Intake Of Green Leafy Vegetables Research Articles

Editors' note: Nutrients and bioactives in green leafy vegetables and cognitive decline: Prospective study

In “Nutrients and bioactives in green leafy vegetables and cognitive decline: Prospective study,” authors Morris et al. described that a high intake of green leafy vegetables protects against cognitive decline. Drs. Kurlawala et al. suggest that the high fiber in leafy greens may influence the gut microbiome to decrease inflammation and, from there, the development of neurodegenerative disease. They call for further studies into the links among diet, gut microbiome, and neurodegenerative disease. In “Nutrients and bioactives in green leafy vegetables and cognitive decline: Prospective study,” authors Morris et al. described that a high intake of green leafy vegetables protects against cognitive decline. Drs. Kurlawala et al. suggest that the high fiber in leafy greens may influence the gut microbiome to decrease inflammation and, from there, the development of neurodegenerative disease. They call for further studies into the links among diet, gut microbiome, and neurodegenerative disease.

Fruit and Vegetable Consumption and Their Association With the Indicators of Iron and Inflammation Status Among Adolescent Girls

Background: The objective of this study was to identify an association among dietary components, iron, and inflammatory status among adolescent girls.Method: Dietary information for 85 adolescent girls was collected through food frequency questionnaires. Biomarkers of iron and inflammatory status were analyzed.Results: We found that 28.2% of adolescent girls had anemia and 65.9% girls were iron-deficient. Girls who did not consume guava had 3.8-fold (95% confidence interval =1.1–9.4; p = 0.020) increased the risk of having low serum iron levels. Girls who consumed amaranth had significantly (p = 0.024) higher serum hepcidin levels (n = 44; 129.7 ± 81.40 pg/mL vs n = 41; 94.6 ± 55.8 pg/mL) as well as ferritin levels (n = 44; 19.7 ± 16.4 µg/L vs n = 41; 14.0 ± 10.2 µg/L). Overall consumption of fruits and green leafy vegetables among girls significantly affects their iron status.Conclusions: Regular consumption of vitamin C–rich fruits and green leafy vegetable intake are imperative for improvement of iron status among adolescent girls.

Pre-pregnancy fast food and fruit intake is associated with time to pregnancy.

STUDY QUESTION Is preconception dietary intake associated with reduced fecundity as measured by a longer time to pregnancy (TTP)? SUMMARY ANSWER Lower intake of fruit and higher intake of fast food in the preconception period were both associated with a longer TTP. WHAT IS KNOWN ALREADY Several lifestyle factors, such as smoking and obesity, have consistently been associated with a longer TTP or infertility, but the role of preconception diet in women remains poorly studied. Healthier foods or dietary patterns have been associated with improved fertility, however, these studies focused on women already diagnosed with or receiving treatments for infertility, rather than in the general population. STUDY DESIGN, SIZE, DURATION This was a multi-center pregnancy-based cohort study of 5628 nulliparous women with low-risk singleton pregnancies who participated in the Screening for Pregnancy Endpoints (SCOPE) study. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 5598 women were included. Data on retrospectively reported TTP and preconception dietary intake were collected during the first antenatal study visit (14-16 weeks' gestation). Dietary information for the 1 month prior to conception was obtained from food frequency questions for fruit, green leafy vegetables, fish and fast foods, by a research midwife. Use of any fertility treatments associated with the current pregnancy was documented (yes, n = 340, no, n = 5258). Accelerated failure time models with log normal distribution were conducted to estimate time ratios (TR) and 95% CIs. The impact of differences in dietary intake on infertility (TTP >12 months) was compared using a generalized linear model (Poisson distribution) with robust variance estimates, with resulting relative risks (RR) and 95% CIs. All analyses were controlled for a range of maternal and paternal confounders. Sensitivity analyses were conducted to explore potential biases common to TTP studies. MAIN RESULTS AND THE ROLE OF CHANCE Lower intakes of fruit and higher intakes of fast food were both associated with modest increases in TTP and infertility. Absolute differences between the lowest and highest categories of intake for fruit and fast food were in the order of 0.6-0.9 months for TTP and 4-8% for infertility. Compared with women who consumed fruit ≥3 times/day, the adjusted effects of consuming fruit ≥1- 0- 0-<2 times/week, or no fast food, corresponded to an 18, 34 and 41% reduced risk of infertility (Ptrend <0.001). Pre-pregnancy intake of green leafy vegetables or fish were not associated with TTP or infertility. Estimates remained stable across a range of sensitivity analyses. LIMITATIONS, REASONS FOR CAUTION Collection of dietary data relied on retrospective recall and evaluated a limited range of foods. Paternal dietary data was not collected and the potential for residual confounding cannot be eliminated. Compared to prospective TTP studies, retrospective TTP studies are prone to a number of potential sources of bias. WIDER IMPLICATIONS OF THE FINDINGS These findings underscore the importance of considering preconception diet for fecundity outcomes and preconception guidance. Further research is needed assessing a broader range of foods and food groups in the preconception period. STUDY FUNDING/COMPETING INTEREST(S) The SCOPE database is provided and maintained by MedSciNet AB (http://medscinet.com). The Australian SCOPE study was funded by the Premier's Science and Research Fund, South Australian Government (http://www.dfeest.sa.gov.au/science-research/premiers-research-and-industry-fund). The New Zealand SCOPE study was funded by the New Enterprise Research Fund, Foundation for Research Science and Technology; Health Research Council (04/198); Evelyn Bond Fund, Auckland District Health Board Charitable Trust. The Irish SCOPE study was funded by the Health Research Board of Ireland (CSA/2007/2; http://www.hrb.ie). The UK SCOPE study was funded by National Health Service NEAT Grant (Neat Grant FSD025), Biotechnology and Biological Sciences Research council (www.bbsrc.ac.uk/funding; GT084) and University of Manchester Proof of Concept Funding (University of Manchester); Guy's and St. Thomas' Charity (King's College London) and Tommy's charity (http://www.tommys.org/; King's College London and University of Manchester); and Cerebra UK (www.cerebra.org.uk; University of Leeds). L.E.G. is supported by an Australian National Health and Medical Research Council (NHMRC) Early Career Fellowship (ID 1070421). L.J.M. is supported by a SACVRDP Fellowship; a program collaboratively funded by the National Heart Foundation, the South Australian Department of Health and the South Australian Health and Medical Research Institute. L.C.K. is supported by a Science Foundation Ireland Program Grant for INFANT (12/RC/2272). C.T.R. was supported by a National Health and Medical Research Council (NHMRC) Senior Research Fellowship (GNT1020749). There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable.

Prevalence of risk factors for non-communicable diseases in urban slum of Salem, Tamil Nadu

Background: Developing countries like India are experiencing increased burden of non-communicable diseases causing significant morbidity and mortality, both in urban and rural population. In this study we assessed the Risk factors of NCDs and its burden.Methods: There are four slums in the field practice area of UHTC, Annapoorana Medical College, Salem. Out of which one slum was selected by lot sampling and the participants by simple random sampling method. This survey included a total of 512 participants (272 males, 240 females) of age &gt;20 years. The participants were interviewed with a pre-tested questionnaire. The study instrument was based on WHO STEP wise approach for surveillance of NCDs. STEP 1 and STEP 2 were used in our study. The performa included anthropometric measurements, blood pressure and questions related to tobacco use, alcohol consumption, dietary pattern, physical exercise. Microsoft Excel 2007 was used for data entry, SPSS version 24 for data analysis.Results: It was found that the prevalence of risk factors for NCDs was high. Tobacco use in any form was seen in 21.3% of the study population, alcohol consumption in 28.1%, overweight and obesity in 20.7%, sedentary habits in 84.6%, irregular intake of green leafy vegetables and fruits in 85% and high salt intake in 38.5% was observed.Conclusions: The study showed higher prevalence of risk factors for NCDs. This alarms the heavy future burden of NCDs in the urban slum that requires appropriate early actions to prevent risk factors, reducing the disease burden.

Nutritional and mineral composition of selected green leafy vegetables

Green Leafy Vegetables (GLV) is essential for healthy life. The analysis of nutritional composition and some essential major elements such as calcium, magnesium, potassium and sodium of the leaves of Cardiospermum halicacabum, Premna latifolia, Delonix elata, Argyreia pomacea, Mollugo pentaphylla and Pisonia grandis were carried out using standard methods. The results ranged as follows; moisture (62.86 ±2.55 - 77.80 ±3.27%), ash (7.33 ± 0.38 - 12.49 ±0.22 %), fat (2.18 ±0.09 - 4.75 ±0.22 %), fiber (7.88 ±0.61 - 15.30 ±0.59 %), protein (0.53 ±0.04 -3.52 ±0.06 %) and carbohydrate (0.89 ±0.09 - 5.65 ±0.11%). Vitamin C content was determined using a well-established 2, 4-dinitrophenyl hydrazine method (DNPH). Vitamin C content of GLVs ranged from 134.50 ±2.61 mg/100g for D. elata to 12.43 ±3.44 mg/100g for A. pomacea. Total phenolic content was in the range of 4.28 ±1.2mg GAE/100g for M. pentaphylla and 46.07 ±3.42 mg GAE/100g for D. elata. The mineral elements were ranged as follows: Sodium (116.4 ±3.8 - 190.2 ±2.6 mg/100g), potassium (94.5 ±2.9 - 127.3 ±2.4 mg/100g), calcium (84.9 ±2.2 - 272.6 ±2.8mg/100g) and magnesium (28.3 ±2.5 - 103.6 ±4.2 mg/100g). The results suggest that the green leafy vegetables contain considerable amount of essential micronutrients in addition to the presence of high amounts of vitamin C. The results also indicate that the high intake of GLVs could provide nutritional requirements necessary for the normal growth thus giving adequate protection against diseases arising from malnutrition.

Household Food and Nutrient Intake of Semai Aborigines of Peninsular Malaysia

Background: Malaysia is experiencing nutrition transition currently whereby the spectrum of nutrition is shifting from malnutrition towards overweight and obesity. The indigenous population of Malaysia continues to be in a state of poverty which apparently affects their food and nutrient intake. Methods: A total of 462 households with 2367 inhabitants irrespective of age and physiologic group were selected from 40 village zones spread along seven districts of Perak by population proportion to size sampling. The demographic, socio-economic, educational status and availability of physical amenities were collected through a pre-tested questionnaire. Food and nutrient intake was assessed by twenty-four-hour recall method on all members of households. All results were presented as mean values and percentages. Results: 71% of the families live below Poverty Level Incomes. Only 34% of men and 31% of women had received formal education. The Semai aborigines could meet only 70% of their energy needs. Cereals and pulses (92.5% of RNI) formed the major dietaries. Insufficient intake of green leafy vegetables (<50% of RNI), fruits (30% of RNI) and dairy products (15% of RNI) marked poor dietary diversity. Less than 50% of mean intake were recorded for vitamin A (14%), riboflavin (33.51%), iron (41%) and iodine (49%). Inadequate education, fewer employment, poor sanitary conditions, poor choices and unavailability of nutrient rich foods are the major factors that contribute to poor dietary diversity. The intervention and supplementation programs have not reached the marginalized community alike especially those residing in interior of forest fringes. Application: Nutrition education and empowerment in terms of education and employment can revert the current situation. Keywords: Food Pattern, Nutrient Intake, Malaysia, Orang Asli, Semai

Assessment of food habits and dietary intake of rural women

A survey was carried out to assess the health and dietary status of rural women of Shaheed Bhagat Singh District. The data pertaining to background information, food habits and morbidity status were collected through an interview schedule. The results revealed that there was quite lower intake of green leafy vegetables (3.9%), fruits (14.8%), roots, tubers and other vegetables (31.9%), pulses (62.5%), cereals (71.9%) and milk products (72.3%) as compared to Suggested Dietary Guidelines (SDI) by the Indian Council of Medical Research. While the intake of fats and oils (112.9%) was found more than the SDI probably due to wrong feeding habits. The study also revealed that fever, cold, tiredness, headache and loss of appetite was frequently occurring health problems among the respondents, probably due to less intake of food items as suggested. Thus, it can be said that to improve the heath status of the respondents right feeding practices need to be taught through nutritional counseling, trainings, seminars and campaign etc.

Differences in modifiable factors of oral squamous cell carcinoma in the upper and lower of oral fissure.

The aim of this study was to explore differences in the effects of modifiable factors on oral squamous cell carcinoma (OSCC) occurring in the lower oral fissure (LOF) and upper oral fissure (UOF). We conducted a case-control study with 697 OSCC patients (119 UOF and 578 LOF) and 1910 frequency-matched controls in Fujian province, China. Data on demographic characteristics and possible modifiable factors was collected using a structured questionnaire. Unconditional logistic regression was utilized to calculate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Alcohol drinking was more strongly associated with an increased risk of OSCC-LOF than OSCC-UOF. Tobacco smoking, the number of teeth lost ≥5, wearing denture, and recurrent oral ulceration showed similarly associations with OSCC-LOF and -UOF risk. Similarly, the beneficial effects of tea consumption, tooth-brushing ≥2times per day, high intake of fresh fish, seafood, green-leafy vegetables, other vegetables and fruits were not significantly different on OSCC-LOF and -UOF. Although most of the modifiable factors exert similar effects on both OSCC sites, this study suggests that the sites of oral cavity in LOF may be affected more by alcohol drinking than the sites in UOF. Further studies with larger samples are warranted to confirm our findings.

Abstract 5315: Dietary intake and risk of lung cancer in non-smoking women: a hospital-based case-control study in Xuanwei and Fuyuan, China

Abstract Xuanwei and Fuyuan are rural counties in China that have the highest lung cancer rates in the country among non-smoking women. This alarming public health burden has been attributed to the combustion of smoky (bituminous) coal for heating and cooking, which can produce carcinogenic emissions such as polycyclic aromatic hydrocarbons (PAHs). Previous studies found that green leafy vegetables could absorb PAHs through air and direct soil contamination. Further, oral ingestion of PAHs was found be to associated with pulmonary adenoma development in animal feeding studies. Therefore, we investigated the associations between lung cancer risk and dietary intake of specific green leafy vegetables and other foods in non-smoking women of this farming region. We conducted a hospital-based case-control study of 1,074 female lung cancer patients and 977 frequency-matched controls from Xuanwei and Fuyuan, China in 2006-2013. Dietary intake was self-reported on questionnaires and categorized as never, several times/year, several times/month, several times/week, and every day. Unconditional logistic regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (CI) of lung cancer in relation to intake of specific green leafy vegetables (i.e. lettuce, cabbage, fennel, spinach, hollow vegetables), corn, buckwheat, carrots, tomatoes, dried and fresh chili, pickled vegetables, bean curd, mushrooms, and preserved meats. Models were adjusted for age, county, first-degree relative with lung cancer, passive smoke exposure, education, lifetime smoky coal tonnage, respiratory disease history, time spent indoors, and menopausal status. Separate models were fitted for each dietary factor. We found that increased consumption of several green leafy vegetables was associated with increased risk of lung cancer. Eating hollow vegetables every day was associated with 2.50 (95% CI: 1.18, 5.27) times the odds of lung cancer compared to never. Similarly, eating lettuce (OR=2.13, 95% CI: 1.41, 3.21) and cabbage (OR=1.82, 95% CI: 1.21, 2.69) every day was associated with increased risks compared to several times a year or less. Conversely, eating bean curd (OR=0.54, 95% CI: 0.40, 0.72) several times a week was associated with decreased risk compared to several times a year or less; while eating buckwheat (OR=0.59, 95% CI: 0.40, 0.89) several times a week was associated with decreased risk compared to never. No significant associations were found for fennel, spinach, and other foods. Our findings suggest that increased consumption of a variety of green leafy vegetables may be related to elevated lung cancer risk in non-smoking women from Xuanwei and Fuyuan, China, independent of other risk factors. The increased risk may be due to environmental contamination of crops from coal combustion. Conversely, frequent consumption of bean curd and buckwheat was found to be protective. Citation Format: Jason Y. Wong, Bryan A. Bassig, Wei Hu, Jinming Zhang, Wei Jie Seow, Neil E. Caporaso, Bu-tian Ji, Robert S. Chapman, George S. Downward, Jihua Li, Jun He, Kaiyun Yang, Yunchao Huang, Roel Vermeulen, Nathaniel Rothman, Qing Lan. Dietary intake and risk of lung cancer in non-smoking women: a hospital-based case-control study in Xuanwei and Fuyuan, China [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 5315. doi:10.1158/1538-7445.AM2017-5315

Feasibility Outcomes of a Pilot Randomized Controlled Trial to Increase Cruciferous and Green Leafy Vegetable Intake in Post‐Treatment Head and Neck Cancer Survivors

ObjectivePrevious research has shown higher intake of green leafy (GLV) and cruciferous vegetables (CV) are associated with improved biomarkers of prognosis and disease‐free survival in patients diagnosed with head and neck cancer (HNC). These observational study results have not yet been corroborated in a randomized controlled trial (RCT). The purpose of this study was to determine the feasibility of implementing a RCT to increase CV and GLV intake in post‐treatment HNC survivors.MethodsBetween January 2015 – April 2015, 17 post‐treatment HNC survivors were recruited via an institutional cancer registry and randomized to one of two groups: 1) an intervention group (n=9) that received weekly telephone dietary counseling aimed at reaching specific goals for weekly intake of CV (2.5 cups/week) and GLV (3.5 cups/week) or 2) a usual care attention control group (n=8). Participants completed a baseline survey, three 24‐hour dietary recalls, a blood draw, and anthropometric measures prior to randomization and at the end of the 12‐week study period. Feasibility outcomes included recruitment, retention, adherence, and safety. Retention was measured as the number completing the 12‐week study. Adherence was measured as completion of the weekly telephone sessions (for both groups) and self‐reported weekly CV and GLV intake for the intervention group.ResultsDuring the enrollment period, 350 incident HNC cases were screened for eligibility. Of these, n=98 were eligible for study participation and n=252 were ineligible. Reasons for ineligibility were “deceased” (n=93), “wrong/inactive numbers/unable to reach” (n=60) and “medical exclusions” (n=27). Of the n=98 eligible HNC cases, n=17 agreed to participate for an enrollment rate of 17.3%. The most common reason for non‐participation was “distance” (n=48). Other reasons for non‐participation included “not interested” (n=19) and “too busy” (n=5). Throughout the study period the retention rate was 100%. Mean intervention adherence rates for weekly goals were 68.7% for GLV, 66.6% for CV, and 66.9% overall. The mean adherence rate for completion of weekly telephone counseling was 92.5%. No serious adverse events were reported. Participants in the intervention group reported an overall mean increase of 4.4 and 2.9 cups of GLV and CV per week from baseline (pre‐intervention) intake, respectively.ConclusionThese results support the feasibility and acceptability of a post‐treatment intervention aimed at increasing CV and GLV intake in HNC survivors and suggest it may offer a promising strategy to improve vegetable consumption in this population. A larger RCT is warranted to assess the efficacy of this intervention on disease outcomes.Support or Funding InformationThis study was supported by a NIH/NCI Cancer Prevention and Control Training Grant: R25 CA047888 and a Research Enhancement Project Grant from the University of Alabama at Birmingham Center for Palliative and Supportive Care.

Determinants of anemia among pregnant mothers attending antenatal care in Dessie town health facilities, northern central Ethiopia, unmatched case -control study.

IntroductionAnemia affects around 38.2% and 22% of pregnant women at a global and national level respectively. In developing countries, women start pregnancy with already depleted body stores of iron and other vitamins with significant variation of anemia within and between regions.ObjectiveTo identify the determinants of anemia among pregnant mothers attending antenatal care in Dessie town health facilities, northern central Ethiopia.MethodsA health facility based unmatched case control study was conducted among 112 cases and 336 controls from January to March 2016 G.C. The sample size was determined by using Epi Info version 7.1.5.2. Study subjects were selected using consecutive sampling technique. Data were collected using a structured questionnaire, entered using Epi Data version 3.1 and analyzed using SPSS version 20. Bivariable and multivariable logistic regression model was used to see the determinants of anemia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value<0.05 were used to see the significant association.ResultsFailure to take dark green leafy vegetables per two weeks (AOR = 5.02, 95% CI: 2.16, 11.71), didn’t take chicken per two weeks (AOR = 2.68, 95% CI: 1.22, 5.86), 1st trimester (AOR = 2.07, 95% CI: 1.12, 3.84), 3rd trimester (AOR = 2.96, 95% CI: 1.53, 5.72), HIV infection (AOR = 6.78, 95% CI: 2.28, 20.18) and medication (AOR = 3.57 95% CI: 1.60, 7.98) were positively associated with anemia.ConclusionsInadequate intake of dark green leafy vegetables, inadequate consumption of chicken, trimester of the current pregnancy, HIV infection and medication were the determinants of anemia among pregnant women. Therefore, anemia prevention strategy should include promotion of adequate intake of dark green leafy vegetables and chicken, increase meal pattern during the entire pregnancy and strengthen the prevention of mother to child HIV transmission/antenatal care programs.

An Adolescent and Early Adulthood Dietary Pattern Associated with Inflammation and the Incidence of Breast Cancer.

Adolescence is a highly susceptible period for mammary carcinogenesis, but few prospective studies have examined the role of adolescent diet in breast cancer risk. Reduced rank regression has previously been used to identify a dietary pattern associated with markers of inflammation (C-reactive protein, IL6, and TNFα receptor 2). We investigated whether an adolescent and early adulthood inflammatory dietary pattern was associated with breast cancer among 45,204 women in the Nurses' Health Study II using reduced rank regression. Participants completed a food frequency questionnaire in 1998 about their high school diet (HS-FFQ) and a FFQ in 1991 when they were ages 27-44 years. Among women who completed the HS-FFQ, 1,477 cases of breast cancer were diagnosed during 22 years of follow-up. An adolescent and early adulthood dietary pattern characterized by inflammation was associated with an increased incidence of premenopausal but not postmenopausal breast cancer. Women in the fifth quintile of the inflammatory pattern score had multivariable adjusted HRs for premenopausal breast cancer of 1.35 for adolescent diet [95% confidence interval (95% CI), 1.06-1.73; Ptrend = 0.002] and 1.41 for early adulthood diet (95% CI, 1.11-1.78; Ptrend = 0.006) compared with women in the first quintile. The corresponding RRs for postmenopausal breast cancer were 0.84 (95% CI, 0.60-1.17) for adolescent and 0.76 (95% CI, 0.54-1.06) for adult intake. Overall, our findings support the notion that an adolescent and early adulthood diet characterized by high intake of sugar-sweetened and diet soft drinks, refined grains, red and processed meat, and margarine, and low intake of green leafy vegetables, cruciferous vegetables, and coffee may increase the incidence of premenopausal breast cancer. Cancer Res; 77(5); 1179-87. ©2017 AACR.

Fruit and vegetable intake and risk of incident of type 2 diabetes: results from the consortium on health and ageing network of cohorts in Europe and the United States (CHANCES).

There is limited information to support definitive recommendations concerning the role of diet in the development of type 2 Diabetes mellitus (T2DM). The results of the latest meta-analyses suggest that an increased consumption of green leafy vegetables may reduce the incidence of diabetes, with either no association or weak associations demonstrated for total fruit and vegetable intake. Few studies have, however, focused on older subjects. The relationship between T2DM and fruit and vegetable intake was investigated using data from the NIH-AARP study and the EPIC Elderly study. All participants below the age of 50 and/or with a history of cancer, diabetes or coronary heart disease were excluded from the analysis. Multivariate logistic regression analysis was used to calculate the odds ratio of T2DM comparing the highest with the lowest estimated portions of fruit, vegetable, green leafy vegetables and cabbage intake. Comparing people with the highest and lowest estimated portions of fruit, vegetable or green leafy vegetable intake indicated no association with the risk of T2DM. However, although the pooled OR across all studies showed no effect overall, there was significant heterogeneity across cohorts and independent results from the NIH-AARP study showed that fruit and green leafy vegetable intake was associated with a reduced risk of T2DM OR 0.95 (95% CI 0.91,0.99) and OR 0.87 (95% CI 0.87,0.90) respectively. Fruit and vegetable intake was not shown to be related to incident T2DM in older subjects. Summary analysis also found no associations between green leafy vegetable and cabbage intake and the onset of T2DM. Future dietary pattern studies may shed light on the origin of the heterogeneity across populations.

Association of Dietary Nitrate Intake With Primary Open-Angle Glaucoma: A Prospective Analysis From the Nurses' Health Study and Health Professionals Follow-up Study.

Nitric oxide signaling alterations in outflow facility and retinal blood flow autoregulation are implicated in primary open-angle glaucoma (POAG). Nitric oxide donation has emerged as a POAG therapeutic target. An exogenous source of nitric oxide is dietary nitrates. To evaluate the association between dietary nitrate intake, derived mainly from green leafy vegetables, and POAG. We followed up participants biennially in the prospective cohorts of the Nurses' Health Study (63 893 women; 1984-2012) and the Health Professionals Follow-up Study (41 094 men; 1986-2012) at each 2-year risk period. Eligible participants were 40 years or older, were free of POAG, and reported eye examinations. The primary exposure was dietary nitrate intake. Information on diet and potential confounders was updated with validated questionnaires. The main outcome was the incidence of POAG and POAG subtypes; 1483 cases were confirmed with medical records and classified into subtypes defined by intraocular pressure (IOP) (≥22 or <22 mm Hg) or by visual field (VF) loss pattern at diagnosis (peripheral loss only or early paracentral loss). Cohort-specific and pooled multivariable rate ratios (MVRRs) and 95% CIs were estimated. During 1 678 713 person-years of follow-up, 1483 incident cases of POAG were identified. The mean (SD) age for the 1483 cases was 66.8 (8.3). Compared with the lowest quintile of dietary nitrate intake (quintile 1: approximately 80 mg/d), the pooled MVRR for the highest quintile (quintile 5: approximately 240 mg/d) was 0.79 (95% CI, 0.66-0.93; P for trend = .02). The dose response was stronger (P for heterogeneity = .01) for POAG with early paracentral VF loss (433 cases; quintile 5 vs quintile 1 MVRR = 0.56; 95% CI, 0.40-0.79; P for trend < .001) than for POAG with peripheral VF loss only (835 cases; quintile 5 vs quintile 1 MVRR = 0.85; 95% CI, 0.68-1.06; P for trend = .50). The association did not differ (P for heterogeneity = .75) by POAG subtypes defined by IOP (997 case patients with IOP ≥22 mm Hg: quintile 5 vs quintile 1 MVRR = 0.82; 95% CI, 0.67-1.01; P for trend = .11; 486 case patients with IOP <22 mm Hg: quintile 5 vs quintile 1 MVRR = 0.71; 95% CI, 0.53-0.96; P for trend = .12). Green leafy vegetables accounted for 56.7% of nitrate intake variation. Compared with consuming 0.31 servings per day, the MVRR for consuming 1.45 or more servings per day was 0.82 for all POAG (95% CI, 0.69-0.97; P for trend = .02) and 0.52 for POAG with paracentral VF loss (95% CI, 0.29-0.96; P for trend < .001). Higher dietary nitrate and green leafy vegetable intake was associated with a lower POAG risk, particularly POAG with early paracentral VF loss at diagnosis.

The effect of green leafy and cruciferous vegetable intake on the incidence of cardiovascular disease: A meta-analysis.

Does the consumption of green leafy vegetables including cruciferous vegetables significantly reduce the incidence of cardiovascular disease? This research question was answered via employing the statistical methods of meta-analysis by synthesizing relevant worldwide studies that address the association between the consumption of green leafy vegetables and risk of incidence of said diseases. All meta-analysis calculations included determination of effect sizes of relative risk, and their respective 95% confidence intervals, heterogeneity of the studies, relative weights for each study, and significance (p) for each study. Eight studies met the inclusion criteria, which investigated the relationship between the incidences of total cardiovascular disease with the intake of green leafy vegetables. The overall effect size (random effect model) was: RR = 0.842 (95% CI = 0.753 to 0.941), p = 0.002, which indicates a significant 15.8% reduced incidence of cardiovascular disease.

Dietary Habits of Type 2 Diabetes Patients: Variety and Frequency of Food Intake.

The objective of the present study was to observe the dietary patterns and food frequencies of type 2 diabetes patients attending the clinics of the Family Practice Center of the University of Sri Jayewardenepura, located in a highly urbanized area in Sri Lanka. An interviewer administered questionnaire based cross-sectional study was conducted among randomly selected 100 type 2 diabetes patients [age 35–70 years; mean age 55 ± 9 (males = 44; females = 56)]. The data were analyzed by SPSS version 18.0 software. Vegetables, fatty foods, and poultry consumption were in accordance with the national guidelines. A significant percentage (45.5%) consumed rice mixed meals for all three meals and only 67% consumed fruits at least once a day. Majority (71%) consumed full-cream milk and sugar intake (77%) was in accordance with the guidelines. Noncaloric sweetener usage was nonexistent. Daily green leafy vegetable intake and the quantity consumed were inadequate to obtain beneficial effects. From the study population, 44% [females 50%; males 36%] of the patients were either overweight or obese. However, only 60% of those patients accepted that they were either overweight or obese. Only 14% exercised daily while 69% never exercised. Study revealed the importance of educating patients with type 2 diabetes on dietary changes and more importantly the involvement in regular physical exercises.

Implementing Perennial Kitchen Garden Model to Improve Diet Diversity in Melghat, India.

Lack of diet diversity causing micronutrient deficiency is common in developing countries and is gaining attention due to the hidden consequences of impaired physical and cognitive development. This paper describes the propagation of a sustainable perennial kitchen garden (KG) model to address household (HH) diet diversity in Melghat. Nutrient dense plants, comprising of minimum one tree (perennial) and one green leafy vegetable (GLV) were given to participating HHs along with qualitative interventions. Baseline survey was conducted in winter 2011 followed by seasonal surveys over 2 years to record changes in KG practices, dietary intake and childcare practices. Marked increase from 4% at baseline to 95% at endline was seen in the KG maintainance. Increased diversity was seen in all food categories other than cereals and pulses. Variety of GLVs consumed increased over the two winters as well as the 2 summers. However, no change in the quantity of GLV consumed was noted which was attributed to the duration of the study period being insufficient for the trees to grow and provide adequate leaves for consumption. Notably, livelihood component was not promoted and HHs were encouraged to harvest and distribute excess seeds to relatives and neighbours. The study generated huge demand from HHs within the intervention and neighbouring villages. It concludes that a well designed perennial KG along with imparting adequate knowledge can be a sustainable practice to increase diet diversity and GLV intake which would help address micronutrient deficiencies in the community.

Higher intake of fruits, vegetables or their fiber reduces the risk of type2 diabetes: A meta-analysis.

Some previous studies reported no significant association of consuming fruit or vegetables, or fruit and vegetables combined, with type2 diabetes. Others reported that only a greater intake of green leafy vegetables reduced the risk of type2 diabetes. To further investigate the relationship between them, we carried out a meta-analysis to estimate the independent effects of the intake of fruit, vegetables and fiber on the risk of type2 diabetes. Searches of MEDLINE and EMBASE for reports of prospective cohort studies published from 1 January 1966 to 21 July 2014 were carried out, checking reference lists, hand-searching journals and contacting experts. The primary analysis included a total of 23 (11+12) articles. The pooled maximum-adjusted relative risk of type2 diabetes for the highest intake vs the lowest intake were 0.91 (95% confidence interval [CI] 0.87-0.96) for total fruits, 0.75 (95% CI 0.66-0.84) for blueberries, 0.87 (95% CI 0.81-0.93) for green leafy vegetables, 0.72 (95% CI 0.57-0.90) for yellow vegetables, 0.82 (95% CI 0.67-0.99) for cruciferous vegetables and 0.93 (95% CI 0.88-0.99) for fruit fiber in these high-quality studies in which scores were seven or greater, and 0.87 (95% CI 0.80-0.94) for vegetable fiber in studies with a follow-up period of 10years or more. A higher intake of fruit, especially berries, and green leafy vegetables, yellow vegetables, cruciferous vegetables or their fiber is associated with a lower risk of type2 diabetes.

Diet and Physical Activity in Relation to Metabolic Syndrome among Urban Indian Men and Women

The relationship of diet and physical activity with metabolic syndrome (MS) was studied among 60 male and female (40–60 y) urban Indian MS patients. Intake of green leafy vegetables, other vegetables, fruits and milk were significantly (p ≤ .01) associated with reduced fat mass and waist circumference and increased lean body mass. Energy, carbohydrates, and fat intakes were significantly (p ≤ .01) correlated with increased body fat and waist circumference and reduced lean body mass. Energy, total and saturated fat intake were positively and significantly (p ≤ .05; .01) correlated with total cholesterol. Total fat was also significantly (p ≤ .05; .01) correlated with increased systolic blood pressure (r = 0.33), serum triglycerides (r = 0.33), LDL-C (r = 0.29) and VLDL-C (r = 0.28). Increased TDEE was significantly (p ≤ .01) associated with decreased body fat and waist circumference (r = 0.53 and 0.60) and increased lean body mass (r = 0.68).

Behavioural risk factors distribution of cardiovascular diseases and its association with normotension, prehypertension and hypertension amongst tea garden population in Dibrugarh district of Assam

Problem consideredThe burden of cardiovascular diseases (CVD) in India is increasing at an alarming rate for the last few decades. AimsTo assess the distribution of behavioural risk factors of CVDs and its association with normotension, prehypertension and hypertension among tea garden population in Dibrugarh District of Assam. MethodsA community-based cross-sectional study using the World Health Organizations (WHO) Stepwise methodology. A multistep random sampling was done to include adults aged 35 years and above. Data was collected using a pretested and predesigned questionnaire and blood pressure was recorded. Statistical analysis was done using proportions, chi-square test and multiple logistic regression (MLR) analysis. ResultsPrevalence of hypertension was 44.8% (551) with 481 (39.1%) being pre hypertensive. Prevalence of tobacco use was 1107 (89.9%) with 1049 (85.2%) being current users while alcohol use was 858 (69.7%). Inadequate intake of green leafy vegetables (≤3 servings/week) was found in 807 (65.6%) and fruits in 1210 (98.3%). Weekly intake of high energy food was found in 176 (58.66%) while added salt intake in 758 (61.6%), Physical inactivity (mainly sedentary) in 339 (27.5%). MLR analysis showing significant association between educational status, stress, high energy food, tobacco use, alcohol, overweight/obesity and diabetes with prehypertension and physical activity, high energy food, tobacco use, alcohol, extra salt and diabetes with hypertension. ConclusionsThe study revealed high prevalence of various risk factors. There is a need to reduce the risk factor prevalence of CVD to address the future epidemic of non-communicable disease amongst this group.