Metabolic syndrome is a term encompassing risk factors for coronary heart disease, stroke and type 2 diabetes. It is becoming more prevalent globally, even in areas where micronutrient deficiencies are prevalent. The 2 most important risk factors are: 1) central obesity and 2) insulin resistance – the body doesn’t use insulin effectively to regulate blood glucose levels. Unfortunately, metabolic syndrome isn’t occurring only in western societies. Cultures are transforming globally. Kaduka and colleagues conducted a cross-sectional survey of 539 adults living in Nairobi.
Archive for 'February 2012'
A new study reports that lower levels of omega-3 fatty acids, docosahexaenoic (DHA) and eicosapentaenoic (EPA), measured in red blood cells (RBC) is associated with smaller brain volumes and evidence of cognitive impairment. Tan and colleagues measured RBC DHA and EPA levels in 1,547 people participating in the Framingham Study. The study population had an average age of 67y and were free of dementia. Brain volume was measured by MRI scan. Those in the lowest quartile of DHA levels had brain volumes equivalent to about 2 years of structural brain aging. They also scored lower on tests of visual memory, problem solving, multi-tasking and abstract thinking. This study builds upon an earlier report on Australian infants by Meldrum and associates.
The Institute of Medicine published a workshop report ‘Measuring Progress in Obesity Prevention’. Nearly 69% of US adults and 32% of children are either overweight or obese. The estimated annual medical cost burden is $147 billion: almost $500 per person per year. This is the average. A deeper look shows many disparities. Since data has been collected, obesity prevalence is higher among Black and Mexican American women than others (White women and men of all ethnicities). The gap is not narrowing.
Despite recurring images of stunted children in developing countries, too often the child is being held by an overweight adult. This is the double burden of malnutrition: the coexistence of inadequate intakes of essential micronutrients (vitamins and minerals) and overweight/obesity. Oddo and colleagues report data collected from 247,126 rural households in Indonesia (2000-2003) and 168,317 in Bangladesh (2003-2006). 32% of over 400,000 women, averaging 28y of age, were overweight. 25% of the children were stunted. Overweight and stunted child pairs were found in 11% of Indonesian households. In about half of these pairs, the mother had a BMI > 25. In rural Bangladesh, 4% of the population had an overweight mother-stunted child pair. Again, the mother had a BMI >25 in about 50% of these pairs.
Disease risks increase with nutritional inadequacy: vitamin D and osteoporosis, vitamin C and scurvy, etc. Iron supplementation prevents anemia, it doesn’t create superman. Folate supplementation prevents neural tube defects and helps produce beautiful, healthy babies. But nutrients are not drugs. So why do scientists seem to always use a drug paradigm to study nutrients? In a new meta-analysis, Clarke and colleagues report that homocysteine levels have no relationship with cardiovascular disease. The title of their paper suggests that previous research linking homocysteine levels with coronary heart disease was biased. Unfortunately, this study also has flaws,
In 1912 a scientist named Casmir Funk coined the term “vitamins” to describe bioactive substances essential for human and animal health. 100 years later, deficiencies of the 13 vitamins are still being found. The latest case report by Scarano and colleagues describes neurological dysfunction because of thiamin deficiency in a 27y old woman two months following bariatric surgery. How can this be? In this case, it is because of surgery to facilitate weight loss which reduced food intake and nutrient absorption. However, malnutrition is usually caused because a person is not getting enough food or eating foods which do not contain enough essential vitamins and minerals. Hunger is solvable. One solution is to choose foods naturally rich or fortified with vitamins and minerals. Another solution could be a multivitamin-mineral supplement.
Being overweight or obese increases the risk of diabetes. For many people their pancreas cannot produce enough insulin to drive glucose into cells. Because of a lack of insulin production, circulating glucose levels remain elevated for hours after a meal. Jans and colleagues tested the impact of diet fat type, saturated (SFA) vs monounsaturated (MUFA) vs polyunsaturated (PUFA), on postprandial insulin sensitivity. Using labeled palmitate and a randomized crossover study design, they measured the effect of 3 high-fat mixed liquid meals (40 g oil) on insulin and glucose levels and muscle metabolism.
Higher plasma vitamin D levels are associated with lower risk of diabetes. So finds a new study published in Diabetes Care. Pittas and colleagues analyzed observational data from the Diabetes Prevention Program (DPP) on patient records with an average followup time of 2.7 years. This is important. As of July 2011, the World Health Organization estimates that 346 million people have diabetes. They project that deaths attributable to diabetes will double between 2005 and 2030. More than 80% of diabetes deaths occur in low- and middle-income countries. Earlier this month, linked with increased risk of diabetes in the Korean population. More than half of adults in the UK may have inadequate serum vitamin D
Let’s be honest. Nutritionists tend to favor whole foods. They claim that ‘one can get all the nutrients needed from a balanced diet’. It is true if you eat like a nutritionist. Unfortunately, most don’t. And until fried potatoes and potato chips aren’t the number one vegetable, there is likely to be a nutrition gap It’s time to speak from the heart. Most of us are not successful in meeting dietary recommendations. We barely eat 2 servings of fruits and vegetables a day. In fact, Americans eat 1.03 cups of fruit and 1.58 cups of vegetables. According to Siega-Riz and co-authors, the most commonly consumed vegetable for children 21-24 months is French fries or other fired potatoes.
The first scientific was published reporting that nutrients, DHA and omega-3 fatty acids, can modify rate of visual decline in individuals with retinitis pigmentosa. Berson and colleagues analyzed dietary intake by 357 patients from 3 trials. Individuals were randomized to 15,000 IU vitamin A daily for 4-6y. Mean rates of visual decline were lower in those consuming more than 200 mg omega-3 fatty acids per day (vs < 200 mg/d) in combination with vitamin A. Patients typically report night blindness in adolescence. About 2 million people are diagnosed with this eye disease worldwide (1 in 4,000)
Living a healthy life, including getting plenty of exercise, regular medical check-ups and maintaining a healthy weight, and avoiding smoking, radiation, certain infections and excessive alcohol consumption, form the basis of proven recommendations to avoid cancer. We are still researching other ways to reduce our risk of cancer. Andreeva and colleagues report in the Archives of Internal Medicine on an RCT that investigated whether B vitamins and omega-3 polyunsaturated fatty acids at levels achievable by a healthy diet can prevent cancer in 2500 older French adults. These subjects were recruited if they had experienced a heart attack, unstable angina or a stroke in the previous 12 months, and supplemented for 5 years. The primary endpoint was actually cardiovascular disease, and for this risk population there was no improvement in outcomes. Cancer was a secondary endpoint and was found in 7 percent of the study participants by the end.
Dietary patterns are associated with risk of many chronic diseases. Because people select foods to eat, and nutrient-based randomized control trials in humans haven’t always confirmed animal and in vitro studies, many prefer food-based dietary guidelines. The FAO makes this clear in its Preparation and use of food-based dietary guidelines. . As do the USDA and HHS in the Dietary Guidelines for Americans. However, nutrient Intakes are important. And independent from dietary patterns. Omega-3 fatty acids are important structural lipids for the brain. The type of fat consumed affects lipid membrane composition, membrane fluidity, and the function of entities embedded in these bilayers. As reviewed by Lauritzen and colleagues in the introduction to their paper, higher intakes of long-chain omega-3 fatty acids
Celebrating its 25th birthday, DSM Sight and Life programme releases a book entitled “Micronutrients, Macro Impact: The story of vitamins and a hungry world” and describing its 25 year history battling hidden hunger. 100 years ago, in 1912, Casimir Funk coined the term ‘vitamins’ to describe bioactive substances essential for human and animal health. Since then, a variety of vitamins with different chemical structures have been identified. Unlike carbohydrates, fat and protein, vitamins are not used to build cells or for energy. They protect the body from damaging effects of toxic compounds, regulate metabolic processes, and promote growth and development. Vitamins are essential for life. Unfortunately, millions of people do not consume adequate amounts of vitamins. Severe vitamin deficiencies lead to death. Inadequate intakes cripple. For example, vitamin A deficiency leads to blindness. Vitamin C deficiency causes
Here’s the situation. A family shares a car. Mum drives it to work every day and a high school son and daughter use it evenings and weekends. Mum has been out of town on business since Sunday. It is Thursday morning and she gets into the car. Does she check the gas gauge? Or does she rely upon the information shared at breakfast by the kids with respect to the last time they put gas in the car? How much? When? Have they driven it since? How far? A study by Ganji and colleagues in the Journal of Nutrition demonstrates the importance of using accurate measures, e.g. serum 25(OH)D concentrations, rather than recall, e.g. self-reported food records, to estimate status, e.g. prevalence of vitamin D deficiency. In the most accurate evaluation of serum 25(OH)D levels to date, they report
Malnutrition is a global challenge. A child dies from hunger every 6 seconds. Almost 1 billion people suffer from chronic hunger worldwide. Without food, people struggle to work. Children struggle to learn. Feed the Future is a $3.5 billion pledge to tackle global food insecurity. Micronutrient powders are one of the most effective nutritional interventions to eradicate nutrient deficiencies in resource-poor communities. However, the current foil packaging to preserve the integrity of vitamin and mineral powders creates significant waste since 200-300 million packets are distributed annually. And two-thirds of the current cost of production of these powders is the packaging.
Researchers test hypotheses and seek to publish their findings in journals reviewed by their peers. Most fields, including nutrition, have researchers with differing opinions, different hypotheses regarding mechanisms of action, differences in closely-held assumptions, and varied scientific pedigrees. Researchers compete to find answers to questions and promote theories to obtain funding for their research. As a researcher, it is stimulating to debate. As a consumer, public debates cause confusion. Take for example, folic acid fortification. Despite the fact that Lee and colleagues could not find an adverse relationship between folic acid intake and colorectal health in a detailed epidemiologic analysis of 121,700 nurses and 51,529 male health professionals, Vanderwall and colleagues set out to identify
The Superbowl is over. It was exciting. Right to the final minute and the last hail mary throw. In reflection, the game was memorable. The snacks were good. And that was good too because more fruit and vegetable platters are consumed on Superbowl Sunday than any other day of the year. Murphy and co-authors studied food consumption data of 8,072 individuals obtained from NHANES. They report that only 40% men and 60% of women met dietary recommendations for fruit and vegetables. These individuals had higher phytonutrient intakes. Still, almost 2/3 of their daily intake of 5 phytonutrients was consumed from a single food. Carrots provided 72.5% and 30.8% of their alpha-carotene and beta-carotene, respectively.
Older people are at risk of vitamin B12 deficiency due to the effects of aging on the gastrointestinal system. Vitamin B12 is needed in only very small quantities (1.5 - 3 micrograms per day is the recommended intake in many countries) but is vital for amino acid and DNA synthesis, particularly for the nervous system including the brain, and red blood cell production. The absorption of vitamin B12 is rather complex compared to other nutrients. A biochemical test based on functional vitamin B12 status has been developed that uses urine samples, potentially increasing the acceptance of vitamin B12 testing. Flatley et al report on how well this test correlates with blood levels and other factors in the American Journal of Clinical Nutrition.
The cross-sectional and longitudinal analysis of a survey of older adults by van Schoor and co-workers further supports research linking lower homocysteine levels and higher vitamin B12 status with better physical performance in older people. The authors looked at a subset of a representative cohort of 3000 Dutch adults aged over 62 in the Longitudinal Aging Study Amsterdam (LASA), initially enrolled in 1992 to 1993. Blood samples to measure homocysteine levels and vitamin B12 were taken at the start of the study and also in 1995 to 1996 and 1998 to 1999. Participants were assessed for physical performance with three tests that looked at coordination, proximal muscle strength and balance.