High Saturated Fat Intake Research Articles

Substitution of high-dose sucrose with fructose in high-fat diets resulted in higher plasma concentrations of aspartic acid, cystine, glutamic acid, ornithine and phenylalanine, and higher urine concentrations of arginine and citrulline

High fructose intake has been shown to increase circulating alanine transaminase in humans, which could reflect damage to the liver by fructose but could also be linked to higher level of transamination of amino acids in liver. Therefore, we hypothesized that a diet with high content of fructose would affect the amino acid composition in rat plasma and urine differently from a diet with high sucrose content. Because high intake of sucrose and fructose is often accompanied with high intake of saturated fat in the Western-style diet, we wanted to compare the effects of high fructose/sucrose in diets with normal or high content of coconut oil on individual free amino acids plasma and urine. Male Wistar rats were fed diets with normal (10 wt%) or high (40 wt%) content of sucrose or fructose, with normal or high fat content (7 or 22 wt%) and 20 wt% protein (casein). Rats fed high-fructose high-fat diet had higher plasma concentrations of aspartic acid, cystine, glutamic acid, ornithine, and phenylalanine and higher urine concentrations of arginine and citrulline when compared to rats fed high-sucrose high-fat diet. Substituting normal content of sucrose with fructose in the diets had little impact on amino acids in plasma and urine. Serum concentrations of alanine transaminase, aspartate transaminase, and creatinine, and urine cystatin C and T cell immunoglobulin mucin-1 concentrations were comparable between the groups and within normal ranges. To conclude, substituting high-dose sucrose with high-dose fructose in high-fat diets affected amino acid compositions in plasma and urine.

Food Security Levels and Dietary Intake in Mexican Women from Sinaloa

Abstract Objectives We aim to compare dietary intakes among food secure and food insecure vulnerable women from Culiacan, Sinaloa. Methods Cross-sectional study design. We collected data by direct interviews from adult females. Questionnaires included socio-demographic characteristics, the Mexican Food Security Scale and a 24-h recall. Weight and height were measured, and BMI was calculated. Associations between food security levels and dietary intakes were assessed using Mann-Whitney U test for continuous variables and Χ2 test for categorical variables. Data is presented as mean ± SD or median (IQR). Results One hundred and seventy five women (aged: 46.2 ± 15.9 y; BMI: 29.8 ± 6.8 k/m2), participated in this research. The prevalence of household food security (HFS) was 51%, whereas 49% of the population reported some level of household food insecurity (HFI); 26% mild insecurity, 12% moderate insecurity and 11% severe insecurity. Energy intake was 1586 kcal (1149, 2147 kcal), the percentage of energy from carbohydrates was 56%, from fat 28%, and from protein 16%. Daily intake of saturated fat did not comply with the national recommendation, saturated fat provided 11% of daily energy, monounsaturated fat 10%, and polyunsaturated fat 7%. There were no differences between groups (HFS vs. HFI) for age, BMI and energy intake; however, the HFS group had a significantly higher intake of saturated fat; 19 vs. 13 g (P = 0.006). Sugar and calcium intake were also higher in the HFS than in the HFI group, 69 vs. 51 g and 716 vs. 510 mg, respectively (P < 0.05). Total fat (53 vs. 43 g), riboflavin (1.27 vs. 0.99 mg) and vitamin A (398 vs. 337 µg RE) showed a trend towards an increased intake in the HFS group (P < 0.100). Food security is associated with higher intake of macro and micronutrients, although further analysis is needed to identify the main food sources of saturated fat, sugar and calcium. Conclusions Although there is a high prevalence of overweight and obesity, deficient dietary intake of micronutrients could indicate the presence of “hidden hunger” (micronutrients deficiencies) on this vulnerable population. A better understanding of the relationship between food security and dietary intake in this population, may be useful in developing successful interventions. Funding Sources UAS, CONACyT.

Bitter Taste Sensitivity Is Determined by TAS2R38 Haplotype, Associated with Saturated Fat Intake and Is Lower in Overweight and Obese Compared to Normal Weight UK adults

Abstract Objectives Taste perception (sensitivity) may be determined by genetic variations in taste receptors and it affects food intake. Lower fat taste sensitivity is associated with higher dietary fat intake and body mass index (BMI). Recently, associations between bitter and fat taste sensitivity have been reported whereby bitter taste perception may be involved in textural perception of dietary fat. However, it is not clear if lower sensitivity to bitter taste would lead to an actual higher fat intake. Our objectives were to explore the associations between haplotypes in the bitter taste receptor TAS2R38, bitter taste sensitivity and fat intake and if bitter taste sensitivity is lower in individuals with higher BMI. Methods Ethical approval was obtained from the St Mary's and Oxford Brookes University Ethics Committee. Eighty-eight healthy Caucasian participants (44% male and 56% female; mean BMI 24.9 ± 4.8 kg/m2 and mean age 35 ± 14 years) completed this cross-sectional study. Height and weight were measured and genotyping performed for rs713598, rs1726866, rs10246939 genetic variants in the TAS2R38. Haplotypes were determined with Haploview software. Participants rated the intensity of a phenylthiocarbamide (PTC) impregnated strip on the general Labelled Magnitude Scale (gLMS) to determine bitter taste sensitivity and were classified as bitter tasters and non-tasters. Dietary fat intake was calculated from the EPIC-Norfolk Food Frequency Questionnaire and expressed as % total energy intake. Results TAS2R38 haplotypes were associated with bitter taster status (P < 0.005). PTC ratings of intensity were negatively correlated with % saturated fat (SFA) intake (rs = −0.256, P = 0.016). %SFA and %total fat (rs = 0.656, P < 0.005) and %total fat and energy intake (kcal) (rs = 0.225, P = 0.035) were positively correlated. Normal weight participants rated PTC strips as more intense compared to overweight and obese participants (mean rank 53 vs. 41, P = 0.033). Conclusions Bitter taste perception is determined by genetics and lower sensitivity to this taste is associated with higher intake of SFA. Lower bitter taste sensitivity in overweight/obese participants suggests that impaired bitter taste may be associated with an overall unhealthier and more energy dense dietary pattern. Funding Sources St Mary's and Oxford Brookes University.

Cocaine Use and Inflammation Is Associated with Diet Quality in People Living with HIV (PLWH) from the MASH Cohort

Abstract Objectives Cocaine use is one of the most widely used illicit drugs in Miami, FL and especially among PLWH. Cocaine use is associated with greater systemic inflammation and poor dietary intake. Lifestyle factors such as diet may influence inflammation and further exacerbate the effects of substance use and HIV infection on systemic inflammation. This study examined the relationships of cocaine use, inflammation and diet quality in PLWH from the Miami Adult Studies on HIV (MASH) cohort. Methods After obtaining informed consent, data on demographics, socioeconomic status, substance use and parameters of HIV disease progression (CD4 cell count and HIV viral load) were collected from 50 participants enrolled in the MASH cohort in Miami, FL. A total of 4 to 5 24-hour recalls were collected for each participant. Diet quality was assessed using the USDA Healthy Eating Index (HEI)-2015. Interleukin 6 (IL-6) was measured using the Quantikine ELISA kit (R&D Systems, Minneapolis, MN). Statistical analyses used descriptive statistics, Spearman's correlations, Mann-Whitney U and logistic regression. Results The participants’ mean age was 55 ± 6.81, 58% were male, and 68% were African Americans. Overall the diet quality was low with a total median HEI-2015 score of 44.5 (IQR = 38.8–53.8), lower than the general US population score of 59 (P < 0.001) and it was not significantly correlated with IL-6 scores (r = −0.212, P = 139). Cocaine users had significantly lower total median HEI scores [41 (IQR = 35–48) vs.45 (IQR = 41–57.50), P = 0.048] than cocaine non-users. Component HEI scores of whole fruit (r = −0.280, P = 0.049) and saturated fat (r = −0.341, P = 0.015) were correlated with IL-6. Moreover, lower saturated fat intake reduced odds of having IL-6 above the median (OR = 0.710, 95% CI: 0.544–0.928, P = 0.012), after controlling for age, sex, income, education, and cocaine use. Conclusions Diet quality was low for all the participants and significantly lower for those who used cocaine compared to non-users. Higher inflammation was associated with lower fruit and higher saturated fat intakes. Larger studies are needed to elucidate these relationships in order to develop appropriate interventions for PLWH. These results highlight the need for nutritional counseling for PLWH, especially if the condition is associated with cocaine use. Funding Sources NIDA and NIMHD.

Cardio-Metabolic Effects of High-Fat Diets and Their Underlying Mechanisms-A Narrative Review.

The majority of the epidemiological evidence over the past few decades has linked high intake of fats, especially saturated fats, to increased risk of diabetes and cardiovascular disease. However, findings of some recent studies (e.g., the PURE study) have contested this association. High saturated fat diets (HFD) have been widely used in rodent research to study the mechanism of insulin resistance and metabolic syndrome. Two separate but somewhat overlapping models—the diacylglycerol (DAG) model and the ceramide model—have emerged to explain the development of insulin resistance. Studies have shown that lipid deposition in tissues such as muscle and liver inhibit insulin signaling via the toxic molecules DAG and ceramide. DAGs activate protein kinase C that inhibit insulin-PI3K-Akt signaling by phosphorylating serine residues on insulin receptor substrate (IRS). Ceramides are sphingolipids with variable acyl group chain length and activate protein phosphatase 2A that dephosphorylates Akt to block insulin signaling. In adipose tissue, obesity leads to infiltration of macrophages that secrete pro-inflammatory cytokines that inhibit insulin signaling by phosphorylating serine residues of IRS proteins. For cardiovascular disease, studies in humans in the 1950s and 1960s linked high saturated fat intake with atherosclerosis and coronary artery disease. More recently, trials involving Mediterranean diet (e.g., PREDIMED study) have indicated that healthy monounsaturated fats are more effective in preventing cardiovascular mortality and coronary artery disease than are low-fat, low-cholesterol diets. Antioxidant and anti-inflammatory effects of Mediterranean diets are potential mediators of these benefits.

Reduction in saturated fat intake for cardiovascular disease.

Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. To assess the effect of reducing saturated fat intake and replacing it with carbohydrate (CHO), polyunsaturated (PUFA), monounsaturated fat (MUFA) and/or protein on mortality and cardiovascular morbidity, using all available randomised clinical trials. We updated our searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid) and Embase (Ovid) on 15 October 2019, and searched Clinicaltrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) on 17 October 2019. Included trials fulfilled the following criteria: 1) randomised; 2) intention to reduce saturated fat intake OR intention to alter dietary fats and achieving a reduction in saturated fat; 3) compared with higher saturated fat intake or usual diet; 4) not multifactorial; 5) in adult humans with or without cardiovascular disease (but not acutely ill, pregnant or breastfeeding); 6) intervention duration at least 24 months; 7) mortality or cardiovascular morbidity data available. Two review authors independently assessed inclusion, extracted study data and assessed risk of bias. We performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity analyses, funnel plots and GRADE assessment. We included 15 randomised controlled trials (RCTs) (16 comparisons, ~59,000 participants), that used a variety of interventions from providing all food to advice on reducing saturated fat. The included long-term trials suggested that reducing dietary saturated fat reduced the risk of combined cardiovascular events by 21% (risk ratio (RR) 0.79; 95% confidence interval (CI) 0.66 to 0.93, 11 trials, 53,300 participants of whom 8% had a cardiovascular event, I² = 65%, GRADE moderate-quality evidence). Meta-regression suggested that greater reductions in saturated fat (reflected in greater reductions in serum cholesterol) resulted in greater reductions in risk of CVD events, explaining most heterogeneity between trials. The number needed to treat for an additional beneficial outcome (NNTB) was 56 in primary prevention trials, so 56 people need to reduce their saturated fat intake for ~four years for one person to avoid experiencing a CVD event. In secondary prevention trials, the NNTB was 32. Subgrouping did not suggest significant differences between replacement of saturated fat calories with polyunsaturated fat or carbohydrate, and data on replacement with monounsaturated fat and protein was very limited. We found little or no effect of reducing saturated fat on all-cause mortality (RR 0.96; 95% CI 0.90 to 1.03; 11 trials, 55,858 participants) or cardiovascular mortality (RR 0.95; 95% CI 0.80 to 1.12, 10 trials, 53,421 participants), both with GRADE moderate-quality evidence. There was little or no effect of reducing saturated fats on non-fatal myocardial infarction (RR 0.97, 95% CI 0.87 to 1.07) or CHD mortality (RR 0.97, 95% CI 0.82 to 1.16, both low-quality evidence), but effects on total (fatal or non-fatal) myocardial infarction, stroke and CHD events (fatal or non-fatal) were all unclear as the evidence was of very low quality. There was little or no effect on cancer mortality, cancer diagnoses, diabetes diagnosis, HDL cholesterol, serum triglycerides or blood pressure, and small reductions in weight, serum total cholesterol, LDL cholesterol and BMI. There was no evidence of harmful effects of reducing saturated fat intakes. The findings of this updated review suggest that reducing saturated fat intake for at least two years causes a potentially important reduction in combined cardiovascular events. Replacing the energy from saturated fat with polyunsaturated fat or carbohydrate appear to be useful strategies, while effects of replacement with monounsaturated fat are unclear. The reduction in combined cardiovascular events resulting from reducing saturated fat did not alter by study duration, sex or baseline level of cardiovascular risk, but greater reduction in saturated fat caused greater reductions in cardiovascular events.

Abstract MP27: Saturated Fat Intake From Dairy Sources Is Associated With Reduced Cardiovascular Risk In Framingham Offspring Study Women

Introduction: While saturated fat (SFA) intake has long been considered as an important risk factor for cardiovascular disease (CVD), some evidence in recent years has called these findings into question. There is limited evidence examining the separate effects of SFAs from different food sources on cardiovascular risk. Objective: The goal of this study was to determine whether higher (vs. lower) intakes of SFA from dairy and non-dairy sources were associated with risk of incident cardiovascular disease. Methods: Data from 1991 adults, ages 30 and older, who were free of CVD at the time of baseline dietary assessment in the prospective Framingham Offspring Study were included in these analyses. Dairy and non-dairy SFA was assessed using 3-day diet records at exams 3 and 5; intakes were adjusted for body weight using the residual method. Subjects were followed from exam 5 to exam 9 for CVD events (median follow-up 16.9 years). Cox proportional hazards models were used to adjust for confounding by sex, age, BMI, physical activity, smoking (pack-years), non-dairy SFA (in dairy SFA models, and vice versa for non-dairy models), and time dependent occurrence of hypertension or use of lipid-lowering medications. Results: Subjects were classified into 3 categories of sex-specific intake of dairy SFA (<9, 9-<13, and ≥13 g/day for men; <6, 6-<9, ≥9 g/day for women) and non-dairy SFA (<15, 15-<18 and ≥18 g/day for men; <12, 12-<15, and ≥15 g/day for women). Women with moderate (vs. low) and high (vs. low) dairy SFA intakes had 56% (95% CI: 0.27-0.71) and 20% (95% CI: 0.56-1.14) lower CVD risks, respectively, while women consuming high (vs. low) non-dairy SFA had 22% (CI: 0.52-1.16) lower risks. Neither dairy-based SFA nor non-dairy SFA intake was associated with CVD occurrence in men. To determine whether the combined effects of SFA from dairy and non-dairy sources were associated with CVD risk, we cross-classified SFA intakes from the two sources (i.e., high/low dairy SFA intake: <9 vs. ≥9 g/day for men, <6 vs ≥6 g/day for women; high/low non-dairy SFA intake: <15 vs. ≥15 g/day for both men & women). Overall, subjects with higher intakes of dairy SFA combined with lower intakes of non-dairy SFA had the lowest risks of CVD (HR:0.73; 95% CI: 0.54-0.98). These effects were stronger in women (HR:0.60; 95% CI: 0.41-0.88), and non-statistically significant in men (HR: 0.88; 95% CI: 0.54-1.43). Women with higher combined intakes of SFA from both dairy and non-dairy sources still had 44% lower risks of CVD. However, higher intakes of SFA from non-dairy sources alone was not associated with CVD risk in either men or women. Conclusions: Saturated fats derived from dairy sources were associated with a reduced risk of incident CVD in women. For both men and women, those who had higher intakes of dairy-derived SFA combined with lower intakes of non-dairy SFA tended to have lower risks of CVD than those with lower intakes of SFA from both sources.

An Overview on the Associations between Health Behaviors and Brain Health in Children and Adolescents with Special Reference to Diet Quality.

Unhealthy diet has been associated with overweight, obesity, increased cardiometabolic risk, and recently, to impaired cognition and academic performance. The aim of this review is to provide an overview of the associations between health behaviors and cognition and academic achievement in children and adolescents under 18 years of age with a special reference to diet quality. Dietary patterns with a low consumption of fish, fruits, and vegetables, and high in fast food, sausages, and soft drinks have been linked to poor cognition and academic achievement. The studies on the associations between the high intake of saturated fat and red meat and low intake of fiber and high-fiber grain products with cognition are limited. The available evidence and physiological mechanisms suggest that diet may have direct, indirect, and synergistic effects on brain and cognition with physical activity, sedentary behaviors, cardiometabolic health, and sleep, but the associations have been modest. Therefore, integrating a healthy diet, physically active lifestyle, and adequate sleep may provide optimal circumstances for brain development and learning. We conclude that most of the existing literature is contained in cross-sectional studies, which therefore highlights the need for longitudinal and intervention studies on the effects of diet, physical activity, sedentary behavior, and sleep on cognition and academic performance.

How achievable are free sugar recommendations in healthy dietary patterns for 1–5 year olds in Ireland?

The World Health Organisation (WHO) strongly recommends reducing free sugar intake to < 10% energy, and suggests a further conditional reduction to < 5% energy. This study aims to assess how achievable these free sugar intake recommendations are in healthy diets of 1–5 year olds in Ireland and to identify the main food contributors.Using minimal added sugar, fat and no added salt, four-day food intake patterns were developed for 1–5 year old children (n30 girls; n30 boys) representing different percentile levels on the WHO growth charts. These food intake patterns were based on foods commonly consumed in the Irish National Pre-school Nutrition Survey and adjusted to meet energy, macronutrient and micronutrient requirements. The free sugar content of each food used was identified according to the WHO definition and estimated using food composition tables. Free sugar content of the four-day patterns was assessed against the two WHO recommendations. Subjects were compared depending on recommendations achieved. Where necessary, nutrients were estimated per 500kcal to control for energy.Food intake patterns of all subjects (n60) achieved the WHO recommendation of < 10% energy, with 50% (n30) meeting the further recommendation of < 5% energy. Subjects with free sugar intakes < 5% energy compared with those not meeting this recommendation, were younger (2 years vs. 3.5 years, p < 0.001), had lower energy intakes (946kcal vs. 1263.8kcal, p < 0.001), higher fat intakes (37% vs. 29%, p < 0.001), higher saturated fat intakes (18% vs. 13%, p < 0.001) and lower carbohydrate intakes (46% vs. 53%, p < 0.001). When estimated per 500kcal they had lower intakes of fibre (5.0 g vs. 6.2 g, p < 0.001) and vitamin D (5.9μg vs. 6.3μg, p < 0.001) and higher intakes of vitamin A (177.3μg vs. 108.5μg, p < 0.001) and DHA and EPA (0.3 g vs. 0.2 g, p < 0.001). The main foods contributing to free sugar intakes in these subjects were cereals (29% of free sugar intake), yoghurts (27%), breads (5%) and ice cream (4%). By comparison the main foods contributing to free sugar in subjects whose intakes exceeded 5% energy included yoghurts (22%), stewed apples (9%) and puddings (6%).This analysis demonstrates the WHO strong recommendation of < 10% energy for free sugar was easily achievable, but the further conditional recommendation (< 5%) was more difficult. This was only achieved at younger ages and was associated with increased intakes of fat and saturated fat and lower intakes of fibre and vitamin D. The main food contributors to free sugar in healthy diets for 1–5 year olds are important sources of nutrients.

Energy balance and occupational activity as predictors of obesity risk in women.

AbstractReduced occupational energy expenditure and increased energy intake are important contributors to the increasing prevalence of obesity. The aim of this study was to examine whether sedentary occupations, and specific indicators of energy intake and expenditure are associated with obesity risk in Australian women. Data were from 3,444 participants in the Australian Longitudinal Study on Women's Health, who reported their weight, dietary intake, physical activity and occupation in 2009 (at age 31–36), and weight in 2012. Participants were categorised as having a ‘less sedentary’ or ‘sedentary work’, based on occupation and activity patterns at work. Multivariate models were conducted to examine the odds of being obese (> 30 body-mass index) and risk of obesity in the two occupational groups based on energy balance factors (diet and physical activity). Models were adjusted for major confounders (smoking, education, income, number of children).There was no significant difference in the prevalence of obesity between groups (20.3% less sedentary vs 22.7% sedentary work, p = 0.11) at baseline. Being in the highest total energy intake tertile, saturated fat intake > 35g/d and drinking 3 or more sugar-sweetened beverages per week increased the odds of being obese in both groups. But to a higher extent in ‘less sedentary work’ (OR 2.11 95%CI 1.41–3.19; OR 3.04 95%CI 2.09–4.45; 2.07 95%CI 1.45–2.97, respectively). High physical activity (> 1000MET.min/week) was consistently associated with lower odds of being obese (OR 0.64 95%CI 0.43–0.97 ‘less sedentary’; OR 0.58 95%CI 0.36–0.93 ‘sedentary work’) but lower incidence of obesity only in ‘less sedentary work’ group (IRR 0.52 95%CI 0.30–0.88, absolute risk 14%). High sugar-sweetened beverages increased the incidence of obesity only in this group (IRR 1.72 95%CI 1.08–2.73, absolute risk 23%). Having a sedentary work per se did not play a major role in obesity prevalence and risk in women. Instead, high saturated fat and SSB intake, and physical inactivity remained the major contributors to obesity prevalence and risk, particularly for those in less sedentary jobs.

Household Food Insecurity and Dietary Saturated Fat in Rural Appalachia

Purpose: To explore the relationship between food insecurity and dietary saturated fat intake in rural Central Appalachia. Design: Cross-sectional analysis of baseline data from a longitudinal interventional studySample: Baseline assessment of dietary saturated fat intake and food security in volunteers who had resided in rural Central Appalachia for at least five years and were enrolled in a cooking skills class.Method: Volunteers (n=56, 89.3% female) completed the USDA Household Food Security Survey Module (HFSSM) and Diet History Questionnaire-II. Average age was 56.5 (range 18-76) years. Average intake of saturated fat was calculated using DietCalc software. Food security was measured using the HFSSM. Descriptive and inferential statistical analyses were conducted using SAS, v. 9.3 with an alpha level of .05.Findings: High or marginal food security was experienced by 75% with 25% of participants experiencing low/very low food security. Average daily saturated fat was 26 grams. Significant findings included greater saturated fat consumption in men; lower saturated fat consumption with older age; older age being associated with lower food insecurity; and no association between food insecurity and saturated fat intake. Average daily saturated fat gram intake was significantly lower for females than males; the group means were 23.6 (SD = 12.4) and 49.6 (SD = 15.0) for these two groups, respectively (t = 4.8, P < .001). For every 10-year increase in age, there was a 2.7 gram decrease in daily saturated fat intake.Conclusions: Historical food traditions and method of food preparation likely contribute to the lack of an association between high food security and saturated fat intake in rural Appalachia. Food insecurity was not associated with saturated fat intake in our sample. Additional research is needed to determine to the full impact of food insecurity on dietary fat intake in Appalachia.Keywords:  Food Insecurity, Appalachian Region, Fatty Acids Saturated, Poverty DOI:  http://dx.doi.org/10.14574/ojrnhc.v19i1.568 Acknowledgments:  This study was funded by the National Institute of Nursing Research Grant 5K23NR014883-02.

Low Carbohydrate and Low-Fat Diets: What We Don't Know and Why we Should Know It.

In the 1940s, the diet-heart hypothesis proposed that high dietary saturated fat and cholesterol intake promoted coronary heart disease in “at-risk” individuals. This hypothesis prompted federal recommendations for a low-fat diet for “high risk” patients and as a preventive health measure for everyone except infants. The low carbohydrate diet, first used to treat type 1 diabetes, became a popular obesity therapy with the Atkins diet in the 1970s. Its predicted effectiveness was based largely on the hypothesis that insulin is the causa prima of weight gain and regain via hyperphagia and hypometabolism during and after weight reduction, and therefore reduced carbohydrate intake would promote and sustain weight loss. Based on literature reviews, there are insufficient randomized controlled inpatient studies examining the physiological significance of the mechanisms proposed to support one over the other. Outpatient studies can be confounded by poor diet compliance such that the quality and quantity of the energy intake cannot be ascertained. Many studies also fail to separate macronutrient quantity from quality. Overall, there is no conclusive evidence that the degree of weight loss or the duration of reduced weight maintenance are significantly affected by dietary macronutrient quantity beyond effects attributable to caloric intake. Further work is needed.

Association between dietary sodium, calcium, saturated fat and blood pressure in obese Egyptian adolescents

BackgroundOverweight/obesity, high dietary fat, sodium and low calcium intake are recognized as risk factors for primary hypertension in obese adults, children and adolescents.AimThe aim of this work was to assess the association between some dietary factors (fat, sodium, calcium) and blood pressure (BP) among obese Egyptian adolescents.Subjects and methodsSeventy-seven adolescents shared in this study. Their height and weight were reported. Body mass index (BMI) was calculated. Blood pressure was measured; the mean values were corrected for age and sex in the form of centile. Dietary interview consisting of 24 h recall was performed. Fasting blood glucose and serum lipid profile were determined.ResultsData revealed that, the percent of the prehypertensive was 42.86% and 38.80%, for boys and girls, no hypertensive cases were recorded. The mean values of their weight, DBP, and the serum lipid parameters were high compared to their controls; significant differences were found between the daily intake of calories, protein, carbohydrate, dietary fiber and cholesterol at p ≤ 0.05. The mean values of the daily intake of the vitamins and minerals were low in all groups compared to the RDAs, except sodium intake which was high in the prehypertensive boys and normal and prehypertensive girls.ConclusionThis study showed a high incidence of pre-hypertension among obese Egyptian adolescents, which is associated with high intake of sodium, saturated fat and cholesterol, along with low intake of calcium.

Milk Fat Intake and Telomere Length in U.S. Women and Men: The Role of the Milk Fat Fraction.

The associations between milk intake frequency and milk fat consumption and telomere length, an index of biological aging, were studied using an NHANES sample of 5,834 U.S. adults and a cross-sectional design. The milk consumption variables were assessed with the NHANES Diet Behavior and Nutrition questionnaire. The quantitative polymerase chain reaction method was used to measure leukocyte telomere length. Results showed that milk consumption frequency was not related to telomere length; however, there was a strong association between milk fat intake and telomere length. With the sample delimited to milk drinkers only, milk fat intake was linearly and inversely related to telomere length, after adjusting for the covariates (F = 8.6, P = 0.0066). For each 1 percentage point increase in milk fat consumed (e.g., 1% to 2%), adults had more than 4 years of additional biological aging. With milk fat intake divided into 5 categories (i.e., milk abstainers, nonfat, 1%, 2%, and full-fat milk), mean telomere lengths differed across the categories (F = 4.1, P = 0.0093). The mean telomere difference between the extremes of milk fat intake (nonfat vs. full-fat) was 145 base pairs, representing years of additional biological aging for full-fat milk consumers. Effect modification testing indicated that the milk fat and cellular aging association may be partly due to saturated fat intake differences across the milk fat groups. When the sample was delimited to adults reporting only high total saturated fat intake (tertile 3), the milk fat and telomere relationship was strong. However, when the sample was restricted to adults reporting only low saturated fat consumption (tertile 1), there was no relationship between milk fat intake and telomere length. Overall, the findings highlight an association of increased biological aging in U.S. adults who consumed high-fat milk. The results support the latest Dietary Guidelines for Americans (2015–2020), which recommend consumption of low-fat milk, but not high-fat milk, as part of a healthy diet.

Trends in Dietary Carbohydrate, Protein, and Fat Intake and Diet Quality Among US Adults, 1999-2016

Changes in the economy, nutrition policies, and food processing methods can affect dietary macronutrient intake and diet quality. It is essential to evaluate trends in dietary intake, food sources, and diet quality to inform policy makers. To investigate trends in dietary macronutrient intake, food sources, and diet quality among US adults. Serial cross-sectional analysis of the US nationally representative 24-hour dietary recall data from 9 National Health and Nutrition Examination Survey cycles (1999-2016) among adults aged 20 years or older. Survey cycle. Dietary intake of macronutrients and their subtypes, food sources, and the Healthy Eating Index 2015 (range, 0-100; higher scores indicate better diet quality; a minimal clinically important difference has not been defined). There were 43 996 respondents (weighted mean age, 46.9 years; 51.9% women). From 1999 to 2016, the estimated energy from total carbohydrates declined from 52.5% to 50.5% (difference, -2.02%; 95% CI, -2.41% to -1.63%), whereas that of total protein and total fat increased from 15.5% to 16.4% (difference, 0.82%; 95% CI, 0.67%-0.97%) and from 32.0% to 33.2% (difference, 1.20%; 95% CI, 0.84%-1.55%), respectively (all P < .001 for trend). Estimated energy from low-quality carbohydrates decreased by 3.25% (95% CI, 2.74%-3.75%; P < .001 for trend) from 45.1% to 41.8%. Increases were observed in estimated energy from high-quality carbohydrates (by 1.23% [95% CI, 0.84%-1.61%] from 7.42% to 8.65%), plant protein (by 0.38% [95% CI, 0.28%-0.49%] from 5.38% to 5.76%), saturated fatty acids (by 0.36% [95% CI, 0.20%-0.51%] from 11.5% to 11.9%), and polyunsaturated fatty acids (by 0.65% [95% CI, 0.56%-0.74%] from 7.58% to 8.23%) (all P < .001 for trend). The estimated overall Healthy Eating Index 2015 increased from 55.7 to 57.7 (difference, 2.01; 95% CI, 0.86-3.16; P < .001 for trend). Trends in high- and low-quality carbohydrates primarily reflected higher estimated energy from whole grains (0.65%) and reduced estimated energy from added sugars (-2.00%), respectively. Trends in plant protein were predominantly due to higher estimated intake of whole grains (0.12%) and nuts (0.09%). From 1999 to 2016, US adults experienced a significant decrease in percentage of energy intake from low-quality carbohydrates and significant increases in percentage of energy intake from high-quality carbohydrates, plant protein, and polyunsaturated fat. Despite improvements in macronutrient composition and diet quality, continued high intake of low-quality carbohydrates and saturated fat remained.

Short-term Dietary Interventions for the Management of Nonalcoholic Fatty Liver.

Non-alcoholic fatty liver disease (NAFLD) affects millions of individuals on a global scale and currently no gold standard treatment exists. The risk of developing NAFLD is considerably higher with increasing body mass index. Consequently, weight loss should be recommended to all overweight patients with fatty liver. However, lifestyle interventions, irrespective of weight status, may also influence the condition. The aim herein is to present examples of short-term interventions which assess direct effects of dietary-related components on hepatic steatosis. This review includes studies with short-term dietary-related interventions of up to 16 weeks that evaluate their efficacy in reducing intrahepatic lipid contents (hepatic steatosis). This review primarily focuses on the three main macronutrients: dietary carbohydrates, fats and proteins. High saturated fat intake and high consumption of carbohydrates, particularly from simple sugars such as fructose are reported as risk factors for hepatic steatosis. Overall, shortterm hypocaloric diets have shown beneficial effects in reducing intrahepatic lipid contents. Macronutrient manipulations such as carbohydrate restriction as well as the consumption of unsaturated fatty acids are also reported to have efficacious effects. This review highlights the different dietary interventions that can influence hepatic steatosis in the short term, illustrating both pro and anti-steatotic effects.

Prevalence and associations of behavioural risk factors with blood lipids profile in Lebanese adults: findings from WHO STEPwise NCD cross-sectional survey

ObjectiveTo examine associations of behavioural risk factors, namely cigarette smoking, physical activity, dietary intakes and alcohol consumption, with blood lipids profile.Design and participantsData drawn from a cross-sectional study involving participants...

A proinflammatory diet is associated with inflammatory gene expression among healthy, non-obese adults: Can social ties protect against the risks?

The Western diet, characterized by high intake of saturated fat, sugar, and salt, is associated with elevated inflammation and chronic disease risk. Few studies have investigated molecular mechanisms linking diet and inflammation; however, a small number of randomized controlled trials suggest that consuming an anti-inflammatory diet (i.e., a primarily plant-based diet rich in monounsaturated fat and lean protein) decreases proinflammatory gene expression. The current study investigated the association between everyday diet and proinflammatory gene expression, as well as the extent to which central adiposity and social involvement modulate risk. Participants were healthy middle-aged and older adults (N = 105) who completed a food frequency questionnaire and reported how many close social roles they have. Anthropometric measurements and blood samples also were collected; gene expression data were analyzed from LPS-stimulated peripheral blood mononuclear cells for interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)-α. The inflammatory potential of each participant’s diet was calculated using the Dietary Inflammatory Index (DII®). Participants with higher DII® scores, indicating a more proinflammatory diet, had greater IL-6 (b = −0.02, SE = 0.008, p = .01), IL-1β (b = −0.01, SE = 0.006, p = .03), and TNF-α (b = −0.01, SE = 0.005, p = .04) gene expression if they had a smaller sagittal abdominal diameter (SAD); effects were not seen among those with higher SADs. Social involvement served a protective role, such that participants with smaller SADs had greater IL-6 (b = 0.01, SE = 0.004, p = .049) and IL-1β (b = 0.01, SE = 0.003, p = .045) gene expression only if they had less social involvement; there was no effect of diet on gene expression among those who reported greater social participation. Results are the first to demonstrate a link between self-reported diet and proinflammatory gene expression. Importantly, the effect of diet on gene expression depended upon both body fat composition and social participation, both of which have previously been linked directly with proinflammatory gene expression and inflammation.

Effects of red meat, white meat, and nonmeat protein sources on atherogenic lipoprotein measures in the context of low compared with high saturated fat intake: a randomized controlled trial

Dietary recommendations to limit red meat are based on observational studies linking intake to cardiovascular disease (CVD) risk together with the potential of its saturated fatty acid (SFA) content to raise low-density lipoprotein (LDL) cholesterol. However, the relation of white meat to CVD risk, and the effects of dietary protein source on lipoprotein particle subfractions, have not been extensively evaluated. We tested whether levels of atherogenic lipids and lipoproteins differed significantly following consumption of diets with high red meat content compared with diets with similar amounts of protein derived from white meat or nonmeat sources, and whether these effects were modified by concomitant intake of high compared with low SFAs. Generally healthy men and women, 21-65 y, body mass index 20-35 kg/m2, were randomly assigned to 1 of 2 parallel arms (high or low SFA) and within each, allocated to red meat, white meat, and nonmeat protein diets consumed for 4 wk each in random order. The primary outcomes were LDL cholesterol, apolipoprotein B (apoB), small+medium LDL particles, and total/high-density lipoprotein cholesterol. Analysis included participants who completed all 3 dietary protein assignments (61 for high SFA; 52 for low SFA). LDL cholesterol and apoB were higher with red and white meat than with nonmeat, independent of SFA content (P<0.0001 for all, except apoB: red meat compared with nonmeat [P=0.0004]). This was due primarily to increases in large LDL particles, whereas small+medium LDL and total/high-density lipoprotein cholesterol were unaffected by protein source (P=0.10 and P=0.51, respectively). Primary outcomes did not differ significantly between red and white meat. Independent of protein source, high compared with low SFA increased LDL cholesterol (P=0.0003), apoB (P=0.0002), and large LDL (P=0.0002). The findings are in keeping with recommendations promoting diets with a high proportion of plant-based food but, based on lipid and lipoprotein effects, do not provide evidence for choosing white over red meat for reducing CVD risk. This trial was registered at Clinicaltrials.gov as NCT01427855.

Comprehensive Analysis of the Real Lifestyles of T1D Patients for the Purpose of Designing a Personalized Counselor for Prandial Insulin Dosing.

Post-prandial hyperglycemia is still a challenging issue in intensified insulin therapy. Data of 35 T1D patients during a four-week period were analyzed: RT-CGM (real time continuous glucose monitoring) record, insulin doses, diet (including meal photos), energy expenditure, and other relevant conditions. Patients made significant errors in carbohydrate counting (in 56% of cooked and 44% of noncooked meals), which resulted in inadequate insulin doses. Subsequently, a mobile application was programmed to provide individualized advice on prandial insulin dose. When using the application, a patient chooses only the type of categorized situation (e.g., meals with other relevant data) without carbohydrates counting. The application significantly improved postprandial glycemia as normoglycemia was reached in 95/105 testing sessions. Other important findings of the study include: A high intake of saturated fat (median: 162% of recommended intake); a low intake of fiber and vitamin C (median: 42% and 37%, respectively, of recommended intake); an increase in overweight/obesity status (according to body fat measurement), especially in women (median of body fat: 30%); and low physical activity (in 16/35 patients). The proposed individualized approach without carbohydrate counting may help reach postprandial normoglycemia but it is necessary to pay attention to the lifestyle habits of T1D patients too.