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Author(s): Giles S. H. Yeo * UPFs are the new bad kid on the block when it comes to diet and health. But what are they and is it possible [...]

The gut microbiota of hunter-gatherers and populations consuming a rural agrarian diet is distinct, and contains greater diversity than the microbiota of Westerners (4-9) (Extended Data Fig. 1). One possible [...], The gut is home to trillions of microorganisms that have fundamental roles in many aspects of human biology, including immune function and metabolism (1, 2). The reduced diversity of the gut microbiota in Western populations compared to that in populations living traditional lifestyles presents the question of which factors have driven microbiota change during modernization. Microbiota-accessible carbohydrates (MACs) found in dietary fibre have a crucial involvement in shaping this microbial ecosystem, and are notably reduced in the Western diet (high in fat and simple carbohydrates, low in fibre) compared with a more traditional diet (3). Here we show that changes in the microbiota of mice consuming a low-MAC diet and harbouring a human microbiota are largely reversible within a single generation. However, over several generations, a low-MAC diet results in a progressive loss of diversity, which is not recoverable after the reintroduction of dietary MACs. To restore the microbiota to its original state requires the administration of missing taxa in combination with dietary MAC consumption. Our data illustrate that taxa driven to low abundance when dietary MACs are scarce are inefficiently transferred to the next generation, and are at increased risk of becoming extinct within an isolated population. As more diseases are linked to the Western microbiota and the microbiota is targeted therapeutically, microbiota reprogramming may need to involve strategies that incorporate dietary MACs as well as taxa not currently present in the Western gut.

Introduction Lignans, found in seeds, legumes, berries and cereals (Milder et al., 2005; Penalvo et al., 2005a), may have health benefits and possibly protect, or indicate protection against chronic diseases [...], Objectives: The aim of this study was to examine the variation of enterolactone from fasting and non-fasting blood of middle-aged healthy women eating a normal diet to determine the usefulness of a single sample in epidemiological studies. Subjects and methods: Twenty-six women born between 1940 and 1950 were recruited within the Malmo Diet and Cancer cohort. Three non-fasting and two overnight fasting samples were collected from each individual during a 5-week period. Twenty-one participated in all measurements. Enterolactone concentrations were analyzed by time-resolved fluoroimmunoassay. Results: The within-subject and between-subject variations (coefficient of variations, CV) were estimated to 59 and 89% respectively for fasting samples and 71 and 67% for non-fasting samples. The intraclass correlation coefficients (ICC) were estimated to 0.66 (95% confidence interval (CI) 0.35-0.84) for fasting and 0.48 (95% CI, 0.22-0.72) for non-fasting samples. Conclusions: Although the estimated ICC for blood samples was moderate, it indicates that enterolactone levels of both fasting and non-fasting blood samples should be useful in future projects within the Malmo Diet and Cancer cohort. doi:10.1038/sj.ejcn.1602811; published online 30 May 2007 Keywords: enterolactone; serum; lignans; biomarker; time-resolved fluoroimmunoassay

Introduction Head injury (HI) represents a major cause of death in young adult populations in developed countries. HI is characterized by important metabolic alterations, in particular hypermetabolism and hypercatabolism mediated [...], Objective: The benefit of immune-enhancing diets (IEDs) in the intensive care unit remains controversial. Considering their complexity, the role of each component, in particular arginine (Arg), in their properties is largely unknown. The aim of this study was to determine the role of arginine in the immunomodulatory effects of an IED (Crucial®) in head-injured rats. Design: Thirty-four rats were randomized into five groups: AL (ad libitum), HI (head-injured), HISTD (HI + standard enteral nutrition, EN), HI-STD-Arg (HI + standard EN + Arg in equimolar concentration to Arg in IED), and HI-IED (HI + IED). These isocaloric and isonitrogenous diets were administered over 4 days. After death, the thymus was removed and weighed. The density of CD25, CD4 and CD8 on lymphocytes from blood and from Peyer patches was evaluated. Mesenteric lymph nodes, liver and spleen were cultured for analysis of enterobacterial translocation and dissemination. Measurements and results: HI induced an atrophy of the thymus which was not corrected by the standard diet (HI 0.27 ± 0.03, HI-STD 0.35 ± 0.03 vs. AL 0.49 ± 0.02 g; p < 0.05). However, the standard diet supplemented with arginine limited the thymic atrophy and the IED restored thymus weight. CD25 density and interleukin-2 production were increased only in the HI-STD-Arg and HI-IED groups (p < 0.05). Head injury induced enterobacterial translocation and dissemination which were blunted only in the HI-STD-Arg group (p < 0.05). Conclusions: In this rat HI model, arginine appears to be safe, contributes to a large extent to the immunomodulatory effects of the IED, and seems to limit enterobacterial translocation and dissemination more efficiently alone than in an IED. Keywords Arginine * Head injury * Immune-enhancing diet * Dysimmunity * Enteral nutrition * Bacterial translocation

Objectives: To determine the reliability and relative construct validity of the Modified Constipation Assessment Scale (MCAS) and use it to assess bowel function in oncology outpatients receiving radiotherapy. Design: Validation [...]

It has long been known that stress affects both the stomach and colon, as shown by the very high prevalence of gastrointestinal symptoms among patients with psychiatric illness. The source [...]

A New Scenario The past century has brought tremendous change to our social health condition. Whereas medical science and technology have, through the development of antibiotics, vaccinations, and improvements in [...]

Children in the United States are drinking less milk because they are drinking more of other beverages such as soft drinks and fruit drinks (1-3). This decline in milk consumption [...]

********** Because nutrition is a basic human need, most nutritionists think of actions to improve the diet status of individuals as being simply and obviously the 'right thing to do.' [...], EF Myers is Director, Scientific Affairs and Research at ADA headquarters in Chicago, IL; JF Guthrie, PhD, MPH, RD, is assistant deputy director for child nutrition research, Food Assistance & Nutrition Research Program, Economic Research Service, US Department of Agriculture in Washington, DC.

********* ABSTRACT Objective Evaluate the baseline nutrient intake of an HIV positive population that includes significant representation from women and minorities, and determine the relationship between state of disease and [...], M.N. Woods is an associate professor, J. E. Forrester is an assistant professor, S. C. Skinner and J. H. Kim are programmers, J. L. Connors is a senior research nutritionist, and S. L. Gorbach is a professor, all with the Department of Family Medicine and Community Health at Tufts University School of Medicine, Boston, Mass. At the time of the study, M. Silva was an assistant professor with the Department of Community Health and Medicine at Tufts University School of Medicine, and is now chief Infectious Disease Service, Hospital Universitario de Caracas, Venezuela. D. Spiegelman is an associate professor in the Department of Epidemiology and Biostatistics, Harvard School of Public Health, Boston, Mass, and is also an adjunct associate professor with the Department of Family Medicine and Community Health at Tufts University School of Medicine, Boston, Mass. T. Knox is an assistant professor in the Department of Medicine, Division of Gastroenterology, New England Medical Center Hospital, Boston, Mass, and is an associate professor of medicine at Tufts University School of Medicine, Boston, Mass.

********** ABSTRACT Objective To examine the dietary habits of patients with ischemic heart disease 1 year after they received either dietary advice on using the Plate Model and how to [...], C. Dalgard is a doctoral student in the Department of Clinical Biochemistry and Clinical Genetics, University of Southern Denmark, Odense. At the time the study was completed, she was a research assistant in preventive atherosclerosis, University of Southern Denmark, Odense. A. Thuroe is a clinical dietitian at Odense University Hospital, Odense, Denmark. B. Haastrup is a research fellow in the Department of Cardiology, Skejby Hospital, Odense, Denmark. At the time the study was completed, she was with the Department of Cardiology, Odense University Hospital, Odense, Denmark. T. Haghfelt is department head and professor in the Department of Cardiology, Odense University Hospital, Odense, Denmark. S. Stender is the department head in the Department of Clinical Biochemistry, Gentofte Amtssygehus, Hellerup, Denmark. At the time the study was completed, he was a research professor of preventive atherosclerosis, University of Southern Denmark, Odense, Denmark.

The role of the dietitian has changed from one that requires dietitians to follow procedures for providing nutrition in health care facilities to a role that requires dietitians to demonstrate [...], The purpose of this project was to design, implement, and improve a nationwide medical nutrition therapy (MNT) intervention program for nutritionally at-risk employees and their dependents and retirees (hereinafter referred to as clients) with a Fortune 100 company (Texas Instruments, Dallas, Tex) with a dispersed population of 80,000. Preferred Nutrition Therapists (PNT), a network of registered dietitians, with the assistance of the Texas Instruments Health Promotion and Benefits Department, identified International Classification of Diseases, 9th ed (ICD-9), codes for which MNT intervention was appropriate. PNT then negotiated a contract with the Texas Instruments Health Promotion and Benefits Department and implemented clients' serf-referral process. The main challenge was to promote utilization of a new service from an outside vendor (PNT) and to measure outcomes in meaningful ways. The goal was to use MNT as a tool to prevent the progression of clients' diseases to states that require more costly treatments. PNT used a continuous quality improvement process to refine the system and improve information gathering and reporting, by providing quarterly reports to the Health Promotion and Benefits Department. These reports summarized the outcomes for all clients seen at least 3 times during the quarter. The cost was less than $0.35 per member per month (less than the employer spent on advertising the program), and 0.5% of the population requested MNT during the first year of implementation (about what was expected for a new carveout benefit).

Introduction Obesity and obesity-related morbidity are global crises that affect all age groups (Karnik and Kanekar 2012), especially children (Wang and Lobstein 2006). Although the prevalence of obesity may be [...], BACKGROUND: Exposure to secondhand smoke (SHS) may increase risk for obesity, but few studies have investigated the joint effects of exposure to SHS and diet. OBJECTIVES: We examined the interaction of exposure to SHS and diet on the prevalence of obesity among 6- to 19-year-olds who participated in the 2007-2010 National Health and Nutrition Examination Survey. METHODS: We characterized exposure using a novel biomarker [4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL)], an established biomarker (cotinine), and self-report. Multinomial logistic regression models examined the association of SHS exposure on the prevalence of overweight and obesity as separate outcomes (compared with normal/underweight). Interaction by diet was assessed by introducing interaction terms (with SHS) of the individual nutrients [dietary fiber, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), vitamin C, and vitamin E] into separate models. RESULTS: Approximately half of the children had NNAL and cotinine levels above the limit of detection, indicating exposure to SHS. Interaction results suggest that the prevalence of obesity among children with both high exposure to SHS and low levels of certain nutrients (dietary fiber, DHA, or EPA) is greater than would be expected due to the effects of the individual exposures alone. Little or no evidence suggesting more or less than additive or multiplicative interaction was observed for vitamin C or vitamin E. The association between SHS and obesity did not appear to be modified by dietary vitamin C or vitamin E. CONCLUSIONS: Childhood obesity prevention strategies aimed at reducing SHS exposures and improving diets may exceed the expected benefits based on targeting either risk factor alone. http://dx.doi.org/10.1289/ehp.1510138

Objective: to assess levels of fruit and vegetable consumption in elderly people, and to examine the socioeconomic, physical and psychological factors which influence this consumption. Methods: a three-phase survey: face [...]

Comprehensive reviews of the scientific literature linking diet and major chronic diseases have found strong evidence that the total amount and types of fat in the diet influence risk of [...], Objective To evaluate the importance of information on low-fat diet practices and consumption of reduced-fat foods for accurate assessment of energy and fat intakes using a semiquantitative food frequency questionnaire (FFQ). Subjects Subjects were 7,419 women, aged 50 to 79 years, who filled out an FFQ as part of eligibility screening for a diet modification component and/or a hormone replacement trial in a multicenter study of chronic disease prevention in postmenopausal women (Women's Health Initiative). Statistical analysis For 26 FFQ questions, we recoded the low-fat diet choices of participants to a high-fat counterpart and recalculated energy and fat intakes. We then determined the decrease in energy and nutrient estimates attributable to adding low-fat options to the FFQ. Results Low-fat diet practices were widespread in this population. For example, 69% of respondents rarely or never ate skin on chicken, 76% rarely or never ate fat on meat, 36% usually drank nonfat milk, 52% usually ate low-fat or fat-free mayonnaise, 59% ate low-fat chips/snacks, and 42% ate nonfat cheese. These low-fat choices had substantial effects on energy and nutrient estimates. Absolute decreases (and mean percentage decreases) for energy and nutrient measures attributable to adding low-fat diet options to the FFQ were 196 kcal (11.4%) energy, 9 percentage points in percentage energy from fat (22.3%), 23.2 g fat (29.0%), and 9.6 g saturated fat (32.5%). Black and Hispanic women and women of lower socioeconomic status reported significantly fewer low-fat diet practices than white women and women of higher socioeconomic status. Conclusion Failure to collect information on low-fat diet practices with an FFQ will result in an upward bias in estimates of energy and fat intake, and the amount of error will vary by the personal characteristics of respondents. J Am Diet Assoc. 1996; 96:670-676, 679.

Many clinical and epidemiologic studies have addressed the impact of diet on chronic disease risk (1,2). In most cases, the focus has been on individual foods or nutrients and their [...], Objectives Assessing the quality of the total diet is a relatively new focus of studies in nutritional epidemiology. New indexes of healthful eating patterns have been largely limited to US populations. This study used evaluative criteria developed in the United States to assess diet quality and dietary diversity of French adults. Methods Habitual dietary intakes of a representative sample of 837 adults (361 men and 476 women) in the Val-de-Marne Departement were evaluated. Evaluative measures of diet quality included a modified diet quality index (DQI), a dietary diversity (DD) score, and a dietary variety score (DVS). The 5-point DQI assessed compliance with the key guidelines of the US Department of Agriculture (USDA) for healthy people. The DD score counted the number of major food groups consumed whereas the DVS counted the total number of foods consumed on a regular basis. Results Few French adults consumed diets consistent with the USDA dietary recommendations. Only 14% of respondents derived less than 30% of energy from fat and only 4% derived less than 10% of energy from saturated fat. As a result, 63% of the sample had DQI scores of either 0 or 1. In contrast, close to 90% of respondents scored a maximum of 5 in DD. Persons whose diets met US dietary recommendations also had the lowest DVSs. Conclusions Methodologic factors and cultural biases may account for some of the observed differences between French and US data. Nevertheless, studies of diet quality and diversity are a promising new approach to the study of the total diet and associated health outcomes and may provide new insight into the French paradox. J Am Diet Assoc. 1996; 96:663-669.

Consumption of high-fat diets has been implicated in the development and maintenance of obesity; studies in rats (1,2) and in adult men and women (3-7) provide evidence supporting a causal [...]

In spite of a decline of about 3% per year in mortality rates for coronary heart disease (CHD) since 1968, CHD remains the major cause of death in the United [...]

Human immunodeficiency virus (HIV) is the etiologic agent that causes HIV infection and acquired immunodeficiency syndrome (AIDS). However, it has not been established whether the virus is solely responsible for [...]

Rapid developments in molecular biology have reached the bedside, and we are in a new era of clinical care. The treatment of anemia in patients with renal failure is a [...]

Malnutrition is an important consequence of infection with the human immunodeficiency virus (HIV); it occurs to some degree throughout the course of the disease (1). Severe malnutrition, or wasting, is [...]

In 1985, the National Institutes of Health and the Health Care Finance Administration of the US Department of Health and Human Services planned a prospective, randomized clinical trial to test [...]

The experience of a myocardial infarction and the accompanying anxiety may lead to behavioral disturbances in the patient (1) and the spouse (2). The consequences of such a cardiac event [...]

Osteoporosis, along with heart disease and breast cancer, is one of the three most serious diseases affecting women. Few people appreciate the following facts: * Nearly half of all women [...]

The contribution of diet to atherosclerosis is well documented. Indeed, several lines of evidence suggest that in westernized societies the incidence of coronary heart disease is proportional to the percentage [...]

The National Aeronautics and Space Administration (NASA) Occupational Health Program is a comprehensive program that provides a broad range of occupational health services to approximately 24,000 employees around the United [...]

Obesity is believed to be caused by a positive energy balance over time, where energy intake exceeds energy expenditure. This belief is challenged by a number of descriptive studies of [...]

For years, the Recommended Dietary Allowances RDAs) served as nutritional guidelines for individuals and institutions (1). The original guidelines, aimed primarily at prevention of clinical deficiencies, were later supplemented with [...], Many recent studies have implicated dietary factors in the cause and prevention of important diseases, including cancer, coronary heart disease, birth defects, and cataracts. There is strong evidence that vegetables and fruits protect against these diseases; however,the active constituents are incompletely identified. Whether fat per se is a major cause of disease is a question still under debate, although saturated and partially hydrogenated fats probably increase the risk of coronary heart disease. One clear conclusion from existing epidemiologic evidence is that many individuals in the United States have suboptimal diets and that the potential for disease prevention by improved nutrition is substantial.

The nutritional status of hospitalized patients can play a role in their recovery rate and the length of their hospital stay. Malnutrition as defined through defined standard laboratory tests and [...], The length of a patient's stay in a hospital is an indication of the patient's recovery rate. Length of hospital stay has also become an important economic factor for hospitals. This is especially true since 1983 as a result of implementation of the Prospective Payment System based on diagnosis-related groups. In this study, the results of routine laboratory tests of nutritional status were examined for relationships between nutritional status and the length of hospital stay. We conducted a retrospective analysis of 163 patients with diverticulosis and diverticulitis of the colon to determine which nutrition assessment parameters are sensitive in predicting recovery rate (length of hospital stay). We found that serum albumin level was negatively correlated with length of hospital stay. Women without gastrointestinal bleeding stayed an average of 20.1 ± 8.5 days when serum albumin level was 30 g/L or less vs 11.2 ± 10.5 days when it was greater than 30 g/L. Hemoglobin and or hematocrit levels were also negatively correlated with length of hospital stay for this group. Women without bleeding stayed an average of 16.4±13.4 days when the hemoglobin level was 120 g/L or less vs 10.4 ± 9.1 days when it was greater than 120 g/L. These results suggest that a patient's nutritional status upon admission has an effect on the length of hospital stay for patients with diverticular disease. J Am Diet Assoc. 1992; 92:429-433.