Habitual Dietary Intake Research Articles

Habitual dietary calcium intakes and calcium metabolism in healthy adults Chinese: a systematic review and meta-analysis.

To investigate the metabolic differences of calcium requirements between Chinese and Westerners, we examined systematically the characteristics of calcium metabolism in Chinese adults with habitual dietary calcium intakes. We searched PubMed, Cochrane Library, SinoMed, and National Index to Chinese Newspapers & Periodicals, from inception to March 17, 2015, as well as the bibliographies of any relevant papers and journals, for trials assessing calcium metabolism in healthy Chinese adults within 18-60 years of age on the typical Chinese diet. We extracted a standardized dataset from metabolic studies that reported intake, retention, urinary excretion, faecal excretion and/or fractional absorption of calcium. We pooled data with a random effects meta-analysis. Of 2,046 citations identified by the search strategy, 12 studies (comprising 137 participants, 13 aggregate data deriving from 257 individual data) met the inclusion criteria. Metabolic data with self-chosen or typical Chinese diets were analyzed. Mean daily intakes of calcium ranged between 288 and 948 mg. Mean calcium retentions of each study were between 13 and 294 mg/d. The overall pooled value for dietary intake, urinary excretion, faecal excretion, retention and fractional absorption of calcium were 583 mg/d, 117 mg/d, 381 mg/d, 72 mg/d and 33.3%. Dietary calcium intake and faecal calcium excretion explained almost 85% of the heterogeneity of calcium retention. Chinese adults could maintain a positive calcium balance with plant-based diets at calcium intakes as low as 300 mg/d through increasing fractional calcium absorption and decreasing calcium excretion in urine and faeces.

The Association between Renal Hyperfiltration and the Sources of Habitual Protein Intake and Dietary Acid Load in a General Population with Preserved Renal Function: The KoGES Study.

Although the differential response of the kidney to the acute load of various sources of dietary protein in subjects with normal renal function is well known, the influence of habitual dietary protein intake and dietary acid load on renal function has not been tested well. The association between renal hyperfiltration (RHF), the earlier and possibly reversible stage of chronic kidney disease, and the sources of habitual dietary protein and dietary acid load was analyzed with the baseline data of 123,169 middle-aged healthy Koreans of a large prospective cohort study, who had a baseline estimated glomerular filtration rate (eGFR) >60 mL/min/m2 and no known history of diabetes and/or hypertension. eGFR was calculated with the Chronic Kidney Disease Epidemiology Collaboration equation using serum creatinine and RHF was defined as eGFR >95th percentile after adjustment for age, sex, height, and body weight. Dietary acid load was calculated with estimated net endogenous acid production (eNEAP). Although the level of habitual intake of animal protein was positively and vegetable protein was negatively associated with RHF, this association was significant only in women and younger participants (younger than sex-specific median age). The odds for RHF increased as the percentile rank of eNEAP increased until about the 50th percentile and then leveled off. The positive association between eNEAP and RHF was significant in both sexes and age groups. Dietary acid load was associated with RHF regardless of sex and age and rather than the amount of the total or the individual sources of habitual dietary protein, may be a better target for the dietary intervention of chronic kidney disease.

Association between adherence to the Mediterranean diet and semen quality parameters in male partners of couples attempting fertility.

Is adherence to the Mediterranean diet (MedDiet) associated with better semen quality in men of subfertile couples attempting fertility? Greater adherence to the MedDiet, as assessed through the validated Mediterranean diet score (MedDietScore), was significantly associated with higher sperm concentration, total sperm count and sperm motility. A-posteriori dietary pattern approaches have revealed that dietary patterns characterized by high intakes of fruits, vegetables, whole grains, fish and low intake of meat are associated with better semen quality. Yet, whether adherence to the MedDiet is associated with better semen profile remains largely unexplored. This was a cross-sectional study of 225 men from couples attending a fertility clinic in Athens, Greece, recruited between November 2013 and May 2016. The study was designed to evaluate the influence of habitual dietary intake and lifestyle on fertility outcomes. Men aged 26-55 years, 51.1% overweight or obese, 20.9% smokers, with complete dietary data were analyzed. Diet was assessed via a food-frequency questionnaire and adherence to the MedDiet was assessed through the MedDietScore (range: 0-55; higher scores indicating greater adherence to MedDiet). Semen quality was evaluated according to World Health Organization 2010 guidelines. Multiple logistic regression analysis was used to evaluate associations between tertiles of the MedDietScore and the likelihood of having abnormal semen parameters, after adjusting for potential confounders. Compared to men in the highest tertile of the MedDietScore (≥37, N=66), a higher percentage of men in the lowest tertile of the score (≤30, N=76) exhibited below the WHO reference values for sperm concentration (47.4% vs 16.7%, P<0.001), total sperm count (55.3% vs 22.7%, P<0.001), total motility (65.8% vs 31.8%, P<0.001), progressive motility (84.2 vs 62.1%, P=0.011) and sperm morphology (50.0 vs 28.8%, P=0.023). In the multivariable adjusted models, men in the lowest tertile of the MedDietScore had ~2.6 times higher likelihood of having abnormal sperm concentration, total sperm count and motility, compared to men in the highest tertile of the score. The main limitation of the study stems from its cross-sectional nature, limiting our ability to determine causality. The results suggest that greater compliance to the MedDiet may help improve semen quality. Whether this translates into differences in male fertility remains to be elucidated. Our findings are consistent with previous studies showing that dietary patterns with some of the characteristics of the MedDiet, i.e. rich in fruit, vegetables, legumes and whole grains, are associated with better measures of semen quality. No funding was obtained. The authors have no competing interests to declare. n/a.

Fatty acid intake and its dietary sources in relation with markers of type 2 diabetes risk: The NEO study

Objective:The aim of this study was to examine the relations between intakes of total, saturated, mono-unsaturated, poly-unsaturated and trans fatty acids (SFA, MUFA, PUFA and TFA), and their dietary sources (dairy, meat and plant) with markers of type 2 diabetes risk.Subjects/Methods:This was a cross-sectional analysis of baseline data of 5675 non-diabetic, middle-aged participants of the Netherlands Epidemiology of Obesity (NEO) study. Associations between habitual dietary intake and fasting and postprandial blood glucose and insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), HOMA of β-cell function (HOMA-B) and Disposition Index were assessed through multivariable linear regression models with adjustments for demographic, lifestyle and dietary factors.Results:Mean (s.d.) intakes in percent of energy (En%) were 34.4 (5.8) for total fatty acids, 12.4 (2.9) for SFA, 12.2 (2.4) for MUFA, 6.9 (1.9) for PUFA and 0.6 (0.2) for TFA. As compared with carbohydrates, only SFA was weakly inversely associated with fasting insulin, HOMA-IR and HOMA-B. When stratified by dietary source, all fatty acids from meat were positively associated with fasting insulin — total fatty acidsmeat (per 5 En%: 10.0%; 95% confidence interval: 4.0, 16.3), SFAmeat (per 1 En%: 3.7%; 0.4, 7.2), MUFAmeat (per 1 En%: 5.0%; 2.0, 8.1), PUFAmeat (per 1 En%: 17.3%; 6.0, 29.7) and TFAmeat (per 0.1 En%: 10.5%; 3.2, 18.3). Similarly, all fatty acids from meat were positively associated with HOMA-IR and HOMA-B and inversely with Disposition Index.Conclusions:Our study suggests that the relations between fatty acid intakes and markers of type 2 diabetes risk may depend on the dietary sources of the fatty acids. More epidemiological studies on diet and cardiometabolic disease are needed, addressing possible interactions between nutrients and their dietary sources.

Habitual Dietary Nitrate Intake in Highly Trained Athletes.

Although beetroot juice, as a nitrate carrier, is a popular ergogenic supplement among athletes, nitrate is consumed through the regular diet as well. We aimed to assess the habitual dietary nitrate intake and identify the main contributing food sources in a large group of highly trained athletes. Dutch highly trained athletes (226 women and 327 men) completed 2-4 web-based 24-hr dietary recalls and questionnaires within a 2- to 4-week period. The nitrate content of food products and food groups was determined systematically based on values found in regulatory reports and scientific literature. These were then used to calculate each athlete's dietary nitrate intake from the web-based recalls. The median[IQR] habitual nitrate intake was 106[75-170] mg/d (range 19-525 mg/d). Nitrate intake correlated with energy intake (ρ = 0.28, p < .001), and strongly correlated with vegetable intake (ρ = 0.78, p < .001). In accordance, most of the dietary nitrate was consumed through vegetables, potatoes and fruit, accounting for 74% of total nitrate intake, with lettuce and spinach contributing most. When corrected for energy intake, nitrate intake was substantially higher in female vs male athletes (12.8[9.2-20.0] vs 9.4[6.2-13.8] mg/MJ; p < .001). This difference was attributed to the higher vegetable intake in female vs male athletes (150[88-236] vs 114[61-183] g/d; p < .001). In conclusion, median daily intake of dietary nitrate in highly trained athletes was 106 mg, with large interindividual variation. Dietary nitrate intake was strongly associated with the intake of vegetables. Increasing the intake of nitrate-rich vegetables in the diet might serve as an alternative strategy for nitrate supplementation.

Dietary Intake Is Associated with Occlusal Force Rather Than Number of Teeth in 80-y-Old Japanese.

There has been a growing interest in the association between the number of teeth and dietary intake in older populations. However, people around the age of 80 y have frequently lost most of their teeth, and dental prostheses replacing the missing teeth play an important role in masticatory function. Therefore, masticatory function cannot be evaluated by the number of teeth alone. The occlusal force of the complete dental arches is an index of masticatory function, reflecting not only the number of teeth, but the effect of removable dentures. The purpose of this cross-sectional study was to determine the relative importance of the number of teeth and occlusal force in association with dietary intake in 80-y-old Japanese people. This study included 760 community-dwelling Japanese people aged 79 y to 81 y. The authors measured bilateral maximal occlusal force in the intercuspal position using pressure-sensitive sheets. Removable denture wearers kept their dentures in place during the measurements. Energy-adjusted food groups and nutrient intake during the preceding month were assessed by a brief self-administered diet history questionnaire. The authors assessed linear trends in food and nutrient intake in relation to the number of teeth and occlusal force after adjusting for gender and socioeconomic status (education level, financial status, family structure, resident area and BMI). P values of < 0.05 were considered to be statistically significant. The authors found that the number of teeth was not associated with the energy-adjusted intake of any food group examined. In contrast, a decline in occlusal force was significantly associated with a lower intake of vegetables, fish and shellfish, protein, polyunsaturated fatty acids, dietary fiber and most vitamins and minerals ( P for trend < 0.05). We conclude that food and nutrient intake was more closely associated with occlusal force than the number of teeth in community-dwelling Japanese people aged 79 y to 81 y. Knowledge Transfer Statement: This cross-sectional study of older Japanese people showed that, after controlling for considerable covariates, occlusal force rather than the number of teeth is positively associated with energy-adjusted intake of vegetables, fish and shellfish, protein, polyunsaturated fatty acids, dietary fiber and most of vitamins and minerals. This means that reduced occlusal force may unconsciously lead older people toward a habitual unhealthy dietary intake. Older people have frequently lost most of their teeth and require prosthetics to restore masticatory function. Bilateral occlusal force is therefore a better measure of masticatory function than the number of remaining teeth. Our findings suggest that prosthetic rehabilitation is a significant factor in the prevention and management of chronic diseases and frailty through better dietary intake in older populations.

The Association between Dietary Vitamin A and Carotenes and the Risk of Primary Liver Cancer: A Case-Control Study.

Dietary intake of vitamin A (VA) and carotenes has shown beneficial effects for decreasing the risk of some types of cancer, but findings on the risk of primary liver cancer (PLC) are inconsistent. This case–control study explored the associations between the dietary intake of VA and carotenes and the risk of PLC. We recruited 644 incident PLC patients (diagnosed within one month of each other) and 644 age- and gender-matched controls in Guangzhou, China. A food frequency questionnaire was used to assess habitual dietary intake. Logistic regression analyses found that higher intakes of VA and carotenes were independently associated with decreased PLC risk (all P-trend < 0.001). The multivariable-adjusted ORs (95% CI) of PLC for the highest (vs. lowest) quartile were 0.34 (0.24–0.48) for vitamin A and 0.35 (0.25–0.49) for carotenes. The associations were not significantly modified by smoking, alcohol, or tea drinking (P-interactions: 0.062–0.912). Dose–response analysis showed a U-shaped VA–PLC relationship, with sharply decreased risks at the intakes of about 1000 μg retinol equivalent (RE)/day, and then slowly went down toward the flat-bottomed risks with the lowest risk at 2300 μg RE/day. Our findings suggest that greater intake of retinol, carotenes, and total VA may decrease PLC risk among the Chinese population at an intake of 1000 μg RE/day or greater from food sources.

The Mediterranean Diet and Cognitive Function among Healthy Older Adults in a 6-Month Randomised Controlled Trial: The MedLey Study.

Evidence from a limited number of randomised controlled intervention trials (RCTs) have shown that a Mediterranean dietary pattern may reduce the risk of cognitive decline and enhance cognitive function among healthy older adults. However, there are currently no data in non-Mediterranean older adult populations. The present study aimed to address this gap by examining the effect of a Mediterranean dietary pattern (MedDiet) for six months on aspects of cognitive function in a randomised controlled intervention trial (the MedLey study) that extended for a duration of 18 months. In the final analysed cohort, a total of 137 men and women (mean age of 72.1 ± 5.0 years) randomly assigned to either a MedDiet or control diet (HabDiet) (i.e., habitual dietary intake), were assessed on a comprehensive neuropsychological test battery, including 11 individual tests. In multivariable-adjusted models, the MedDiet group did not perform significantly better than the HabDiet control group for executive functioning (adjusted mean differences: +2.53, 95% CI −2.59 to 7.65, p = 0.33); speed of processing (adjusted mean differences: +3.24, 95% CI −1.21 to 7.70, p = 0.15); memory (adjusted mean differences: +2.00, 95% CI −3.88 to 7.88, p = 0.50); visual-spatial ability (adjusted mean differences: +0.21, 95% CI −0.38 to 0.81, 0.48); and overall age-related cognitive performance (adjusted mean differences: +7.99, 95% CI −4.00 to 19.9, p = 0.19). In conclusion, this study did not find evidence of a beneficial effect of a MedDiet intervention on cognitive function among healthy older adults.

Influence of habitual dietary fibre intake on the responsiveness of the gut microbiota to a prebiotic: protocol for a randomised, double-blind, placebo-controlled, cross-over, single-centre study

IntroductionThe commensal gut microbiota have been shown to have an impact on human health as aberrant gut microbiota have been linked to disease. Dietary constituents are influential in shaping the...

The effect of the apolipoprotein E genotype on response to personalized dietary advice intervention: findings from the Food4Me randomized controlled trial

Background: The apolipoprotein E (APOE) risk allele (ɛ4) is associated with higher total cholesterol (TC), amplified response to saturated fatty acid (SFA) reduction, and increased cardiovascular disease. Although knowledge of gene risk may enhance dietary change, it is unclear whether ɛ4 carriers would benefit from gene-based personalized nutrition (PN).Objectives: The aims of this study were to 1) investigate interactions between APOE genotype and habitual dietary fat intake and modulations of fat intake on metabolic outcomes; 2) determine whether gene-based PN results in greater dietary change than do standard dietary advice (level 0) and nongene-based PN (levels 1–2); and 3) assess the impact of knowledge of APOE risk (risk: E4+, nonrisk: E4−) on dietary change after gene-based PN (level 3).Design: Individuals (n = 1466) recruited into the Food4Me pan-European PN dietary intervention study were randomly assigned to 4 treatment arms and genotyped for APOE (rs429358 and rs7412). Diet and dried blood spot TC and ω-3 (n–3) index were determined at baseline and after a 6-mo intervention. Data were analyzed with the use of adjusted general linear models.Results: Significantly higher TC concentrations were observed in E4+ participants than in E4− (P < 0.05). Although there were no significant differences in APOE response to gene-based PN (E4+ compared with E4−), both groups had a greater reduction in SFA (percentage of total energy) intake than at level 0 (mean ± SD: E4+, −0.72% ± 0.35% compared with −1.95% ± 0.45%, P = 0.035; E4−, −0.31% ± 0.20% compared with −1.68% ± 0.35%, P = 0.029). Gene-based PN was associated with a smaller reduction in SFA intake than in nongene-based PN (level 2) for E4− participants (−1.68% ± 0.35% compared with −2.56% ± 0.27%, P = 0.025).Conclusions: The APOE ɛ4 allele was associated with higher TC. Although gene-based PN targeted to APOE was more effective in reducing SFA intake than standard dietary advice, there was no difference between APOE “risk” and “nonrisk” groups. Furthermore, disclosure of APOE nonrisk may have weakened dietary response to PN. This trial was registered at clinicaltrials.gov as NCT01530139.

MON-P024: Characterization of Habitual Dietary Protein Intake Among Dutch Physically Active Elderly

MON-P024: Characterization of Habitual Dietary Protein Intake Among Dutch Physically Active Elderly

Carotenoids and alkylresorcinols as objective biomarkers of diet quality when assessing the validity of a web-based food record tool and a food frequency questionnaire in a middle-aged population

Recently, two web-based dietary assessment tools were developed; a 4-day food record tool (the Riksmaten method), and a food frequency questionnaire (MiniMeal-Q). The aim of this study was to use objective biomarkers to examine the ability of the two methods to capture habitual dietary intake. In total, 200 individuals from the pilot study of the Swedish CArdioPulmonary bioImage Study (SCAPIS) participated. Plasma concentration of carotenoids were determined with high-performance liquid chromatography (HPLC) and used as biomarkers of fruit and vegetable intake. A gas chromatography mass spectrometry (GC-MS) method was used to quantify alkylresorcinol homologues, which were used as biomarkers of whole grain wheat and rye intake. The correlations between energy-adjusted fruit and vegetable intakes and plasma carotenoid concentrations (except lycopene) were stronger amongst women than men (r = 0.46 and r = 0.20 for the Riksmaten method, and r = 0.50 and r = 0.31 for MiniMeal-Q, respectively). For whole grains, the correlations of energy-adjusted intakes and alkylresorcinols were higher using the Riksmaten method (r = 0.30 and r = 0.29 for women and men) than the MiniMeal-Q (r = 0.25 and r = 0.20, respectively). In regression analyses between plasma carotenoids (except lycopene) and reported intake of fruits and vegetables, the R2 were 21.6 % and 5.1 % for women and men by the Riksmaten method, and correspondingly, 18.0 % and 6.6 % by the MiniMeal-Q. In the final full models, adjusted for smoking and BMI, all regression models remained statistically significant. The regression analyses of plasma alkylresorcinols and reported intake of whole grains showed an R2 of 9.4 % and 9.7 % for women and men by the Riksmaten method, and correspondingly, 5.3 % and 8.4 % by the MiniMeal-Q. In the final full models, adjusted for smoking and age, all regression models remained statistically significant, except for women in MiniMeal-Q. Both dietary assessment methods were able to capture dietary intake based on food groups with a similar precision. Agreements with objective biomarkers ranged from low to moderate, depending on sex and diet quality indicator. While the ability to capture whole grain intake was weak for both methods and sexes, the assessment of vegetable and fruit intake performed in a satisfactory manner for women in both methods.

Cumulative consumption of branched-chain amino acids and incidence of type 2 diabetes.

Plasma branched-chain amino acids (BCAAs, including leucine, isoleucine and valine) were recently related to risk of type 2 diabetes (T2D). Dietary intake is the only source of BCAAs; however, little is known about whether habitual dietary intake of BCAAs affects risk of T2D. We assessed associations between cumulative consumption of BCAAs and risk of T2D among participants from three prospective cohorts: the Nurses' Health Study (NHS; followed from 1980 to 2012); NHS II (followed from 1991 to 2011); and the Health Professionals Follow-up Study (HPFS; followed from 1986 to 2010). We documented 16097 incident T2D events during up to 32 years of follow-up. After adjustment for demographics and traditional risk factors, higher total BCAA intake was associated with an increased risk of T2D in men and women. In the meta-analysis of all cohorts, comparing participants in the highest quintile with those in the lowest quintile of intake, hazard ratios (95%confidence intervals) were for leucine 1.13 (1.07-1.19), for isoleucine 1.13 (1.07-1.19) and for valine 1.11 (1.05-1.17) (all P for trend < 0.001). In a healthy subsample, higher dietary BCAAs were significantly associated with higher plasma levels of these amino acids (P for trend = 0.01). Our data suggest that high consumption of BCAAs is associated with an increased risk of T2D.

Habitual dietary protein intake affects body iron status in Japanese female college rhythmic gymnasts: a follow-up study.

BackgroundMany rhythmic gymnasts stay lean by reducing their body weight (BW); however, this may result in iron deficiency (ID). Our previous cross-sectional study reported an association between ID incidence and protein intake in gymnasts during the pre-season. The present study aimed to examine the association between dietary protein intake and ID incidence in a 2-year follow-up study.MethodsElite Japanese female college rhythmic gymnasts [mean age ± standard deviation (SD): 18.4 ± 0.5 years] were recruited on a voluntary basis every August for 9 years. Anthropometric, dietary intake, and hematological parameters were measured at baseline and 2 years later. A total of 20 participants without ID at baseline were divided into either a lower (L, n = 11) or higher (H, n = 9) protein group based on median protein intake (1.3 g protein/kg BW).ResultsParticipants consumed 1.08 ± 0.16 and 1.55 ± 0.14 g/kg BW of protein in the L and H groups, respectively. No significant changes in the intake of protein and other nutrients were observed between baseline and 2-year follow-up in both groups. ID was observed in a total of eight (72.8 %) participants in the L group and one (11.2 %) in the H group at follow-up. The incidence of ID was significantly lower in the H group than the L group (Fisher’s exact test, odds ratio, 0.043; 95 % CI 0.004–0.552; p = 0.010).ConclusionsDuring the pre-season weight loss period, habitually higher protein intake may reduce ID incidence among elite college female rhythmic gymnasts.

Nutritional status of lactating women in Bogor district, Indonesia: cross-sectional dietary intake in three economic quintiles and comparison with pre-pregnant women.

The way in which women accommodate for their increased nutritional needs during the lactation period is poorly investigated. In a cross-sectional study involving 220 lactating women (LW), equally distributed in economic quintiles (Q2, Q3, Q4), we investigated whether habitual dietary intake of LW differed from that of 200 pre-pregnant women (PPW) studied using the same methodology. Differences in dietary intake and nutrition sufficiency according to economic status were also investigated. Dietary intake data were collected using 2×24-h dietary recalls and FFQ. Energy, protein, Fe, Ca, Zn and vitamins A and C intakes were calculated utilising local food composition tables and were compared against Indonesian recommendations for adequacy. Energy and protein intakes 25 % of LW. For Q2-LW, this proportion was >50 %, except for protein. LW across all studied economic quintiles approximately doubled their vegetable intake, and 71 % of LW indicated a belief that this enhances lactation performance. Biochemical status parameters were analysed in a subset of forty-five women. Anaemia as well as Fe, Zn and Se deficiencies were prevalent among LW, supporting the nutrient intake deficiency data. Despite increasing intakes in LW compared with PPW, habitual diets in the study area do not provide for daily nutrient requirements in substantial proportions for both LW and PPW across all investigated economic groups.

Nutritional Status and Habitual Dietary Intake Are Associated with Frail Skin Conditions in Community-Dwelling Older People.

Prevention of frail skin is important in older people because frail skin is associated with a risk of injury in this population. In this study, we investigated the association of nutritional status and habitual dietary intake with skin conditions in community-dwelling older people. Cross-sectional study. Three community settings in Japan from autumn to winter. Older people aged ≥65 years without care-need certification (n=118). Malnutrition and obesity were evaluated to assess the nutritional status. Nutrient and food group intakes per 1000 kcal were evaluated using a brief self-administered diet history questionnaire. Dietary patterns based on food groups were evaluated by principal component analysis. Skin condition parameters, including stratum corneum hydration, appearance of xerosis (specific symptom sum score [SRRC score]), and dermal intensity by high-frequency ultrasonography, were measured on a lower leg. Multiple linear regression analysis was performed with adjustment for confounders. The mean (standard deviation) age was 74.1 (4.8) years, and 83.1% of participants were female. A higher intake of plant fat (p=0.018) was associated with a lower SRRC score. Higher intakes of α-tocopherol (p=0.050) and vitamin C (p=0.017) were associated with increased dermal intensity. A body mass index ≥25 (p=0.016) was associated with decreased dermal intensity. A dietary pattern characterized by higher vegetable and fruit intake was associated with a better skin condition. Plant fat, antioxidant vitamins, and a dietary pattern characterized by vegetables and fruits showed positive and obesity showed negative associations for frail skin in community-dwelling older people.

The effect of dietary interventions and nutritional supplementation on bone mineral density in otherwise healthy adults with osteopenia: A systematic review

AbstractThere are many health and economic consequences for patients with osteopenia, the precursor to osteoporosis. A range of treatments may provide positive outcomes for otherwise healthy adults, including dietary and exercise approaches, either alone or in combination. The primary aim of this systematic review was to evaluate the effect of dietary approaches (including diet alone, diet with dietary supplements, both with or without physical activity intervention) on bone mineral density (BMD) to treat adults aged ≥18 years who were classified as having osteopenia. Six databases (Ovid MEDLINE including Ovid Medline in process, Cochrane Library, EMBASE, CINAHL Plus, Web of Science and Scopus) were searched systematically to identify randomised controlled trials of dietary approaches to treat osteopenic adults published from 1994 to November 2014. Study eligibility was determined, and included studies were assessed for risk of bias. Outcome data, particularly the primary outcomes of BMD T‐ and Z‐scores or other measures of bone density, were combined narratively. The searches yielded 3511 papers, with three studies fulfilling the inclusion criteria. These studies included 254 participants, all free‐living post‐menopausal females with confirmed osteopenia. Vitamin D interventions were tested in all included studies, with none showing significant differences between intervention and placebo groups on BMD. This review has identified a lack of evidence to guide clinical practice in this area. Opportunities exist for future research to determine the effect of non‐pharmacological approaches to osteopenia treatment in healthy populations, especially research that considers younger‐aged and male populations, physical activity, habitual dietary intake and key bone health nutrients.

Plasma Metabolome Correlates with Habitual Dietary Intakes among Chinese Adults

ObjectiveWe used untargeted metabolomics to identify potential novel dietary biomarkers and provide insights into biological pathways underlying diet‐disease relations.MethodsIncluded in the study were 903 Chinese women and men drawn from the Shanghai Women's and Men's Health Studies. They were 40–74 years old and had no diabetes, cardiovascular disease, or cancer at blood draw. Dietary intakes during one year prior to blood draw were assessed by trained interviewers using validated food‐frequency questionnaires. The present analyses focused on 19 food groups. Untargeted plasma metabolome was measured by Metabolon Inc., which detected 689 metabolites with known identities and 690 unidentified metabolites. Partial Spearman correlation with control of the false discovery rate (FDR) was used to identify significant food‐metabolite associations. Potential confounders adjusted included age, sex, total energy intake, body mass index, smoking, alcohol drinking, physical activity, fasting hours, and time of blood draw.ResultsAt FDR &lt;0.05, tea, rice, dairy, fish, apples/pears, berries/melons, peanuts, poultry, eggs, allium vegetables, starchy vegetables, soy foods, and citrus fruit were each correlated with at least one plasma metabolite (P‐value = 5×10−34 to 1×10−3; correlation coefficient = −0.44 to 0.41). Strong correlations included tea with methylxanthines and their metabolites, peanuts with tryptophan betaine and indoleacrylate, and dairy and fish with certain unidentified metabolites. Many metabolites were associated with multiple food groups, e.g. glycerate and threonate with various fruits and ergothioneine with poultry, fish, and rice, suggesting shared food components or eating habits. Some metabolites were associated with single food group, e.g. alliin with alliums and 3‐carboxy‐4‐methyl‐5‐propyl‐2‐furanpropanoate (CMPF) with fish, suggesting that they might serve as specific biomarkers for these foods.ConclusionsWe identified multiple plasma metabolites significantly associated with habitual food intakes among middle‐aged and older urban Chinese adults. Future studies are needed to confirm our findings.Support or Funding InformationThis work was supported, in part, by the US National Institutes of Health [R37CA070867 and UM1CA182910 to Dr. W. Zheng, UM1CA173640, R01HL079123 and NO2‐CP11010‐66 to Dr. X.O. Shu]. This work was also supported, in part, by the Breast Cancer Research Stamp Fund, awarded through competitive peer review and the Intramural Research Program of the National Cancer Institute, National Institutes of Health.

Iron Status and Regulation in High‐Risk Pregnant African American Women

Iron is essential across the lifecycle but is critical during pregnancy. African American (AA) women are more likely to be iron deficient (ID) during pregnancy and classified as having a high‐risk pregnancy due to factors including existing medical conditions and obesity. Such conditions can also compromise maternal iron metabolism due to inflammation‐induced overexpression of the iron‐regulatory peptide hormone hepcidin. The aim of this study was to examine iron status and regulation during the 2nd and 3rd trimester of pregnancy in AA women classified as a high‐risk pregnancy.MethodsNon‐fasting venous blood was drawn at 22 and 32 weeks gestation for the assessment of iron status, hepcidin, and inflammation. Anthropometric and survey data was also obtained. Ferritin &lt; 15.0 and &lt; 30.0 ng/ml (to account for inflammatory effects on ferritin) was used to define iron deficiency. Descriptive statistics were calculated and changes in the clinical parameters between the 2nd and 3rd trimester were evaluated via paired t‐test.ResultsForty seven women, mean age 28 (± 6.6) years and pre‐pregnancy BMI of 32.6 (± 11.6) kg/m2 were recruited. Mean habitual dietary iron intake was 38 mg/day. Between the 2nd and 3rd trimester, significant (p &lt; 0.05) declines in serum iron, ferritin, transferrin saturation, hepcidin, and C‐reactive protein were observed. During the 2nd trimester, 28% of women were ID increasing to 50% in the 3rd trimester based on ferritin &lt; 15.0 ng/ml. When using a ferritin cut‐point of &lt; 30.0 ng/ml, 68% and 87% of women were classified as ID, respectively.ConclusionMaternal iron deficiency was prevalent among these high‐risk pregnant AA women. Although hepcidin declined significantly between trimesters, concentrations in this cohort were higher than previously reported in healthy pregnancy suggesting decreased maternal iron bioavailability. Because elevated maternal hepcidin may impair dietary iron absorption, further research is warranted in this high‐risk group.Support or Funding InformationCenter for Clinical and Translational Science (UL1RR029879) CCTS Pilot Grant Award, Award Number CCTS08011‐02

Diet Quality Scores and Risk of Nasopharyngeal Carcinoma in Chinese Adults: A Case-Control Study.

Many studies show that dietary factors may affect the risk of nasopharyngeal carcinoma (NPC). We examined the association between overall diet quality and NPC risk in a Chinese population. This case-control study included 600 NPC patients and 600 matched controls between 2009 and 2011 in Guangzhou, China. Habitual dietary intake and various covariates were assessed via face-to-face interviews. Diet quality scores were calculated according to the Healthy Eating Index-2005 (HEI-2005), the alternate Healthy Eating Index (aHEI), the Diet Quality Index-International (DQI-I), and the alternate Mediterranean Diet Score (aMed). After adjustment for various lifestyle and dietary factors, greater diet quality scores on the HEI-2005, aHEI, and DQI-I—but not on the aMed—showed a significant association with a lower risk of NPC (p-trends, <0.001–0.001). The odds ratios (95% confidence interval) comparing the extreme quartiles of the three significant scores were 0.47 (0.32–0.68) (HEI-2005), 0.48 (0.33–0.70) (aHEI), and 0.43 (0.30–0.62) (DQI-I). In gender-stratified analyses, the favorable association remained significant in men but not in women. We found that adherence to the predefined dietary patterns represented by the HEI-2005, aHEI, and DQI-I scales predicted a lower risk of NPC in adults from south China, especially in men.