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Perspective: Impact of the National Academy of Sciences, Engineering, and Medicine Report on the Process for the 2020 Dietary Guidelines Advisory Committee
Barbara O Schneeman, Jamy D Ard, Carol J Boushey, Regan L Bailey, Rachel Novotny, Linda G Snetselaar, Janet M de Jesus, Eve E Stoody
doi : 10.1093/advances/nmab023
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1051–1057
The National Academy of Sciences, Engineering, and Medicine (NASEM) recommended steps to redesign the process of developing the Dietary Guidelines for Americans (DGA) are based on 5 guiding principles (enhance transparency; promote diversity of expertise and experience; support a deliberative process; manage biases and conflicts of interest; and adopt state-of-the-art processes and methods). Using these principles and recommendations, the USDA and HHS updated the process for developing the 2020–2025 Dietary Guidelines, including the process for appointing members and managing the work of the 2020 Dietary Guidelines Advisory Committee. Modifications included having public comment on the topics and questions to be addressed by the Federal Advisory Committee, reviewing professional and financial activities on potential appointees to the committee prior to their appointment, redesigning the website to provide status updates on the work of the committee as analytical frameworks and draft conclusions were developed, strengthening the approaches for conducting systematic reviews, and adding a public meeting for discussion of the final report before its submission to the Secretaries of the USDA and HHS. Because the DGA is reviewed and updated every 5 y, it is possible to learn from each cycle what works well and where improvements in the process can be implemented. The current article illustrates, from the perspective of the advisory committee, the impact of the NASEM report on the development of the scientific report by examining changes in the process consistent with the 5 principles.
Perspective: The Importance of Water Security for Ensuring Food Security, Good Nutrition, and Well-being
Sera L Young, Edward A Frongillo, Zeina Jamaluddine, Hugo Melgar-Qui?onez, Rafael Pérez-Escamilla, Claudia Ringler, Asher Y Rosinger
doi : 10.1093/advances/nmab003
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1051–1057
The National Academy of Sciences, Engineering, and Medicine (NASEM) recommended steps to redesign the process of developing the Dietary Guidelines for Americans (DGA) are based on 5 guiding principles (enhance transparency; promote diversity of expertise and experience; support a deliberative process; manage biases and conflicts of interest; and adopt state-of-the-art processes and methods). Using these principles and recommendations, the USDA and HHS updated the process for developing the 2020–2025 Dietary Guidelines, including the process for appointing members and managing the work of the 2020 Dietary Guidelines Advisory Committee. Modifications included having public comment on the topics and questions to be addressed by the Federal Advisory Committee, reviewing professional and financial activities on potential appointees to the committee prior to their appointment, redesigning the website to provide status updates on the work of the committee as analytical frameworks and draft conclusions were developed, strengthening the approaches for conducting systematic reviews, and adding a public meeting for discussion of the final report before its submission to the Secretaries of the USDA and HHS. Because the DGA is reviewed and updated every 5 y, it is possible to learn from each cycle what works well and where improvements in the process can be implemented. The current article illustrates, from the perspective of the advisory committee, the impact of the NASEM report on the development of the scientific report by examining changes in the process consistent with the 5 principles.
Perspective: Nutritional Strategies Targeting the Gut Microbiome to Mitigate COVID-19 Outcomes
Laurence Daoust, Geneviève Pilon, André Marette
doi : 10.1093/advances/nmab031
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1074–1086
More than a year has passed since the first reported case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection in the city of Wuhan in China's Hubei Province. Until now, few antiviral medications (e.g., remdesivir) or drugs that target inflammatory complications associated with SARS-CoV2 infection have been considered safe by public health authorities. By the end of November 2020, this crisis had led to >1 million deaths and revealed the high susceptibility of people with pre-existing comorbidities (e.g., obesity, diabetes, coronary heart disease, hypertension) to suffer from a severe form of the disease. Elderly people have also been found to be highly susceptible to SARS-CoV2 infection and morbidity. Gastrointestinal manifestations and gut microbial alterations observed in SARS-CoV2–infected hospitalized patients have raised awareness of the potential role of intestinal mechanisms in increasing the severity of the disease. It is therefore critically important to find alternative or complementary approaches, not only to prevent or treat the disease, but also to reduce its growing societal and economic burden. In this review, we explore potential nutritional strategies that implicate the use of polyphenols, probiotics, vitamin D, and ?-3 fatty acids with a focus on the gut microbiome, and that could lead to concrete recommendations that are easily applicable to both vulnerable people with pre-existing metabolic comorbidities and the elderly, but also to the general population.
Perspective: Framework for Developing Recommended Intakes of Bioactive Dietary Substances
Allison A Yates, Johanna T Dwyer, John W Erdman, Jr, Janet C King, Barbara J Lyle, Barbara O Schneeman, Connie M Weaver, serving as an ad hoc Working Group on a Framework for Developing Recommended Intakes for Dietary Bioactives
doi : 10.1093/advances/nmab044
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1087–1099
Dietary bioactives are food substances that promote health but are not essential to prevent typical deficiency conditions. Examples include lutein and zeaxanthin, omega-3 fatty acids, and flavonoids. When quality evidence is available, quantified intake recommendations linking dietary bioactives with specific health benefits will enable health professionals to provide evidence-based information to consumers. Without evidence-based recommendations, consumers use information from available sources that often lack standards and rigor. This article describes a framework to develop guidance based on quality evidence fully vetted for efficacy and safety by qualified experts, and designed to communicate the amounts of specific dietary bioactive compounds with identified health benefits. The 4-step Framework described here can be adapted by credible health organizations to work within their guideline development process. Standards of practice used in clinical guidelines are adapted to quantify dietary bioactive intake recommendations from foods consumed by the general public, by taking into account that side effects and trade-offs are often needed for medical treatments but are not acceptable for dietary bioactives. In quantifying dietary bioactive recommendations, this Framework establishes 4 decision-making steps: 1) characterize the bioactive, determine amounts in specific food sources, and quantify intakes; 2) evaluate safety; 3) quantify the causal relation between the specific bioactive and accepted markers of health or normal function via systematic evidence reviews; and 4) translate the evidence into a quantified bioactive intake statement. This Framework provides a working model that can be updated as new approaches are advanced.
Perspective: A Legal and Nutritional Perspective on the Introduction of Quinoa-Based Infant and Follow-on Formula in the EU
Naomi Vita Venlet, Kasper Arthur Hettinga, Hanna Schebesta, Nadia Bernaz
doi : 10.1093/advances/nmab041
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1100–1107
Infants are vulnerable consumers and highly depend on dietary proteins for growth and development during their first months of life. Infant formula (IF) and follow-on formula (FOF) have been developed to meet these requirements, although few protein sources are currently allowed to be used. At the same time, allergies to these available protein sources are becoming more frequent. There is thus a need to explore alternative protein sources for infant nutrition. One alternative could be quinoa, which is a pseudocereal that is naturally free from gluten and has a high protein content and quality. This review assessed the composition, nutritional properties, and applicability of quinoa proteins for IF and FOF as well as the legal framework for their use in the European Union (EU). The protein quality of isolated quinoa proteins (IQPs) is relatively high compared with other plant-based proteins like rice. Besides, during the protein isolation process, unfavorable compounds are mostly removed, ensuring that the final product can comply with the maximum residue concentrations allowed. Overall, IF and FOF are strictly regulated under the Foods for Specific Groups (FSG) Regulation (EU) No 609/2013 and more research is needed before the introduction of IQP in such products is considered, but this review shows it has several promising features that warrant further investigation.
Perspective: Defining Carbohydrate Quality for Human Health and Environmental Sustainability
Rebekah Schulz, Joanne Slavin
doi : 10.1093/advances/nmab050
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1108–1121
Plant foods are universally promoted for their links to improved human health, yet carbohydrate-containing foods are often maligned based on isolated, reductionist methods that fail to assess carbohydrate foods as a matrix of nutrients and food components. Currently accepted positive carbohydrate quality indices include plant food, whole-grain content, and dietary fiber, while negative health outcomes are linked to high intakes of added sugar and high glycemic index. More recently, negative health aspects have been linked to ultra-processed foods, which are often high in carbohydrates. Yet, carbohydrate staples such as grains and dairy products are both enriched and fortified, resulting in these carbohydrate foods containing important nutrients of concern such as dietary fiber, potassium, vitamin D, and calcium. This Perspective analyzes carbohydrate metrics used in dietary guidance and labeling and finds limitations in accepted indices included in standardized quality carbohydrate definitions and also proposes additional indices to benefit both human and environmental health. As nutrition recommendations shift away from a single-nutrient focus to a more holistic dietary pattern approach that is flexible and adaptable for each individual, it is necessary to determine the quality components that make up these patterns. This review concludes that current approaches that demonize staple carbohydrate foods do little to promote the recommended patterns of foods known to improve health status and reduce disease risk.
Understanding Pathways Between Agriculture, Food Systems, and Nutrition: An Evidence and Gap Map of Research Tools, Metrics, and Methods in the Last 10 Years
Thalia M Sparling, Howard White, Samuel Boakye, Denny John, Suneetha Kadiyala
doi : 10.1093/advances/nmaa158
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1122–1136
New tools, metrics, and methods in agriculture, food systems, and nutrition (A&N) research proliferated in the decade following the 2007–2008 food price crisis. We map these developments across themes derived from conceptual A&N pathways and expert consultations. We created an interactive Evidence and Gap Map (EGM) from a systematic search of published and gray literature since 2008, following Campbell Collaboration guidelines. We retrieved over 30,000 reports from published literature databases, and individually searched 20 online repositories. We systematically screened 24,359 reports by title and/or abstract, 1577 by full report, and included 904 eligible reports. The EGM consists of rows of thematic domains and columns of types of tools, metrics, and methods, as well as extensive coding applied as filters. Each cell of the map represents research surrounding a type of tool, metric, or method within a given theme. Reports in each cell are grouped by stage of development, which expand to a corresponding bibliography. Users can filter EGM reports by various characteristics. The 4 most populated domains were: diets, nutrition, and health; primary food production; water, sanitation, and hygiene; and environment and sustainability. The 4 most common types of metrics, methods, and tools were: diet metrics; footprint analysis (especially water); technology applications; and network or Bayesian analysis. Gaps represent areas of few or no reports of innovation between 2008 and 2018. There were gaps in reports and innovations related to: power or conflicts of interest; food environments; markets; private sector engagement; food loss and waste; conflict; study design and system-level tools, metrics, and methods. The EGM is a comprehensive tool to navigate advances in measurement in A&N research: to highlight trends and gaps, conduct further synthesis and development, and prioritize the agenda for future work. This narrative synthesis accompanies the EGM, which can be found at https://www.anh-academy.org/evidence-and-gap-map.
Racial-Ethnic Disparities in Obesity and Biological, Behavioral, and Sociocultural Influences in the United States: A Systematic Review
Jungwon Min, Hailee Goodale, Hong Xue, Rebecca Brey, Youfa Wang
doi : 10.1093/advances/nmaa162
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1137–1148
For a comprehensive understanding of high-level obesity in the USA, we studied the trends of obesity prevalence since 2007, and related biological, behavioral, and sociocultural factors in obesity racial/ethnic disparities. We searched PubMed, Embase, and national data archives for the studies using national survey data and published in English from January 1, 2007 to September 11, 2020. Forty-seven studies met the inclusion criteria and were systematically reviewed. After a short leveling-off during 2009–2012, the US national prevalence of obesity has steadily increased. Although women had higher racial/ethnic disparities in obesity and severe obesity than men, it decreased due to the significant drop in non-Hispanic black (NHB) women in the last 10 y. However, obesity and severe obesity prevalence increased in Mexican-American (MA) men, MA boys, and MA girls and became similar to or surpassing NHB groups. Substantial racial/ethnic disparities remained in the past decade. Even at the same level of BMI, MAs and non-Hispanic Asians had a higher percent of body fat and metabolic syndrome than other ethnic/racial groups. NHB's cultural preference for a large body significantly associated weight misperception and lower weight control practices. In addition to socioeconomic status, health behaviors, neighborhood environments, and early childhood health factors explained substantial racial/ethnic differences in obesity. Differences in biological, behavioral, and sociocultural characteristics should be considered in future public health intervention efforts to combat obesity in the USA.
The Association Between Personality Traits and Dietary Choices: A Systematic Review
Cecilia Maria Esposito, Alessandro Ceresa, Massimiliano Buoli
doi : 10.1093/advances/nmaa166
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1149–1159
Increasing evidence shows how diet may play a role in improving health including mental health. Of note, personality may influence the type of diet and consequently the prognosis of medical and psychiatric conditions. The purpose of the present systematic review is to summarize the available data regarding the influence of personality on dietary habits affecting health outcomes. A search in the main databases was conducted matching the terms “personality,” “personality traits” with “food choices,” “food preferences,” “diet,” and “dietary habits.” A total of 1856 articles were screened, and 24 articles were finally included. Exclusion criteria consisted of studies on animals or children, studies about eating disorders, types of diet not clearly associated with health outcomes, and studies for marketing reasons. Several studies showed that personality traits can influence both dietary choices and the type of diet, including the preference for healthy or unhealthy food. Unfavorable personality traits such as neuroticism and alexithymia (the inability to identify and describe emotions) were associated with unhealthy diet habits such as low consumption of fruit and vegetables, and the increased consumption of sugar and saturated fats. Personality seems to play a role in food selection and in the propensity to change diet. The interpretation of these results should be weighted by the different cultural contexts in which the studies were conducted and the extreme heterogeneity of tools used to assess personality and food preferences. Future research should clarify how personality can affect diet in specific populations such as patients with severe psychiatric disorders.
Caffeinated Coffee Consumption and Health Outcomes in the US Population: A Dose–Response Meta-Analysis and Estimation of Disease Cases and Deaths Avoided
Matteo Di Maso, Paolo Boffetta, Eva Negri, Carlo La Vecchia, Francesca Bravi
doi : 10.1093/advances/nmaa177
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1160–1176
To explore the role of coffee on health outcomes in the United States, where coffee consumption is common, we conducted a meta-analysis of prospective studies investigating the magnitude (any compared with no consumption) and the dose–response shape (cups per day) of the associations between caffeinated coffee consumption and incidence/mortality of cardiovascular disease (CVD), as well as incidence of type 2 diabetes (T2D), hepatocellular carcinoma (HCC), endometrial cancer, melanoma, and nonmelanoma skin cancer. We selected the desirable health outcomes that have been shown to be positively associated with coffee consumption. Studies were identified by searching PubMed/Embase databases up to September 2019. Inclusion criteria included prospective studies that investigated the relation of ?3 categories of caffeinated coffee consumption and the outcomes of interest. Twenty-six studies (42 distinct cohorts), with 93,706 cases/deaths and 3,713,932 participants, met the inclusion criteria. In any coffee consumers, there was a significant inverse association with the risk of CVD (RR = 0.90; 95% CI: 0.84, 0.96), T2D (RR = 0.90; 95% CI: 0.85, 0.96), endometrial cancer (RR = 0.85; 95% CI: 0.78, 0.92), melanoma (RR = 0.89; 95% CI: 0.80, 0.99), and nonmelanoma skin cancer (RR = 0.92; 95% CI: 0.89, 0.95). Coffee consumption was also inversely associated with HCC (RR = 0.93; 95% CI: 0.80, 1.08), without reaching statistical significance. The dose–response relation was nonlinear uniquely for CVD (P-nonlinearity = 0.01). In particular, the largest risk reduction was observed for 3–4 cups/d (?120 mL/cup) and no reduction thereafter. For other outcomes, the risk decreased linearly over the whole coffee consumption range. Current patterns of consumption in the United States would account for a fraction of avoided cases/deaths ranging from 6% to 12% according to the outcome considered. This study confirms the beneficial health effects of caffeinated coffee consumption in the US population on the health outcomes considered, and quantifies their possible magnitude.
Effects of Whole Grain Intake, Compared with Refined Grain, on Appetite and Energy Intake: A Systematic Review and Meta-Analysis
Lisa M Sanders, Yong Zhu, Meredith L Wilcox, Katie Koecher, Kevin C Maki
doi : 10.1093/advances/nmaa178
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1177–1195
Results from observational studies indicate that whole grain (WG) intake is inversely associated with BMI and risk of weight gain. WG intake may influence energy balance and body composition through effects on appetite and energy intake. To evaluate the impact of WG food consumption on appetite and energy intake, a systematic review and meta-analysis was performed of results from randomized controlled trials (RCTs) assessing WG food consumption, appetite, and energy intake in adults. A search of PubMed, Scopus, and Food Science and Technology Abstracts yielded 36 RCTs measuring subjective appetite ratings after consuming WG foods compared with refined grain (RG) controls. Thirty-two of these studies reported AUCs for subjective appetite (hunger, fullness, satiety, desire to eat, or prospective consumption) and/or energy intake and were included in the meta-analysis. Pooled estimates from meta-analyses are expressed as standardized mean differences (SMDs). Compared with RG foods, intake of WG foods resulted in significant differences in AUCs for subjective hunger (SMD: ?0.34; 95% CI: ?0.46, ?0.22; P < 0.001), fullness (SMD: 0.49; 95% CI: 0.31, 0.66; P < 0.001), satiety (SMD: 0.33; 95% CI: 0.18, 0.47; P < 0.001), and desire to eat (SMD: ?0.33; 95% CI: ?0.46, ?0.20; P < 0.001). There were small, nonsignificant reductions in prospective consumption ratings (P = 0.08) and energy intake (P = 0.07) with WG intake compared with RG. These results support the view that consumption of WG foods, compared with RG foods, significantly impacts subjective appetite, and might partly explain the inverse associations between WG food intake and risk of overweight, obesity, and weight gain over time.
Total, Dietary, and Supplemental Magnesium Intakes and Risk of All-Cause, Cardiovascular, and Cancer Mortality: A Systematic Review and Dose–Response Meta-Analysis of Prospective Cohort Studies
Amir Bagheri, Sina Naghshi, Omid Sadeghi, Bagher Larijani, Ahmad Esmaillzadeh
doi : 10.1093/advances/nmab001
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1196–1210
A meta-analysis of prospective studies was conducted to examine the association of total, supplemental, and dietary magnesium intakes with risk of all-cause, cancer, and cardiovascular disease (CVD) mortality and identify the dose–response relations involved in these association. We performed a systematic search of PubMed, Scopus, Google Scholar, and ISI Web of Knowledge up to April 2020. Prospective cohort studies that reported risk estimates for the association between total, supplemental, and dietary magnesium intakes and risk of mortality were included. Random effects models were used. Nineteen publication with a total of 1,168,756 participants were included in the current meta-analysis. In total, 52,378 deaths from all causes, 23,478 from CVD, and 11,408 from cancer were identified during the follow-up period of 3.5 to 32 years. Dietary magnesium intake was associated with a lower risk of all-cause [pooled effect size (ES): 0.87; 95% CI: 0.79, 0.97; P = 0.009; I2 = 70.7%; P < 0.001] and cancer mortality (pooled ES: 0.80; 95% CI: 0.67, 0.97; P = 0.023; I2 = 55.7%; P = 0.027), but not with CVD mortality (pooled ES: 0.93; 95% CI: 0.82, 1.07; P = 0.313; I2 = 72.3%; P < 0.001). For supplemental and total magnesium intakes, we did not find any significant associations with risks of all-cause, CVD, and cancer mortality. However, linear dose–response meta-analysis indicated that each additional intake of 100 mg/d of dietary magnesium was associated with a 6% and 5% reduced risk of all-cause and cancer mortality, respectively. In conclusion, higher intake of dietary magnesium was associated with a reduced risk of all-cause and cancer mortality, but not CVD mortality. Supplemental and total magnesium intakes were not associated with the risk of all-cause, CVD, and cancer mortality. These findings indicate that consumption of magnesium from dietary sources may be beneficial in reducing all-cause and cancer mortality and thus have practical importance for public health.
Neuroprotective Potential of Ellagic Acid: A Critical Review
Ashutosh Gupta, Amit Kumar Singh, Ramesh Kumar, Sarah Jamieson, Abhay Kumar Pandey, Anupam Bishayee
doi : 10.1093/advances/nmab007
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1211–1238
Ellagic acid (EA) is a dietary polyphenol present in various fruits, vegetables, herbs, and nuts. It exists either independently or as part of complex structures, such as ellagitannins, which release EA and several other metabolites including urolithins following absorption. During the past few decades, EA has drawn considerable attention because of its vast range of biological activities as well as its numerous molecular targets. Several studies have reported that the oxidative stress–lowering potential of EA accounts for its broad-spectrum pharmacological attributes. At the biochemical level, several mechanisms have also been associated with its therapeutic action, including its efficacy in normalizing lipid metabolism and lipidemic profile, regulating proinflammatory mediators, such as IL-6, IL-1?, and TNF-?, upregulating nuclear factor erythroid 2-related factor 2 and inhibiting NF-?B action. EA exerts appreciable neuroprotective activity by its free radical–scavenging action, iron chelation, initiation of several cell signaling pathways, and alleviation of mitochondrial dysfunction. Numerous in vivo studies have also explored the neuroprotective attribute of EA against various neurotoxins in animal models. Despite the increasing number of publications with experimental evidence, a critical analysis of available literature to understand the full neuroprotective potential of EA has not been performed. The present review provides up-to-date, comprehensive, and critical information regarding the natural sources of EA, its bioavailability, metabolism, neuroprotective activities, and underlying mechanisms of action in order to encourage further studies to define the clinical usefulness of EA for the management of neurological disorders.
Diet and the Microbiota–Gut–Brain Axis: Sowing the Seeds of Good Mental Health
Kirsten Berding, Klara Vlckova, Wolfgang Marx, Harriet Schellekens, Catherine Stanton, Gerard Clarke, Felice Jacka, Timothy G Dinan, John F Cryan
doi : 10.1093/advances/nmaa181
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1239–1285
Over the past decade, the gut microbiota has emerged as a key component in regulating brain processes and behavior. Diet is one of the major factors involved in shaping the gut microbiota composition across the lifespan. However, whether and how diet can affect the brain via its effects on the microbiota is only now beginning to receive attention. Several mechanisms for gut-to-brain communication have been identified, including microbial metabolites, immune, neuronal, and metabolic pathways, some of which could be prone to dietary modulation. Animal studies investigating the potential of nutritional interventions on the microbiota–gut–brain axis have led to advancements in our understanding of the role of diet in this bidirectional communication. In this review, we summarize the current state of the literature triangulating diet, microbiota, and host behavior/brain processes and discuss potential underlying mechanisms. Additionally, determinants of the responsiveness to a dietary intervention and evidence for the microbiota as an underlying modulator of the effect of diet on brain health are outlined. In particular, we emphasize the understudied use of whole-dietary approaches in this endeavor and the need for greater evidence from clinical populations. While promising results are reported, additional data, specifically from clinical cohorts, are required to provide evidence-based recommendations for the development of microbiota-targeted, whole-dietary strategies to improve brain and mental health.
Gut Microbiota-Derived Trimethylamine N-Oxide and Kidney Function: A Systematic Review and Meta-Analysis
Yan Zeng, Man Guo, Xia Fang, Fangyuan Teng, Xiaozhen Tan, Xinyue Li, Mei Wang, Yang Long, Yong Xu
doi : 10.1093/advances/nmab010
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1286–1304
Elevated circulating trimethylamine N-oxide (TMAO) concentrations have been observed in patients with chronic kidney disease (CKD). We aimed to systematically estimate and quantify the association between TMAO concentrations and kidney function. The PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science databases were systematically searched from 1995 to 1 June, 2020, for clinical studies on circulating TMAO concentrations and kidney function indicators. We used R software to conduct meta-analyses of the extracted data. A cumulative meta-analysis was applied to test whether health status affected the pooled effect value. Meta-regression and subgroup analyses were performed to identify possible sources of heterogeneity. Ultimately, we included a total of 32 eligible clinical studies involving 42,062 participants. In meta-analyses of continuous-outcome variables, advanced CKD was associated with a 67.9 ?mol/L (95% CI: 52.7, 83.2; P < 0.01) increase in TMAO concentration, and subjects with high concentrations of TMAO had a 12.9 mL/(min·1.73 m2) (95% CI: ?16.6, ?9.14; P < 0.01) decrease in glomerular filtration rate (GFR). In meta-analyses of the correlations, TMAO was strongly inversely correlated with GFR [Fisher's z-transformed correlation coefficient (ZCOR): ?0.45; 95% CI: ?0.58, ?0.32; P < 0.01] and positively associated with the urine albumin-to-creatinine ratio (UACR; ZCOR: 0.26; 95% CI: 0.08, 0.43; P < 0.01), serum creatinine (sCr; ZCOR: 0.43; 95% CI: 0.28, 0.58; P < 0.01), urine albumin excretion rate (UAER; ZCOR: 0.06; 95% CI: 0.04, 0.09; P < 0.01), blood urea (ZCOR: 0.50; 95% CI: 0.29, 0.72; P < 0.01), blood uric acid (ZCOR: 0.32; 95% CI: 0.25, 0.38; P < 0.01), and serum cystatin C (CysC; ZCOR: 0.47, 95% CI: 0.44, 0.51; P < 0.01). This is the first systematic review and meta-analysis to reveal a negative association between circulating TMAO concentrations and kidney function.
Impacts of Selected Dietary Nutrient Intakes on Skeletal Muscle Insulin Sensitivity and Applications to Early Prevention of Type 2 Diabetes
Xin Zhang, Doudou Xu, Meixia Chen, Yubo Wang, Linjuan He, Lu Wang, Jiangwei Wu, Jingdong Yin
doi : 10.1093/advances/nmaa161
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1305–1316
As the largest tissue in the body, skeletal muscle not only plays key roles in movement and glucose uptake and utilization but also mediates insulin sensitivity in the body by myokines. Insulin resistance in the skeletal muscle is a major feature of type 2 diabetes (T2D). A weakened response to insulin could lead to muscle mass loss and dysfunction. Increasing evidence in skeletal muscle cells, rodents, nonhuman primates, and humans has shown that restriction of caloric or protein intake positively mediates insulin sensitivity. Restriction of essential or nonessential amino acids was reported to facilitate glucose utilization and regulate protein turnover in skeletal muscle under certain conditions. Furthermore, some minerals, such as zinc, chromium, vitamins, and some natural phytochemicals such as curcumin, resveratrol, berberine, astragalus polysaccharide, emodin, and genistein, have been shown recently to protect skeletal muscle cells, mice, or humans with or without diabetes from insulin resistance. In this review, we discuss the roles of nutritional interventions in the regulation of skeletal muscle insulin sensitivity. A comprehensive understanding of the nutritional regulation of insulin signaling would contribute to the development of tools and treatment programs for improving skeletal muscle health and for preventing T2D.
Use of the Healthy Eating Index in Intervention Studies for Cardiometabolic Risk Conditions: A Systematic Review
Paula Brauer, Dawna Royall, Ariellia Rodrigues
doi : 10.1093/advances/nmaa167
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1317–1331
Researchers and counselors need diet-assessment tools that characterize diet at baseline and over time in diet counseling and coaching interventions. Among possible tools, the Healthy Eating Index (HEI) is of interest in cardiometabolic treatment as it has undergone significant validation and development. The objective of this study was to systematically review relevant intervention studies using the HEI and its adaptations to examine whether diet interventions improve diet quality as measured by the HEI and the magnitude of change in included diet-quality scores following dietary intervention. Two databases [Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed] were searched for articles published from January 1995 to December 2019. The review included intervention studies in adults presenting with overweight/obesity and obesity-related chronic disease (metabolic syndrome, diabetes, prediabetes, hypertension, dyslipidemia) who received education or counseling, and the HEI was evaluated from baseline to follow-up (US or Canadian version) or Alternate HEI. Study quality was assessed using Cochrane risk of bias for randomized controlled trials (RCTs) or Cochrane Risk of Bias for Nonrandomized interventions (ROBINS-I). A total of 25 studies were included: 15 RCTs, 3 quasi-experimental studies, and 7 pre-post studies. Eight different versions of the HEI were used. Results demonstrated that diet quality assessed by HEI and its adaptations improved to a clinically relevant degree, especially in studies where multiple food behaviors/food-behavior goals were the focus and where an intensive, long-term intervention was compared with a no-treatment control group. There was wide variation in magnitude of change in included diet-quality indicators. Use of the HEI and its adaptations and other diet-quality tools is promising for better characterization of diet-counseling interventions and results when multiple food behaviors are a focus. Additional development is encouraged.
Associations between Maternal Dietary Patterns and Perinatal Outcomes: A Systematic Review and Meta-Analysis of Cohort Studies
Shima Abdollahi, Sepideh Soltani, Russell J de Souza, Scott C Forbes, Omid Toupchian, Amin Salehi-Abargouei
doi : 10.1093/advances/nmaa156
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1332–1352
The aim was to systematically review and meta-analyze prospective cohort studies investigating the relation between maternal dietary patterns during pregnancy with pregnancy and birth outcomes. PubMed, Scopus, and ISI Web of Science were searched from inception until October 2019 for eligible studies. Studies reporting relative risk, ORs, or incidences (for binary data) or means ± SDs or B-coefficients (for continuous outcomes) comparing the highest and lowest adherence with maternal dietary patterns were included. Dietary patterns were categorized as “healthy,” “unhealthy,” or “mixed.” No language restrictions were applied. Study-specific effect sizes with SEs for outcomes of interest were pooled using a random-effects model. Quality of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Sixty-six relevant publications were included. A higher maternal adherence to a healthy diet was associated with a reduced risk of gestational hypertension (14%, P < 0.001), maternal depression (40%, P = 0.004), low birth weight (28%, P = 0.001), preterm birth (56%, P < 0.001), higher gestational weight gain (Hedges’ g: 0.15; P = 0.01), and birth weight (Hedges’ g: 0.19; P = 0.007). Higher maternal adherence to an unhealthy or a mixed diet was associated with higher odds of gestational hypertension (23%, P < 0.001 for unhealthy, and 8%, P = 0.01 for mixed diet). In stratified analyses, a higher healthy eating index was associated with reduced odds of being large based on gestational age (31%, P = 0.02) and a higher head circumference at birth (0.23 cm, P = 0.02). The Mediterranean and “prudent” dietary patterns were related to lower odds of being small based on gestational age (46%, P = 0.04) and preterm birth (52%, P = 0.03), respectively. The overall GRADE quality of the evidence for most associations was low or very low, indicating that future high-quality research is warranted. This study was registered at http://www.crd.york.ac.uk/PROSPERO as CRD42018089756.
Western Dietary Patterns, Foods, and Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Prospective Cohort Studies
Wei Quan, Maomao Zeng, Ye Jiao, Yong Li, Chaoyi Xue, Guoping Liu, Zhaojun Wang, Fang Qin, Zhiyong He, Jie Chen
doi : 10.1093/advances/nmaa184
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1353–1364
An increasing number of epidemiological studies suggest that adherence to Western dietary patterns (WDPs) is associated with risk of gestational diabetes mellitus (GDM), but results remain inconsistent. Therefore, we conducted a systematic review and meta-analysis of the effect of WDPs and typical Western dietary foods on GDM. A literature search was performed in PubMed, Embase, Web of Knowledge, and the Cochrane Library up to December 2019. Cohort studies investigating the combined associations of WDPs with incidence of GDM were included. Reviewers were paired, and they independently reviewed and assessed studies, extracted data, and evaluated study quality. Pooled HRs were calculated using random-effects models. Heterogeneity and publication bias tests were also conducted. Twenty-one prospective cohort studies with 191,589 participants, including 12,331 women with GDM, were included in our analysis. The pooled risk ratio (RR) of WDPs was 1.52 (95% CI: 1.21, 1.91), indicating a significant association with GDM risk in Western countries. Potatoes (pooled RR: 1.12; 95% CI: 0.93, 1.35) showed a nonsignificant (P > 0.05) relation to GDM risk. However, consumption of animal meat (pooled RR: 1.35; 95% CI: 1.16, 1.57) and fast food (pooled RR: 1.75; 95% CI: 1.41, 2.19) showed a positive association with the risk of developing GDM. Subgroup analysis demonstrated that the consumption of red meat and processed red meat increased the risk of GDM more than either poultry or fish intake. Our study provides further evidence for understanding the relation between dietary factors and increased GDM risk and contributes to reducing the incidence of GDM through healthy diets.
Meal Pattern Analysis in Nutritional Science: Recent Methods and Findings
Cathal O'Hara, Eileen R Gibney
doi : 10.1093/advances/nmaa175
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1365–1378
There is a scarcity of dietary intake research focusing on the intake of whole meals rather than on the nutrients and foods of which those meals are composed. This growing area of research has recently begun to utilize advanced statistical techniques to manage the large number of variables and permutations associated with these complex meal patterns. The aim of this narrative review was to evaluate those techniques and the meal patterns they detect. The 10 observational studies identified used techniques such as principal components analysis, clustering, latent class analysis, and decision trees. They examined meal patterns under 3 categories: temporal patterns (relating to the timing and distribution of meals), content patterns (relating to combinations of foods within a meal and combinations of those meals over a day), and context patterns (relating to external elements of the meal, such as location, activities while eating, and the presence or absence of others). The most common temporal meal patterns were the 3 meals/d pattern, the skipped breakfast pattern, and a grazing pattern consisting of smaller but more frequent meals. The 3 meals/d pattern was associated with increased diet quality compared with the other 2 patterns. Studies identified between 7 and 12 content patterns with limited similarities between studies and no clear associations between the patterns and diet quality or health. One study simultaneously examined temporal and context meal patterns, finding limited associations with diet quality. No study simultaneously examined other combinations of meal patterns. Future research that further develops the statistical techniques required for meal pattern analysis is necessary to clarify the relations between meal patterns and diet quality and health.
Alcohol and Brain Development in Adolescents and Young Adults: A Systematic Review of the Literature and Advisory Report of the Health Council of the Netherlands
Janette de Goede, Kerstin G van der Mark-Reeuwijk, Kees P Braun, Saskia le Cessie, Sarah Durston, Rutger C M E Engels, Anna E Goudriaan, Karel G M Moons, Wilma A M Vollebergh, Taco J de Vries, Reinout W Wiers, Jaap Oosterlaan
doi : 10.1093/advances/nmaa170
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1379–1410
Young people, whose brains are still developing, might entail a greater vulnerability to the effects of alcohol consumption on brain function and development. A committee of experts of the Health Council of the Netherlands evaluated the state of scientific knowledge regarding the question whether alcohol negatively influences brain development in young people. A systematic literature search for prospective studies was performed in PubMed and PsychINFO, for longitudinal studies of adolescents or young adults ranging between 12 and 24 y of age at baseline, investigating the relation between alcohol use and outcome measures of brain structure and activity, cognitive functioning, educational achievement, or alcohol use disorder (AUD), with measures at baseline and follow-up of the outcome of interest. Data were extracted from original articles and study quality was assessed using the Newcastle-Ottawa Scale. A total of 77 studies were included, 31 of which were of sufficient quality in relation to the study objectives. There were indications that the gray matter of the brain develops abnormally in young people who drink alcohol. In addition, the more often young people drink or the younger they start, the higher the risk of developing AUD later in life. The evidence on white matter volume or quality, brain activity, cognitive function, and educational achievement is still limited or unclear. The committee found indications that alcohol consumption can have a negative effect on brain development in adolescents and young adults and entails a risk of later AUD. The committee therefore considers it a wise choice for adolescents and young adults not to drink alcohol.
Prophylactic Probiotic Supplementation for Preterm Neonates—A Systematic Review and Meta-Analysis of Nonrandomized Studies
Mangesh Deshmukh, Sanjay Patole
doi : 10.1093/advances/nmaa164
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1411–1423
Systematic review and meta-analyses of randomized controlled trials (RCTs) show that probiotics reduce the risk of necrotizing enterocolitis (NEC ? Stage II), late onset sepsis (LOS), all-cause mortality, and feeding intolerance in preterm neonates. Data from observational studies is important to confirm probiotic effects in clinical practice. We aimed to compare outcomes before and after implementing routine probiotic supplementation (RPS) in preterm neonates (<37 weeks of gestation) by performing a systematic review of non-RCTs using Cochrane methodology. Databases including PubMed, The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane Central library, and Google Scholar were searched in May 2020. A meta-analysis was performed using a random effects model. Categorical measure of effect size was expressed as OR and 95% CI. Statistical heterogeneity was assessed by the chi-squared test, I2 statistic. The level of evidence (LOE) was summarized using GRADE (Grading of Recommendations Assessment, Development, and Evaluation) guidelines. Primary outcomes were NEC ? Stage II, LOS, and all-cause mortality. Secondary outcomes included probiotic sepsis. Thirty good-quality non-RCTs (n = 77,018) from 18 countries were included. The meta-analysis showed RPS was associated with significantly reduced: 1) NEC ? Stage II (30 studies, n = 77,018; OR: 0.60; 95% CI: 0.50, 0.73; P <0.00001, I2: 65%; LOE: Moderate), 2) LOS: (21 studies, n = 65,858; OR: 0.85; 95% CI: 0.74, 0.97; P = 0.02, I2: 74%; LOE: Low), and 3) all-cause mortality (27 non-RCTs, n = 70,977; OR: 0.77; 95% CI: 0.68, 0.88; P = 0.0001, I2: 49%; LOE: Low). Subgroups: 1) extremely low birth weight (ELBW: birth weight <1000 g) neonates: RPS was associated with significantly reduced NEC ? Stage II (4.5% compared with 7.9%). However, there was no difference in LOS and mortality. 2) Multistrain RPS was more effective than single strain. One study reported 3 nonfatal cases of probiotic sepsis. In summary, moderate- to low-quality evidence indicates that RPS was associated with significantly reduced NEC ? Stage II, LOS, and all-cause mortality in neonates <37 weeks of gestation and NEC ? Stage II in ELBW neonates.
Nutrition in HIV-Infected Infants and Children: Current Knowledge, Existing Challenges, and New Dietary Management Opportunities
Olufemi K Fabusoro, Luis A Mejia
doi : 10.1093/advances/nmaa163
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1424–1437
HIV infection and undernutrition remain significant public health concerns for infants and children. In infants and children under these conditions, undernutrition is one of the leading causes of death. Proper management of nutrition and related nutrition complications in these groups with increased nutrition needs are prominent challenges, particularly in HIV-prevalent poor-resource environments. Several studies support the complexity of the relation between HIV infection, nutrition, and the immune system. These elements interact and create a vicious circle of poor health outcomes. Recent studies on the use of probiotics as a novel approach to manage microbiome imbalance and gut-mucosal impairment in HIV infection are gaining attention. This new strategy could help to manage dysbiosis and gut-mucosal impairment by reducing immune activation, thereby potentially forestalling unwanted health outcomes in children with HIV. However, existing trials on HIV-infected children are still insufficient. There are also conflicting reports on the dosage and effectiveness of single or multiple micronutrient supplementation in the survival of HIV-infected children with severe acute malnutrition. The WHO has published guidelines that include time of initiation of antiretroviral therapy for HIV-pregnant mothers and their HIV-exposed or HIV-infected children, micronutrient supplementation, dietary formulations, prevention, and management of HIV therapy. However, such guidelines need to be reviewed owing to recent advances in the field of nutrition. There is a need for new intervention studies, practical strategies, and evidence-based guidelines to reduce the disease burden, improve adherence to treatment regimen, and enhance the nutrition, health, and well-being of HIV-infected infants and children. This review provides up-to-date scientific information on current knowledge and existing challenges for nutrition therapy in HIV-infected infants and children. Moreover, it presents new research findings that could be incorporated into current guidelines.
Healthy Aging—Nutrition Matters: Start Early and Screen Often
Susan B Roberts, Rachel E Silver, Sai Krupa Das, Roger A Fielding, Cheryl H Gilhooly, Paul F Jacques, Jennifer M Kelly, Joel B Mason, Nicola M McKeown, Meaghan A Reardon, Sheldon Rowan, Edward Saltzman, Barbara Shukitt-Hale, Caren E Smith, Allen A Taylor, Dayong Wu, Fang Fang Zhang, Karen Panetta, Sarah Booth
doi : 10.1093/advances/nmab032
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1438–1448
The amount of time spent in poor health at the end of life is increasing. This narrative review summarizes consistent evidence indicating that healthy dietary patterns and maintenance of a healthy weight in the years leading to old age are associated with broad prevention of all the archetypal diseases and impairments associated with aging including: noncommunicable diseases, sarcopenia, cognitive decline and dementia, osteoporosis, age-related macular degeneration, diabetic retinopathy, hearing loss, obstructive sleep apnea, urinary incontinence, and constipation. In addition, randomized clinical trials show that disease-specific nutrition interventions can attenuate progression—and in some cases effectively treat—many established aging-associated conditions. However, middle-aged and older adults are vulnerable to unhealthy dietary patterns, and typically consume diets with inadequate servings of healthy food groups and essential nutrients, along with an abundance of energy-dense but nutrient-weak foods that contribute to obesity. However, based on menu examples, diets that are nutrient-dense, plant-based, and with a moderately low glycemic load are better equipped to meet the nutritional needs of many older adults than current recommendations in US Dietary Guidelines. These summary findings indicate that healthy nutrition is more important for healthy aging than generally recognized. Improved public health messaging about nutrition and aging, combined with routine screening and medical referrals for age-related conditions that can be treated with a nutrition prescription, should form core components of a national nutrition roadmap to reduce the epidemic of unhealthy aging.
Health Coaching Strategies for Weight Loss: A Systematic Review and Meta-Analysis
Sofia Mendes Sieczkowska, Alisson Padilha de Lima, Paul Alan Swinton, Eimear Dolan, Hamilton Roschel, Bruno Gualano
doi : 10.1093/advances/nmaa159
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1449–1460
Health coaching has emerged as a potential supporting tool for health professionals to overcome behavioral barriers, but its efficacy in weight management remains unclear. We conducted a systematic review and meta-analysis to synthesize and evaluate the quality of evidence supporting the use of self-reported health coaching for weight loss. Seven electronic databases (PubMed, Web of Science, Scopus, Cochrane, Psyinfo, Virtual Health Library, and Scielo) were independently searched from inception to May 2020. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation recommendations. Any study that investigated a self-reported health coaching intervention with the goal of inducing weight loss in individuals of any age, health, or training status was considered for inclusion. Quantitative data were analyzed using multilevel hierarchical metaregression models conducted within a Bayesian framework. A total of 653 studies were screened and 38 were selected for inclusion. The quality of evidence supporting outcomes based on the entire evidence base was very low and studies were deemed to have high risk of bias. Meta-analysis of controlled studies provided evidence of an effect favoring coaching compared with usual care but was trivial in magnitude [effect size (ES)0.5: ?0.09; 95% credible interval (CrI): ?0.17, ?0.02]. The multilevel extension of Egger's regression-intercept test indicated the existence of publication bias, whereas a sensitivity analysis based only on those studies deemed to be of high quality provided no evidence of an effect of coaching on weight loss (ES0.5: ?0.04; 95% CrI: ?0.12, 0.09). Considered collectively, the results of this investigation indicate that the available evidence is not of sufficient quality to support the use of self-reported health coaching as a health care intervention for weight loss. This trial was registered at Prospective Register of Systematic Reviews (PROSPERO) as CRD42020159023.
Metabolic Strategies for Inhibiting Cancer Development
Philippe Icard, Mauro Loi, Zherui Wu, Antonin Ginguay, Hubert Lincet, Edouard Robin, Antoine Coquerel, Diana Berzan, Ludovic Fournel, Marco Alifano
doi : 10.1093/advances/nmaa174
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1461–1480
The tumor microenvironment is a complex mix of cancerous and noncancerous cells (especially immune cells and fibroblasts) with distinct metabolisms. These cells interact with each other and are influenced by the metabolic disorders of the host. In this review, we discuss how metabolic pathways that sustain biosynthesis in cancer cells could be targeted to increase the effectiveness of cancer therapies by limiting the nutrient uptake of the cell, inactivating metabolic enzymes (key regulatory ones or those linked to cell cycle progression), and inhibiting ATP production to induce cell death. Furthermore, we describe how the microenvironment could be targeted to activate the immune response by redirecting nutrients toward cytotoxic immune cells or inhibiting the release of waste products by cancer cells that stimulate immunosuppressive cells. We also examine metabolic disorders in the host that could be targeted to inhibit cancer development. To create future personalized therapies for targeting each cancer tumor, novel techniques must be developed, such as new tracers for positron emission tomography/computed tomography scan and immunohistochemical markers to characterize the metabolic phenotype of cancer cells and their microenvironment. Pending personalized strategies that specifically target all metabolic components of cancer development in a patient, simple metabolic interventions could be tested in clinical trials in combination with standard cancer therapies, such as short cycles of fasting or the administration of sodium citrate or weakly toxic compounds (such as curcumin, metformin, lipoic acid) that target autophagy and biosynthetic or signaling pathways.
Effects of Unsweetened Preloads and Preloads Sweetened with Caloric or Low-/No-Calorie Sweeteners on Subsequent Energy Intakes: A Systematic Review and Meta-Analysis of Controlled Human Intervention Studies
Han Youl Lee, Maia Jack, Theresa Poon, Daniel Noori, Carolina Venditti, Samer Hamamji, Kathy Musa-Veloso
doi : 10.1093/advances/nmaa157
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1481–1499
Effects of isocaloric (sweetness differences but constant calories) preloads and isosweet (caloric differences but constant sweetness) preloads, as well as preloads that were neither isosweet nor isocaloric (sweetness and caloric differences) on subsequent ad libitum meal and total (preload + ad libitum) energy intakes were investigated. Thirty-five crossover studies were eligible for inclusion, representing 116 comparisons (41, isocaloric; 41, isosweet; and 34, neither isosweet nor isocaloric). References of existing reviews and literature from 4 databases were searched. The calculated raw mean differences in ad libitum and total energy intakes were pooled in meta-analyses using a random-effects model and the inverse of the variance as the weighting factor. Energy intakes at an ad libitum meal were significantly lower for low-/no-calorie sweetener (LNCS)–sweetened compared with unsweetened preloads in the isocaloric comparison (?55.5 kcal; 95% CI: ?82.9, ?28.0 kcal; P < 0.001); however, the difference in energy intake was not significant in additional sensitivity analyses (i.e., removal of comparisons where the matrix was a capsule and when xylitol was the LNCS). For the isosweet comparison, although the pooled energy intake at the ad libitum meal was significantly greater with the LNCS-sweetened preload compared with the caloric sweetener (CS)–sweetened preload (58.5 kcal; 95% CI: 35.4, 81.7 kcal; P < 0.001), the pattern was reversed when total energy intake was considered (?132.4 kcal; 95% CI: ?163.2, ?101.6 kcal; P < 0.001), explained by only partial compensation from the CS-sweetened preload. The results were similar when assessing ad libitum and total energy intakes when unsweetened compared with CS-sweetened preloads were consumed. Unsweetened or LNCS-sweetened preloads appear to have similar effects on intakes when compared with one another or with CS-sweetened preloads. These findings suggest that LNCS-sweetened foods and beverages are viable alternatives to CS-sweetened foods and beverages to manage short-term energy intake.
Sucralose and Cardiometabolic Health: Current Understanding from Receptors to Clinical Investigations
Sydney Risdon, Sylvain Battault, Alonso Romo-Romo, Matthieu Roustit, Loic Briand, Grégory Meyer, Paloma Almeda-Valdes, Guillaume Walther
doi : 10.1093/advances/nmaa185
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1500–1513
The excess consumption of added sugar is consistently found to be associated with weight gain, and a higher risk of type 2 diabetes mellitus, coronary heart disease, and stroke. In an effort to reduce the risk of cardiometabolic disease, sugar is frequently replaced by low- and null-calorie sweeteners (LCSs). Alarmingly, though, emerging evidence indicates that the consumption of LCSs is associated with an increase in cardiovascular mortality risk that is amplified in those who are overweight or obese. Sucralose, a null-caloric high-intensity sweetener, is the most commonly used LCS worldwide, which is regularly consumed by healthy individuals and patients with metabolic disease. To explore a potential causal role for sucralose in increased cardiovascular risk, this present review summarizes the preclinical and clinical data from current research detailing the effects of sucralose on systems controlling food intake, glucose homeostasis, and gut microbiota.
Functional Meat Products as Oxidative Stress Modulators: A Review
Adri?n Macho-Gonz?lez, Sara Bastida, Alba Garcimart?n, Mar?a Elvira L?pez-Oliva, Pilar Gonz?lez, Juana Bened?, Mar?a José Gonz?lez-Mu?oz, Francisco J S?nchez-Muniz
doi : 10.1093/advances/nmaa182
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1514–1539
High meat consumption has been associated with increased oxidative stress mainly due to the generation of oxidized compounds in the body, such as malondialdehyde, 4-hydroxy-nonenal, oxysterols, or protein carbonyls, which can induce oxidative damage. Meat products are excellent matrices for introducing different bioactive compounds, to obtain functional meat products aimed at minimizing the pro-oxidant effects associated with high meat consumption. Therefore, this review aims to summarize the concept and preparation of healthy and functional meat, which could benefit antioxidant status. Likewise, the key strategies regarding meat production and storage as well as ingredients used (e.g., minerals, polyphenols, fatty acids, walnuts) for developing these functional meats are detailed. Although most effort has been made to reduce the oxidation status of meat, newly emerging approaches also aim to improve the oxidation status of consumers of meat products. Thus, we will delve into the relation between functional meats and their health effects on consumers. In this review, animal trials and intervention studies are discussed, ascertaining the extent of functional meat products’ properties (e.g., neutralizing reactive oxygen species formation and increasing the antioxidant response). The effects of functional meat products in the frame of diet–gene interactions are analyzed to 1) discover target subjects that would benefit from their consumption, and 2) understand the molecular mechanisms that ensure precision in the prevention and treatment of diseases, where high oxidative stress takes place. Long-term intervention-controlled studies, testing different types and amounts of functional meat, are also necessary to ascertain their positive impact on degenerative diseases.
Effect of Acid or Base Interventions on Bone Health: A Systematic Review, Meta-Analysis, and Meta-Regression
Yibing Han, Min An, Li Yang, Liuran Li, Shitao Rao, Yanzhen Cheng
doi : 10.1093/advances/nmab002
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1540–1557
Osteoporosis is a global health issue among the aging population. The effect of the acid or base interventions on bone health remains controversial. This study performed a systematic review and meta-analysis to investigate effects of acidic diets and alkaline supplements on bone health simultaneously. We conducted a comprehensive literature search in 5 available databases and 1 registered clinical trial system to identify randomized controlled trials (RCTs) that assessed effects of the acid-base intervention on bone health. Depending on heterogeneity across studies, the pooled effects were calculated by fixed-effects or random-effects models. The present study included 13 acidic diet intervention studies and 13 alkaline supplement studies for final quantitative assessments. The meta-analysis showed that acidic diets significantly increased net acid excretion [NAE; standardized mean difference (SMD) = 2.99; P = 0.003] and urinary calcium excretion (SMD = 0.47, P < 0.00001) but had no significant effect on bone turnover markers and bone mineral density (BMD). On the other hand, alkaline supplement intervention significantly reduced NAE (SMD = ?1.29, P < 0.00001), urinary calcium excretion (SMD = ?0.44, P = 0.007), bone resorption marker aminoterminal cross-linking telopeptide (NTX; SMD = ?0.29, P = 0.003), and bone formation marker osteocalcin (OC; SMD = ?0.23, P = 0.02), but did not affect the other bone turnover markers. Furthermore, alkaline supplements significantly increased BMD in femoral neck [mean difference (MD) = 1.62, P < 0.00001, I2 = 0%], lumbar spine (MD = 1.66, P < 0.00001, I2 = 87%), and total hip (MD = 0.98, P = 0.02, I2 = 99%). Subsequently, meta-regression analyses identified 1 study that substantially contributed to the high heterogeneity of BMD in the latter 2 sites, but sensitivity analysis suggested that this study did not affect the significant pooled effects. Despite that, the results should be interpreted with caution and need to be further validated by a larger RCT. In summary, through integrating evidence from RCTs, the present meta-analysis initially suggests that alkaline supplements may be beneficial to bone metabolism and acidic diets may not be harmful to bone health. This work may be clinically useful for both clinicians and patients with osteoporosis.
Calorie Restriction as a New Treatment of Inflammatory Diseases
Tunay K?kten, Franck Hansmannel, Ndeye Coumba Ndiaye, Anne-Charlotte Heba, Didier Quilliot, Natacha Dreumont, Djésia Arnone, Laurent Peyrin-Biroulet
doi : 10.1093/advances/nmaa179
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1558–1570
Immoderate calorie intake coupled with a sedentary lifestyle are major determinants of health issues and inflammatory diseases in modern society. The balance between energy consumption and energy expenditure is critical for longevity. Excessive energy intake and adiposity cause systemic inflammation, whereas calorie restriction (CR) without malnutrition, exerts a potent anti-inflammatory effect. The objective of this review was to provide an overview of different strategies used to reduce calorie intake, discuss physiological mechanisms by which CR might lead to improved health outcomes, and summarize the present knowledge about inflammatory diseases. We discuss emerging data of observational studies and randomized clinical trials on CR that have been shown to reduce inflammation and improve human health.
The Efficacy of Ketogenic Therapies in the Clinical Management of People with Neurodegenerative Disease: A Systematic Review
Lauren S Dewsbury, Chai K Lim, Genevieve Z Steiner
doi : 10.1093/advances/nmaa180
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1571–1593
Ketone bodies have potential disease-modifying activity that represent a novel therapeutic approach for neurodegenerative diseases (NDD). The aim of this systematic review was to summarize and evaluate the evidence for the application of ketogenic therapies (dietary or exogenous ketogenic agents) for NDD and provide recommendations for future research. Eight databases were electronically searched for articles reporting on controlled trials (?4 wk duration) that induced ketosis or elevated serum ketone concentrations in people with NDD. Of 4498 records identified, 17 articles met the inclusion criteria with a total of 979 participants including studies on mild cognitive impairment (MCI; n = 6), multiple sclerosis (n = 4), Alzheimer's disease (n = 5), Parkinson's disease (n = 1), and MCI secondary to Parkinson's disease (n = 1). Of 17 studies, 7 were randomized double-blind placebo-controlled trials. Most studies used dietary interventions (n = 9), followed by medium-chain triglycerides (n = 7) and a fasting protocol (n = 1). Generally, trials were 6 wk in duration and assessed cognition as the primary outcome. Studies were heterogeneous in type and severity of NDD, interventions used, and outcomes assessed. Overall, 3/17 studies carried a low risk of bias. Based on available evidence, exogenous ketogenic agents may be more feasible than dietary interventions in NDD from a compliance and adherence perspective; more research is required to confirm this. Recommendations for future research include improving exogenous formulations to reduce adverse effects, exploring interindividual factors affecting response-to-treatment, and establishing a “minimum required dose” for clinically meaningful improvements in disease-specific symptoms, such as cognition or motor function.
Comment on "Associations Between Tea and Cancer Risk in Two Umbrella Reviews"
Mengshi Yi, Turun Song, Yong Zhou
doi : 10.1093/advances/nmab042
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1594–1595
Reply to Yi M et al
Gwang Hun Jeong, Giuseppe Grosso, Dagfinn Aune, Brendon Stubbs, Ai Koyanagi, Eunyoung Cho, Edward L Giovannucci, Jae I L Shin
doi : 10.1093/advances/nmab043
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1595–1596
Corrigendum to Roberts et al. Healthy Aging—Nutrition Matters, Start Early and Screen Often. Adv Nutr 2021;12(4):1438–48
doi : 10.1093/advances/nmab067
Advances in Nutrition, Volume 12, Issue 4, July 2021, Pages 1597–1598
Corrigendum: Back to the Roots: Revisiting the Use of the Fiber-Rich Cichorium intybus L. Taproots
Marie-Luise Puhlmann, Willem M de Vos
doi : 10.1093/advances/nmab082
Advances in Nutrition, Volume 12, Issue 4, July 2021, Page 1598
The fashionable gluten-free diet—wear with caution
Claire L Jansson-Knodell, Alberto Rubio-Tapia
doi : 10.1093/ajcn/nqaa371
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 491–492
Olympic gold medalist in swimming Dana Vollmer, the current men's world top-ranked tennis player Novak Djokovic, 6-time Olympian Nordic combined skier Todd Lodwick, and National Football League quarterback Drew Brees are just a few examples of world-class athletes who have adopted and touted the benefits of the gluten-free diet (GFD). Riding the wave of these athlete and other celebrity endorsements, the diet has become extremely popular. In addition, the expanding gluten-free product market is making it more accessible to the general public. Although initially designed for those with celiac disease, dermatitis herpetiformis, and wheat allergy, the GFD is followed by many without celiac disease or...
Weight and mortality: why body composition matters
Andrew O Odegaard, JoAnn E Manson
doi : 10.1093/ajcn/nqaa409
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 493–494
BMI (kg/m2) is a nonspecific metric of body size that does not inform on body composition or the distribution of adipose tissue in an individual or a population. Yet, as a proxy for adiposity and the most widely used metric to define population levels of obesity, BMI has significant epidemiologic utility in predicting chronic disease and mortality risk across populations (1). In obesity-related research, it is seemingly a rite of passage for investigators to report on the prediction of mortality risk according to readily accessible BMI values within the population under study (2). This is primarily motivated by the...
Dairy foods and the risk of type 2 diabetes: getting the “fats” straight?
Benoît Lamarche
doi : 10.1093/ajcn/nqaa376
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 495–496
According to the World Health Organization, more than 400 million people worldwide suffer from diabetes, with numbers having increased steadily over the last 40 years (1). Often a direct consequence of obesity, type 2 diabetes (T2D) and its comorbidities can be effectively managed and prevented through healthy lifestyles, including healthy eating. According to the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) in the United States, a healthy diet for the management of diabetes is based on variety and should include, among other foods, low- or non-fat milk, yogurt, and cheese, as opposed to higher-fat dairy foods, to limit the intake...
“Instead of what,” and repeated 4-year interval change regarding red meat and T2D: increasing causal inference in nutritional epidemiology through methodological advances
Christopher Gardner
doi : 10.1093/ajcn/nqaa385
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 497–498
Recommendations to limit consumption of red meat, particularly processed red meat, have been made by many national and global health organizations due to associations with chronic diseases such as heart disease and cancer (1, 2). Many of these recommendations have been in place for decades. Reports of associations of red meat consumption with type 2 diabetes (T2D) have been more limited (3). The evidence base for these recommendations comes from a variety of lines of evidence, including long-term observational epidemiological studies with clinical outcomes of morbidity and mortality, short-term randomized controlled trials (RCTs) examining physiological response to dietary factors such...
Dietary prevention of breast cancer in high-risk women: role of carotenoids
Anne McTiernan
doi : 10.1093/ajcn/nqaa399
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 499–500
Worldwide, >2 million women are diagnosed with breast cancer each year (1). Among women with high-risk germline variants, lifetime risk of breast cancer development can approach 70% (2). Women with high breast density on mammographic imaging also have a higher lifetime risk for breast cancer (3). For women at elevated breast cancer risk, prevention strategies have focused on intensive screening for early disease, chemoprevention, and prophylactic surgery (4–6). Lifestyle factors, including diet, have been linked to breast cancer etiology, but few studies have provided data specific to high-risk women. Meta-analyses and pooled analyses have found...
Malnutrition in patients with heart failure
Khursheed N Jeejeebhoy
doi : 10.1093/ajcn/nqaa406
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 501–502
Patients with heart failure have significant loss of weight and wasting, especially in the terminal stages of this condition. The question is the extent to which these changes are related to an inability to consume and utilize nutrients, in contrast to cachexia, wherein similar body changes occur as a result of excessive cytokine production as opposed to a deficiency of nutrients (1). Furthermore, true cachexia does not respond to specialized nutritional interventions. The distinction between these 2 conditions is critical, both from a clinical and research perspective, since pathophysiologies and therapies differ substantially. When presented with an underweight patient, or group of research...
Nutrigenomics: lessons learned and future perspectives
Lorraine Brennan, Baukje de Roos
doi : 10.1093/ajcn/nqaa366
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 503–516
The omics technologies of metabolomics, transcriptomics, proteomics, and metagenomics are playing an increasingly important role in nutrition science. With the emergence of the concept of precision nutrition and the need to understand individual responses to dietary interventions, it is an opportune time to examine the impact of these tools to date in human nutrition studies. Advances in our mechanistic understanding of dietary interventions were realized through incorporation of metabolomics, proteomics, and, more recently, metagenomics. A common observation across the studies was the low intra-individual variability of the omics measurements and the high inter-individual variation. Harnessing this data for use in the development of precision nutrition will be important. Metabolomics in particular has played a key role in the development of biomarkers of food intake in an effort to enhance the accuracy of dietary assessments. Further work is needed to realize the full potential of such biomarkers and to demonstrate integration with current strategies, with the goal of overcoming the well-established limitations of self-reported approaches. Although many of the nutrigenomic studies performed to date were labelled as proof-of-concept or pilot studies, there is ample evidence to support the use of these technologies in nutrition science. Incorporating omic technologies from the start of study designs will ensure that studies are sufficiently powered for such data. Furthermore, multi-disciplinary collaborations are likely to become even more important to aid analyses and interpretation of the data.
Persistent confusion in nutrition and obesity research about the validity of classic nonparametric tests in the presence of heteroscedasticity: evidence of the problem and valid alternatives
Cynthia M Kroeger, Keisuke Ejima, Bridget A Hannon, Tanya M Halliday, Bryan McComb ...
doi : 10.1093/ajcn/nqaa357
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 517–524
The use of classic nonparametric tests (cNPTs), such as the Kruskal–Wallis and Mann–Whitney U tests, in the presence of unequal variance for between-group comparisons of means and medians may lead to marked increases in the rate of falsely rejecting null hypotheses and decreases in statistical power. Yet, this practice remains prevalent in the scientific literature, including nutrition and obesity literature. Some nutrition and obesity studies use a cNPT in the presence of unequal variance (i.e., heteroscedasticity), sometimes because of the mistaken rationale that the test corrects for heteroscedasticity. Herein, we discuss misconceptions of using cNPTs in the presence of heteroscedasticity. We then discuss assumptions, purposes, and limitations of 3 common tests used to test for mean differences between multiple groups, including 2 parametric tests: Fisher's ANOVA and Welch's ANOVA; and 1 cNPT: the Kruskal–Wallis test. To document the impact of heteroscedasticity on the validity of these tests under conditions similar to those used in nutrition and obesity research, we conducted simple simulations and assessed type I error rates (i.e., false positives, defined as incorrectly rejecting the null hypothesis). We demonstrate that type I error rates for Fisher's ANOVA, which does not account for heteroscedasticity, and Kruskal–Wallis, which tests for differences in distributions rather than means, deviated from the expected significance level. Greater deviation from the expected type I error rate was observed as the heterogeneity increased, especially in the presence of an imbalanced sample size. We provide brief tutorial guidance for authors, editors, and reviewers to identify appropriate statistical tests when test assumptions are violated, with a particular focus on cNPTs.
Circulating carotenoids and breast cancer among high-risk individuals
Cheng Peng, Chi Gao, Donghao Lu, Bernard A Rosner, Oana Zeleznik ...
doi : 10.1093/ajcn/nqaa316
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 525–533
Carotenoids represent 1 of few modifiable factors to reduce breast cancer risk. Elucidation of interactions between circulating carotenoids and genetic predispositions or mammographic density (MD) may help inform more effective primary preventive strategies in high-risk populations.
The impact of diets rich in low-fat or full-fat dairy on glucose tolerance and its determinants: a randomized controlled trial
Kelsey A Schmidt, Gail Cromer, Maggie S Burhans, Jessica N Kuzma, Derek K Hagman ...
doi : 10.1093/ajcn/nqaa301
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 534–547
Dairy foods, particularly yogurt, and plasma biomarkers of dairy fat intake are consistently inversely associated with incident type 2 diabetes. Yet, few trials assessing the impact of dairy on glucose homeostasis include fermented or full-fat dairy foods.
Dietary protein intake does not modulate daily myofibrillar protein synthesis rates or loss of muscle mass and function during short-term immobilization in young men: a randomized controlled trial
Sean Paul Kilroe, Jonathan Fulford, Sarah Jackman, Andrew Holwerda, Annemie Gijsen ...
doi : 10.1093/ajcn/nqaa136
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 548–561
Short-term (<1 wk) muscle disuse lowers daily myofibrillar protein synthesis (MyoPS) rates resulting in muscle mass loss. The understanding of how daily dietary protein intake influences such muscle deconditioning requires further investigation.
Formal maternal employment is associated with lower odds of exclusive breastfeeding by 14 weeks postpartum: a cross-sectional survey in Naivasha, Kenya
S B Ickes, V M Oddo, H K Sanders, R Nduati, D M Denno ...
doi : 10.1093/ajcn/nqaa351
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 562–573
In many low- and middle-income countries, improvements in exclusive breastfeeding (EBF) have stalled, delaying reductions in child mortality. Maternal employment is a potential barrier to EBF.
Postdischarge interventions for children hospitalized with severe acute malnutrition: a systematic review and meta-analysis
Christie C A Noble, Jonathan P Sturgeon, Mutsa Bwakura-Dangarembizi, Paul Kelly, Beatrice Amadi ...
doi : 10.1093/ajcn/nqaa359
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 574–585
Children hospitalized with severe acute malnutrition (SAM) have poor long-term outcomes following discharge, with high rates of mortality, morbidity, and impaired neurodevelopment. There is currently minimal guidance on how to support children with SAM following discharge from inpatient treatment.
Neurodevelopment and growth until 6.5 years of infants who consumed a low-energy, low-protein formula supplemented with bovine milk fat globule membranes: a randomized controlled trial
Niklas Timby, Marie Adamsson, Erik Domell?f, Tove Grip, Olle Hernell ...
doi : 10.1093/ajcn/nqaa354
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 586–592
We previously reported results from a randomized controlled trial in which we found that Swedish infants consuming an experimental low-energy, low-protein formula (EF) supplemented with bovine milk fat globule membranes (MFGMs) until 6 mo of age had several positive outcomes, including better performance in the cognitive domain of Bayley Scales of Infant and Toddler Development 3rd Edition at 12 mo of age, and higher plasma cholesterol concentrations during the intervention, than infants consuming standard formula (SF).
Food insecurity is associated with magnetic resonance–determined nonalcoholic fatty liver and liver fibrosis in low-income, middle-aged adults with and without HIV
Javier A Tamargo, Kenneth E Sherman, Adriana Campa, Sabrina S Martinez, Tan Li ...
doi : 10.1093/ajcn/nqaa362
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 593–601
Nonalcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in the United States. Food-insecure individuals often depend on low-cost, energy-dense but nutritionally poor foods, resulting in obesity and chronic diseases related to NAFLD.
Maternal gut microbiota reflecting poor diet quality is associated with spontaneous preterm birth in a prospective cohort study
Victoria Gershuni, Yun Li, Michal Elovitz, Hongzhe Li, Gary D Wu ...
doi : 10.1093/ajcn/nqaa361
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 602–611
A processed diet, high in fat and low in fiber, is associated with differences in the gut microbiota and adverse health outcomes in humans; however, little is known about the diet–microbiota relation and its impact on pregnancy. Spontaneous preterm birth (SPTB), a pregnancy outcome with serious short- and long-term consequences, occurs more frequently in black and in obese women in the United States.
Replacing the consumption of red meat with other major dietary protein sources and risk of type 2 diabetes mellitus: a prospective cohort study
Anne Mette L Würtz, Marianne U Jakobsen, Monica L Bertoia, Tao Hou, Erik B Schmidt ...
doi : 10.1093/ajcn/nqaa284
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 612–621
Greater consumption of red meat has been associated with a higher risk of type 2 diabetes mellitus (T2DM). A decreased intake of red meat and simultaneous increased intake of other high-protein foods may be associated with a lower risk of T2DM. These analyses of specific food replacements for red meat may provide more accurate dietary advice.
Genetic, lifestyle, and health-related characteristics of adults without celiac disease who follow a gluten-free diet: a population-based study of 124,447 participants
Thomas J Littlejohns, Amanda Y Chong, Naomi E Allen, Matthew Arnold, Kathryn E Bradbury ...
doi : 10.1093/ajcn/nqaa291
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 622–629
The number of gluten-free diet followers without celiac disease (CD) is increasing. However, little is known about the characteristics of these individuals.
Magnesium intake is associated with a reduced risk of incident liver cancer, based on an analysis of the NIH-American Association of Retired Persons (NIH-AARP) Diet and Health Study prospective cohort
Shailja C Shah, Xiangzhu Zhu, Qi Dai, Richard M Peek, Jr, Martha J Shrubsole
doi : 10.1093/ajcn/nqaa326
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 630–638
Liver cancer incidence and mortality are escalating globally. Magnesium intake has been studied extensively in nonmalignant liver pathology, but the association between dietary intake of magnesium and primary liver malignancy has not been previously evaluated.
Relation of body fat mass and fat-free mass to total mortality: results from 7 prospective cohort studies
Anja M Sedlmeier, Sebastian E Baumeister, Andrea Weber, Beate Fischer, Barbara Thorand ...
doi : 10.1093/ajcn/nqaa339
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 639–646
Fat mass and fat-free mass may play independent roles in mortality risk but available studies on body composition have yielded inconsistent results.
Long-term dietary intake from infancy to late adolescence is associated with gut microbiota composition in young adulthood
Kolade Oluwagbemigun, Aoife N O'Donovan, Kirsten Berding, Katriona Lyons, Ute Alexy ...
doi : 10.1093/ajcn/nqaa340
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 647–656
Gut microbiota composition as influenced by long-term diet may be associated with the risk of adult chronic diseases. Thus, establishing the relation of long-term diet, particularly starting from early life, with adult microbiota composition would be an important research advance.
Sugar-sweetened beverage (SSB) consumption is associated with lower quality of the non-SSB diet in US adolescents and young adults
Alex M Doherty, Allison M Lacko, Barry M Popkin
doi : 10.1093/ajcn/nqaa342
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 657–664
Since 2003–4, the United States has seen large declines in sugar-sweetened beverage (SSB) intake overall, especially among non-Hispanic white (NHW) subpopulations. However, obesity prevalence has not shown comparable declines in the 2 highest SSB-consuming groups, adolescents and young adults. Little is understood about the quality of the diet excluding SSBs (non-SSB diet).
Risk factors for postdischarge mortality following hospitalization for severe acute malnutrition in Zimbabwe and Zambia
Mutsa Bwakura-Dangarembizi, Cherlynn Dumbura, Beatrice Amadi, Deophine Ngosa, Florence D Majo ...
doi : 10.1093/ajcn/nqaa346
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 665–674
Children discharged from hospital following management of complicated severe acute malnutrition (SAM) have a high risk of mortality, especially HIV-positive children. Few studies have examined mortality in the antiretroviral therapy (ART) era.
Healthful dietary patterns and risk of end-stage kidney disease: the Singapore Chinese Health Study
Ting-Ting Geng, Tazeen H Jafar, Nithya Neelakantan, Jian-Min Yuan, Rob M van Dam ...
doi : 10.1093/ajcn/nqaa348
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 675–683
Although adherence to healthful dietary patterns has been associated with a lower risk of kidney function decline in Western populations, evidence in Asian populations remains scanty.
Long-term diet quality is associated with gut microbiome diversity and composition among urban Chinese adults
Danxia Yu, Sang M Nguyen, Yaohua Yang, Wanghong Xu, Hui Cai ...
doi : 10.1093/ajcn/nqaa350
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 684–694
Few population-based studies have evaluated the influence of long-term diet on the gut microbiome, and data among Asian populations are lacking.
The impact of malnutrition on short-term morbidity and mortality in ambulatory patients with heart failure
Shirley Sze, Pierpaolo Pellicori, Jufen Zhang, Joan Weston, Andrew L Clark
doi : 10.1093/ajcn/nqaa311
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 695–705
Malnutrition is common in patients with chronic heart failure (CHF) and is associated with adverse outcomes, but it is uncertain how malnutrition should best be evaluated.
Risk of metabolic syndrome and metabolic phenotypes in relation to biomarker-calibrated estimates of energy and protein intakes: an investigation from the Women's Health Initiative
Alexi Vasbinder, Lesley F Tinker, Marian L Neuhouser, Mary Pettinger, Lauren Hale ...
doi : 10.1093/ajcn/nqaa334
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 706–715
Metabolic syndrome (MetS) is associated with increased mortality independent of BMI, resulting in discordant metabolic phenotypes, such as metabolically healthy obese and metabolically unhealthy normal-weight individuals. Studies investigating dietary intake in MetS have reported mixed results, due in part to the limitations of self-reported measures.
Effect of food variety on intake of a meal: a systematic review and meta-analysis
Rochelle Embling, Aimee E Pink, Jennifer Gatzemeier, Menna Price, Michelle D Lee ...
doi : 10.1093/ajcn/nqaa352
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 716–741
Many studies have shown that food variety—the presence of multiple foods and/or sensory characteristics within and across meals—increases intake. However, studies report mixed findings, and effect size remains unclear.
Associations of lifestyle risk factors with overweight or obesity among adolescents: a multicountry analysis
Sabera Sultana, Md Mizanur Rahman, Byron Sigel, Masahiro Hashizume
doi : 10.1093/ajcn/nqaa337
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 742–750
About 35% of the global burden of disease has roots in adolescence. Health in adolescence is an important determinant of health in adulthood.
Reward-related gustatory and psychometric predictors of weight loss following bariatric surgery: a multicenter cohort study
Gabriela Ribeiro, Marta Camacho, Ana B Fernandes, Gonçalo Cotovio, Sandra Torres ...
doi : 10.1093/ajcn/nqaa349
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Pages 751–761
Reward sensitivity has been proposed as a potential mediator of outcomes for bariatric surgery.
Calendar of Events
doi : 10.1093/ajcn/nqab041
The American Journal of Clinical Nutrition, Volume 113, Issue 3, March 2021, Page 762
Due to the ongoing COVID-19 pandemic, events around the world are being postponed or moved online. For the most current information on events listed below, please visit the meeting's website.
