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PubMed2006

Dental complications following gastric restrictive bariatric surgery.

BACKGROUND: Morbid obesity is a scourge of the 21st century. The effective therapeutic measure is bariatric surgery. The medical literature has inadequately reported the potential deleterious effects of such surgery on dental health. Acidic levels in the oral cavity, which are known to be one of the postoperative side-effects of bariatric surgery, directly result in dental caries and tooth erosion. We investigated the self-assessment of postoperative bariatric patients with regard to their dental health and associated variables. METHODS: 113 patients (25% compliance), who had been operated on in three Jerusalem hospitals, responded to a mailed questionnaire. RESULTS: Patients' average age was 40+/-10 years; bariatric surgery had been performed 5+/-4 years previously. Of the patients, 37% reported eating more sweet foods after surgery, only 20% reported improved oral hygiene, only 34% reported increased frequency of visits to the dentist, and 37% reported greater dental hypersensitivity after surgery. Significant associations were found between reported dental hypersensitivity and vomiting (P=0.013), and also dental hypersensitivity and indigestion (P=0.021). Patients from the three hospitals reported different patterns of visits to the dentist. The most common variable (80% of the subjects) associated with visits to the dentist after surgery was dental hypersensitivity. CONCLUSION: Medical teams need to consider potential dental problems after bariatric surgery, and to supply their patients with the appropriate information and instructions regarding oral hygiene maintenance, healthy dietary patterns and regular dental health monitoring by a dentist or dental hygienist.

Adult↗
PubMed1989

Nutrition and esophageal cancer.

Several case control studies in esophageal cancer employing a food-frequency dietary questionnaire suggested a fairly uniform dietary pattern which could be implicated in the causation of the disease. Although various micronutrients (vitamins and trace elements) have also been found to have either a positive or negative association, findings were more clear-cut for the different food items contributing the micronutrients than for the specific micronutrients themselves. The difficulties encountered in dietary interviews in case control studies are discussed. Nutritional supplementation has a theoretical rationale, but clinical experience with randomized trials did not support the same.

Diet↗
PubMed2000

Natural bioactive substances in milk and colostrum: effects on the arterial blood pressure system.

High blood pressure is a significant public health problem worldwide which is associated with increased risk of cardiovascular disease, stroke, and renal disease. The development of this disease is influenced by genetic and environmental factors. The results of many studies have linked increased consumption of milk and milk products with lower blood pressure and reduced risk of hypertension. The intake of several minerals found in milk has been demonstrated to have an inverse relationship with blood pressure. Peptides formed during the digestion of milk proteins have also been demonstrated to have a blood pressure lowering effect. Other components in milk that have been examined for their effects on blood pressure have been less promising. More recent data indicate that a dietary pattern that is low in fat, with fruits, vegetables, and low fat dairy products can significantly reduce blood pressure and lower risk of developing high blood pressure.

Animals↗
PubMed2004

Intakes of plant foods, fibre and fat and risk of breast cancer--a prospective study in the Malmö Diet and Cancer cohort.

The objective of this study was to investigate prospectively the associations between intakes of plant foods, fibre and relative fat and risk of breast cancer in a subsample of 11 726 postmenopausal women in the Malmö Diet and Cancer cohort. Data were obtained by an interview-based diet history method, a structured questionnaire, anthropometrical measurements and national and regional cancer registries. During 89 602 person-years of follow-up, 342 incident cases were documented. Cox regression analysis examined breast cancer risks adjusted for potential confounders. High fibre intakes were associated with a lower risk of postmenopausal breast cancer, incidence rate ratio=0.58, 95% CI: 0.40, 0.84, for the highest quintile of fibre intake compared to the lowest quintile. The combination high fibre-low fat had the lowest risk when examining the effect in each cell of cross-classified tertiles of fibre and fat intakes. An interaction (P=0.049) was found between fibre- and fat-tertiles. There was no significant association between breast cancer risk and intakes of any of the plant food subgroups. These findings support the hypothesis that a dietary pattern characterised by high fibre and low fat intakes is associated with a lower risk of postmenopausal breast cancer.

Aged↗
PubMed1990

Relationship between urinary amino acids and diets in Spanish Cardiovascular Diseases and Alimentary Comparison Study.

A randomized, cross-sectional study was carried out to examine dietary pattern and urinary amino acids excretion in two Spanish free-living populations. A total of 288 adults (50-54 years old; 50% men and 50% women), randomly selected from the census, took part in the study; of these, 146 were living in an urban district of Madrid and 142 in a rural area. Dietary intakes by 7-day recall questionnaires, smoking habits, and alcohol intake were examined in each participant, and 24-h urine was collected in aliquot cups designed for the Cardiovascular Diseases and Alimentary Comparison (CARDIAC) Study. All amino acid excretions averaged higher in men than in women in both areas, and higher in the urban than in the rural population. Main dietary differences between urban and rural populations were higher consumption of fish in urban than in rural populations and higher consumption of bread in rural than in urban populations. Urinary taurine excretion as well as 3-methylhistidine or histidine were significantly associated with fish and meat consumptions, respectively, estimated by 7-day dietary recall questionnaires.

Amino Acids↗
PubMed1982

Fecal sterols and bacterial beta-glucuronidase activity: a preliminary metabolic epidemiology study of healthy volunteers from Umea, Sweden, and metropolitan New York.

The dietary pattern, fecal bile acid and neutral sterol concentrations, and the bacterial beta-glucuronidase activity of 2 population groups with a varied risk for colon cancer development (i.e., a high-risk population in the metropolitan New York area and an intermediate-risk population in Umea, Sweden) were investigated. The average daily intake of dietary protein was the same in the 2 groups, but the fat intake was higher in Umea than in New York. The daily total fiber intake was also higher in Umea, as was the daily total stool output. The concentration of fecal secondary bile acids and beta-glucuronidase activity was lower in Umea than in New York, but the total daily excretion of these constituents was the same in both groups. The data suggest that one of the factors contributing to the lower risk of colon cancer in Umea, despite the high dietary fat intake, is the high intake of dietary whole grain and cereal fiber, which leads to an increase in stool bulk, thus diluting and/or binding promoters.

Bacteria↗
PubMed2006

Nutrigenomics: integrating genomic approaches into nutrition research.

It has been suggested that the supermarket of today will be the pharmacy of tomorrow. Such statements have been derived from recognition of our increasing ability to optimize nutrition, and maintain a state of good health through longer periods of life. The new field of nutrigenomics, which focuses on the interaction between bioactive dietary components and the genome, recognizes that current nutritional guidelines may be ideal for only a relatively small proportion of the population. There is good evidence that nutrition has significant influences on the expression of genes, and, likewise, genetic variation can have a significant effect on food intake, metabolic response to food, individual nutrient requirements, food safety, and the efficacy of disease-protective dietary factors. For example, a significant number of human studies in various areas are increasing the evidence for interactions between single nucleotide polymorphisms (SNPs) in various genes and the metabolic response to diet, including the risk of obesity. Many of the same genetic polymorphisms and dietary patterns that influence obesity or cardiovascular disease also affect cancer, since overweight individuals are at increased risk of cancer development. The control of food intake is profoundly affected by polymorphisms either in genes encoding taste receptors or in genes encoding a number of peripheral signaling peptides such as insulin, leptin, ghrelin, cholecystokinin, and corresponding receptors. Total dietary intake, and the satiety value of various foods, will profoundly influence the effects of these genes. Identifying key SNPs that are likely to influence the health of an individual provides an approach to understanding and, ultimately, to optimizing nutrition at the population or individual level. Traditional methods for identification of SNPs may involve consideration of individual variants, using methodologies such as restriction fragment length polymorphisms or quantitative real-time PCR assays. New developments allow identification of up to 500,000 SNPs in an individual, and with increasingly lowered pricings these developments may explode the population-level potential for dietary optimization based on nutrigenomic approaches.

Chronic Disease↗
PubMed1975

Effects of high risk and low risk diets for colon carcinogenesis on fecal microflora and steroids in man.

We investigated the effects of a high meat mixed Western diet and a nonmeat diet, representing the dietary pattern of high and low risk areas for colon cancer, respectively, on fecal microflora dn on bile acid and neutral sterol patterns in man. The total anaerobic microflora as well as the count of Bacteroides, Bifidobacterium, Peptococcus, and anaerobic Lactobacillus were significantly higher during the period of consumption of a high meat mixed Western diet comparted with the nonmeat-diet consumption period. The difference in total fecal bile acid excretion was not significant between the two dietary periods. Fecal excretion of microbially modified bile acids and neutral sterols was decreased when subjects eating a high meat diet transferred to a nonmeat diet. These results support the fact that diet plays a modifying role on the composition of intestinal microflora, bile acids, and neutral sterols.

Adult↗
PubMed1994

Diet quality index: capturing a multidimensional behavior.

OBJECTIVE: Data for 5,484 adults (aged 21 years and older) who participated in the 1987-88 Nationwide Food Consumption Survey (NFCS) were used to develop an index of overall dietary intake that related to the major, diet-related, chronic diseases in the United States. The low response rate of the 1987-88 NFCS has raised concerns about potential bias, but this large data set is useful for methodologic studies and research that does not attempt to generalize the results to the US population. ANALYSES: Dietary recommendations from the 1989 National Academy of Sciences publication Diet and Health were stratified into three levels of intake for scoring. Individuals who met a dietary goal were given a score of zero. Those who did not meet a goal, but had a fair diet, were given one point, and those who had a poor diet were given two points. These points were summed across eight diet variables to score the index from zero (excellent diet) to 16 (poor diet). RESULTS: Lower index scores were positively associated with high intakes of other important measures of diet quality (eg, fiber, vitamin C). We found that single nutrients (such as dietary fat) were not necessarily associated with other measures of diet quality. CONCLUSION: We concluded that this index ranking of overall dietary patterns was reflective of total diet quality, though substantial misclassification can result from using single nutrients or foods as indicators of diet quality.

Adult↗
PubMed2004

Nutritional fats and the risk of type 2 diabetes and cancer.

Dietary factors are important predictors for the risk of diabetes type 2. Increased consumption of fibre-rich foods, fruits and vegetables as well as limited amounts of total and saturated fats are essential elements in the prevention of diabetes type 2. The association between these dietary factors and the appearance of diabetes was not only present in cohort studies but were also major elements in the dietary part of the two large diabetes prevention trials (Finnish Diabetes Prevention Study, Diabetes Prevention Program). There is also strong evidence for a relation between obesity and total fat intake and the incidence of certain types of cancers. There is a significant correlation between total fat intake and the risk of cancer; however, it is much weaker than that of the effect of red meat. Recommendations to decrease red meat intake, particularly processed meat, may decrease the risk of colorectal and prostate cancer and may have beneficial effects on breast cancer as well, although this evidence is less compelling. Overall, recommendations focused on controlling or reducing body weight by regular physical activity and avoidance of excessive energy intake from all sources, particularly from fat and saturated fats, by increasing consumption of fibre-rich carbohydrates, vegetables and fruits are effective in decreasing the risk for type 2 diabetes by more than 50% in high-risk individuals. Similar dietary patterns are likely to diminish the manifestation of certain forms of cancers. These conclusions are in agreement with current recommendations for cancer prevention as propagated by the American Cancer Society.

Diabetes Mellitus, Type 2↗
PubMed1997

Dietary practices and lipid intake in relation to plasma lipid profile in Hong Kong Chinese.

OBJECTIVE: To study dietary lipid intake and plasma lipid profile of the Hong Kong Chinese population as part of a territory wide survey on cardiovascular risk factors. DESIGN: Randomised age and sex stratified survey. SUBJECTS: 1010 subjects aged 25-74 y (500 men, 510 women). MEASUREMENTS: A food frequency method with food tables compiled for Hong Kong was used for nutrient quantitation, while a separate questionnaire was used to examine dietary practices. Plasma lipid profile was estimated using standard laboratory methods. RESULTS: Total calorie, fat, saturated fatty acid (SFA), poly- and mono-unsaturated fatty acid (PUFA and MUFA), and cholesterol intake were higher in men; however when adjusted for caloric intake no difference was observed. Men had lower intake of PUFA as percentage of total energy had a higher Hegsted Score compared with women. Subjects consuming beans twice or more per week had lower total cholesterol and LDL-cholesterol concentrations. Overall, the population dietary intake was close to the ideal for cardiovascular health: percentage fat not greater than 30% of the total calorie intake, saturated fat intake not greater than 10% of calories, and cholesterol less than 180 mg/1000 Kcal. CONCLUSION: The dietary pattern for Hong Kong Chinese appear to be satisfactory with respect to cardiovascular health.

Adult↗
PubMed1985

Dietary changes and their possible effect on blood pressure.

In this summary, the authors have attempted to examine reports of associations between various dietary habits and practices on one hand, and serum lipids or clinical disease on the other hand. There seems to be little doubt that both hypertension and ischemic heart disease have a nutritional background, but in all likelihood, there are other factors such as hereditary traits, occupational hazards, and perhaps personal habits including cigarette smoking, alcohol abuse and prolonged ingestion of medicinal drugs. One of the strongest correlates seems to be the role of complex carbohydrates in regulating blood lipid concentrations. Carbohydrates not only have an effect on the endocrine system that regulates blood volume, but they also influence absorption of fat soluble substances from the digestive tract and if natural fiber is included, it has an effect on fecal bulk, transit time of the fecal stream, and reabsorption of bile acids and neutral sterols. Epidemiologically, there is some evidence that the changes that occurred in the American diet in the years between 1914-1944 may well have played a permissive role in the genesis of a portion of the coronary heart disease, high blood pressure and stroke that occurred in the United States. It is not too farfetched to suggest that had the American servicemen been given more cereal food products including bread and other baked food items, instead of excessive amounts of meat and fats, the dietary pattern of America might well have been substantially different. Furthermore, this difference could easily have influenced the pattern of atherosclerosis and hypertension. A great deal more work is needed to confirm or refute these suggestions.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1994

Vegetarian and other complex diets, fats, fiber, and hypertension.

Although much of the attention on diet and hypertension has centered around the rule of specific nutrients such as sodium, potassium, and alcohol, it has become evident that certain complex dietary patterns have a blood pressure-lowering effect and may help protect against the development of hypertension. It remains to be seen whether these effects on blood pressure require complex but specific combinations of nutrients or, alternatively, are due to hitherto unrecognized single nutrients with antihypertensive properties. The issues are difficult to resolve because people eat foods, not single nutrients, and there is a high degree of association between different nutrients in foods and patterns of food intake, as well as potentially confounding effects of other factors associated with eating habits such as age, body fat distribution, physical activity, alcohol consumption, tobacco use, and psychosocial stress.

Diet↗
PubMed2001

Choose a diet that is low in saturated fat and cholesterol and moderate in total fat: subtle changes to a familiar message.

"Choose a diet that is low in saturated fat and cholesterol and moderate in total fat," issued in Nutrition and Your Health: Dietary Guidelines for Americans in the year 2000, has an interesting and lengthy history. The first guideline, for which there was extensive scientific data to show that dietary excess increased chronic disease risk, prompted much scientific discussion and debate when implemented as dietary guidance. Three major changes in the guideline are noted since it was issued in 1980, i.e., numerical goals for dietary fats; the applicability of recommended fat intakes for all individuals > or =2 y old; and rewording to emphasize reducing saturated fat and cholesterol intakes. The shift in emphasis includes the terminology moderate fat, which replaces the phrasing low fat. National data about the food supply, the population's dietary intake, knowledge, attitudes and behaviors, and nutritional status indicators (e.g., serum cholesterol levels) related to dietary fats help to monitor nutrition and health in the population. Experts consider that national data, although not without limitations, are sufficient to conclude that U.S. intakes of fats, as a proportion of energy, have decreased. The lower intakes of saturated fat and cholesterol are consistent with decreases in blood cholesterol levels and lower rates of coronary mortality over the past 30 years. Strategies are needed and some are suggested, to further encourage the population to achieve a dietary pattern that is low in saturated fat and cholesterol and moderate in total fat. Other suggestions are offered to improve national nutrition monitoring and surveillance related to the guideline.

Age Factors↗
PubMed2006

[Cardiovascular risk factors in adolescents: biological and behavioral indicators].

OBJECTIVE: To provide descriptive information and investigate to what extent behavioral risk factors for cardiovascular diseases are associated with biological risk factors in the young population. METHODS: The sample included 452 adolescents (246 girls and 206 boys) between 15 and 18 years of age selected in a high school in the city of Londrina, Paraná. Risk factors of a behavioral nature were analyzed as regards insufficient physical activity, excessive intake of fat and cholesterol and smoking. As biological risk factor indicators we used overweight, high arterial pressure levels, and adverse concentration of serum lipids and lipoproteins. RESULTS: Approximately 20% of the girls and 16% of the boys presented at least one biological risk factor for development of cardiovascular diseases. Overweight was significantly associated with excessive intake of fats, while elevated arterial pressure was related to sedentary lifestyle and smoking. Excessive intake of fat and cholesterol indicated increased risk of undesirable concentrations of serum lipids and lipoproteins. The risk associated with altered blood pressure and serum lipids and lipoprotein was increased two-fold in smokers when compared with nonsmokers. CONCLUSION: The results reinforce the need for interventions targeted at the adoption of a healthy lifestyle, including the regular practice of physical exercise, appropriate dietary patterns, and abstention from smoking as of an early age.

Adolescent↗
PubMed1998

Dietary sugar and lung cancer: a case-control study in Uruguay.

To examine whether dietary sugar modifies lung cancer risk, a case-control study involving 463 cases with lung cancer and 465 hospitalized controls was conducted in Uruguay in the period 1993-1996. Dietary patterns were assessed in detail using a 64-item food-frequency questionnaire, which allowed the calculation of total energy intake. After adjustment for potential confounders through a model that included tobacco smoking and total energy, total fat, vitamin C, and alpha-carotene intakes, an increased risk for sugar-rich foods, total sucrose intake, sucrose to dietary fiber ratio, and glycemic index for lung cancer was observed (odds ratio for highest category of total sucrose intake = 1.55, 95% confidence interval = 0.99-2.44). When lung cancer was analyzed separately by cell type, odds ratios for small cell and large cell undifferentiated carcinoma were higher than those observed for squamous cell and adenocarcinoma of the lung. The joint effect of pack-years, total fat intake, and sucrose intake was associated with an increased risk of 28.3 (95% confidence interval = 13.4-59.7) for high values of the three variables. The study suggests that high sucrose intake could be an important risk factor in lung carcinogenesis. Further studies, both epidemiological and experimental, are needed to replicate the present findings and to clarify the mechanism(s) of sucrose intake in lung carcinogenesis.

Adult↗
PubMed2003

Physical sports activity during leisure time and dietary intake of foods and nutrients in a large Spanish cohort.

This study evaluated the dietary pattern of foods and nutrients according to levels of vigorous leisure time physical activity (PA) assessed at recruitment within the Spanish cohort of the European Prospective Investigation on Cancer (EPIC) study (37,287 healthy volunteers with complete information). We used a validated PA questionnaire (PAQ) to measure the weekly frequency and duration of different kinds of sport activities. For dietary assessment, we used a validated diet history questionnaire that included all items consumed with a frequency of at least twice a month. We tested differences in food and nutrient intake according to PA duration by means of both an analysis of variance and an analysis of covariance adjusted for confounding factors. Linear increases or decreases in food and nutrient intake across PA levels were tested by means of a regression analysis. Only 11% of men and 6% of women performed at least 3 hours/week of intense PA, which is similar to current recommendations. Overall, main nutrient and total energy intakes were similar across different PA levels (<2% change in total energy intake between extreme PA categories). However, the intake of some foods and vitamins did significantly (p .05) increase as PA increased. The average gender-weighted percentage change in the intake of food and vitamins increased when moving from the lowest levels of PA to the highest. There was an increase in the intake of the following: 15.9% in vegetables, 6.7% in fruit, 9% in fish, 5.6% in dairy products, 10% in vitamin C, 5.9% in vitamin E, 7.2% in retinol, 19.7% in total carotene, 40.1% in alpha-carotene, 20.4% in beta-carotene, 11.2% in licopene, and 26.1% in lutein. BMI, which was above average for the cohort (mean +/- SD: 28.4 +/- 4.2), decreased steadily when PA increased. To sum up, in this large Spanish cohort, the differences in dietary intake relative to levels of PA were not found either in the amount of total energy consumed nor in the number of main macronutrients but rather in the intake of certain foods which, while having very little or moderate caloric content, are very rich in highly bioactive elements such as vitamins and provitamins.

Adult↗
PubMed1986

Low-fat intake with falling fiber intake commensurate with rarity of noninfective bowel diseases in blacks in Soweto, Johannesburg, South Africa.

Among urban blacks in Johannesburg, South Africa, a measure of westernization of diet has occurred. Yet, the frequencies of most noninfective bowel diseases not only are low but also appear to have scarcely increased. To assess more adequately the current dietary pattern, a survey was undertaken. Results indicated a habitually low-fat intake, which supplied a mean of 24% of energy but also greatly decreased fiber intake (now about 14 g daily). Possibly, a meaningful rise in the incidence of bowel diseases requires, among other things, simultaneous rise in fat intake; alternatively, there are factors yet unknown in the dietary context of urban blacks (perhaps operating in their bowels) that are inhibiting rises in the diseases mentioned.

Adult↗