High-fat Dairy Products Research Articles

Prospective Study of Dietary Patterns, Bone Lead Levels and Risk of Incident Coronary Heart Disease in Men

Introduction: Cumulative lead exposure has been associated with cardiovascular outcomes. Previous studies have examined individual nutrients known to affect lead toxico-kinetics and toxico-dynamics. Instead of individual nutrients, we examined whether overall dietary pattern derived from a food-frequency questionnaire can modify the association between cumulative lead exposure and incident coronary heart disease (CHD). Methods: We examined 588 men from the VA Normative Aging Study who had bone lead levels measured by K-shell-X-ray fluorescence and were free of CHD at the time of measurement. Dietary patterns were identified from a FFQ with 40 predefined food groups using factor analysis. Diet scores were dichotomized to examine effect modification. Cox proportional hazard models were used to compute hazard ratios and 95% confidence intervals for incident CHD (from 1991 to 2011; median follow-up time=10 years). Results: We derived two major dietary patterns. The ‘prudent’ pattern was identified with high intakes of fruit, whole grains, vegetables, legumes, poultry and seafood; while, the ‘Western’ pattern was characterized by high intakes of red meat, processed meat, refined grains, high-fat dairy products, fries, butter and eggs. After adjustment for age, smoking, body mass index, education, and ratio of total cholesterol to high-density lipoprotein, the HR of CHD was 1.42 (95%CI: 1.12-1.81) with a 2-fold increase in patella lead levels, among participants with lower prudent pattern score. Whereas the HR of CHD was 1.09 (95%CI: 0.87-1.37) among higher prudent pattern score participants (p for interaction=0.10). In contrast, subjects with lower western pattern score had a HR of 1.08 (95%CI: 0.85-1.36); while those with higher western pattern score had an HR of 1.43 (95%CI: 1.12-1.81) (p for interaction=0.09). Conclusion: Our findings provide suggestive evidence that diet patterns may play important roles in individual vulnerability to lead-related CHD risk.

DEVELOPMENT OF A BRAIN HEALTH FOOD GUIDE FOR USE IN MIDDLE-AGED AND OLDER ADULTS

The Alzheimer’s Association, USA, recently argued that ‘there is sufficiently strong evidence to conclude that a healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline’. While results from most epidemiologic studies support diets which emphasize plant-based foods to maintain cognitive function; there is not consensus on best characteristics across all food groups, especially dietary fats. Consequently there remains a need to derive evidence-based recommendations to describe an optimal diet pattern to support cognitive health. As such, we developed a Brain Health Food Guide (BHFG), which could ultimately be used to support dietary change in middle aged and older adults. A primary consideration in developing the BHFG was to harmonize diet patterns across two RCTs, PREDIMED (Mediterranean-style diet) and ENCORE (DASH diet), which differ markedly in their fat recommendations; both of which demonstrated improved cognitive performance associated with diet change. Relevant data from observational prospective studies exploring a diet-cognition relationship were collated. Conversion factors were developed to enable comparison across studies with different serving size definitions or studies that that expressed serving size as volumes versus those expressed in units of mass. In terms of dietary fat, studies generally supported an intervention that simultaneously targets reductions in SFA consumption while promoting greater contribution of PUFA and MUFA to total fat intake—particularly from plant sources. The evidence supporting targets to increase or decrease total fat intake was equivocal. Translating across all food groups, the BHFG emphasizes vegetables (raw leafy greens, cruciferous vegetables), fruits (berries), nuts, fish, legumes, and low-fat dairy products. It includes whole grains, poultry, and moderate alcohol consumption. It is reduced in red and processed meats, refined grains, commercial sweets, pre-packaged foods, sugared drinks, and high-fat dairy products. A brain healthy eating pattern, based on observational and intervention studies, can be derived from existing literature.

The effect of dietary changes on distinct components of the metabolic syndrome in a young Sri Lankan population at high risk of CVD.

South Asian populations are predisposed to early onset of the metabolic syndrome. Lifestyle intervention programmes have demonstrated a reduction in the metabolic syndrome and CVD risk; however, the most effective components of the multi-faceted lifestyle interventions are unknown. We studied 2637 Sri Lankan males (n 1237) and females (n 1380), with a mean BMI of 23·9 (sd 4·2) kg/m2, aged 22·5 (sd 10·0) years, who had participated in a 5-year lifestyle-modification programme to examine the effect of dietary changes on distinct components of the metabolic syndrome. The dietary intervention comprised advice to replace polished starches with unpolished starches, high-fat meat and dairy products with low-fat products and high-sugar beverages and snacks with low-sugar varieties. For the purposes of this analysis, data from the control and intensive lifestyle groups were combined. Anthropometric and biochemical data were recorded, and a FFQ was completed annually. Multiple regression was used to determine the effect of the dietary changes on distinct components of the metabolic syndrome. The ratio unpolished:polished rice was inversely related to change in fasting glucose (β=-0·084, P=0·007) and TAG (β=-0·084, P=0·005) and positively associated with change in HDL-cholesterol (β=0·066, P=0·031) at the 5-year follow-up after controlling for relevant confounders. Red meat intake was positively associated with fasting glucose concentrations (β=0·05, P=0·017), whereas low-fat (β=-0·046, P=0·018) but not high-fat dairy products (β=0·003, P=0·853) was inversely related to glucose tolerance at the follow-up visit. Replacement of polished with unpolished rice may be a particularly effective dietary advice in this and similar populations.

Circulation Research “In This Issue” Anthology

Circulation Research “In This Issue” Anthology

Native milk fat globule size and its influence on whipping properties

The objective of this study was to investigate the influence of native milk fat globule size on the aeration of high fat dairy products with regard to maximum firmness time, gas inclusion and foam stability. The results showed that whipping time to maximum firmness was inversely proportional to mean fat globule size for both unhomogenised and slightly homogenised (2 MPa) creams. Additionally, increasing native mean fat globule size of the creams resulted in increased overrun. No significant differences in serum drainage were found between creams with different native milk fat globule size. Furthermore, when creams with native large mean fat globules were homogenised, the results showed that the maximum firmness time was in accordance with the mean fat globule size of non-aggregated creams. In the present study, cream fractionation was achieved by creaming or in a cost effective and fast manner using a modified centrifugal separator.

Dietary patterns and benign breast diseases: a case-control study.

Several studies have investigated the relation between benign breast diseases (BBD) and food intake. However, dietary patterns of these patients have not been taken into consideration up to now. The aim of this study is to determine the association between dietary patterns and BBD. In this case-control study, ninety-six patients with BBD and seventy controls were selected from women attending the Iranian Center for Breast Cancer affiliated with Academic Center for Education, Culture and Research. Demographic, physical activity and semi-quantitative FFQ were completed. The main dietary patterns were extracted by factor analysis. Two major dietary patterns emerged: Healthy dietary pattern including fish, poultry, eggs, low-fat dairy products, vegetables, legumes, nuts and seeds, whole grains, oil and mayonnaise, olives, fruits; and Unhealthy dietary pattern including red meats, organ and processed meats, high-fat dairy products, refined grains, sweets and desserts, animal and solid fats. After adjustment for age, BMI and energy intake, the participants in the highest tertile of Healthy dietary pattern (OR 0·44; 95 % CI 0·20, 0·99) were less likely to have BBD compared with those in the first tertile. After adjustment for other confounding variables, this relationship still remained close to significant level. However, higher consumption of Unhealthy dietary pattern was not associated with the risk of BBD. In conclusion, Healthy dietary pattern might be inversely associated with the risk of BBD; however, this result should be interpreted with caution. Future studies are needed to confirm our findings.

Dairy consumption in association with weight change and risk of becoming overweight or obese in middle-aged and older women: a prospective cohort study1–3

Studies have reported inconsistent findings on the association between dairy product intake and weight change and obesity. Only a few prospective studies have investigated the role of dairy consumption in both weight change and risk of becoming overweight or obese and whether these associations depend on the initial body weight. We prospectively investigated how dairy product intake was associated with weight change and risk of becoming overweight or obese in initially normal-weight women. We studied 18,438 women aged ≥45 y from the Women's Health Study who were free of cardiovascular disease, cancer, and diabetes and had initial body mass index (BMI; in kg/m(2)) from 18.5 to <25 at baseline. Dairy intake was assessed with the use of a 131-item food-frequency questionnaire. Women self-reported body weight along with obesity-related risk factors on baseline and annual follow-up questionnaires. At each follow-up time, women were categorized as normal weight (BMI: 18.5 to <25), overweight (BMI: 25 to <30), or obese (BMI ≥30). During a mean follow-up of 11.2 y, 8238 women became overweight or obese. Multivariable-adjusted mean ± SD changes in body weight during the follow-up (18 y) were 1.90 ± 0.09, 1.88 ± 0.08, 1.86 ± 0.09, 1.82 ± 0.09, and 1.65 ± 0.09 kg in quintiles 1-5 of total dairy intake, respectively (P-trend = 0.003). Greater intake of high-fat dairy products, but not intake of low-fat dairy products, was associated with less weight gain (P-trend = 0.004). In multivariable-adjusted analyses, lower risk of becoming overweight or obese was observed in the highest quintile of high-fat dairy product intake (HR: 0.92, 95% CI: 0.86, 0.99). Dietary or supplemental calcium or vitamin D was not associated with risk of becoming overweight or obese. Greater consumption of total dairy products may be of importance in the prevention of weight gain in middle-aged and elderly women who are initially normal weight.

Exploring the association of dairy product intake with the fatty acids C15:0 and C17:0 measured from dried blood spots in a multipopulation cohort: Findings from the Food4Me study.

The use of biomarkers in the objective assessment of dietary intake is a high priority in nutrition research. The aim of this study was to examine pentadecanoic acid (C15:0) and heptadecanoic acid (C17:0) as biomarkers of dairy foods intake. The data used in the present study were obtained as part of the Food4me Study. Estimates of C15:0 and C17:0 from dried blood spots and intakes of dairy from a Food Frequency Questionnaire were obtained from participants (n = 1180) across seven countries. Regression analyses were used to explore associations of biomarkers with dairy intake levels and receiver operating characteristic analyses were used to evaluate the fatty acids. Significant positive associations were found between C15:0 and total intakes of high-fat dairy products. C15:0 showed good ability to distinguish between low and high consumers of high-fat dairy products. C15:0 can be used as a biomarker of high-fat dairy intake and of specific high-fat dairy products. Both C15:0 and C17:0 performed poorly for total dairy intake highlighting the need for caution when using these in epidemiological studies.

A Western dietary pattern is associated with higher blood pressure in Iranian adolescents.

The dietary determinants of adolescent blood pressure (BP) are not well understood. We determined the association between major dietary patterns and BP in a sample of Iranian adolescents. This cross-sectional study was conducted among a representative sample (n=557) of Shirazi adolescents aged 12-19years. Participants' systolic and diastolic BP was measured using a validated oscillometric BP monitor. Usual dietary intakes during the past 12months were assessed using a valid and reproducible 168-item semiquantitative food frequency questionnaire through face-to-face interviews. Principal component factor analysis was used to identify major dietary patterns based on a set of 25 predefined food groups. Overall, three major dietary patterns were identified, among which only the Western pattern (abundant in soft drinks, sweets and desserts, salt, mayonnaise, tea and coffee, salty snacks, high-fat dairy products, French fries, and red or processed meats) had a significant association with BP. After adjusting for potential confounders in the analysis of covariance models, multivariable adjusted means of the systolic and mean BP of subjects in the highest tertile of the Western pattern score were significantly higher than those in the lowest tertile (for systolic BP: mean difference 6.9mmHg, P=0.001; and for mean BP: mean difference 4.2mmHg, P=0.003). A similar but statistically insignificant difference was observed in terms of diastolic BP. The findings suggest that a Western dietary pattern is associated with higher BP in Iranian adolescents. However, additional large-scale prospective studies with adequate methodological quality are required to confirm these findings.

Identifying Major Dietary Patterns Among the Elderly in Tehran Health Homes

Iranians. Objectives: Our objective was to identify the major dietary intake patterns among the elderly in the health homes located in Zone 5 of Tehran city, Iran. Patients and Methods: In this cross-sectional study (descriptive), 368 elderly people (≥ 60 years old) were randomly selected. Their usual dietary intake during the past year was assessed using a 168-item semiquantitative food frequency questionnaire. Major food patterns were derived using factor analysis after the classification of food items into 26 groups. Results: Four major dietary patterns were identified in the studied population: 1) healthy pattern, characterized by a higher intake of vegetables, tomato and tomato sauce, vegetable oil, olive, and fruits; 2) unhealthy pattern, characterized by a higher intake of red meat, fast food, snacks, sugar, honey and jam, soft drinks, and high-fat dairy products; 3). traditional pattern characterized by intake of whole grains, hydrogenated oil and animal fat, beans, salt, and pickles; and 4) protein-rich pattern, characterized by intake of chicken and poultry, fish, grains, and organ meats. These four major dietary patterns explained 16.3%, 7.5%, 6.7%, and 5.7% of the total variance, respectively. Conclusions: Four major dietary patterns were identified in the present studied population that can be used to provide tangible dietary advice for the elderly.

Abstract A32: Dairy intake in relation to disease-specific and total mortality after prostate cancer diagnosis

Abstract Introduction: Literature is limited regarding post-diagnostic dairy intake and prostate cancer survival. We evaluated dietary intake of total, high-fat, and low-fat dairy in relation to disease-specific and total mortality after prostate cancer diagnosis. Methods: We included 926 men from the Physicians' Health Study diagnosed with non-metastatic prostate cancer from 1982 to 2012, who completed a food frequency questionnaire a median of 5.1 years after diagnosis and were followed thereafter to assess mortality for a median of 9.9 years. Cox proportional hazards regression estimated the association between frequency categories of dairy intake and prostate cancer-specific and all-cause mortality. Person-years of follow-up were counted from the date of FFQ completion until death or end of follow-up, whichever came first. Models were adjusted for age at diagnosis, total energy intake, vigorous exercise, body mass index, smoking status, clinical stage, Gleason score, prostate specific antigen levels at diagnosis, indicators for prudent dietary pattern and western dietary pattern, and time interval between diagnosis and FFQ completion. Results: A total of 333 men died during follow-up, including 56 due to prostate cancer. Post-diagnosed dairy consumption was relatively limited, with medians of 1.7 servings/day for total dairy intake, 0.64 servings/day for high-fat dairy intake, and 1 serving/day for low-fat dairy intake. Men consuming dairy foods more than 3 times per day had a 76% higher risk of total mortality and a 144% increased risk of prostate cancer specific mortality than those consuming less than one dairy product per day (relative risk (RR)=1.76, 95% confidence interval (CI): 1.21, 2.55, Plinear-trend=0.001 for total mortality; RR=2.44, 95%CI: 0.99, 6.03, Plinear-trend=0.03 for disease-specific mortality). For total mortality, high-fat dairy intake (RR≥2 times/day vs &amp;lt;3 times/week=1.69, 95%CI: 1.11, 2.57) appeared to be more deleterious than low-fat dairy intake (RR≥2 times/day vs &amp;lt;3 times/week=1.25, 95%CI: 0.88, 1.77). The elevated risks of prostate cancer- specific mortality were comparable for high-fat dairy (RR≥2 times/day vs &amp;lt;3 times/week=1.81, 95% CI=0.71, 4.59) and low fat-dairy (RR≥2 times/day vs &amp;lt;3 times/week=1.83, 95%CI=0.75, 4.47). Conclusions: Among men diagnosed with non-metastatic prostate cancer, post-diagnostic dairy food intake was associated with greater prostate cancer-specific and all-cause mortality. The associations of low-fat and high-fat dairy were comparable for prostate cancer-specific mortality, while intake of high-fat dairy products may be particularly detrimental for total mortality. Citation Format: Meng Yang, Stacey A. Kenfield, Erin L. Van Blarigan, Kathryn M. Wilson, Julie L. Batista, Howard D. Sesso, Jing Ma, Meir J. Stampfer, Jorge E. Chavarro. Dairy intake in relation to disease-specific and total mortality after prostate cancer diagnosis. [abstract]. In: Proceedings of the Thirteenth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2014 Sep 27-Oct 1; New Orleans, LA. Philadelphia (PA): AACR; Can Prev Res 2015;8(10 Suppl): Abstract nr A32.

Measurement of the total choline content in 48 commercial dairy products or dairy alternatives

In this work, the total choline and choline-containing moieties (free choline, glycerophosphocholine, phosphocholine, phosphatidylcholine, lysophosphatidylcholine and sphingomyelin) of 48 dairy products or dairy alternatives available in Canada were determined by hydrophilic interaction liquid chromatography-tandem mass spectrometry (LC–MS/MS). The average total choline content for one serving of fluid milk and alternative (i.e. 250mL as defined by Canada's Food Guide) was 32.9±2.4mg for cow's milk, 24.9±0.1mg for goat's milk and 31.2±4.2mg for soy beverage. The average total choline content for one serving of yogurt (175g) was 25.6±3.2mg. One serving of cheese (50g) provided 7.1±1.1mg of total choline on average. Our data show that for dairy products there is a negative correlation between the total choline content on a dry weight basis and the fat content (r=−0.734, P<0.001). Overall, we determined the choline content of a variety of dairy products which can supplement the data in the existing United States Department of Agriculture (USDA) choline database and be used in accurately estimating dietary choline intake in epidemiological studies. Hence, dairy products are a good source of choline with low fat products generally being a better source of choline than high fat dairy products.

Dietary Patterns of Young Females and Their Association With Waist Circumference as a Health Index in Northwest of Iran, 2007.

Background:Despite the higher prevalence of overweight and obesity among young people in western countries, the 50th and 95th percentile ranks for waist circumference in the Iranian young Females are higher than those of the western ones.Objectives:Identifying major dietary patterns in Iranian young females, which associate with central obesity, can probably explain the difference between Iranian young females’ pattern and those of their western peers regarding obesity.Patients and Methods:In the current cross-sectional study, a total of 257 young females aged 11 - 15 years old from Talaat Intelligent Guidance School, Tabriz, Iran (2007) were selected for the study using non-probability simple sampling method. Then, usual dietary intakes of all subjects were evaluated by a food frequency questionnaire and anthropometric measurements such as weight, height, waist circumference, and Body Mass Index (BMI) using the standard protocols. Data were analyzed by inferential statistics (One-way ANOVA, Tukey test for Post-Hoc Analysis, Chi-square test, age-adjusted means, analysis of covariance with Bonferroni correction, correlation and partial correlation) by SPSS software.Results:In the current study, six major dietary patterns were extracted using factor analysis method. Before and after controlling the age, subjects in the upper tertile of the Iranian Central Obesity Making Dietary Pattern (rich in cruciferous vegetables, green leafy vegetables, soft drinks, tomatoes, other vegetables and vegetable oils) had larger waist circumference in comparison with the ones in the lower tertile (before controlling for age: 64.2 ± 9 vs. 61.6 ± 7 P = 0.03; after: 64.5 ± 0.8 vs. 61.5 ± 0.8, P = 0.009). However in lacto vegetarian dietary pattern (rich in legumes, potato, other vegetables, dough, high-fat dairy products and margarine), individuals in the upper tertile had significantly lower weight, waist circumference and body mass index (BMI) in comparison with the ones in the lower tertile (weight: 44.9 ± 9.3 vs. 51.4 ± 10.6, P < 0.01; WC: 59.9 ± 8 vs. 64 ± 7.9, P < 0.01; BMI: 18.6 ± 3.1 vs. 20.6 ± 3.5, P < 0.01).Conclusions:The current study findings suggest that the Iranian Central Obesity Making Dietary Pattern is directly associated with waist circumference (marker of central obesity), while lacto vegetarian dietary pattern is reversely associated with weight, waist circumference and BMI. Special obesity pattern in Iranian young females can be justified by Iranian Central Obesity Making Dietary Pattern”.

Empirically derived dietary patterns in relation to psychological disorders.

Psychological disorders are highly prevalent worldwide. The present study aimed to investigate the relationship between major dietary patterns and prevalence of psychological disorders in a large sample of Iranian adults. A cross-sectional study was done to identify dietary patterns derived from factor analysis. Dietary data were collected through the use of a validated dish-based semi-quantitative FFQ. Psychological health was examined by use of the Hospital Anxiety and Depression Scale and the General Health Questionnaire. The study was conducted in Isfahan, Iran, within the framework of the Study on Epidemiology of Psychological, Alimentary Health and Nutrition (SEPAHAN). Iranian adults (n 3846) aged 20-55 years. After adjustment for potential confounders, greater adherence to the lacto-vegetarian dietary pattern was protectively associated with depression in women (OR=0·65; 95 % CI 0·46, 0·91). Normal-weight participants in the top quintile of this dietary pattern tended to have decreased odds of anxiety compared with those in the bottom quintile (OR=0·61; 95 % CI 0·38, 1·00). In addition, the traditional dietary pattern was associated with increased odds of depression (OR=1·42; 95 % CI 1·01, 1·99) and anxiety (OR=1·56; 95 % CI 1·00, 2·42) in women. Normal-weight participants in the highest quintile of the traditional dietary pattern had greater odds for anxiety (OR=1·89; 95 % CI 1·12, 3·08) compared with those in the lowest quintile. The Western dietary pattern was associated with increased odds of depression in men (OR=1·73; 95 % CI 1·07, 2·81) and anxiety in normal-weight participants (OR=2·05; 95 % CI 1·22, 3·46). There was a significant increasing trend in the odds of psychological distress across increasing quintiles of the fast food dietary pattern in women (P-trend=0·02). Recommendation to increase the intake of fruits, citrus fruits, vegetables, tomato and low-fat dairy products and to reduce the intakes of snacks, high-fat dairy products, chocolate, carbonated drinks, sweets and desserts might be associated with lower chance of psychological disorders.

Food sources of fat may clarify the inconsistent role of dietary fat intake for incidence of type 2 diabetes

Dietary fats could affect glucose metabolism and obesity development and, thereby, may have a crucial role in the cause of type 2 diabetes (T2D). Studies indicated that replacing saturated with unsaturated fats might be favorable, and plant foods might be a better choice than animal foods. Nevertheless, epidemiologic studies suggested that dairy foods are protective. We hypothesized that, by examining dietary fat and its food sources classified according to fat type and fat content, some clarification regarding the role of dietary fat in T2D incidence could be provided. A total of 26,930 individuals (61% women), aged 45-74 y, from the Malmö Diet and Cancer cohort were included in the study. Dietary data were collected by using a modified diet-history method. During 14 y of follow-up, 2860 incident T2D cases were identified. Total intake of high-fat dairy products (regular-fat alternatives) was inversely associated with incident T2D (HR for highest compared with lowest quintiles: 0.77; 95% CI: 0.68, 0.87; P-trend < 0.001). Most robust inverse associations were seen for intakes of cream and high-fat fermented milk (P-trend < 0.01) and for cheese in women (P-trend = 0.02). High intake of low-fat dairy products was associated with increased risk, but this association disappeared when low- and high-fat dairy were mutually adjusted (P-trend = 0.18). Intakes of both high-fat meat (P-trend = 0.04) and low-fat meat (P-trend < 0.001) were associated with increased risk. Finally, we did not observe significant association between total dietary fat content and T2D (P-trend = 0.24), but intakes of saturated fatty acids with 4-10 carbons, lauric acid (12:0), and myristic acid (14:0) were associated with decreased risk (P-trend < 0.01). Decreased T2D risk at high intake of high- but not of low-fat dairy products suggests that dairy fat partly could have contributed to previously observed protective associations between dairy intake and T2D. Meat intake was associated with increased risk independently of the fat content.

Reversing Breast Cancer in a Premenopausal Woman: A Case for Phyto-Nutritional Therapy

Globally, breast cancer incidence increases at 1% to 2% annually. It is the number one cause of cancer death in women. Current literature implies that soy food intake is linked to decreased risk of breast cancer due to its rich isoflavones. On the other hand, intake of animal fat, red meat, organ meat and high-fat dairy products during premenopausal years may increase risk for this cancer, but no apparent risk has been established for fish or poultry intake. Monounsaturated fat and the improved ratio of omega-3 to omega-6 fatty acids have showed potential to reduce risk. On the other hand, high glycemic index diet but not glycemic load is associated with a significantly increased risk. Central rather than general obesity carries similar risk. Furthermore, lifestyle rather than genetic differences are widely implicated in breast cancer. A comprehensive phyto-nutritional therapy was adopted for treating a case involving stage IV breast cancer in a premenopausal woman, who was turned away by a hospital offering conventional treatment. The therapy involved designing and monitoring the implementation of dietary plans to achieve optimum health outcomes for the major abnormal metabolic blood/urine markers identified for this particular patient. Nutrient-dense food items with generous servings of a variety of spices and herbs, supplemented by vitamins, minerals and phyto-extracts was prescribed as part of the therapy. Many non-toxic dietary nutrients and phytonutrients are known cytotoxic agents promoting cancer regression via apoptosis pathways, which have yet to be fully understood. Conclusion : The complete remission of the malignancy initiated by this natural therapy would suggest that an advanced stage breast cancer is a metabolic disorder reversible by an evidence-based phyto-nutritional therapy. While not all cases of malignancy can possibly be completely reversed, the positive outcome achieved in partnership with the patient warrants further study involving larger number of women with similar level of malignancy.

Adherence to the Western Pattern Is Potentially an Unfavorable Indicator of Asthenozoospermia Risk: A Case-Control Study

Objective: The aim of this case-control study was to examine the relationship between dietary patterns and asthenozoospermia risk.Methods: In total, 107 incident asthenozoospermic men and 235 age-matched controls were interviewed through the infertility clinics in Tehran, Iran, from January 2012 to November 2013. Usual dietary intakes were collected using a semiquantitative food frequency questionnaire and semen quality data were analyzed according to the fifth edition of the World Health Organization (WHO) guidelines. Dietary patterns were derived using factor analysis. The first tertile served as the reference category for regression analyses.Results: In principal component analysis, 2 dietary patterns emerged: a “prudent pattern” (leafy green vegetables, yellow vegetables, other vegetables, tomatoes, fish and other seafood, fruits and natural fruit juices, legumes, whole grains, poultry, tea and coffee, low-fat dairy products, and vegetable oils) and a “Western pattern” (organ meats, red and processed meats, sugar, soft drinks and confectionary, pasta, rice and refined grains, potatoes, french fries and fast foods, high-fat dairy products, hydrogenated fats, mayonnaise and fatty sauces, and snacks). After adjustment for potential confounders, participants in the highest tertile of the prudent pattern scores had 54% lower risk of asthenozoospermia compared to those in the lowest (p for trend: 0.003). Being in the highest tertile of the Western pattern was positively associated with asthenozoospermia risk (odds ratio [OR] = 2.86; 95% confidence interval [CI], 1.83–2.97).Conclusions: Our findings suggest that adherence to the Western pattern is potentially an unfavorable indicator of asthenozoospermia risk and a diet composed mainly of plant-based foods may be associated with a reduced risk.

A Healthy Diet Is Associated with Less Endothelial Dysfunction and Less Low-Grade Inflammation over a 7-Year Period in Adults at Risk of Cardiovascular Disease1–3

Background: A healthy diet rich in fish, fruit, and vegetables, but moderate in alcohol and low in dairy products and meat, has been associated with a lower rate of incident cardiovascular disease (CVD). The underlying mechanisms, however, remain unclear. Endothelial dysfunction and low-grade inflammation play important roles in CVD. A healthy diet might modify these phenomena.Objective: We investigated the associations between the above food groups and overall biomarker scores of endothelial dysfunction and low-grade inflammation in a 7-y longitudinal study.Methods: Using longitudinal data from 557 participants at increased CVD risk from the CODAM (Cohort on Diabetes and Atherosclerosis Maastricht) Study, we assessed diet intake by food-frequency questionnaire and measured plasma biomarkers of endothelial dysfunction [von Willebrand factor, soluble vascular cell adhesion molecule 1, soluble endothelial selectin, soluble thrombomodulin, soluble intercellular adhesion molecule 1 (sICAM-1)] and low-grade inflammation [C-reactive protein, serum amyloid A, interleukin (IL)-6, IL-8, tumor necrosis factor α, and sICAM-1]. At baseline, participants were aged 59.6 ± 6.9 y. Measurements were performed then and after 7 y. Biomarkers were combined into overall scores (sum of z scores; higher scores indicating worse function). Longitudinal data were analyzed with generalized estimating equations and adjusted for sex, age, glucose metabolism, energy intake, body mass index, physical activity, alcohol consumption, and smoking.Results: Higher consumption of fish (per 100 g/wk), but not total consumption of vegetables, fruit, alcohol-containing beverages, dairy products, or meat, was associated with a lower overall endothelial dysfunction score over 7 y (β: −0.027; 95% CI: −0.051, −0.004). No associations were observed with the overall low-grade inflammation score. Further food component analyses indicated that consumption of more lean fish (per 100 g/wk) and raw vegetables (per 100 g/d), and fewer high-fat dairy products (per 100 g/d) was associated with less endothelial dysfunction [(β: −0.038; 95% CI: −0.072, −0.005), (β: −0.095; 95% CI: −0.191, 0.000), and (β: −0.070; 95% CI: −0.131, −0.009), respectively]. Consumption of more fresh fruit (per 100 g/d), wine (per 100 mL/wk), and poultry (per 100 g/d), and fewer high-fat dairy products (per 100 g/d) was associated with less low-grade inflammation [(β: −0.074; 95% CI: −0.133, −0.015), (β:−0.006; 95% CI: −0.013, 0.001), (β:−0.247; 95% CI: -0.479, -0.014), and (β:−0.100; 95% CI: −0.182, −0.019), respectively].Conclusion: These data suggest that the dietary modification of endothelial dysfunction and low-grade inflammation, processes that are important in atherothrombosis, is possible.

Amino acid composition of human uterine fluid: association with age, lifestyle and gynaecological pathology.

STUDY QUESTIONDo the amino acid levels of human uterine fluid vary with age, BMI, phase of menstrual cycle, benign pathology or diet?SUMMARY ANSWERThe levels of 18 amino acids in human uterine fluid were shown to be affected only by maternal diet.WHAT IS KNOWN ALREADYMurine, bovine and ovine uterine amino acid content has been reported, but no reliable data on the human exist. Murine studies have demonstrated that the intrauterine periconceptional nutritional environment is affected by maternal diet.STUDY DESIGN, SIZE, DURATIONUterine secretions were aspirated from 56 women aged 18–45 years. The women were recruited preoperatively from gynaecological theatre operating schedules or hysterosalpingo-contrast-sonography (HyCoSy) lists. A proportion of these women had proven fertility; however, the majority were being investigated for subfertility. The BMI, gynaecological history and dietary pattern of these women were also assessed.PARTICIPANTS/MATERIALS, SETTING, METHODSReverse phase high performance liquid chromatography was used to analyse the concentrations of 18 amino acids within the uterine fluid and blood serum. The results were analysed against the women's stage of cycle, age, BMI and diet.MAIN RESULTS AND THE ROLE OF CHANCEThe profile of 18 amino acids in uterine fluid was described. In total, human uterine fluid was observed to contain an amino acid concentration of 3.54 mM (interquartile range: 2.27–6.24 mM). The relative concentrations of 18 amino acids were not significantly altered by age, BMI, cycle phase or the presence of specific benign gynaecological pathologies. However, a diet identified by a validated scoring system as being less healthy was associated with higher concentrations of asparagine (P = 0.018), histidine (P = 0.011), serine (P = 0.033), glutamine (P = 0.049), valine (P = 0.025), phenylalanine (P = 0.019), isoleucine (P = 0.025) and leucine (P = 0.043) in the uterine fluid compared with a healthier diet, defined as one with a higher intake of fresh vegetables, fruit, whole-grain products and fish and a low intake of red and processed meat and high fat dairy products. There were no significant correlations between serum amino acid concentrations and those in the uterine fluid.LIMITATIONS, REASONS FOR CAUTIONOur results enabled us to detect the effect of diet on the concentrations of amino acids in human uterine fluid; however, the study may not have had sufficient numbers to detect mild effects of BMI or age.WIDER IMPLICATIONS OF THE FINDINGSThese findings increase our understanding of the nutritional environment encountered by the preimplantation embryo, and indicate how periconceptional diet may alter this. Given the importance of early embryo environment for programming of development and future health, this information may aid in the development of nutritional interventions aimed at optimizing the preimplantation phase of human embryo development in vivo.STUDY FUNDING/COMPETING INTEREST(S)This work was funded by the NIHR, the Medical Research Council (G0701153) and the University of Southampton and was supported by the NIHR BRC in Nutrition and Southampton University NHS Foundation Trust. The authors declare no conflicts of interest.

Dairy Product Consumption Has No Impact on Biomarkers of Inflammation among Men and Women with Low-Grade Systemic Inflammation

Background:Randomized controlled trials specifically designed to assess inflammation-related outcomes in response to dairy consumption are lacking. Objective:We investigated the impact of dairy food consumption on biomarkers of inflammation in healthy men and women with low-grade systemic inflammation. Methods:In a multicenter randomized crossover study, 112 adult men and women with high-sensitivity C-reactive protein (hs-CRP) values >1 mg/L consumed 3 servings/d of dairy (375 mL low-fat milk, 175 g low-fat yogurt, and 30 g regular-fat cheddar cheese) or energy-matched control (fruit juice, vegetable juice, cashews, and 1 cookie) products as part of prudent 4-wk diets, each separated by a 4- to 8-wk washout period. Serum concentrations of inflammation biomarkers were measured at the beginning and end of each dietary phase. Expression levels of key inflammatory genes and transcription factors in whole blood cells were assessed at the end of each diet by real-time polymerase chain reaction in a random subset of 53 subjects. Results:Analysis of within-diet changes (post- vs. prediet values) showed a significant reduction in hs-CRP concentrations after the control diet (−11.7%, P = 0.05) but no change after the dairy diet (−7.3%, P = 0.47). As a result, changes in hs-CRP differed between the dairy and control diets (P = 0.04). Both the control and dairy diets similarly reduced interleukin-6 concentrations compared with diet-specific baseline values (−17.6% and −19.9%, respectively; P < 0.0001 for both, P = 0.77 for between-diet comparison). No between- or within-diet difference was observed in adiponectin concentrations, and there was also no between-diet difference in the expression of inflammatory genes and transcription factors. Conclusion:Consistent with data from previous work, these results suggest that short-term consumption of a combination of low- and high-fat dairy products as part of a healthy diet has no adverse effects on inflammation. This trial was registered at www.clinicaltrials.gov as NCT01444326.