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PubMed2006

[Vegetarian nutrition: preventive potential and possible risks. Part 2: animal foods and recommendations].

INTRODUCTION: As shown in the first part of this article, consuming high amounts of fruits, vegetables, whole grains and nuts can lower the risk for several chronic diseases. However, the relevance of animal foods consumed within a vegetarian diet is less well-known. MATERIALS AND METHODS: We followed a nutritive and a metabolic-epidemiological approach to obtain dietary recommendations. A MEDLINE-research was performed for all animal food groups relevant with a vegetarian diet (key words: "eggs", "milk", "dietary pattern" "vegetarian diet", "cancer", "cardiovascular disease", "diabetes mellitus", "osteoporosis", "vitamin D", "vitamin B(12)", "iron", "iodine"). All relevant food groups were characterized regarding their nutrient content and rated with respect to the available metabolic-epidemiological evidence. RESULTS: Based on the evidence criteria of the WHO/FAO, colorectal cancer risk reduction by a high intake of milk and milk products is assessed as probable, while a higher risk of prostate and ovarial carcinomas is also probable. The evidence of a risk-increasing effect of eggs relating to cardiovascular disease, colorectal cancer and breast cancer is assessed as probable. As the data of prospective cohort studies suggest, a prudent diet pattern characterized high in fruits, vegetables, whole grains and nuts is associated with a lower risk of coronary heart disease and diabetes mellitus type 2. In contrast, there is no overall association between prudent diet pattern and risk of breast cancer or colorectal cancer. The critical key nutrients for vegetarians are vitamin D and B12, iodine and iron. CONCLUSION: For the first time evidence based dietary recommendations were provided for persons on a vegetarian diet in the D-A-CH-region.

Animals↗
PubMed1984

A multifactorial diet in the management of hyperlipidaemia.

To augment the effectiveness of conventional lipid-lowering treatment, a diet has been evolved combining modified fat content with an increase in vegetable-derived fibre and protein. This was evaluated in 37 hyperlipidaemic and normal ambulant subjects in whom plasma lipid and lipoprotein responses were measured for 4.7-11 months. Mean reductions in plasma cholesterol, triglyceride and low density lipoprotein cholesterol levels were 22, 24 and 25% respectively; there was no significant change in the cholesterol concentrations in high density lipoprotein or in its HDL2 subclass. The effectiveness of the diet in reducing hyperlipidaemia, its influence in optimizing the distribution of cholesterol between plasma lipoprotein classes, and its nutrient composition suggest that it is an advance on existing lipid-lowering dietary patterns.

Adult↗
PubMed2003

Fortification, supplementation, and nutrient balance.

Efforts to combat nutrient deficiencies have centered on supplemental nutrient administration and addition of selected nutrients to the food chain in the form of food fortification. Over the past several decades, and as the association between diet and chronic diseases became apparent, supplementation and fortification were also targeted at healthy individuals, with the aim of reducing their risk of future diseases such as cardiovascular diseases, diabetes, and cancer. While supplementation strategies are playing a major role in reducing micronutrient deficiencies around the world, there is less compelling evidence for their role in reducing risk of chronic diseases in healthy individuals, perhaps with the exception of folic acid and reduction of neural tube defects. Nevertheless, with our increasing understanding of the genetic heterogeneity of human nutrient requirements, it is likely that certain groups or populations may clearly benefit from higher intakes of certain nutrients. In addition to supplementation or fortification with specific nutrients, the consumption of certain dietary patterns (such as the Mediterranean diet) is associated with a reduced risk of chronic diseases, particularly cardiovascular diseases.

Dietary Supplements↗
PubMed2001

Diet, nutrition and cancer prevention: where are we going from here?

Since the national declaration of the war on cancer three decades ago, research on carcinogenesis has yielded a tremendous knowledge base on cancer. Cancer cells are the result of multiple genetic defects resulting from exposure to environmental, dietary and infectious agents. Multistep and multistage carcinogenesis may span 20 y or more, a time that provides research and clinical opportunities to suppress this disease in its early and premalignant stages before clinical symptomatic, invasive stages. Where do we go from here? After this year's milestone of gene sequencing accomplishments, further research opportunities arise in pursuing studies on the mechanisms of the acquired capacities of cancer cells, including their limitless replicative potential, sustained angiogenesis and invasion and avoidance of apoptosis. With new DNA chip technology and functional proteomics, complex nutrient-gene interactions may now be investigated. Research on nutrient-gene interactions not only provides pathophysiologic mechanisms of cancer causation and prevention, but also improves the ability to conduct cancer surveillance, crucial in identifying at-risk populations. By combining chemoprevention approaches, from the use of single nutrients to multiple dietary constituents and functional foods, the scope of future cancer prevention strategies will be broadened. Research on eating behavior and changing dietary patterns must be included in any cancer prevention strategy. A new paradigm for diet, nutrition and cancer prevention can be developed using multidisciplinary approaches that include lifestyle and environmental changes, dietary modifications and physical activity consciousness to reduce the burden of cancer not only for high risk individuals but for the general population as well.

DNA Methylation↗
PubMed1999

Iron intake and iron status of preschool children: associations with breakfast cereals, vitamin C and meat.

OBJECTIVE: To examine associations between breakfast cereal consumption and iron status and identify dietary patterns that might improve iron status in this vulnerable group. DESIGN: Analysis of data from the UK National Diet and Nutrition Survey (NDNS) of children aged 1.5-4.5 years, including dietary intakes calculated from 4-day weighed records. SUBJECTS: Data were used from 904 children with haematological measurements, excluding those taking iron supplements; 20% had low iron stores (ferritin < 10 microgl-1) while 8% were anaemic (Hb < 11 g dl-1). RESULTS: High cereal consumers had significantly higher iron intakes than low cereal consumers (classified by tertiles) but the 10% difference in mean ferritin levels was not significant (P= 0.067). Lower intakes of vitamin C and meat among high consumers of cereal may have diluted the impact of cereal iron on iron status. When children were reclassified according to their intakes of vitamin C and iron from meat and breakfast cereals, the group with high (above median) intakes of two or more factors had a higher mean haemoglobin (Hb) level and a lower prevalence of anaemia compared with the group with low (below median) intakes of all three dietary constituents. CONCLUSIONS: Nutritional advice that aims to improve iron status should emphasize not only rich sources of iron but also factors that may enhance or inhibit absorption. Strategies to optimize iron status in this vulnerable age group include consuming an iron-fortified breakfast cereal, vitamin C-rich fruit or drink at breakfast, and avoiding tea with (or after) meals.

Anemia, Iron-Deficiency↗
PubMed2004

Effects of acute chromium supplementation on postprandial metabolism in healthy young men.

BACKGROUND: Chromium (Cr) potentiates the action of insulin in the cell and improves glucose tolerance after long-term supplementation. OBJECTIVE: We hypothesized that Cr may also have acute effects and might be beneficial in lowering the glycemic index of a meal. METHODS: We studied the effects of short-term Cr supplementation using a randomized crossover design. Thirteen apparently healthy, non-smoking young men of normal body mass index performed three trials each separated by one week. Test meals, providing 75 g of available carbohydrates, consisted of white bread with added Cr (400 or 800 microg as Cr picolinate) or placebo. RESULTS: After addition of 400 and 800 microg Cr incremental area under the curve (AUC) for capillary glucose was 23% (p = 0.053) and 20% (p = 0.054), respectively, lower than after the white bread meal. These differences reached significance if the subjects were divided into responders (n = 10) and non-responders (n = 3). For the responders AUC after 400 and 800 microg Cr was reduced by 36% and 30%, respectively (Placebo 175 +/- 22, Cr400 111 +/- 14 (p < 0.01), Cr800 122 +/- 15 mmol. min/L (p < 0.01)). Glycemia was unchanged after addition of Cr in the non-responders. Responders and non-responders differed significantly in their nutrient intake and eating pattern, and total serum iron concentration tended to be lower in the responder group (p = 0.07). CONCLUSIONS: Acute chromium supplementation showed an effect on postprandial glucose metabolism in most but not all subjects. The response to Cr may be influenced by dietary patterns.

Adult↗
PubMed1997

Diet, nutrition and prostate cancer.

Although much has been written, little is known about the causes of prostate cancer. Variations between populations in the incidence of invasive cancers, together with changes in the incidence of invasive cancers in migrants, have pointed to environmental (lifestyle) factors that might be amenable to intervention. Conversely, there is a lack of international variation in the prevalence of microscopic tumours, so the essential question is: what causes only some of the common microscopic tumours to become aggressive? Dietary factors hold the most promise in this regard and have been the subject of recent reviews. The strongest and most consistent effects are positive associations with animal products such as red meats, eggs and dairy foods, and possibly by implication, fat. Evidence of a protective effect of fruit and vegetables is weak and inconsistent, as is the relationship with vitamin A and carotenoids, such as beta-carotene. There are some interesting leads. Lycopene, the carotenoid found in tomatoes, has been reported to be protective; alpha-tocopherol supplementation has shown a protective effect in one intervention study; and vitamin D has been shown to be protective in a prospective study. Interest is also growing in phytoestrogens and the extent to which dietary manipulation with these and other phytochemicals might influence prostate cancer by modifying male sex hormone levels or actions. There is limited evidence of associations with obesity. It is not known whether these are related to a particular dietary pattern or to possible physiological effects on the male's hormonal milieu. Associations with lean body mass are likely to be related to the action of androgens during growth and development. Dietary and nutritional effects on prostate cancer do not appear to be strong, but they may be subtle and attenuated by measurement error. To explore these aspects further will require large prospective studies that include improved (repeated) dietary measurements and also blood sampling, so that genetic polymorphisms can be adequately investigated. Such studies are underway.

Alcohol Drinking↗
PubMed2003

Dietary factors in atherogenesis.

Emerging evidence continues to increase our awareness of the complexity of pathologic processes involved in atherogenesis. Dietary modulation exclusively targeting cholesterol consumption is rapidly becoming an archaic mode of intervention as alternative theories of atherogenesis evolve. The interaction of nutrients that occurs with different dietary patterns has been the subject of intense research. Similarly, the effect of diet on vascular reactivity, lipid metabolic kinetics, and antioxidant potential has enormous implications for therapeutic modalities targeting atherosclerosis. Many dietary strategies aimed at inhibiting and preventing atherogenesis have resulted from ongoing research. Consensus opinions extrapolated from available data have also emerged. Regardless, the precise role of dietary modulation in atherogenesis is yet to be fully elucidated. This article reviews recent evidence relating to the interface between dietary factors and biologic models of atherogenesis. Clinical implications and practical applications are also discussed.

Animals↗
PubMed2000

Dietary cholesterol and atherosclerosis.

The perceived relationship between dietary cholesterol, plasma cholesterol and atherosclerosis is based on three lines of evidence: animal feeding studies, epidemiological surveys, and clinical trials. Over the past quarter century studies investigating the relationship between dietary cholesterol and atherosclerosis have raised questions regarding the contribution of dietary cholesterol to heart disease risk and the validity of dietary cholesterol restrictions based on these lines of evidence. Animal feeding studies have shown that for most species large doses of cholesterol are necessary to induce hypercholesterolemia and atherosclerosis, while for other species even small cholesterol intakes induce hypercholesterolemia. The species-to-species variability in the plasma cholesterol response to dietary cholesterol, and the distinctly different plasma lipoprotein profiles of most animal models make extrapolation of the data from animal feeding studies to human health extremely complicated and difficult to interpret. Epidemiological surveys often report positive relationships between cholesterol intakes and cardiovascular disease based on simple regression analyses; however, when multiple regression analyses account for the colinearity of dietary cholesterol and saturated fat calories, there is a null relationship between dietary cholesterol and coronary heart disease morbidity and mortality. An additional complication of epidemiological survey data is that dietary patterns high in animal products are often low in grains, fruits and vegetables which can contribute to increased risk of atherosclerosis. Clinical feeding studies show that a 100 mg/day change in dietary cholesterol will on average change the plasma total cholesterol level by 2.2-2.5 mg/dl, with a 1.9 mg/dl change in low density lipoprotein (LDL) cholesterol and a 0.4 mg/dl change in high density lipoprotein (HDL) cholesterol. Data indicate that dietary cholesterol has little effect on the plasma LDL:HDL ratio. Analysis of the available epidemiological and clinical data indicates that for the general population, dietary cholesterol makes no significant contribution to atherosclerosis and risk of cardiovascular disease.

Animals↗
PubMed1988

The association of dietary fat with serum cholesterol in vegetarians: the effect of dietary assessment on the correlation coefficient.

The biologic relation between dietary fats and serum cholesterol established in controlled dietary studies usually has not been found in cross-sectional studies of the general population. In vegetarian groups, dietary variables and serum cholesterol have been correlated significantly. To examine the role of technique of dietary assessment versus the dietary pattern of vegetarians, the authors studied the relation of diet with total serum cholesterol in 46 predominantly vegetarian adults in the Boston, Massachusetts, area in 1973-1974. The basis of the dietary information was 10-day diet records. Total serum cholesterol was positively associated with dietary cholesterol (r = 0.53) and saturated fatty acids (r = 0.50) in partial correlation analysis adjusted for age, sex, and triceps skinfold. The use of one-day dietary records lowered these correlation coefficients to about 0.3. Analysis of the components of variation of nutrient intake demonstrated that the vegetarians had a lower within-person variance, a higher between-person variance, or both compared with nonvegetarian study groups. Biologic responsiveness to dietary fat in the vegetarians was similar to that predicted by the Keys equation derived from nonvegetarians. Therefore, multiple-day averaging of dietary records and relatively smaller ratio of within-person to between-person variation in intake favor the detection of cross-sectional associations of diet with serum cholesterol.

Adult↗
PubMed2002

Methods to increase fruit and vegetable intake with and without a decrease in fat intake: compliance and effects on body weight in the nutrition and breast health study.

Dietary patterns that involve a decrease in fat and an increase in fruit and vegetable (FV) intake have been suggested to decrease cancer risks. In this study, intervention methods to selectively modify dietary fat and/or FV intakes were developed. Compliance to the diets and the effects on body weight are shown, because both of these dietary changes can impact on and be confounded by changes in energy intake. A total of 122 women with a family history of breast cancer were randomized onto one of four diets for 12 mo. Counseling methods were devised to increase amount and variety of FV consumed with or without a decrease in fat intake using modified exchange list diets. Women on the low-fat and combination low-fat/high-FV diet arms decreased their fat intakes to approximately 16% of energy. Women on the high-FV and the combination low-fat/high-FV diet arms increased FV intakes to approximately 11 servings/day. Despite counseling efforts to maintain baseline energy intakes, mean body weight increased significantly by 6 pounds in women in the high-FV diet arm and decreased significantly by 5 pounds in women in the low-fat diet arm. Percent body fat also was increased in the high-FV diet arm and decreased in the low-fat diet arm. Body weight and percent body fat in the combination diet arm did not change significantly. Control of energy intake, therefore, appears to have been achieved only when the addition of FV to the diet was balanced by a decrease in fat intake and both dietary components were enumerated daily. Maintenance of energy intake, therefore, did not appear to be attained intrinsically when individuals were counseled to make changes in the composition of their diets.

Adipose Tissue↗
PubMed1993

Natural history of the colorectal cancer.

Colorectal cancer appears as a continuous process, starting with the normal cells and progressively growing towards malignancy. The aim of this review is to focus on the stages of that transformation and the means available for reducing the risk of this particular cancer. Although genetic factors have been identified, dietary pattern, the presence of inflammatory bowel disease and adenomas seem to play the most important role in the occurrence of colorectal cancer. The prevention of colorectal cancer should include changes in dietary habits, resection of adenomatous polyps as well as early detection of cancer. Studies testing these approaches are few and so far, none has proven effective in improving survival.

Cell Transformation, Neoplastic↗
PubMedDate not supplied

Demographics, not beverage consumption, is associated with diet quality.

BACKGROUND: Demographic characteristics and beverage choices may affect diet quality. OBJECTIVE: To estimate the independent associations between consumption of food categories of the US Department of Agriculture Food Guide Pyramid, beverage consumption, gender, age, family income, and race/ethnicity with the Healthy Eating Index (HEI). METHODS: Data from the Continuing Survey of Food Intake by Individuals 1994-96, 1998 were used to develop multiple regression models of demographics and food and beverage consumption regressed on the HEI. RESULTS: After adolescence (13-19 years), males consistently had a lower diet quality than females. Young adults (20-29 years) had the poorest diet quality. Family income had a positive association with the HEI. Controlling for income, African-Americans had lower HEI scores than other race/ethnicity groups. Caucasians consumed significantly more milk products than did the other race/ethnicity groups. Consumption of beverages had a weak but positive association with the HEI. CONCLUSIONS: Family income and race/ethnicity have unique and independent associations with the HEI and dietary patterns.

Adolescent↗
PubMedDate not supplied

Study of the factors associated with dental caries in children who receive early dental care.

The present study investigated the factors associated with the development of dental caries in preschool children who receive regular dental care and follow-up. The research was carried out at the Baby Clinic, Londrina State University, and comprised two hundred preschool children, whose ages ranged from 24 to 48 months, as well as their mothers, who had already taken part in a dental program at the Baby Clinic during, at least, the previous twelve months. Regarding oral hygiene habits, there was no significant difference between the preschool children who presented with caries and those who did not present with caries. However, the presence of visible bacterial plaque on the upper incisors was strongly associated with the presence of dental caries. Other factors associated with the presence of caries were: period of formal education of the father or of both parents equal or inferior to 8 years, high sugar consumption and bottle-feeding during sleep. In the studied population, the dietary pattern is still the main cause of carious lesions. In addition, the presence of visible bacterial plaque on the labial surface of the upper incisors must be considered as an important clinical sign, often associated with inadequate patterns of diet and oral hygiene.

Adult↗
PubMed2003

Human plasma levels of POPs, and diet among native people from Uelen, Chukotka.

Some of the people living in the Chukotka Peninsula of Russia depend heavily on marine mammals, but little is known of the exact dietary patterns and plasma levels of POPs among these populations. In this study, POPs levels in plasma from 50 participants from the isolated community of Uelen (Bering Strait) were determined and related to dietary information obtained through a food frequency questionnaire. The intake of marine mammals was high and the combined intake of blubber from walrus, seal and whale was a significant predictor (p < 0.01) of plasma concentrations of sum PCBs and borderline for sum CDs (p = 0.02) and sum DDTs (p = 0.04). There was a significant gender difference in the levels of POPs, and among women there was a significant increase with age. Extensive breastfeeding and lower blubber intake among women could be possible explanations for this gender difference. Despite the high intake of blubber the plasma levels of PCBs and DDTs were lower than some of those reported for the East Coast of Greenland. The geometric mean values for sum PCBs (17 congeners) and sum DDTs were 1316 ng g(-1) lipids and 563 ng g(-1) lipids, respectively. PCB 163, which partly co-eluted with PCB 138, was found in high concentrations (40% of PCB 138). This raises questions regarding the validity of using PCB 138 and PCB 153 to calculate the level of Arochlor 1260. The geometric mean of sum CDs was 518 ng g(-1) lipids. Concentrations of beta-HCH (geometric mean; 410 ng g(-1) lipids) were higher than observed for other native populations depending on marine mammals. Transportation of beta-HCH by ocean currents through the Bering Strait into the Arctic Ocean or regional point sources might explain these elevated levels.

Adult↗
PubMed2003

Environmental concerns and diet in Singapore.

Many factors affect how people perceive the world and their environment, and how such perceptions affect lifestyle decisions, yet the relationship between personal perceptions about environmental hazards and diet is rarely examined. In this study, environmental concerns on a local and global scale were examined, along with dietary patterns, to determine if there were associations and age-related differences. The hypothesis that concerns about water pollution might be reflected in choices about seafood consumption was examined. Many aspects of dietary choices varied significantly by age, including (1) younger people ate more "fast food" than others, (2) subjects aged 22-32 yr ate more meals in restaurants than older or younger people, (3) older individuals drank more tea than younger subjects, while younger people drank more soda than older people, and (4) there were few significant differences in total fish and shellfish meals, although young people ate more meals of other types of meat. Individuals who rated their health the best reported significantly fewer seafood meals than others. People who listed pollution as the major environmental problem did not consume seafood less often than others. While pollution was listed as the most important environmental problem globally, people distinguished between air and water pollution only for Singapore. Although Singapore, with its rapidly expanding economy, has reason to be concerned about both water and air pollution, only 14% of those listing pollution as the main Singapore environmental problem mentioned "water pollution." Singapore has been able to take measures to reduce water pollution from internal sources. Respondents considered air pollution a greater problem, perhaps reflecting recent haze disasters from deliberately set forest fires in Indonesia, which are beyond the direct control of Singapore or Singaporeans.

Adolescent↗
PubMed1997

Associations of race/ethnicity, education, and dietary intervention with the validity and reliability of a food frequency questionnaire: the Women's Health Trial Feasibility Study in Minority Populations.

This report describes the associations of race/ethnicity and years of education with the validity, reliability, and bias of a self-administered food frequency questionnaire (FFQ) designed to be sensitive to low-fat, regional, and ethnic dietary patterns. Data were from the Women's Health Trial Feasibility Study in Minority Populations, a randomized clinical trial conducted between 1992 and 1994 to test the feasibility of a low-fat dietary intervention that targeted low-income, black, and Hispanic women. Of 1,015 participants eligible for these analyses, 28.1% were black, 16.2% were Hispanic, and 12.3% had not completed high school. The analyses focused on percentage of energy obtained from fat, and used 4-day food records as the criterion instrument. Validity at baseline, defined as the correlation between FFQs and food records, was lower among blacks than among whites (0.26 vs. 0.49; p < 0.001), did not differ between Hispanics and whites, and was lower among women with fewer years of education (0.19, 0.35, 0.49, and 0.42 for <12, 12, 13-15, and > or =16 years of education, respectively; for trend, p < 0.05). Six months after randomization, validity increased in most race/ethnicity and education subgroups, and differences across groups became small and statistically nonsignificant. Validity increased significantly among participants receiving the dietary intervention, while increases among control women were somewhat smaller. Reliability, defined as the correlation between baseline and 6-month measures among controls, was similar across racial/ethnic and educational groups. Bias at baseline, defined as the mean value from the FFQ minus the mean from the food record, was 4.6 percentage points of energy from fat; it was lowest among blacks (p < 0.01) and did not differ by years of education. These results suggest that special protocols which address participant training may be necessary when using self-administered FFQs in minority or poorly educated populations.

Aged↗
PubMed1999

Study of diet, biomarkers and cancer risk in the United States, China and Costa Rica.

One striking paradox in epidemiologic research is the strong association between diet and cancer in ecologic studies compared with the weaker associations reported in many within-country case-control and cohort studies. However, most ecologic studies have relied on indirect measures of dietary intake, such as food disappearance data. The objectives of our study were to assess the feasibility of collecting dietary and biomarker data from individuals living in countries having markedly different dietary patterns and cultures and to examine the magnitude of the between-country variation in their measurement. Adults surveyed in Shanghai (China), Costa Rica and King County (Washington, USA) completed a 24-hr dietary recall, a cancer risk factor survey, and provided a blood sample. We analyzed a subset of the blood specimens for vitamins C, E, carotenoids and phospholipid fatty acids. We observed substantial differences in nutrient intakes and in mean plasma concentrations of dietary biomarkers across the study populations. For example, King County participants had the highest daily intake of vitamin C (mean 78.3 +/- 12.2 mg compared with 42.6 +/- 38.3 mg in Shanghai and 34.8 +/- 43.8 mg in Costa Rica). The mean plasma vitamin C level in King County was also the highest of the 3 study sites: 927.9 +/- 43.9 microg/dl in King County, 585.7 +/- 35.9 microg/dl in Shanghai and 461.1 +/- 33.1 microg/dl in Costa Rica. Plasma trans fatty acids (a biomarker of a diet high in hydrogenated fats) were highest in King County and lowest in Shanghai.

Adult↗