Whole Grain Intake Research Articles

207P - Significant changes in dietary intake and physical activity after breast cancer diagnosis in a Chinese breast cancer cohort study

Background: The diagnosis of cancer can motivate survivors to modify lifestyles, typically involving diet and physical activity. Few data have reported pre- and post-diagnostic lifestyle habits in Chinese population. Methods: In an on-going prospective cohort study which involved 1462 Chinese women with early-stage breast cancer, we evaluated dietary intake and lifestyle factors pre- and post- breast cancer diagnosis. Validated food frequency questionnaires were used to evaluate dietary intake. Leisure time physical activity was measured by a modified Chinese Baecke questionnaire. This report compared changes of dietary intake and physical activity between 12 months before and 18 months after diagnosis of breast cancer. Results: Intake of whole grains, refined grains, fruits, vegetables, eggs, and nuts increased significantly post-diagnosis (Range, 54%-72% increase; P < 0.001, each; Table). Conversely, after diagnosis consumption of red meat, processed meat, poultry, dairy products, soy, sugar drinks, and coffee significantly decreased (Range, 32%-63% decrease; P < 0.001, each). The level of physical activity (MET-hour per week) post-diagnosis was significantly increased (median, 0.75 vs. 5.25; P < 0.001), with 58% of patients became more physically active. However, the proportion of women that met the WCRF/AICR Cancer Prevention recommendations about physical activity (10 MET-hour per week) was still low, only 21% women met at pre-diagnosis, increasing to 34% at post-diagnosis.Table207PFood groupPre-diagnosis [Median (IQR), g/1000kcal/day]Pre-diagnosis [Median (IQR), g/1000kcal/day]Refined grains269.9 (213.3-348.3)319.6 (257.8-391.2)Whole grains3.6 (0-11.9)7.4 (0.7-30.0)Fruits95.1 (54.3-137.8)140.4 (92.0-193.6)Vegetables194.1 (136.8-263.2)271.5 (197.3-359.8)Eggs8.3 (4.1-14.8)10.1 (5.2-16.9)Red meat48.3 (29.1-72.7)38.2 (20.3-62.0)Processed meat1.7 (0.3-4.8)0.4 (0-2.4)Poultry20.4 (9.6-38.2)1.1 (0-7.1)Dairy products15.4 (5.0-44.5)5.7 (0.6-15.9)Soy28.1 (12.8-55.1)23.3 (8.3-49.0)*IQR, inter quartile range. Open table in a new tab *IQR, inter quartile range. Conclusions: In this cohort study, Chinese breast cancer patients reported significant changes in dietary intake and increased physical activity level and a higher proportion met the WCRF/AICR Cancer Prevention recommendations after cancer diagnosis. These findings provided crucial information on lifestyle behaviors in Chinese breast cancer survivors, and provided information to healthcare professionals on survivors’ health and quality of life. Legal entity responsible for the study: The Chinese University of Hong Kong Funding: World Cancer Research Fund International (Grant Number WCRF 2010/249 and WCRF 2014/1197). Disclosure: All authors have declared no conflicts of interest.

Perspective: The Paradox in Dietary Advanced Glycation End Products Research—The Source of the Serum and Urinary Advanced Glycation End Products Is the Intestines, Not the Food

AbstractInconsistent research results have impeded our understanding of the degree to which dietary advanced glycation end products (dAGEs) contribute to chronic disease. Early research suggested that Western-style fast foods, including grilled and broiled meats and French fries, contain high levels of proinflammatory advanced glycation end products (AGEs). However, recent studies with state-of-the-art ultraperformance LC-tandem mass spectrometry (UPLC-MS) found that there is no evidence that these foods have elevated levels of dAGEs relative to other foods. Paradoxically, observational research found that the intake of fruits (mainly apples), fruit juices (apple juice), vegetables, nuts, seeds, soy, and nonfat milk, which are foods synonymous with healthy eating, as well as the intake of cold breakfast cereals, whole grains (breads), and sweets, which are sources of high-fructose corn syrup (HFCS), were associated with elevated serum and urinary N-ε-carboxymethyl-lysine (CML). Ironically, these are the same foods found to have lower CML levels, as measured by UPLC-MS. One possible explanation for this paradox is that the source of the elevated CML is the intestines, not the food. When considered collectively, dAGE research results are consistent with the “fructositis” hypothesis, which states that intake of foods and beverages with high fructose-to-glucose ratios (HFCS-sweetened foods and beverages, agave syrup, crystalline fructose, apple juice, and apple juice blends) promotes the intestinal in situ formation of readily absorbed, proinflammatory extracellular, newly identified, fructose-associated AGE, an overlooked source of immunogenic AGEs.

National pattern of grain products consumption among Canadians in association with body weight status

BackgroundObesity in Canadian adults is showing upward trends. Consumption of whole-grains is one recommendation for the prevention of obesity. Despite the apparent nutritional and energy content differences between whole and refined grains, knowledge relating refined grains to weight gain in Canadian adults is scarce. The aim of this study was to assess the consumption of specific grain-based foods at the regional and national levels, and to evaluate the association between grain consumption with overweight or obesity in Canadian adults.MethodsWe used the 2004 Canadian Community Health Survey data. The association between type of grain product consumed and Body Mass Index (BMI) in adults aged ≥19y was evaluated by logistic regression.ResultsThe mean daily intake of whole grains (86 ± 1.9 g/day) was significantly less than refined grains (276.6 ± 3.8 g/day), which was different across provinces. After adjustment for caloric needs, male consumers showed significantly lower intake of whole grains than females. Accordingly, the incidence of overweight or obesity was higher in males than in females. Also, in comparison to whole grains, the consumption of refined grains was associated with a higher risk of overweight or obesity among adults.ConclusionCanadians’ preference was refined grain products consumption, based on 2004 Health Survey, which was significantly associated with overweight/obesity. Hence, consumption of whole grains should be more effectively promoted rather than refined grain products to prevent obesity and its complications such as cardiovascular diseases and type 2 diabetes.

Nature, Nurture, and Cancer Risks: Genetic and Nutritional Contributions to Cancer.

It is speculated that genetic variants are associated with differential responses to nutrients (known as gene-diet interactions) and that these variations may be linked to different cancer risks. In this review, we critically evaluate the evidence across 314 meta-analyses of observational studies and randomized controlled trials of dietary risk factors and the five most common cancers (breast, lung, prostate, colorectal, and stomach). We also critically evaluate the evidence across 13 meta-analyses of observational studies of gene-diet interactions for the same cancers. Convincing evidence for association was found only for the intake of alcohol and whole grains in relation to colorectal cancer risk. Three nutrient associations had highly suggestive evidence and another 15 associations had suggestive evidence. Among the examined gene-diet interactions, only one had moderately strong evidence.

Recent Uptrend in Whole-Grain Intake Is Absent for Low-Income Adolescents, National Health and Nutrition Examination Survey, 2005-2012.

IntroductionWhole-grain consumption reduces risk of chronic disease, yet adolescents consume suboptimal amounts. It is unclear whether trends in consumption of whole grains have been positive among adolescents, and research assessing disparities by socioeconomic status is limited. The objective of our study was to evaluate recent trends in whole-grain consumption by US adolescents.MethodsWe examined data on 3,265 adolescents aged 13 to18 years from the National Health and Nutrition Examination Survey (NHANES) 2005–2012. Intake of whole and refined grains was analyzed by using generalized linear models, and odds of no whole-grain intake were examined with logistic regression, adjusting for socioeconomic and demographic factors. We evaluated trends and examined heterogeneity of trends with respect to annual household income.ResultsDaily whole-grain consumption among adolescents increased overall by about a quarter-ounce–equivalent per day (oz-eq/d) (P trend <.001). We found a significant relationship between whole-grain intake and income. Daily whole grains (recommended as ≥3 oz-eq/d), increased (0.6 to 1.0 oz-eq/d) among high-income adolescents (P trend < .001) but remained at 0.5 oz-eq/d for low-income adolescents. The ratio of whole grains to total grains (recommended to be at least 50%) rose from 7.6% to 14.2% for high-income adolescents (P trend < .001), with no significant trend for the low-income group. Consumption of refined grains did not change. Odds of having no whole grains trended downward, but only for the high-income adolescents (P trend = .01).ConclusionThese data show significant (albeit modest) trends toward increased intake of whole grains among high-income adolescents nationwide that are absent among low-income peers. Future interventions and policies should address barriers to whole-grain consumption among this vulnerable group.

Abstract CT138: Increasing dietary rice bran and navy bean intake for colorectal cancer control and prevention: A randomized-controlled pilot investigation

Abstract Adhering to the American Institute for Cancer Research (AICR) Recommendations for Cancer Prevention, including increasing dietary intake of whole grains and beans, has been shown to reduce colorectal cancer (CRC) burden. Dietary rice bran (RB) and navy beans (NB) are examples of these foods with high dietary fiber content and other important phytochemicals that have inhibited colon carcinogenesis in animal and human epidemiological studies. Alongside widespread affordability and accessibility, we formed a community-academic partnership to advance RB and NB dietary chemoprevention research in a pilot phase II study titled BENEFIT: Beans/Bran Enriching Nutritional Eating For Intestinal health Trial (NCT01929122). We established feasibility of increased consumption in CRC survivors and examined changes in dietary intake and gut microflora. Twenty-nine participants completed the 4-week, randomized-controlled dietary intervention that included consuming RB (30g/day), NB powder (35g/day), or neither (control) via study provided meals and snacks. Fasting blood, urine, and stool were collected at baseline, 2-week, and 4-week time points. The amount of RB or NB consumed (ranging from 4-9% daily caloric intake) led to increased dietary fiber, iron, zinc, thiamin, niacin, vitamin B6, folate, and alpha-tocopherol intake, as measured by NutritionistProTM. Stool microbiome analysis from RB group showed significant genus level increases in Methanobrevibacter, Paraprevotella, Ruminococcus, and Bifidobacterium compared to the control group, as well as increased gut bacterial richness and diversity. The NB group increased gut bacterial richness and revealed increases in three previously unidentified species. Plasma, urine, and stool metabolome changes revealed increases in a number of microbial, host, and diet derived metabolites, such as phytosterols, fatty acids, amino acids, bile acids, and small molecule byproducts of carbohydrate metabolism. In addition, human stool metabolite extracts were assessed before and after RB or NB consumption to observe reduced growth of CRC cells. Dietary biomarkers of RB and NB consumption are under investigation and have revealed specific metabolite profiles including pyridoxine (vitamin B6), beta-hydroxyisovaleroylcarnitine and beta-hydroxyisovalerate (RB), and pipecolate and S-methylcysteine (NB). These results support dietary RB or NB modulation of metabolism from digestion, microbiota, and microbial biotransformation. Our pilot findings warrant further evaluation of these specific foods in a larger cohort and for a longer duration of consumption to assess CRC control and prevention markers in the colon tissue. Next phase studies underway include dietary modulation of human colonic inflammation for CRC chemoprevention. Citation Format: Erica C. Borresen, Renee C. Oppel, Dustin G. Brown, Regina J. Brown, Elizabeth P. Ryan. Increasing dietary rice bran and navy bean intake for colorectal cancer control and prevention: A randomized-controlled pilot investigation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr CT138. doi:10.1158/1538-7445.AM2017-CT138

A Western Diet Pattern Is Associated with Higher Concentrations of Blood and Bone Lead among Middle-Aged and Elderly Men

Background: Little is known about the effects of overall dietary pattern on lead concentration.Objective: We examined the association of overall dietary patterns, derived from a semiquantitative food frequency questionnaire, with bone and blood lead concentrations.Methods: These longitudinal analyses included mostly non-Hispanic white, middle-aged-to-elderly men from the Veterans Affairs Normative Aging Study. Long-term lead exposures were measured as tibia and patella lead concentrations by using K-shell-X-ray fluorescence. Short-term lead exposures were measured as blood lead concentrations by using graphite furnace atomic absorption spectroscopy. Dietary pattern scores were derived by using factor analysis. Linear mixed-effects models were utilized to predict blood lead concentrations among 983 men, aged 44-92 y at baseline, with a total of 3273 observations (during 1987-2008). We constructed linear regression models to determine the relations between dietary patterns and bone lead concentrations among 649 participants with an age range of 49-93 y.Results: Two major dietary patterns were identified: a prudent dietary pattern, characterized by high intakes of fruit, legumes, vegetables, whole grains, poultry, and seafood; and a Western dietary pattern, characterized by high intakes of processed meat, red meat, refined grains, high-fat dairy products, French fries, butter, and eggs. After adjusting for age, smoking status, body mass index, total energy intake, education, occupation, neighborhood-based education and income level, men in the highest tertile of the Western pattern score (compared with the lowest) had 0.91 μg/dL (95% CI: 0.41, 1.42 μg/dL) higher blood lead, 5.96 μg/g (95% CI: 1.76, 10.16 μg/g) higher patella lead, and 3.83 μg/g (95% CI: 0.97, 6.70 μg/g) higher tibia lead. No significant association was detected with the prudent dietary pattern in the adjusted model.Conclusions: These findings suggest that the Western diet is associated with a greater lead body burden among the middle-aged-to-elderly men. More studies are needed to examine the underlying mechanisms by which dietary patterns are associated with lead concentrations.

Maternal Dietary Patterns during Pregnancy Are Associated with Newborn Body Composition

Background: Maternal dietary intake during pregnancy may influence offspring growth and adiposity. Specific dietary patterns associated with newborn adiposity have not been identified.Objective: We aimed to identify patterns of maternal dietary intake associated with gestational weight gain (GWG) and fasting glucose during pregnancy and to evaluate whether adherence to these patterns is associated with newborn adiposity.Methods: In the Healthy Start prospective cohort, dietary intake during pregnancy was assessed via 24-h recalls. Reduced-rank regression identified dietary patterns predictive of GWG and fasting glucose. Associations between dietary patterns and newborn fat mass, fat-free mass, and adiposity were estimated by using linear regression models among 764 ethnically diverse mother-infant pairs.Results: Two dietary patterns were identified. Pattern 1, correlated with greater GWG (r = 0.22, P < 0.01), was characterized by a higher consumption of poultry, nuts, cheese, fruits, whole grains, added sugars, and solid fats. Greater adherence to pattern 1 (upper compared with lower tertile) predicted a greater newborn fat-free mass (61 g; 95% CI: 12, 110 g) but no difference in fat mass or adiposity. Pattern 2, correlated with greater maternal fasting glucose (r = 0.16, P < 0.01), was characterized by a higher consumption of eggs, starchy vegetables, solid fats, fruits, and nonwhole grains and a lower consumption of dairy foods, dark-green vegetables, and whole grains. Greater adherence to pattern 2 was associated with a greater newborn birth weight (80 g; 95% CI: 15, 145 g), fat mass (33 g; 95% CI: 8, 59 g), and adiposity (0.9%; 95% CI: 0.3%, 1.6%).Conclusions: Among pregnant women, adherence to a dietary pattern characterized by an intake of poultry, nuts, cheese, and whole grains was associated with greater GWG but not maternal fasting glucose or newborn adiposity. Adherence to a pattern characterized by an intake of eggs, starchy vegetables, and nonwhole grains was associated with higher maternal fasting glucose and greater newborn adiposity. Maternal dietary patterns during pregnancy may influence newborn body composition.

Perspective: A Definition for Whole-Grain Food Products—Recommendations from the Healthgrain Forum

Whole grains are a key component of a healthy diet, and enabling consumers to easily choose foods with a high whole-grain content is an important step for better prevention of chronic disease. Several definitions exist for whole-grain foods, yet these do not account for the diversity of food products that contain cereals. With the goal of creating a relatively simple whole-grain food definition that aligns with whole-grain intake recommendations and can be applied across all product categories, the Healthgrain Forum, a not-for-profit consortium of academics and industry working with cereal foods, established a working group to gather input from academics and industry to develop guidance on labeling the whole-grain content of foods. The Healthgrain Forum recommends that a food may be labeled as “whole grain” if it contains ≥30% whole-grain ingredients in the overall product and contains more whole grain than refined grain ingredients, both on a dry-weight basis. For the purposes of calculation, added bran and germ are not considered refined-grain ingredients. Additional recommendations are also made on labeling whole-grain content in mixed-cereal foods, such as pizza and ready meals, and a need to meet healthy nutrition criteria. This definition allows easy comparison across product categories because it is based on dry weight and strongly encourages a move from generic whole-grain labels to reporting the actual percentage of whole grain in a product. Although this definition is for guidance only, we hope that it will encourage more countries to adopt regulation around the labeling of whole grains and stimulate greater awareness and consumption of whole grains in the general population.

Consumption of key food groups during the postpartum period in low-income, non-Hispanic black mothers

The postpartum period can impact diet quality and subsequently place women at greater risk for overweight or obesity. This study examined consumption of key food groups during the first 2 years postpartum among low income, non-Hispanic black, first-time mothers. Data were from the Infant Care, Feeding and Risk of Obesity Study, a cohort of 217 mother–infant dyads, followed from 3 to 18 months postpartum, collected from 2003 to 2007. At each study visit (3, 6, 9, 12, and 18 months) 24-h dietary recalls were collected. Consumption levels were compared to those recommended from the 2010 Dietary Guidelines for Americans (DGAs) for each of the following food groups: fruits, vegetables, grains, whole grains, protein foods and dairy, as well as an estimated upper limit for sugar-sweetened beverage (SSB) consumption. At each time point, mothers met recommended intake levels for grains and protein foods only. In random-intercept logistic regression models, no demographic or household characteristics were associated with a likelihood of consuming recommended levels for any of the food groups according to the DGAs. Given the low intake of fruits, vegetables, whole grains and lean protein foods and high intake of SSBs and refined grains, interventions targeting women's diet during the postpartum period are warranted.

Consumption of obesogenic foods in non-Hispanic black mother-infant dyads.

Obesity continues to be a problem in the United States. Of particular concern is the epidemic of early childhood obesity. A significant predictor of child diet is maternal diet, but little is known about this relationship during infancy. This study examined the association between maternal and infant consumption of key food groups from 6 to 18months using data from the Infant Care, Feeding, and Risk of Obesity Study, a prospective cohort of 217 non-Hispanic black, low-income, first-time mothers. Using data from 24-hr dietary recalls collected during in-home visits at 6, 9, 12, and 18months, we assessed longitudinal associations between mother and child intake of both energy-dense, nutrient-poor (obesogenic) food groups and fibre-, nutrient-rich food groups using random intercept logistic regression. Both mothers and their infants had high intake of sugar-sweetened beverages, desserts, and sweets and low intake of vegetables and whole grains. Infant consumption of key food groups was strongly associated with maternal consumption, suggesting the need for focused interventions to target maternal diet as a pathway to decreasing risk for the establishment of poor dietary patterns early in life.

Novel urinary alkylresorcinol metabolites as biomarkers of whole grain intake in free-living Swedish adults.

Most studies on the role of whole grain for health rely on self-reported intake data, which are prone to measurement errors. There is a need for dietary biomarkers that can provide an objective measure of intake. Alkylresorcinols (AR) and their main metabolites 3,5-dihydroxybenzoic acid (DHBA) and 3-(3,5-dihydroxyphenyl)-propanoic acid (DHPPA) have been proposed as biomarkers for whole grain (WG) wheat and rye intake. The medium-term reproducibility and relative validity of four putative urinary AR metabolites (3,5-dihydroxycinnamic acid (DHCA), 5-(3,5-dihydroxyphenyl) pentanoic acid (DHPPTA), 2-(3,5-dihydroxybenzamido)acetic acid (DHBA-glycine) and 3,5-dihydroxycinnamic acid amide (DHCA-amide)) as biomarkers for WG intake were investigated. Three-day weighed food records and 24-h urine samples from two occasions 2-3 months apart were obtained from 69 Swedish adults. WG intake was calculated and urinary AR metabolites were analyzed. The medium-term reproducibility determined for DHCA, DHPPTA, and DHBA-glycine varied from moderate-to-excellent (intra-class correlation coefficient = 0.63-0.85). Moreover, DHCA and DHPPTA excretion correlated well with self-reported total WG intake (r=0.55, p<0.001 and r=0.42, p<0.001, respectively). DHCA or DHPPTA excretion in 24-h urine might be a suitable medium- to long-term biomarker of WG wheat and rye intake. These findings need to be confirmed in populations with low and infrequent WG intake.

Adherence to the Western, Prudent and Mediterranean dietary patterns and breast cancer risk: MCC-Spain study

ObjectiveTo externally validate the previously identified effect on breast cancer risk of the Western, Prudent and Mediterranean dietary patterns. Study designMCC-Spain is a multicase-control study that collected epidemiological information on 1181 incident cases of female breast cancer and 1682 healthy controls from 10 Spanish provinces. Three dietary patterns derived in another Spanish case-control study were analysed in the MCC-Spain study. These patterns were termed Western (high intakes of fatty and sugary products and red and processed meat), Prudent (high intakes of low-fat dairy products, vegetables, fruits, whole grains and juices) and Mediterranean (high intake of fish, vegetables, legumes, boiled potatoes, fruits, olives, and vegetable oil, and a low intake of juices). Their association with breast cancer was assessed using logistic regression models with random province-specific intercepts considering an interaction with menopausal status. Risk according to tumour subtypes – based on oestrogen (ER), progesterone (PR) and human epidermal growth factor 2 (HER2) receptors (ER+/PR+ & HER2−; HER2+; ER−/PR− & HER2−) – was evaluated with multinomial regression models. Main outcome measuresBreast cancer and histological subtype. ResultsOur results confirm most of the associations found in the previous case-control study. A high adherence to the Western dietary pattern seems to increase breast cancer risk in both premenopausal women (OR4thvs.1stquartile (95% CI):1.68 (1.02;2.79); OR1SD-increase (95% CI):1.19 (1.02;1.40)) and postmenopausal women (OR4thvs.1stquartile(95% CI):1.48(1.07;2.05); OR1SD-increase(95% CI): 1.14 (1.01;1.29)). While high adherence to the Prudent pattern did not show any effect on breast cancer, the Mediterranean dietary pattern seemed to be protective, but only among postmenopausal women (OR4thvs.1stquartile (95% CI): 0.72 (95% CI 0.53;0.98); p-int=0.075). There were no significant differences by tumour subtype. ConclusionDietary recommendations based on a departure from the Western dietary pattern in favour of the Mediterranean diet could reduce breast cancer risk in the general population.

Avenacosides: Metabolism, and potential use as exposure biomarkers of oat intake.

Exposure biomarkers used for objective estimation of whole-grain (WG) intake are essential for epidemiologic studies of WG consumption, however, up to now, no exposure biomarkers were developed for WG oat intake. This study investigates the potential of oat unique components, Avenacoside-B (AVE-B) and -A (AVE-A), as exposure biomarkers of oat intake. An in vivo study performed in mice and an in vitro batch fecal fermentation study were used to investigate the potential metabolic routes of AVE-B and -A. Twelve healthy volunteers were recruited in the human urinary pharmacokinetic study, each participant received a single dose of oat bran as breakfast, 48h urine samples were collected at baseline and after treatment period, and AVE-B and -A were quantified by LC-MS/MS. Deglycosylation metabolic route was identified as the major metabolic path for AVE-B and -A. Urinary AVE-B and -A concentrations increased rapidly after oat ingestion, reached their maximum excretion rates (ERmax ) fairly simultaneously within 5h, then decreased gradually. And the mean eliminate half-lives (T1/2 ) for AVE-B and -A were determined as 6.22 and 4.55h, respectively. Oat AVE-B and -A have great potential to be used as specific exposure biomarkers to reflect oat intake.

Dietary Patterns and Metabolic Syndrome among Type 2 Diabetes Patients in Gaza Strip, Palestine.

The prevalence of metabolic syndrome is raising worldwide; however, the role of diet in the origin of metabolic syndrome is not understood well. This study identifies major dietary patterns among type 2 diabetes mellitus patients with and without metabolic syndrome; and its association with metabolic syndrome components in Gaza Strip, Palestine. This cross sectional study was conducted among 1200 previously diagnosed type 2 diabetes mellitus (both genders, aged 20 - 64 years) patients receiving care in primary healthcare centers in Gaza Strip, Palestine. Metabolic syndrome was defined based on the International Diabetes Federation criteria; dietary patterns were evaluated using a validated semi-quantitative food frequency questionnaire. Statistical analysis was performed using SPSS version 20. Two major dietary patterns were identified by factor analysis: Asian-like pattern and sweet-soft drinks-snacks pattern. After adjustment for confounding variables, patients in the highest tertile of the Asian-like pattern characterized by a high intake of whole grains, potatoes, beans, legumes, vegetables, tomatoes and fruithad a lower odds for (Metabolic syndrome, central obesity, high triglycerides, low HDL cholesterol and high blood pressure), (OR 0.766 CI 95% (.642-.914)), (OR 0.797 CI 95% (.652-.974)), (OR 0.791 CI 95% (.687-.911)), (OR 0.853 CI 95% (.743-.978)) and (OR 0.815 CI 95% (.682-.973)) respectively, (P value < 0.05 for all). No significant association was found between the sweet-soft drinks-snacks pattern with metabolic syndrome and its components. The Asian-like pattern may be associated with a lower prevalence of metabolic syndrome and its components among type 2 diabetes patients.

Long term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study

Objective To examine the association of long term intake of gluten with the development of incident coronary heart disease.Design Prospective cohort study.Setting and participants 64 714 women in the Nurses’...

Whole-Grain Intake, Reflected by Dietary Records and Biomarkers, Is Inversely Associated with Circulating Insulin and Other Cardiometabolic Markers in 8- to 11-Year-Old Children

Background: Whole-grain consumption seems to be cardioprotective in adults, but evidence in children is limited.Objective: We investigated whether intakes of total whole grain and dietary fiber as well as specific whole grains were associated with fat mass and cardiometabolic risk profile in children.Methods: We collected cross-sectional data on parental education, puberty, diet by 7-d records, and physical activity by accelerometry and measured anthropometry, fat mass index by dual-energy X-ray absorptiometry, and blood pressure in 713 Danish children aged 8-11 y. Fasting blood samples were obtained and analyzed for alkylresorcinols, biomarkers of whole-grain wheat and rye intake, HDL and LDL cholesterol, triacylglycerols, insulin, and glucose. Linear mixed models included puberty, parental education, physical activity, and intakes of energy, fruit and vegetables, saturated fat, and n-3 (ω-3) polyunsaturated fatty acids.Results: Median (IQR) whole-grain and dietary fiber intakes were 52 g/d (35-72 g/d) and 17 g/d (14-22 g/d), respectively. Fourteen percent of children were overweight or obese and most had low-risk cardiometabolic profiles. Dietary whole-grain and fiber intakes were not associated with fat mass index but were inversely associated with serum insulin [both P < 0.01; e.g., with 0.68 pmol/L (95% CI: 0.26, 1.10 pmol/L) lower insulin · g whole grain-1 · MJ-1]. Whole-grain oat intake was inversely associated with fat mass index, systolic blood pressure, and LDL cholesterol (all P < 0.05) as well as insulin (P = 0.003), which also tended to be inversely associated with whole-grain rye intake (P = 0.11). Adjustment for fat mass index did not change the associations. The C17-to-C21 alkylresorcinol ratio, reflecting whole-grain rye to wheat intake, was inversely associated with insulin (P < 0.001).Conclusions: Higher whole-grain intake was associated with lower serum insulin independently of fat mass in 8- to 11-y-old Danish children. Whole-grain oat intake was linked to an overall protective cardiometabolic profile, and whole-grain rye intake was marginally associated with lower serum insulin. This supports whole grains as healthy dietary components in childhood. This trial was registered at clinicaltrials.gov as NCT01577277.

Alternate Mediterranean diet score is positively associated with skeletal muscle mass index in middle-aged adults.

Researches have suggested Mediterranean diet might lower the risk of chronic diseases, but data on skeletal muscle mass (SMM) are limited. This community-based cross-sectional study examined the association between the alternate Mediterranean diet score (aMDS) and SMM in 2230 females and 1059 males aged 40-75 years in Guangzhou, China. General information and habitual dietary information were assessed in face-to-face interviews conducted during 2008-2010 and 3 years later. The aMDS was calculated by summing the dichotomous points for the items of higher intakes of whole grain, vegetables, fruits, legumes, nuts, fish and ratio of MUFA:SFA, lower red meat and moderate ethanol consumption. The SMM of the whole body, limbs, arms and legs were measured using dual-energy X-ray absorptiometry during 2011-2013. After adjusting for potential covariates, higher aMDS was positively associated with skeletal muscle mass index (SMI, SMM/height2, kg/m2) at all of the studied sites in males (all P trend<0·05). The multiple covariate-adjusted SMI means were 2·70 % (whole body), 2·65 % (limbs), 2·50 % (arms) and 2·70 % (legs) higher in the high (v. low) category aMDS in males (all P<0·05). In females, the corresponding values were 1·35 % (P trend=0·03), 1·05, 0·52 and 1·20 %, (P trend>0·05). Age-stratified analyses showed that the favourable associations tended to be more pronounced in the younger subjects aged less than the medians of 59·2 and 62·2 years in females and males (P interaction>0·10). In conclusion, the aMDS shows protective associations with SMM in Chinese adults, particularly in male and younger subjects.

Dietary Patterns and Alcohol Consumption During Pregnancy: Secondary Analysis of Avon Longitudinal Study of Parents and Children.

Large general population surveys show that heavy regular and episodic alcohol consumption are associated with lower intakes of fruits and vegetables, and higher intakes of processed and fried meat. This is of particular concern regarding pregnant women, as both alcohol intake and inadequate maternal nutrition are independently associated with adverse fetal outcomes. The current study aimed to determine associations between maternal dietary patterns and alcohol consumption during pregnancy. Women were participating in the Avon Longitudinal Study of Parents and Children, and provided details of alcohol consumption at 18weeks' gestation and diet at 32weeks' gestation (n=9,839). Dietary patterns were derived from the food frequency questionnaire data using principal components analysis. Associations between alcohol consumption and dietary patterns were determined using multiple linear regression, adjusted for various sociodemographic and lifestyle factors. After adjustment, drinking ≥1 unit/d during the first trimester (β=0.23 [95% CI: 0.08, 0.38]; p=0.002) and binge drinking (≥4 units in 1day) during the first half of pregnancy (β=0.14 [95% CI: 0.07, 0.21]; p<0.0001) were associated with greater adherence to the "Processed" dietary pattern (high intakes of processed meat and low intakes of fruit and vegetables). Light-to-moderate alcohol consumption (≤1 drink/d) during the first trimester was associated with greater adherence to the "Health conscious" dietary pattern (high intakes of fruit, vegetables, whole grains, and fish) (β=0.09 [95% CI: 0.04, 0.14]; p<0.0001). Two important components of health behavior during pregnancy appear to be related: greater consumption of processed foods associated with heavier alcohol consumption, and healthier dietary choices associated with light-to-moderate alcohol intake. Potential synergistic effects of these behaviors may have implications for maternal and fetal health and warrant further investigation. A more holistic approach to addressing health behaviors in women of reproductive age is required.

DIETARY CHOLESTEROL LOWERS RISK OF TYPE 2 DIABETES IN THE FRAMINGHAM OFFSPRING STUDY

Beginning in the 1960s, limiting dietary cholesterol (DC) was widely considered a strategy for protecting against cardiovascular disease (CVD) risk. Recently, the 2013 American College of Cardiology/American Heart Association Lifestyle Guidelines for the Reduction of Cardiovascular Disease concluded that the evidence was insufficient to support continued restriction of DC intake for prevention of CVD; the Dietary Guidelines Advisory Committee no longer considers DC to be a “nutrient of concern”. However, questions remain about whether DC is a risk factor for type 2 diabetes mellitus (T2DM). The objective of this study was to estimate the effects of DC alone and in combination with selected markers of a healthy diet (e.g. fruits &amp; vegetables, whole grains, fiber) on fasting glucose (FG) and risk of developing T2DM. Men and women without T2DM who were 35–64 years of age at the time of dietary assessment in the Framingham Offspring Study were included these analyses and followed for 20 years. Three‐day food records were collected at exams 3 and 5. Individuals were classified according to sex‐specific DC intake (low, moderate, and high intakes for men: &lt;200, 200–&lt;400, and ≥400 mg/day; for women: &lt;150, 150–&lt;350, and ≥350 mg/day). Longitudinal mixed models were used to estimate the adjusted mean fasting glucose (FG) at five follow‐up exams, 4 years apart. Cox proportional hazard's models were used to estimate the risk of developing T2DM; final models were adjusted for age, education, physical activity, cigarette smoking, alcohol intake, and baseline body mass index (BMI). At baseline, men consuming ≥400 mg of DC had lower mean FG than those consuming &lt;200 mg (FG: 93.8 vs 96.6, p‐trend: 0.0006); results were similar in women. There was no evidence that higher DC intake had an adverse effect on FG throughout all years of follow‐up. Among both men and women, longitudinal mixed models showed that those consuming the highest (vs. lowest) amounts of DC had the lowest FG levels at baseline (p&lt;0.0001) and lowest throughout the 20 years of follow‐up (p=0.0008). In addition, those subjects with high intakes of DC had a 22% lower risk of developing T2DM (HR: 0.78; 95% CI: 0.52–1.15) over time. To evaluate the combined effects of DC and other healthy diet patterns, we cross‐classified subjects according to their intake of both DC and the particular food serving as a marker of a healthy diet. The foods most strongly associated with a lower risk of T2DM and that modified the effects of DC were whole grains and fiber. Adults consuming ≥300 mg/day of DC and ≥0.5 servings/day of whole grains had a 38% lower risk of developing T2DM (95% CI: 0.41–0.93), while those consuming ≥300 mg/day of DC who had low whole intakes had only a 21% lower risk and those with lower DC intakes but higher intakes of whole grains had a 13% lower risk. These results suggest a positive synergistic effect between DC and whole grain consumption. Dietary fiber also modified the effects of DC on T2DM risk. Subjects consuming ≥300 mg/day of DC and ≥15 grams of dietary fiber had a 43% lower risk of T2DM (95% CI: 0.40–0.83) than those consuming less DC and less fiber. These results suggest that higher intakes of DC do not adversely affect fasting glucose levels or risk of T2DM and may even be beneficial when consumed in combination with a healthy diet.Support or Funding InformationNational Heart, Lung and Blood Institute's Framingham Heart Study (Contract No. HHSN268201500001I) and a small grant from the American Egg Board ‐ Egg Nutrition Center.