Individual Dietary Components Research Articles

The Effects of Nutritional Knowledge on the Dietary Practices of People Living with HIV in Kayole Division, Nairobi-Kenya

Introduction and background: Appropriate nutrition knowledge influences the dietary intake in all income setups. This further influences the dietary adequacy and nutrition status. Nutritional knowledge is very important to People Living with HIV (PLHIV). It must be meaningful to influence their dietary practices. This is through the adaption of optimal dietary practices. Dietary practices also influence the nutrition status, enhance drug metabolism and efficacy. Information on the influence of nutrition knowledge on dietary practices of PLHIV is scarce. Objective: Thus, this study sought to establish the association between nutrition knowledge and individual dietary practices components of HIV patients in low income settings. Methods: A cross-sectional analytical study was conducted among149 persons with Human immunodeficiency virus (HIV) and attached to Women Fighting HIV/AIDS in Kenya (WOFAK) centre in Kayole division. The researcher administered questionnaires which had been pretested and assessed for validity and reliability in data collection on 149 PLHIV. Spearman’s rho was used to establish the relationship between nutrition knowledge and dietary practices. Results: The relationship between nutrition knowledge and the number of meals consumed in a day (0.001), the frequency at which fruits (0.001), vegetables (0.003), legumes (0.003), animal products (0.001) and were-delete cereals (0.020) consumed was positive and significant (p<0.05) respectively. Nutrition knowledge influences the dietary practices of HIV patients. This is by increasing the choice and intake of foods that are nutrient dense; that boost the immunity while preventing loss of muscle and also restricting on foods that would impact their nutrition status negatively. Conclusions and recommendations: Dietary practices were more optimal as the nutrition knowledge increased. Appropriate nutrition information should be communicated to PLHIV at the point of contact with care centres. PLHIV in low income settings should be guided in the choice of nutritious affordable foods within their economic capacity. Follow up should be provided to ensure that nutritional knowledge impacted on PLHIV is translated to dietary practices for better health outcome.

Junk food and heart disease: the missing tooth

Most clinicians recognise that junk food consumption is associated with premature heart disease. The general consensus is that this relationship can be explained by the saturated fats in these foods increasing obesity, diabetes and hyperlipidaemia risk and the high salt content raising blood pressure. However, an emerging body of evidence has now demonstrated an association between poor oral health and cardiovascular disease (CVD) risk. As well as having high levels of saturated fat and salt, junk foods often contain a great deal of sugar and the effect this has on oral health may be an important additional mechanism by which junk food elevates risk of CVD. The global consumption of junk food is unquestionably on the rise. The astronomical growth of the fast food industry in the past few decades has led to the proportion of foods consumed from these outlets rising dramatically and this trend is more recently being mirrored in the developing world, with urbanisation occurring in many parts of Asia and Africa. Worryingly, fast food outlets are most prevalent in low-income neighbourhoods, and there have been suggestions that policy-makers should consider limiting the number per community, particularly in school areas. Among different types of junk food, soft drinks have raised particular concerns and are the main source of free sugar for many individuals. From 1980 to 2000, for example, the contribution of soft drinks to total sugar intake more than doubled from a level of 15% to 37% and these figures have continued to increase since. There is now a convincing evidence base linking poor oral health, in particular periodontal disease, to amplified CVD risk. Periodontal disease occurs as the result of untreated dental caries, which is in turn driven by a number of factors including poor oral hygiene and excess sugar consumption. It has been noted that the free sugars in fizzy drinks and other junk foods are particularly potent drivers of this. Individual studies have demonstrated links between periodontal disease and atherosclerosis as well as various clinical CVD outcomes. In addition, proxy markers for periodontal disease such as tooth loss and reduced tooth brushing have also been associated with higher levels of CVD. The mechanism by which poor oral health increases CVD risk is thought to be an inflammatory response to chronic infection. The inflammatory component of atherosclerosis has long been recognised and periodontal disease is an extremely common chronic infection, associated with elevated inflammatory biomarkers including C-reactive protein. Thus, the increase to the systemic inflammatory burden caused by this disease may mediate the increase in atherosclerosis. Indeed, findings from prospective longitudinal studies indicate that inflammatory biomarkers may be useful predictors of future CVD. In the most recent UK national guidance on the prevention of CVD at population level, the National Institute for Health and Clinical Excellence discusses the importance of policy and legislation being used to influence various key dietary areas. These include protecting children from irresponsible marketing, ensuring clear food-labelling systems and empowering local authorities to have greater influence over fast-food outlets. The policy goals for individual dietary components, meanwhile, include reductions in salt and saturated fat consumption and an increased public awareness about the harmful effects of industrially produced trans-fatty acids. Although reductions in sugar are indirectly mentioned, this is not yet a major policy goal in these guidelines. Decreasing the consumption of junk food is complex and requires a multifaceted approach. Reducing availability seems to be an important step with density of outlets being associated with consumption patterns, particularly in children. Another means of reducing availability is through pricing and taxation. Evidence has revealed that even modest increases in prices of fast food, for example, may be sufficient to achieve reductions in consumption. There has been much debate about this in the international community, with governments, public health departments

2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk

2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk

The association between carotid intima media thickness and individual dietary components and patterns

AimsTo review: 1) the correlation between individual dietary components and carotid intima media thickness (cIMT); 2) the relationship between dietary patterns and cIMT; 3) the effect of dietary interventions on cIMT progression. Data synthesisAn electronic search for epidemiological and intervention trials investigating the association between dietary components or patterns of intake and cIMT was performed in PUBMED, EMBASE and the Cochrane Library. Epidemiological data shows that a higher intake of fruit, wholegrains and soluble fibre and lower consumption of saturated fat in favour of polyunsaturated fat is associated with lower cIMT. In people at high risk of cardiovascular disease >93 g/day of fruit is associated with lower cIMT. Lower cIMT has also been observed when >0.79 serves/day of wholegrains and >25 g/day of fibre, predominately in the soluble form is consumed. Saturated fat is positively associated with cIMT, for every 10 g/day increase in saturated fat cIMT is 0.03 mm greater. Olive oil is inversely associated with cIMT, with a benefit seen when >34 g/day is consumed. While there are many epidemiological studies exploring the association between dietary intake and cIMT there are few intervention studies. Intervention studies show that a Mediterranean diet may reduce cIMT progression, especially in those with a higher cIMT. ConclusionsA Mediterranean style dietary pattern, which is high in fruits, wholegrains, fibre and olive oil and low in saturated fat, may reduce carotid atherosclerosis development and progression. However further research from randomised controlled trials is required to understand the association between diet and cIMT and the underlying mechanisms.

A parallel randomized trial on the effect of a healthful diet on inflammageing and its consequences in European elderly people: Design of the NU-AGE dietary intervention study

BackgroundThe proportion of European elderly is expected to increase to 30% in 2060. Combining dietary components may modulate many processes involved in ageing. So, it is likely that a healthful diet approach might have greater favourable impact on age-related decline than individual dietary components. This paper describes the design of a healthful diet intervention on inflammageing and its consequences in the elderly. MethodsThe NU-AGE study is a parallel randomized one-year trial in 1250 apparently healthy, independently living European participants aged 65–80 years. Participants are randomised into either the diet group or control group. Participants in the diet group received dietary advice aimed at meeting the nutritional requirements of the ageing population. Special attention was paid to nutrients that may be inadequate or limiting in diets of elderly, such as vitamin D, vitamin B12, and calcium.C-reactive protein is measured as primary outcome. DiscussionThe NU-AGE study is the first dietary intervention investigating the effect of a healthful diet providing targeted nutritional recommendations for optimal health and quality of life in apparently healthy European elderly. Results of this intervention will provide evidence on the effect of a healthful diet on the prevention of age related decline.

Food for Thought: Hypertension-Control Diet Also Slowed Cognitive Decline

Food for Thought: Hypertension-Control Diet Also Slowed Cognitive Decline

Role of dietary factors in survival and mortality in colorectal cancer: a systematic review

The role of dietary factors in the outcome of colorectal cancer (CRC) has been the subject of many studies, but results are inconclusive. Presented here are the results of a systematic review of studies published on dietary factors and CRC outcome in the English literature between March 2002 and March 2012. Studies were subdivided into survival studies in CRC patients and CRC mortality studies in the general population. Sixteen of the 636 studies identified--5 on survival and 11 on mortality--met the predefined inclusion criteria. No consistent association between individual dietary components and CRC outcome was detected in the survival studies. In the mortality studies, an association between meat intake and increased CRC mortality was found in two ecologic studies; however, two prospective cohort studies did not confirm this association. An inverse association between cereal intake and CRC mortality was found in two ecologic studies. In conclusion, published studies investigating dietary factors and outcome in CRC are heterogeneous in design and findings. No dietary component was conclusively and consistently associated with survival in CRC patients. The results of mortality studies seem to indicate that meat intake has an adverse effect on CRC mortality, while cereal intake may be protective.

Dietary Strategies to Optimize Wound Healing after Periodontal and Dental Implant Surgery: An Evidence-Based Review

Methods to optimize healing through dietary strategies present an attractive option for patients, such that healing from delicate oral surgeries occurs as optimally as possible with minimal patient-meditated complications through improper food choices. This review discusses findings from studies that have investigated the role of diet, either whole foods or individual dietary components, on periodontal health and their potential role in wound healing after periodontal surgery. To date, research in this area has largely focused on foods or individual dietary components that may attenuate inflammation or oxidant stress, or foster de novo bone formation. These studies suggest that a wide variety of dietary components, including macronutrients and micronutrients, are integral for optimal periodontal health and have the potential to accelerate oral wound healing after periodontal procedures. Moreover, this review provides guidance regarding dietary considerations that may help a patient achieve the best possible outcome after a periodontal procedure.

Effects of diet on gut microbiota profile and the implications for health and disease.

Gut microbes are present in large concentrations on the human intestinal mucosal surface and play important roles in health and disease of the host. Numerous groups of gut microbes are associated with immunological and metabolic diseases and in maintaining health status of the host. Among these health- and disease-associated gut microbes, Bacteroides, Clostridium and Bifidobacterium appear regularly in the list. Scientific and clinical evidence available to date indicates that diet is a major driving factor for the establishment of the gut microbiome. Slow digestible carbohydrates (human milk glycan, inulin and fructooligosaccharide), insoluble complex carbohydrates and protein diets favor the growth of Bacteroides, Clostridium and Bifidobacterium. Fat on the other hand suppresses the number of Bacteroides, Clostridium and Bifidobacterium; whereas polyphenols in general suppress Bacteroides and Clodtridium but enhance the Bifodobacterium. The implication is that dietary habits could be a major determinant of health and disease susceptibility. Dietary strategies could be an effective means of potentially inducing changes in intestinal microbiota and are certainly achievable, thus facilitating correction of intestinal microbiome aberrations or imbalances to improve our health. Most of the physiological and functional interactions between individual dietary components and the concoction of foods in a meal and gut microbiota have not yet been well studied. A concerted effort is required to acquire better understanding of their interaction in order to rationally maintain our intestinal microbiome homeostasis and general health through dietary intervention.

β-Carotene and other carotenoids in protection from sunlight

Protection against skin damage from sunlight by nutritional means has been examined. Likewise, there has been work on the topical application of phytochemicals to the skin. This review focuses on the nutritional aspect of phytochemicals in humans-ie, the provision of carotenoid micronutrients by dietary means to the skin and their role in protection. Human intervention studies have documented protective effects for β-carotene or for lycopene provided either by a carotenoid-rich diet or by supplementation. In exposed tissues, light induces primary and secondary photooxidative processes. Scavenging of reactive oxygen species is considered to be a mechanism of action underlying the protective activity of carotenoids. However, food comprises a complex mixture of numerous constituents, so that other components may also contribute to the observed activity. Molecules with suitable structures absorb UV light and prevent direct damage of cellular targets. Phytoene and phytofluene are precursor molecules of higher unsaturated carotenoids and occur in various fruit and vegetables. Their absorption spectra cover the UVB and UVA range, respectively, thus potentially contributing to photoprotective effects of carotenoid-rich food. Because of the physiologic turnover time of skin, several weeks are required for protective effects to appear. Photoprotection through individual dietary components such as β-carotene or lycopene in terms of sun protection factor is considerably lower than that achieved by using topical sunscreens. However, an optimal supply of antioxidant micronutrients in the skin increases basal dermal defense against UV irradiation, supports longer-term protection, and contributes to maintenance of skin health and appearance.

A Preoperative Protein Free Diet Protects Against Renal Ischemia and Reperfusion Injury

Background: Ischemia and reperfusion (I/R) injury is a serious and common complication of organ transplantation. Previously we showed that both two weeks of 30% dietary restriction and three days of preoperative fasting protects against renal I/R injury. In the present study, we investigated whether the protective effect was induced by a reduction of calories, or by absence of a specific food component. Materials and methods: Male C57BL/6 mice (n= 6/group) had ad libitum access to diets free of protein-, methionine-, tryptophan-,leucine, carbohydrate or fat before induction of renal I/R injury. Renal I/R injury was induced by clamping both kidneys during 37 minutes. After removing the clamp, I/R injury was assessed by serum urea levels and signs of animal discomfort. Mice fed ad libitum control diets and pair-fed (PF) controls for the deficient diets were used as control. Results: A 14 day preoperative protein-, methionine-, tryptophan- or leucine-free diet protected against renal I/R injury. PF controls revealed that mice on modified diets restricted their calorie intake by 30%. Since we previously showed that 30% dietary restriction for 14 days induces protection against I/R injury the effect of individual dietary components could not be separated from the effect of DR. Three days of 30% DR does not induce protection against I/R injury. Therefore we administered these diets during 3 preoperative days, and found that only the protein-free diet protected against renal I/R injury. Conclusion: A three day preoperative protein-deficient diet protects against renal I/R injury. These data show that the absence of protein is responsible for the protection induced by DR.

Are existing measures of overall diet quality associated with peak bone mass in young premenopausal women?

Low peak bone mass in young adulthood is associated with an increased risk of osteoporosis and fracture after menopause, and an understanding of the modifiable factors that contribute to low peak bone mass is important for fracture prevention. Diet is an important modifiable factor linked to bone health and, although studies have examined the role of individual dietary components in bone health, bone growth and maintenance are complex processes, and such studies may not adequately represent the role of diet in these processes. To address this issue, a cross-sectional analysis of 226 healthy, premenopausal women aged 18-30 years was conducted to determine whether existing indices of overall diet quality are associated with bone density in premenopausal women nearing peak bone mass. Bone density was measured using dual-energy X-ray absorptiometry and diet quality was measured using two overall diet scores based on current dietary guidelines: the Recommended Food Score and the Alternate Healthy Eating Index (AHEI). In the multiple linear regression, bone density did not increase across quartiles of either diet quality score and was not associated with continuous diet quality variables. Furthermore, none of the individual AHEI components (e.g. fruit intake, vegetable intake) were associated with bone density. These findings suggest that existing diet quality scores are not appropriate for studies of peak bone mass, most likely because they do not give sufficient weight to foods and nutrients important to bone health. We recommend the development of a diet pattern index that better predicts bone mass measures.

Dietary insulin load, dietary insulin index, and risk of pancreatic cancer

Although hyperinsulinemia and insulin resistance have been hypothesized to be involved in pancreatic carcinogenesis, studies that have examined glycemic load or individual dietary components that influence glucose concentrations yielded inconclusive results. Our objective was to investigate whether dietary insulin load and dietary insulin index are associated with the risk of pancreatic cancer. We prospectively followed 86,740 women and 46,147 men who were free of cancer and diabetes at baseline in the Nurses' Health Study and the Health Professionals Follow-Up Study. During ≤26 y of follow-up, 691 pancreatic cancer cases were documented. Dietary insulin load was calculated as a function of the food insulin index, and the energy content of individual foods was reported on food-frequency questionnaires. The dietary insulin index was calculated by dividing the dietary insulin load by the total energy intake. Dietary insulin load and dietary insulin index were not associated with the overall risk of pancreatic cancer. In a comparison of the highest with the lowest quintiles, the pooled multivariate RRs of pancreatic cancer were 1.05 (95% CI: 0.82, 1.34) for dietary insulin load and 0.96 (95% CI: 0.75, 1.23) for dietary insulin index. In individuals with an elevated BMI (in kg/m(2); ≥27.5) or with low physical activity, a high insulin load was associated with small, nonsignificant increases in the risk of pancreatic cancer; in a comparison of the highest with the lowest tertile of intake, the positive association became more apparent in those who were both overweight and inactive (RR: 2.03; 95% CI: 1.05, 3.93; P-trend = 0.04). A diet that induces an elevated postprandial insulin response does not influence the overall risk of pancreatic cancer. However, a diet with a high insulin load may increase the risk in individuals with a preexisting state of insulin resistance.

Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men

Specific dietary and other lifestyle behaviors may affect the success of the straightforward-sounding strategy "eat less and exercise more" for preventing long-term weight gain. We performed prospective investigations involving three separate cohorts that included 120,877 U.S. women and men who were free of chronic diseases and not obese at baseline, with follow-up periods from 1986 to 2006, 1991 to 2003, and 1986 to 2006. The relationships between changes in lifestyle factors and weight change were evaluated at 4-year intervals, with multivariable adjustments made for age, baseline body-mass index for each period, and all lifestyle factors simultaneously. Cohort-specific and sex-specific results were similar and were pooled with the use of an inverse-variance-weighted meta-analysis. Within each 4-year period, participants gained an average of 3.35 lb (5th to 95th percentile, -4.1 to 12.4). On the basis of increased daily servings of individual dietary components, 4-year weight change was most strongly associated with the intake of potato chips (1.69 lb), potatoes (1.28 lb), sugar-sweetened beverages (1.00 lb), unprocessed red meats (0.95 lb), and processed meats (0.93 lb) and was inversely associated with the intake of vegetables (-0.22 lb), whole grains (-0.37 lb), fruits (-0.49 lb), nuts (-0.57 lb), and yogurt (-0.82 lb) (P≤0.005 for each comparison). Aggregate dietary changes were associated with substantial differences in weight change (3.93 lb across quintiles of dietary change). Other lifestyle factors were also independently associated with weight change (P<0.001), including physical activity (-1.76 lb across quintiles); alcohol use (0.41 lb per drink per day), smoking (new quitters, 5.17 lb; former smokers, 0.14 lb), sleep (more weight gain with <6 or >8 hours of sleep), and television watching (0.31 lb per hour per day). Specific dietary and lifestyle factors are independently associated with long-term weight gain, with a substantial aggregate effect and implications for strategies to prevent obesity. (Funded by the National Institutes of Health and others.).

Bioactive Compounds and Cancer

Bioactive Compounds and Cancer

P40 *Local food environments and dietary quality

IntroductionDietary quality is an important predictor of health outcome and plays a prominent role in premature death from a number of chronic health conditions including cardiovascular disease and some cancers....

College Students' Ability to Self-identify Healthiness of Diet and Dietary Components

The objective of this study was to evaluate college students' ability to self-identify the overall healthiness of their diet and intakes of the individual dietary components of the Healthy Eating Index (HEI).

Mediterranean diet and upper aerodigestive tract cancer: the Greek segment of the Alcohol-Related Cancers and Genetic Susceptibility in Europe study

Several dietary factors have been associated with the occurrence of cancers of the oral cavity and oropharynx, larynx and oesophagus, collectively called upper aerodigestive tract (UADT) cancers, but the evidence is considered as inconclusive. We hypothesised that the traditional Mediterranean dietary pattern may be more strongly inversely associated with UADT cancer risk than individual dietary components, and may explain the unexpectedly low incidence of these cancers in Greece. In the context of the European alcohol-related cancers and genetic susceptibility in Europe project, we have conducted a hospital-based case-control study in Athens, Greece, comparing 239 incident UADT cases and 194 hospital controls with admission diagnoses unrelated to tobacco, alcohol or diet. Adherence to Mediterranean diet was assessed through a widely used score, which ranges from 0 (minimal adherence) to 9 (maximal adherence) and increases with high consumption of plant foods and olive oil and low consumption of meat, dairy products and saturated lipids. Stricter adherence to the Mediterranean diet was associated with a substantial and significant decrease in UADT cancer risk (30% for a two-unit increase in score), whereas after mutual adjustment, no individual dietary component of this diet was significantly associated with this risk. Adherence to the traditional Mediterranean diet is associated with reduced risk of UADT cancers, and may explain the lower incidence of UADT cancers in Greece, in spite of the smoking and drinking habits of this population.

Dietary Patterns and Colorectal Adenoma and Cancer Risk: A Review of the Epidemiological Evidence

A number of studies exploring associations between individual dietary components and colorectal adenoma or cancer risk have yielded conflicting results. The study of food-based dietary patterns in relation to chronic disease risk represents an alternative approach to the evaluation of single dietary exposures in epidemiological investigations. Results from prospective cohort and population-based case-control studies examining associations between dietary patterns and colorectal cancer or adenoma risk were evaluated and described in this review. Despite notable differences in population characteristics, study design, and methods used for characterizing dietary patterns across the different studies, two general dietary patterns were found to modestly predict colorectal adenoma and cancer risk. A healthier pattern consisting of greater intakes of fruits and vegetables, and lower intakes of red and processed meat, appeared protective against colorectal adenoma and cancer incidence. Findings also suggest that a less healthy pattern characterized by higher intakes of red and processed meat, as well as potatoes and refined carbohydrates, may increase risk. Continued research efforts are needed to evaluate the cumulative and interactive effects of numerous dietary exposures on colorectal cancer risk.

Liver Fatty Acid Binding Protein (L-FABP) as a Target for the Prevention of High Fat Diet Induced Obesity and Hepatic Steatosis

An epidemic of obesity, fueled in large part by increased consumption of diets enriched in saturated fat, has heightened interest in the pathways and mechanisms that modulate the uptake and utilization of individual dietary lipid components. Emerging evidence has implicated members of the intracellular fatty acid binding protein (FABP) multigene family as important metabolic sensors that may regulate substrate trafficking and metabolic compartmentalization. Among these, liver fatty acid binding protein (L-FABP, Fabp1) is an abundant cytosolic protein expressed in both mammalian small intestinal enterocytes and hepatocytes. L-Fabp -/- mice were protected against hepatic steatosis following a prolonged fast, suggesting a role in modulating hepatic FA trafficking in response to augmented lipid mobilization from adipose stores. In addition, L-Fabp -/- mice are protected against obesity and hepatic steatosis when fed a high saturated fat diet or a high saturated fat diet containing cholesterol (ie Western diet), but not when fed a high fat diet containing polyunsaturated fat. These findings imply substrate specificity in the lipid sensing functions of L-FABP. Together the data suggest that L-FABP regulates elements of both intestinal and hepatic FA trafficking as well as cholesterol metabolism and in turn exerts an important role in the pathogenesis of diet- induced obesity and hepatic steatosis through specific diet- gene interactions.