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Ultraprocessed foods and cardiovascular health: it's not just about the nutrients
Mark Lawrence
doi : 10.1093/ajcn/nqaa333
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 257–258,
For almost a century, a food's nutritional quality was generally assessed in terms of its nutrient content. From time to time adjustments to this nutrient-oriented view of nutritional quality were made to accommodate advances in nutrition science. For example, with knowledge that synergies among nutrients can affect their bioavailability (1), it became broadly accepted wisdom that, in terms of its health potential, a food is “more than the sum of the nutrients it contains”.
Carotenoids and healthy aging: the fascination continues
Benedetta Bartali, Richard D Semba
doi : 10.1093/ajcn/nqaa364
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 259–260, https://doi.org/10.1093/ajcn/nqaa364
Red, orange, and yellow pigments, known as carotenoids, are widespread and abundant in nearly all organisms in the plant and animal kingdoms. Animals, with rare exception, are unable to synthesize carotenoids and obtain them by consuming plants. There are >1000 carotenoids in nature, of which >30 have been described in human milk and serum. From the 1830s through 1930s, major carotenoids in the human diet were identified in plants: carotene from carrot, lutein from plant leaves, lycopene from tomato, zeaxanthin from corn, and cryptoxanthin from papaya. During the same period, carotenoids were isolated from animal biofluids and tissues such as plasma, human milk, placenta, corpus...
Short-term periods of strenuous physical activity lower iron absorption
Gary M Brittenham
doi : 10.1093/ajcn/nqaa365
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 261–262,
In this issue of the American Journal of Clinical Nutrition, Hennigar and colleagues (1) report a meticulously designed and controlled investigation with the overall finding that strenuous physical activity decreases iron absorption compared to rest, as assessed using stable iron isotope (54Fe, 57Fe) appearance curves. In brief, 10 volunteer, healthy, active-duty military personnel completed a randomized, cross-over, controlled-feeding clinical trial involving two 72-h periods of simulated sustained military and training operations. These episodes of physical activity consisted of three ?60- to 120-min steady-state exercise bouts per day, required high energy expenditure (?5000 to 6000 total kcal/d), and were notable...
The concept of “food addiction” helps inform the understanding of overeating and obesity: YES
Ashley N Gearhardt, Johannes Hebebrand
doi : 10.1093/ajcn/nqaa343
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 263–267
Addictive substances such as opiates and other drugs are highly reinforcing and some (but not all) individuals consume them compulsively. Highly processed (HP) foods have unnaturally high concentrations of refined carbohydrates and fat. These foods are highly reinforcing and some (but not all) individuals consume them compulsively. HP foods, like addictive substances, are more effective in activating reward-related neural systems than minimally processed foods. More importantly, HP foods are associated with the behavioral indicators of addiction: diminished control over consumption, strong craving, continued use despite negative consequences, and repeated failed attempts to reduce or eliminate intake. Thus, HP foods are key in addictive patterns of food intake. Like addictive drugs, HP foods are complex, human-made substances designed to effectively deliver reinforcing ingredients (e.g., refined carbohydrates, fat). Withdrawal and tolerance are not necessary for an addiction classification; however, HP foods can trigger both these processes. On a public health level, the negative consequences of HP foods are high, even for those without clinically relevant levels of addictive eating. The recognition that some foods can be addictive will inform clinical obesity treatment and underscore the importance of environmentally focused policy interventions.
The concept of “food addiction” helps inform the understanding of overeating and obesity: NO
Johannes Hebebrand, Ashley N Gearhardt
doi : 10.1093/ajcn/nqaa344
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 268–273
Overeating is a complex behavioral phenotype in terms of both physiology and psychology. The mere transference of the diagnostic criteria for substance use disorders to define food addiction is too simplistic, for the following reasons: 1) a range of somatic and mental disorders require exclusion; 2) food addiction requires distinction from the physiological need to ingest sufficient calories to maintain a high body weight; 3) intentional weight loss can induce an eating behavior mimicking food addiction; 4) the concept lacks validation, especially in light of the high prevalence of “food addiction” in patients with anorexia nervosa; and 5) this construct has not led to novel and successful treatments for overeating and obesity. The concept of food addiction has the potential to distract from the need for focus on environmental influencers to combat the obesity pandemic.
The concept of “food addiction” helps inform the understanding of overeating and obesity: Debate Consensus
Ashley N Gearhardt, Johannes Hebebrand
doi : 10.1093/ajcn/nqaa345
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 274–276
There is an ongoing scientific debate about whether unhealthy, highly processed foods are addictive and whether this contributes to overeating and obesity. Through this debate series, we identified numerous points of consensus, including that 1) addictive-like eating exists, 2) mechanisms implicated in substance-related and addictive disorders contribute to overeating and obesity, and 3) food industry practices are also a key contributor to this phenomenon. We also agree that obesity, a multifaceted condition, is not synonymous with addictive-like eating and that further research is needed to clarify the understanding of addictive-like eating. Disagreements remain regarding the strength of evidence that highly processed foods are addictive, the appropriate framework for conceptualizing addictive-like eating, and the societal implications of identifying unhealthy, highly processed foods as addictive. Finally, we highlight future research needed to address existing gaps in the scientific literature that underlie continuing controversies, most notably the need for scientific consensus about what measures should be used to evaluate whether highly processed foods are addictive.
The homeoviscous adaptation to dietary lipids (HADL) model explains controversies over saturated fat, cholesterol, and cardiovascular disease risk
Marit Kolby Zin?cker, Karianne Svendsen, Simon Nitter Dankel
doi : 10.1093/ajcn/nqaa322
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 277–289,
SFAs play the leading role in 1 of the greatest controversies in nutrition science. Relative to PUFAs, SFAs generally increase circulating concentrations of LDL cholesterol, a risk factor for atherosclerotic cardiovascular disease (ASCVD). However, the purpose of regulatory mechanisms that control the diet-induced lipoprotein cholesterol dynamics is rarely discussed in the context of human adaptive biology. We argue that better mechanistic explanations can help resolve lingering controversies, with the potential to redefine aspects of research, clinical practice, dietary advice, public health management, and food policy. In this paper we propose a novel model, the homeoviscous adaptation to dietary lipids (HADL) model, which explains changes in lipoprotein cholesterol as adaptive homeostatic adjustments that serve to maintain cell membrane fluidity and hence optimal cell function. Due to the highly variable intake of fatty acids in humans and other omnivore species, we propose that circulating lipoproteins serve as a buffer to enable the rapid redistribution of cholesterol molecules between specific cells and tissues that is necessary with changes in dietary fatty acid supply. Hence, circulating levels of LDL cholesterol may change for nonpathological reasons. Accordingly, an SFA-induced raise in LDL cholesterol in healthy individuals could represent a normal rather than a pathologic response. These regulatory mechanisms may become disrupted secondarily to pathogenic processes in association with insulin resistance and the presence of other ASCVD risk factors, as supported by evidence showing diverging lipoprotein responses in healthy individuals as opposed to those with metabolic disorders such as insulin resistance and obesity. Corresponding with the model, we suggest alternative contributing factors to the association between elevated LDL cholesterol concentrations and ASCVD, involving dietary factors beyond SFAs, such as an increased endotoxin load from diet–gut microbiome interactions and subsequent chronic low-grade inflammation that interferes with fine-tuned signaling pathways.
The 2020 Nobel Peace Prize rewards the persistent vision of a world without hunger, famine, or malnutrition
Patrick Webb
doi : 10.1093/ajcn/nqaa355
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 290–293,
Why did the UN World Food Programme (WFP) receive the 2020 Nobel Peace Prize? And what does that have to do with nutrition? The answer to both questions is embedded in renewed concerns globally about food insecurity.
Food substitution models for nutritional epidemiology
Daniel B Ibsen, Anne Sofie D Laursen, Anne Mette L Würtz, Christina C Dahm, Eric B Rimm ...
doi : 10.1093/ajcn/nqaa315
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 294–303,
The advantage of using specified substitution analysis in nutritional epidemiology has been clearly demonstrated in studies of macronutrient intake and disease risk. However, the method has not been widely applied in studies of food intake. The aim of this article is to describe and compare the interpretation and application of different food substitution models in epidemiologic studies on diet and disease development. Both theoretically and in the context of a specific example, we discuss methodologic issues to be considered, including modeling of food substitutions using diet at a single time point or at multiple time points (focusing on dietary changes), choice of substitution unit, adjustment for total energy intake, and adjustment for confounding. We argue that specified food substitution analyses can be used to identify optimal food composition of the diet and that these analyses are thus highly relevant to inform public health policy decision makers.
Associations of prenatal methylmercury exposure and maternal polyunsaturated fatty acid status with neurodevelopmental outcomes at 7 years of age: results from the Seychelles Child Development Study Nutrition Cohort 2
J J Strain, Tanzy M Love, Alison J Yeates, Daniel Weller, Maria S Mulhern ...
doi : 10.1093/ajcn/nqaa338
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 304–313
Fish is a primary source of protein and n-3 PUFA but also contains methylmercury (MeHg), a naturally occurring neurotoxicant to which, at sufficient exposure levels, the developing fetal brain is particularly sensitive.
Liraglutide after diet-induced weight loss for pain and weight control in knee osteoarthritis: a randomized controlled trial
Henrik Gudbergsen, Anders Overgaard, Marius Henriksen, Eva Ejlersen W?hrens, Henning Bliddal ...
doi : 10.1093/ajcn/nqaa328
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 314–323
Weight loss is critical for preventing and managing obesity-related diseases. There is a notable lack of valid and reliable means to manage patients with overweight/obesity and knee osteoarthritis (KOA).
Eucaloric diets enriched in palm olein, cocoa butter, and soybean oil did not differentially affect liver fat concentration in healthy participants: a 16-week randomized controlled trial
Welma Stonehouse, Domenico Sergi, Bianca Benassi-Evans, Genevieve James-Martin, Nathan Johnson ...
doi : 10.1093/ajcn/nqaa347
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 324–337
Effects of dietary fat quality on liver fat remain to be elucidated. Inconsistent evidence may be influenced by fatty acid saturation, chain-length, and regio-specificity within triacylglycerol (TAG) molecules.
A prospective study of waist circumference trajectories and incident cardiovascular disease in China: the Kailuan Cohort Study
Liang Wang, Yujin Lee, Yuntao Wu, Xinyuan Zhang, Cheng Jin ...
doi : 10.1093/ajcn/nqaa331
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 338–347
Single measurements of waist circumference (WC) predict the incident cardiovascular disease (CVD); however, long-term patterns of WC and their association with the incidence of CVD are poorly characterized.
Development and validation of nomograms for the prediction of low muscle mass and radiodensity in gastric cancer patients
Feng-Min Zhang, Xiao-Lei Chen, Qian Wu, Wen-Xi Dong, Qian-Tong Dong ...
doi : 10.1093/ajcn/nqaa305
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 348–358
The skeletal muscle mass index (SMI) and skeletal muscle radiodensity (SMD) are important components of sarcopenia and malnutrition. However, their assessment requires additional resources in cancer patients, which is inconvenient for the early detection of sarcopenia and malnutrition.
Energy deficit increases hepcidin and exacerbates declines in dietary iron absorption following strenuous physical activity: a randomized-controlled cross-over trial
Stephen R Hennigar, James P McClung, Adrienne Hatch-McChesney, Jillian T Allen, Marques A Wilson ...
doi : 10.1093/ajcn/nqaa289
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 359–369,
Strenuous physical activity promotes inflammation and depletes muscle glycogen, which may increase the iron regulatory hormone hepcidin. Hepcidin reduces dietary iron absorption and may contribute to declines in iron status frequently observed following strenuous physical activity.
Acute dose-response effect of coffee-derived chlorogenic acids on the human vasculature in healthy volunteers: a randomized controlled trial
Louise H Naylor, Diane Zimmermann, Marjorie Guitard-Uldry, Laure Poquet, Antoine Lévêques ...
doi : 10.1093/ajcn/nqaa312
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 370–379
Epidemiological studies have reported lower risk of cardiovascular disease with moderate coffee consumption. In addition, emerging evidence indicates that consumption of coffee beverages enriched in chlorogenic acids (CGAs) may influence blood pressure and endothelial function, suggesting that the beneficial cardiovascular effect of coffee may relate to its CGA content.
Infections and systemic inflammation are associated with lower plasma concentration of insulin-like growth factor I among Malawian children
Kenneth Maleta, Yue-Mei Fan, Juho Luoma, Ulla Ashorn, Jaden Bendabenda ...
doi : 10.1093/ajcn/nqaa327
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 380–390,
Insulin-like growth factor I (IGF-I) is the most important hormonal promoter of linear growth in infants and young children.
Effects of fructose restriction on liver steatosis (FRUITLESS); a double-blind randomized controlled trial
Nynke Simons, Pandichelvam Veeraiah, Pomme I H G Simons, Nicolaas C Schaper, M Eline Kooi ...
doi : 10.1093/ajcn/nqaa332
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 391–400
There is an ongoing debate on whether fructose plays a role in the development of nonalcoholic fatty liver disease.
Combined association of general and central obesity with incidence and mortality of cancers in 22 sites
Solange Parra-Soto, Fanny Petermann-Rocha, Jirapitcha Boonpor, Stuart R Gray, Jill P Pell ...
doi : 10.1093/ajcn/nqaa335
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 401–409
Body mass index (BMI) and waist circumference (WC) are measures of general and central obesity, respectively, and both have been shown to be associated with cancer. However, there is insufficient evidence of their combined association with the risk of cancer.
Dietary leucine requirement of older men and women is higher than current recommendations
Sylwia Szwiega, Paul B Pencharz, Mahroukh Rafii, Mackenzie Lebarron, Jessica Chang ...
doi : 10.1093/ajcn/nqaa323
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 410–419,
Current national (34 mg . kg?1 . d?1) and international (39 mg kg?1 . d?1) recommendations for leucine in older adults are based on data from young adults. Evidence suggests that the leucine requirements of older adults are higher than those of young adults.
The effect of bovine colostrum/egg supplementation compared with corn/soy flour in young Malawian children: a randomized, controlled clinical trial
Tatiana Bierut, Laura Duckworth, Mark Grabowsky, M Isabel Ordiz, Marie L Laury ...
doi : 10.1093/ajcn/nqaa325
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 420–427
Bovine colostrum with egg powder (BC/egg) is rich in essential amino acids and immunoactive compounds.
Association between ultraprocessed food intake and cardiovascular health in US adults: a cross-sectional analysis of the NHANES 2011–2016
Zefeng Zhang, Sandra L Jackson, Euridice Martinez, Cathleen Gillespie, Quanhe Yang
doi : 10.1093/ajcn/nqaa276
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 428–436,
Higher intake of ultraprocessed foods (UPFs) might be associated with increased risk of cardiovascular disease.
Total carotenoid intake is associated with reduced loss of grip strength and gait speed over time in adults: The Framingham Offspring Study
Shivani Sahni, Alyssa B Dufour, Roger A Fielding, Anne B Newman, Douglas P Kiel ...
doi : 10.1093/ajcn/nqaa288
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 437–445
Lower antioxidant serum concentrations have been linked to declines in lean mass and physical function in older adults. Yet population data on the effect of dietary antioxidants on loss of muscle strength and physical function are lacking.
Ultra-processed food consumption is associated with increased risk of all-cause and cardiovascular mortality in the Moli-sani Study
Marialaura Bonaccio, Augusto Di Castelnuovo, Simona Costanzo, Amalia De Curtis, Mariarosaria Persichillo ...
doi : 10.1093/ajcn/nqaa299
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 446–455,
Consumption of ultra-processed food (UPF) is gaining growing attention in relation to disease/mortality risk, but less is known on the main nutritional factors or biological mechanisms potentially underlying such associations.
Low vitamin D status is associated with hearing loss in the elderly: a cross-sectional study
Betsy Szeto, Chris Valentini, Anil K Lalwani
doi : 10.1093/ajcn/nqaa310
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 456–466
The elderly are at increased risk of both hearing loss (HL) and osteoporosis. Bone mineral density (BMD) has been putatively linked to HL. However, the roles of serum calcium concentrations and vitamin D status have yet to be elucidated.
Meal regularity is associated with self-esteem among grade 5 children
Katherine F Eckert, Mark Asbridge, Leslie Anne Campbell, Sam Stewart, Mark Bennett ...
doi : 10.1093/ajcn/nqaa321
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 467–475
Meal regularity is associated with many aspects of mental health. However, few studies have examined whether a relationship exists between meal regularity and self-esteem in children.
A high-protein total diet replacement increases energy expenditure and leads to negative fat balance in healthy, normal-weight adults
Camila L P Oliveira, Normand G Boulé, Arya M Sharma, Sarah A Elliott, Mario Siervo ...
doi : 10.1093/ajcn/nqaa283
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 476–487
High-protein diets and total diet replacements are becoming increasingly popular for weight loss; however, further research is needed to elucidate their impact on the mechanisms involved in weight regulation.
Corrigendum to: A high-protein total diet replacement increases energy expenditure and leads to negative fat balance in healthy, normal-weight adults. Am J Clin Nutr 2021;113:476–487
doi : 10.1093/ajcn/nqaa391
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Pages 488–489
Corrigendum to: A high-protein total diet replacement increases energy expenditure and leads to negative fat balance in healthy, normal-weight adults. Am J Clin Nutr 2021;113:476–487.
Calendar of Events
doi : 10.1093/ajcn/nqaa446
The American Journal of Clinical Nutrition, Volume 113, Issue 2, February 2021, Page 490
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.
