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Nordic Diet and Inflammation-A Review of Observational and Intervention Studies.
Lankinen, M, Uusitupa, M, Schwab, U
Nutrients. 2019;11(6)
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Inflammation is understood to play a major role in in the development of chronic diseases, such as cardiovascular disease, type 2 diabetes and neurodegenerative diseases. There has been considerable research carried out into the anti-inflammatory effects of particular diets, primarily the Mediterranean diet, which has consistently shown the potential to reduce inflammation and promote health. The positive results are consequential of the high intake of fresh fruit and vegetables along with fresh fish and olive oil along with minimal intake of inflammatory foods such as saturated fats and meat. The Nordic diet has similar requisites to the Mediterranean diet only it includes the use of canola oil as opposed to olive oil and includes the consumption of berries. Researchers attribute obesity as the main cause of increased inflammatory markers with weight loss being the most reliable method of reducing markers. They also stress the importance of good quality food, of which the Nordic diet offers. This review paper looks at the anti-inflammatory effect of foods consumed with the Nordic diet and includes research using randomised and controlled dietary trials and observational studies. Investigations into anti-inflammatory properties of the Nordic diet are in their infancy, so it is not yet possible to stipulate anti-inflammatory effects of the Nordic diet, but future research looks promising.
Abstract
Low-grade inflammation (LGI) has been suggested to be involved in the development of chronic diseases. Healthy dietary patterns, such as the Mediterranean diet (MD), may decrease the markers of LGI. Healthy Nordic diet (HND) has many similarities with MD, but its effects on LGI are less well known. Both of these dietary patterns emphasize the abundant use of fruits and vegetables (and berries in HND), whole grain products, fish, and vegetable oil (canola oil in HND and olive oil in MD), but restrict the use of saturated fat and red and processed meat. The aim of this narrative review is to summarize the results of studies, which have investigated the associations or effects of HND on the markers of LGI. Altogether, only two publications of observational studies and eight publications of intervention trials were found through the literature search. Both observational studies reported an inverse association between the adherence to HND and concentration of high sensitivity C-reactive protein (hsCRP). A significant decrease in the concentration of hsCRP was reported in two out of four intervention studies measuring hsCRP. Single intervention studies reported the beneficial effects on interleukin 1Ra and Cathepsin S. Current evidence suggests the beneficial effects on LGI with HND, but more carefully controlled studies are needed to confirm the anti-inflammatory effects of the HND.
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Sorting out the Value of Cruciferous Sprouts as Sources of Bioactive Compounds for Nutrition and Health.
Abellán, Á, Domínguez-Perles, R, Moreno, DA, García-Viguera, C
Nutrients. 2019;11(2)
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Vegetable sprouts are naturally rich in nutrients and other beneficial compounds. The sprouts of cruciferous vegetables, such as broccoli, kale, radish and pak choi, stand out due to their high contents of glucosinolates and phenolic compounds. The aim of this review was to compile and update the available knowledge on the production, nutritional composition, and health benefits of cruciferous sprouts. A number of studies have found that compounds found in cruciferous sprouts have anti-cancer, anti-inflammatory, and antioxidant capacities. Consumption of cruciferous sprouts contributes to healthy glucose, insulin and fat levels in the blood, and may be beneficial for the treatment of some metabolic disorders, such as type 2 diabetes. There is evidence that compounds in cruciferous sprouts are a useful tool for enhancing phase II enzymes in the liver, and benefit levels of interleukine-6, C-reactive protein, and tumour necrosis factor-α, and inhibition of NF-κB, among others. The active compounds in these sprouts have an influence on several cardiovascular processes, potentially reducing the risk of several diseases. The lack of consistency between studies with regard to sampling schedules, doses, sample size, etc. means that it is not possible at this time to state the effective dose of sprouts or their active compounds needed in order to achieve health benefits. Further research is needed in this area.
Abstract
Edible sprouts with germinating seeds of a few days of age are naturally rich in nutrients and other bioactive compounds. Among them, the cruciferous (Brassicaceae) sprouts stand out due to their high contents of glucosinolates (GLSs) and phenolic compounds. In order to obtain sprouts enriched in these phytochemicals, elicitation is being increasing used as a sustainable practice. Besides, the evidence regarding the bioavailability and the biological activity of these compounds after their dietary intake has also attracted growing interest in recent years, supporting the intake of the natural food instead of enriched ingredients or extracts. Also, there is a growing interest regarding their uses, consumption, and applications for health and wellbeing, in different industrial sectors. In this context, the present review aims to compile and update the available knowledge on the fundamental aspects of production, enrichment in composition, and the benefits upon consumption of diverse edible cruciferous sprouts, which are sources of phenolic compounds and glucosinolates, as well as the evidence on their biological actions in diverse pathophysiological situations and the molecular pathways involved.
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Intermittent Fasting in Cardiovascular Disorders-An Overview.
Malinowski, B, Zalewska, K, Węsierska, A, Sokołowska, MM, Socha, M, Liczner, G, Pawlak-Osińska, K, Wiciński, M
Nutrients. 2019;11(3)
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Intermittent fasting (IF) is an eating pattern that cycles between periods of fasting and eating. IF has gained popularity in recent years with people wanting to lose weight, and it may have many long-term health benefits. In this review, the authors looked at human and animal studies using variations of IF including time restricted eating (TRE), where eating is confined within a specific window during the day (for example 8 hours eating and 16 hours fasting), and alternate day fasting (ADF), where a day of eating normally is alternated with a day of either fasting entirely, or significant calorie restriction. The authors found that IF is related to many beneficial effects on the cardiovascular system, involving atherosclerosis progression, benefits for diabetes mellitus type 2 such as improved glucose metabolism and insulin sensitivity, lowering of blood pressure, and other cardiovascular risk factors (such as lipid profile and inflammation). It is currently unclear whether the benefits of IF are solely due to weight loss or other mechanisms. The success of every type of diet depends on compliance, and IF seems to be as easy or easier to follow than more traditional diets for many people. Fasting is not recommended for people with hormonal imbalances, pregnant and breastfeeding women, and diabetics. People with eating disorders and underweight people are also not recommended to use the intermittent fasting diet. In recent years, the IF diet and its varieties have become increasingly popular. This diet not only serves to reduce body weight but seems to have other long-term health benefits. However, individuals’ current health and situation should be considered before commencing the IF diet.
Abstract
Intermittent fasting is a form of time restricted eating (typically 16 h fasting and 8 h eating), which has gained popularity in recent years and shows promise as a possible new paradigm in the approach to weight loss and the reduction of inflammation, and has many potential long term health benefits. In this review, the authors will incorporate many aspects of fasting, mainly focusing on its effects on the cardiovascular system, involving atherosclerosis progression, benefits for diabetes mellitus type 2, lowering of blood pressure, and exploring other cardiovascular risk factors (such as lipid profile and inflammation).
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Effect of Alpha-Lipoic Acid Supplementation on Endothelial Function and Cardiovascular Risk Factors in Overweight/Obese Youths: A Double-Blind, Placebo-Controlled Randomized Trial.
Tromba, L, Perla, FM, Carbotta, G, Chiesa, C, Pacifico, L
Nutrients. 2019;11(2)
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Children who are obese or overweight are at a higher risk of developing heart disease. Damage to the lining of the blood vessels may be an early indicator of potential heart disease. Alpha-lipoic acid (ALA) is a supplement that has anti-oxidant and anti-inflammatory effects, and has been shown to improve blood vessel function in adults with metabolic diseases, and children with type 1 diabetes. It is not yet known whether ALA supplementation can benefit cardiovascular health in overweight/obese youths. The aim of this double-blind placebo-controlled randomised trial was to investigate whether supplementation with ALA improved endothelial function and risk factors for cardiovascular disease in overweight and obese youths. 64 overweight/obese youths aged 8-16 years old were given either 800mg ALA or a placebo for 12 weeks. All participants were instructed to follow a balanced low-calorie diet and advised to engage in a moderate daily exercise program (60 min/day at least five days a week). At the end of the study, blood vessel function, as assessed by flow-mediated dilation (FMD) of the brachial artery, did not change significantly in either of the groups. However, the basal and peak diameter of the brachial artery significantly increased after ALA treatment, compared to placebo. There were no significant changes between groups or over time for blood pressure, weight or body mass index (BMI), nor were there any significant changes in glucose, insulin or fat levels within the blood. The authors concluded that ALA supplementation improves the tone of blood vessels and may have a beneficial effect on heart health in overweight/obese youths.
Abstract
undefined: Endothelial dysfunction is recognized as an early sign of systemic atherosclerosis, and it represents a therapeutic target to prevent long-term cardiovascular (CV) consequences. Alpha-lipoic acid (ALA) is a commonly used dietary supplement exerting anti-oxidant and anti-inflammatory effects. We investigated whether a three-month treatment with ALA improves endothelial function, as assessed by flow-mediated dilation (FMD) of the brachial artery, and clinical and metabolic risk factors in overweight/obese youths. We enrolled 67 overweight/obese children, and 22 normal-weight metabolically healthy controls. Overweight/obese youths were randomly allocated in a double-blinded manner to receive ALA ( = 34) or placebo ( = 33). Of these, 64 (32 ALA, 32 placebo) completed the follow-up. At baseline, in ALA and placebo groups, FMD was similar, but lower as compared with that in controls ( = 0.045). At three months, within the ALA and placebo groups, FMD did not change significantly. However, the basal and peak diameter of brachial artery significantly increased after ALA treatment as compared to placebo ( = 0.036 and = 0.01, respectively). There were no significant within- and between-group changes for anthropometric and metabolic variables. The results show that ALA supplementation improves vascular tone and may have a beneficial effect on CV health in overweight/obese youths.
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The effect of different sources of fish and camelina sativa oil on immune cell and adipose tissue mRNA expression in subjects with abnormal fasting glucose metabolism: a randomized controlled trial.
de Mello, VD, Dahlman, I, Lankinen, M, Kurl, S, Pitkänen, L, Laaksonen, DE, Schwab, US, Erkkilä, AT
Nutrition & diabetes. 2019;9(1):1
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Dietary fish oils, particularly omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found in oily fish, nuts and seeds have long been researched and purported to have both anti-inflammatory and glucose-stabilising effects when consumed orally and it is widely believed that in reducing low-grade inflammation and stabilising blood glucose levels, the risk of suffering from type 2 diabetes, heart disease or a stroke is reduced. Lean fish on the other hand has been far less researched with regards to its protective effects. This study was a randomised controlled study designed to assess and compare the protective effects of fish oils and Camelina Sativa oil (CSO - a seed oil containing alpha-linolenic acid) on inflammatory-related genes in subjects with suggestive pre-diabetes. Subjects were allocated to a randomised group and instructed to consume a given amount of either fatty fish, lean fish, camelina oil, or no fish/oil (control group). The study was carried out on 72 participants over a 12-week period. Although no significant change could be seen on inflammatory gene expression for the group consuming fatty fish, there was a modest decrease in inflammatory gene markers in the group consuming lean fish and a significant decrease in the group consuming CSO. Implications from this study suggest that CSO exerts its protective effect by reducing inflammation, therefore possibly decreasing the risk of strokes and cardiovascular episodes. The authors suggest that consuming a variety of fish, especially lean fish 4 times/ week could also play a protective role in cardiovascular health and type 2 diabetes.
Abstract
BACKGROUND/OBJECTIVES Molecular mechanisms linking fish and vegetable oil intakes to their healthy metabolic effects may involve attenuation of inflammation. Our primary aim was to examine in a randomized controlled setting whether diets enriched in fatty fish (FF), lean fish (LF) or ALA-rich camelina sativa oil (CSO) differ in their effects on the mRNA expression response of selected inflammation-related genes in peripheral blood mononuclear cells (PBMCs) and subcutaneous adipose tissue (SAT) in subjects with impaired fasting glucose. SUBJECTS/METHODS Samples from 72 participants randomized to one of the following 12-week intervention groups, FF (n = 19), LF (n = 19), CSO (n = 17) or a control group (n = 17), were available for the PBMC study. For SAT, 39 samples (n = 8, n = 10, n = 9, n = 12, respectively) were available. The mRNA expression was measured at baseline and 12 weeks by TaqMan® Low Density Array. RESULTS In PBMCs, LF decreased ICAM1 mRNA expression (P < 0.05), which was different (P = 0.06, Bonferroni correction) from the observed increase in the FF group (P < 0.05). Also, compared to the control group, LF decreased ICAM1 mRNA expression (P < 0.05). Moreover, the change in ICAM1 mRNA expression correlated positively with the intake of FF (P < 0.05) and negatively with the intake of LF (P < 0.05), independently of study group. A diet enriched in CSO, a rich source of alpha-linolenic acid (ALA), decreased PBMC IFNG mRNA expression (P < 0.01). The intake of CSO in the CSO group, but not the increase in plasma ALA proportions, correlated inversely with the IFNG mRNA expression in PBMCs (P = 0.08). In SAT, when compared with the control group, the effect of FF on decreasing IL1RN mRNA expression was significant (P < 0.03). CONCLUSION We propose that CSO intake may partly exert its benefits through immuno-inflammatory molecular regulation in PBMCs, while modulation of ICAM1 expression, an endothelial/vascular-related gene, may be more dependent on the type of fish consumed.
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The Effect of a Pilot Dietary Intervention on Pain Outcomes in Patients Attending a Tertiary Pain Service.
Brain, K, Burrows, TL, Rollo, ME, Hayes, C, Hodson, FJ, Collins, CE
Nutrients. 2019;11(1)
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A recent link between dietary intake and chronic pain has led to increased research in the role of nutrition in pain management. The aim of this pilot study was to determine the impact of dietary consultations with or without nutritional supplement on pain levels and quality of life among 42 adults experiencing chronic pain. Participants were randomised to one of four combinations of intervention components – dietary consultation or waitlist controls and supplement fruit juice or placebo fruit juice. A questionnaire encompassing pain, quality of life and dietary intake were completed at baseline and six weeks upon completion of the intervention. This study found all groups had significant improvements in outcomes of pain level and quality of life. The dietary consultation groups had clinically important improvements in pain outcomes compared to the waitlist control group. Based on these results, the authors conclude a dietitian-delivered dietary intervention can improve pain scores, quality of life and dietary intake among people experiencing chronic pain and warrant the need for a larger scale study.
Abstract
undefined: The aim of this study was to examine the effect of a six-week 2 × 2 design on pain scores, quality of life, and dietary intake in patients attending an Australian tertiary pain clinic. The two intervention components were (1) personalized dietary consultations or waitlist control, and (2) active or placebo dietary supplement (fruit juice). Sixty participants were randomized into one of four groups at baseline (68% female, mean age 49 ± 15 years) with 42 completing the study (70% retention). All groups had statistically significant improvements in three of five pain outcomes. The personalized dietary consultation groups had clinically important improvements in three of five pain outcomes compared to the waitlist control groups. All groups had a statistically significant improvement in six of eight quality-of-life categories post intervention. All groups increased percentage energy from nutrient-dense foods (+5.2 ± 1.4%, < 0.001) with a significant group-by-time effect for percentage energy from total fat ( = 0.024), with the personalized dietary consultations plus placebo fruit juice reporting the largest reduction (-5.7 ± 2.3%). This study indicates that dietitian-delivered dietary intervention can improve pain scores, quality of life, and dietary intake of people experiencing chronic pain. Future research should evaluate efficacy in a full-powered randomized control trial.
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Parity and the use of folic acid supplementation during pregnancy
BMJ Nutrition, Prevention & Health
2019
Abstract
Objective: Folic acid (FA) supplementation has long been recommended before and during pregnancy to reduce the risk of neural tube defects. Factors influencing adherence to FA supplementation have been extensively evaluated, but little is known on the effect of parity. This study comes to examine the association between parity and maternal use of FA prior to and during pregnancy. Methods: In this retrospective population-based study, we identified mothers (N=228 555) of all children (N=578 204) born between the years 2000 and 2016 among members of a large health provider in Israel. Data on FA supplementation purchases were obtained from centralised medical databases. Results: The median (IQR) total dose of FA purchased 12 months prior to child birth among previously nulliparous women (120 mg, 48–240) was significantly (p<0.001) higher than the dose purchased by women with one (90 mg (39–202)) and two prior births (84 mg (36–182)). The dose was even lower in women for three or more prior births (75 mg (36–165)). Despite the overall increasing secular trend in FA purchases during the study period, the negative relationship with parity remained. Conclusions: Adherence to FA supplementation is negatively associated with parity. Women with increasing parity may be at higher risk for pregnancy complications associated with low FA levels. The results of this study may inform the design of interventions to specifically increase adherence to FA supplementations among multiparous women.
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Disruption of the Gut Ecosystem by Antibiotics.
Yoon, MY, Yoon, SS
Yonsei medical journal. 2018;59(1):4-12
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The gut microbiome is a complex ecosystem of different micro-organisms, such as bacteria, viruses and fungi, living in the human intestines. It’s involved in numerous functions, such as extracting energy and nutrition from food, protecting against disease-causing microorganisms, and supporting the immune system of the host, and therefore affecting human health and disease. This paper is a review of studies on the effects of antibiotics on the gut microbiota. It outlines how different types of antibiotics can alter the intestinal environment and the composition of the microbes, resulting in various physiological changes that can trigger disease. Relevant mechanisms, such as inflammatory response and the use of intestinal nutrients by infectious bacteria are discussed. Finally, it discusses faecal microbiota transplantation (FMT) and probiotics as treatment approaches, aimed at restoring a disturbed intestinal environment.
Abstract
The intestinal microbiota is a complex ecosystem consisting of various microorganisms that expands human genetic repertoire and therefore affects human health and disease. The metabolic processes and signal transduction pathways of the host and intestinal microorganisms are intimately linked, and abnormal progression of each process leads to changes in the intestinal environment. Alterations in microbial communities lead to changes in functional structures based on the metabolites produced in the gut, and these environmental changes result in various bacterial infections and chronic enteric inflammatory diseases. Here, we illustrate how antibiotics are associated with an increased risk of antibiotic-associated diseases by driving intestinal environment changes that favor the proliferation and virulence of pathogens. Understanding the pathogenesis caused by antibiotics would be a crucial key to the treatment of antibiotic-associated diseases by mitigating changes in the intestinal environment and restoring it to its original state.
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Crying Time and RORγ/FOXP3 Expression in Lactobacillus reuteri DSM17938-Treated Infants with Colic: A Randomized Trial.
Savino, F, Garro, M, Montanari, P, Galliano, I, Bergallo, M
The Journal of pediatrics. 2018;192:171-177.e1
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The causes of infant colic are unknown, but growing evidence shows a possible link with the gut microbiome. Increased inflammation has also been found in infants with colic, and this could be linked to dysbiosis. This double-blind, placebo-controlled clinical trial investigated whether supplementation with the probiotic Lactobacillus reuteri (L reuteri) DSM 17938 could reduce the crying time and modify inflammation in a group of infants with colic. Infants enrolled in the trial were less than 12 weeks old, with a healthy birth weight and predominantly breastfed. Infants with colic were given either 5 million colony-forming units (CFU) of L reuteri DSM 17938 or a placebo daily for 1 month. Crying times were significantly shortened among infants with colic given the probiotic, whilst the concentration of transcription factors for cells that help to regulate the immune system increased significantly. Infants treated with the probiotic showed an increase in the percentage of Lactobacillus and a decrease in the inflammatory marker faecal calprotectin. The authors concluded that their findings support the hypothesis that dysbiosis and inflammation may contribute to the onset of infant colic.
Abstract
OBJECTIVES To evaluate crying time, retinoid-related orphan receptor-γ (RORγ) and forkhead box P3 (FOXP3) messenger RNA levels (transcription factors that can modulate T cell responses to gut microbes), and to investigate gut microbiota and fecal calprotectin in infants treated with Lactobacillus reuteri for infantile colic. STUDY DESIGN A double-blind, placebo-controlled randomized trial was conducted in primary care in Torino from August 1, 2015 to September 30, 2016. Patients suffering from infantile colic were randomly assigned to receive daily oral L reuteri (1 × 10 colony forming unit) or placebo for 1 month. Daily crying times were recorded in a structured diary. FOXP3 and RORγ messenger RNA in the peripheral blood was assessed with real-time TaqMan reverse transcription polymerase chain reaction. Gut microbiota and fecal calprotectin were evaluated. RESULTS After infants with colic were supplemented with L reuteri DSM 17938 for 30 days, crying times were significantly shorter among infants with colic in the probiotic group compared with infants in the placebo group (74.67 ± 25.04 [IQR = 79] minutes /day vs 147.85 [IQR = 135] minutes /day [P = .001]). The FOXP3 concentration increased significantly (P = .009), resulting in decreased RORγ/FOXP3 ratios: 0.61 (IQR = 0.60) at day 0 and 0.48 (IQR = 0.28) at day 30 (P = .028). Furthermore, the probiotic increased the percentage of Lactobacillus (P = .049) and decreased fecal calprotectin (P = .0001). CONCLUSIONS Infants with colic treated with L reuteri for 30 days had a significantly decreased crying time and an increased FOXP3 concentration, resulting in a decreased RORγ/FOXP3 ratio. The treatment reduced fecal calprotectin. TRIAL REGISTRATION ClinicalTrials.gov: NCT00893711.
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Swimming pool exposure is associated with autonomic changes and increased airway reactivity to a beta-2 agonist in school aged children: A cross-sectional survey.
Cavaleiro Rufo, J, Paciência, I, Silva, D, Martins, C, Madureira, J, Oliveira Fernandes, E, Padrão, P, Moreira, P, Delgado, L, Moreira, A
PloS one. 2018;13(3):e0193848
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Studies have shown an association between swimming in chemically-treated pools and a higher risk of asthma in children, although the mechanism is not fully understood. This study aimed to investigate how swimming pool attendance influences lung and nervous system function in school-aged children. Around 800 children were classified as current swimmers (CS), past swimmers (PS) or non-swimmers (NS). The children underwent several tests to determine their lung function and allergic response to common allergens. Parasympathetic nervous system function was tested by measuring the speed at which their pupils constricted in response to light. The current swimmers group had significantly lower pupil constriction speeds compared to PS and NS, suggesting a poorer functioning of the autonomic nervous system, possibly due to inflammation resulting from swimming pool chemical exposure. CS experienced greater constriction of the airways compared to NS. A non-significant trend for a higher risk of asthma, atopic eczema and rhinitis, was observed in swimmers. The authors concluded that swimming pool attendance appears to be associated with autonomic nervous system changes and increased baseline airway smooth muscle constriction even in children without asthma.
Abstract
BACKGROUND Endurance swimming exercises coupled to disinfection by-products exposure has been associated with increased airways dysfunction and neurogenic inflammation in elite swimmers. However, the impact of swimming pool exposure at a recreational level on autonomic activity has never been explored. Therefore, this study aimed to investigate how swimming pool attendance is influencing lung and autonomic function in school-aged children. METHODS A total of 858 children enrolled a cross sectional survey. Spirometry and airway reversibility to beta-2 agonist, skin-prick-tests and exhaled nitric oxide measurements were performed. Pupillometry was used to evaluate autonomic nervous function. Children were classified as current swimmers (CS), past swimmers (PS) and non-swimmers (NS), according to the amount of swimming practice. RESULTS Current swimmers group had significantly lower maximum and average pupil constriction velocities when compared to both PS and NS groups (3.8 and 5.1 vs 3.9 and 5.3 vs 4.0 and 5.4 mm/s, p = 0.03 and p = 0.01, respectively). Moreover, affinity to the beta-2 agonist and levels of exhaled nitric oxide were significantly higher in CS when compared to NS (70 vs 60 mL and 12 vs 10 ppb, p<0.01 and p = 0.03, respectively). A non-significant trend for a higher risk of asthma, atopic eczema and allergic rhinitis was found with more years of swimming practice, particularly in atopic individuals (β = 1.12, 1.40 and 1.31, respectively). After case-case analysis, it was possible to observe that results were not influenced by the inclusion of individuals with asthma. CONCLUSIONS Concluding, swimming pool attendance appears to be associated with autonomic changes and increased baseline airway smooth muscle constriction even in children without asthma.
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