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Systematic Review on Polyphenol Intake and Health Outcomes: Is there Sufficient Evidence to Define a Health-Promoting Polyphenol-Rich Dietary Pattern?
Del Bo', C, Bernardi, S, Marino, M, Porrini, M, Tucci, M, Guglielmetti, S, Cherubini, A, Carrieri, B, Kirkup, B, Kroon, P, et al
Nutrients. 2019;(6)
Abstract
Growing evidence support association between polyphenol intake and reduced risk for chronic diseases, even if there is a broad debate about the effective amount of polyphenols able to exert such protective effect. The present systematic review provides an overview of the last 10-year literature on the evaluation of polyphenol intake and its association with specific disease markers and/or endpoints. An estimation of the mean total polyphenol intake has been performed despite the large heterogeneity of data reviewed. In addition, the contribution of dietary sources was considered, suggesting tea, coffee, red wine, fruit and vegetables as the main products providing polyphenols. Total flavonoids and specific subclasses, but not total polyphenols, have been apparently associated with a low risk of diabetes, cardiovascular events and all-cause mortality. However, large variability in terms of methods for the evaluation and quantification of polyphenol intake, markers and endpoints considered, makes it still difficult to establish an evidence-based reference intake for the whole class and subclass of compounds. Nevertheless, the critical mass of data available seem to strongly suggest the protective effect of a polyphenol-rich dietary pattern even if further well targeted and methodologically sound research should be encouraged in order to define specific recommendations.
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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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Abstract
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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Dietary total antioxidant capacity and mortality from all causes, cardiovascular disease and cancer: a systematic review and dose-response meta-analysis of prospective cohort studies.
Parohan, M, Anjom-Shoae, J, Nasiri, M, Khodadost, M, Khatibi, SR, Sadeghi, O
European journal of nutrition. 2019;(6):2175-2189
Abstract
PURPOSE No conclusive information is available about the association between dietary total antioxidant capacity (DTAC) and risk of mortality. Current meta-analysis of prospective cohort studies was done to summarize available findings on the association between DTAC and risk of death from all-cause, cancer and cardiovascular diseases (CVDs). METHODS Online databases were searched to detect relevant publications up to January 2018, using relevant keywords. To pool data, either fixed-effects or random-effects model was used. Furthermore, linear and non-linear dose-response analyses were also done. RESULTS In total, five prospective studies were included in the current systematic review and meta-analysis. In a follow-up period of 4.3-16.5 years, there were 38,449 deaths from all-cause, 4470 from cancer and 2841 from CVDs among 226,297 individuals. A significant inverse association was found between DTAC and all-cause mortality (combined effect size: 0.62, 95% CI 0.60-0.64). Such finding was also seen for cancer (combined effect size: 0.81, 95% CI 0.75-0.88) and CVD (combined effect size: 0.71, 95% CI 0.63-0.82) mortality. Findings from linear dose-response meta-analysis revealed that a 5 mmol/day increment in DTAC based on ferric reducing antioxidant power (FRAP) and oxygen radical absorbance capacity (ORAC) was associated with 7% and 15% lower risk of all-cause mortality, respectively. Based on findings from non-linear dose-response meta-analysis, a significant reduction in risk of all-cause mortality was seen when increasing FRAP from 2 to 12 mmol/day (P-nonlinearity = 0.002) and ORAC from 5 to 11 mmol/day (P-nonlinearity < 0.001). CONCLUSIONS Adherence to diet with high total antioxidant capacity was associated with decreased risk of death from all-cause, cancer and CVDs.
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Dietary Inflammatory Potential and the Risk of Neurodegenerative Diseases in Adults.
Kheirouri, S, Alizadeh, M
Epidemiologic reviews. 2019;(1):109-120
Abstract
Nutrition and diet have been suggested to enhance or inhibit cognitive performance and the risk of several neurodegenerative diseases. We conducted a systematic review to elucidate the relationship between the inflammatory capacity of a person's diet and the risk of incident neurodegenerative diseases. We searched major medical databases for articles published through June 30, 2018. Original, full-text, English-language articles on studies with human participants which investigated the link between dietary inflammatory potential and risk of developing neurodegenerative diseases were included. Duplicate and irrelevant studies were removed, and data were compiled through critical analysis. Initially, 457 articles were collected via the searching method, of which 196 studies remained after removal of duplicates. Fourteen articles were screened and found to be relevant to the scope of the review. After critical analysis, 10 were included in the final review. In all studies but one, a higher dietary inflammatory index (DII) was related to higher risk of developing neurodegenerative disease symptoms, including memory and cognition decline and multiple sclerosis. Of 3 studies that assessed the association of DII with levels of circulating inflammation markers, 2 indicated that DII was positively correlated with inflammatory marker levels. Low literacy, an unhealthy lifestyle, and individual nutritional status were the factors involved in a diet with inflammatory potential. These findings enhance confidence that DII is an appropriate tool for measurement of dietary inflammatory potential and validate the role of diets with inflammatory potential in the pathophysiology of neurodegenerative diseases. DII may be correlated with levels of circulating inflammatory markers.
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The Dietary Management of Patients with Irritable Bowel Syndrome: A Narrative Review of the Existing and Emerging Evidence.
Algera, J, Colomier, E, Simrén, M
Nutrients. 2019;(9)
Abstract
Even though irritable bowel syndrome (IBS) has been known for more than 150 years, it still remains one of the research challenges of the 21st century. According to the current diagnostic Rome IV criteria, IBS is characterized by abdominal pain associated with defecation and/or a change in bowel habit, in the absence of detectable organic causes. Symptoms interfere with the daily life of patients, reduce health-related quality of life and lower the work productivity. Despite the high prevalence of approximately 10%, its pathophysiology is only partly understood and seems multifactorial. However, many patients report symptoms to be meal-related and certain ingested foods may generate an exaggerated gastrointestinal response. Patients tend to avoid and even exclude certain food products to relieve their symptoms, which could affect nutritional quality. We performed a narrative paper review of the existing and emerging evidence regarding dietary management of IBS patients, with the aim to enhance our understanding of how to move towards an individualized dietary approach for IBS patients in the near future.
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Special Commentary: Is diet management helpful in familial hypercholesterolemia?
Gidding, SS
Current opinion in clinical nutrition and metabolic care. 2019;(2):135-140
Abstract
PURPOSE OF REVIEW Familial hypercholesterolemia is a genetic condition where low-density lipoprotein (LDL) receptor defects cause severe elevations of LDL cholesterol. As significant LDL-lowering effects are needed, medication is considered the cornerstone of therapy, and dietary therapy has received less emphasis. This review will re-visit older studies of diet intervention and new insights from genetic and mechanistic studies to determine the value of diet management for familial hypercholesterolemia patients. RECENT FINDINGS Saturated fat reduction improves cardiovascular outcomes, particularly in those with genetic predisposition to risk. Secular trends in saturated fat intake may have improved familial hypercholesterolemia outcomes. Dietary mechanisms of LDL cholesterol-lowering complement pharmacologic approaches. SUMMARY Diet treatment adds incremental health benefit to pharmacologic treatment in familial hypercholesterolemia.
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Possible relation between consumption of different food groups and depression.
Grases, G, Colom, MA, Sanchis, P, Grases, F
BMC psychology. 2019;(1):14
Abstract
BACKGROUND Diverse studies have investigated the relationship between diet and depression. In fact some cross-sectional studies suggested that a healthy diet reduced the risk for depression. The main objective of this study was to assess the relationship of consumption of different food groups with depression. The food groups were selected based on their content of substances that were precursors to neurotransmitters (tryptophan or inositol) or their effect on oxidative stress. METHODS This observational retrospective study compared the diets of individuals who were with depressive symptoms (Beck Depression Inventory Questionnaire [BDI] ≥ 10; 53 women, 23 men, age 38+/- 11) and with no depressive levels (BDI < 10; 33 women, 23 men, age 41+/- 13). Dietary data were collected from a questionnaire that asked about consumption of legumes, nuts, whole-grain foods, fruits and vegetables, chocolate, and sweet foods and refined sugars. RESULTS Depressed individuals consumed significantly lower amounts of legumes, fruits, and vegetables, but higher amounts of sweets and refined sugars (p < 0.05 for all comparisons). After statistical adjustment for age and sex, the consumption of no legumes (adjusted odds ratio [aOR] = 2.60, 95% confidence interval [CI] = 1.19-5.67), low consumption of fruits and vegetables (aOR = 2.69, 95% CI = 1.18-6.13), and high consumption of sweet foods and refined sugars (aOR = 1.91, 95% CI = 1.23-2.99) were significantly associated with depression. The two groups had no significant differences in the consumption of chocolate. DISCUSSION The results indicate significant relationships of the consumption of certain foods with depression, although the study design precludes any conclusions regarding causality. Further studies are necessary to determine the causal relationships of the consumption of specific foods with depression, and of depression with the consumption of specific foods. CONCLUSION In spite of the limitations, we find that individuals without depression consumed more legumes, fruits, and vegetables, but fewer sweets and pastries than those with depression.
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Building Blocks for Healthy Children: Evaluation of a Child Care Center-Based Obesity Prevention Pilot Among Low-Income Children.
Schuler, BR, Fowler, B, Rubio, D, Kilby, S, Wang, Y, Hager, ER, Black, MM
Journal of nutrition education and behavior. 2019;(8):958-966
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Abstract
OBJECTIVE To assess the impact of a multilevel nutrition intervention for low-income child care environments, staff, and center-enrolled children. DESIGN A cluster-randomized, controlled trial conducted among eligible centers. Staff and parent self-report surveys and objective field observations at baseline and follow-up were conducted. SETTING A total of 22 low-income child care centers (enrolling ≥ 25 2- to 5-year-old children). PARTICIPANTS Children aged 18-71 months; 408 children and 97 staff were randomized into intervention (208 children and 50 staff) and waitlist-control groups (200 children and 45 staff). Retention rates were high (87% for children and 93% for staff). INTERVENTION(S): A 6-session, 6-month director's child nutrition course with on-site technical support for center teachers. MAIN OUTCOME MEASURE(S): Center nutrition/physical activity environment; staff feeding styles, dietary patterns, and attitudes about food; child food preferences and dietary patterns. ANALYSIS Covariance regression analyses to assess the intervention effect, adjusting for clustering within centers. RESULTS Significant intervention effects were found for the center nutrition training/education environment (b = 3.01; P = .03), nutrition total scores (b = 1.29; P = .04), and staff-level prompting/encouraging feeding styles (b = 0.38; P = .04). No significant intervention effects were found for child-level measures. CONCLUSIONS AND IMPLICATIONS Curriculum-driven training and implementation support improved nutritional policies and practices and staff-child interactions during meals. Future research could extend the intervention to families and the evaluation to children's dietary behaviors and weight changes.
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High soy isoflavone or soy-based food intake during infancy and in adulthood is associated with an increased risk of uterine fibroids in premenopausal women: a meta-analysis.
Qin, H, Lin, Z, Vásquez, E, Luan, X, Guo, F, Xu, L
Nutrition research (New York, N.Y.). 2019;:30-42
Abstract
Numerous studies have examined the association of soy isoflavones or soy-based food intake with the risk of uterine fibroids (UF), but the results are inconsistent. The purpose of this meta-analysis was to quantitatively assess whether high soy isoflavones intake is associated with an increased risk of UF. PUBMED and EMBASE databases were reviewed to screen for relevant published studies up to December 2018. Using key words of uterine fibroid and isoflavone, we identified 4 studies focusing on infancy intake and 7 studies evaluating intake during adulthood. The pooled odds ratio (OR) and corresponding 95% confidence interval (95% CI) were calculated using a random-effect model. In addition, subgroup analyses and 2-stage random-effect dose-response were also performed. When comparing high vs low intake of soy isoflavones, we found that there were positive associations of UF among patients being fed soy formula during infancy (OR, 1.19; 95% CI, 0.99-1.43; P = .06) and with high consumption of soy-based foods in adulthood (OR, 2.50; 95% CI, 1.09-5.74; P = .03), respectively. Additionally, dose-response analysis showed the pooled ORs (95% CIs) of UF risk for low, moderate, and high intake of soy isoflavones were 1.00 (0.87-1.14), 1.08 (0.94-1.24), and 1.23 (0.99-1.53) when compared to occasional intake, respectively. Our findings suggest that high soy isoflavones or soy-based food intake during infancy and in adulthood is associated with an increased risk of uterine fibroids in premenopausal women. There is a need for large-scale prospective cohort studies using more accurate measurements of soy isoflavones to further ascertain our study findings.
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Promoting fruit and vegetable intake in childbearing age women at risk for gestational diabetes mellitus: A randomised controlled trial.
Vézina-Im, LA, Perron, J, Lemieux, S, Robitaille, J
Journal of health psychology. 2019;(5):600-612
Abstract
This randomised controlled trial verified the efficacy of an implementation intentions intervention ( n = 24) to promote fruit and vegetable consumption among childbearing age women at risk for gestational diabetes mellitus against a control condition based on the question-behaviour effect ( n = 26). There was only a significant time effect ( F(2,85) = 5.69, p = 0.0048). Both groups increased their vegetable consumption compared to baseline at 3 months ( p = 0.0022) and 6 months ( p = 0.0042). There were no significant effects on weight, waist circumference and blood glucose levels. Implementation intentions and the question-behaviour effect appear to be effective behaviour change techniques to promote vegetable intake among this high-risk population.