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Correspondence of folate dietary intake and biomarker data.
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Correspondence of folate dietary intake and biomarker data.

Am J Clin Nutr. 2017 Apr 26;:

Authors: Bailey RL, Fulgoni VL, Taylor CL, Pfeiffer CM, Thuppal SV, McCabe GP, Yetley EA

Abstract
Background: Public health concerns with regard to both low and high folate status exist in the United States. Recent publications have questioned the utility of self-reported dietary intake data in research and monitoring.Objectives: The purpose of this analysis was to examine the relation between self-reported folate intakes and folate status biomarkers and to evaluate their usefulness for several types of applications.Design: We examined usual dietary intakes of folate by using the National Cancer Institute method to adjust two 24-h dietary recalls (including dietary supplements) for within-person variation and then compared these intakes with serum and red blood cell (RBC) folate among 4878 men and nonpregnant, nonlactating women aged ≥19 y in NHANES 2011-2012, a nationally representative, cross-sectional survey, with respect to consistency across prevalence estimates and rank order comparisons.Results: There was a very low prevalence (<1%) of folate deficiency when serum (<7 nmol/L) and RBC (<305 nmol/L) folate were considered, whereas a higher proportion of the population reported inadequate total dietary folate intakes (6%). Similar patterns of change occurred between intakes and biomarkers of folate status when distributions were examined (i.e., dose response), particularly when diet was expressed in μg. Intakes greater than the Tolerable Upper Intake Level greatly increased the odds of having high serum folate (OR: 17.6; 95% CI: 5.5, 56.0).Conclusions: When assessing folate status in the United States, where fortification and supplement use are common, similar patterns in the distributions of diet and biomarkers suggest that these 2 types of status indicators reflect the same underlying folate status; however, the higher prevalence estimates for inadequate intakes compared with biomarkers suggest, among other factors, a systematic underestimation bias in intake data. Caution is needed in the use of dietary folate data to estimate the prevalence of inadequacy among population groups. The use of dietary data for rank order comparisons or to estimate the potential for dietary excess is likely more reliable.

PMID: 28446502 [PubMed - as supplied by publisher]




Dietary long-chain fatty acids and carbohydrate biomarker evaluation in a controlled feeding study in participants from the Women's Health Initiative cohort.
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Dietary long-chain fatty acids and carbohydrate biomarker evaluation in a controlled feeding study in participants from the Women's Health Initiative cohort.

Am J Clin Nutr. 2017 Apr 26;:

Authors: Song X, Huang Y, Neuhouser ML, Tinker LF, Vitolins MZ, Prentice RL, Lampe JW

Abstract
Background: Biomarkers of macronutrient intake are lacking. Controlled human feeding studies that preserve the normal variation in nutrient and food consumption are necessary for the development and validation of robust nutritional biomarkers.Objective: We aimed to assess the utility of serum phospholipid fatty acids (PLFAs) as biomarkers of dietary intakes of fatty acids, total fat, and carbohydrate.Design: We used an individualized controlled feeding study in which 153 postmenopausal women from the Women's Health Initiative (WHI) were provided with a 2-wk controlled diet that mimicked each individual's habitual food intake. A total of 41 PLFAs were measured with the use of gas chromatography in end-of-feeding-period fasting serum samples and expressed in both relative and absolute concentrations. R(2) values (percentages of variation explained) from linear regressions of (ln-transformed) consumed fatty acids (individual, groups, and broad categories) on (ln-transformed) corresponding measures of serum PLFAs alone and together with selected participant-related variables (age, race/ethnicity, body mass index, season of study participation, education level, and estimated energy intake from doubly labeled water) were used for evaluation against established urinary recovery biomarkers of energy and protein intake as benchmarks. Models to predict intakes of other nutrients were also explored.Results: Intakes of eicosapentaenoic acid and docosahexaenoic acid achieved the benchmark of R(2) > 36% with or without covariates. When all 41 serum PLFAs and participant-related covariates were initially included in the model for selection, cross-validated R(2) achieved >36% for consumed total carbohydrate (grams per day), total saturated fatty acids (SFAs), percentage of energy from SFAs, and total trans fatty acids with serum PLFAs in both relative and absolute concentrations.Conclusions: Serum PLFA biomarkers perform similarly to established energy and protein urinary recovery biomarkers in describing intake variations for several nutrients and, thus, appear suitable for application in this population of postmenopausal women. This approach represents an important methodologic contribution toward the utilization of nutritional biomarkers to assess macronutrient intake. This trial was registered at clinicaltrials.gov as NCT00000611.

PMID: 28446501 [PubMed - as supplied by publisher]




Protective effect of homovanillyl alcohol on cardiovascular disease and total mortality: virgin olive oil, wine, and catechol-methylathion.
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Protective effect of homovanillyl alcohol on cardiovascular disease and total mortality: virgin olive oil, wine, and catechol-methylathion.

Am J Clin Nutr. 2017 Apr 26;:

Authors: De la Torre R, Corella D, Castañer O, Martínez-González MA, Salas-Salvador J, Vila J, Estruch R, Sorli JV, Arós F, Fiol M, Ros E, Serra-Majem L, Pintó X, Gómez-Gracia E, Lapetra J, Ruiz-Canela M, Basora J, Asensio EM, Covas MI, Fitó M

Abstract
Background: Hydroxytyrosol is a phenolic compound that is present in virgin olive oil (VOO) and wine. Hydroxytyrosol-related foods have been shown to protect against cardiovascular disease (CVD).Objective: We investigated the associations between hydroxytyrosol and its biological metabolite, 3-O-methyl-hydroxytyrosol, also known as homovanillyl alcohol (HVAL), with CVD and total mortality.Design: We included 1851 men and women with a mean ± SD age of 66.8 ± 6 y at high risk of CVD from prospective cohort data. The primary endpoint was a composite of myocardial infarction, stroke, and death from cardiovascular causes; the secondary endpoint was all-cause mortality. Twenty-four-hour urinary hydroxytyrosol and HVAL and catechol-O-methyltransferase (COMT) rs4680 genotypes were measured.Results: After multivariable adjustment, all biomarkers were associated, as a continuous variable, with lower CVD risk, but only HVAL showed a strong inverse association (HR: 0.44; 95% CI: 0.25, 0.80) for the comparison between quintiles. Only HVAL, as a continuous variable, was associated with total mortality (HR: 0.81; 95% CI: 0.70, 0.95). Individuals in the highest quintile of HVAL compared with the lowest had 9.2 (95% CI: 3.5, 20.8) and 6.3 (95% CI: 2.3, 12.1) additional years of life or years free of CVD, respectively, after 65 y. Individuals with the rs4680GG genotype had the highest HVAL concentrations (P = 0.05). There was no association between COMT genotypes and events or interaction between COMT genotypes and HVAL concentrations.Conclusions: We report, for the first time to our knowledge, an independent association between high urinary HVAL concentrations and a lower risk of CVD and total mortality in elderly individuals. VOO and wine consumption and a high metabolic COMT capacity for methylation are key factors for high HVAL concentrations. The association that stems from our results reinforces the benefits of 2 key components of the Mediterranean diet (wine and VOO). This trial was registered at www.predimed.es as ISRCTN35739639.

PMID: 28446500 [PubMed - as supplied by publisher]




Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies.
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Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies.

Am J Clin Nutr. 2017 Apr 26;:

Authors: Schwingshackl L, Schwedhelm C, Hoffmann G, Lampousi AM, Knüppel S, Iqbal K, Bechthold A, Schlesinger S, Boeing H

Abstract
Background: Suboptimal diet is one of the most important factors in preventing early death and disability worldwide.Objective: The aim of this meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups, including whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages, with risk of all-cause mortality.Design: We conducted a systematic search in PubMed, Embase, and Google Scholar for prospective studies investigating the association between these 12 food groups and risk of all-cause mortality. Summary RRs and 95% CIs were estimated with the use of a random effects model for high-intake compared with low-intake categories, as well as for linear and nonlinear relations. Moreover, the risk reduction potential of foods was calculated by multiplying the RR by optimal intake values (serving category with the strongest association) for risk-reducing foods or risk-increasing foods, respectively.Results: With increasing intake (for each daily serving) of whole grains (RR: 0.92; 95% CI: 0.89, 0.95), vegetables (RR: 0.96; 95% CI: 0.95, 0.98), fruits (RR: 0.94; 95% CI: 0.92, 0.97), nuts (RR: 0.76; 95% CI: 0.69, 0.84), and fish (RR: 0.93; 95% CI: 0.88, 0.98), the risk of all-cause mortality decreased; higher intake of red meat (RR: 1.10; 95% CI: 1.04, 1.18) and processed meat (RR: 1.23; 95% CI: 1.12, 1.36) was associated with an increased risk of all-cause mortality in a linear dose-response meta-analysis. A clear indication of nonlinearity was seen for the relations between vegetables, fruits, nuts, and dairy and all-cause mortality. Optimal consumption of risk-decreasing foods results in a 56% reduction of all-cause mortality, whereas consumption of risk-increasing foods is associated with a 2-fold increased risk of all-cause mortality.Conclusion: Selecting specific optimal intakes of the investigated food groups can lead to a considerable change in the risk of premature death.

PMID: 28446499 [PubMed - as supplied by publisher]




Diet quality of US adolescents during the transition to adulthood: changes and predictors.
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Diet quality of US adolescents during the transition to adulthood: changes and predictors.

Am J Clin Nutr. 2017 Apr 26;:

Authors: Lipsky LM, Nansel TR, Haynie DL, Liu D, Li K, Pratt CA, Iannotti RJ, Dempster KW, Simons-Morton B

Abstract
Background: Influences on diet quality during the transition from adolescence to adulthood are understudied.Objective: This study examined association of 3 diet-quality indicators-Healthy Eating Index-2010 (HEI), Whole Plant Foods Density (WPF), and Empty Calories (EC; the percentage of calories from discretionary solid fat, added sugar and alcohol)-with lifestyle behaviors, baseline weight status, and sociodemographic characteristics in US emerging adults.Design: Data come from the first 4 waves (annual assessments) of the NEXT Plus Study, a population-based cohort of 10th graders enrolled in 2010 (n = 566). At each assessment, participants completed 3 nonconsecutive 24-h diet recalls, wore accelerometers for 7 d, and self-reported meal practices and sedentary behaviors. Self-reported sociodemographic characteristics were ascertained at baseline. Generalized estimating equations examined associations of time-varying diet quality with baseline weight status and sociodemographic characteristics and time-varying lifestyle behaviors.Results: Diet quality improved modestly from baseline (mean ± SE: HEI, 44.07 ± 0.53; WPF, 1.24 ± 0.04; and EC, 35.66 ± 0.55) to wave 4 for WPF (1.44 ± 0.05, P < 0.001) and EC (33.47 ± 0.52, P < 0.001), but not HEI (45.22 ± 0.60). In longitudinal analyses, higher HEI and lower EC scores were observed in Hispanic compared with white participants. Better diet quality was associated with greater moderate-to-vigorous physical activity, more frequent breakfast and family meals, less frequent fast food and meals during television viewing, and shorter durations of television viewing, gaming, and online social networking. Diet-quality indicators were not consistently associated with time-varying physical inactivity, baseline weight status, or sociodemographic characteristics.Conclusions: Diet quality of emerging adults in the US remained suboptimal, but some aspects improved marginally over the 4-y study period. Meal contexts and sedentary behaviors may represent important intervention targets. There is substantial room for improvement in diet quality in all sociodemographic subgroups. This trial was registered at clinicaltrials.gov as NCT01031160.

PMID: 28446498 [PubMed - as supplied by publisher]




Best (but oft-forgotten) practices: mediation analysis.
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Best (but oft-forgotten) practices: mediation analysis.

Am J Clin Nutr. 2017 Apr 26;:

Authors: Fairchild AJ, McDaniel HL

Abstract
This contribution in the "Best (but Oft-Forgotten) Practices" series considers mediation analysis. A mediator (sometimes referred to as an intermediate variable, surrogate endpoint, or intermediate endpoint) is a third variable that explains how or why ≥2 other variables relate in a putative causal pathway. The current article discusses mediation analysis with the ultimate intention of helping nutrition researchers to clarify the rationale for examining mediation, avoid common pitfalls when using the model, and conduct well-informed analyses that can contribute to improving causal inference in evaluations of underlying mechanisms of effects on nutrition-related behavioral and health outcomes. We give specific attention to underevaluated limitations inherent in common approaches to mediation. In addition, we discuss how to conduct a power analysis for mediation models and offer an applied example to demonstrate mediation analysis. Finally, we provide an example write-up of mediation analysis results as a model for applied researchers.

PMID: 28446497 [PubMed - as supplied by publisher]




Mobile-based intervention intended to stop obesity in preschool-aged children: the MINISTOP randomized controlled trial.
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Mobile-based intervention intended to stop obesity in preschool-aged children: the MINISTOP randomized controlled trial.

Am J Clin Nutr. 2017 Apr 26;:

Authors: Nyström CD, Sandin S, Henriksson P, Henriksson H, Trolle-Lagerros Y, Larsson C, Maddison R, Ortega FB, Pomeroy J, Ruiz JR, Silfvernagel K, Timpka T, Löf M

Abstract
Background: Traditional obesity prevention programs are time- and cost-intensive. Mobile phone technology has been successful in changing behaviors and managing weight; however, to our knowledge, its potential in young children has yet to be examined.Objective: We assessed the effectiveness of a mobile health (mHealth) obesity prevention program on body fat, dietary habits, and physical activity in healthy Swedish children aged 4.5 y.Design: From 2014 to 2015, 315 children were randomly assigned to an intervention or control group. Parents in the intervention group received a 6-mo mHealth program. The primary outcome was fat mass index (FMI), whereas the secondary outcomes were intakes of fruits, vegetables, candy, and sweetened beverages and time spent sedentary and in moderate-to-vigorous physical activity. Composite scores for the primary and secondary outcomes were computed.Results: No statistically significant intervention effect was observed for FMI between the intervention and control group (mean ± SD: -0.23 ± 0.56 compared with -0.20 ± 0.49 kg/m(2)). However, the intervention group increased their mean composite score from baseline to follow-up, whereas the control group did not (+0.36 ± 1.47 compared with -0.06 ± 1.33 units; P = 0.021). This improvement was more pronounced among the children with an FMI above the median (4.11 kg/m(2)) (P = 0.019). The odds of increasing the composite score for the 6 dietary and physical activity behaviors were 99% higher for the intervention group than the control group (P = 0.008).Conclusions: This mHealth obesity prevention study in preschool-aged children found no difference between the intervention and control group for FMI. However, the intervention group showed a considerably higher postintervention composite score (a secondary outcome) than the control group, especially in children with a higher FMI. Further studies targeting specific obesity classes within preschool-aged children are warranted. This trial was registered at clinicaltrials.gov as NCT02021786.

PMID: 28446496 [PubMed - as supplied by publisher]