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Comparison of the Effects of a Bean-Based and a White Rice-Based Breakfast Diet on Postprandial Glucose and Insulin Levels in Chinese Patients with Type 2 Diabetes.
Xiong, Q, Li, Z, Nie, R, Meng, X, Yang, XJ
Medical science monitor : international medical journal of experimental and clinical research. 2021;:e930349
Abstract
BACKGROUND This study compared the effects of a bean-based and a white rice-based breakfast diet on postprandial glucose and insulin levels in Chinese patients with type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS We recruited 63 patients with T2DM. The patients participated in the randomized 2×2 crossover trial. The bean-based diet group and white rice control group were matched for 50 g of available carbohydrate at breakfast. The patients followed the diets for 3 days. Vein blood samples were collected at 0, 30, 60, 120, and 180 min after eating. Data were analyzed using a repeated-measures analysis of variance. The results are expressed as the mean±standard error of mean (SEM) or as the median with interquartile range values. RESULTS Compared with the white rice control, postprandial glucose was significantly lower with the bean-based diet treatments at 60 min (P=0.004), 120 min (P=0.000), and 180 min (P=0.000). The insulin levels of the bean-based diet group were significantly higher at 60 min (P=0.013). The C-peptide levels of the bean-based diet group were significantly higher at 30 min (P=0.042) and 60 min (P=0.005) postprandial. The glucose area under the curve (AUC) showed a similar trend (P=0.000). There were no statistically significant differences in the AUC of insulin and C-peptide, except C-peptide AUC at 0 to 60 min (P=0.027). CONCLUSIONS Compared with a white rice-based breakfast, a bean-based diet significantly reduced postprandial glucose levels and promoted insulin secretion. These results support a dietary approach to reduce postprandial hyperglycemia.
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Dietary Nutrient Intake and Progression to Late Age-Related Macular Degeneration in the Age-Related Eye Disease Studies 1 and 2.
Agrón, E, Mares, J, Clemons, TE, Swaroop, A, Chew, EY, Keenan, TDL, ,
Ophthalmology. 2021;(3):425-442
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PURPOSE To analyze associations between the dietary intake of multiple nutrients and risk of progression to late age-related macular degeneration (AMD), its subtypes, and large drusen. DESIGN Post hoc analysis of 2 controlled clinical trial cohorts: Age-Related Eye Disease Study (AREDS) and AREDS2. PARTICIPANTS Eyes with no late AMD at baseline among AREDS participants (n = 4504) and AREDS2 participants (n = 3738) totaled 14 135 eyes. Mean age was 71.0 years (standard deviation, 6.7 years), and 56.5% of patients were women. METHODS Fundus photographs were collected at annual study visits and graded centrally for late AMD. Dietary intake of multiple nutrients was calculated from food frequency questionnaires. MAIN OUTCOME MEASURES Progression to late AMD, geographic atrophy (GA), neovascular AMD, and (separate analyses) large drusen. RESULTS Over median follow-up of 10.2 years, of the 14 135 eyes, 32.7% progressed to late AMD. For 9 nutrients, intake quintiles 4 or 5 (vs. 1) were associated significantly (P ≤ 0.0005) with decreased risk of late AMD: vitamin A, vitamin B6, vitamin C, folate, β-carotene, lutein and zeaxanthin, magnesium, copper, and alcohol. For 3 nutrients, quintiles 4 or 5 were associated significantly with increased risk: saturated fatty acid, monounsaturated fatty acid, and oleic acid. Similar results were observed for GA. Regarding neovascular AMD, 9 nutrients were associated nominally with decreased risk-vitamin A, vitamin B6, β-carotene, lutein and zeaxanthin, magnesium, copper, docosahexaenoic acid, omega-3 fatty acid, and alcohol-and 3 nutrients were associated with increased risk-saturated fatty acid, monounsaturated fatty acid, and oleic acid. In separate analyses (n = 5399 eyes of 3164 AREDS participants), 12 nutrients were associated nominally with decreased risk of large drusen. CONCLUSIONS Higher dietary intake of multiple nutrients, including minerals, vitamins, and carotenoids, is associated with decreased risk of progression to late AMD. These associations are stronger for GA than for neovascular AMD. The same nutrients also tend to show protective associations against large drusen development. Strong genetic interactions exist for some nutrient-genotype combinations, particularly omega-3 fatty acids and CFH. These data may justify further research into underlying mechanisms and randomized trials of supplementation.
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The Relation between Red Meat and Whole-Grain Intake and the Colonic Mucosal Barrier: A Cross-Sectional Study.
Jawhara, M, Sørensen, SB, Heitmann, BL, Halldórsson, ÞI, Pedersen, AK, Andersen, V
Nutrients. 2020;(6)
Abstract
The Colonic Mucosal Barrier (CMB) is the site of interaction between the human body and the colonic microbiota. The mucus is the outer part of the CMB and is considered as the front-line defense of the colon. It separates the host epithelial lining from the colonic content, and it has previously been linked to health and diseases. In this study, we assessed the relationship between red meat and whole-grain intake and (1) the thickness of the colonic mucus (2) the expression of the predominant mucin gene in the human colon (MUC2). Patients referred to colonoscopy at the University Hospital of Southern Denmark- Sonderjylland were enrolled between June 2017 and December 2018, and lifestyle data was collected in a cross-sectional study design. Colonic biopsies, blood, urine, and fecal samples were collected. The colonic mucus and bacteria were visualized by immunostaining and fluorescence in situ hybridization techniques. We found a thinner mucus was associated with high red meat intake. Similarly, the results suggested a thinner mucus was associated with high whole-grain intake, albeit to a lesser extent than red meat. This is the first study assessing the association between red meat and whole-grain intake and the colonic mucus in humans. This study is approved by the Danish Ethics Committee (S-20160124) and the Danish Data Protecting Agency (2008-58-035). A study protocol was registered at clinical trials.gov under NCT04235348.
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Dietary Insulin Load and Cancer Recurrence and Survival in Patients With Stage III Colon Cancer: Findings From CALGB 89803 (Alliance).
Morales-Oyarvide, V, Yuan, C, Babic, A, Zhang, S, Niedzwiecki, D, Brand-Miller, JC, Sampson-Kent, L, Ye, X, Li, Y, Saltz, LB, et al
Journal of the National Cancer Institute. 2019;(2):170-179
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BACKGROUND Evidence suggests that diets inducing postprandial hyperinsulinemia may be associated with increased cancer-related mortality. The goal of this study was to assess the influence of postdiagnosis dietary insulin load and dietary insulin index on outcomes of stage III colon cancer patients. METHODS We conducted a prospective observational study of 1023 patients with resected stage III colon cancer enrolled in an adjuvant chemotherapy trial who reported dietary intake halfway through and six months after chemotherapy. We evaluated the association of dietary insulin load and dietary insulin index with cancer recurrence and survival using Cox proportional hazards regression adjusted for potential confounders; statistical tests were two-sided. RESULTS High dietary insulin load had a statistically significant association with worse disease-free survival (DFS), comparing the highest vs lowest quintile (adjusted hazard ratio [HR] = 2.77, 95% confidence interval [CI] = 1.90 to 4.02, Ptrend < .001). High dietary insulin index was also associated with worse DFS (highest vs lowest quintile, HR = 1.75, 95% CI = 1.22 to 2.51, Ptrend= .01). The association between higher dietary insulin load and worse DFS differed by body mass index and was strongest among patients with obesity (HR = 3.66, 95% CI = 1.88 to 7.12, Pinteraction = .04). The influence of dietary insulin load on cancer outcomes did not differ by mutation status of KRAS, BRAF, PIK3CA, TP53, or microsatellite instability. CONCLUSIONS Patients with resected stage III colon cancer who consumed a high-insulinogenic diet were at increased risk of recurrence and mortality. These findings support the importance of dietary management following resection of colon cancer, and future research into underlying mechanisms of action is warranted.
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A 5Ad Dietary Protocol for Functional Bowel Disorders.
Ibrahim, F, Stribling, P
Nutrients. 2019;(8)
Abstract
Functional bowel disorders (FBDs) affect around 20% of the population worldwide and are associated with reduced quality of life and high healthcare costs. Dietary therapies are frequently implemented to assist with symptom relief in these individuals, however, there are concerns regarding their complexity, restrictiveness, nutritional adequacy, and effectiveness. Thus, to overcome these limitations, a novel approach, the 5Ad Dietary Protocol, was designed and tested for its efficacy in reducing the severity of a range of gastrointestinal symptoms in 22 subjects with FBDs. The protocol was evaluated in a repeated measures MANOVA design (baseline week and intervention week). Measures of stool consistency and frequency were subtyped based on the subject baseline status. Significant improvements were seen in all abdominal symptom measures (p < 0.01). The effect was independent of body mass index (BMI), age, gender, physical activity level, and whether or not the subjects were formally diagnosed with irritable bowel syndrome (IBS) prior to participation. Stool consistency and frequency also improved in the respective contrasting subtypes. The 5Ad Dietary Protocol proved to be a promising universal approach for varying forms and severities of FBDs. The present study paves the way for future research encompassing a longer study duration and the exploration of underlying physiological mechanisms.
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The investigation of diet recovery after distal gastrectomy.
Kim, TH, Lee, YJ, Bae, K, Park, JH, Hong, SC, Jung, EJ, Ju, YT, Jeong, CY, Park, TJ, Park, M, et al
Medicine. 2019;(41):e17543
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This study aims to investigate the adaptation process of the alimentary tract after distal gastrectomy and understand the impact of remnant stomach volume (RSV) on diet recovery.One year after gastrectomy, although patients' oral intake had increased, the RSV was decreased and small bowel motility was enhanced. Patients with a larger RSV showed no additional benefits regarding nutritional outcomes.We prospectively enrolled patients who underwent distal gastrectomy with Billroth II reconstruction to treat gastric cancer at a tertiary hospital cancer center between September 2009 and February 2012. Demographic data, diet questionnaires, computed tomography (CT), and contrast fluoroscopy findings were collected. Patients were divided into 2 groups according to the RSV calculated using CT gastric volume measurements (large vs small). Dietary habits and nutritional status were compared between the groups.Seventy-eight patients were enrolled. Diet volume recovered to 90% of baseline by the 36 postoperative month, and RSV was 70% of baseline at 6 months after surgery and gradually decreased over time. One year after surgery, small bowel transit time was 75% compared to the 1st postoperative month (P < .05); however, transit time in the esophagus and remnant stomach showed no change in any studied interval. Compared to patients with a small RSV, those with a large RSV showed no differences in diet volume, habits, or other nutritional benefits (P > .05).Diet recovery for distal gastrectomy patients was achieved by increased small bowel motility. The size of the remnant stomach showed no positive impact on nutritional outcomes.
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An Empirical Dietary Inflammatory Pattern Score Is Associated with Circulating Inflammatory Biomarkers in a Multi-Ethnic Population of Postmenopausal Women in the United States.
Tabung, FK, Giovannucci, EL, Giulianini, F, Liang, L, Chandler, PD, Balasubramanian, R, Manson, JE, Cespedes Feliciano, EM, Hayden, KM, Van Horn, L, et al
The Journal of nutrition. 2018;(5):771-780
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BACKGROUND The empirical dietary inflammatory pattern (EDIP) score has been associated with concentrations of circulating inflammatory biomarkers in European Americans. OBJECTIVE We used the EDIP score, a weighted sum of 18 food groups that characterizes dietary inflammatory potential based on circulating concentrations of inflammatory biomarkers, to test the hypothesis that a pro-inflammatory dietary pattern is associated with inflammatory biomarker concentrations in a US multi-ethnic population. METHODS In this cross-sectional study, we calculated EDIP scores using baseline food frequency questionnaire data from 31,472 women, aged 50-79 y, in the Women's Health Initiative observational study and clinical trials. Circulating biomarkers outcomes at baseline were: C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor (TNF)-α, TNF receptor (TNFR) 1 and 2, and adiponectin. We used multivariable-adjusted linear regression analyses to estimate absolute concentrations and relative differences in biomarker concentrations, overall and in subgroups of race/ethnicity and BMI (body mass index) categories. RESULTS Independent of energy intake, BMI, physical activity, and other potential confounding variables, higher EDIP scores were significantly associated with higher (lower for adiponectin) absolute concentrations of all 6 biomarkers. On the relative scale, the percentage of difference in the concentration of biomarkers, among women in the highest compared to the lowest EDIP quintile, was: CRP, +13% (P-trend < 0.0001); IL-6, +15% (P-trend < 0.0001); TNF-α, +7% (P-trend = 0.0007); TNFR1, +4% (P-trend = 0.0009); TNFR2, +5% (P-trend < 0.0001); and adiponectin, -13% (P-trend <0.0001). These associations differed by racial/ethnic groups and by BMI categories. Whereas the absolute biomarker concentrations were lower among European-American women and among normal-weight women, the associations with diet were stronger than among women of African-American or Hispanic/Latino origin and among overweight and obese women. CONCLUSIONS Findings demonstrate the successful replication of an empirical hypothesis-oriented a posteriori dietary pattern score in a multi-ethnic population of postmenopausal women, with subgroup differences by race/ethnicity and body weight. Future research needs to apply the score in non-US populations.
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Phase II Feasibility Study of a Weight Loss Intervention in Female Breast and Colorectal Cancer Survivors (SWOG S1008).
Greenlee, H, Lew, DL, Hershman, DL, Newman, VA, Hansen, L, Hartman, SJ, Korner, J, Shi, Z, Sardo Molmenti, CL, Sayegh, A, et al
Obesity (Silver Spring, Md.). 2018;(10):1539-1549
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OBJECTIVE This study aimed to test the feasibility of a 12-month weight loss intervention using telephone-based counseling plus community-situated physical activity (PA) in female breast cancer (BC) and colorectal cancer (CRC) survivors. METHODS This multisite cooperative group study enrolled sedentary, female, postmenopausal BC and CRC survivors with BMI ≥ 25 kg/m2 to receive 12-month fitness center memberships and telephone counseling encouraging 150 min/wk of PA and a 500-kcal/ddecrease in energy intake. Feasibility criteria included accrual, adherence, and retention. Target weight loss was ≥ 5%. RESULTS Among 25 BC survivors, median baseline BMI was 37.2 (range: 27.7-54.6), accrual occurred in 10 months, 60% and 28% met diet and exercise goals, 80% provided 12-month measures, and average weight loss was 7.6% (95% CI: -3.9%, 19.2%). Among 23 CRC survivors, median BMI was 31.8 (range: 26.4-48.7), accrual occurred in 24 months, 61% and 17% met diet and exercise goals, 87% provided measures, and average weight loss was 2.5% (95% CI: -8.2%, 13.3%). CONCLUSIONS It is feasible to recruit and retain BC survivors in a cooperative group diet and PA weight loss trial. BC survivors achieved clinically meaningful weight loss but did not meet a priori adherence goals. In CRC survivors, recruitment was more difficult, and the intervention was less effective.
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Association between diet quality and measures of body adiposity using the Rate Your Plate survey in patients presenting for coronary angiography.
Ganguzza, L, Ngai, C, Flink, L, Woolf, K, Guo, Y, Gianos, E, Burdowski, J, Slater, J, Acosta, V, Shephard, T, et al
Clinical cardiology. 2018;(1):126-130
Abstract
BACKGROUND Diet is a modifiable risk factor for cardiovascular disease; however, dietary patterns are historically difficult to capture in the clinical setting. Healthcare providers need assessment tools that can quickly summarize dietary patterns. Research should evaluate the effectiveness of these tools, such as Rate Your Plate (RYP), in the clinical setting. HYPOTHESIS RYP diet quality scores are associated with measures of body adiposity in patients referred for coronary angiography. METHODS Patients without a history of coronary revascularization (n = 400) were prospectively approached at a tertiary medical center in New York City prior to coronary angiography. Height, weight, and waist circumference (WC) were measured; body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. Participants completed a 24-question RYP diet survey. An overall score was computed, and participants were divided into high (≥58) and low (≤57) diet quality groups. RESULTS Participants in the high diet quality group (n = 98) had significantly lower measures of body adiposity than did those in the low diet quality group (n = 302): BMI (P < 0.001), WC (P = 0.001), WHtR (P = 0.001). There were small but significant inverse correlations between diet score and BMI, WC, and WHtR (P < 0.001). These associations remained significant after adjustment for demographics, tobacco use, and socioeconomic factors. CONCLUSIONS Higher diet quality scores are associated with lower measures of body adiposity. RYP is a potential instrument to capture diet quality in a high-volume clinical setting. Further research should evaluate the utility of RYP in cardiovascular risk-factor control.
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Elevated reward response to receipt of palatable food predicts future weight variability in healthy-weight adolescents.
Winter, SR, Yokum, S, Stice, E, Osipowicz, K, Lowe, MR
The American journal of clinical nutrition. 2017;(4):781-789
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Background: Both an elevated brain-reward-region response to palatable food and elevated weight variability have been shown to predict future weight gain.Objective: We examined whether the brain-reward response to food is related to future weight variability.Design: A total of 162 healthy-weight adolescents, who were aged 14-18 y at baseline, were enrolled in the study and were assessed annually over a 3-y follow-up period with 127 participants completing the final 3-y follow-up assessment. With the use of functional magnetic resonance imaging, we tested whether the neural responses to a cue that signaled an impending milkshake receipt and the receipt of the milkshake predicted weight variability over the follow-up period. Weight variability was modeled with a root mean squared error method to reflect fluctuations in weight independent of the net weight change.Results: Elevated activation in the medial prefrontal cortex and supplementary motor area, cingulate gyrus, cuneus and occipital gyrus, and insula in response to milkshake receipt predicted greater weight variability. Greater activation in the precuneus and middle temporal gyrus predicted lower weight variability.Conclusions: From our study data, we suggest that the elevated activation of reward and emotional-regulation brain regions (medial prefrontal cortex, cingulate cortex, and insula) and lower activation in self-reference regions (precuneus) in response to milkshake receipt predict weight variability over 3 y of follow-up. The fact that the reward response in the current study emerged in response to high-calorie palatable food receipt suggests that weight variability may be a measure of propensity periods of a positive energy balance and should be examined in addition to measures of the net weight change. With our collective results, we suggest that weight variability and its brain correlates should be added to other variables that are predictive of weight gain to inform the design of obesity-preventive programs in adolescents. This trial was registered at clinicaltrials.gov as NCT01807572.