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Journal Cover American Journal of Clinical Nutrition
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   Full-text available via subscription Subscription journal
   ISSN (Print) 0002-9165 - ISSN (Online) 1938-3207
   Published by American Society for Nutrition Homepage  [3 journals]
  • Variations in energy intake: it is more complicated than we think
    • Authors: Lam, Y. Y; Ravussin, E.
      Pages: 1169 - 1170
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.167742
      Issue No: Vol. 106, No. 5 (2017)
  • When to eat! [Editorials]
    • Authors: Dhurandhar, N. V; Binks, M.
      Pages: 1171 - 1172
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.167759
      Issue No: Vol. 106, No. 5 (2017)
  • Salt substitution is a promising but unproven intervention for stroke
           management [Editorials]
    • Authors: Neal, B; Wu, J. H.
      Pages: 1173 - 1174
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.167767
      Issue No: Vol. 106, No. 5 (2017)
  • Surrogate disease markers as substitutes for chronic disease outcomes in
           studies of diet and chronic disease relations [Perspective]
    • Authors: Yetley, E. A; DeMets, D. L, Harlan, W. R.
      Pages: 1175 - 1189
      Abstract: Surrogate biomarkers for clinical outcomes afford scientific and economic efficiencies when investigating nutritional interventions in chronic diseases. However, valid scientific results are dependent on the qualification of these disease markers that are intended to be substitutes for a clinical outcome and to accurately predict benefit or harm. In this article, we examine the challenges of evaluating surrogate markers and describe the framework proposed in a 2010 Institute of Medicine report. The components of this framework are presented in the context of nutritional interventions for chronic diseases. We present case studies of 2 well-accepted surrogate markers [blood pressure within sodium intake and cardiovascular disease (CVD) context and low density lipoprotein–cholesterol concentrations within a saturated fat and CVD context]. We also describe additional cases in which the evidence is insufficient to validate their surrogate status. Guidance is offered for future research that evaluates or uses surrogate markers.
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.164046
      Issue No: Vol. 106, No. 5 (2017)
  • Within-day protein distribution does not influence body composition
           responses during weight loss in resistance-training adults who are
           overweight [Obesity and eating disorders]
    • Authors: Hudson, J. L; Kim, J. E, Paddon-Jones, D, Campbell, W. W.
      Pages: 1190 - 1196
      Abstract: Background: Emerging research suggests that redistributing total protein intake from 1 high-protein meal/d to multiple moderately high-protein meals improves 24-h muscle protein synthesis. Over time, this may promote positive changes in body composition.Objective: We sought to assess the effects of within-day protein intake distribution on changes in body composition during dietary energy restriction and resistance training.Design: In a randomized parallel-design study, 41 men and women [mean ± SEM age: 35 ± 2 y; body mass index (in kg/m2): 31.5 ± 0.5] consumed an energy-restricted diet (750 kcal/d below the requirement) for 16 wk while performing resistance training 3 d/wk. Subjects consumed 90 g protein/d (1.0 ± 0.03 g · kg–1 · d–1, 125% of the Recommended Dietary Allowance, at intervention week 1) in either a skewed (10 g at breakfast, 20 g at lunch, and 60 g at dinner; n = 20) or even (30 g each at breakfast, lunch, and dinner; n = 21) distribution pattern. Body composition was measured pre- and postintervention.Results: Over time, whole-body mass (least-squares mean ± SE: –7.9 ± 0.6 kg), whole-body lean mass (–1.0 ± 0.2 kg), whole-body fat mass (–6.9 ± 0.5 kg), appendicular lean mass (–0.7 ± 0.1 kg), and appendicular fat mass (–2.6 ± 0.2 kg) each decreased. The midthigh muscle area (0 ± 1 cm2) did not change over time, whereas the midcalf muscle area decreased (–3 ± 1 cm2). Within-day protein distribution did not differentially affect these body-composition responses.Conclusion: The effectiveness of dietary energy restriction combined with resistance training to improve body composition is not influenced by the within-day distribution of protein when adequate total protein is consumed. This trial was registered at as NCT02066948.
      Keywords: Obesity and Metabolism Research Articles
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.158246
      Issue No: Vol. 106, No. 5 (2017)
  • No metabolic effects of mustard allyl-isothiocyanate compared with placebo
           in men [Obesity and eating disorders]
    • Authors: Langeveld, M; Tan, C. Y, Soeters, M. R, Virtue, S, Watson, L. P, Murgatroyd, P. R, Ambler, G. K, Vidal-Puig, S, Chatterjee, K. V, Vidal-Puig, A.
      Pages: 1197 - 1205
      Abstract: Background: Induction of nonshivering thermogenesis can be used to influence energy balance to prevent or even treat obesity. The pungent component of mustard, allyl-isothiocyanate (AITC), activates the extreme cold receptor transient receptor potential channel, subfamily A, member 1 and may thus induce energy expenditure and metabolic changes.Objective: The objective of our study was to evaluate the potential of mustard AITC to induce thermogenesis (primary outcome) and alter body temperature, cold and hunger sensations, plasma metabolic parameters, and energy intake (secondary outcomes).Design: Energy expenditure in mice was measured after subcutaneous injection with vehicle, 1 mg norepinephrine/kg, or 5 mg AITC/kg. In our human crossover study, 11 healthy subjects were studied under temperature-controlled conditions after an overnight fast. After ingestion of 10 g of capsulated mustard or uncapsulated mustard or a capsulated placebo mixture, measurements of energy expenditure, substrate oxidation, core temperature, cold and hunger scores, and plasma parameters were repeated every 30 min during a 150-min period. Subjects were randomly selected for the placebo and capsulated mustard intervention; 9 of 11 subjects received the uncapsulated mustard as the final intervention because this could not be blinded. After the experiments, energy intake was measured with the universal eating monitor in a test meal.Results: In mice, AITC administration induced a 32% increase in energy expenditure compared with vehicle (17.5 ± 4.9 J · min–1 · mouse–1 compared with 12.5 ± 1.2 J · min–1 · mouse–1, P = 0.03). Of the 11 randomly selected participants, 1 was excluded because of intercurrent illness after the first visit and 1 withdrew after the second visit. Energy expenditure did not increase after ingestion of capsulated or uncapsulated mustard compared with placebo. No differences in substrate oxidation, core temperature, cold and hunger scores, or plasma parameters were found, nor was the energy intake at the end of the experiment different between the 3 conditions.Conclusion: The highest tolerable dose of mustard we were able to use did not elicit a relevant thermogenic response in humans. This trial was registered at as ISRCTN19147515.
      Keywords: Dietary Bioactive Compounds Research Articles
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.116.148395
      Issue No: Vol. 106, No. 5 (2017)
  • Investigating predictors of eating: is resting metabolic rate really the
           strongest proxy of energy intake' [Nutritional status, dietary intake,
           and body composition]
    • Authors: McNeil, J; Lamothe, G, Cameron, J. D, Riou, M.-E, Cadieux, S, Lafreniere, J, Goldfield, G, Willbond, S, Prudhomme, D, Doucet, E.
      Pages: 1206 - 1212
      Abstract: Background: Evidence suggests that fat-free mass and resting metabolic rate (RMR), but not fat mass, are strong predictors of energy intake (EI). However, body composition and RMR do not explain the entire variance in EI, suggesting that other factors may contribute to this variance.Objective: We aimed to investigate the associations between body mass index (in kg/m2), fat mass, fat-free mass, and RMR with acute (1 meal) and daily (24-h) EI and between fasting appetite ratings and certain eating behavior traits with daily EI. We also evaluated whether RMR is a predictor of the error variance in acute and daily EI.Design: Data collected during the control condition of 7 studies conducted in Ottawa, Ontario, Canada, were included in these analyses (n = 191 and 55 for acute and daily EI, respectively). These data include RMR (indirect calorimetry), body composition (dual-energy X-ray absorptiometry), fasting appetite ratings (visual analog scales), eating behavior traits (Three-Factor Eating Questionnaire), and EI (food buffet or menu).Results: Fat-free mass was the best predictor of acute EI (R2 = 0.46; P < 0.0001). The combination of fasting prospective food consumption ratings and RMR was the best predictor of daily EI (R2 = 0.44; P < 0.0001). RMR was a statistically significant positive predictor of the error variance for acute (R2 = 0.20; P < 0.0001) and daily (R2 = 0.23; P < 0.0001) EI. RMR did, however, remain a statistically significant predictor of acute (R2 = 0.32; P < 0.0001) and daily (R2 = 0.30; P < 0.0001) EI after controlling for this error variance.Conclusions: Our findings suggest that combined measurements of appetite ratings and RMR could be used to estimate EI in weight-stable individuals. However, greater error variance in acute and daily EI with increasing RMR values was observed. Future studies are needed to identify whether greater fluctuations in daily EI over time occur with increasing RMR values. This trial was registered at as NCT02653378.
      Keywords: Research Need: Understanding Nutrition-related Behaviors
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.153718
      Issue No: Vol. 106, No. 5 (2017)
  • Later circadian timing of food intake is associated with increased body
           fat [Nutritional status, dietary intake, and body composition]
    • Authors: McHill, A. W; Phillips, A. J, Czeisler, C. A, Keating, L, Yee, K, Barger, L. K, Garaulet, M, Scheer, F. A, Klerman, E. B.
      Pages: 1213 - 1219
      Abstract: Background: Weight gain and obesity have reached alarming levels. Eating at a later clock hour is a newly described risk factor for adverse metabolic health; yet, how eating at a later circadian time influences body composition is unknown. Using clock hour to document eating times may be misleading owing to individual differences in circadian timing relative to clock hour.Objective: This study examined the relations between the timing of food consumption relative to clock hour and endogenous circadian time, content of food intake, and body composition.Design: We enrolled 110 participants, aged 18–22 y, in a 30-d cross-sectional study to document sleep and circadian behaviors within their regular daily routines. We used a time-stamped-picture mobile phone application to record all food intake across 7 consecutive days during a participant’s regular daily routines and assessed their body composition and timing of melatonin release during an in-laboratory assessment.Results: Nonlean individuals (high body fat) consumed most of their calories 1.1 h closer to melatonin onset, which heralds the beginning of the biological night, than did lean individuals (low body fat) (log-rank P = 0.009). In contrast, there were no differences between lean and nonlean individuals in the clock hour of food consumption (P = 0.72). Multiple regression analysis showed that the timing of food intake relative to melatonin onset was significantly associated with the percentage of body fat and body mass index (both P < 0.05) while controlling for sex, whereas no relations were found between the clock hour of food intake, caloric amount, meal macronutrient composition, activity or exercise level, or sleep duration and either of these body composition measures (all P> 0.72).Conclusions: These results provide evidence that the consumption of food during the circadian evening and/or night, independent of more traditional risk factors such as amount or content of food intake and activity level, plays an important role in body composition. This trial was registered at as NCT02846077.
      Keywords: Obesity and Metabolism Research Articles, Research Need: Variability in Individual Responses to Diet and Foods
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.161588
      Issue No: Vol. 106, No. 5 (2017)
  • Time of day and eating behaviors are associated with the composition and
           function of the human gastrointestinal microbiota [Nutritional status,
           dietary intake, and body composition]
    • Authors: Kaczmarek, J. L; Musaad, S. M, Holscher, H. D.
      Pages: 1220 - 1231
      Abstract: Background: Preclinical research has shown that the gastrointestinal microbiota exhibits circadian rhythms and that the timing of food consumption can affect the composition and function of gut microbes. However, there is a dearth of knowledge on these relations in humans.Objective: We aimed to determine whether human gastrointestinal microbes and bacterial metabolites were associated with time of day or behavioral factors, including eating frequency, percentage of energy consumed early in the day, and overnight-fast duration.Design: We analyzed 77 fecal samples collected from 28 healthy men and women. Fecal DNA was extracted and sequenced to determine the relative abundances of bacterial operational taxonomic units (OTUs). Gas chromatography–mass spectroscopy was used to assess short-chain fatty acid concentrations. Eating frequency, percentage of energy consumed before 1400, and overnight-fast duration were determined from dietary records. Data were analyzed by linear mixed models or generalized linear mixed models, which controlled for fiber intake, sex, age, body mass index, and repeated sampling within each participant. Each OTU and metabolite were tested as the outcome in a separate model.Results: Acetate, propionate, and butyrate concentrations decreased throughout the day (P = 0.006, 0.04, and 0.002, respectively). Thirty-five percent of bacterial OTUs were associated with time. In addition, relations were observed between gut microbes and eating behaviors, including eating frequency, early energy consumption, and overnight-fast duration.Conclusions: These results indicate that the human gastrointestinal microbiota composition and function vary throughout the day, which may be related to the circadian biology of the human body, the microbial community itself, or human eating behaviors. Behavioral factors, including timing of eating and overnight-fast duration, were also predictive of bacterial abundances. Longitudinal intervention studies are needed to determine causality of these biological and behavioral relations. This trial was registered at as NCT01925560.
      Keywords: Gut Microbiome Research Articles
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.156380
      Issue No: Vol. 106, No. 5 (2017)
  • Comparison of midupper arm circumference and weight-for-height z score for
           assessing acute malnutrition in Bangladeshi children aged 6-60 mo: an
           analytical study [Nutritional status, dietary intake, and body
    • Authors: Hossain, M. I; Ahmed, T, Arifeen, S. E, Billah, S. M, Faruque, A, Islam, M. M, Jackson, A. A.
      Pages: 1232 - 1237
      Abstract: Background: In clinical settings, wasting in childhood has primarily been assessed with the use of a weight-for-height z score (WHZ), and in community settings, it has been assessed via the midupper arm circumference (MUAC) with a cutoff
      Keywords: Research Need: Impact of Nutrition on Healthy Growth, Development, and Reproduction
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.116.139881
      Issue No: Vol. 106, No. 5 (2017)
  • Plasma glucose and insulin responses after consumption of breakfasts with
           different sources of soluble fiber in type 2 diabetes patients: a
           randomized crossover clinical trial [Carbohydrate metabolism and diabetes]
    • Authors: de Carvalho, C. M; de Paula, T. P, Viana, L. V, Machado, V. M, de Almeida, J. C, Azevedo, M. J.
      Pages: 1238 - 1245
      Abstract: Background: The amount and quality of carbohydrates are important determinants of plasma glucose after meals. Regarding fiber content, it is unclear whether the intake of soluble fibers from foods or supplements has an equally beneficial effect on lowering postprandial glucose.Objective: The aim of our study was to compare the acute effect of soluble fiber intake from foods or supplements after a common meal on postprandial plasma glucose and plasma insulin in patients with type 2 diabetes (T2D).Design: A randomized crossover clinical trial was conducted in patients with T2D. Patients consumed isocaloric breakfasts (mean ± SD: 369.8 ± 9.4 kcal) with high amounts of fiber from diet food sources (total fiber: 9.7 g; soluble fiber: 5.4 g), high amounts of soluble fiber from guar gum supplement (total fiber: 9.1 g; soluble fiber: 5.4 g), and normal amounts of fiber (total fiber: 2.4 g; soluble fiber: 0.8 g). Primary outcomes were postprandial plasma glucose and insulin (0–180 min). Data were analyzed by repeated measures ANOVA and post hoc Bonferroni test.Results: A total of 19 patients [aged 65.8 ± 7.3 y; median (IQR), 10 (5–9) y of T2D duration; glycated hemoglobin 7.0% ± 0.8%; body mass index (in kg/m2) 28.2 ± 2.9] completed 57 meal tests. After breakfast, the incremental area under the curve (iAUC) for plasma glucose [mg/dL · min; mean (95% CI)] did not differ between high fiber from diet (HFD) [7861 (6257, 9465)] and high fiber from supplement (HFS) [7847 (5605, 10,090)] (P = 1.00) and both were lower than usual fiber (UF) [9527 (7549, 11,504)] (P = 0.014 and P = 0.037, respectively). iAUCs [μIU/mL · min; mean (95% CI)] did not differ (P = 0.877): HFD [3781 (2513, 5050)], HFS [4006 (2711, 5302), and UF [4315 (3027, 5603)].Conclusions: Higher fiber intake was associated with lower postprandial glucose at breakfast, and the intake of soluble fiber from food and supplement had a similar effect in patients with T2D. This trial was registered at as NCT02204384.
      Keywords: Diabetes
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.157263
      Issue No: Vol. 106, No. 5 (2017)
  • Effect of prior meal macronutrient composition on postprandial glycemic
           responses and glycemic index and glycemic load value determinations
           [Carbohydrate metabolism and diabetes]
    • Authors: Meng, H; Matthan, N. R, Ausman, L. M, Lichtenstein, A. H.
      Pages: 1246 - 1256
      Abstract: Background: The potential impact of prior meal composition on the postprandial glycemic response and glycemic index (GI) and glycemic load (GL) value determinations remains unclear.Objective: We determined the effect of meals that varied in macronutrient composition on the glycemic response and determination of GI and GL values of a subsequent standard test food.Design: Twenty healthy participants underwent 6 test sessions within 12 wk. The subjects received each of 3 isocaloric breakfast meals (i.e., high carbohydrate, high fat, or high protein) on separate days in a random order, which was followed by a standard set of challenges (i.e., white bread and a glucose drink) that were tested on separate days in a random order 4 h thereafter. Each challenge provided 50 g available carbohydrate. Arterialized venous blood was sampled throughout the 2-h postchallenge period. GI, GL, and insulin index (II) values were calculated with the use of the incremental area under the curve (AUCi) method, and serum lipids were determined with the use of standard assays.Results: The consumption of the high-protein breakfast before the white-bread challenge attenuated the rise in the postprandial serum glucose response (P < 0.0001) and resulted in lower glucose AUCi (P < 0.0001), GI (P = 0.0096), and GL (P = 0.0101) values than did the high-carbohydrate and high-fat breakfasts. The high-protein breakfast resulted in a lower insulin AUCi (P = 0.0146) for white bread than did the high-fat breakfast and a lower II value (P = 0.0285) than did the high-carbohydrate breakfast. The 3 breakfasts resulted in similar serum lipid responses to the white-bread challenge.Conclusions: These data indicate that the macronutrient composition of the prior meal influences the glycemic response and the determination of GI and GL values for white bread. Future studies are needed to determine whether the background food macronutrient composition influences mean dietary GI and GL values that are calculated for eating patterns, which may alter the interpretation of the associations between these values and chronic disease risk. This trial was registered at as NCT01023646.
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.162727
      Issue No: Vol. 106, No. 5 (2017)
  • In the elderly, meat protein assimilation from rare meat is lower than
           that from meat that is well done [Energy and protein metabolism]
    • Authors: Buffiere, C; Gaudichon, C, Hafnaoui, N, Migne, C, Scislowsky, V, Khodorova, N, Mosoni, L, Blot, A, Boirie, Y, Dardevet, D, Sante-Lhoutellier, V, Remond, D.
      Pages: 1257 - 1266
      Abstract: Background: Meat cooking conditions in in vitro and in vivo models have been shown to influence the rate of protein digestion, which is known to affect postprandial protein metabolism in the elderly.Objective: The present study was conducted to demonstrate the effect of cooking conditions on meat protein assimilation in the elderly. We used a single-meal protocol to assess the meat protein absorption rate and estimate postprandial meat protein utilization in elderly subjects.Design: The study recruited 10 elderly volunteers aged 70–82 y. Each received, on 2 separate occasions, a test meal exclusively composed of intrinsically 15N-labeled bovine meat (30 g protein), cooked at 55°C for 5 min [rare meat (RM)] or at 90°C for 30 min [fully cooked meat (FCM)], and minced. Whole-body fluxes of leucine, before and after the meal, were determined with the use of a [1-13C]leucine intravenous infusion. Meat protein absorption was recorded with the use of 15N enrichment of amino acids.Results: Postprandial time course observations showed a lower concentration in the plasma of indispensable amino acids (P < 0.01), a lower entry rate of meat leucine in the plasma (P < 0.01), and a lower contribution of meat nitrogen to plasma amino acid nitrogen (P < 0.001), evidencing lower peripheral bioavailability of meat amino acids with RM than with FCM. This was associated with decreased postprandial whole-body protein synthesis with RM than with FCM (40% compared with 56% of leucine intake, respectively; P < 0.01).Conclusions: Whereas meat cooking conditions have little effect on postprandial protein utilization in young adults, the present work showed that the bioavailability and assimilation of meat amino acids in the elderly is lower when meat is poorly cooked. In view to preventing sarcopenia, elderly subjects should be advised to favor the consumption of well-cooked meat. This trial was registered at as NCT02157805.
      Keywords: Research Need: Role of Nutrition in Health Maintenance
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.158113
      Issue No: Vol. 106, No. 5 (2017)
  • Intake of potassium- and magnesium-enriched salt improves functional
           outcome after stroke: a randomized, multicenter, double-blind controlled
           trial [Vitamins, minerals, and phytochemicals]
    • Authors: Pan, W.-H; Lai, Y.-H, Yeh, W.-T, Chen, J.-R, Jeng, J.-S, Bai, C.-H, Lin, R.-T, Lee, T.-H, Chang, K.-C, Lin, H.-J, Hsiao, C.-F, Chern, C.-M, Lien, L.-M, Liu, C.-H, Chen, W.-H, Chang, A.
      Pages: 1267 - 1273
      Abstract: Background: Stroke is one of the leading causes of mortality and neurologic deficits. Management measures to improve neurologic outcomes are in great need. Our previous intervention trial in elderly subjects successfully used salt as a carrier for potassium, demonstrating a 41% reduction in cardiovascular mortality by switching to potassium-enriched salt. Dietary magnesium has been associated with lowered diabetes and/or stroke risk in humans and with neuroprotection in animals.Objective: Because a large proportion of Taiwanese individuals are in marginal deficiency states for potassium and for magnesium and salt is a good carrier for minerals, it is justifiable to study whether further enriching salt with magnesium at an amount near the Dietary Reference Intake (DRI) amount may provide additional benefit for stroke recovery.Design: This was a double-blind, randomized controlled trial comprising 291 discharged stroke patients with modified Rankin scale (mRS) ≤4. There were 3 arms: 1) regular salt (Na salt) (n = 99), 2) potassium-enriched salt (K salt) (n = 97), and 3) potassium- and magnesium-enriched salt (K/Mg salt) (n = 95). The NIH Stroke Scale (NIHSS), Barthel Index (BI), and mRS were evaluated at discharge, at 3 mo, and at 6 mo. A good neurologic performance was defined by NIHSS = 0, BI = 100, and mRS ≤1.Results: After the 6-mo intervention, the proportion of patients with good neurologic performance increased in a greater magnitude in the K/Mg salt group than in the K salt group and the Na salt group, in that order. The K/Mg salt group had a significantly increased OR (2.25; 95% CI: 1.09, 4.67) of achieving good neurologic performance compared with the Na salt group. But the effect of K salt alone (OR: 1.58; 95% CI: 0.77, 3.22) was not significant.Conclusions: This study suggests that providing the DRI amount of magnesium and potassium together long term is beneficial for stroke patient recovery from neurologic deficits. This trial was registered at as NCT02910427.
      Keywords: Research Need: Role of Nutrition in Medical Management
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.116.148536
      Issue No: Vol. 106, No. 5 (2017)
  • Randomized controlled trial on the impact of early-life intervention with
           bifidobacteria on the healthy infant fecal microbiota and metabolome
           [Growth, development, and pediatrics]
    • Authors: Bazanella, M; Maier, T. V, Clavel, T, Lagkouvardos, I, Lucio, M, Maldonado-Gomez, M. X, Autran, C, Walter, J, Bode, L, Schmitt-Kopplin, P, Haller, D.
      Pages: 1274 - 1286
      Abstract: Background: Early-life colonization of the intestinal tract is a dynamic process influenced by numerous factors. The impact of probiotic-supplemented infant formula on the composition and function of the infant gut microbiota is not well defined.Objective: We sought to determine the effects of a bifidobacteria-containing formula on the healthy human intestinal microbiome during the first year of life.Design: A double-blind, randomized, placebo-controlled study of newborn infants assigned to a standard whey-based formula containing a total of 107 colony-forming units (CFU)/g of Bifidobacterium bifidum, Bifidobacterium breve, Bifidobacterium longum, B. longum subspecies infantis (intervention), or to a control formula without bifidobacteria (placebo). Breastfed controls were included. Diversity and composition of fecal microbiota were determined by 16S ribosomal RNA gene amplicon sequencing, and metabolite profiles were analyzed by ultrahigh-performance liquid chromatography–mass spectrometry over a period of 2 y.Results: Infants (n = 106) were randomly assigned to either the interventional (n = 48) or placebo (n = 49) group; 9 infants were exclusively breastfed throughout the entire intervention period of 12 mo. Infants exposed to bifidobacteria-supplemented formula showed decreased occurrence of Bacteroides and Blautia spp. associated with changes in lipids and unknown metabolites at month 1. Microbiota and metabolite profiles of intervention and placebo groups converged during the study period, and long-term colonization (24 mo) of the supplemented Bifidobacterium strains was not detected. Significant differences in microbiota and metabolites were detected between infants fed breast milk and those fed formula (P < 0.005) and between infants birthed vaginally and those birthed by cesarean delivery (P < 0.005). No significant differences were observed between infant feeding groups regarding growth, antibiotic uptake, or other health variables (P> 0.05).Conclusion: The supplementation of bifidobacteria to infant diet can modulate the occurrence of specific bacteria and metabolites during early life with no detectable long-term effects. This trial was registered at as DRKS00003660.
      Keywords: Gut Microbiome Research Articles, Research Need: Impact of Nutrition on Healthy Growth, Development, and Reproduction
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.157529
      Issue No: Vol. 106, No. 5 (2017)
  • Inflammatory potential of the diet and colorectal tumor risk in persons
           with Lynch syndrome [Cancer]
    • Authors: Brouwer, J. G; Makama, M, van Woudenbergh, G. J, Vasen, H. F, Nagengast, F. M, Kleibeuker, J. H, Kampman, E, van Duijnhoven, F. J.
      Pages: 1287 - 1294
      Abstract: Background: Persons with Lynch syndrome (LS) have high lifetime risk of developing colorectal tumors (CRTs) because of a germline mutation in one of their mismatch repair (MMR) genes. An important process in the development of CRTs is inflammation, which has been shown to be modulated by diet.Objective: We aimed to investigate the association between the inflammatory potential of the diet and the risk of CRTs in persons with LS.Design: We used the dietary intake of 457 persons with LS from a prospective cohort study to calculate the adapted dietary inflammatory index (ADII). The ADII was split into tertiles in which the highest tertile reflects the most proinflammatory potential of the diet. Cox proportional hazard models, with robust sandwich variance estimates to adjust for dependency within families, were used to calculate HRs and 95% CIs of CRTs by ADII tertile. HRs were adjusted for age, smoking status, and education level, and number of colonoscopies as a time-dependent variable. A potential effect measure modification was explored by stratifying the results by mutated MMR gene, sex, and a history of CRTs. We performed sensitivity analyses by repeating the analyses in non–nonsteroidal anti-inflammatory drug (NSAID) users (n = 315).Results: During a median follow-up time of 59 mo, 200 participants (43.8%) developed CRTs. No significant association was shown between highest compared with lowest ADII tertiles (HR for highest compared with lowest tertiles: 1.37; 95% CI: 0.80, 2.34). Stratification by mutated MMR gene, sex, and CRT history did not show significantly differential associations (P-interactions ≥ 0.64). In non-NSAID users, an HR of 1.60 (95% CI: 0.88, 2.93) for highest compared with lowest tertiles was shown. No significant effect modification was shown in this group either (P-interactions ≥ 0.24).Conclusion: A proinflammatory potential of the diet does not seem to be significantly associated with CRT risk in persons with LS.
      Keywords: Research Need: Role of Nutrition in Medical Management
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.152900
      Issue No: Vol. 106, No. 5 (2017)
  • Trajectories of maternal weight from before pregnancy through postpartum
           and associations with childhood obesity [Nutritional epidemiology and
           public health]
    • Authors: Leonard, S. A; Rasmussen, K. M, King, J. C, Abrams, B.
      Pages: 1295 - 1301
      Abstract: Background: Prepregnancy body mass index [BMI (in kg/m2)], gestational weight gain, and postpartum weight retention may have distinct effects on the development of child obesity, but their combined effect is currently unknown.Objective: We described longitudinal trajectories of maternal weight from before pregnancy through the postpartum period and assessed the relations between maternal weight trajectories and offspring obesity in childhood.Design: We analyzed data from 4436 pairs of mothers and their children in the National Longitudinal Survey of Youth 1979 (1981–2014). We used latent-class growth modeling in addition to national recommendations for prepregnancy BMI, gestational weight gain, and postpartum weight retention to create maternal weight trajectory groups. We used modified Poisson regression models to assess the associations between maternal weight trajectory group and offspring obesity at 3 age periods (2–5, 6–11, and 12–19 y).Results: Our analysis using maternal weight trajectories based on either latent-class results or recommendations showed that the risk of child obesity was lowest in the lowest maternal weight trajectory group. The differences in obesity risk were largest after 5 y of age and persisted into adolescence. In the latent-class analysis, the highest-order maternal weight trajectory group consisted almost entirely of women who were obese before pregnancy and was associated with a>2-fold increase in the risk of offspring obesity at ages 6–11 y (adjusted RR: 2.39; 95% CI: 1.97, 2.89) and 12–19 y (adjusted RR: 2.74; 95% CI: 2.13, 3.52). In the analysis with maternal weight trajectory groups based on recommendations, the risk of child obesity was consistently highest for women who were overweight or obese at the beginning of pregnancy.Conclusion: These findings suggest that high maternal weight across the childbearing period increases the risk of obesity in offspring during childhood, but high prepregnancy BMI has a stronger influence than either gestational weight gain or postpartum weight retention.
      Keywords: Research Need: Impact of Nutrition on Healthy Growth, Development, and Reproduction
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.158683
      Issue No: Vol. 106, No. 5 (2017)
  • Biomarkers of food intake and nutrient status are associated with glucose
           tolerance status and development of type 2 diabetes in older Swedish women
           [Nutritional epidemiology and public health]
    • Authors: Savolainen, O; Lind, M. V, Bergström, G, Fagerberg, B, Sandberg, A.-S, Ross, A.
      Pages: 1302 - 1310
      Abstract: Background: Diet is frequently associated with both the development and prevention of type 2 diabetes (T2D), but there is a lack of objective tools for assessing the relation between diet and T2D. Biomarkers of dietary intake are unconfounded by recall and reporting bias, and using multiple dietary biomarkers could help strengthen the link between a healthy diet and the prevention of T2D.Objective: The objective of this study was to explore how diet is related to glucose tolerance status (GTS) and to future development of T2D irrespective of common T2D and cardiovascular disease risk factors by using multiple dietary biomarkers.Design: Dietary biomarkers were measured in plasma from 64-y-old Swedish women with different GTS [normal glucose tolerance (NGT; n = 190), impaired glucose tolerance (IGT; n = 209), and diabetes (n = 230)]. The same subjects were followed up after 5 y to determine changes in glucose tolerance (n = 167 for NGT, n = 174 for IGT, and n = 159 for diabetes). ANCOVA and logistic regression were used to explore baseline data for associations between dietary biomarkers, GTS, and new T2D cases at follow-up (n = 69).Results: Of the 10 dietary biomarkers analyzed, β-alanine (beef) (P-raw < 0.001), alkylresorcinols C17 and C19 (whole-grain wheat and rye) (P-raw = 0.003 and 0.011), eicosapentaenoic acid (fish) (P-raw = 0.041), 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid (CMPF) (fish) (P-raw = 0.002), linoleic acid (P-raw < 0.001), oleic acid (P-raw = 0.003), and α-tocopherol (margarine and vegetable oil) (P-raw < 0.001) were associated with GTS, and CMPF (fish) (OR: 0.72; 95% CI: 0.56, 0.93; P-raw = 0.013) and α-tocopherol (OR: 0.71; 95% CI: 0.51, 0.98; P-raw = 0.041) were inversely associated with future T2D development.Conclusions: Several circulating dietary biomarkers were strongly associated with GTS after correction for known T2D risk factors, underlining the role of diet in the development and prevention of T2D. To our knowledge, this study is the first to use multiple dietary biomarkers to investigate the link between diet and disease risk.
      Keywords: Diabetes, Research Need: Role of Nutrition in Health Maintenance
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.152850
      Issue No: Vol. 106, No. 5 (2017)
  • Cluster randomized controlled trial of a consumer behavior intervention to
           improve healthy food purchases from online canteens [Nutritional
           epidemiology and public health]
    • Authors: Delaney, T; Wyse, R, Yoong, S. L, Sutherland, R, Wiggers, J, Ball, K, Campbell, K, Rissel, C, Lecathelinais, C, Wolfenden, L.
      Pages: 1311 - 1320
      Abstract: Background: School canteens represent an opportune setting in which to deliver public health nutrition strategies because of their wide reach and frequent use by children. Online school-canteen ordering systems, where students order and pay for their lunch online, provide an avenue to improve healthy canteen purchases through the application of consumer-behavior strategies that have an impact on purchasing decisions.Objective: We assessed the efficacy of a consumer-behavior intervention implemented in an online school-canteen ordering system in reducing the energy, saturated fat, sugar, and sodium contents of primary student lunch orders.Design: A cluster-randomized controlled trial was conducted that involved 2714 students (aged 5–12 y) from 10 primary schools in New South Wales, Australia, who were currently using an online canteen ordering system. Schools were randomized in a 1:1 ratio to receive either the intervention (enhanced system) or the control (standard online ordering only). The intervention included consumer-behavior strategies that were integrated into the online ordering system (targeting menu labeling, healthy food availability, placement, and prompting).Results: Mean energy (difference: –567.25 kJ; 95% CI: –697.95, –436.55 kJ; P < 0.001), saturated fat (difference: –2.37 g; 95% CI: –3.08, –1.67 g; P < 0.001), and sodium (difference: –227.56 mg; 95% CI: –334.93, –120.19 mg; P < 0.001) contents per student lunch order were significantly lower in the intervention group than in the control group at follow-up. No significant differences were observed for sugar (difference: 1.16 g; 95% CI: –0.50, 2.83 g; P = 0.17).Conclusions: The study provides strong evidence supporting the effectiveness of a consumer-behavior intervention using an existing online canteen infrastructure to improve purchasing behavior from primary school canteens. Such an intervention may represent an appealing policy option as part of a broader government strategy to improve child public health nutrition. This trial was registered at as ACTRN12616000499482.
      Keywords: Research Need: Understanding Nutrition-related Behaviors, Research Need: How the Food Environment and Supply Affects Dietary and Lifestyle Choices
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.158329
      Issue No: Vol. 106, No. 5 (2017)
  • Genetic variation of habitual coffee consumption and glycemic changes in
           response to weight-loss diet intervention: the Preventing Overweight Using
    • Authors: Han, L; Ma, W, Sun, D, Heianza, Y, Wang, T, Zheng, Y, Huang, T, Duan, D, Bray, J. G. A, Champagne, C. M, Sacks, F. M, Qi, L.
      Pages: 1321 - 1326
      Abstract: Background: Coffee consumption has been associated with glucose metabolism and risk of type 2 diabetes.Objective: We examined whether the genetic variation determining habitual coffee consumption affected glycemic changes in response to weight-loss dietary intervention.Design: A genetic risk score (GRS) was calculated based on 8 habitual coffee consumption–associated single nucleotide polymorphisms. We used general linear models to test changes in glycemic traits in groups randomly assigned to high- and low-fat diets according to tertiles of the GRS.Results: We observed significant interactions between the GRS and low compared with high dietary fat intake on 6-mo changes in fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) (P-interaction = 0.023 and 0.022, respectively), adjusting for age, sex, race, physical activity, smoking, alcohol, seasonal variation, and baseline values of the respective outcomes. Participants with a higher GRS of habitual coffee consumption showed a greater reduction in fasting insulin and a marginally greater decrease in HOMA-IR in the low-fat diet intervention group.Conclusions: Our data suggest that participants with genetically determined high coffee consumption may benefit more by eating a low-fat diet in improving fasting insulin and HOMA-IR in a short term. This trial was registered at as NCT00072995 and NCT03258203.
      Keywords: Obesity and Metabolism Research Articles
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.156232
      Issue No: Vol. 106, No. 5 (2017)
  • Erratum for Gergen et al. Lack of a relation between serum
           25-hydroxyvitamin D concentrations and asthma in adolescents. Am J Clin
           Nutr 2013;97:1228-34. [Errata]
    • Pages: 1327 - 1327
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.167429
      Issue No: Vol. 106, No. 5 (2017)
  • Textbook of Global Health, Fourth Edition, by A-E Birn, Y Pillay, and TH
           Holtz. Reviewed by MT Tan [Book Review]
    • Authors: Tan M. T.
      Pages: 1328 - 1328
      PubDate: 2017-11-01T09:30:18-07:00
      DOI: 10.3945/ajcn.117.162073
      Issue No: Vol. 106, No. 5 (2017)
  • Calendar of Events [From the American Society for Nutrition]
    • Pages: 1329 - 1329
      PubDate: 2017-11-01T09:30:18-07:00
      Issue No: Vol. 106, No. 5 (2017)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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