Average American Diet Research Articles

Changes in Gut Microbiota and Plasma, Fecal, and Urinary Metabolites Following Mediterranean Diets With Varying Quantities of Lean Beef Compared to an Average American Diet

Changes in Gut Microbiota and Plasma, Fecal, and Urinary Metabolites Following Mediterranean Diets With Varying Quantities of Lean Beef Compared to an Average American Diet

Pharmacological effect of walnuts consumption on metabolic syndrome: a current view

Cardiovascular disease (CVD) is the leading cause of death worldwide (WHO, 2017). In addition to the global and national morbidity and mortality burdens of the disease, it imposes a substantial economic burden on society. The American heart association predicts that by 2035, 45% of Americans will suffer from CVD with costs expected to reach $1.1 trillion annually. Clinical trials have demonstrated that a nut-containing diet low in saturated fat and cholesterol, while high in poly and monounsaturated fatty acids has a beneficial effect on plasma lipids and lipoproteins when compared with either a low fat or average American diet. Other bioactive compounds present in walnuts, including micronutrients, fiber, and phytochemicals, may also contribute to their cardio protective effect by reducing inflammation, improving vascular reactivity, and lowering oxidative stress. It has been demonstrated that the consumption of walnuts resulted in significant reduction in body mass index (BMI), percentage of body fat, increased lean body mass and an increased amount of water in the body. A large population cohort study also demonstrated a marked reduction in body weight and other anthropometric parameters in people on regular consumption of walnuts.

Nutrient analysis of three low-carbohydrate diets differing in carbohydrate content.

Low-carbohydrate diets are increasing in popularity. Despite clinical evidence demonstrating their safety and efficacy, concerns regarding the nutrient adequacy of low-carbohydrate diets persist. The aims of this study were to assess the nutrient adequacy of three 7-day meal plans that delivered 20 (VLCD20), 40 (VLCD40), and 100 (LCD100) grams of net carbohydrate per day respectively. Nutrient analyses were conducted using USDA Food Data Central. All three low-carbohydrate meal plans exceeded recommendations for vitamins A, C, D, E, K, thiamin, riboflavin, niacin, B6, folate and B12 in males and females 31-70 years and exceeded calcium recommendations for adults 31-50 years but remained below the Tolerable Upper Intake Level. VLCD40 and LCD100 met or exceeded fiber recommendations for females ages 31-70 years and were adequate for males 51-70 years. None of the meal plans contributed meaningful amounts of added sugar. The plans exceeded the Recommended Dietary Allowance for protein for adults ages 31-70 years of age but were within the Acceptable Macronutrient Distribution Range of 10-35% of energy. The plans slightly exceeded recommendations for saturated fat and sodium but were lower in these nutrients than the average American diet and had more favorable omega-6 to omega-3 and sodium to potassium ratios than is typical. All three meals plans met or exceeded the Estimated Average Requirement for micronutrients in females ages 31-50 years, the population group most likely to consume low-carbohydrate diets. Well-constructed low-carbohydrate meal plans can be nutritionally adequate in adults.

Restaurant outlet density and the healthfulness of food purchases: evidence from FoodAPS.

The average American household's diet and food purchasing patterns are out of sync with federal recommendations. Researchers have connected this with the large and growing rates of obesity, diabetes, and other diet-related ailments in the U.S. Restaurant food has been discussed a potential contributor to unhealthful diets, as it is often calorically dense. We investigate the association between household access to restaurants and diet quality using USDA FoodAPS data and NPD ReCount data. We define radii around households to measure restaurant outlet counts and apply a regression analysis incorporating household characteristics. We find that neither restaurant counts nor openings share many statistically or economically significant associations with average dietary quality. Household characteristics and demographics are far more powerful in explaining variation in diet quality. Our findings align with the large and growing body of empirical research that suggests that personal preferences and other household characteristics are more important than the food environment in explaining food choices and diet quality. Given the extant research on the importance of access to large supermarkets, our results suggest that access to food retailers is more important in explaining diet quality than access to restaurants.

Reducing saturated fat intake lowers LDL-C but increases Lp(a) levels in African Americans: the GET-READI feeding trial

Reducing dietary saturated fatty acids (SFA) intake results in a clinically significant lowering of low-density lipoprotein cholesterol (LDL-C) across ethnicities. In contrast, dietary SFA’s role in modulating emerging cardiovascular risk factors in different ethnicities remains poorly understood. Elevated levels of lipoprotein(a) [Lp(a)], an independent cardiovascular risk factor, disproportionally affect individuals of African descent. Here, we assessed the responses in Lp(a) levels to dietary SFA reduction in 166 African Americans enrolled in GET-READI (The Gene-Environment Trial on Response in African Americans to Dietary Intervention), a randomized controlled feeding trial. Participants were fed two diets in random order for 5 weeks each: 1) an average American diet (AAD) (37% total fat: 16% SFA), and 2) a diet similar to the Dietary Approaches to Stop Hypertension (DASH) diet (25% total fat: 6% SFA). The participants’ mean age was 35 years, 70% were women, the mean BMI was 28 kg/m2, and the mean LDL-C was 116 mg/dl. Compared to the AAD diet, LDL-C was reduced by the DASH-type diet (mean change: −12 mg/dl) as were total cholesterol (−16 mg/dl), HDL-C (−5 mg/dl), apoA-1 (−9 mg/dl) and apoB-100 (−5 mg/dl) (all P < 0.0001). In contrast, Lp(a) levels increased following the DASH-type diet compared with AAD (median: 58 vs. 44 mg/dl, P < 0.0001). In conclusion, in a large cohort of African Americans, reductions in SFA intake significantly increased Lp(a) levels while reducing LDL-C. Future studies are warranted to elucidate the mechanism(s) underlying the SFA reduction-induced increase in Lp(a) levels and its role in cardiovascular risk across populations.

Higher adherence to the Dietary Approaches to Stop Hypertension (DASH Diet) is associated with lower greenhouse gases and land use from protein foods

IntroductionThe average American diet is high in red and processed meats which increases one's risk for chronic diseases and requires more land and water to produce and yields greater greenhouse gases (GHG) compared to other protein foods. Reduction of red and processed meat intake, such as seen with the Dietary Approaches to Stop Hypertension (DASH diet), could benefit human and environmental health.ObjectiveThe objective of this study is to predict the environmental sustainability of the DASH diet by evaluating the GHG, land use, and water withdrawals from protein foods within the self-selected diets of people who were encouraged to follow the DASH diet.MethodsDietary data was collected from 380 Midwesterners aged 35-70 years old with hypertension using the Automated Self-Administered 24-Hour (ASA 24) Recall System. DASH diet adherence was measured using a nutrient-based DASH score. GHG, land use, and water withdrawals were obtained using Carnegie Mellon University's Economic Input-Output Life Cycle Assessment (eiolca.net) using the Purchaser model (cradle-to-consumer). Multiple linear regressions were used to view associations between individual DASH nutrient scores and environmental impacts of total, animal, and plant protein foods.ResultsDiets that met DASH diet guidelines, as indicated by higher individual DASH nutrient scores, were associated with less GHG and land use from total and animal protein foods but more GHG and land use from plant-protein foods, with a few exceptions. The pattern was not clear for water withdrawals. Diets with the greatest adherence had around 25–50% lower GHG and land use from total protein foods than diets with the lowest adherence. Changes may be due to decreased consumption of total and animal protein foods, selection of animal protein foods with lower environmental impacts, and increased consumption of plant protein foods.ConclusionAdhering to the DASH diet can promote the consumption of less environmentally demanding protein foods resulting in lower GHG and land use from protein foods. However, claims regarding the sustainability of the entire dietary pattern cannot be determined based off the current study. Regardless, it is evident that environmental impacts should be considered alongside health impacts when selecting, promoting, or recommending a dietary pattern.

Abstract 10997: Reduction in Dietary Saturated Fat Intake Lowers LDL-C but Increases Lp(a) Levels in African Americans: Findings From the GET-READI Randomized Controlled Crossover Feeding Trial

Reduction in dietary saturated fatty acids (SFA) intake results in a significant clinically meaningful lowering of LDL-C across ethnicities. In contrast, the role of dietary SFA reduction in modulating emerging risk factors for cardiovascular disease (CVD) in different ethnic groups remains poorly understood. An elevated level of lipoprotein(a) [Lp(a)], an independent casual risk factor for CVD, disproportionally affects African Americans. In this study, we assessed the responses in Lp(a) to dietary SFA reduction specifically in African Americans (N=166) enrolled in GET-READI (The Gene-Environment Trial on Response in African Americans to Dietary Intervention), a randomized controlled feeding trial. Men and women with above optimal LDL-C were fed two diets in a random order for five weeks each: (1) the average American diet (AAD) (37% total fat: 16% SFA), and (2) a diet similar to the Dietary Approaches to Stop Hypertension (DASH) combination diet (25% total fat: 6% SFA). The mean age of participants was 33 years (range: 18-64 years), 70% were women, the mean BMI was 28.4 kg/m 2 and LDL-C was 116 mg/dL. At the end the 5-week intervention period with the DASH diet, compared with the end of the AAD diet, LDL-C was significantly reduced (mean change: -12.4 mg/dL, p &lt;0.0001), as were the levels of total cholesterol (-16.6 mg/dL, p &lt;0.0001), HDL-C (-5 mg/dL, p &lt;0.0001), apoA-1 (-8.7 mg/dL, p &lt;0.0001) and apoB-100 (-5.7 mg/dL, p &lt;0.0001). In contrast, Lp(a) levels were significantly increased following the DASH diet compared to AAD (from a median value of 44 mg/dL with AAD to 58 mg/dL with DASH; mean change: +11.2 mg/dL, p &lt;0.0001). As LDL-C measurements typically include Lp(a)-cholesterol, the “true” LDL-C decrease is estimated at -16 mg/dL, i.e., an underestimation by about 30%. In conclusion, in a large cohort of African Americans, an ethnic group with a high burden of elevated Lp(a), reductions in SFA intake significantly increased Lp(a) while reducing LDL-C. These findings suggest that dietary SFA reduction exerted an opposing effect on the circulating levels of two highly-atherogenic lipoproteins. Future studies are warranted to elucidate mechanism(s) underlying the SFA reduction-induced increase in Lp(a) and its role in CVD risk across population groups.

Herbs and Spices Modulate Gut Bacterial Composition in Adults at Risk for CVD: Results of a Prespecified Exploratory Analysis from a Randomized, Crossover, Controlled-Feeding Study

Herbs and spices are rich in polyphenolic compounds that may influence gut bacterial composition. The effect of culinary doses of herbs and spices consumed as part of a well-defined dietary pattern on gut bacterial composition has not been previously studied. The aim of this prespecified exploratory analysis was to examine gut bacterial composition following an average American diet (carbohydrate: 50% kcal; protein: 17%; total fat: 33%; saturated fat: 11%) containing herbs and spices at 0.5, 3.3, and 6.6 g.d-1.2100 kcal-1 [low-, moderate-, and high-spice diets, respectively (LSD, MSD, and HSD)] in adults at risk for CVD. Fifty-four adults (57% female; mean ± SD age: 45 ± 11 y; BMI: 29.8 ± 2.9 kg/m2; waist circumference: 102.8 ± 7.1 cm) were included in this 3-period, randomized, crossover, controlled-feeding study. Each diet was provided for 4 wk with a minimum 2-wk washout period. At baseline and the end of each diet period, participants provided a fecal sample for 16S rRNA gene (V4 region) sequencing. QIIME2 was used for data filtration, sequence clustering, taxonomy assignment, and statistical analysis. α-diversity assessed by the observed features metric ( P = 0.046) was significantly greater following the MSD as compared with the LSD; no other between-diet differences in α-diversity were detected. Differences in β-diversity were not observed between the diets ( P = 0.45). Compared with baseline, β-diversity differed following all diets ( P < .02). Enrichment of the Ruminococcaceae family was observed following the HSD as compared with the MSD (relative abundance = 22.14%, linear discriminant analysis = 4.22, P = 0.03) and the LSD (relative abundance = 24.90%, linear discriminant analysis = 4.47, P = 0.004). The addition of herbs and spices to an average American diet induced shifts in gut bacterial composition after 4 wk in adults at risk for CVD. The metabolic implications of these changes merit further investigation. This trial was registered at clinicaltrials.gov as NCT03064932.

Identification of different lipoprotein response types in people following a Mediterranean diet pattern with and without whole eggs

A Mediterranean (MED) diet decreases atherogenic lipoproteins and cardiovascular disease risk. We tested the hypothesis that daily consumption of whole eggs in a MED diet improves lipid metabolism compared with responses of both a control American diet and a MED diet without whole eggs. Thirty-nine overweight to obese participants were recruited into a randomized, crossover designed, controlled feeding trial evaluating 3 diets: a control, average American diet (AAD), a MED diet without whole eggs (MED-E), and a MED diet plus whole fresh eggs (1 whole egg/1000 kcal; MED+E). Treatments lasted 4 weeks followed by a >4-week washout period. Lipid concentrations, lipoprotein particle size, and number were determined at baseline and posttreatment. Intake of the AAD and MED-E decreased total cholesterol and low-density lipoprotein (LDL) concentrations (change from baseline, P < .05), without a treatment effect. Similarly, MED-E reduced (change from baseline, P < .05) triglyceride concentrations, without a treatment effect. Particle concentrations were reduced for intermediate-density lipoprotein (IDL; 26%, P < .05) and total LDL (8%, P < .05) by MED-E intake only. Very low-density lipoprotein size was reduced by MED-E intake (treatment effect, P = .04). Variability in responses, assessed by unsupervised machine learning, identified 3 main clusters of IDL- and LDL-type responses. Adoption of a MED diet meal plan without whole eggs improved lipid parameters associated with reduced cardiovascular disease risk. Significant treatment differences following inclusion of whole eggs were not observed. Individual differences in lipoprotein responses warrants further exploration.

The Effect of Meals Containing Culinary Doses of Spices on Postprandial Endothelial Function, Lipemia and Glycemia: A Randomized, Crossover, Controlled-Feeding Study

ObjectivesThe objective was to examine the effect of meals containing 0.6 g (low-spice meal), 3.7 g (moderate-spice meal), and 7.4 g (high-spice meal) of herbs/spices on postprandial flow mediated dilation (FMD), triglycerides, insulin and glucose in men and post-menopausal women at-risk for cardiovascular disease. MethodsA 3-period, randomized, crossover, controlled-feeding study was conducted. Participants consumed an average American diet containing 0.5 (low-spice diet), 3.3 (moderate-spice diet), and 6.6 (high-spice diet) g/d/2100 kcal of herbs and spices for 4-weeks. At baseline and the end of each diet period, participants were given a meal challenge (1192 kcal; carbohydrate 145 g; protein 62 g; fat 44 g; saturated fat 20 g). The spice dose in the test meal corresponded to the spice level of the diet consumed for the previous 4 weeks. Blood was sampled at 0, 30, 60, 120, 180, 240 minutes for analysis of triglycerides, glucose, and insulin. FMD was measured at 0,120 and 240 minutes. ResultsThe analytic sample included 43 participants (males 65%; age 48 ± 11 years; BMI 28.9 ± 2.9 kg/m2, FMD 6.2 ± 2.3%). No between-meal differences were observed for FMD (meal P = 0.30; time P < 0.001; meal by time interaction P > 0.99). The area under the curve for triglycerides (P = 0.39), glucose (P = 0.49) and insulin (P = 0.07) was not different between the meals. ConclusionsFollowing intake of an average American diet with three different doses of spices (0.5, 3.3 and 6.6 g/d/2100 kcal) for 4-weeks, FMD, triglyceride, glucose and insulin responses to meals containing 0.6 g, 3.7 g and 7.4 g of spices were not different. These findings suggest that following 4-weeks of exposure to spice-containing diets, spice exposure from a meal does not dose-dependently affect endothelial function, lipemia and glucose homeostasis in the 4-hours post meal. Funding SourcesMcCormick Science Institute; National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1 TR002014.

Wild Rice and Brown Rice Reduce Liver and Serum Lipids in Wistar Rats fed Either a Total Western Diet or a High Fat Diet

ObjectivesNon-alcoholic fatty liver disease (NAFLD) prevalence is increasing, and no pharmacological intervention exists to treat it. Here, we determined the effect of feeding wild rice and brown rice on liver lipids and the gut microbiome when fed two different high fat background diets meant to induce fatty liver. MethodsIn the HFD trial, male Wistar rats (n = 8 per group) were fed either a high fat diet (HF), or a HF containing either 20% wild rice (WR) or 20% brown rice (BR) for 8 weeks. Cecal contents, liver, and epididymal fat pads were harvested. Microbiome analysis of cecal contents was conducted by 16S sequencing. In the TWD trial, male Wistar rats (n = 12 per group) were fed the AIN-93G diet (Basal), the Total Western Diet (TWD; a high fat diet that mimics the average American diet), or the TWD containing 30% WR (WR) for 10 weeks, then liver and epididymal fat pads were harvested. ResultsIn the HFD trial, both WR and BR significantly reduced total liver lipids compared to HF (p < 0.0001). However, epididymal fat pad weight was not reduced in either of the rice groups compared to HF (p > 0.05). Serum cholesterol was also reduced in WR compared to HF (p < 0.0188). In the TWD trial, the TWD elevated total liver lipids compared to Basal, but WR reduced liver lipids significantly (p < o.oo6) compared to TWD. WR did not lower epididymal fat pad weight (p > 0.1) compared to TWD. Additionally, p-AMPK/AMPK was increased in WR compared to TWD (p < 0.003). This shift in AMPK activation was not seen in the HFD trial (p > 0.05). In the HFD trial microbiome analysis, the beta-diversity measure of community dissimilarity indicated that WR had a significantly different microbial profile compared to the animals fed the HF diet (p < 0.003) while BR had an increased abundance of lactobacillus (p < 0.03) compared to animals fed the HF diet. ConclusionsWild rice feeding reduced fatty liver, using two different high fat background diets, and altered the gut microbiome. Wild rice should be further explored as a dietary approach to prevent development of non-alcoholic fatty liver disease (NAFLD), and to investigate whether hepatic lipid reductions are mediated by changes in the gut microbiome. Funding SourcesThe TWD trial was sponsored by the Whiteside Institute for Clinical Research and the HFD trial was sponsored by the Minnesota Cultivated Wild Rice Council.

Impact of a 7-day homogeneous diet on interpersonal variation in human gut microbiomes and metabolomes

Gut microbiota metabolism of dietary compounds generates a vast array of microbiome-dependent metabolites (MDMs), which are highly variable between individuals. The uremic MDMs (uMDMs) phenylacetylglutamine (PAG), p-cresol sulfate (PCS), and indoxyl sulfate (IS) accumulate during renal failure and are associated with poor outcomes. Targeted dietary interventions may reduce toxic MDM generation; however, it is unclear if inter-individual differences in diet or gut microbiome dominantly contribute to MDM variance. Here, we use a 7-day homogeneous average American diet to standardize dietary precursor availability in 21 healthy individuals. During dietary homogeneity, the coefficient of variation in PAG, PCS, and IS (primary outcome) did not decrease, nor did inter-individual variation in most identified metabolites; other microbiome metrics showed no or modest responses to the intervention. Host identity and age are dominant contributors to variability in MDMs. These results highlight the potential need to pair dietary modification with microbial therapies to control MDM profiles.

Plasma fatty acid responses to a calorie-restricted, DASH-style diet with lean beef

BackgroundPlasma fatty acid (FA) levels are used as biomarkers of health outcomes and nutritional intake. MethodsThis was an exploratory analysis of the plasma FA profile from a parallel-designed, controlled-feeding study in older, obese adults (females, n = 17; males, n = 11) consuming a DASH-based diet with two levels of lean beef (3oz and 6oz per day). Plasma FA levels (as percent composition) were measured by gas chromatography from five timepoints over the 12-week intervention. The primary plasma FA change patterns modeled were sustained (initial change to ‘new normal’) or homeostatic (initial change, then return toward original baseline). ResultsThe study diet was low in fat (< 60 g/d), especially polyunsaturated FAs (PUFAs; < 5 g/d), compared to the average American diet of obese individuals as described by a nationally representative sample. Participants lost ∼6% of body mass and lowered plasma fasting triglyceride levels by ∼9% over the course of the study. With strong to very strong strength of evidence, the individual FAs displaying a sustained response were C16:1n7t, C18:1n9, C20:1n9, and C18:2n6, and homeostatic response, C18:0, 24:0, C24:1n9, C18:3n6, C20:4n6, and C22:6n3 (Ps < 0.0021, Bonferroni-adjusted). The data suggested that systematic changes in both the PUFA and de novo lipogenesis pathways occurred. ConclusionsDiet can affect plasma FA changes both due to nutritional composition and by affecting metabolic processes.

Herbs and spices at a relatively high culinary dosage improves 24-hour ambulatory blood pressure in adults at risk of cardiometabolic diseases: a randomized, crossover, controlled-feeding study

ABSTRACTBackgroundIntake of a single meal containing herbs and spices attenuates postprandial lipemia, hyperglycemia, and oxidative stress, and improves endothelial function. There has been limited investigation of the effect of longer-term intake of mixed herbs and spices on risk factors for cardiometabolic diseases.ObjectivesThe objective was to assess the effect of an average American diet containing herbs and spices at 0.5 (low-spice diet; LSD), 3.3 (moderate-spice diet; MSD), and 6.6 (high-spice diet; HSD) g · d−1 · 2100 kcal−1 on lipids and lipoproteins as well as other risk factors for cardiometabolic diseases in at-risk adults.MethodsA 3-period, randomized, crossover, controlled-feeding study with 71 participants was conducted at the Pennsylvania State University. Each diet was consumed for 4 wk with a minimum 2-wk washout period. Outcomes were assessed at baseline and the end of each diet period.ResultsNo between-diet effects were observed for LDL cholesterol, the primary outcome. Between-diet differences were observed for mean 24-h systolic (P = 0.02) and diastolic (P = 0.005) ambulatory blood pressure. The HSD lowered mean 24-h systolic blood pressure compared with the MSD (−1.9 mm Hg; 95% CI: −3.6, −0.2 mm Hg; P = 0.02); the difference between the HSD and LSD was not statistically significant (−1.6 mm Hg; 95% CI: −3.3, 0.04 mm Hg; P = 0.058). The HSD lowered mean 24-h diastolic blood pressure compared with the LSD (−1.5 mm Hg; 95% CI: −2.5, −0.4 mm Hg; P = 0.003). No differences were detected between the LSD and MSD. No between-diet effects were observed for clinic-measured blood pressure, markers of glycemia, or vascular function.ConclusionsIn the context of a suboptimal US-style diet, addition of a relatively high culinary dosage of mixed herbs and spices (6.6 g · d−1 · 2100 kcal−1) tended to improve 24-h blood pressure after 4 wk, compared with lower dosages (0.5 and 3.3 g · d−1 · 2100 kcal−1), in adults at elevated risk of cardiometabolic diseases.This trial was registered at clinicaltrials.gov as NCT03064932.

Association of Intestinal Microbial Dysbiosis With Chronic Obstructive Pulmonary Disease.

Normal gut flora plays various beneficial roles for the human body, including the protection against inflammatory states and mucosal viral infections. It also influences the immune system of the body. The metabolites produced by the gut bacteria control local and other systemic organs' immune functions like the lungs and brain, playing a role in their response to acute and chronic illnesses. Probiotics have shown beneficial effects on lung health. On the contrary, dysbiosis is associated with several diseases, including asthma, chronic bronchitis, emphysema, allergies, and other acute viral infections. By altering the diet of patients with respiratory diseases like patients with chronic obstructive pulmonary diseases (COPD), we may be able to mitigate their conditions. This literature review aims to discuss the mechanisms altering the gastrointestinal flora, the pathophysiology of gut and lung axis, the role of diet in gut microbe health, and the association of COPD with gut dysbiosis and peptic ulcer disease (PUD). We have extracted the data from PubMed and Google Scholar, consisting of review articles, case-control studies, and animal studies. The studies showed an association between gut microbes and different lung diseases. It is found that gut dysbiosis not only disrupts intestinal immunity but may also facilitate the development of COPD. Present studies also show an increased seroprevalence of Helicobacter pylori in patients with COPD. The strategies that can improve lung functions, especially in COPD patients, include prebiotics and probiotic supplementation to a diet more balanced than the current average American diet.

Intake of a Mediterranean Diet Reduces Atherogenic Lipid Profiles but the Effect Is Diminished by Daily Egg Intake

Abstract Objectives A Mediterranean diet (Med Diet) decreases atherogenic lipoproteins and cardiovascular disease (CVD) risk. It is unknown how high cholesterol intake within a Med Diet will affect these parameters. The objective of this project was to evaluate the daily inclusion of whole eggs, a high cholesterol food, in the Med Diet on lipid and lipoprotein profiles. Methods Overweight to obese men (8) and women (25) were recruited into a randomized, cross-over designed, controlled feeding study evaluating three isocaloric test diets: a) Control –average American diet from What We Eat in America, b) Med Diet, and c) Med Diet plus whole, fresh eggs (1 whole egg/1000 kcal; Med Diet + Egg). The Control and Med Diet contained egg substitute. Participants were directed to consume only those foods provided during each 4-week diet treatment period. Each treatment period was separated by &amp;gt; 4-week washout period. Fasting blood was taken pre- and post-treatment for determination of lipid concentrations, lipoprotein particle size and number. Results Intake of the Control and Med Diet, but not the Med Diet + Egg, decreased (time effect, P &amp;lt; 0.05) total cholesterol and low density lipoprotein (LDL) concentrations, but an overall diet treatment effect did not occur. Med Diet, but not Control or Med Diet + Egg, reduced (time effect, P &amp;lt; 0.05) triglyceride concentrations, but an overall treatment effect did not occur. Particle numbers (P &amp;lt; 0.05) were reduced (P &amp;lt; 0.05) for intermediate density lipoprotein (26%) and total LDL (8%) by Med Diet intake but not by the other diets, and an overall treatment effect was not observed. Very low density lipoprotein size was reduced (P &amp;lt; 0.05) by Med Diet intake and an overall treatment effect occurred (P = 0.04). Variability in responses was assessed by hierarchical clustering heatmap analysis of blood lipid responses. Three main categories of responses types were present but not defined by dietary treatment. Conclusions Daily intake of a Mediterranean diet meal pattern or an average American diet without whole eggs reduced blood lipid and/or lipoprotein concentrations associated with CVD risk; addition of daily egg intake blunted these reductions. However, the variability in the study population responses warrants further nutrigenomic exploration. Funding Sources USDA-ARS 3062-53000-001-00D and the American Egg Board.

Herbs and Spices Modulate Gut Microbiota Composition: A Randomized, Crossover, Controlled-Feeding Study

Abstract Objectives The effect of culinary doses of herbs and spices, consumed as part of a well-defined dietary pattern, on gut microbiota composition has not been previously studied. The aim of this study was to examine gut microbial composition following an average American diet (carbohydrate: 50% kcal; protein: 17%; total fat: 33%; saturated fat: 11%; sodium: 3000 mg/d) containing herbs and spices at 0.5 (Low Spice Diet; LSD), 3.3 (Moderate Spice Diet; MSD) and 6.6 (High Spice Diet; HSD) g/day/2100 kcal in adults at-risk for cardiovascular disease (CVD). Methods Fifty-four adults (57% female; 45 ± 11 years, BMI 29.8 ± 2.9 kg/m2; waist circumference 102.8 ± 7.1 cm) were included in this three-period, randomized, crossover, controlled-feeding study. Each diet was provided for 4-weeks with a minimum 2-week wash-out period. At baseline and the end of each diet period subjects provided a fecal sample for 16S rRNA gene sequencing. QIIME2 was used for data filtration, sequence clustering, taxonomy assignment and statistical analysis. Linear discriminant analysis Effect Size (LEfSe) analyses were used to determine enriched biomarker taxa following each diet. Results No between-diet differences in alpha diversity were observed based on Faith's Phylogenetic Diversity, Observed Operational Taxonomic Units (OTUs), and Pielou's Evenness (Kruskal-Walllis, P &amp;gt; 0.05). Principal coordinate analysis showed beta-diversity following the HSD significantly differed from baseline (PERMANOVA, P = 0.030). LEfSe pairwise analyses identified multiple taxa that were differentially abundant following the spice-containing diets vs. baseline. Compared to baseline, 34 taxa were enriched with the HSD, 22 taxa were enriched with the MSD and 20 taxa were enriched with the LSD. Members of the taxa enriched with the HSD are known short-chain fatty acid producers (Faecalibacterium and Butyricimonas). Conclusions The addition of herbs and spices at 0.5, 3.3, and 6.6 g/day/2100 kcal to an average American diet altered gut microbiota composition, and resulted in enrichment of short-chain fatty acid producers, after 4-weeks in adults at elevated risk for CVD. Funding Sources McCormick Science Institute; NCATS NIH (1UL1TR002014–01); Grant from the Howard Hughes Medical Institute through the Precollege and Undergraduate Science Education Program to Juniata College supported the computational research.

A Culinary Dose of Herbs and Spices Improves 24-Hour Blood Pressure in Adults at Risk for Cardiometabolic Diseases: A Randomized, Crossover, Controlled-Feeding Study

Abstract Objectives Intake of a herb/spice containing meal attenuates post-prandial lipemia, hyperglycemia and oxidative stress, and improves endothelial function. No randomized controlled trials have examined the cardiometabolic effects of longer-term intake of mixed herbs and spices. We aimed to assess the effect of an average American diet containing herbs and spices at 0.5 (Low Spice Diet; LSD), 3.3 (Moderate Spice Diet; MSD) and 6.6 (High Spice Diet; HSD) g/day/2100 kcal on lipids/lipoproteins as well as other risk factors for cardiometabolic diseases in at-risk adults. Methods A three-period, randomized, crossover, controlled-feeding study including 71 participants (55% female; 44 ± 11 years, BMI 29.7 ± 2.9 kg/m2; waist circumference 102.4 ± 7.3 cm) was conducted. Each diet was provided for 4-weeks with a minimum 2-week wash-out period. Outcomes were assessed at baseline and the end of each diet period. On 2 separate days at each time point a fasting blood draw was taken for analysis of lipids/lipoproteins, glucose and insulin. A SphygmoCor XCEL was used for pulse wave analysis and pulse wave velocity assessment, and participants wore an ambulatory blood pressure monitor for a 24-hour period. Results No between-diet effects were observed for LDL-cholesterol, the primary outcome. Between-diet differences were observed for mean 24-hour systolic (P &amp;lt; 0.001) and diastolic (P &amp;lt; 0.001) blood pressure. The HSD lowered mean 24-hour systolic and diastolic blood pressure compared to the MSD (−2.2 mmHg; 95% CI −0.7, −3.8; P = 0.002 and −1.6 mmHg; 95% CI −0.6, −2.5; P &amp;lt; 0.001, respectively) and LSD (−2.1 mmHg; 95% CI −3.6, −0.6; P = 0.004 and −1.7 mmHg; 95% CI −0.7, −2.7; P &amp;lt; 0.001, respectively); no differences were detected between the LSD and MSD. No between-diet effects were observed for clinic measured blood pressure, markers of glycemia, or vascular function. Conclusions In the context of a suboptimal U.S. style diet, addition of a culinary dose of mixed herbs and spices (6.6 g/day/2100kcal) improved 24-hour blood pressure after 4-weeks, compared to lower doses (0.5 and 3.3 g/day/2100 kcal), in adults at elevated risk for cardiometabolic diseases. Funding Sources McCormick Science Institute and the National Center for Advancing Translational Sciences, National Institutes of Health (1UL1TR002014–01).

Alternative diets among adolescents: facts or fads?

With rising rates of chronic noninfectious diseases across the United States thought to be associated with the average American diet, many have adopted alternative diets. Most of these diets promise weight reduction via adherence to strict dietary guidelines, often removing certain types of food. With access to a plethora of information online, it is easy for adolescents to become confused when making dietary decisions. Although these diets promise benefits, it is important to understand common shortcomings and how to overcome them for safe implementation among adolescents. This review discusses the theory, implementation, and risks associated with intermittent fasting as well as vegetarian, vegan, ketogenic, Atkins, Paleolithic, and Mediterranean diets. These considerations are further modified for pediatric populations with a focus on the social influences on dieting. Although these diets may be promising, successful adherence to them requires addressing possible shortcomings associated with a certain diet. Pediatricians should be aware of how these dietary strategies may be properly implemented in order to prevent any harm to the patient. Empowering the patient and their families through informational resources is recommended. Pediatricians should also discuss motivations underlying their patient's dietary changes in order to determine whether these motivations are healthy.

The Type and Amount of Dietary Fat Affect Plasma Factor VIIc, Fibrinogen, and PAI-1 in Healthy Individuals and Individuals at High Cardiovascular Disease Risk: 2 Randomized Controlled Trials

Factor VIIc, fibrinogen, and plasminogen activator inhibitor 1 (PAI-1) are cardiovascular disease (CVD) risk factors and are modulated, in part, by fat type and amount. We evaluated fat type and amount on the primary outcomes: factor VIIc, fibrinogen, and PAI-1. In the Dietary Effects on Lipoproteins and Thrombogenic Activity (DELTA) Trial, 2 controlled crossover feeding studies evaluated substituting carbohydrate or MUFAs for SFAs. Study 1: healthy participants (n=103) were provided with (8 wk) an average American diet [AAD; designed to provide 37% of energy (%E) as fat, 16% SFA], a Step 1 diet (30%E fat, 9% SFA), and a diet low in SFA (Low-Sat; 26%E fat, 5% SFA). Study 2: participants (n=85) at risk for CVD and metabolic syndrome (MetSyn) were provided with (7 wk) an AAD, a step 1 diet, and a high-MUFA diet (designed to provide 37%E fat, 8% SFA, 22% MUFA). Study 1: compared with AAD, the Step 1 and Low-Sat diets decreased mean factor VIIc by 1.8% and 2.6% (overall P=0.0001), increased mean fibrinogen by 1.2% and 2.8% (P=0.0141), and increased mean square root PAI-1 by 0.0% and 6.0% (P=0.0037), respectively. Study 2: compared with AAD, the Step 1 and high-MUFA diets decreased mean factor VIIc by 4.1% and 3.2% (overall P<0.0001), increased mean fibrinogen by 3.9% and 1.5% (P=0.0083), and increased mean square-root PAI-1 by 2.0% and 5.8% (P=0.1319), respectively. Replacing SFA with carbohydrate decreased factorVIIc and increased fibrinogen in healthy and metabolically unhealthy individuals and also increased PAI-1 in healthy subjects. Replacing SFA with MUFA decreased factorVIIc and increased fibrinogen but less than carbohydrate. Our results indicate an uncertain effect of replacing SFA with carbohydrate or MUFA on cardiometabolic risk because of small changes in hemostatic factors and directionally different responses to decreasing SFA. This trial was registered at https://clinicaltrials.gov/ct2/show/NCT00000538?term=NCT00000538&rank=1 as NCT00000538.