentration had no significant effect on the oxidation of the oil.

Saturated fat and human health: a protocol for a methodologically innovative systematic review and meta-analysis to inform public health nutrition guidelines

BACKGROUND

The health effects of dietary fats are a controversial issue on which experts and authoritative organizations have often disagreed. Care providers, guideline developers, policy-makers, and researchers use systematic reviews to advise patients and members of the public on optimal dietary habits, and to formulate public health recommendations and policies. Existing reviews, however, have serious limitations that impede optimal dietary fat recommendations, such as a lack of focus on outcomes important to people, substantial risk of bias (RoB) issues, ignoring absolute estimates of effects together with comprehensive assessments of the certainty of the estimates for all outcomes.

OBJECTIVE

We therefore propose a methodologically innovative systematic review using direct and indirect evidence on diet and food-based fats (i.e., reduction or replacement of saturated fat with monounsaturated or polyunsaturated fat, or carbohydrates or protein) and the risk of important health outcomes.

METHODS

We will collaborate with an experienced research librarian to search MEDLINE, EMBASE, CINAHL, and the Cochrane Database of Systematic Reviews (CDSR) for randomized clinical trials (RCTs) addressing saturated fat and our health outcomes of interest. In duplicate, we will screen, extract results from primary studies, assess their RoB, conduct de novo meta-analyses and/or network meta-analysis, assess the impact of missing outcome data on meta-analyses, present absolute effect estimates, and assess the certainty of evidence for each outcome using the GRADE contextualized approach. Our work will inform recommendations on saturated fat based on international standards for reporting systematic reviews and guidelines.

CONCLUSION

Our systematic review and meta-analysis will provide the most comprehensive and rigorous summary of the evidence addressing the relationship between saturated fat modification for people-important health outcomes. The evidence from this review will be used to inform public health nutrition guidelines.

TRIAL REGISTRATION

PROSPERO Registration: CRD42023387377 .

Multi-Nutrient Analysis of Dietary Macronutrients with All-Cause, Cardiovascular, and Cancer Mortality: Data from NHANES 1999-2014

Macronutrients are a major component of the human diet. However, few studies have assessed their collective association with mortality. We sought to evaluate the associations of macronutrient intake with all-cause, cardiovascular, and cancer mortality in US adults using a multi-nutrient approach. This prospective cohort analysis used data from the National Health and Nutrition Examination Survey from the years 1999 to 2014. The participants included 33,681 US adults aged 20−85 years (52.5% female). The maximum follow-up time was 16.8 years, with a total of 4398 total deaths, including 772 cardiovascular deaths and 952 cancer deaths. The associations between mortality and dietary macronutrients were explored using three-dimensional generalized additive models, allowing for visual and statistical inference of complex nonlinear associations. Absolute macronutrient intake demonstrated a three-way interactive association with all-cause mortality (p < 0.001), cardiovascular mortality (p = 0.02), and cancer mortality (p = 0.05), adjusted for age, sex, ethnicity, socioeconomic status, dietary quality, and lifestyle. Compositionally, a high caloric diet composed of moderately high protein (20%), moderate fat (30%), and moderate carbohydrate (50%) levels was associated with the highest mortality risk. Across the total energy intake levels, lower mortality risk was observed in two separate regions consisting of higher protein (30%), higher carbohydrate (60%), and lower fat levels (10%) or lower protein (10%), moderate carbohydrate (45%), and higher fat levels (45%). These findings highlight a complex nonlinear and interactive association between macronutrients and all-cause mortality such that several distinct dietary compositions are associated with similarly high or low risk. Future research is needed to explore the drivers of these associations and whether they differ across varying dietary patterns and populations.

Saturated fat: villain and bogeyman in the development of cardiovascular disease?

AIMS

Cardiovascular disease (CVD) is the leading global cause of death. For decades, the conventional wisdom has been that the consumption of saturated fat (SFA) undermines cardiovascular health, clogs the arteries, increases risk of CVD, and leads to heart attacks. It is timely to investigate whether this claim holds up to scientific scrutiny. The purpose of this paper is to review and discuss recent scientific evidence on the association between dietary SFA and CVD.

METHODS AND RESULTS

PubMed, Google scholar, and Scopus were searched for articles published between 2010 and 2021 on the association between SFA consumption and CVD risk and outcomes. A review was conducted examining observational studies and prospective epidemiologic cohort studies, randomized controlled trials (RCTs), systematic reviews and meta-analyses of observational studies and prospective epidemiologic cohort studies, and long-term RCTs. Collectively, neither observational studies, prospective epidemiologic cohort studies, RCTs, systematic reviews, and meta-analyses have conclusively established a significant association between SFA in the diet and subsequent cardiovascular risk and coronary artery disease, myocardial infarction, or mortality nor a benefit of reducing dietary SFAs on CVD rick, events, and mortality. Beneficial effects of replacement of SFA by polyunsaturated or monounsaturated fat or carbohydrates remain elusive.

CONCLUSION

Findings from the studies reviewed in this paper indicate that the consumption of SFA is not significantly associated with CVD risk, events, or mortality. Based on the scientific evidence, there is no scientific ground to demonize SFA as a cause of CVD. SFA naturally occurring in nutrient-dense foods can be safely included in the diet.

Beneficial effects of monounsaturated fatty acid-rich blended oils with an appropriate polyunsaturated/saturated fatty acid ratio and a low n-6/n-3 fatty acid ratio on the health of rats

BACKGROUND

The effects of dietary fat on health are influenced by its fatty acid profile. We aimed to determine the effects of monounsaturated fatty acid (MUFA)-rich blended oils (BO) containing a balance of polyunsaturated fatty acids (PUFAs) and saturated fatty acids (SFAs) and with a low n-6/n-3 PUFA ratio on the health of rats fed normal or high-fat diets. The BO was obtained by mixing red palm oil, rice bran oil (RO), tea seed oil and flaxseed oil in appropriate proportions.

RESULTS

BO consumption reduced the serum low-density lipoprotein cholesterol (LDL-C), non-esterified fatty acid (NEFA), insulin (INS), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1 (IL-1), high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), lipid peroxide (LPO) and oxidized LDL (ox-LDL) concentrations and the homeostasis model assessment of insulin resistance (HOMA-IR); it increased the high-density lipoprotein cholesterol (HDL-C), glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) concentrations, and the bone mineral density (BMD) versus control oil-containing normal and high-fat diets. BO also reduced the triglyceride (TG), hs-CRP, MDA, ox-LDL and reactive oxygen species (ROS) concentrations; and increased the serum HDL-C and SOD, and BMD versus RO-containing high-fat diets. Finally, BO reduced the glucose (GLU) and INS, and HOMA-IR; it increased HDL-C, SOD, femoral weight and BMD versus RO-containing normal diets.

CONCLUSION

BOs with an appropriate fatty acid profile have beneficial effects on the glucolipid metabolism, inflammation, oxidative stress and bone quality of rats when included in both normal and high-fat diets. © 2022 Society of Chemical Industry.

Saturated fats, dairy foods and cardiovascular health: No longer a curious paradox?

Cardiovascular diseases (CVDs) are a major cause of death and morbidity in many parts of the world, and many dietary guidelines limit the intake of saturated fatty acids (SFA) as they are regarded as an important risk factor for CVDs due to their association with increased blood cholesterol. Dairy foods are often a major contributor to dietary intake of SFA, and since many dietary guidelines contain restrictions on SFA intake, this can lead to a moderation of dairy food intake despite meta-analyses generally showing dairy to have a neutral or negative association with CVDs. Many prospective studies and randomised controlled trials do not support a simple positive association between SFA intake and the risk of atherosclerotic CVD and its components although some early studies had a number of methodological weakness. Studies that included blood cholesterol data do broadly support the positive relationship between SFA and blood low-density lipoprotein cholesterol (LDL-C) but without increased CVD risk resulting, despite LDL being a causal factor in atherosclerotic CVD. These data suggest that LDL-C alone is not a consistently good predictor or cause of CVD risk, perhaps particularly in relation to dairy food consumption although some non-dairy food studies have also shown LDL-C reduction was not reflected in reduced CVD risk. This narrative review examines some reasons for these findings. Overall, restrictions on dairy food intake do not seem warranted, although there remains a need to further understand the association of different dairy food types with chronic diseases, perhaps particularly for type 2 diabetes.

Validation of Food Compass with a healthy diet, cardiometabolic health, and mortality among U.S. adults, 1999-2018

The Food Compass is a nutrient profiling system (NPS) to characterize the healthfulness of diverse foods, beverages and meals. In a nationally representative cohort of 47,999 U.S. adults, we validated a person's individual Food Compass Score (i.FCS), ranging from 1 (least healthful) to 100 (most healthful) based on cumulative scores of items consumed, against: (a) the Healthy Eating Index (HEI) 2015; (b) clinical risk factors and health conditions; and (c) all-cause mortality. Nationally, the mean (SD) of i.FCS was 35.5 (10.9). i.FCS correlated highly with HEI-2015 (R = 0.81). After multivariable-adjustment, each one SD (10.9 point) higher i.FCS associated with more favorable BMI (-0.60 kg/m² [-0.70,-0.51]), systolic blood pressure (-0.69 mmHg [-0.91,-0.48]), diastolic blood pressure (-0.49 mmHg [-0.66,-0.32]), LDL-C (-2.01 mg/dl [-2.63,-1.40]), HDL-C (1.65 mg/d [1.44,1.85]), HbA1c (-0.02% [-0.03,-0.01]), and fasting plasma glucose (-0.44 mg/dL [-0.74,-0.15]); lower prevalence of metabolic syndrome (OR = 0.85 [0.82,0.88]), CVD (0.92 [0.88,0.96]), cancer (0.95 [0.91,0.99]), and lung disease (0.92 [0.88,0.96]); and higher prevalence of optimal cardiometabolic health (1.24 [1.16,1.32]). i.FCS also associated with lower all-cause mortality (HR = 0.93 [0.89,0.96]). Findings were similar by age, sex, race/ethnicity, education, income, and BMI. These findings support validity of Food Compass as a tool to guide public health and private sector strategies to identify and encourage healthier eating.

Association between density of convenience and small grocery stores with diet quality in adults living in Mexico City: A cross sectional study

There is evidence of the association between different retail stores and food consumption, yet research is still limited in low- and medium-income countries, where the context of the food retail environment is different from that observed in high-income countries. Specifically, less is known about how convenience and small grocery stores, which offer products with immediate access, are associated with the diet as a whole. The present study assessed the association between density of convenience and small grocery stores and diet quality in adults from the Mexico City Representative Diabetes Survey 2015. A final sample size of 1,023 adults aged 20–69 years was analyzed. The density of stores was measured using Euclidean buffers within 500 meters of each participant's home. The Mexican Alternate Healthy Eating Index (MxAHEI) was used to assess diet quality. Multivariable Poisson models were used to test the association of convenience and small grocery stores densities with the MxAHEI. Although our results were not statistically significant, we observed a lower diet quality score among adults from Mexico City living in areas with a higher density of small grocery and convenience stores. More research is needed on the influence of environmental food retail on food consumption.

An analysis of the recent US dietary guidelines process in light of its federal mandate and a National Academies report

The US Dietary Guidelines for Americans is an enormously influential policy that has guided US nutrition programs since 1980. During these last 40 years, some researchers have expressed concern that the guidelines are based on an insufficiently rigorous assessment of the scientific evidence, a view that was largely substantiated by a Congressionally mandated 2017 report by the National Academies of Sciences, Engineering, and Medicine, which identified a need for enhanced transparency, greater scientific rigor, and updates to the scientific methodology for the DGA process. This paper traces the history of these ideas and contextualizes the DGA within the law and regulations that govern its process. The paper also discusses how recent iterations of the Dietary Guidelines have not fully adhered to these guiding documents, which has resulted in diminished independence of the expert committee in charge of evaluating the science for the DGA and a continued lack of a fully rigorous scientific process for producing consistent and trustworthy guidelines for the public.

Scientific advice related to nutrient profiling for the development of harmonised mandatory front-of-pack nutrition labelling and the setting of nutrient profiles for restricting nutrition and health claims on foods

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver scientific advice related to nutrient profiling for the development of harmonised mandatory front‐of‐pack nutrition labelling and the setting of nutrient profiles for restricting nutrition and health claims on foods. This Opinion is based on systematic reviews and meta‐analyses of human studies on nutritionally adequate diets, data from the Global Burden of Disease framework, clinical practice guidelines, previous EFSA opinions and the priorities set by EU Member States in the context of their Food‐Based Dietary Guidelines and associated nutrient/food intake recommendations. Relevant publications were retrieved through comprehensive searches in PubMed. The nutrients included in the assessment are those likely to be consumed in excess or in inadequate amounts in a majority of European countries. Food groups with important roles in European diets have been considered. The Panel concludes that dietary intakes of saturated fatty acids (SFA), sodium and added/free sugars are above, and intakes of dietary fibre and potassium below, current dietary recommendations in a majority of European populations. As excess intakes of SFAs, sodium and added/free sugars and inadequate intakes of dietary fibre and potassium are associated with adverse health effects, they could be included in nutrient profiling models. Energy could be included because a reduction in energy intake is of public health importance for European populations. In food group/category‐based nutrient profiling models, total fat could replace energy in most food groups owing to its high‐energy density, while the energy density of food groups with low or no fat content may be well accounted for by the inclusion of (added/free) sugars. Some nutrients may be included in nutrient profiling models for reasons other than their public health importance, e.g. as a proxy for other nutrients of public health importance, or to allow for a better discrimination of foods within the same food category.

Maternal Dietary Quality and Dietary Inflammation Associations with Offspring Growth, Placental Development, and DNA Methylation

The ‘Developmental Origins of Health and Diseases’ hypothesis posits that prenatal maternal diet influences offspring growth and later life health outcomes. Dietary assessment has focused on selected nutrients. However, this approach does not consider the complex interactions between foods and nutrients. To provide a more comprehensive approach to public health, dietary indices have been developed to assess dietary quality, dietary inflammation and risk factors for non-communicable diseases. Thus far, their use in the context of placental development is limited and associations with offspring outcomes have been inconsistent. Although epidemiological studies have focused on the role of maternal diet on foetal programming, the underlying mechanisms are still poorly understood. Some evidence suggests these associations may be driven by placental and epigenetic changes. In this narrative review, we examine the current literature regarding relationships between key validated diet quality scores (Dietary Inflammatory Index [DII], Mediterranean diet [MD], Healthy Eating Index [HEI], Alternative Healthy Eating Index [AHEI], Dietary Approaches to Stop Hypertension [DASH], Glycaemic Index [GI] and Glycaemic Load [GL]) in pregnancy and birth and long-term offspring outcomes. We summarise findings, discuss potential underlying placental and epigenetic mechanisms, in particular DNA methylation, and highlight the need for further research and public health strategies that incorporate diet quality and epigenetics.

The Contribution of Foods Prepared Outside the Home to the Diets of 18- to 30-Year-Old Australians: The MYMeals Study

Young adults are the highest consumers of food prepared outside home (FOH) and gain most weight among Australian adults. One strategy to address the obesogenic food environment is menu labelling legislation whereby outlets with >20 stores in one state and >50 Australia-wide must display energy content in kJ. The aim of this study was to assess the contribution of FOH to the energy and macronutrients, saturated fat, total sugars and sodium intakes of young Australians. One thousand and one 18 to 30-year-olds (57% female) residing in Australia’s most populous state recorded all foods and beverages consumed and the location of preparation for three consecutive days using a purpose-designed smartphone application. Group means for the daily consumption of energy, percentage energy (%E) for protein, carbohydrate, total sugars, total and saturated fats, and sodium density (mg/1000 kJ) and proportions of nutrients from FOH from menu labelling and independent outlets were compared. Overall, participants consumed 42.4% of their energy intake from FOH with other nutrients ranging from 39.8% (sugars) to 47.3% (sodium). Independent outlets not required to label menus, contributed a greater percentage of energy (23.6%) than menu labelling outlets (18.7%, p < 0.001). Public health policy responses such as public education campaigns, extended menu labelling, more detailed nutrition information and reformulation targets are suggested to facilitate healthier choices.