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American Journal of Clinical Nutrition
Journal Prestige (SJR): 3.438
Citation Impact (citeScore): 6
Number of Followers: 143  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0002-9165 - ISSN (Online) 1938-3207
Published by Oxford University Press Homepage  [396 journals]
  • Another indication for the use of oral vitamin B-12 supplementation
    • Authors: Alpers D.
      Pages: 1 - 3
      PubDate: Fri, 06 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy118
      Issue No: Vol. 108, No. 1 (2018)
  • Rethinking apolipoprotein A-II in lipid metabolism
    • Authors: Pownall H.
      Pages: 4 - 5
      PubDate: Fri, 06 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy136
      Issue No: Vol. 108, No. 1 (2018)
  • Efficacy of oral compared with intramuscular vitamin B-12 supplementation
           after Roux-en-Y gastric bypass: a randomized controlled trial
    • Authors: Schijns W; Homan J, van der Meer L, et al.
      Pages: 6 - 12
      Abstract: ABSTRACTBackgroundAfter Roux-en-Y gastric bypass (RYGB), patients often develop a vitamin B-12 deficiency.ObjectiveOur objective was to investigate whether oral supplementation increases and normalizes low vitamin B-12 concentrations (vitamin B-12 > 200 pmol/L) in RYGB patients as compared to intramuscular injections.DesignA randomized controlled trial in RYGB patients with subnormal serum B-12 concentrations was performed. One group (IM B-12) received bimonthly intramuscular hydroxocobalamin injections (2000 µg as loading dose and 1000 µg at follow-up) for 6 mo. The second group (oral B-12) received daily doses of oral methylcobalamin (1000 µg). Serum vitamin B-12 was determined at baseline (T0) and at 2 (T1), 4 (T2), and 6 mo (T3) after start of treatment. Concentrations of the secondary markers methylmalonic acid (MMA) and homocysteine (Hcy) were measured at T0 and T3.ResultsFifty patients were included and randomized, 27 in IM B-12 and 23 in oral B-12. The median vitamin B-12 concentration at T0 was 175 pmol/L (range: 114–196 pmol/L) for IM B-12 and 167 pmol/L (range: 129–199 pmol/L) for oral B-12. Vitamin B-12 normalized in all individuals, and there was no significant difference in vitamin B-12 between the two groups. MMA and Hcy concentrations decreased significantly after 6 mo within each group (P < 0.001 and P < 0.001 for MMA and P = 0.03 and P = 0.045 for Hcy, respectively). There was no significant difference between the groups at 6 mo for both MMA and Hcy (P = 0.53 and P = 0.79).ConclusionThe efficacy of oral vitamin B-12 supplementation was similar to that of hydroxocobalamin injections in the present study. Oral supplementation can be used as an alternative to hydroxocobalamin injections to treat RYGB patients with low values of serum vitamin B-12. This trial was registered at as NCT02270749.
      PubDate: Thu, 21 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy072
      Issue No: Vol. 108, No. 1 (2018)
  • Plasma metabolites and lipids predict insulin sensitivity improvement in
           obese, nondiabetic individuals after a 2-phase dietary intervention
    • Authors: Meyer A; Montastier E, Hager J, et al.
      Pages: 13 - 23
      Abstract: ABSTRACTBackgroundWeight loss in obese individuals aims to reduce the risk of type 2 diabetes by improving glycemic control. Yet, significant intersubject variability is observed and the outcomes remain poorly predictable.ObjectiveThe aim of the study was to predict whether an individual will show improvements in insulin sensitivity above or below the median population change at 6 mo after a low-calorie-diet (LCD) intervention.DesignWith the use of plasma lipidomics and metabolomics for 433 subjects from the Diet, Obesity, and Genes (DiOGenes) Study, we attempted to predict good or poor Matsuda index improvements 6 mo after an 8-wk LCD intervention (800 kcal/d). Three independent analysis groups were defined: “training” (n = 119) for model construction, “testing” (n = 162) for model comparison, and “validation” (n = 152) to validate the final model.ResultsInitial modeling with baseline clinical variables (body mass index, Matsuda index, total lipid concentrations, sex, age) showed limited performance [area under the curve (AUC) on the “testing dataset” = 0.69; 95% CI: 0.61, 0.77]. Significantly better performance was achieved with an omics model based on 27 variables (AUC = 0.77; 95% CI: 0.70, 0.85; P = 0.0297). This model could be greatly simplified while keeping the same performance. The simplified model relied on baseline Matsuda index, proline, and phosphatidylcholine 0-34:1. It successfully replicated on the validation set (AUC = 0.75; 95% CI: 0.67, 0.83) with the following characteristics: specificity = 0.73, sensitivity = 0.68, negative predictive value = 0.60, and positive predictive value = 0.80. Marginally lower performance was obtained when replacing the Matsuda index with homeostasis model assessment of insulin resistance (AUC = 0.72; 95% CI: 0.64, 0.80; P = 0.08).ConclusionsOur study proposes a model to predict insulin sensitivity improvements, 6 mo after LCD completion in a large population of overweight or obese nondiabetic subjects. It relies on baseline information from 3 variables, accessible from blood samples. This model may help clinicians assessing the large variability in dietary interventions and predict outcomes before an intervention. This trial was registered at as NCT00390637.
      PubDate: Wed, 06 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy087
      Issue No: Vol. 108, No. 1 (2018)
  • Calcium absorption may be affected after either sleeve gastrectomy or
           Roux-en-Y gastric bypass in premenopausal women: a 2-y prospective study
    • Authors: Carrasco F; Basfi-fer K, Rojas P, et al.
      Pages: 24 - 32
      Abstract: ABSTRACTBackgroundAlthough Roux-en-Y gastric bypass (RYGBP) is known to reduce calcium absorption (CA), the effects of vertical sleeve gastrectomy (SG) and its long-term implications on CA have not yet been studied.ObjectiveThe aim of this study was to evaluate changes in CA and its relation with modifications of bone mineral density (BMD), intakes of calcium and vitamin D, vitamin D status, and parathyroid hormone (PTH) concentrations ≤24 mo after SG and RYGBP, respectively.DesignTwenty-six premenopausal women undergoing SG [mean ± SD body mass index (BMI; kg/m2): 37.3 ± 3.2; age: 34.2 ± 10.2 y] and 32 undergoing RYGBP (BMI: 42.0 ± 4.2; age: 37.3 ± 8.1 y) were studied at baseline (presurgery) and followed up at 12 and 24 mo after surgery. BMD, bone alkaline phosphatase activity, and serum PTH, 25-hydroxyvitamin D [25(OH)D], calcium, magnesium, and phosphorus concentrations were determined. Food and supplement intakes were recorded. CA was measured by using a dual stable isotope method.ResultsIn premenopausal women, CA was significantly reduced from 36.5% ± 2.0% preoperatively to 21.0% ± 2.3% and 18.8% ± 3.4% at 12 and 24 mo post–SG surgery, respectively. CA also decreased significantly from 41.5% ± 2.8% preoperatively to 27.9% ± 3.8% and 18.5% ± 2.2% 12 and 24 mo after RYGBP, respectively. No difference was found between type of surgery (time × group interaction, P = 0.60). Considering both groups combined, 56.6% of the variance in CA at the 12-mo but not at the 24-mo follow-up was explained by serum PTH and 25(OH)D concentrations, together with vitamin D and calcium intakes.ConclusionsCA was similarly reduced in both SG and RYGBP compared with baseline, and it was not associated with changes in BMD or body weight loss. This reduction in CA could be explained only partially by calcium intake increase. This trial is registered at as ISRCTN31937503.
      PubDate: Fri, 15 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy071
      Issue No: Vol. 108, No. 1 (2018)
  • A Mediterranean-style eating pattern with lean, unprocessed red meat has
           cardiometabolic benefits for adults who are overweight or obese in a
           randomized, crossover, controlled feeding trial
    • Authors: O'Connor L; Paddon-Jones D, Wright A, et al.
      Pages: 33 - 40
      Abstract: ABSTRACTBackgroundA Mediterranean-style eating pattern (Mediterranean Pattern) is often described as being low in red meat. Research shows that lean, unprocessed red meat can be incorporated into healthy eating patterns to improve cardiometabolic disease (CMD) risk factors.ObjectiveWe assessed the effects of consuming different amounts of lean, unprocessed red meat in a Mediterranean Pattern on CMD risk factors. We hypothesized that consuming a Mediterranean Pattern would improve CMD risk factors and that red meat intake would not influence these improvements.DesignIn an investigator-blinded, randomized, crossover, controlled feeding trial, 41 subjects [mean ± SD age: 46 ± 2 y; mean ± SD body mass index (kg/m2): 30.5 ± 0.6] were provided with a Mediterranean Pattern for two 5-wk interventions separated by 4 wk of self-selected eating. The Mediterranean Patterns contained ∼500 g [typical US intake (Med-Red)] and ∼200 g [commonly recommended intake in heart-healthy eating patterns (Med-Control)] of lean, unprocessed beef or pork per week. Red meat intake was compensated by poultry and other protein-rich foods. Baseline and postintervention outcomes included fasting blood pressure, serum lipids, lipoproteins, glucose, insulin, and ambulatory blood pressure. The presented results were adjusted for age, sex, and body mass at each time point (P < 0.05).ResultsTotal cholesterol decreased, but greater reductions occurred with Med-Red than with Med-Control (−0.4 ± 0.1 and −0.2 ±0.1 mmol/L, respectively, intervention × time = 0.045]. Low-density lipoprotein decreased with Med-Red but was unchanged with Med-Control [−0.3 ± 0.1 and −0.1 ± 0.1 mmol/L, respectively, intervention × time = 0.038], whereas high-density lipoprotein (HDL) concentrations decreased nondifferentially [−0.1 ± 0.0 mmol/L]. Triglycerides, total cholesterol:HDL, glucose, and insulin did not change with either Med-Red or Med-Control. All blood pressure parameters improved, except during sleep, independent of the red meat intake amount.ConclusionsAdults who are overweight or moderately obese may improve multiple cardiometabolic disease risk factors by adopting a Mediterranean-style eating pattern with or without reductions in red meat intake when red meats are lean and unprocessed. This trial was registered at as NCT02573129.
      PubDate: Wed, 13 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy075
      Issue No: Vol. 108, No. 1 (2018)
  • Chocolate intake and heart disease and stroke in the Women's Health
           Initiative: a prospective analysis
    • Authors: Greenberg J; Manson J, Neuhouser M, et al.
      Pages: 41 - 48
      Abstract: ABSTRACTBackgroundThree recent meta-analyses found significant prospective inverse associations between chocolate intake and cardiovascular disease risk. Evidence from these meta-analyses suggests that such inverse associations may only apply to elderly individuals or those with pre-existing major chronic disease.ObjectiveWe assessed the association between habitual chocolate intake and subsequent incident coronary heart disease (CHD) and stroke, and the potential effect of modification by age.DesignWe conducted multivariable Cox regression analyses using data from 83,310 postmenopausal women free of baseline pre-existing major chronic disease in the prospective Women's Health Initiative cohort. Chocolate intake was assessed using a food-frequency questionnaire. Physician-adjudicated events or deaths were ascertained up to 30 September 2013.ResultsAfter exclusions, there were 3246 CHD and 2624 stroke events or deaths, representing incidence rates of 3.9% and 3.2% during 1,098,091 and 1,101,022 person-years (13.4 y), respectively. We found no association between consumption of chocolate and risk of CHD (P for linear trend = 0.94) or stroke (P = 0.24). The results for CHD and stroke combined were similar (P = 0.30), but were significantly modified by age (P for interaction = 0.02). For women age <65 y at baseline, those who ate 1 oz (28.35 g) of chocolate <1/mo, 1 to <1.5/mo, 1.5 to <3.5/mo, 3.5/mo to <3/wk, and ≥3/wk had HRs (95% CIs) of 1.00 (referent), 1.17 (1.00, 1.36), 1.05 (0.90, 1.22), 1.09 (0.94, 1.25), and 1.27 (1.09, 1.49), respectively (P for linear trend = 0.005). No association was apparent for older women.ConclusionWe observed no association between chocolate intake and risk of CHD, stroke, or both combined in participants free of pre-existing major chronic disease. The relation for both combined was modified by age, with a significant positive linear trend and an increased risk in the highest quintile of chocolate consumption among women age <65 y. This trial was registered at as NCT03453073.
      PubDate: Thu, 21 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy073
      Issue No: Vol. 108, No. 1 (2018)
  • Polyphenol exposure and risk of type 2 diabetes: dose-response
           meta-analyses and systematic review of prospective cohort studies
    • Authors: Rienks J; Barbaresko J, Oluwagbemigun K, et al.
      Pages: 49 - 61
      Abstract: ABSTRACTBackgroundType 2 diabetes is characterized by impaired glucose metabolism. Bioactive compounds in fruits and vegetables such as polyphenols have been suggested to influence glucose metabolism.ObjectiveThe aim of the current study was to systematically review the literature and conduct dose-response meta-analyses to summarize evidence of polyphenol exposure in association with incident type 2 diabetes.DesignProspective epidemiologic studies published before January 2018 were searched through 2 databases. Log-transformed multivariable adjusted hazard and odds ratios were combined in a random-effects model. Meta-analyses comparing extreme quantiles of polyphenol exposure were further explored with the use of linear and nonlinear dose-response meta-analyses.ResultsEighteen studies investigated the association between polyphenols (51 different compounds in total) and type 2 diabetes. A comparison of extreme quantiles revealed inverse associations for intakes of polyphenols (HR: 0.56; 95% CI: 0.34, 0.93), flavonoids (HR: 0.88; 95% CI: 0.81, 0.96), flavonols (HR: 0.92; 95% CI: 0.85, 0.98), flavan-3-ols (HR: 0.89; 95% CI: 0.81, 0.99), catechins (HR: 0.86; 95% CI: 0.75, 0.97), anthocyanidins (HR: 0.86; 95% CI: 0.81, 0.91), isoflavones (HR: 0.92; 0.86, 0.97), daidzein (HR: 0.89; 95% CI: 0.83, 0.95), genistein (HR: 0.92; 95% CI: 0.86, 0.99), and stilbenes (HR: 0.44; 95% CI: 0.26, 0.72), and biomarkers of daidzein (HR: 0.81; 95% CI: 0.66, 0.99) and genistein (HR: 0.79; 95% CI: 0.62, 0.99). In the dose-response meta-analysis, nonlinear associations were observed for intakes of polyphenols, flavonoids, flavanones, anthocyanidins, anthocyanins, and biomarkers of genistein. A linear dose-response association was observed for phenolic acids.ConclusionsThis study adds to the evidence showing that diets rich in polyphenols, and particularly flavonoids, play a role in the prevention of type 2 diabetes. For most associations evidence for nonlinearity was found, suggesting a recommendable amount of intake associated with the lowest risk of type 2 diabetes. Therefore, future studies are warranted in which nonlinear associations are further explored.
      PubDate: Thu, 21 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy083
      Issue No: Vol. 108, No. 1 (2018)
  • High plasma apolipoprotein B identifies obese subjects who best ameliorate
           white adipose tissue dysfunction and glucose-induced hyperinsulinemia
           after a hypocaloric diet
    • Authors: Bissonnette S; Saint -Pierre N, Lamantia V, et al.
      Pages: 62 - 76
      Abstract: ABSTRACTBackgroundTo optimize the prevention of type 2 diabetes (T2D), high-risk obese subjects with the best metabolic recovery after a hypocaloric diet should be targeted. Apolipoprotein B lipoproteins (apoB lipoproteins) induce white adipose tissue (WAT) dysfunction, which in turn promotes postprandial hypertriglyceridemia, insulin resistance (IR), and hyperinsulinemia.ObjectiveThe aim of this study was to explore whether high plasma apoB, or number of plasma apoB lipoproteins, identifies subjects who best ameliorate WAT dysfunction and related risk factors after a hypocaloric diet.DesignFifty-nine men and postmenopausal women [mean ± SD age: 58 ± 6 y; body mass index (kg/m2): 32.6 ± 4.6] completed a prospective study with a 6-mo hypocaloric diet (−500 kcal/d). Glucose-induced insulin secretion (GIIS) and insulin sensitivity (IS) were measured by 1-h intravenous glucose-tolerance test (IVGTT) followed by a 3-h hyperinsulinemic-euglycemic clamp, respectively. Ex vivo gynoid WAT function (i.e., hydrolysis and storage of 3H-triolein–labeled triglyceride-rich lipoproteins) and 6-h postprandial plasma clearance of a 13C-triolein–labeled high-fat meal were measured in a subsample (n = 25).ResultsPostintervention first-phase GIISIVGTT and total C-peptide secretion decreased in both sexes, whereas second-phase and total GIISIVGTT and clamp IS were ameliorated in men (P < 0.05). Baseline plasma apoB was associated with a postintervention increase in WAT function (r = 0.61) and IS (glucose infusion rate divided by steady state insulin (M/Iclamp) r = 0.30) and a decrease in first-phase, second-phase, and total GIISIVGTT (r = −0.30 to −0.35) without sex differences. The association with postintervention amelioration in WAT function and GIISIVGTT was independent of plasma cholesterol (total, LDL, and HDL), sex, and changes in body composition. Subjects with high baseline plasma apoB (1.2 ± 0.2 g/L) showed a significant increase in WAT function (+105%; P = 0.012) and a decrease in total GIISIVGTT (−34%; P ≤ 0.001), whereas sex-matched subjects with low plasma apoB (0.7 ± 0.1 g/L) did not, despite equivalent changes in body composition and energy intake and expenditure.ConclusionsHigh plasma apoB identifies obese subjects who best ameliorate WAT dysfunction and glucose-induced hyperinsulinemia, independent of changes in adiposity after consumption of a hypocaloric diet. We propose that subjects with high plasma apoB represent an optimal target group for the primary prevention of T2D by hypocaloric diets. This trial was registered at BioMed Central as ISRCTN14476404.
      PubDate: Mon, 18 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy070
      Issue No: Vol. 108, No. 1 (2018)
  • Estimation of the maternal vitamin D intake that maintains circulating
           25-hydroxyvitamin D in late gestation at a concentration sufficient to
           keep umbilical cord sera ≥25–30 nmol/L: a dose-response, double-blind,
           randomized placebo-controlled trial in pregnant women at northern latitude
    • Authors: O'Callaghan K; Hennessy Á, Hull G, et al.
      Pages: 77 - 91
      Abstract: ABSTRACTBackgroundIn the absence of dose-response data, Dietary Reference Values for vitamin D in nonpregnant adults are extended to pregnancy.ObjectiveThe aim was to estimate vitamin D intake needed to maintain maternal 25-hydroxyvitamin D [25(OH)D] in late gestation at a concentration sufficient to prevent newborn 25(OH)D <25–30 nmol/L, a threshold indicative of increased risk of nutritional rickets.DesignWe conducted a 3-arm, dose-response, double-blind, randomized placebo-controlled trial in Cork, Ireland (51.9oN). A total of 144 white-skinned pregnant women were assigned to receive 0, 10 (400 IU), or 20 (800 IU) µg vitamin D3/d from ≤18 wk of gestation. Vitamin D metabolites at 14, 24, and 36 wk of gestation and in cord sera, including 25(OH)D3, 3-epi-25(OH)D3, 24,25(OH)2D3, and 25(OH)D2 were quantified by liquid chromatography–tandem mass spectrometry. A curvilinear regression model predicted the total vitamin D intake (from diet and antenatal supplements plus treatment dose) that maintained maternal 25(OH)D in late gestation at a concentration sufficient to maintain cord 25(OH)D at ≥25–30 nmol/L.ResultsMean ± SD baseline 25(OH)D was 54.9 ± 10.7 nmol/L. Total vitamin D intakes at the study endpoint (36 wk of gestation) were 12.1 ± 8.0, 21.9 ± 5.3, and 33.7 ± 5.1 µg/d in the placebo and 10-µg and 20-µg vitamin D3 groups, respectively; and 25(OH)D was 24.3 ± 5.8 and 29.2 ± 5.6 nmol/L higher in the 10- and 20-µg groups, respectively, compared with placebo (P < 0.001). For maternal 25(OH)D concentrations ≥50 nmol/L, 95% of cord sera were ≥30 nmol/L and 99% were >25 nmol/L. The estimated vitamin D intake required to maintain serum 25(OH)D at ≥50 nmol/L in 97.5% of women was 28.9 µg/d.ConclusionsThirty micrograms of vitamin D per day safely maintained serum 25(OH)D concentrations at ≥50 nmol/L in almost all white-skinned women during pregnancy at a northern latitude, which kept 25(OH)D at >25 nmol/L in 99% and ≥30 nmol/L in 95% of umbilical cord sera. This trial was registered at as NCT02506439.
      PubDate: Wed, 06 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy064
      Issue No: Vol. 108, No. 1 (2018)
  • Long-chain polyunsaturated fatty acids, gestation duration, and birth
           size: a Mendelian randomization study using fatty acid desaturase variants
    • Authors: Bernard J; Pan H, Aris I, et al.
      Pages: 92 - 100
      Abstract: ABSTRACTBackgroundIn randomized trials, supplementation of n–3 (ω-3) long-chain polyunsaturated fatty acids (LC-PUFAs) during pregnancy has resulted in increased size at birth, which is attributable to longer gestation.ObjectiveWe examined this finding by using a Mendelian randomization approach utilizing fatty acid desaturase (FADS) gene variants affecting LC-PUFA metabolism.DesignAs part of a tri-ethnic mother-offspring cohort in Singapore, 35 genetic variants in FADS1, FADS2, and FADS3 were genotyped in 898 mothers and 1103 offspring. Maternal plasma n–3 and n–6 PUFA concentrations at 26–28 wk of gestation were measured. Gestation duration was derived from an ultrasound dating scan in early pregnancy and from birth date. Birth length and weight were measured. Eight FADS variants were selected through a tagging-SNP approach and examined in association with PUFA concentrations, gestation duration among spontaneous labors, and birth size with the use of ethnicity-adjusted linear regressions and survival models that accounted for the competing risks of induced labor and prelabor cesarean delivery.ResultsMaternal FADS1 variant rs174546, tagging for 8 other variants located on FADS1 and FADS2, was strongly related to plasma n–6 but not n–3 LC-PUFA concentrations. Offspring and maternal FADS3 variants were associated with gestation duration among women who had spontaneous labor: each copy of rs174450 minor allele C was associated with a shorter gestation by 2.2 d (95% CI: 0.9, 3.4 d) and 1.9 d (0.7, 3.0 d) for maternal and offspring variants, respectively. In survival models, rs174450 minor allele homozygotes had reduced time to delivery after spontaneous labor compared with major allele homozygotes [HR (95% CI): 1.51 (1.18, 1.95) and 1.51 (1.20, 1.89) for mothers and offspring, respectively].ConclusionsWith the use of a Mendelian randomization approach, we observed associations between FADS variants and gestation duration. This suggests a potential role of LC-PUFAs in gestation duration. This trial was registered at as NCT01174875.
      PubDate: Wed, 06 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy079
      Issue No: Vol. 108, No. 1 (2018)
  • Pregnancy loss of control over eating: a longitudinal study of maternal
           and child outcomes
    • Authors: Micali N; Al Essimii H, Field A, et al.
      Pages: 101 - 107
      Abstract: ABSTRACTBackgroundTo our knowledge, no previous studies have investigated longitudinal outcomes of maternal loss of control over eating (LOC) in pregnancy in a general population sample.ObjectiveWe aimed to determine whether pregnancy LOC is associated with dietary, gestational weight gain, and offspring birth-weight outcomes in a large population-based prospective study of pregnant women and their children. We also explored the association with offspring weight at age 15.5 y.DesignWomen (n = 11,132) from the Avon Longitudinal Study of Parents and Children (ALSPAC) were included. Crude and adjusted logistic and multinomial regression models were used. LOC in pregnancy and diet at 32 wk of gestation were assessed by self-report. Pregnancy weight gain and birth weight were obtained from obstetric records. Child weight and height were objectively measured at age 15.5 y.ResultsLOC in pregnancy was common (36.3%). Women with pregnancy LOC reported higher total energy intake, consumed more snacks, and had lower vitamin B-6, A, and C intake compared with women without LOC. Women with frequent LOC had lower vitamin B-1 and folate intake [respectively: b = −0.05 (95% CI: −0.07, −0.02) and b = −7.1 (95% CI: −11.8, −2.3) in adjusted analyses], and gained on average 3.74 kg (95% CI: 3.33, 4.13 kg) more than women without LOC. Frequent and occasional LOC were associated with higher birth weight [respectively: b = 0.07 (95% CI: 0.03, 0.1), b = 0.04 (95% CI: 0.02, 0.06)]. Offspring of mothers with frequent pregnancy LOC had 2-fold increased odds of being overweight/obese at 15.5 y [OR = 2.02 (95% CI: 1.37, 3.01)].ConclusionsPregnancy LOC eating is common and has an adverse short- and long-term impact on mother and offspring, but has received very limited attention. Our findings further the understanding of risk factors for obesity and highlight a need for improved identification of maternal pregnancy loss of control eating. This trial was registered at as NCT03269253.
      PubDate: Tue, 05 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy040
      Issue No: Vol. 108, No. 1 (2018)
  • Nutrient enrichment of human milk with human and bovine milk–based
           fortifiers for infants born weighing <1250 g: a randomized clinical
    • Authors: O'Connor D; Kiss A, Tomlinson C, et al.
      Pages: 108 - 116
      Abstract: ABSTRACTBackgroundHuman milk-based fortifiers (HMBFs) are being adopted in neonatal care to enrich the nutrients in human milk for very low birth weight (VLBW) infants despite being costly and there being limited efficacy data. No randomized clinical trial has evaluated the use of HMBF compared with bovine milk–based fortifiers (BMBFs) in the absence of formula feeding.ObjectiveTo determine if HMBF compared with BMBF for routine nutrient enrichment of human milk improves feeding tolerance, reduces morbidity, reduces fecal calprotectin (a measure of gut inflammation), and supports the growth of infants <1250 g.DesignIn this blinded randomized clinical trial, infants born weighing <1250 g were recruited from neonatal units in Ontario, Canada between August 2014 and November 2015. The infants were fed mother's milk and donor milk as required. Fortification commenced at 100 mL/kg per day of HMBF (0.81 kcal/mL) or BMBF (0.72 kcal/mL) and advanced at 140 mL/kg per day to 0.88 and 0.78 kcal/mL, respectively. The primary outcome was percentage of infants with a feeding interruption for ≥12 h or a >50% reduction in feeding volume. Secondary outcomes included a dichotomous mortality and morbidity index (i.e., affirmative for any one of death, late-onset sepsis, necrotizing enterocolitis, chronic lung disease, or severe retinopathy of prematurity), fecal calprotectin, and growth.ResultsOf 232 eligible infants, 127 (54.7%) were randomized (n = 64 HMBF, n = 63 BMBF). Mean ± SD birth weight and gestational age of infants were 888 ± 201 g and 27.7 ± 2.5 wk, respectively. No statistically significant differences were identified in feeding interruptions [17/64 HMBF, 20/61 BMBF; unadjusted risk difference: −6.2% (95% CI: −22.2%, 9.8%)]. There was no statistically significant difference in the mortality and morbidity index (48.4% HMBF, 49.2% BMBF, adjusted P = 0.76), changes in fecal calprotectin, or growth z scores.ConclusionsAmong infants born weighing <1250 g and exclusively fed human milk, the use of HMBF did not improve feeding tolerance or reduce mortality and morbidity compared with BMBF. This trial was registered at as NCT02137473.
      PubDate: Fri, 15 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy067
      Issue No: Vol. 108, No. 1 (2018)
  • Metabolic signature of healthy lifestyle and its relation with risk of
           hepatocellular carcinoma in a large European cohort
    • Authors: Assi N; Gunter M, Thomas D, et al.
      Pages: 117 - 126
      Abstract: ABSTRACTBackgroundStudies using metabolomic data have identified metabolites from several compound classes that are associated with disease-related lifestyle factors.ObjectiveIn this study, we identified metabolic signatures reflecting lifestyle patterns and related them to the risk of hepatocellular carcinoma (HCC) in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.DesignWithin a nested case-control study of 147 incident HCC cases and 147 matched controls, partial least squares (PLS) analysis related 7 modified healthy lifestyle index (HLI) variables (diet, BMI, physical activity, lifetime alcohol, smoking, diabetes, and hepatitis) to 132 targeted serum-measured metabolites and a liver function score. The association between the resulting PLS scores and HCC risk was examined in multivariable conditional logistic regression models, where ORs and 95% CIs were computed.ResultsThe lifestyle component's PLS score was negatively associated with lifetime alcohol, BMI, smoking, and diabetes, and positively associated with physical activity. Its metabolic counterpart was positively related to the metabolites sphingomyelin (SM) (OH) C14:1, C16:1, and C22:2, and negatively related to glutamate, hexoses, and the diacyl-phosphatidylcholine PC aaC32:1. The lifestyle and metabolomics components were inversely associated with HCC risk, with the ORs for a 1-SD increase in scores equal to 0.53 (95% CI: 0.38, 0.74) and 0.28 (0.18, 0.43), and the associated AUCs equal to 0.64 (0.57, 0.70) and 0.74 (0.69, 0.80), respectively.ConclusionsThis study identified a metabolic signature reflecting a healthy lifestyle pattern which was inversely associated with HCC risk. The metabolic profile displayed a stronger association with HCC than did the modified HLI derived from questionnaire data. Measuring a specific panel of metabolites may identify strata of the population at higher risk for HCC and can add substantial discrimination compared with questionnaire data. This trial was registered at as NCT03356535.
      PubDate: Thu, 21 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy074
      Issue No: Vol. 108, No. 1 (2018)
  • Fat label compared with fat content: gastrointestinal symptoms and brain
           activity in functional dyspepsia patients and healthy controls
    • Authors: Lee I; Kullmann S, Scheffler K, et al.
      Pages: 127 - 135
      Abstract: ABSTRACTBackgroundHigh-fat meals are associated with dyspeptic symptoms in functional dyspepsia (FD) patients. It is still unclear how fat is processed, or how FD symptoms and neuronal activities are modulated by psychological factors.ObjectiveWe investigated brain activity by functional magnetic resonance imaging (fMRI) after the ingestion of high- and low-fat foods with correct/incorrect fat information.DesignWe compared 12 FD patients and 14 healthy controls (HCs). We recorded resting-state fMRI on four different days before and after ingestion of four yogurts (200 mL, 10% or 0.1% fat, “low fat” or “high fat” label).ResultsFD patients showed more pronounced dyspeptic symptoms than did HCs, and symptoms were relieved less after consuming high fat–labeled yogurt than low fat–labeled yogurt, irrespective of the actual fat content. This is indicative of either a placebo effect of low-fat information or a nocebo effect of high-fat information on symptom expression. FD patients showed greater activity than did HCs in occipital areas before and after ingestion regardless of fat content and label, as well as greater activity in the middle frontal gyrus before ingestion. In addition, functional connectivity (FC) from the insula to the occipital cortex (I-O) increased after high fat ingestion and decreased after low fat ingestion in FD patients. FC from the insula to the precuneus (I-P) was higher in FD patients than in HCs after ingestion of low fat–labeled yogurt. In FD patients, I-O FC negatively correlated with nausea and I-P FC with FD symptom intensity, food craving, and depression.ConclusionsOur results endorse the importance of psychological perception of food on the incidence of dyspeptic symptoms and on the altered brain activities. These findings show the importance of cognitive components in perceptions of fat, food craving, depression, and brain functions in pathophysiologic mechanisms of FD.This trial was registered at as NCT02618070.
      PubDate: Mon, 18 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy077
      Issue No: Vol. 108, No. 1 (2018)
  • Effects of intraduodenal administration of the artificial sweetener
           sucralose on blood pressure and superior mesenteric artery blood flow in
           healthy older subjects
    • Authors: Pham H; Stevens J, Rigda R, et al.
      Pages: 156 - 162
      Abstract: ABSTRACTBackgroundPostprandial hypotension (PPH) occurs frequently, particularly in older people and those with type 2 diabetes, and is associated with increased morbidity and mortality. The magnitude of the decrease in blood pressure (BP) induced by carbohydrate, fat, and protein appears to be comparable and results from the interaction of macronutrients with the small intestine, including an observed stimulation of mesenteric blood flow. It is not known whether artificial sweeteners, such as sucralose, which are widely used, affect BP.ObjectiveThe aim of this study was to evaluate the effects of intraduodenal sucralose on BP and superior mesenteric artery (SMA) blood flow, compared with intraduodenal glucose and saline (control), in healthy older subjects.DesignTwelve healthy subjects (6 men, 6 women; aged 66–79 y) were studied on 3 separate occasions in a randomized, double-blind, crossover design. After an overnight fast, subjects had concurrent measurements of BP and heart rate (HR; automated device), SMA blood flow (Doppler ultrasound), and blood glucose (glucometer) during intraduodenal infusion of 1) glucose (25% wt:vol, ∼1400 mOsmol/L), 2) sucralose (4 mmol/L, ∼300 mOsmol/L), or 3) saline (0.9% wt:vol, ∼300 mOsmol/L) at a rate of 3 mL/min for 60 min followed by intraduodenal saline for a further 60 min.ResultsThere was a decrease in mean arterial BP (P < 0.001) during intraduodenal glucose [baseline (mean ± SEM): 91.7 ± 2.6 mm Hg compared with t = 60 min: 85.9 ± 2.8 mm Hg] but not during intraduodenal saline or intraduodenal sucralose. The HR (P < 0.0001) and SMA blood flow (P < 0.0001) also increased during intraduodenal glucose but not during intraduodenal saline or intraduodenal sucralose. As expected, blood glucose concentrations increased in response to glucose (P < 0.0001) but not saline or sucralose.ConclusionsIn healthy older subjects, intraduodenal administration of the artificial sweetener sucralose was not associated with changes in BP or SMA blood flow. Further studies are therefore warranted to determine the potential role for artificial sweeteners as a therapy for PPH. This trial was registered at as ACTRN12617001249347.
      PubDate: Wed, 06 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy060
      Issue No: Vol. 108, No. 1 (2018)
  • Plasma trimethylamine-N-oxide and related metabolites are associated with
           type 2 diabetes risk in the Prevención con Dieta Mediterránea (PREDIMED)
    • Authors: Papandreou C; Bulló M, Zheng Y, et al.
      Pages: 163 - 173
      Abstract: ABSTRACTBackgroundThe role of trimethylamine-N-oxide (TMAO) in type 2 diabetes (T2D) is currently partially understood and controversial.ObjectiveThe aim of this study was to investigate associations between TMAO and related metabolites with T2D risk in subjects at high risk of cardiovascular disease.DesignThis is a case-cohort design study within the Prevención con Dieta Mediterránea (PREDIMED) study, with 251 incident T2D cases and a random sample of 694 participants (641 noncases and 53 overlapping cases) without T2D at baseline (median follow-up: 3.8 y). We used liquid chromatography–tandem mass spectrometry to measure plasma TMAO, l-carnitine, betaine, lyso-phosphatidylcholine (LPC) and lyso-phosphatidylethanolamine (LPE) species, phosphocholine, α-glycerophosphocholine, and choline at baseline and after 1 y. We examined associations with the use of weighted Cox proportional hazard models, accounting for the weighted case-cohort design by the Barlow method.ResultsAfter adjustment for recognized T2D risk factors and multiple testing, individuals in the highest quartile of baseline TMAO and α-glycerophosphocholine had a lower risk of T2D [HR (95% CI): 0.52 (0.29, 0.89) and 0.46 (0.24, 0.89), respectively]. The HR (95% CI) comparing the extreme quartiles of betaine was 0.41 (0.23, 0.74). Similar trends were observed for C16:0 LPC, C18:1 LPC, C18:0 LPC, C20:4 LPC, C22:6 LPC, C18:1 LPC plasmalogen, and C16:0 LPE. After correcting for multiple comparisons, participants in the highest quartile of 1-y changes in oleic acid LPC plasmalogen concentrations had a lower T2D risk than the reference quartile.ConclusionWhether the associations between plasma TMAO and certain metabolite concentrations with T2D risk reflect its pathophysiology or represent an epiphenomenon needs to be elucidated. This trial is registered at as ISRCTN35739639.
      PubDate: Fri, 06 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy058
      Issue No: Vol. 108, No. 1 (2018)
  • Effects of walnut consumption on blood lipids and other cardiovascular
           risk factors: an updated meta-analysis and systematic review of controlled
    • Authors: Guasch-Ferré M; Li J, Hu F, et al.
      Pages: 174 - 187
      Abstract: ABSTRACTBACKGROUNDIntervention studies suggest that incorporating walnuts into the diet may improve blood lipids without promoting weight gain.OBJECTIVEWe conducted a systematic review and meta-analysis of controlled trials evaluating the effects of walnut consumption on blood lipids and other cardiovascular risk factors.DesignWe conducted a comprehensive search of PubMed and EMBASE databases (from database inception to January 2018) of clinical trials comparing walnut-enriched diets with control diets. We performed random-effects meta-analyses comparing walnut-enriched and control diets for changes in pre-post intervention in blood lipids (mmol/L), apolipoproteins (mg/dL), body weight (kg), and blood pressure (mm Hg).RESULTSTwenty-six clinical trials with a total of 1059 participants were included. The following weighted mean differences (WMDs) in reductions were obtained for walnut-enriched diets compared with control groups: −6.99 mg/dL (95% CI: −9.39, −4.58 mg/dL; P < 0.001) (3.25% greater reduction) for total blood cholesterol (TC) and −5.51 mg/dL (95% CI: −7.72, −3.29 mg/dL; P < 0.001) (3.73% greater reduction) for low-density lipoprotein (LDL) cholesterol. Triglyceride concentrations were also reduced in walnut-enriched diets compared with control [WMD = −4.69 (95% CI: −8.93, −0.45); P = 0.03; 5.52% greater reduction]. More pronounced reductions in blood lipids were observed when walnut interventions were compared with American and Western diets [WMD for TC = −12.30 (95% CI: −23.17, −1.43) and for LDL = −8.28 (95% CI: −13.04, −3.51); P < 0.001]. Apolipoprotein B (mg/dL) was also reduced significantly more on walnut-enriched diets compared with control groups [WMD = −3.74 (95% CI: −6.51, −0.97); P = 0.008] and a trend towards a reduction was observed for apolipoprotein A [WMD = −2.91 (95% CI: −5.98, 0.08); P = 0.057]. Walnut-enriched diets did not lead to significant differences in weight change (kg) compared with control diets [WMD = −0.12 (95% CI: −2.12, 1.88); P = 0.90], systolic blood pressure (mm Hg) [WMD = −0.72 (95% CI: −2.75, 1.30); P = 0.48], or diastolic blood pressure (mm Hg) [WMD = −0.10 (95% CI: −1.49, 1.30); P = 0.88].ConclusionsIncorporating walnuts into the diet improved blood lipid profile without adversely affecting body weight or blood pressure.
      PubDate: Thu, 21 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy091
      Issue No: Vol. 108, No. 1 (2018)
  • Epigenomics and metabolomics reveal the mechanism of the APOA2-saturated
           fat intake interaction affecting obesity
    • Authors: Lai C; Smith C, Parnell L, et al.
      Pages: 188 - 200
      Abstract: ABSTRACTBackgroundThe putative functional variant −265T>C (rs5082) within the APOA2 promoter has shown consistent interactions with saturated fatty acid (SFA) intake to influence the risk of obesity.ObjectiveThe aim of this study was to implement an integrative approach to characterize the molecular basis of this interaction.DesignWe conducted an epigenome-wide scan on 80 participants carrying either the rs5082 CC or TT genotypes and consuming either a low-SFA (<22 g/d) or high-SFA diet (≥22 g/d), matched for age, sex, BMI, and diabetes status in the Boston Puerto Rican Health Study (BPRHS). We then validated the findings in selected participants in the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) Study (n = 379) and the Framingham Heart Study (FHS) (n = 243). Transcription and metabolomics analyses were conducted to determine the relation between epigenetic status, APOA2 mRNA expression, and blood metabolites.ResultsIn the BPRHS, we identified methylation site cg04436964 as exhibiting significant differences between CC and TT participants consuming a high-SFA diet, but not among those consuming low-SFA. Similar results were observed in the GOLDN Study and the FHS. Additionally, in the FHS, cg04436964 methylation was negatively correlated with APOA2 expression in the blood of participants consuming a high-SFA diet. Furthermore, when consuming a high-SFA diet, CC carriers had lower APOA2 expression than those with the TT genotype. Lastly, metabolomic analysis identified 4 pathways as overrepresented by metabolite differences between CC and TT genotypes with high-SFA intake, including tryptophan and branched-chain amino acid (BCAA) pathways. Interestingly, these pathways were linked to rs5082-specific cg04436964 methylation differences in high-SFA consumers.ConclusionsThe epigenetic status of the APOA2 regulatory region is associated with SFA intake and APOA2 −265T>C genotype, promoting an APOA2 expression difference between APOA2 genotypes on a high-SFA diet, and modulating BCAA and tryptophan metabolic pathways. These findings identify potential mechanisms by which this highly reproducible gene-diet interaction influences obesity risk, and contribute new insights to ongoing investigations of the relation between SFA and human health.This study was registered at as NCT03452787.
      PubDate: Tue, 12 Jun 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy081
      Issue No: Vol. 108, No. 1 (2018)
  • Use of people-first language with regard to obesity
    • Authors: Palad C; Stanford F.
      Pages: 201 - 203
      PubDate: Wed, 04 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy076
      Issue No: Vol. 108, No. 1 (2018)
  • Reply to ST McSorley et al.
    • Authors: Suchdev P; Young M, Williams A, et al.
      Pages: 202 - 203
      PubDate: Fri, 06 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqx074
      Issue No: Vol. 108, No. 1 (2018)
  • Comment on the Biomarkers Reflecting Inflammation and Nutritional
           Determinants of Anemia (BRINDA) project
    • Authors: McSorley S; Talwar D, McMillan D.
      Pages: 204 - 205
      PubDate: Fri, 06 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqx071
      Issue No: Vol. 108, No. 1 (2018)
  • Calendar of Events
    • Pages: 204 - 204
      PubDate: Fri, 06 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ajcn/nqy159
      Issue No: Vol. 108, No. 1 (2018)
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