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American Journal of Clinical Nutrition
Journal Prestige (SJR): 3.438
Citation Impact (citeScore): 6
Number of Followers: 197  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0002-9165 - ISSN (Online) 1938-3207
Published by Oxford University Press Homepage  [406 journals]
  • Metabolically healthy obesity: what's in a name'
    • Authors: Magkos F.
      Pages: 533 - 539
      Abstract: ABSTRACTMetabolically healthy obesity refers to an obesity phenotype with no or little evidence of metabolic dysfunction. Lower liver fat content and visceral adipose tissue, greater insulin sensitivity and secretion, greater cardiorespiratory fitness, and a predominantly lower body (i.e., leg) fat deposition are key physiological traits of a metabolically healthy phenotype. About 35% of all subjects with obesity are metabolically healthy. These individuals have approximately half the risk of developing type 2 diabetes and cardiovascular disease compared with metabolically unhealthy subjects with obesity, but they still have a significantly greater risk (by 50–300%) compared with metabolically healthy lean subjects. Therefore, absence of metabolic risk factors in people with obesity should not be a contraindication for weight-loss treatment. Metabolically healthy obesity needs to be treated, and this need is reinforced by the fact that this phenotype is not stable over time, as ∼50% of these subjects will cease being metabolically healthy within ∼10 y. Intervening early is therefore important. Weight loss dose-dependently decreases visceral adipose tissue and liver fat content, and it improves multiorgan insulin sensitivity and β-cell function (i.e., it beneficially affects many of the physiological traits of a metabolically healthy phenotype); however, weight loss is very difficult to maintain. This typically results in disappointment among patients and hinders adherence, which is likely critical for the limited success of most weight-loss treatments in the long term. On the other hand, using ≥1 metabolic health targets in a non-weight-loss-centered treatment paradigm that includes prudent dietary changes and increased physical activity can serve as an appropriate first goal that can help motivate patients toward the long-term goals of obesity treatment.
      PubDate: Wed, 26 Jun 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz133
      Issue No: Vol. 110, No. 3 (2019)
  • Exercise for weight loss
    • Authors: Westerterp K.
      Pages: 540 - 541
      Abstract: Negative energy balance and subsequent weight loss can be achieved by either reducing energy intake (1) or increasing energy expenditure, the latter usually by exercise. Exercise-induced weight loss, however, is usually small, and smaller than expected from an exercise-induced increase in energy expenditure (2). In this issue of the Journal, Martin et al. (3) try to identify mechanisms for the phenomenon termed “weight compensation” in response to exercise in overweight and obese participants.
      PubDate: Fri, 07 Jun 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz070
      Issue No: Vol. 110, No. 3 (2019)
  • About “spendthrift” and “thrifty” phenotypes: resistance and
           susceptibility to overeating revisited
    • Authors: Müller M.
      Pages: 542 - 543
      Abstract: Body weight control relates to changes in energy balance during underfeeding and overfeeding explaining weight loss and weight gain. In humans, there is considerable intersubject variability in weight changes and energy expenditure (EE) in response to controlled under- and overfeeding. This is partly explained by the variances in changes in EE per changes in body mass. In the Minnesota Starvation Experiment, adaptive thermogenesis (AT) was described as the decrease in resting energy expenditure (REE) greater than expected from changes in fat-free mass alone (1). AT has also been shown to relate to REE and activity-related EE during muscular work (2, 3). AT is viewed as a measure of energy conservation.
      PubDate: Fri, 07 Jun 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz090
      Issue No: Vol. 110, No. 3 (2019)
  • Preventing weight gain more important than weight loss and more realistic
           to study in cohorts than in randomized controlled trials
    • Authors: Gardner C.
      Pages: 544 - 545
      Abstract: Despite decades of awareness, very little progress has been made in halting and reversing the global obesity epidemic. The article in this issue of the Journal by Satija et al. (1) is another in a long line of studies addressing diet and weight change. A reasonable question is whether this study adds anything new to the already extensive body of evidence in this challenging area of research, and the good news is that it does.
      PubDate: Sat, 25 May 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz101
      Issue No: Vol. 110, No. 3 (2019)
  • Mushrooms and health
    • Authors: Dragsted L.
      Pages: 546 - 547
      Abstract: In the paper by Lee et al. in this issue of the Journal, no effect on cardiovascular disease (CVD), stroke, or diabetes risk was observed when comparing mushroom intake ≥5 times/wk with intake of <1 time/mo (1). Their investigation is the largest prospective study to date on mushrooms and health with a total follow-up of >100,000 health professionals from 1986 until 2012. In addition, no effects of mushroom intake were observed in a subset of ∼15,000 men and women on any intermediate biomarkers, including blood lipids, C-peptide, and several markers related to inflammation. The null findings were highly consistent and had narrow confidence intervals. Hence, the null hypothesis would seem by far the most plausible.
      PubDate: Fri, 07 Jun 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz096
      Issue No: Vol. 110, No. 3 (2019)
  • Egg yolk, source of bad cholesterol and good lipids'
    • Authors: Rosenson R; Song W.
      Pages: 548 - 549
      Abstract: The association between dietary cholesterol and atherosclerotic cardiovascular disease (ASCVD) has been controversial. Since the Framingham Heart Study found in the mid-20th century that elevated serum cholesterol concentrations were strongly linked with the risk of cardiovascular disease, there have been continued efforts to explore the effects of dietary cholesterol intake on serum cholesterol concentrations and cardiovascular disease. A large meta-analysis of prospective cohort studies found that dietary cholesterol increased both serum total cholesterol and LDL cholesterol, but no statistically significant association was found with coronary artery disease (1).
      PubDate: Fri, 07 Jun 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz105
      Issue No: Vol. 110, No. 3 (2019)
  • Assessing the Tolerable Upper Intake Level for folic acid: interpreting
           the evidence from the DRI perspective
    • Authors: Yaktine A.
      Pages: 550 - 551
      Abstract: The DRIs for folate, published in 1998, established the Tolerable Upper Intake Level (UL) for adults, including pregnant women aged ≥19 y, at 1000 µg/d of folic acid from fortified foods and/or dietary supplements (1). The process for setting the folate UL follows the DRI paradigm established by the Institute of Medicine (IOM) (2).
      PubDate: Wed, 12 Jun 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz124
      Issue No: Vol. 110, No. 3 (2019)
  • Gene–environment interplay: what do our genes say about dietary
    • Authors: Ahmad K Wu W.
      Pages: 552 - 553
      Abstract: The role of a healthy diet in disease prevention has been a topic of fundamental interest for millennia, and to improve the health and nutrition of its population, the US government has published the Dietary Guidelines for Americans (DGA) since 1980. Based on these guidelines, scientists have subsequently developed a DGA Adherence Index (DGAI) to better quantify the intake of a healthy diet (1). Meanwhile, healthy diets, the epigenetic diet, intermittent fasting, and various diet compositions are being increasingly studied in the context of aging and longevity in human and nonhuman species (2). When one considers how environmental factors affect gene expression, diet is of course a central factor that, through its interplay with the human genome, may modify the inflammation, metabolism, and composition of the body, which ultimately leads to various disease states.
      PubDate: Sat, 27 Jul 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz158
      Issue No: Vol. 110, No. 3 (2019)
  • Lack of historical evidence to support folic acid exacerbation of the
           neuropathy caused by vitamin B12 deficiency
    • Authors: Berry R.
      Pages: 554 - 561
      Abstract: ABSTRACTIn 1998 a Tolerable Upper Intake Level (UL) for folic acid was established based on case reports from the 1940s suggesting that high-dosage folic acid intake, used to treat patients with pernicious anemia, had the potential to precipitate or speed-up the development of neurological problems. This UL has been employed in the decision-making process used by more than 80 countries to establish programs to fortify staple foods with folic acid to prevent neural tube birth defects. Some have claimed that this UL is flawed and has become an obstacle to the wider adoption of neural tube defect prevention programs and have called for re-evaluation of the scientific validity of this UL. Case reports cannot establish causality, but they can reveal patterns in the timing of the onset and treatment of patients with pernicious anemia. These patterns can be compared with secular trends of usual medical practice for the treatment of pernicious anemia and with the changes in usage of folic acid preparations, including recommended therapeutic dosage and precautions for its usage surrounding the synthesis of folic acid in 1945 and vitamin B12 in 1948. Folic acid package inserts, early editions of hematology textbooks, and international expert reports provide valuable historical information. The recommended therapeutic daily dosage for folic acid of 5–20 mg was unchanged from 1946 through to 1971. The likely cause of the neurological problems encountered is the development of vitamin B12 neuropathy when pernicious anemia was treated with high-dosage folic acid before vitamin B12 was widely available in the early 1950s. Thus, the historical record does not provide compelling evidence that folic acid can potentially cause neurologic complications among those with low vitamin B12 status and lends support for reconsidering the basis for the UL of folic acid.
      PubDate: Wed, 12 Jun 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz089
      Issue No: Vol. 110, No. 3 (2019)
  • The impact of keto-adaptation on exercise performance and the role of
           metabolic-regulating cytokines
    • Authors: Sherrier M Li H.
      Pages: 562 - 573
      Abstract: ABSTRACTThe ketogenic diet (KD) is a normocaloric diet composed of high-fat, low-carbohydrate, and adequate protein that induces fasting-like effects and results in the production of ketone bodies. Initially used widely for children with refractory epilepsy, the KD gained popularity due to its beneficial effects on weight loss, diabetes, and cancer. In recent years, there has been a resurgence in interest surrounding the KD and exercise performance. This review provides new insights into the adaptation period necessary for enhancement in skeletal muscle fat and ketone oxidation after sustained nutritional ketosis. In addition, this review highlights metabolically active growth factors and cytokines, which may function as important regulators of keto-adaptation in the setting of exercise and the KD.
      PubDate: Fri, 26 Jul 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz145
      Issue No: Vol. 110, No. 3 (2019)
  • Changes in intake of plant-based diets and weight change: results from 3
           prospective cohort studies
    • Authors: Satija A; Malik V, Rimm E, et al.
      Pages: 574 - 582
      Abstract: ABSTRACTBackgroundStudies have found beneficial effects of plant-based diets on weight. However, not all plant foods are necessarily beneficial.ObjectivesThe aim of this study was to examine associations of changes in intake of 3 variations of plant-based diet indices (overall, healthful, and unhealthful) with weight change over 4-y intervals spanning >20 y.MethodsData from 3 ongoing prospective observational cohort studies in the United States were used, namely the Nurses’ Health Study (NHS), NHS2, and the Health Professionals Follow-up Study (HPFS), with 126,982 adult men and women. Self-reported diet data were collected every 4 y, and self-reported weight data were used to compute weight change every 4 y over >20 y of follow-up.ResultsOn average, participants gained a mean of 0.90 kg (HPFS) to 1.98 kg (NHS2) over 4-y intervals. Different types of plant-based diet indices were associated with different amounts of weight gain. After adjusting for several potential confounders, including concomitant changes in other lifestyle factors, a 1-SD increase in intake of an overall plant-based diet index was associated with 0.04 kg less weight gain over 4-y periods (95% CI: 0.05, 0.02 kg; P < 0.001). A 1-SD increase in intake of a healthful version of a plant-based diet index (emphasizing whole grains, fruits/vegetables, nuts/legumes, vegetable oils, tea/coffee) was associated with 0.68 kg less weight gain over 4-y periods (95% CI: 0.69, 0.66 kg; P < 0.001). Conversely, a 1-SD increase in an unhealthful version of a plant-based diet index (emphasizing refined grains, potato/fries, sweets, sweetened drinks/juices) was associated with 0.36 kg more weight gain (95% CI: 0.34, 0.37 kg, P < 0.001).ConclusionPlant-based diets, especially when rich in healthier plant foods, are associated with less weight gain over 4-y intervals. This supports current recommendations to increase intake of healthy plant foods, and reducing intake of less-healthy plant foods and animal foods, for improved health outcomes.
      PubDate: Sat, 25 May 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz049
      Issue No: Vol. 110, No. 3 (2019)
  • Effect of different doses of supervised exercise on food intake,
           metabolism, and non-exercise physical activity: The E-MECHANIC randomized
           controlled trial
    • Authors: Martin C; Johnson W, Myers C, et al.
      Pages: 583 - 592
      Abstract: ABSTRACTBackgroundExercise is recommended for weight management, yet exercise produces less weight loss than expected, which is called weight compensation. The mechanisms for weight compensation are unclear.ObjectiveThe aim of this study was to identify the mechanisms responsible for compensation.MethodsIn a randomized controlled trial conducted at an academic research center, adults (n = 198) with overweight or obesity were randomized for 24 wk to a no-exercise control group or 1 of 2 supervised exercise groups: 8 kcal/kg of body weight/wk (KKW) or 20 KKW. Outcome assessment occurred at weeks 0 and 24. Energy intake, activity, and resting metabolic rate (RMR) were measured with doubly labeled water (DLW; with and without adjustments for change in RMR), armband accelerometers, and indirect calorimetry, respectively. Appetite and compensatory health beliefs were measured by self-report.ResultsA per-protocol analysis included 171 participants (72.5% women; mean ± SD baseline body mass index: 31.5 ± 4.7 kg/m2). Significant (P < 0.01) compensation occurred in the 8 KKW (mean: 1.5 kg; 95% CI: 0.9, 2.2 kg) and 20 KKW (mean: 2.7 kg; 95% CI: 2.0, 3.5 kg) groups, and compensation differed significantly between the exercise groups (P = 0.01). Energy intake by adjusted DLW increased significantly (P < 0.05) in the 8 KKW (mean: 90.7 kcal/d; 95% CI: 35.1, 146.4 kcal/d) and 20 KKW (mean: 123.6 kcal/d; 95% CI: 64.5, 182.7 kcal/d) groups compared with control (mean: −2.3 kcal/d; 95% CI: −58.0, 53.5 kcal/d). Results were similar without DLW adjustment. RMR and physical activity (excluding structured exercise) did not differentially change among the 3 groups. Participants with higher compared with lower compensation reported increased appetite ratings and beliefs that healthy behaviors can compensate for unhealthy behaviors. Furthermore, they increased craving for sweet foods, increased sleep disturbance, and had worsening bodily pain.ConclusionsCompensation resulted from increased energy intake and concomitant increases in appetite, which can be treated with dietary or pharmacological interventions. Compensation was not due to activity or metabolic changes. This trial was registered at as NCT01264406.
      PubDate: Fri, 07 Jun 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz054
      Issue No: Vol. 110, No. 3 (2019)
  • Metabolic response to fasting predicts weight gain during low-protein
           overfeeding in lean men: further evidence for spendthrift and thrifty
           metabolic phenotypes
    • Authors: Hollstein T; Ando T, Basolo A, et al.
      Pages: 593 - 604
      Abstract: ABSTRACTBackgroundGreater increase in 24-h energy expenditure (24EE) during overfeeding and smaller decrease in 24EE during fasting (“spendthrift” metabolic phenotype) are associated with more weight loss during sustained caloric restriction in overweight subjects.ObjectivesThe aim of this study was to investigate whether these acute metabolic responses can also predict weight gain during sustained overfeeding in lean individuals.MethodsSeven lean men participated in this study. Prior to overfeeding, 24EE responses to fasting and 200% normal-protein overfeeding were measured in a whole-room indirect calorimeter. Volunteers underwent 6 wk of 150% low-protein (2%) overfeeding followed by another wk of weight-maintaining diet, during which 24EE was revaluated. Body composition, 24EE, and various hormone concentrations, including fibroblast growth factor 21 (FGF21), were assessed at baseline, at wk 1, 3, and 6 of the overfeeding period, and 1 wk following overfeeding through the use of dual-energy X-ray absorptiometry, indirect calorimetry, and ELISA. Cumulative energy surplus was calculated from 24EE, daily physical activity, and direct measurements of calories of nutrient intake, feces, and urine by bomb calorimetry.ResultsThe average weight gain during 6 wk of low-protein overfeeding was 3.8 kg (6.1%, min: +2.5%, max: +8.0%). During 24-h fasting at baseline, 24EE decreased on average (mean ± SD) by 158 ± 81 kcal/d (P = 0.007). Subjects with less 24EE decrease during fasting (more metabolically spendthrift individuals) gained less weight (r = −0.84, P = 0.03), less fat mass (r = −0.81, P = 0.049), and stored less calories (r = −0.91, P = 0.03) during overfeeding. Following overfeeding, increased 24EE above requirements for achieved body size was associated with less weight and fat mass gain (r = −0.78, P = 0.04) and with the increase in 24EE during 200% normal-protein overfeeding measured at baseline (r = 0.91, P = 0.005). Serum FGF21 concentrations increased up to 44-fold during overfeeding (P <  0.0001).ConclusionsLow-protein overfeeding may be an important tool to identify metabolic phenotypes (spendthrift compared with thrifty) that characterize susceptibility to weight gain. This trial was registered at as NCT00687115.
      PubDate: Fri, 07 Jun 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz062
      Issue No: Vol. 110, No. 3 (2019)
  • Persistent low body weight in humans is associated with higher
           mitochondrial activity in white adipose tissue
    • Authors: Ling Y; Carayol J, Galusca B, et al.
      Pages: 605 - 616
      Abstract: ABSTRACTBackgroundConstitutional thinness (CT) is a state of low but stable body weight (BMI ≤18 kg/m2). CT subjects have normal-range hormonal profiles and food intake but exhibit resistance to weight gain despite living in the modern world's obesogenic environment.ObjectiveThe goal of this study is to identify molecular mechanisms underlying this protective phenotype against weight gain.MethodsWe conducted a clinical overfeeding study on 30 CT subjects and 30 controls (BMI 20–25 kg/m2) matched for age and sex. We performed clinical and integrative molecular and transcriptomic analyses on white adipose and muscle tissues.ResultsOur results demonstrate that adipocytes were markedly smaller in CT individuals (mean ± SEM: 2174 ± 142 μm 2) compared with controls (3586 ± 216 μm2) (P < 0.01). The mitochondrial respiratory capacity was higher in CT adipose tissue, particularly at the level of complex II of the electron transport chain (2.2-fold increase; P < 0.01). This higher activity was paralleled by an increase in mitochondrial number (CT compared with control: 784 ± 27 compared with 675 ± 30 mitochondrial DNA molecules per cell; P < 0.05). No evidence for uncoupled respiration or “browning” of the white adipose tissue was found. In accordance with the mitochondrial differences, CT subjects had a distinct adipose transcriptomic profile [62 differentially expressed genes (false discovery rate of 0.1 and log fold change >0.75)], with many differentially expressed genes associating with positive metabolic outcomes. Pathway analyses revealed an increase in fatty acid oxidation ( P = 3 × 10−04) but also triglyceride biosynthesis (P = 3.6 × 10−04). No differential response to the overfeeding was observed in the 2 groups.ConclusionsThe distinct molecular signature of the adipose tissue in CT individuals suggests the presence of augm ented futile lipid cycling, rather than mitochondrial uncoupling, as a way to increase energy expenditure in CT individuals. We propose that increased mitochondrial function in adipose tissue is an important mediator in sustaining the low body weight in CT individuals. This knowledge could ultimately allow more targeted approaches for weight management treatment strategies. This trial was registered at as NCT02004821.
      PubDate: Fri, 02 Aug 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz144
      Issue No: Vol. 110, No. 3 (2019)
  • Whole egg consumption compared with yolk-free egg increases the
           cholesterol efflux capacity of high-density lipoproteins in overweight,
           postmenopausal women
    • Authors: Sawrey-Kubicek L; Zhu C, Bardagjy A, et al.
      Pages: 617 - 627
      Abstract: ABSTRACTBackgroundPostmenopausal women are at higher risk for cardiovascular disease (CVD) than their younger counterparts. HDL cholesterol is a biomarker for CVD risk, but the function of HDL may be more important than HDL cholesterol in deciphering disease risk. Although diet continues to be a cornerstone of treatment and prevention of CVD, little is known about how diet affects the functionality of HDL.ObjectivesThe aim of this study was to characterize the effects of whole eggs compared with yolk-free eggs on HDL function and composition in overweight, postmenopausal women and determine how changes in HDL composition are related to HDL functional parameters.MethodsThe study was a 14-wk, single-blind, randomized crossover dietary trial with two 4-wk intervention periods in 20 overweight, postmenopausal women. The crossover treatments were frozen breakfast meals containing 100 g of liquid (∼2) whole eggs compared with 100 g of (∼2) yolk-free eggs per day, separated by a 4-wk washout. Fasting blood samples were taken at the beginning and end of each treatment period to determine the effects on HDL composition and function.ResultsCholesterol efflux capacity increased in the whole-egg treatment (mean ± SD percentage change: +5.69% ± 9.9%) compared with the yolk-free egg treatment (−3.69% ± 5.3%) (P < 0.01), but there were no other significant changes in HDL functions or antioxidant or inflammatory markers. ApoA-I, total cholesterol (TC), LDL cholesterol, and HDL cholesterol also did not change in response to the egg treatment.ConclusionsThe consumption of 2 whole eggs/d by overweight, postmenopausal women showed a significant increase in cholesterol efflux capacity. This increase in cholesterol efflux capacity was seen without significant changes in apoA-I, TC, LDL cholesterol, or HDL cholesterol, supporting the idea that HDL function rather than HDL cholesterol should be addressed in this population. This trial was registered at as NCT02445638.
      PubDate: Fri, 07 Jun 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz088
      Issue No: Vol. 110, No. 3 (2019)
  • Time-restricted feeding plus resistance training in active females: a
           randomized trial
    • Authors: Tinsley G; Moore M, Graybeal A, et al.
      Pages: 628 - 640
      Abstract: ABSTRACTBackgroundA very limited amount of research has examined intermittent fasting (IF) programs, such as time-restricted feeding (TRF), in active populations.ObjectiveOur objective was to examine the effects of TRF, with or without β-hydroxy β-methylbutyrate (HMB) supplementation, during resistance training (RT).MethodsThis study employed a randomized, placebo-controlled, reduced factorial design and was double-blind with respect to supplementation in TRF groups. Resistance-trained females were randomly assigned to a control diet (CD), TRF, or TRF plus 3 g/d HMB (TRFHMB). TRF groups consumed all calories between 1200 h and 2000 h, whereas the CD group ate regularly from breakfast until the end of the day. All groups completed 8 wk of supervised RT and consumed supplemental whey protein. Body composition, muscular performance, dietary intake, physical activity, and physiological variables were assessed. Data were analyzed prior to unblinding using mixed models and both intention-to-treat (ITT) and per protocol (PP) frameworks.ResultsForty participants were included in ITT, and 24 were included in PP. Energy and protein intake (1.6 g/kg/d) did not differ between groups despite different feeding durations (TRF and TRFHMB: ∼7.5 h/d; CD: ∼13 h/d). Comparable fat-free mass (FFM) accretion (+2% to 3% relative to baseline) and skeletal muscle hypertrophy occurred in all groups. Differential effects on fat mass (CD: +2%; TRF: −2% to −4%; TRFHMB: −4% to −7%) were statistically significant in the PP analysis, but not ITT. Muscular performance improved without differences between groups. No changes in physiological variables occurred in any group, and minimal side effects were reported.ConclusionsIF, in the form of TRF, did not attenuate RT adaptations in resistance-trained females. Similar FFM accretion, skeletal muscle hypertrophy, and muscular performance improvements can be achieved with dramatically different feeding programs that contain similar energy and protein content during RT. Supplemental HMB during fasting periods of TRF did not definitively improve outcomes. This study was prospectively registered at as NCT03404271.
      PubDate: Wed, 03 Jul 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz126
      Issue No: Vol. 110, No. 3 (2019)
  • Estimation of the salt intake distribution of Dutch kidney transplant
           recipients using 24-h urinary sodium excretion: the potential of external
           within-person variance
    • Authors: Verkaik-Kloosterman J; Dekkers A, de Borst M, et al.
      Pages: 641 - 651
      Abstract: ABSTRACTBackgroundThere is growing interest in assessing a population's prevalence of inadequate nutrient intake using biomarkers. However, within-person variation is generally ignored because repeated data collections are considered costly and burdensome.ObjectivesThe study aimed to show the importance of estimating, from repeated 24-h urine collections, a population's habitual salt intake and to explore the potential of using the ratio of within-person variance to total variance from an external source (W:T variance) with single 24-h urine collection.MethodsSalt intake was predicted from data for 24-h urinary sodium excretion in adult kidney transplant recipients in 1992–1997 (n = 432) and 2006–2011 (n = 1159). The salt intake distribution of single-day measurements was compared with estimates from multiple 24-h urine collections, which were statistically corrected for within-person variance. Habitual salt intake was also estimated using single-day measurements and external variance estimates. From each distribution, the proportion below specified cut-off values was estimated.ResultsIn 2006–2011 the average habitual salt intake was 10.6 g/d (men) and 8.5 g/d (women); in 1992–1997 these values were 8.6 g/d and 7.5 g/d, respectively. The proportion with salt intake <6 g/d was 5% and 13% in 2006–2011 and 22% and 28% in 1992–1997, respectively, for men and women. Correction for within-person variance significantly narrowed the salt intake distribution—the proportion with salt intake <6 g/d was overestimated by 3–13 percentage points using single-day data. Sensitivity analyses showed the importance of a sufficient sample size for estimating variance components. Variation of the W:T variance showed up to 40 percentage points deviation in the proportion with intakes below a specified cut-off value.ConclusionsTo estimate a population's salt intake distribution, it is important to correct 24-h urinary sodium excretion for within-person variance. Predicting habitual salt intake distribution using single-day measurements with external variances is promising; a sensitivity analysis is recommended to show the effect of different external variances.
      PubDate: Fri, 05 Jul 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz134
      Issue No: Vol. 110, No. 3 (2019)
  • Medium-chain triglycerides (8:0 and 10:0) are promising nutrients for
           sarcopenia: a randomized controlled trial
    • Authors: Abe S; Ezaki O, Suzuki M.
      Pages: 652 - 665
      Abstract: ABSTRACTBackgroundThe combined supplementation of medium-chain triglycerides (MCTs), l-leucine–rich amino acids, and cholecalciferol was previously shown to increase muscle strength and function in frail elderly individuals.ObjectiveWe examined whether treatment with MCTs alone is sufficient to increase muscle strength and function and activities of daily living (ADL) in such individuals.MethodsWe enrolled 64 elderly nursing home residents (85.5 ± 6.8 y) in a 3-mo randomized, controlled, single-blinded intervention trial. The participants were randomly assigned to 3 groups: the first group received supplemental l-leucine (1.2 g) and cholecalciferol (20 μg) enriched with 6 g/d of MCTs (LD + MCT group) as a positive control, the second group received 6 g/d of MCTs (MCT group) as a target, and the third group received 6 g/d of long-chain triglycerides (LCT group) as a negative control. Changes in muscle mass, strength, function, and ADL were monitored 4 times: at baseline, at 1.5 and 3 mo after initiation of the intervention (intervention), and 1.5 mo after termination of the intervention (washout).ResultsThe 64 participants randomly assigned to the 3 groups were included in an intention-to-treat analysis. Forty-eight participants completed the study and were included in a per-protocol analysis. At 3 mo, participants in the MCT group had a 48.1% increase in 10-s leg open and close test performance [intention-to-treat adjusted means: MCT 2.28 n/10 s (1.37, 3.19) compared with LCT −0.59 n/10 s (−1.52, 0.35), P < 0.05], a 27.8% increase in a 30-s repetitive saliva swallowing test [MCT 0.5 n/30 s (0.1, 1.0) compared with LCT −0.5 n/30 s (−0.9, 0.0), P < 0.05], and a 7.5% increase in Functional Independence Measure score, a questionnaire for assessing ADL [MCT 5.6 points (1.3, 9.9) compared with LCT −6.6 points (−11.3, −2.0), P < 0.05].ConclusionMCTs (6 g/d) could increase the muscle strength and function of frail elderly individuals and also improve their ADL. This trial was registered at the University Hospital Medical Information Network Clinical Trial Registry as UMIN000023302.
      PubDate: Tue, 23 Jul 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz138
      Issue No: Vol. 110, No. 3 (2019)
  • Mushroom consumption, biomarkers, and risk of cardiovascular disease and
           type 2 diabetes: a prospective cohort study of US women and men
    • Authors: Lee D; Yang M, Giovannucci E, et al.
      Pages: 666 - 674
      Abstract: ABSTRACTBackgroundMushrooms are good dietary sources of important vitamins, minerals, and bioactive compounds which may be important in the prevention of chronic diseases. However, studies have not prospectively evaluated the potential health effects of mushrooms with respect to major cardiometabolic diseases.ObjectivesThe aim of this study was to examine the association of mushroom consumption with major cardiometabolic diseases and mediating biomarkers in 2 large prospective US cohorts.MethodsWe followed 67,139 women from the Nurses’ Health Study (1986–2012) and 43,541 men from the Health Professionals Follow-up Study (1986–2012) who were free of chronic diseases. Mushroom consumption was assessed at baseline through the use of a food-frequency questionnaire. Cardiometabolic biomarkers were collected in subpopulations of the 2 cohorts. Cox proportional hazards models were used to estimate HRs and 95% CIs of cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke, and type 2 diabetes (T2D), associated with mushroom consumption.ResultsWe identified total 11,894 CVD (7,616 CHD; 4,278 stroke), and 10,206 T2D cases in >2 million person-years of follow-up. In the pooled multivariable-adjusted analysis, participants who consumed ≥5 servings of mushrooms per week had no significantly different risk of total CVD (HR: 1.02; 95% CI: 0.91, 1.14), CHD (HR: 1.00; 95% CI: 0.87, 1.16), stroke (HR: 1.05; 95% CI: 0.87, 1.25), or T2D (HR: 1.04; 95% CI: 0.93, 1.16) than participants who consumed mushrooms <1 time/mo. We consistently found no association between mushroom consumption and the aforementioned cardiometabolic diseases, in subgroups of sex, lifestyle factors, and medical conditions. Moreover, mushroom consumption was not associated with plasma biomarkers of lipids, insulin, and inflammation.ConclusionsWe found no association of mushroom consumption with biomarkers and risks of CVD and T2D in US adults. More large prospective cohort studies are warranted to investigate this association in other racial/ethnic groups.
      PubDate: Fri, 07 Jun 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz057
      Issue No: Vol. 110, No. 3 (2019)
  • Dose-dependent detoxication of the airborne pollutant benzene in a
           randomized trial of broccoli sprout beverage in Qidong, China
    • Authors: Chen J; Johnson J, Egner P, et al.
      Pages: 675 - 684
      Abstract: ABSTRACTBackgroundAirborne pollutants have collectively been classified as a known human carcinogen and, more broadly, affect the health of hundreds of millions of people worldwide. Benzene is a frequent component of air pollution, and strategies to protect individuals against unavoidable exposure to this and other airborne carcinogens could improve the public's health. Earlier clinical trials in Qidong, China, demonstrated efficacy in enhancing the detoxication of benzene using a broccoli sprout beverage.ObjectivesA randomized, placebo-controlled, multidose trial of a broccoli sprout beverage was designed to determine the lowest effective concentration that enhances benzene detoxication adjudged by enhanced excretion of the urinary biomarker, S-phenylmercapturic acid (SPMA).MethodsFollowing informed consent, 170 subjects were randomly assigned in 5 blocks of 34 each to drink either a placebo beverage (n = 55) or 1 of 3 graded concentrations of a broccoli sprout beverage [full (n = 25), one-half (n = 35), and one-fifth (n = 55)] for 10 consecutive days. Concentrations of SPMA arising through induced benzene conjugation with glutathione were quantified by MS in sequential 12-h overnight urine collections during the intervention.ResultsMS was also used to quantify urinary sulforaphane metabolites in each dosing regimen that resulted in a median 24-h urinary output of 24.6, 10.3, and 4.3 µmol, respectively, confirming a dose-dependent de-escalation of the inducing principle within the beverage. A statistically significant increase in benzene mercapturic acids in urine was found for the high-dose group (+63.2%) during the 10-d period. The one-half dose (+11.3%) and one-fifth dose groups (−6.4%) were not significantly different from placebo controls.ConclusionsAn intervention with a broccoli sprout beverage enhanced the detoxication of benzene, an important airborne pollutant, when dosed at a concentration evoking a urinary elimination of ∼25 µmol sulforaphane metabolites per day, and it portends a practical and frugal population-based strategy to attenuate associated long-term health risks of air pollution. This trial was registered at as NCT02656420.
      PubDate: Wed, 03 Jul 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz122
      Issue No: Vol. 110, No. 3 (2019)
  • The role of linoleic acid in asthma and inflammatory markers: a Mendelian
           randomization study
    • Authors: Zhao J; Schooling C.
      Pages: 685 - 690
      Abstract: ABSTRACTBackgroundAsthma is a common respiratory disease, possibly caused by autoimmunity. Linoleic acid (LA), the main n–6 (ω-6) PUFA from widely used vegetable oils, is thought to suppress immune responses that might have benefits for asthma. However, this question has not been examined in randomized controlled trials.ObjectivesTo obtain unconfounded estimates, we assessed how genetically predicted LA affected asthma using 2-sample Mendelian randomization. We also examined its role in white blood cell traits (eosinophil, neutrophil, and low monocyte counts) identified as potential causal factors in asthma.MethodsWe used 18 uncorrelated, genome-wide significant genetic variants to predict LA, which we applied to a large genetic case (n = 19,954)–control (n = 107,715) study of asthma, to the UK Biobank (408,961 people of European ancestry with 26,332 asthma cases), and for white blood cell traits to the UK Biobank. We also repeated the analysis on asthma using 29 replicated, functionally relevant genetic variants. In addition, we examined the role of asthma in LA to assess reverse causality.ResultsGenetically predicted LA was associated with lower risk of asthma (OR: 0.89 per SD increase in LA; 95% CI: 0.85, 0.93), with no association of asthma with LA. Genetically predicted LA was associated with lower eosinophil count (−0.03; 95% CI: −0.061, −0.004) and lower neutrophil count (−0.04; 95% CI: −0.057, −0.023). These estimates were robust to different selections of genetic variants and sensitivity analyses.ConclusionsLA might protect against asthma possibly via white blood cell traits, with relevance to the identification of effective new interventions for asthma.
      PubDate: Tue, 09 Jul 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz130
      Issue No: Vol. 110, No. 3 (2019)
  • Alcohol intake, specific alcoholic beverages, and risk of hip fractures in
           postmenopausal women and men age 50 and older
    • Authors: Fung T; Mukamal K, Rimm E, et al.
      Pages: 691 - 700
      Abstract: ABSTRACTBackgroundAlthough a number of studies have examined the association between alcohol intake and hip fractures, few have considered specific alcoholic beverages separately.ObjectivesWe prospectively assessed total alcohol and specific alcoholic beverage consumption and risk of hip fractures in US men and women.MethodsHealth, lifestyle information, and hip fractures were self-reported on biennial questionnaires between 1980 and 2014 in 75,180 postmenopausal women from the Nurses’ Health Study, and between 1986 and 2014 in 38,398 men aged ≥50 y from the Health Professionals Follow-Up Study. Diet was assessed approximately every 4 y with a semiquantitative FFQ. RRs were computed for hip fracture using Cox proportional hazards models, adjusting for potential confounders.ResultsWe ascertained 2360 incident low trauma hip fractures in women and 709 in men. Among women, RRs for low trauma hip fractures compared with nondrinkers were 0.89 (95% CI: 0.80, 0.99) for an average daily consumption of <5.0 g, 0.81 (95% CI: 0.70, 0.94) for 5.0 to <10.0 g, 0.83 (95% CI: 0.71, 0.96) for 10.0 to <20.0 g, and 0.93 (95% CI: 0.78, 1.10) for ≥20.0 g. Among men, risk declined linearly with higher alcohol consumption (P-trend = 0.002). Multivariable RR compared with nondrinkers was 0.77 (95% CI: 0.59, 1.01), 0.69 (0.49, 0.96), and 0.67 (0.48, 0.95) for an average intake of 10 g/d to <20 g/d, 20 g/d to <30 g/d, and 30.0 g/d or more, respectively. In women, the alcoholic beverage most significantly associated with hip fracture risk was red wine (RR per serving = 0.59; 95% CI: 0.45, 0.79). In men, there was no clear association with specific alcoholic beverages.ConclusionIn these 2 US cohorts, low to moderate alcohol consumption, when compared with no consumption, was associated with a lower risk of hip fractures, particularly with red wine consumption among women.
      PubDate: Tue, 09 Jul 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz135
      Issue No: Vol. 110, No. 3 (2019)
  • Dietary quality and the colonic mucosa–associated gut microbiome in
    • Authors: Liu Y; Ajami N, El-Serag H, et al.
      Pages: 701 - 712
      Abstract: BackgroundDespite tremendous interest in modulating the microbiome to improve health, the association between diet and the colonic mucosa–associated gut microbiome in healthy individuals has not been examined.ObjectiveTo investigate the associations between Healthy Eating Index (HEI)–2005 and the colonic mucosa–associated microbiota.MethodsIn this cross-sectional observational study, we analyzed bacterial community composition and structure using 16S rRNA gene (V4 region) sequencing of 97 colonic mucosal biopsies obtained endoscopically from different colon segments of 34 polyp-free participants. Dietary consumption was ascertained using an FFQ. Differences in α- and β-diversity and taxonomic relative abundances between the higher and lower score of total HEI and its components were compared, followed by multivariable analyses.ResultsThe structure of the microbiota significantly differed by the scores for total HEI, total and whole fruits (HEI 1 and HEI 2), whole grains (HEI 6), milk products and soy beverages (HEI 7), and solid fat, alcohol, and added sugar (HEI 12). A lower score for total HEI and HEIs 2, 7, and 12 was associated with significantly lower richness. A lower score for total HEI was associated with significantly reduced relative abundance of Parabacteroides, Roseburia, and Subdoligranulum but higher Fusobacterium. A lower score for HEI 2 was associated with lower Roseburia but higher Bacteroides. A lower score for HEI 7 was associated with lower Faecalibacterium and Fusobacterium but higher Bacteroides. A lower score for HEI 12 was associated with lower Subdoligranulum but higher Escherichia and Fusobacterium (false discovery rate–adjusted P values <0.05). The findings were confirmed by multivariate analysis. Less abundant bacteria such as Alistipes, Odoribacter, Bilophila, and Tyzzerella were also associated with dietary quality.ConclusionsA lower score for total HEI–2005 was significantly associated with reduced relative abundance of potentially beneficial bacteria but increased potentially harmful bacteria in the colonic mucosa of endoscopically normal individuals.
      PubDate: Wed, 10 Jul 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz139
      Issue No: Vol. 110, No. 3 (2019)
  • Dietary patterns and risk of incident chronic kidney disease: the
           Atherosclerosis Risk in Communities study
    • Authors: Hu E; Steffen L, Grams M, et al.
      Pages: 713 - 721
      Abstract: ABSTRACTBackgroundAdherence to healthy dietary patterns, measured by the Healthy Eating Index (HEI), Alternative Healthy Eating Index (AHEI), and alternate Mediterranean diet (aMed) scores, is associated with a reduced risk of cardiovascular disease. The association between these scores and chronic kidney disease (CKD) is undetermined.ObjectiveWe aimed to estimate the association between the HEI, AHEI, and aMed scores and risk of incident CKD.MethodsWe conducted a prospective analysis in 12,155 participants aged 45–64 y from the Atherosclerosis Risk in Communities (ARIC) Study. We calculated HEI-2015, AHEI-2010, and aMed scores for each participant and categorized them into quintiles of each dietary score. Incident CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2 accompanied by ≥25% decline in estimated glomerular filtration rate, a kidney disease–related hospitalization or death, or end-stage renal disease. We used cause-specific hazard models to estimate risk of CKD from the quintile of the dietary score through to 31 December 2017.ResultsThere were 3980 cases of incident CKD over a median follow-up of 24 y. Participants who had higher adherence to the HEI-2015, AHEI-2010, and aMed scores were more likely to be female, have higher educational attainment, higher income level, be nonsmokers, more physically active, and diabetic compared with participants who scored lower. All 3 dietary scores were associated with lower CKD risk (P-trend < 0.001). Participants who were in the highest quintile of HEI-2015 score had a 17% lower risk of CKD (HR: 0.83; 95% CI: 0.74, 0.92) compared with participants in the lowest quintile. Those in quintile 5 of AHEI-2010 and aMed scores, respectively, had a 20% and 13% lower risk of CKD compared with those in quintile 1.ConclusionHigher adherence to healthy dietary patterns during middle age was associated with lower risk of CKD.
      PubDate: Tue, 06 Aug 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz146
      Issue No: Vol. 110, No. 3 (2019)
  • A short-term religious “fast” from animal products has a minimal
           impact on cardiometabolic health biomarkers irrespective of concurrent
           shifts in distinct plant-based food groups
    • Authors: Bethancourt H; Kratz M, O'Connor K.
      Pages: 722 - 732
      Abstract: ABSTRACTBackgroundPlant-based diets may help improve measures of body fat, blood cholesterol, glucose metabolism, and inflammation. However, limited evidence suggests that the health effects of reducing animal products may depend on the quality of plant-based foods consumed as caloric replacements.ObjectiveThis study examined how temporarily restricting consumption of meat, dairy, and egg (MDE) products for religious purposes influences cardiometabolic health biomarkers and whether any effects of MDE restriction on biomarkers are modified by concurrent shifts in calories, fish, and distinct plant-based foods.DesignThis study followed a sample of 99 individuals in the United States with varying degrees of adherence to Orthodox Christian (OC) guidance to abstain from MDE products during Lent, the 48-d period prior to Easter. Dietary composition was estimated from FFQs and 7-d food records; measures of body fat, blood lipids, glucose metabolism, and inflammation were collected prior to and at the end of Lent.ResultsEach serving decrease in MDE products was associated with an average −3.7% (95% CI: −5.5%, −2.0%; P < 0.0001) and −3.6% (95% CI: −5.8%, −1.3%; P = 0.003) change in fasting total and LDL blood cholesterol, respectively, which were partly explained by minor weight loss. However, the total/HDL cholesterol ratio did not significantly decrease due to an average −3.2% (95% CI: −5.8%, −0.6%; P = 0.02) change in HDL cholesterol. No associations between MDE restrictions and shifts in measures of body fat, glucose, insulin, or C-reactive protein were observed. The data could not provide evidence that changes in cardiometabolic health biomarkers in relation to MDE restriction were modified by concurrent shifts in calories, fish, or plant-based foods.ConclusionTemporary MDE restrictions practiced by this sample of OCs in the United States during Lent had minimal effects on cardiometabolic disease risk factors. Further research among larger samples of OCs is needed to understand how nutritionally distinct and complex combinations of plant-based foods may modify the health effects of religious fasting from MDE products.
      PubDate: Mon, 05 Aug 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz153
      Issue No: Vol. 110, No. 3 (2019)
  • Cumulative intake of artificially sweetened and sugar-sweetened beverages
           and risk of incident type 2 diabetes in young adults: the Coronary Artery
           Risk Development In Young Adults (CARDIA) Study
    • Authors: Hirahatake K; Jacobs D, Jr, Shikany J, et al.
      Pages: 733 - 741
      Abstract: ABSTRACTBackgroundEpidemiological evidence has demonstrated a positive association between artificially sweetened beverage (ASB) and sugar-sweetened beverage (SSB) consumption and type 2 diabetes (T2D) risk. However, research informing this topic in young adults is limited.ObjectiveThis study examined the association between ASB, SSB, and total sweetened beverage (TSB; combined ASB and SSB) consumption and T2D risk in young adults.MethodsA prospective analysis of 4719 Black and White men and women aged 18–30 y at baseline was conducted from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Each participant's beverage intake was assessed using the CARDIA Diet History at baseline and at study Years 7 and 20. Multivariable Cox proportional hazards regression models were used to examine cumulative average ASB, SSB, and TSB intakes and risk of T2D.ResultsDuring the 30-y follow-up period, 680 participants developed T2D. ASB consumption was associated with a 12% greater risk of T2D per serving/day (HR 1.12, 95% CI 1.04–1.20) in a model adjusted for lifestyle factors, diet quality, and dieting behavior. Further adjustments for baseline BMI (HR 1.07, 95% CI 0.99–1.14) and weight change during follow-up (HR 1.04, 95% CI 0.97–1.12) attenuated the association. SSB and TSB consumption as continuous variables per 1 serving/day of intake were associated with 6% and 5% increased risks of T2D, respectively (HRSSB 1.06, 95% CI 1.01–1.10; HRTSB 1.05, 95% CI 1.01–1.09), in the model accounting for lifestyle factors, dieting behavior, baseline BMI, and weight change. Results were consistent when the exposures were modeled in categories of consumption and quintiles.ConclusionsIn young adults, long-term ASB, SSB, and TSB consumption were associated with increased risks of T2D. However, the estimates for ASB were attenuated when accounting for weight changes.
      PubDate: Fri, 02 Aug 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz154
      Issue No: Vol. 110, No. 3 (2019)
  • Healthy diet is associated with gene expression in blood: the Framingham
           Heart Study
    • Authors: Lin H; Rogers G, Lunetta K, et al.
      Pages: 742 - 749
      Abstract: ABSTRACTBackgroundGenes in metabolic and nutrient signaling pathways play important roles in lifespan in model organisms and human longevity.ObjectiveThe aim of this study was to examine the relation of a quantitative measure of healthy diet to gene expression in a community-based cohort.MethodsWe used the 2015 Dietary Guidelines for Americans Adherence Index (DGAI) score to quantify key dietary recommendations of an overall healthy diet. Our current analyses included 2220 Offspring participants (mean age 66 ± 9 y, 55.4% women) and 2941 Third-Generation participants (mean age 46 ± 9 y, 54.5% women) from the Framingham Heart Study. Gene expression was profiled in blood through the use of the Affymetrix Human Exon 1.0 ST Array. We conducted a transcriptome-wide association study of DGAI adjusting for age, sex, smoking, cell counts, and technical covariates. We also constructed a combined gene score from genes significantly associated with DGAI.ResultsThe DGAI was significantly associated with the expression of 19 genes (false discovery rate <0.05). The most significant gene, ARRDC3, is a member of the arrestin family of proteins, and evidence in animal models and human data suggests that this gene is a regulator of obesity and energy expenditure. The DGAI gene score was associated with body mass index (P = 1.4 × 10−50), fasting glucose concentration (P = 2.5 × 10−11), type 2 diabetes (P = 1.1 × 10−5), and metabolic syndrome (P = 1.8 × 10−32).ConclusionsHealthier diet was associated with genes involved in metabolic function. Further work is needed to replicate our findings and investigate the relation of a healthy diet to altered gene regulation.
      PubDate: Wed, 12 Jun 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz060
      Issue No: Vol. 110, No. 3 (2019)
  • Lifestyle intervention modifies the effect of the MC4R genotype on changes
           in insulin resistance among women with prior gestational diabetes: Tianjin
           Gestational Diabetes Mellitus Prevention Program
    • Authors: Chen Y; Liu H, Wang L, et al.
      Pages: 750 - 758
      Abstract: ABSTRACTBackgroundA history of gestational diabetes mellitus (GDM) has been related to an elevated risk of type 2 diabetes. The melanocortin-4 receptor (MC4R) genotype has been related to glycemic changes in women with prior GDM.ObjectiveThe objective of this study was to analyze whether lifestyle intervention modified the association between the MC4R genotype and changes in insulin sensitivity among women with prior GDM.MethodsWe genotyped MC4R rs6567160 and measured glucose and insulin in fasting plasma samples at baseline and during the first 2 follow-up visits in 1128 women with prior GDM. They were randomly assigned to either a 4-y lifestyle intervention involving both diet and physical activity or a control group from a randomized clinical trial, the Tianjin Gestational Diabetes Mellitus Prevention Program. We analyzed the interaction between the MC4R genotype and lifestyle intervention on changes in insulin resistance.ResultsFrom baseline to 1.28 y, the MC4R genotype was related to changes in fasting insulin, HOMA-IR, and homeostasis model assessment of β cell function (HOMA-B) in the intervention group. Each risk allele (C) of rs6567160 was associated with a 0.08-unit greater decrease in log(insulin), log(HOMA-IR), and log(HOMA-B) (P = 0.02, 0.04, and 0.04, respectively), whereas in the control group, each C allele tended to be associated with a greater increase in HOMA-IR (P = 0.09). We found significant interactions between the MC4R genotype and lifestyle intervention on 1.28-y changes in fasting insulin and HOMA-IR (P = 0.006 and 0.008, respectively), and such interaction remained significant when we analyzed the trajectory of changes in insulin and HOMA-IR from baseline to 2.55 y (both P = 0.03).ConclusionsThe exploratory results from the first 2 follow-up visits indicate that women with prior GDM carrying a diabetes-increasing MC4R genotype (CC or TC) may obtain better improvement than the TT genotype in insulin resistance through lifestyle intervention. This trial was registered at as NCT01554358.
      PubDate: Thu, 04 Jul 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz121
      Issue No: Vol. 110, No. 3 (2019)
  • Improving fruit and vegetable intake attenuates the genetic association
           with long-term weight gain
    • Authors: Wang T; Heianza Y, Sun D, et al.
      Pages: 759 - 768
      Abstract: ABSTRACTBackgroundWhether changes in fruit and vegetable intake can modify the effect of genetic susceptibility to obesity on long-term changes in BMI and body weight are uncertain.ObjectiveWe analyzed the interactions of changes in total and specific fruit and vegetable intake with genetic susceptibility to obesity in relation to changes in BMI and body weight.MethodsWe calculated a genetic risk score on the basis of 77 BMI-associated loci to determine the genetic susceptibility to obesity, and examined the interactions of changes in total and specific fruit and vegetable intake with the genetic risk score on changes in BMI and body weight within five 4-y intervals over 20 y of follow-up in 8943 women from the Nurses’ Health Study (NHS) and 5308 men from the Health Professionals Follow-Up Study (HPFS).ResultsIn the combined cohorts, repeated 4-y BMI change per 10-risk allele increment was 0.09 kg/m2 among participants with the greatest decrease in total fruit and vegetable intake and −0.02 among those with the greatest increase in intake (P-interaction <0.001; corresponding weight change: 0.20 kg compared with −0.06 kg). The magnitude of decrease in BMI associated with increasing fruit and vegetable intake was more prominent among participants with high genetic risk than those with low risk. Reproducible interactions were observed for fruits and vegetables separately (both P-interaction <0.001). Based on similar nutritional content, the interaction effect was greatest for berries, citrus fruits, and green leafy vegetables, and the interaction pattern persisted regardless of the different fiber content or glycemic load of fruits and vegetables.ConclusionsGenetically associated increased BMI and body weight could be mitigated by increasing fruit and vegetable intake, and the beneficial effect of improving fruit and vegetable intake on weight management was more pronounced in individuals with greater genetic susceptibility to obesity.
      PubDate: Sat, 13 Jul 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz136
      Issue No: Vol. 110, No. 3 (2019)
  • NIH workshop on human milk composition: summary and visions
    • Authors: Casavale K; Ahuja J, Wu X, et al.
      Pages: 769 - 779
      Abstract: ABSTRACTNationally representative data from mother–child dyads that capture human milk composition (HMC) and associated health outcomes are important for advancing the evidence to inform federal nutrition and related health programs, policies, and consumer information across the governments in the United States and Canada as well as in nongovernment sectors. In response to identified gaps in knowledge, the National Institute of Diabetes and Digestive and Kidney Diseases of the NIH sponsored the “Workshop on Human Milk Composition—Biological, Environmental, Nutritional, and Methodological Considerations” held 16–17 November 2017 in Bethesda, Maryland. Through presentations and discussions, the workshop aimed to 1) share knowledge on the scientific need for data on HMC; 2) explore the current understanding of factors affecting HMC; 3) identify methodological challenges in human milk (HM) collection, storage, and analysis; and 4) develop a vision for a research program to develop an HMC data repository and database. The 4 workshop sessions included 1) perspectives from both federal agencies and nonfederal academic experts, articulating scientific needs for data on HMC that could lead to new research findings and programmatic advances to support public health; 2) information about the factors that influence lactation and/or HMC; 3) considerations for data quality, including addressing sampling strategies and the complexities in standardizing collection, storage, and analyses of HM; and 4) insights on how existing research programs and databases can inform potential visions for HMC initiatives. The general consensus from the workshop is that the limited scope of HM research initiatives has led to a lack of robust estimates of the composition and volume of HM consumed and, consequently, missed opportunities to improve maternal and infant health.
      PubDate: Fri, 05 Jul 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz123
      Issue No: Vol. 110, No. 3 (2019)
  • Defining the plasma folate concentration for optimal neural tube defects
           prevention cannot ignore the impact of the employed methodology
    • Authors: Ferraro S; Panteghini M.
      Pages: 780 - 781
      Abstract: Dear Editor:
      PubDate: Fri, 30 Aug 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz128
      Issue No: Vol. 110, No. 3 (2019)
  • Reply to S Ferraro and M Panteghini
    • Authors: Crider K; Pfeiffer C.
      Pages: 781 - 782
      Abstract: Dear Editor:
      PubDate: Fri, 30 Aug 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz129
      Issue No: Vol. 110, No. 3 (2019)
  • Corrigendum: Effects of red meat, white meat, and nonmeat protein sources
           on atherogenic lipoprotein measures in the context of low compared with
           high saturated fat intake: a randomized controlled trial. Am J Clin Nutr
    • Pages: 783 - 783
      Abstract: Corrigendum: Effects of red meat, white meat, and nonmeat protein sources on atherogenic lipoprotein measures in the context of low compared with high saturated fat intake: a randomized controlled trial. Am J Clin Nutr 2019;110:24–33.
      PubDate: Fri, 30 Aug 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz143
      Issue No: Vol. 110, No. 3 (2019)
  • Erratum to Mendes-Soares et al. Model of personalized postprandial
           glycemic response to food developed for an Israeli cohort predicts
           responses in Midwestern American individuals. Am J Clin Nutr
    • Pages: 783 - 783
      Abstract: Erratum to Mendes-Soares et al. Model of personalized postprandial glycemic response to food developed for an Israeli cohort predicts responses in Midwestern American individuals. Am J Clin Nutr 2019;110:63–75.
      PubDate: Fri, 30 Aug 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz142
      Issue No: Vol. 110, No. 3 (2019)
  • Invitation for Nominations for 2020
    • Pages: 784 - 787
      PubDate: Fri, 30 Aug 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz226
      Issue No: Vol. 110, No. 3 (2019)
  • Calendar of Events
    • Pages: 788 - 788
      PubDate: Fri, 30 Aug 2019 00:00:00 GMT
      DOI: 10.1093/ajcn/nqz210
      Issue No: Vol. 110, No. 3 (2019)
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