Relative Carbohydrate Intake Research Articles

Mendelian randomization study supports relative carbohydrate intake as an independent risk factor for amyotrophic lateral sclerosis

ABSTRACT Objectives Observational studies suggested a potential correlation between dietary intake and amyotrophic lateral sclerosis (ALS), but conflicting findings exist and causality remains unclear. Here, we performed a Mendelian randomization (MR) analysis to evaluate the causal impact of relative intake of (i) carbohydrate, (ii) fat, and (iii) protein on ALS risk. Methods The genome-wide association summary statistics of three dietary macronutrient intake traits and ALS were obtained. Initially, forward and reverse univariable MR (UVMR) analysis were conducted using the inverse variance weighted (IVW) method as the primary approach, supplemented by MR-Egger, weighted median, and maximum likelihood. Subsequently, multivariable MR (MVMR) analysis was performed to assess the independent causal effects of each dietary. Additionally, diverse sensitivity tests were conducted to evaluate the reliability of the MR analyses. Results The forward UVMR analysis conducted by IVW indicated that relative carbohydrate intake significantly increased ALS risk. Furthermore, results from three other MR methods paralleled those from IVW. However, the other two dietary intake traits did not have a causative impact on ALS risk. The reverse UVMR analysis indicated that ALS did not causatively influence the three dietary intake traits. The MVMR analysis showed that after adjusting for the effects of the other two dietary intake traits, relative carbohydrate intake independently and significantly increased ALS risk. Sensitivity tests indicated no significant heterogeneity or horizontal pleiotropy. Discussion MR analysis supported relative carbohydrate independently increasing ALS risk. Nevertheless, further validation of this finding in future large cohorts is required. Abbreviations: ALS: amyotrophic lateral sclerosis; CI: confidence interval; GWAS: genome-wide association study; IV: instrumental variable; IVW: iverse variance weighted; MR: Mendelian randomization; MVMR: multivariable Mendelian randomization; OR: odds ratio; RCT: randomized controlled trial; SNPs: single-nucleotide polymorphisms; UVMR: univariable Mendelian randomization

Causal Effect of Relative Carbohydrate Intake on Hypertension through Psychological Well-Being and Adiposity: A Mendelian Randomization Study.

Observations of the association between carbohydrate intake and hypertension are inconsistent, with mediating pathways unclear. We aimed to investigate the causal effect of relative carbohydrate intake on hypertension and the mediating roles of psychological well-being and adiposity. Using summary-level statistics of genome-wide association studies of European ancestry, we conducted univariable and multivariable Mendelian randomization (MR) to estimate the bidirectional causal association between relative carbohydrate intake (total energy-adjusted, mean: 42-51%) and hypertension (FinnGen: 42,857 cases/162,837 controls; UK Biobank: 77,723 cases/330,366 controls) and two-step MR to assess the mediating effects of psychological well-being indicators and adiposity traits on the association. MR estimates of hypertension from FinnGen and UK Biobank were meta-analyzed using the fixed-effect model given no heterogeneity. Meta-analyses of multivariable MR estimates from FinnGen and UK Biobank indicated that each one-SD higher relative carbohydrate intake was associated with 71% (odds ratio: 0.29; 95% confidence interval: 0.11-0.79) lower risk of hypertension, independently of other dietary macronutrients. Hypertension showed no reverse effect on carbohydrate intake. Five psychological well-being indicators and four adiposity traits causally mediated the association between relative carbohydrate intake and hypertension, including body mass index (mediation proportion: 51.37%), waist circumference (40.54%), waist-to-hip ratio (35.00%), hip circumference (24.77%), major depressive disorder (23.37%), positive affect (17.08%), depressive symptoms (16.52%), life satisfaction (16.05%), and neuroticism (11.22%). Higher relative carbohydrate intake was causally associated with lower hypertension risk, substantially mediated by better psychological well-being and less adiposity. Our findings inform causal targets and pathways for the prevention and intervention of hypertension.

Agave bagasse cookies as a carbon source for lactic acid bacteria

AbstractCurrently, the Agave genus has a high economic importance because due to the products that can be obtained from these plants, with alcoholic beverage production being the most common use. The principal storage carbohydrates of agave are fructans. In this study, the utilization of Agave salmiana (green agave) and Agave atrovirens (ashy agave) bagasse cookies as a carbon source by lactic acid‐producing bacteria (LAB), as well as the acceptability of cookies by consumers was evaluated. The cookies were manufactured and digested in vitro, and fermentation by LAB was performed to evaluate pH changes, bacterial growth, and relative carbohydrate intake. The results showed that the bacteria assimilated the digested agave cookies as a carbon source, and there was no significant difference in the pH of both agave bagasse and the growth of Lacticaseibacillus casei. The highest bacterial growth of the L. lactis was observed at 12 h with green bagasse cookies. The results obtained in the present study demonstrate the potential of agave bagasse to be used as functional food ingredients.

Change in carbohydrate intake one year after Roux-en-Y gastric bypass: A prospective study.

Background and objectives: To investigate the effect of carbohydrate intake before laparoscopic Roux-en-Y gastric bypass (LRYGB) on body weight, body composition and glycaemic status after surgery. Methods: In a tertiary centre cohort study, dietary habits, body composition and glycaemic status were evaluated before and 3, 6 and 12 months after LRYGB. Detailed dietary food records were processed by specialized dietitians on the basis of a standard protocol. The study population was subdivided according to relative carbohydrate intake before surgery. Results: Before surgery, 30 patients had a moderate relative carbohydrate intake (26%-45%, M-CHO), a mean body mass index (BMI) of 40.4 ± 3.9 kg/m² and a mean glycated haemoglobin A1c (A1C) of 6.5 ± 1.2% compared to 20 patients with a high relative carbohydrate intake (> 45%, H-CHO), mean BMI of 40.9 ± 3.7 kg/m² (non-significant, NS) and a mean A1C of 6.2% (NS). One year after surgery, body weight, body composition and glycaemic status were similar in the M-CHO (n = 25) and H-CHO groups (n = 16), despite less caloric intake in the H-CHO group (1317 ± 285 g vs. 1646 ± 345 g in M-CHO, p < 0.01). Their relative carbohydrate intake converged to 46% in both groups, but the H-CHO group reduced the absolute total carbohydrate consumption more than the M-CHO group (190 ± 50 g in M-CHO vs. 153 ± 39 g in H-CHO, p < 0.05), and this was especially pronounced for the mono- and disaccharides (86 ± 30 g in M-CHO vs. 65 ± 27 g in H-CHO, p < 0.05). Conclusion: A high relative carbohydrate intake before LRYGB, did not influence the change in body composition or diabetes status after surgery, despite a significantly lower total energy intake and less mono- and disaccharide consumption after surgery.

Quality of low-carbohydrate diets among Australian post-partum women: Cross-sectional analysis of a national population-based cohort study.

Low-carbohydrate diets (LCDs) are popular among people attempting weight loss and recommended for pregnant women with gestational diabetes (GDM), but they may increase health risks if nutritionally inadequate. We aimed to describe the dietary intake of post-partum women according to their relative carbohydrate intake, overall, and among women attempting weight loss or diagnosed with GDM in their recent pregnancy. This cross-sectional population-based cohort study included 2093 post-partum women aged 25-36 years who participated in the Australian Longitudinal Study on Women's Health. Dietary intake was assessed using a validated food frequency questionnaire. Relative carbohydrate intake was determined using a previously developed LCD score. Data were weighted to account for oversampling of women from rural/remote areas. More than half of women (n[weighted] = 1362, 66.3%) were trying to lose weight, and 4.6% (n[weighted]=88) had GDM in their recent pregnancy. Women with the lowest relative carbohydrate intake (LCD score quartile 4) consumed 36.8% of total energy intake from carbohydrates, and had a lower intake of refined grains, whole grains, fruit and fruit juice, and a higher intake of red and processed meat, compared with women with the highest relative carbohydrate intake (quartile 1). Different food groups, both healthy and unhealthy, were restricted depending on whether women were attempting weight loss and had recent GDM. These findings may reflect a lack of knowledge among post-partum women on carbohydrates and dietary guidelines. Health professionals may have an important role in providing advice and support for post-partum women who wish to restrict their carbohydrate intake, to ensure optimal diet quality.

Higher carbohydrate intake in relation to non-alcoholic fatty liver disease in patients with type 2 diabetes.

Non-alcoholic fatty liver disease (NAFLD) is an overlooked complication of type 2 diabetes (T2D). Current recommendations for the management of NAFLD are mainly focused on weight reduction, overlooking the role of macronutrient composition. Although dietary carbohydrates play a major role in intrahepatic fat synthesis, their association with the progression of liver steatosis has not been fully investigated in patients with T2D. To investigate the association between higher carbohydrate intake and the presence of liver steatosis in patients with T2D. This cross-sectional study included men and women aged 18-60 years diagnosed with T2D. Anthropometric measurements, hepatic steatosis assessment using the controlled attenuation parameter (CAP), blood samples, and dietary data were analyzed. Participants were divided into two groups: NAFLD and NAFLD-free. A two-sample t-test was used to evaluate the differences between the two groups. Stepwise multiple linear regression models adjusted for potential confounders were used to determine the association between CAP values and higher carbohydrate intake. In total, 358 participants were included. NAFLD was present in 79.3% of the participants. Body mass index, waist circumference, ALT, HbA1c, and triglycerides showed direct, while HDL-Cholesterol revealed inverse associations with CAP values. No significant relationship was found between carbohydrate intake and steatosis in the total study sample; however, multiple linear regression analysis revealed a significant relationship between carbohydrate intake and CAP values in patients aged ≤50 years. In patients with T2D, higher carbohydrate intake was associated with liver steatosis in those aged 50 years and below. Further studies are required to confirm the causality between carbohydrate intake and liver steatosis.

Dietary Intakes of Elite Male Professional Rugby Union Players in Catered and Non-Catered Environments

In professional rugby union, it is common for players to switch between catered and non-catered dietary environments throughout a season. However, little is known about the difference in dietary intake between these two settings. Twelve elite male professional rugby union players (28.3 ± 2.9 y, 188.9 ± 9.5 cm, 104.1 ± 13.3 kg) from the New Zealand Super Rugby Championship completed seven-day photographic food diaries with two-way communication during two seven-day competition weeks in both catered and non-catered environments. While no significant differences were observed in relative carbohydrate intake, mean seven-day absolute energy intakes (5210 ± 674 vs. 4341 ± 654 kcal·day-1), relative protein (2.8 ± 0.3 vs. 2.3 ± 0.3 g·kgBM·day-1) and relative fat (2.1 ± 0.3 vs. 1.5 ± 0.3 g·kgBM·day-1) intakes were significantly higher in the catered compared to the non-catered environment (respectively) among forwards (n = 6). Backs (n = 6) presented non-significantly higher energy and macronutrient intakes within a catered compared to a non-catered environment. More similar dietary intakes were observed among backs regardless of the catering environment. Forwards may require more support and/or attention when transitioning between catered and non-catered environments to ensure that recommended dietary intakes are being achieved.

Oral Health Of Division 1 College Female Athletes

A direct correlation exists between overall health and oral health. Previous findings suggest significant oral health issues in athletes which, for Division 1 (D1) college athletes, could negatively impact their performance and overall wellbeing. PURPOSE: To assess if D1 athletes are at an increased risk of developing decay compared to non-athletes by evaluating dental practices, decay causing foods, and salivary protective factors. METHODS: Fifty-four female athletes [32 rowers (R) and 22 soccer players (S)] and 34 female college age-matched Comparisons (C) participated. All subjects completed a Dental Health Questionnaire to assess current dental habits, history of orofacial trauma, and dietary patterns as well as the International Physical Activity Questionnaire (IPAQ) to assess physical activity levels. All subjects underwent a brief dental examination using the Dental Epidemiologic Study: Decay, Missing, Filled Surfaces Index (DMFS). Resting saliva samples were collected and analyzed for salivary IgA using standard ELISA kits. RESULTS: While C were shorter compared to athletes (C: 166 ± 1 cm; R: 169 ± 1 cm; S: 169 ± 1 cm; p < 0.05), there were no differences in weight (C: 71 ± 3 kg; R: 72 ± 1 kg; S: 65 ± 2 kg; p > 0.05). Comparisons had lower levels of physical activity compared with both the R and S groups (C: 945 ± 182 MET/min/wk; R: 3,246 ± 968 MET/min/wk; S: 10,413 ± 2,499 MET/min/wk; p < 0.05). Visits to the dentist in the last year were reported by 70% of C, 75% of R, and 81% of S groups. Compared with C, Soccer had higher intakes of relative carbohydrate intake (C: 41% vs S: 46%, p < 0.05) and refined grains (C: 4 ± 0 oz. eq. vs. S: 6 ± 1 oz. eq., p < 0.05). Rowers had lower DMFS (%Total Surface Area) compared with (C: 6.2% ± 0.9%, R: 3.2% ± 0.6%; p < 0.05); however, there were no differences between S and any other group (S: 4.8% ± 0.9%) (p > 0.05). Soccer players tended to have more decay than rowers (S: 3.5 ± 0.87; R 1.4 ± 0.33; p = 0.07) and had lower resting IgA levels versus C and R (C: 105 ± 13 mg/dL; S: 31 ± 3.7 mg/dL; R; 77 ± 11 mg/dL; p < 0.05). CONCLUSION: Despite similar dental practices, differences in dental health exist between cohorts of female collegiate athletes suggesting less elite athletes exhibit better dental health. In addition, elite soccer players had a reduced resting salivary IgA level, a known dental protective factor.

Bidirectional two-sample Mendelian randomization analysis identifies causal associations between relative carbohydrate intake and depression.

Growing evidence suggests that relative carbohydrate intake affects depression; however, the association between carbohydrates and depression remains controversial. To test this, we performed a two-sample bidirectional Mendelian randomization (MR) analysis using genetic variants associated with relative carbohydrate intake (N = 268,922) and major depressive disorder (N = 143,265) from the largest available genome-wide association studies. MR evidence suggested a causal relationship between higher relative carbohydrate intake and lower depression risk (odds ratio, 0.42 for depression per one-standard-deviation increment in relative carbohydrate intake; 95% confidence interval, 0.28 to 0.62; P = 1.49 × 10-5). Multivariable MR indicated that the protective effect of relative carbohydrate intake on depression persisted after conditioning on other diet compositions. The mediation analysis via two-step MR showed that this effect was partly mediated by body mass index, with a mediated proportion of 15.4% (95% confidence interval, 6.7% to 24.1%). These findings may inform prevention strategies and interventions directed towards relative carbohydrate intake and depression.

The protective effect of relative carbohydrate intake on depression.

The protective effect of relative carbohydrate intake on depression.

Rare Hypomorphic Sucrase Isomaltase Variants in Relation to Irritable Bowel Syndrome Risk in UK Biobank

Rare Hypomorphic Sucrase Isomaltase Variants in Relation to Irritable Bowel Syndrome Risk in UK Biobank

Adolescent Endurance Runners Exhibit Suboptimal Energy Availability and Intakes of Key Nutrients

Backgroud: Despite the evidence of an elevated prevalence of low bone mass in adolescent endurance runners, reports on dietary intake in this population is limited. Objectives: This study aimed to evaluate energy availability (EA) and dietary intake among 72 (n = 60 female, n = 12 male) high school cross-country runners. Methods: The sample consisted of a combined dataset of two cohorts. In both cohorts, the Block Food Frequency Questionnaire (FFQ; 2005 & 2014 versions) assessed dietary intake. Fat free mass was assessed using dual-energy x-ray absorptiometry or bioelectrical impedance analysis. Results: Mean EA was less than recommended (45 kcal/kgFFM/day) among male (35.8 ± 14.4 kcal/kg FFM/day) and female endurance runners (29.6 ± 17.4 kcal/kgFFM/day), with 30.0% of males and 60.0% of females meeting criteria for low EA (<30 kcal/kgFFM/day). Calorie intake for male (2,614.2 ± 861.8 kcal/day) and female (1,879.5 ± 723.6 kcal/day) endurance runners fell below the estimated energy requirement for “active” boys (>3,100 kcal/day) and girls (>2,300 kcal/day). Female endurance runners’ relative carbohydrate intake (4.9 ± 2.1 g/kg/day) also fell below recommended levels (6-10 g/kg/day). Male and female endurance runners exhibited below-recommended intakes of calcium, vitamin D, potassium, fruit, vegetables, grains, and dairy. Compared to male endurance runners, female endurance runners demonstrated lower relative intakes of energy (kcal/kg/day), protein (g/kg/day), fat (g/kg/day), fiber, vegetables, total protein, and oils. Conclusion: This study provides evidence of the nutritional risk of adolescent endurance runners and underscores the importance of nutritional support efforts in this population.

Causal relationship between dietary macronutrient composition and anthropometric measures: A bidirectional two-sample Mendelian randomization analysis

The question whether the proportion of energy provided by fat and carbohydrates in the diet is associated with body mass index (BMI) and waist circumference (WC) is an important public health issue, but determining causality is difficult in epidemiological studies. Using a two-sample bidirectional Mendelian randomization (MR) in both a univariable and multivariable setting, we aimed to determine whether the relative proportion of different macronutrients in the diet (in % of total energy intake (E%)) is causally related to BMI and WC and vice versa. All analyses were based on genome-wide association studies including 268,922 Europeans with dietary data (SSGAC Consortium) and at least 232,101 with anthropometric measures (GIANT Consortium). An inverse-variance weighted approach using modified second-order weights within the radial regression framework was performed. Radial MR-Egger, weighted median and mode, Robust Adjusted Profile Score (RAPS), and Pleiotropy RESidual Sum and Outlier (PRESSO) methods were used in sensitivity analyses to verify MR assumptions. Additionally, multivariable MR was conducted to account for inter correlation between macronutrient intakes. All estimates represent the standard deviation (SD) change in each outcome per one SD change in the respective exposure. We found that genetically predicted relative carbohydrate intake (E%) reduced BMI (β=-0.529; 95% CI:-0.745,-0.312; P-value=2⋅10-6) and WC (β=-0.459; 95% CI:-0.656,-0.262; P-value=5⋅10-6). Both effects were also supported by the multivariable approach: β=-0.441 (95% CI:-0.772,-0.109; P-value=0.009) for BMI and β=-0.410 (95% CI:-0.667,-0.154; P-value=0.002) for WC. Genetically predicted dietary intake of fat (E%) was weaker and positively related to both anthropometric measures. We obtained evidence that a higher BMI and WC increased the relative dietary intake of fat and protein (E%). For example, each SD higher BMI increased protein intake (E%) by 0.114 SD (95% CI: 0.081, 0.147; P-value=9⋅10-12) and each SD higher WC increased protein intake (E%) by 0.078 SD (95% CI: 0.035, 0.121; P-value=4⋅10-4). Sensitivity analyses confirmed these findings revealing consistent effect estimates. Using genetic information to improve causal inference we found evidence, that a low relative carbohydrate proportion (E%) and a high proportion of fat (E%) in the diet is causally related to a higher BMI and a higher WC. Further research considering carbohydrate, fat, and protein quality and possible consequences on micronutrient intake is needed to define the implications for dietary intake recommendations.

Macronutrient Intake And Blood Markers Concentrations In Mexican University Athletes.

PURPOSE: To analyze the association between the concentration of different blood markers and macronutrient intake by sex in university athletes. METHODS: 242 (139 males, 103 females) athletes of different sports were evaluated on their food habits. We administered 24-hour dietary recalls of a training day by standardized staff. Then, we estimated the absolute (g/day) and relative (g/kg/day) macronutrient intake. Also, we obtained uric acid, urea, creatinine, cholesterol, triacylglycerides, glucose, hemoglobin, and hematocrit concentrations from blood analysis. We only analyzed the data of subjects who had their blood samples and dietary recall within a period of no more than 30 days apart. The analysis was divided by sex. RESULTS: Subjects` age, body weight, and height were: 21.4 ±3.0 and 20.7 ±2.0 years, 73.6 ±14.1 and 61.7 ±11.6 kg; and 175.8 ±6.8 and 163.6 ±6.9 cm, for men and women respectively. For males, there were significant associations between relative (beta [95% CI], -0.328 [-0.037 to -0.619]; p = 0.027) and absolute (-0.005 [-0.001 to -0.009]; p = 0.027) protein intake and uric acid concentrations; similarly, absolute protein intake was significantly associated with lower creatinine concentrations (-0.014 [-0.001 to -0.027]; p = 0.031). For females, there was a significant association between relative carbohydrate intake and blood glucose (1.912 [0.259 to 3.566]; p = 0.024). No other significant association was found. CONCLUSIONS: In this study, protein intake was associated with lower blood creatinine and uric acid concentrations in males, and carbohydrate intake with higher blood glucose concentrations in females.

SAT-251 Acute Sleep Change, Laboratory Meal Energy Intake, and Insulin Sensitivity in Children

Background Many studies show a correlation between short sleep duration and obesity/insulin resistance. One hypothesis for this association is that shortened sleep causes increased energy intake (EI). In some studies, experimentally reduced sleep duration has been found to increase total EI. There are mixed findings about the effects of habitual and acute short sleep on the macronutrient content of consumed meals. Additionally, there are few pediatric studies with objectively measured sleep duration (e.g. using actigraphy). Therefore, we aimed to determine if an acute sleep change was associated with greater total EI, altered macronutrient intake, or altered insulin sensitivity in children. Methods Healthy weight and overweight volunteers (n=18, 44% male), aged 7-11 years wore ActiGraph activity monitors for six consecutive 24 hour periods to determine nightly sleep duration. Volunteers were given no direction regarding sleep for the week. On day six, children underwent a standardized oral glucose tolerance test (OGTT) (1.75g/kg, max 75g) after which total EI (kcal) and macronutrient composition (% of total EI) were measured during a lunchtime laboratory test meal (>10,000 kcal; ~12% protein, 32% fat, 56% CHO). Subjects were directed to eat as much as they wanted. Acute change in sleep was calculated by subtracting each participant’s average nightly total sleep time over the entire week from their total sleep time on the fifth night (i.e., night before the test meal). Linear regressions examined associations of acute change in sleep with insulin AUC during OGTT, total EI, % CHO, % fat, and ratio of %CHO to %fat intake. Results Controlling for daily predicted energy needs and physical activity level, acute change in sleep (mean of 27.5 minutes less than average) was not significantly associated with total EI (p=0.58). However, the %CHO trended toward a significant negative correlation (r=-0.47, p=0.05) and %fat was positively associated (r=0.50, p=0.036) with acute change in sleep such that the %CHO to %fat intake ratio was greater in those with greater sleep deficit (p=0.039). Additionally, controlling for BMI-z score, basal insulin, and age, greater sleep deficit was associated with increased insulin AUC during the OGTT (p=0.001). Discussion Contrary to some previous experimental data, acute sleep deficit had no significant association with total EI; however, acute sleep deficit was associated with increased relative carbohydrate intake. Acute sleep deficit was also associated with decreased relative fat intake, a known satiating macronutrient. These data also suggest an acute decrease in insulin sensitivity associated with sleep deficit. All three mechanisms could explain or exacerbate the increased prevalence of obesity and metabolic abnormalities in children with short sleep duration and therefore, provide support for sleep-associated adjunctive treatment for such children.

Carbohydrate Counting: A Simple Method of Dietary Management for Glycemic Control in Japanese Diabetic Hemodialysis Patients.

Carbohydrate counting used in dietary therapy for diabetes is based on the concept that the postprandial rise in blood glucose levels is primarily affected by ingested carbohydrates. This method has been widely accepted and used since 1993, when its usefulness was demonstrated in the United States, largely due to the ease with which patients can understand the method. However, in Japan, there is a common misunderstanding that energy intake determines postprandial blood glucose levels. We examined the effectiveness of using basic carbohydrate counting and advanced carbohydrate counting with Japanese diabetic dialysis patients. With both methods, predialysis blood glucose and HbA1c levels were significantly decreased at the final follow-up compared with preinstruction values. There were no significant changes in other parameters. The carbohydrate counting method was able to be applied independently of, but concurrently with, the control of potassium and phosphorus intake, which is the basis of dietary therapy for dialysis patients. Moreover, those patients who completed the basic carbohydrate counting instruction sessions had a mean relative carbohydrate intake (% of total energy) of 51.0 ± 4.7% per meal, indicating they did not consume a low-carbohydrate diet. Key Messages: At present, there is no literature on carbohydrate counting performed by dialysis patients. Carbohydrate counting is a useful method of dietary management for glycemic control that can be applied independently of, but concurrently with, the control of potassium and phosphorus intake in dietary therapy for dialysis patients.

Prospective Study of Glycemic Load, Glycemic Index, and Carbohydrate Intake in Relation to Risk of Biliary Tract Cancer.

Diets that induce a high glycemic response might increase the risk of biliary tract cancer (BTC). We evaluated the hypothesis that diets with high glycemic load (GL) and high glycemic index (GI), which are measures of the glycemic effect of foods, are associated with an increased incidence of BTC. We used data from a population-based prospective study of 76,014 Swedish adults (age 45-83 years; 57% men) who were free of cancer and had completed a food-frequency questionnaire in the autumn of 1997. Incident cancer cases were ascertained by linkage with the Swedish Cancer Registry. Data were analyzed using Cox proportional hazards regression models. During a mean follow-up of 13.3 years (1,010,777 person-years), we identified 140 extrahepatic BTC cases (including 77 gallbladder cancers) and 23 intrahepatic BTC cases. A high dietary GL was associated with an increased risk of BTC. The multivariable relative risks for the highest versus lowest quartile of dietary GL were 1.63 (95% confidence interval (95% CI), 1.01-2.63) for extrahepatic BTC, 2.14 (95% CI, 1.06-4.33) for gallbladder cancer, and 3.46 (95% CI, 1.22-9.84) for intrahepatic BTC. Dietary GI was statistically significantly positively associated with risk of extrahepatic BTC and gallbladder cancer. We observed no statistically significant association between carbohydrate intake and BTC risk, although all associations were positive. Although these data do not prove a causal relationship, they are consistent with the hypothesis that high-GL and high-GI diets are associated with an increased risk of BTC.

Drosophila melanogaster larvae make nutritional choices that minimize developmental time

Organisms from slime moulds to humans carefully regulate their macronutrient intake to optimize a wide range of life history characters including survival, stress resistance, and reproductive success. However, life history characters often differ in their response to nutrition, forcing organisms to make foraging decisions while balancing the trade-offs between these effects. To date, we have a limited understanding of how the nutritional environment shapes the relationship between life history characters and foraging decisions. To gain insight into the problem, we used a geometric framework for nutrition to assess how the protein and carbohydrate content of the larval diet affected key life history traits in the fruit fly, Drosophila melanogaster. In no-choice assays, survival from egg to pupae, female and male body size, and ovariole number – a proxy for female fecundity – were maximized at the highest protein to carbohydrate (P:C) ratio (1.5:1). In contrast, development time was minimized at intermediate P:C ratios, around 1:2. Next, we subjected larvae to two-choice tests to determine how they regulated their protein and carbohydrate intake in relation to these life history traits. Our results show that larvae targeted their consumption to P:C ratios that minimized development time. Finally, we examined whether adult females also chose to lay their eggs in the P:C ratios that minimized developmental time. Using a three-choice assay, we found that adult females preferentially laid their eggs in food P:C ratios that were suboptimal for all larval life history traits. Our results demonstrate that D. melanogaster larvae make foraging decisions that trade-off developmental time with body size, ovariole number, and survival. In addition, adult females make oviposition decisions that do not appear to benefit the larvae. We propose that these decisions may reflect the living nature of the larval nutritional environment in rotting fruit. These studies illustrate the interaction between the nutritional environment, life history traits, and foraging choices in D. melanogaster, and lend insight into the ecology of their foraging decisions.

Carbohydrate intake in relation to BMI, HbA1c and lipid profile in children and adolescents with type 1 diabetes

To compare reported and recommended carbohydrate intake in children and adolescents with type 1 diabetes (T1D) and to explore associations with BMI, HbA1c and lipid profile. A cross-sectional observational study of reported carbohydrate intake in 46,010 patients with T1D aged 1-18 years from 332 diabetes centres in Germany and Austria in comparison to age-matched healthy children and adolescents. The median reported carbohydrate intake in T1D patients was markedly lower than in healthy children. It varied between 56% and 90% of recommended amounts across the paediatric age range with younger patients showing levels closer to recommend. Lower carbohydrate intake was associated with higher BMI-SDS (p < 0.001), particularly during adolescence, higher total cholesterol (p < 0.001), higher LDL-cholesterol (p = 0.005) and lower HbA1c (p < 0.001). The methodologically simple measure of reported carbohydrate intake may be a valuable addition to the information gathered on paediatric patients with T1D in an outpatient setting. Children and adolescents with T1D appear to restrict their consumption of carbohydrates, which may have adverse effects on BMI and the lipid profile, particularly if there is a compensatory increased fat intake. Health care providers should therefore advise patients and parents of the recommended age-dependent levels of carbohydrate intake.

Refined carbohydrate intake in relation to non-verbal intelligence among Tehrani schoolchildren

Nutrition has long been considered one of the most important environmental factors affecting human intelligence. Although carbohydrates are the most widely studied nutrient for their possible effects on cognition, limited data are available linking usual refined carbohydrate intake and intelligence. The present study was conducted to examine the relationship between long-term refined carbohydrate intake and non-verbal intelligence among schoolchildren. Cross-sectional study. Tehran, Iran. In this cross-sectional study, 245 students aged 6-7 years were selected from 129 elementary schools in two western regions of Tehran. Anthropometric measurements were carried out. Non-verbal intelligence and refined carbohydrate consumption were determined using Raven's Standard Progressive Matrices test and a modified sixty-seven-item FFQ, respectively. Data about potential confounding variables were collected. Linear regression analysis was applied to examine the relationship between non-verbal intelligence scores and refined carbohydrate consumption. Individuals in top tertile of refined carbohydrate intake had lower mean non-verbal intelligence scores in the crude model (P < 0.038). This association remained significant after controlling for age, gender, birth date, birth order and breast-feeding pattern (P = 0.045). However, further adjustments for mother's age, mother's education, father's education, parental occupation and BMI made the association statistically non-significant. We found a significant inverse association between refined carbohydrate consumption and non-verbal intelligence scores in regression models (β = -11.359, P < 0.001). This relationship remained significant in multivariate analysis after controlling for potential confounders (β = -8.495, P = 0.038). The study provides evidence indicating an inverse relationship between refined carbohydrate consumption and non-verbal intelligence among Tehrani children aged 6-7 years. Prospective studies are needed to confirm our findings.