Journal of the American College of Nutrition

The risk of infection may be increased in people under stress such as shift workers. This study examined the effect of a fermented dairy product containing the probiotic Lactobacillus casei DN-114 001 (verum) on the incidence of respiratory and gastrointestinal common infectious diseases (CIDs) and on immune functions in healthy shift workers. The study was single-center, randomized, double-blind, and controlled. Volunteers received 200 g/day of verum (n = 500) or control product (n = 500) for 3 months; 1-month follow-up was carried out. The cumulated number of CIDs (primary outcome) was not significantly different between groups. Because the Poisson distribution of the primary parameter did not fully fit the observed data, a post hoc categorical analysis was applied and showed a significantly lower cumulated number of CIDs in the verum group during the product consumption phase (odds ratio [OR] = 0.75, 95% confidence interval [CI] 0.59-0.95, p = 0.017). Verum also reduced the proportion of volunteers experiencing at least 1 CID (43% vs. 51%, p = 0.005), increased the time to the first occurrence of CID (p = 0.017) in the whole population, and reduced the cumulated number of CIDs in the subgroup of smokers (p = 0.033). In the course of CID, cumulated duration of fever was lower in the verum group (in the whole study phase) (p = 0.022), and an increase in leukocyte, neutrophil, and natural killer (NK) cell counts and activity (p = 0.047 to p < 0.001) was observed compared with control group. Verum was safe and well tolerated. The results indicate that daily consumption of a fermented dairy product containing Lactobacillus casei DN-114 001 could reduce the risk of common infections in stressed individuals such as shift workers.

This study reports on the prevalence of hypomagnesemia (4.5%), by the stringent criterion of less than or equal to 1.25 mEq/L, and hypokalemia (17%) in 1,000 ambulatory hypertensive patients under treatment at the VA Medical Center, Oklahoma City. The hypomagnesemic group required a greater number of antihypertensive medications than the nonhypomagnesemic patients to maintain their blood pressure in the acceptable range. These observations suggest the possibility that magnesium may play an important role in blood pressure control and indicate the need for further studies.

The circulating 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25-(OH)2D] concentrations were studied in a patient receiving increasing doses of phenytoin. The plasma 1,25(OH)2D concentrations were independent of the dose of phenytoin administered, as well as of the drug plasma concentrations. The plasma 25(OH)D concentrations were, on the other hand, increased by low phenytoin concentration but rapidly declined when the dose of phenytoin was increased and/or as the length of time of exposure to the drug increased. A linear relationship (R = 0.9651, P less than 0.05) was found between the plasma 25(OH)D concentrations and the dose/plasma phenytoin concentration ratio, suggesting that chronic phenytoin administration may have a dose-related effect on the circulating 25(OH)D concentrations.

In Belgium, important regional differences in mortality exist which have been linked to differences in dietary consumption patterns. To study regional food consumption in Belgium, sales data of 103 spreading and cooking fat products in 110 branch stores of a major supermarket chain (Colruyt) for 12 months (1991-92) were analyzed. Sale of more ordinary and polyunsaturated spreading margarine and of more polyunsaturated low-fat spread in the north in combination with a greater sale of butter and dairy low-fat spread in the south resulted in a P/S-ratio of 0.99 in the north vs. 0.40 in the south (p < 0.001) and a U/S-ratio of 1.93 vs. 1.10 (p < 0.001) for spreading fats. The P/S- and U/S-ratios of cooking fats were lower in the north (ns). Mortality data correlated positively with the sale of butter and dairy low-fat spread and negatively with sales data of spreading margarine, polyunsaturated spreading margarine, and polyunsaturated low-fat spread (all p < 0.001). Sales data from supermarket chains provide useful information on regional fat consumption and offer interesting perspectives of trends over time.

The purpose of this study was to compare low-fat (LF) meal and high-fat (HF) meal on the postprandial lipemic responses according to the -1131T>C polymorphism of the APOA5 gene in a population usually consuming a LF diet and having a high frequency of the variant allele at the APOA5 -1131T>C SNP. This study was conducted using a cross-over design and 49 non-obese healthy men (42.8 +/- 0.7 yrs, 23.9 +/- 0.25 kg/m(2)) participated in the meal tolerance test. They were randomly assigned to consume one of two types of experimental enteral formulae (LF vs HF) with a seven-day interval. Blood samples were collected at 0, 2, 3, 4 and 6h after ingestion and analyzed for total and chylomicron TG, glucose, insulin and free fatty acid. No differences were found in anthropometic parameter, calorie and macronutrient intakes and total energy expenditure between TT (n = 23) and TC + CC (n = 26) men. Fasting total TG were higher in TC + CC men than TT men, but fasting chylomicron TG were not significantly different between TT men and C carriers, TT subjects had no significant differences in postprandial responses of total TG and chylomicron TG and postprandial mean changes of chylomicron TG between LF and HF meal. On the other hand, C carriers had delayed peak time of total TG compared to TT subject and higher postprandial response and mean changes of chylomicron TG at HF meal compared to LF meal. The capacity to clear chylomicron-TG or hydrolyze TG might become a rate-limiting factor on HF diet in TC + CC men resulting in higher postprandial triglyceridemia. Therefore, HF diet for C carriers of the APOA5 gene may be one of important CVD risk factors.

Impact of vitamin supplements upon dietary intakes of eight vitamins was examined in 10- and 13-year-old children randomly selected from a biracial community, Bogalusa, LA. More younger children reported taking supplements daily (17%) than did adolescents (12%). Over 90% of the children surveyed had dietary intakes of vitamin E and niacin that met or exceeded the RDA. One-half to two-thirds of children using supplements had adequate intakes of ascorbic acid from diet alone. Children who most needed ascorbic acid supplements were the least likely to take them. One-quarter to one-half of the children did not consume the RDA levels of vitamin A, thiamine, and riboflavin. Adolescents had less adequate vitamin A intakes than younger children. In all surveys, a higher proportion of girls than boys had intakes that did not meet the RDA for vitamins B6 and B12. Vitamin intakes of Bogalusa children and adolescents were comparable to other U.S. surveys. Inclusion of vitamin E and niacin in supplements may be unnecessary.

This comparative study was designed to discover early determinants of systolic (S) and diastolic (D) blood pressure (BP) elevations in 138 Seventh-Day Adventist (SDA) and 89 non-SDA male and female adolescents (median age, 17 years) living at three residential secondary schools in North Carolina. Measurements were made of blood pressure, body weight, and height, and information was collected on lifestyle factors, dietary intake, and other behaviors, including exercise, religiosity, Type A behavior, and anger, by questionnaire. Multiple stepwise regression analyses were performed with BP, either SBP or DBP, as the independent variable. A significant direct association was found only between body weight and BP, but weak associations were shown between BP and other variables, including exercise, diet, religiosity, Type A behavior, and anger. Male and female SDA students showed significantly higher SBPs and DBPs than did non-SDA adolescents though the differences were small (approximately 5 mm for each sex). These findings suggest that the higher BP values of SDA adolescents, who were all practicing lacto-ovo-vegetarians, compared to similarly aged health-conscious non-SDAs, are determined more by eating behaviors that contribute to gains in body weight than by any other lifestyle variable. Furthermore, these data support the notion that the BP-protective effects of the vegetarian diet may not emerge in these SDA youth until early adulthood.

Dietary intakes of carbohydrate (CHO) and fiber were examined in children randomly selected from a biracial community-Bogalusa, LA. Intakes of CHO per 1,000 kcal were similar for both sexes and both races at ages 10 and 13 years. No group or race differences were found for nine components assessed in two cohorts of 10-year-old children examined three years apart. There were sex differences in sucrose (boys less than girls) and lactose (boys greater than girls) intakes. Comparison of 10- and 13-year-olds examined in 1976 showed a racial difference in fiber and starch intakes (black greater than white). Longitudinal comparisons of a cohort of 148 children examined at both 10 and 13 years showed lower lactose intakes over time. At both ages starch, fiber, and glucose intakes per 1,000 kcal were higher in black children, with higher sucrose/starch ratios in white children. The percent of calories from CHO and sugars was higher in Bogalusa children than values for US adults, but starch intakes were lower. None of the children's intakes was compatible with prudent dietary recommendations. Dietary CHO patterns of Bogalusa children reflect food market trends of increased use of simple CHO and decreased use of complex CHO.

This study determined whether older adults who consumed a probiotic mixture would have a greater proportion of circulating CD4+ lymphocytes, altered cytokine production, and a shift in intestinal microbiota toward a healthier microbial community. Participants (70 ± 1 years [mean ± SEM]; n = 32) consumed a probiotic (Lactobacillus gasseri KS-13, Bifidobacterium bifidum G9-1, and Bifidobacterium longum MM2) or a placebo twice daily for 3 weeks with a 5-week washout period between intervention periods. Blood and stools were collected before and after each intervention. The percentage of circulating CD4+ lymphocytes and ex vivo mitogen-stimulated cell cytokine production were measured. In stools, specific bacterial targets were quantified via quantitative polymerase chain reaction (qPCR) and community composition was determined via pyrosequencing. During the first period of the crossover the percentage of CD4+ cells decreased with the placebo (48% ± 3% to 31% ± 3%, p < 0.01) but did not change with the probiotic (44% ± 3% to 42% ± 3%) and log-transformed concentrations of interleukin-10 increased with the probiotic (1.7 ± 0.2 to 3.4 ± 0.2, p < 0.0001) but not the placebo (1.7 ± 0.2 to 2.1 ± 0.2). With the probiotic versus the placebo a higher percentage of participants had an increase in fecal bifidobacteria (48% versus 30%, p < 0.05) and lactic acid bacteria (55% versus 43%, p < 0.05) and a decrease in Escherichia coli (52% versus 27%, p < 0.05). Several bacterial groups matching Faeacalibactierium prausnitzii were more prevalent in stool samples with the probiotic versus placebo. The probiotic maintained CD4+ lymphocytes and produced a less inflammatory cytokine profile possibly due to the changes in the microbial communities, which more closely resembled those reported in healthy younger populations.

The optimum diet composition for weight loss in obese women with or without previous gestational diabetes mellitus remains to be determined. Weight loss may be especially important for the latter group in terms of preventing future gestational as well as non-insulin dependent diabetes mellitus. We studied 40% vs. 55% carbohydrate calorically restricted diets to compare weight loss and metabolic response. We performed a prospective, 12-week, blinded, randomized crossover study of 25 obese women; 13 of whom had previous gestational diabetes. Each woman was allocated to a treatment regimen for 6 weeks and then "crossed over" to the alternative regimen for an additional 6 weeks. Calories were provided in the form of nutritional supplement bars except for the evening meal that comprised 1/3 of the caloric needs. All subjects were seen and weighed weekly. Metabolic variables including glucose tolerance, glycated proteins, lipids, and percent body fat were measured at the beginning, crossover, and end of the study. Women with previous gestational diabetes mellitus were comparable to obese women without a history of previous gestational diabetes except that the former had higher maximum levels of glucose on a glucose tolerance test and higher fasting insulin levels consistent with greater insulin resistance. Weight loss was comparable for all groups during the first 6 weeks but attenuated in all groups during the second 6 weeks of the trial regardless of diabetes history or treatment group allocation. Women with or without a previous history of gestational diabetes had higher triglycerides while on a 55% carbohydrate diet than while on a 40% carbohydrate diet. A weight loss regimen consisting of 40% carbohydrate results in lower triglyceride levels than those achieved with a 55% carbohydrate content diet in obese women. Thus, the hypocaloric diet with the higher fat content produced the more favorable lipid profile in all obese women.

The present study examined the serum and urinary carnitine concentrations of 21 cancer patients with metastatic disease and 13 healthy age-matched controls by taking three consecutive samples during an 8-week period. The serum concentrations of all fractions of carnitine were significantly lower in the female cancer patients than in the female controls. The concentrations of urinary carnitine fractions were relatively higher in the total cancer population; however, only acid-insoluble acylcarnitine (AIAC) was statistically significant. The renal clearance of acid-soluble acylcarnitine (ASAC) and AIAC was significantly greater in cancer subjects than in controls. Significant inverse relationships were established between the ASAC and AIAC clearances and their respective serum concentrations. The renal tubular reabsorption of AIAC was significantly less in cancer patients than in control subjects as indicated by the fractional excretion of carnitine. The increased clearance of acylcarnitine and excretion of large amounts of AIAC are proposed to be a response to chemotherapy and represent a loss of energy to the cancer patient.

Glutathione functions in catalysis, metabolism, transport, and reductive processes and in protection of cells by destruction of free radicals, reactive oxygen intermediates, and other toxic compounds of endogenous and exogenous origin. It also functions as a storage and transport form of cysteine. Depletion of glutathione (effectively accomplished by inhibition of its synthesis) increases sensitivity to radiation and to certain toxic compounds and is of value in combination with radiation therapy or chemotherapy in situations in which cell selectivity can be achieved. Increased cellular levels of glutathione protect cells against radiation and certain toxic compounds. Glutathione levels can be increased by administration of cysteine or of glutathione, but these approaches are not entirely satisfactory. Cellular glutathione levels can be increased by supplying substrate for gamma-glutamylcysteine synthetase or for glutathione synthetase. L-2-Oxothiazolidine-4-carboxylate is well transported into many cells and is converted by 5-oxoprolinase to cysteine, a substrate of gamma-glutamylcysteine synthetase. gamma-Glutamylcysteine and related compounds are effectively transported, especially into renal cells, thus providing substrate for glutathione synthetase; higher than normal levels of glutathione can be achieved because this enzyme is not significantly inhibited by glutathione, whereas gamma-glutamylcysteine synthetase is feedback-inhibited. Derivatives of glutathione that are effectively transported into cells (glutathione itself is not) offer another means of increasing glutathione levels. The monoethyl ester of glutathione (in which the glycine carboxyl group is esterified) is well transported in vivo into liver and kidney and into cultured fibroblasts and lymphoid cells. Glutathione levels much higher than usual can be obtained by this procedure, which protects lymphoid cells against the lethal effects of irradiation and mice against acetaminophen, and which therefore may be a relatively safe way to increase cellular resistance to radiation and certain toxic compounds.

The aim of this work was to determine the effects of specific changes in the structure of (13)C-labeled triglyceride (TG*) on its fecal excretion relative to total stool fat excretion determined simultaneously in patients with reduced exocrine pancreatic function. A series of 47 studies were conducted in 26 young cystic fibrosis (CF) patients and 11 adult patients with chronic pancreatitis over a five year period. Each test consisted of ingesting a single high fat test meal containing both (13)C-labeled triglyceride (TG*) and dysprosium chloride (DyCl(3)) a nonabsorbable marker of intestinal transit; in most studies the food colorant brilliant blue (FD&C blue #1) was administered along with the DyCl(3). The TG*s tested were: P*P*P* = TRIPALMITIN-1,1,1-(13)C(3); SO*S = 2-OCTANOYL-1,3-DISTEARIN-2-octanoyl-1,2-(13)C(2); and P*LP* = 2-LAURYL-1,3-DIPALMITIN-dipalmitoyl-1,1,2,2-(13)C(4). Ingestion of the test meal was followed by collection of individual stools for at least 72 hours. Stools were analyzed for (13)C-Excess ((13)C*), total fat, and Dy. Excretion of P*LP* showed a high degree of linear correlation with stool fat (r(2) = 0.924) over a wide-range of fecal fat values. Excretion of SO*S was also significantly correlated with stool fat, but its excretion was less than 10% at all levels of steatorrhea and the slope of the regression line relating TG* excretion to stool fat was some four to five times smaller than observed for P*LP*. Fecal excretion of P*P*P* was highly correlated with stool fat (r(2) = 0.941) in patients with moderate steatorrhea (<25 g fat/24 hours) and the slope of the regression line (3.20) was considerably greater than for P*LP*. Only results from those studies in which stool collections were complete (Dy excretion >90%) were utilized in the statistical comparisons (36 of 47 studies). The observed highly significant linear correlation between P*LP* and stool fat over the entire range of steatorrhea suggests that P*LP* excretion may be a suitable surrogate for fecal fat in patients with reduced exocrine pancreatic function. Because fecal excretion of TG* administered as described can be accurately determined by sampling only two visually marked stools, development of a noninvasive test to replace the current 72-hour stool fat test using this approach is possible. Use of other engineered TG*s and/or labeled fatty acids, may provide a method for non-invasive in vivo assessment of the specific defect(s) leading to steatorrhea in other patient groups.

To assess the iron and zinc status of young females, aged 14 to 19 years, consuming vegetarian and omnivorous diets. Dietary intakes (via 3-day weighed food records), BMI, and laboratory indices of iron and zinc status were compared in a convenience sample of 79 lacto-ovo-vegetarians (LOV), 16 semi-vegetarians (SV), and 29 omnivorous (OM) females. Twenty-nine percent LOV, 44% SV, and 17% OM had low iron stores (i.e., plasma ferritin < 12 micrograms/L); only 3% had anemia. As well, 24% LOV, 33% SV, and 18% OM had serum zinc < 10.71 mumol/L and 14% LOV, 14% SV, and 17% OM had hair zinc < 1.68 mumol/g. Intakes of iron and ascorbic acid from the weighed food records were associated with serum iron (p < 0.04) and total iron binding capacity (negatively; p < 0.02), respectively, whereas Phy:Zn molar ratios were associated with serum zinc (negatively; p < 0.04). Z-scores for BMI were associated with serum zinc (p < 0.02) and diet type (p < 0.001); serum AP activity was associated with age (p < 0.0001) and oral contraceptive use (p < 0.04). Suboptimal iron and zinc status was attributed to low intakes of poorly available iron and zinc in all dietary groups.

We wanted to learn about plasma patterns of ascorbic acid (AA), beta carotene (BC), and vitamin E (vit E) when each or their various combinations were fed to humans. Conceivably, the combined absorption of these antioxidants could synergize maximum plasma redox potential. Vit E (800 mg/day), BC (30 mg/day), and AA (1000 mg/day) were fed individually or in various combinations with each other to 91 volunteers divided into different feeding groups for 14 days. Plasma vit E, carotenes, and AA patterns were analyzed by standardized methods; values were compared with each group's baseline value. AA feeding did not significantly increase already saturated plasma AA concentrations above baseline. Intake of BC did not influence vitamin A (vit A) levels. Feeding of only vit E or only BC, with or without AA addition, or a combination of BC and vit E significantly increased plasma vit E and carotene levels after 2 days. A statistically (ANOVA) significant increase in plasma vit E above baseline was noted when vit E was ingested combined with AA or BC; this increase in plasma vit E was not significant when AA, BC and vit E were taken in combination. Our results show that BC or AA ingestion in combination with vit E significantly increases circulating vit E above that seen when vit E is individually ingested. Vit E in combination with BC or AA seems a practical means or increasing the circulating antioxidant potential afforded by vit E. Reasons why such synergism does not exist when an AA, BC, vit E combination is ingested is not yet obvious.

Previous in vitro studies have suggested that beta-carotene 15,15'-dioxygenase is an iron-dependent enzyme. However, in vivo, it is difficult to alter iron tissue concentration by varying dietary iron because of homeostatic control. On the other hand, an interaction between iron and copper has been shown, i.e., copper-deficiency results in an increase of iron in rat liver. Therefore, we hypothesized that intestinal iron concentration could be increased by copper-deficiency. Our objective was to examine the effects of iron as affected by dietary copper on beta-carotene 15,15'-dioxygenase activity in the small intestine. Weanling male Sprague-Dawley rats (40 to 45g) were divided into four dietary groups: two copper-adequate groups (6.0 microg Cu/g diet) and two copper-deficient groups (0.6 microg Cu/g) combined with either normal iron (44 microg Fe/g) or high iron (87 microg Fe/g). Iron and copper concentrations were determined by atomic absorption spectrophotometry and the dioxygenase activity by reverse phase HPLC. Intestinal copper concentration was significantly reduced (40%) by the consumption of the copper-deficient diets, but intestinal iron was not changed by doubling dietary iron in rats fed either copper-adequate or copper-deficient diets. However, as hypothesized, the two copper-deficient groups exhibited higher intestinal iron concentration (> or =137%, p<0.001) than the copper-adequate controls. In addition, intestinal beta-carotene 15,15'-dioxygenase activity was increased by 27% and 106%, respectively, for copper-deficient rats fed either normal or high iron diets, compared to the respective copper-adequate controls (p<0.01). The dioxygenase activity was not significantly affected by dietary iron in either copper-adequate or copper-deficient groups. Finally, the enzyme activity was positively correlated (r=0.67, p<0.0001) with iron concentration and negatively correlated (r=-0.49, p<0.01) with copper concentration in small intestine. Intestinal beta-carotene 15,15'-dioxygenase may be an iron-dependent enzyme sensitive to copper status in vivo.

Our specific aim in the 16 year prospective NHANES I epidemiologic follow-up study (NHEFS) was to assess the important roles of modifiable dietary and behavioral factors in causation and prevention of deaths and hospitalizations for coronary heart disease (CHD). Using NHEFS 16 year follow-up data (1971 to 1987), we studied 5811 subjects, 1958 with and 3853 without CHD events, using logistic regression. In age groups 40 to 49, 50 to 59, 60 to 69, and 70 to 74 years (at study entry in 1971-4), the numbers of men and women were respectively 597 and 1019, 570 and 619, 932 and 1042, and 486 and 546. The following factors were independently positively associated (p < .05) with CHD: age, serum cholesterol, body mass index, cigarette use, and region (Midwest, Northeast). The following factors were independently negatively associated (p < .05) with CHD: gender (female), race (black), fish intake, alcohol, high school education, moderate exercise, and moderate and heavy habitual physical activity. Subjects with serum cholesterol > 249 mg/dl benefitted less (p = .04) from fish intake than those with 209 to 249 or < 209, and benefitted less (p = .03) from alcohol intake (CHD incidence [%]): [see text] These associations emphasize the important role of modifiable dietary and behavioral factors in the causation and prevention of CHD.

This study aimed to describe food and nutrient intake for low-income, urban African American children and adolescents, to highlight the need for further nutrition intervention programs and appropriate tools to address overweight and obesity. This was a cross-sectional study using interviewer-administered single 24-hour dietary recalls. Participants were low-income African American boys and girls aged 5-16 years or their caregivers in Baltimore City. Frequency of food consumption and dietary intakes were analyzed by gender and age groups. Eighty-one participants were included for analysis. Mean daily energy intakes exceeded Dietary Reference Intakes (DRIs) from 10% to 71% across all gender-age groups: 2304 kcal for children aged 5-8 years; 2429 kcal and 2732 kcal for boys and girls aged 9-13 years, respectively; and 3339 kcal and 2846 kcal for boys and girls aged 14-16 years, respectively. The most frequently reported consumed foods were sweetened drinks, chips, candies, and milk across all age groups. The majority of participants (79-100%) did not meet the DRIs for dietary fiber and vitamin E across all gender-age groups. Milk accounted for 14%, 17%, and 21% of energy, fat, and protein intake, respectively, among children 5-8 years of age, while pizza was the top source of energy, fat, and protein (11%, 13%, and 18%, respectively) among 14-to 16-year-old adolescents. Sweetened drinks and sweetened juices were major sources of sugar, contributing 33% for 5-8 year olds, 29% for 9-13 year olds, and 35% for 14-16 year olds. Mean daily energy intake exceeded dietary recommendations across all gender-age groups. This study has provided previously unavailable information on diet and highlights foods to be targeted in nutrition intervention programs.

The acute effects of olive oil, milk fat and safflower oil on postprandial lipemia and remnant lipoprotein metabolism were investigated. Eight Healthy male volunteers randomly underwent three types of oral fat-vitamin A loading tests. The test drink was a mixture of retinyl palmitate (RP)(50,000 IU of aqueous vitamin A/m2 body surface area) and one of the three types of oils (40 g of fat/m2 body surface area): olive oil (70.7% oleic acid of total fatty acids); milk fat (69.3% saturated fatty acid); safflower oil (74.2% linoleic acid). Olive oil significantly increased plasma triacylglycerol and RP concentrations 4 hours after fat loading, as compared to other fats. Increases of remnant like particle concentrations were higher after olive oil than after the other two fats. These results show that olive oil increases the magnitude of postprandial chylomicrons and chylomicron remnants compared to milk fat and safflower oil.

To determine seasonal variations in circulating concentrations of growth hormone and IGF-I in healthy, free-living elderly and to identify correlates between dietary intake, growth hormone and IGF-I concentrations in this population. Seven-day diet records and plasma samples were collected throughout a 1-year period. Plasma growth hormone and IGF-I were determined by RIA. Dietary macronutrient intake was determined using Nutritionist IV. The dietary intake of the population corresponded to the established recommendations for percentage of fat, carbohydrate and protein. Carbohydrate intake differed significantly during the year, but protein and fat did not. Hormone concentrations were constant throughout the year, with no significant differences observed. No correlation between plasma growth hormone and IGF-I was observed. Growth hormone and IGF-I concentrations did not correlate with macronutrient intake, however subjects with the lowest energy intakes tended to have higher growth hormone and lower IGF-I than those with higher energy intakes. This study provides important information on the dietary intake and hormone concentrations in normal, healthy elderly which will be useful in comparison with persons of similar age with complicating illnesses or nutrient deficiencies.

We studied the relationship between maternal and cord plasma concentrations of carotenoids, retinol, and tocopherols in normal mother-baby pairs. Healthy pregnant women (n = 10) were recruited at a Montréal hospital. Venous blood samples were collected from the mothers at delivery and cord blood was obtained immediately post partum from the umbilical vein after clamping of the cord. All deliveries were full term deliveries and all babies had normal birth weights. Maternal and umbilical cord blood samples were handled identically. Plasma was digested with lipase and plasma carotenoids were extracted and measured using HPLC. Cord plasma concentration of carotenoids were significantly lower than that of maternal plasma (p < 0.001). There was a high correlation of lutein (r = 0.889, p = 0.006) and cryptoxanthin (r = 0.912, p = 0.0002) between maternal plasma concentrations and cord plasma concentrations. The concentrations of the hydrocarbon carotenoids, alpha-carotene and beta-carotene, were also correlated (r = 0.779, p = 0.0133, & r = 0.782, p = 0.0076, respectively) between maternal plasma and cord plasma. Whereas the plasma concentration of the acyclic carotenoid, lycopene, showed no correlation between the two groups, after adjustment for plasma triglycerides, the lycopene correlation between maternal and cord plasma was the highest (r = 0.975, p = 0.0001) of all the carotenoids tested. Cord plasma retinol concentration, which was 50% of that of maternal plasma, was also found to have no correlation with that of maternal plasma. Plasma concentration of alpha-tocopherol showed no correlation between two groups, whereas there was high correlation between cord and maternal gamma-tocopherol concentrations (r = 0.808, p = 0.0047). The nutritional status of mothers affects the nutritional status of their babies for certain fat soluble nutrients.

Compare the validity and reliability of a one-week fruit, juice and vegetable (FJV) food frequency questionnaire (FFQ) that does not require averaging in response categories and one-week food recognition form (FRF) against three to four 24-hour dietary recalls (24hdr) among mostly African-American boys and 17 to 20 year-old adults for possible use in subsequent intervention studies. In Study One, the FFQ was administered to 40 boys in four Boy Scout (BS) troops on two occasions separated by two weeks. The FRF was administered to 36 boys in four other BS troops after school on six school days, covering seven consecutive days. All these boys completed four 24hdr, including one Sunday. In Study Two, 56 17 to 20 year-old adults completed the FFQ during telephone interviews on two occasions two weeks apart. In between, they completed three 24hdr by telephone interview on one weekend and two weekdays. Participants in Study One were members of eight urban BS troops, and in Study Two were high school (HS) seniors and recent HS graduates. BS data were collected at times scheduled for troop meetings or immediately after school. The young adult group completed telephone interviews in the evenings and on weekends. This research compared a FJV FFQ and a FJV FRF (incorporating the same 24 foods) against three to four 24hdr conducted using NDS software from the University of Minnesota. Descriptive statistics, intraclass correlations, Spearman correlations, corrections for attenuation. The first FFQ provided substantially higher mean consumption estimates for both groups. The FFQ had moderate reliability across assessments and moderate validity coefficients for fruit and total FJV combined for the BS sample. The FRF had higher validity coefficients for juice. The FFQ had moderate reliability and poor validity among the young adult group. Correction for measurement error in the 24hdr substantially increased validity coefficients to high levels for BS fruit and total FJV and to moderate levels for the HS groups, with some exceptions. FFQ more validly assessed fruit and combined FJV consumption for the nine to 14 year-old BS but overestimated mean values. FRF means were closer to those of the 24hdr and were more valid for assessing juice consumption. The FFQ had moderate validity among the young adult group but overestimated consumption. Further research is needed on simpler methods of reporting diet in these age groups.

The purpose of this study was to determine vitamin C intakes among American schoolchildren. We investigated the leading sources of vitamin C in children's diets, the leading vegetables and fruits consumed by children and differences in dietary intake associated with vitamin C consumption. Data from 1,350 7- to 12-year-old and 908 13- to 18-year-old schoolchildren were obtained from the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII). The children were stratified by age and gender and then split into three vitamin C consumption groups based upon two 24-hour recalls: low (0 to 30.0 mg), marginal (30.1 to 59.9 mg), and desirable (>60.0 mg). Data were analyzed by tabulation and by ANOVA followed by post hoc Scheffe's test. Outcome measures included food groups and energy-adjusted intakes of micro- and macronutrients. Among the 7- to 12-year-olds, 12% of boys and 13% of girls had mean vitamin C intakes that were less than 30 mg/day, and, among 13- to 18-year-olds, 14% of boys and 20% of girls had low vitamin C intakes. In addition to consuming significantly more vitamin C, children with desirable vitamin C intakes also consumed significantly more (p <0.001) energy-adjusted folate and vitamin B6; children with low vitamin C intakes tended to have significantly greater (p <0.001) energy-adjusted intakes of fat and saturated fat. Children with desirable vitamin C intakes consumed significantly more (p <0.006) high-vitamin C fruit juice, low-vitamin C vegetables and whole milk. Children with low vitamin C intakes on average consumed two daily servings of vegetables and fruits, of which less than 1/5 of a serving was citrus, while children with desirable vitamin C intakes consumed an average of one daily serving of citrus. A considerable number of children drastically under-consumed vitamin C and total vegetables and fruits. Overall, children with desirable vitamin C intakes had healthier diets, including more milk and vegetables, than did their peers with low vitamin C intakes. Health care professionals should continue to promote at least five daily servings of vegetables and fruits and should advise parents that at least one of these should be rich in vitamin C.

To compare relative weight, weight loss efforts and nutrient intakes among similarly health-conscious vegetarian, past vegetarian and nonvegetarian premenopausal women. Demographic data, lifestyle practices and weight loss efforts (by questionnaire), body mass index (BMI;kg/m2) and dietary intake (via multiple-pass 24-hour diet recall) were compared in a convenience sample of 90 current vegetarians, 35 past vegetarians and 68 nonvegetarians. Age (31.9 +/- 8.8), educational attainment, smoking status, alcohol use, physical activity and perceived health status were similar among the three groups of women. BMI did not differ by dietary pattern and averaged 23.7 +/- 4.7 for all women combined. Participants had intentionally lost > or = 10 pounds a mean of 2.1 times, and 39% of women perceived themselves to be overweight; again, no differences were observed among dietary groups. Dietary intakes of vegetarians and current nonvegetarians were consistent with current recommendations for macronutrient composition (< 30% fat, < 10% saturates). Compared to current nonvegetarians, current vegetarians had lower intakes of protein, saturated fat, cholesterol, niacin, vitamins B12 and D, and higher fiber and magnesium intakes. Vegetarians' mean vitamin B12 and D intakes were well below recommendations. Relative weight and weight loss efforts do not differ by dietary pattern among similarly health-conscious vegetarian and nonvegetarian women. The only differences in nutrient intake with potential health implications were vitamins D and B12.

The objective of this study was to compare changes in plasma 25-hydroxyvitamin D (25(OH)D) levels of younger and older men after three weeks of oral vitamin D supplementation. Nine younger men (22 to 28 years) and nine older men (65 to 73 years) with self-reported vitamin D intakes below 200 IU/d were enrolled in February and randomized to 1800 IU/d of ergocalciferol (vitamin D2, n=11) or to a control group (n=7) and followed for three weeks. Blood was collected at baseline, and after one, two and three weeks for measurement of plasma concentrations of total 25(OH)D, 25(OH)D2 and 25(OH)D3. In both the younger and older supplemented men, 25(OH)D2 and total 25(OH)D concentrations increased significantly during the study, whereas values of these metabolites did not change in younger or older control subjects. No group showed significant changes in 25-hydroxyvitamin D3. There was a significant interaction between age group and supplement group, suggesting that the effect of vitamin D2 supplementation on changes in 25(OH)D2 changes with age. The mean increase in 25(OH)D2 was greater in the younger supplemented men than in the older supplemented men (37+/-9 nmol/L vs. 19.5 nmol/L, p=0.027), and this accounted for their significantly greater increase in total 25(OH)D. These data are consistent with an age-related decline in the absorption, transport or liver hydroxylation of orally-consumed vitamin D.

Lycopene, a carotenoid without provitamin-A activity, is present in many fruits and vegetables; however, tomatoes and processed tomato products constitute the major source of lycopene in North American diet. Among the carotenoids, lycopene is a major component found in the serum and other tissues. Dietary intakes of tomatoes and tomato products containing lycopene have been shown to be associated with decreased risk of chronic diseases such as cancer and cardiovascular diseases in several recent studies. Serum and tissue lycopene levels have also been inversely related with the chronic disease risk. Although the antioxidant properties of lycopene are thought to be primarily responsible for its beneficial properties, evidence is accumulating to suggest other mechanisms such as modulation of intercellular gap junction communication, hormonal and immune system and metabolic pathways may also be involved. This review summarizes the background information about lycopene and presents the most current knowledge with respect to its role in human health and disease.

To evaluate possible changes in USDA nutrient content data for 43 garden crops between 1950 and 1999 and consider their potential causes. We compare USDA nutrient content data published in 1950 and 1999 for 13 nutrients and water in 43 garden crops, mostly vegetables. After adjusting for differences in moisture content, we calculate ratios of nutrient contents, R (1999/1950), for each food and nutrient. To evaluate the foods as a group, we calculate median and geometric mean R-values for the 13 nutrients and water. To evaluate R-values for individual foods and nutrients, with hypothetical confidence intervals, we use USDA's standard errors (SEs) of the 1999 values, from which we generate 2 estimates for the SEs of the 1950 values. As a group, the 43 foods show apparent, statistically reliable declines (R < 1) for 6 nutrients (protein, Ca, P, Fe, riboflavin and ascorbic acid), but no statistically reliable changes for 7 other nutrients. Declines in the medians range from 6% for protein to 38% for riboflavin. When evaluated for individual foods and nutrients, R-values are usually not distinguishable from 1 with current data. Depending on whether we use low or high estimates of the 1950 SEs, respectively 33% or 20% of the apparent R-values differ reliably from 1. Significantly, about 28% of these R-values exceed 1. We suggest that any real declines are generally most easily explained by changes in cultivated varieties between 1950 and 1999, in which there may be trade-offs between yield and nutrient content.

More than 50 years of work have led to the recognition of trivalent chromium as an essential element. Shortly after its identification as an essential element in 1959, its interaction with insulin in vitro and in vivo was established, and the site of action identified as the insulin-sensitive cell membrane. Despite other early clinical successes with chromium supplementation, four major problems have influenced the rate of progress since then: 1) chromium analysis; 2) interaction of chromium with other dietary factors; 3) diagnosis of chromium status; and 4) other controversies, such as the carcinogenic potential of chromium (since disproved) and the lack of an effect on glucose tolerance even in chromium deficient organisms (now explained). These controversies have mostly dissipated as new knowledge integrated seemingly irreconcilable facts and opinions. It is now known that chromium may potentiate the action of insulin either by an effect on insulin dependent functions, or by maintaining these functions with less insulin, or by a combination of both. Despite much progress in the last 30 years, major challenges in chromium research remain, such as the development of practical methods for diagnosing chromium deficiency. Of several approaches for solving this problem, the most feasible might be to standardize the urinary chromium response following an insulinogenic challenge, such as an oral load of glucose or of glucose plus fructose (for maximal stimulation) with urine collection before and during the 2-hour test.

Serum magnesium has been determined by atomic absorption spectrophotometry in a national sample of the United States population between 1971 and 1974. Mean values and percentile distributions are presented for ages 1-74 in males and females in two racial groups. Mean values decreased in both sexes from age 1 to ages 12-24. In females, they increased again after age 25, while males showed little change after age 17. Small sex differences were observed between ages 18 and 45, with men having higher levels than women. Both white males and females had higher serum levels than black males and females of the same age. These differences were statistically significant in many age groups, particularly in young and middle-aged adults. These data are unique inasmuch as they represent the only broad population measurements of serum magnesium in the United States. No comparable data exist as far as is known. The values shown can be considered as normative for the U.S. population. A review of the literature with comparable data was done and results are included; a discussion of the findings from these studies is presented.

To determine levels of intake and food sources of zinc in 1976-80 in US adults between the ages of 19 and 74. Dietary data from 24-hour recalls collected in the Second National Health and Nutrition Examination Survey were analyzed. Levels of zinc intake were compared between demographic subgroups using analysis of variance. The contribution of individual foods to overall zinc consumed was also estimated. Mean daily intakes (+/- SEM) were 15.5 mg +/- 0.4 and 9.8 mg +/- 0.2 in white men and women, respectively. Mean daily intake estimates in black men and women (12.3 mg +/- 0.8 and 7.8 mg +/- 0.3, respectively) were significantly lower. Lower intakes were observed in women versus men, in older (65 to 74 years) versus younger (19 to 34 years) age groups, and among people with lower versus higher education and income levels. Lower zinc intakes in women and older persons could be mainly attributed to lower overall energy intake compared with gender and age counterparts. However, lower intakes in blacks and persons with lower education or income levels were not explained by differences in energy intake and may be attributed to differences in food selections. Meat and milk products contributed the majority of zinc in recalled diets, accounting for 56 and 60% of total zinc intake in blacks and whites, respectively. Levels and sources of zinc intake in 1976-80 were higher than in more recent national surveys, suggesting that zinc intakes may be declining. Population groups more likely to have lower intakes were women, older adults, blacks, and those with lower levels of education and higher poverty levels.

To study the validity of the visual clinical assessment of weight relative to length and length relative to age as compared to the World Health Organization (WHO) 2006 standard and National Center for Health Statistics (NCHS) 1977 reference in asssessing the physical growth of children younger than 1 year. A prospective cohort study was carried out among 684 infants attending goverment health clinics in 2 states in Malaysia. Body weight, length, and clinical assessment were measured on the same day for 9 visits, scheduled every month until 6 months of age and every 2 months until 12 months of age. All of the 3 z-scores for weight for age (WAZ), length for age (HAZ), and weight for length (WHZ) were calculated using WHO Anthro for Personal Computers software. The average sensitivity and specificity for the visual clinical assessment for the detection of thinness were higher using the WHO 2006 standard as compared with using NCHS 1977. However, the overall sensitivity of the visual clinical assessment for the detection of thin and lean children was lower from 1 month of age until a year as compared with the WHO 2006 standard and NCHS 1977 reference. The positive predictive value (PPV) for the visual clinical assessment versus the WHO 2006 standard was almost doubled as compared with the PPV of visual clinical assessment versus the NCHS 1977 reference. The overall average sensitivity, specificity, PPV, and negative predictive value for the detection of stunting was higher for visual clinical assessment versus the WHO 2006 standard as compared with visual clinical assessment versus the NCHS 1977 reference. The sensitivity and specificity of visual clinical assessment for the detection of wasting and stunting among infants are better for the WHO 2006 standard than the NCHS 1977 reference.

Total cholesterol results of a screening of 134 Munich school children aged 6-11 years are described. In reviewing worldwide studies on blood lipids in children, in the last 10 years, I note a large variance in the so-called "normal" values, with mean levels of total cholesterol ranging from 148 to 214 mg%. Age-, sex-, and race-specific reference data for a population are needed. Only with these special data can one determine the point for intervention. With school health education programs, including medical screening examinations, the aim of primary prevention of coronary heart disease can be reached.

To assess the performance of weight related nutritional markers (reported involuntary weight loss greater than 10%, measured weight loss and body mass index-BMI-) in predicting HIV disease progression. Multirisk cohort of HIV-1 infected patients. The three nutritional variables were studied in Cox proportional hazard models as time dependant variables. The sample included 2376 subjects (median follow up: 43.1 months), of those 675 experienced an AIDS defining event. After adjustment for well known prognostic factors, the reported weight loss greater than 10% tripled the risk of progression to clinical AIDS (Hazard ratio [HR] 3.0. 95% confidence interval [CI] 2.5-3.7). For measured weight loss under 5%. between 5% and 10% and greater than 10% of baseline weight compared with no weight loss, hazard ratios were respectively 1.8 (CI 1.5-2.2), 2.6 (CI 2.1-3.2) and 5.1 (CI 4.1-6.4). The relative risks of AIDS were 1.7 (CI 1.3-2.2) for BMI between 17 kg/m2 and 18.5 kg/m2, 2.6 (CI 1.7-4.0) for BMI between 16 kg/m2 and 17 kg/m2 and 4.7 (CI 3.0-7.4) for BMI under 16 kg/m2. Even a limited weight loss measured at a given time during follow up increases the risk of HIV progression; moreover, a simple cross-sectionnal measure of BMI has a good predictive value for subsequent development of clinical disease.

We investigated the association of extent of daily energy intake from evening food intake with self-reported body weight and nutrient intake. Using data from the 1985-86 CSFII, we estimated the proportion of daily energy from foods/beverages reportedly consumed after 5 p.m. on 4 non-consecutive days by 1802 women, aged 19-50 years. The mean +/- SE of 4-day average energy from evening food intake was 46 +/- 0.4%. Body mass index was not associated with percent energy from evening food intake in unadjusted or multiple-covariate-adjusted regression analyses. In multiple-covariate-adjusted regression models, percent energy from fat, protein, and grams of alcohol reported were positively associated with percent energy from evening food intake (p < 0.05); while percent energy from carbohydrate, and percent RDA of vitamins C, B-6, and folate were inversely associated with evening eating. The results do not support the hypothesis regarding the association of relative weight with percent energy from evening food intake. However, statistically significant differences in intake of some nutrients in relation to extent of evening food intake were noted.

Low reporting of food intake is an acknowledged problem in dietary assessments; however, differences in food intake relative to reporting status are poorly understood. This study examined the relation of a measure of dietary reporting status with the nature of food intake reported by adults in the third National Health and Nutrition Examination Survey. Subjects were 6948 women and 6452 men, 20 years of age or older, with a complete and reliable 24-hour dietary recall. The ratio of reported energy intake to estimated basal energy expenditure (EI/BEE) was computed as a measure of dietary reporting status. The independent relation of EI/BEE ratio with 1) the amount, number, and energy density of nutrient-dense and low-nutrient-dense foods, 2) the number of reported eating occasions, 3) macro- and micronutrient intake and 4) serum concentrations of folate, ascorbate and carotenoids were examined using gender-specific multiple regression models. The EI/BEE ratio related positively with the amount, number and energy density of both nutrient-dense and low-nutrient-dense foods, and grams of alcoholic beverages. The EI/BEE ratio was an independent negative predictor of serum folate, ascorbate and alpha-carotene concentrations confirming the underreporting of food sources of these nutrients. The relative odds of reporting < or = 30% of energy as fat or < 10% of energy as saturated fat decreased with ratio of EI/BEE; however, the odds of reporting all five food groups or meeting the recommended intake of selected micronutrients increased with EI/BEE. The quantity and the quality of food intake reported in the 24-hour recall in NHANES III differed in relation to the ratio of EI/BEE.

Consumption of soft drinks has been hypothesized to be negatively associated with calcium intake. However, fortification of some foods and beverages may have affected calcium intake. The purpose of this study was to examine changes in calcium intake and the association of milk consumption with key beverage consumption and demographic variables using the most current data available. Several techniques were used to describe how age, gender, race/ethnicity, and beverage consumption were associated with milk and calcium intake using the Continuing Survey of Food Intake by Individuals 1994-1996, 1998 (CSFII) and the National Health and Nutrition Examination Survey 1999-2002 (NHANES). Using bivariate and multivariate regression analyses, we examined the independent relationships of total non-beverage energy intake, fluid milk consumption, non-milk beverage consumption, and demographics with calcium intake. During the time period between CSFII and NHANES, milk consumption decreased and RCSD consumption increased among children 6-11 y. Calcium intake was unaffected. Among other age categories, milk consumption either did not change or increased (females 40-59 y), while RCSD consumption increased. Calcium intake either did not change or increased in most age-gender categories, including adolescent females. Fluid milk consumption exhibited the strongest association with calcium intake. Fruit juice consumption was also positively associated with calcium intake in most age-gender categories. Consumption of other beverages, including RCSD, had little or no association with calcium intake. Consumption of low-fat milk should be encouraged, but calcium fortification of certain foods and beverages and calcium supplementation may be needed to further increase calcium intake.

To examine the association between calcium intake and dairy product consumption with overweight and obesity in young adults. The sample used in this study consisted of 1306 young adults, ages 19-38 years, who participated in the 1995-1996 young adult survey. Analysis was performed with analysis of covariance (ANCOVA) for ethnicity-gender groups separately. No significant association was found between dairy product consumption, calcium intake and overweight, defined by body mass index or waist circumference. However, there was a significant inverse association between calcium intake, low-fat dairy product consumption and waist-to-hip ratio in white males. Increasing intake of calcium and low-fat dairy products may be associated with lower abdominal adiposity, particularly in young adult white males.

A major diet-related problem in the US has changed from growth retardation to childhood obesity. This paper compares the consumption patterns of children using data from nationally representative surveys conducted by the US Department of Agriculture from 1986 to 1994. Children's consumption patterns were analyzed by age groups, income groups and food security levels. From 1986 to 1994, no distinct trends of the energy intakes of children 5 years of age and under were observed. In 1994, a greater percentage of children were meeting the dietary guidelines for fat and saturated fat than in 1989-91. However, most of the children's diet in each sex/age category still exceeds the dietary guideline's recommendations.

To examine the relationship between whole grain consumption and body mass index (BMI) in a sample of American adult women. Dietary intake data from the National Health and Nutrition Examination Survey 1999-2000 were linked to the USDA Pyramid Servings Database. Women 19 years of age and older (n = 2,092) were classified into groups based on their average whole grain (WG) intake: 0 servings, more than 0 but less than 1 serving, and > or =1 servings per day. Within these classifications, mean BMI, mean waist circumference and percent overweight/obese (BMI > or = 25) were identified as primary dependent variables. Regression and logistic regression analyses were used to assess associations between BMI, waist circumference and percent of the population overweight/obese (BMI > or =25) and WG consumption. Women consuming at least one serving of WG had a significantly lower mean BMI and waist circumference than women with no WG consumption (p < 0.05). Multiple regression analysis showed a significant inverse relationship between BMI and whole grain intake after adjustment for age, energy intake, dietary fiber and alcohol intake (p = 0.004). This effect was mildly attenuated but remained significant after further adjustment for level of physical activity, smoking status, ethnicity and education (p = 0.018). The odds ratio for having a BMI > or = 25 was 1.47 (95% CI 1.12-1.94; p for trend 0.013) for women consuming no WG compared to those consuming at least one serving, after adjustment for all covariates. These data support other research suggesting increased WG intake may contribute to a healthy body weight in adult women.

To assess the impact of breakfast skipping and type of breakfast consumed on energy/nutrient intake, nutrient adequacy, and diet quality. Cross-sectional. The National Health and Nutrition Examination Survey (NHANES), 1999-2002. Young adults (20-39 years, n = 2615). A 24-hour dietary recall was used, with breakfast defined as self-reported. Covariate-adjusted sample-weighted means for the entire day's energy/nutrient intakes, mean adequacy ratio (MAR) for nutrient intakes, and diet quality (i.e., Healthy Eating Index [HEI]-2005) scores were compared using analysis of variance and Bonferroni's correction (p < 0.0167) among breakfast skippers (BS), ready-to-eat-cereal breakfast consumers (RTECC), and other breakfast consumers (OBC). Energy/nutrient intakes and food consumption at breakfast were also compared (p ≤ 0.05). Twenty-five percent of young adults were BS, 16.5% were RTECC, and 58.4% were OBC. Intakes of total energy, percent energy from carbohydrate, and dietary fiber were higher in RTECC than in BS and OBC. Percent energy intake from added sugars was higher in BS than in RTECC and OBC. Compared with BS and RTECC, OBC consumed a lower percent energy from carbohydrates and total sugars, but consumed a higher percent energy from total fat and discretionary solid fats and had a higher cholesterol intake. Intakes of several micronutrients were higher in RTECC than in BS and OBC. Both MAR and total HEI scores were the highest in RTECC and higher in OBC than in BS. The HEI scores for intakes of whole fruits, total/whole grains, milk, and percent energy from solid fat/alcohol/added sugar were the highest in RTECC and higher in OBC than in BS. Compared with OBC, RTECC had a higher HEI score for the intake of saturated fat. At breakfast, RTECC consumed higher intakes of total fruits, whole grains, dairy products, carbohydrates and total sugars, dietary fiber, and several micronutrients than OBC, who consumed higher intakes of meat/poultry/fish, eggs, total fat, discretionary oils/solid fats, cholesterol, and sodium than RTECC. Thus, RTECC had more favorable nutrient intakes and better diet quality than BS and OBC.

Epidemiological studies have shown positive findings associated with legume consumption and measures of cardiovascular disease and obesity. However, few observational trials have examined beans as a separate food variable when determining associations with health parameters. To determine the association of consuming beans on nutrient intakes and physiological parameters using the National Health and Examination Survey (NHANES) 1999-2002. Using data from NHANES 1999-2002, a secondary analysis was completed with a reliable 24-hour dietary recall where three groups of bean consumers were identified (N = 1,475). We determined mean nutrient intakes and physiological values between bean consumers and non-consumers. Least square means, standard errors and ANOVA were calculated using appropriate sample weights following adjustment for age, gender, ethnicity and energy. Relative to non-consumers, bean consumers had higher intakes of dietary fiber, potassium, magnesium, iron, and copper (p's < 0.05). Those consuming beans had a lower body weight (p = 0.008) and a smaller waist size (p = 0.043) relative to non-consumers. Additionally, consumers of beans had a 23% reduced risk of increased waist size (p = 0.018) and a 22% reduced risk of being obese (p = 0.026). Also, baked bean consumption was associated with a lower systolic blood pressure. Bean consumers had better overall nutrient intake levels, better body weights and waist circumferences, and lower systolic blood pressure in comparison to non-consumers. These data support the benefits of bean consumption on improving nutrient intake and health parameters.

The health effects of added sugars have received much attention, but few studies have examined the association between foods that naturally contain sugar, such as 100% fruit juice, and risk of obesity and related conditions. Therefore, our purpose was to study the association between 100% fruit juice intake and risk of obesity and metabolic syndrome in a representative sample of the U.S. population. Cross-sectional analysis of a multiethnic sample of U.S. adults from the National Health and Nutrition Examination Survey 1999-2004 was undertaken to examine the association between 100% fruit juice consumption and the odds of obesity (body mass index [BMI] ≥ 30 kg/m2) and metabolic syndrome (Adult Treatment Panel [ATP] III definition). We used logistic regression analysis to estimate the odds of obesity and metabolic syndrome per category of fruit juice consumption exposure, while adjusting for covariates that may be confounders of this association. Of 14,196 adults included in the sample, 3961 were consumers of fruit juice. Consumers of 100% fruit juice, relative to nonconsumers, had lower mean BMI, lower waist circumference, and lower homeostasis model assessment (HOMA) insulin resistance (p < 0.001). Level of intake (oz/d) had a linear inverse association with HOMA (p < 0.001), whereas the association with BMI and waist circumference was U-shaped (p < 0.001). Consumers relative to nonconsumers had 22% (95% confidence interval [CI] = 13%-30%) lower odds of obesity and 15% (95% CI = 10%-28%) lower odds of metabolic syndrome. After adjustment for demographics and lifestyle factors, the lower odds of obesity remained statistically significant, but a statistically significant reduction in odds of metabolic syndrome was no longer noted. Compared with nonconsumers, those who consumed 100% fruit juice were leaner, were more insulin sensitive, and had lower odds of obesity and metabolic syndrome. The association with metabolic syndrome was explained primarily by other lifestyle factors, while the association with obesity remained independent. Experimental studies are needed to determine whether any direct physiologic link exists between consumption of 100% fruit juice and lower risks for obesity and metabolic syndrome.

Few recent epidemiologic studies have assessed the effect that nut consumption (including tree nuts and peanuts) has on health risks, including metabolic syndrome (MetS). This study compared the health risk for cardiovascular disease, type 2 diabetes, and MetS of nut consumers with that of nonconsumers. Adults 19+ years (n = 13,292) participating in the 1999-2004 National Health and Nutrition Examination Survey were used. Intake from 24-hour recalls was used to determine intake. Nut/tree nut consumers consumed ≥¼; ounce per day. Covariate-adjusted means, standard errors, and prevalence rates were determined for the nut consumption groups. The prevalence of nut consumers was 18.6% ± 0.7% and 21.0% ± 0.9% in those 19-50 years and 51 years and older, respectively. Nut consumption was associated with a decreased body mass index (27.7 kg/m(2) ± 0.2 vs 28.1 ± 0.1 kg/m(2), p < 0.05), waist circumference (95.6 ± 0.4 cm vs 96.4 ± 0.3 cm, p < 0.05), and systolic blood pressure (121.9 ± 0.4 mmHg vs 123.20 ± 0.3 mmHg, p < 0.01) compared with nonconsumers. Tree nut consumers also had a lower weight (78.8 ± 0.7 kg vs 80.7 ± 0.3 kg, p < 0.05). Nut consumers had a lower percentage of two risk factors for MetS: hypertension (31.5% ± 1.0% vs 34.2% ± 0.8%, p < 0.05) and low high density lipoprotein-cholesterol (HDL-C) (29.6% ± 1.0% vs 34.8% ± 0.8%, p < 0.01). Tree nut consumers had a lower prevalence of four risk factors for MetS: abdominal obesity (43.6% ± 1.6% vs 49.5% ± 0.8%, p < 0.05), hypertension (31.4% ± 1.2% vs 33.9% ± 0.8%, p < 0.05), low HDL-C (27.9% ± 1.7% vs 34.5% ± 0.8%, p < 0.01), high fasting glucose (11.4% ± 1.4% vs 15.0% ± 0.7%, p < 0.05), and a lower prevalence of MetS (21.2% ± 2.1% vs 26.6% ± 0.7%, p < 0.05). Nut/tree nut consumption was associated with a decreased prevalence of selected risk factors for cardiovascular disease, type 2 diabetes, and MetS.

We tested the hypothesis that cessation of habitual ingestion of breakfast cereals would be associated with elevated plasma homocyst(e)ine concentrations. We anticipated that those subjects who reported consuming breakfast cereals containing 100 to 400 ,microg of folic acid per serving before entering the study would achieve higher plasma homocyst(e)ine concentrations if, in addition to their regular diet, they began ingesting a daily serving of breakfast cereal that contained less than 10 microg of folic acid per serving. Seventy-nine subjects consumed a daily serving of breakfast cereal containing either < 10 microg or folic acid per serving (placebo) or breakfast cereal containing 200 microg of folic acid per serving (folic acid fortified). Cessation of intake of commercially available breakfast cereal was associated with homocyst(e)ine elevation. Breakfast cereal containing 200 microg folic acid per day was sufficient to maintain the homocyst(e)ine lowering effects of commercial cereals. Habitual consumption of commercially available fortified breakfast cereals, usually containing 100 to 400 microg folic acid per serving, had significant homocyst(e)ine lowering effects as shown by the homocyst(e)ine increase after cessation of habitual intake of commercial breakfast cereal. Substitution of breakfast cereal containing only 200 microg folic acid per day was sufficient to maintain the homocyst(e)inelowering effects of commercial cereals.

Various nutrition guidelines recommend increased consumption of fruits and vegetables (F+V); a Year 2000 goal targets five or more daily servings of F+V. Decisions are needed regarding how to define F+V to facilitate measurement of goal achievement. Four alternative definitions (narrow and broad, each with and without legumes) were developed and applied to food frequencies from 133 children and 211 parents. Results varied by definition. Mean intake met the goal of five or more daily servings regardless of definition and exceeded it for both broad definitions by children and both broad definitions and the narrow definition with legumes for adults. Median intakes met the goal for all definitions except for children with the narrow definition without legumes, and exceeded it for children with both broad definitions and for adults with the broad definition with legumes. These differences by definition indicate that a clear definition of F+V is needed.

Objective: Adequate calcium and vitamin D intakes are critical during all life cycle stages. This study aimed to characterize usual intakes of calcium and vitamin D from food and dietary supplements in specific subpopulations of Americans so that fortification/enrichment and supplementation efforts may be targeted toward populations who are truly in need. Methods: The National Cancer Institute method was used to estimate usual intakes of calcium and vitamin D by source and compared usual intakes to the established Dietary Reference Intakes for U.S. residents aged ≥4 years using National Health and Nutrition Examination Survey 2001-2002, 2003-2004, 2005-2006, and 2007-2008 data sets. Results: These results showed for the first time that low-income, overweight, and/or obese minority populations may be at greater risk of calcium and vitamin D insufficiency. Children aged 4-8 years were more likely to obtain recommended dairy intakes compared with older children and adults of all ages. Food intakes of calcium decreased with age in adults. Adults who used supplemental calcium showed a lower prevalence of insufficiency. Calcium and vitamin D intakes from food and dietary supplements were not related to vegetarian status. Excessive intakes of calcium and vitamin D above the tolerable upper intake level were low among all studied populations and "overnutrification" was not widely present across these analyses. Conclusions: Age- and gender-specific supplementation and modest use of fortification with calcium and vitamin D may be warranted for targeting certain subpopulations, particularly older adults, teenagers, minorities, and those who are low income and overweight and/or obese. Practical application: This study aimed to characterize usual intakes of calcium and vitamin D from food and dietary supplements in specific subpopulations of Americans so that fortification/enrichment and supplementation efforts may be better targeted. Low-income, overweight, and/or obese minority populations may be at a greater risk of calcium and vitamin D insufficiency.

Objective: To compare micronutrient intake status of those overweight and those obese with normal weight adults. Methods: Using total nutrient intake (from foods and supplements) from the National Health and Nutrition Examination Survey (NHANES) 2001-2008, we determined usual intakes for micronutrients using the National Cancer Institute methodology in adults (n = 18,177). Only subjects with reliable dietary records were included and pregnant and lactating females were excluded. Subjects were categorized by body weight status as either normal weight (body mass index [BMI] < 25), overweight (BMI ≥ 25 to < 30), or obese (BMI ≥ 30). Results: A substantial proportion of the adult population (over 40%) had inadequate intakes of vitamin A, vitamin C, vitamin D, vitamin E, calcium, and magnesium. Compared to normal weight adults, obese adults had about 5% to 12% lower (p < 0.05) intakes of micronutrients and higher (p < 0.01) prevalence of nutrient inadequacy. Conclusion: We conclude that obese adults compared to normal weight adults have lower micronutrient intake and higher prevalence of micronutrient inadequacy.

The scope of the diabetes epidemic stresses the critical need for primary prevention. The consumption of foods high in vitamin C has been associated with lower risk of diabetes. The aim of this study was to analyze the relation between vitamin C concentration and glycemic control index in a large sample of U.S. adults without a history of diabetes. We analyzed data collected from 7697 adult participants in the National Health and Nutrition Examination Survey (NHANES) 2003-2006 who did not report a history of diabetes. Multivariate linear regression analyzed the association of vitamin C and hemoglobin A1c (A1c) levels after accounting for potential confounders. We also conducted stratified analyses based on race/ethnicity, gender, age group, body mass index, and vitamin D status. Vitamin C concentrations were inversely associated with A1c (p = 0.0202). Stronger inverse associations were observed in subjects 18-44 years of age (p = 0.0017), as well as in female (p = 0.0035) and Mexican American (p = 0.0149) subgroups. Evidence of a significant interaction between vitamin C and vitamin D was noted in subjects aged 18-44 years and in females (p = 0.0073 and 0.0095 respectively), with the inverse association tending to be evident at lower levels of vitamin D. Vitamin C status may influence glycemic control. Investigators should be cognizant of the interaction of vitamins C and D and should take this into consideration in planning future studies.