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Found 11 results

  1. CarstenR

    Carsten's Current Diet

    Hey, I would be glad about all sorts of suggestions and questions about my diet. I do not have fixed times for meals. Most of the time I start eating around 10 in the morning and eat the last one at 10 in the evening.
  2. Dean Pomerleau

    Dean's Current Diet

    Someone asked me off-list what my current diet looks like, and I realized I haven't updated the on-line information about it in a long time, although I've alluded to it in scattered places on this forum. I figured I consolidate and expand on what I've shared, for others to criticize : These days I eat the following (by calories): ~30% vegetables ~15% starch, ~35% fruit, ~20% nuts/seeds by calories a few other miscellaneous things. Vegetables The vegetables are a huge variety, and prepared once per week into a big mix. Its a combination of 'chunky' vegetables (just about any veggie in the produce aisle), and greens - where the greens typical include a mix of Kale, collards, chard, spinach, and spring mix - mostly organic. I also eat about 80g of homegrown sprouts and microgreens per day, a mix of broccoli, fenugreek, radish, and arugula sprouts. Starches The starches are about 1/2 sweet potatoes, and the other half and even mix of lentils, black beans, chickpeas, wild & brown rice, quinoa, and barley, all cooked al dente. Fruit My fruit calories come from the following. Below the first two, which are the biggest calorie contributors, the others are probably similar in calorie contributions: Berries - Mix of strawberries, blueberries, wild blackberries, cranberries, sour cherries every day Bananas - I modulate these depending on my weight trajectory - I'm around 2-3 per day these days. Melon - Alternating between cantaloupe, honeydew, mango, papaya, pineapple Durian - I admit it, I'm addicted to durian... Orange - 1/2 an small orange per day, with a bit of the peal/pith Apples - One small-to-medium (crabapple-like) wild apple per day, picked in the fall from wild trees near my house Other Tree Fruit - Persimmons (one of my favorites), plums, peaches, nectarines, pears, pomegranate. Depending on the season. About 1/2 of one of these per day. Note - this does not include the non-standard fruits I eat, like avocado (1/2 per day), cucumber, zucchini, tomato (~100g / day), etc. Nuts / Seeds The nuts I eat include: Hazelnuts, Almonds and Walnuts, in equal parts. The seeds I eat are a mix of the following (in descending order of calories): Flax, chia, hemp, sunflower, pumpkin, sesame. Miscellaneous The miscellaneous category includes the following per day: 1/3 ear of corn - 'buttered' with avocado and 'salted' with curry powder, because its tasty. 12g of natto - for vitamin K2 and amyloid breaking. 1.5 tsp of fresh chopped mix of garlic, ginger, tumeric root & horseradish 2 tbsp of cider vinegar 2 tbsp of my ketchup - a homemade mix of cider vinegar, water, tomato paste, sriracha, hot mustard and psyllium as a thickener ~2 tbsp of wide mix of herbs and spices, heavy on the tumeric, but just about anything from the spice aisle you can think of, in a mixture I sprinkle into my "salad dressing" and on my starch mix. 1 Tbsp of fiber & resistant starch - Used as thickener for my salad dressing. Even mix of psyllium husks, plantain flour and potato starch. A small amount of sweetener in my salad dressing (see below) - erythritol & pure stevia. Other Notes: The dressing I make to put on my salad is taken from some of the items listed above, blended together until smooth in my Vitamix. It includes: About 150g of the salad greens - so I don't have to eat them all in leaf form :-) 60g of berry mix The 1/2 orange ~60g of cucumber 100g of tomato 2 tbsp of cider vinegar ~100ml of water 1 Tbsp fiber / resistant starch ~1 tbsp of spice mix A bit of sweetener - erythritol & pure stevia - to make it a little tastier. I eat the exact same thing every day - except for minor variations in fruits and veggies depending on seasonal availability The macronutrient ratio of my diet is about 70:15:15 C:P:F I eat one meal per day, from 6-7:30am. I also drink a lot of lemon water (distilled) before and after my meal from this stainless steel tumbler to avoid coffee/tea close to meal which impedes mineral absorption - ~40oz per day. I also drink a mix of cold & hot brewed, heavily filtered, coffee, black/green/rooibos/herb tea, & ground cacao - about 40-50oz per day. I haven't been counting calories - but it is probably shockingly high, given that I'm weight stable at a BMI of 17.3 (115lbs @ 5'8.5" tall) and my Fitbit tells me I'm exercising in one form or another for an average of about 8-9 hours per day, about 5 hours of that pedaling leisurely at my bike desk. That's it (I think). Criticize away! --Dean
  3. I have attached what I eat in this message. I am eating at least 7 pounds of vegetables a day and right now I am eating around ~200-300g of each vegetable, but I am wondering if I might be better off eating less of the starchy vegetables - peas, carrots, green beans, - and more dark leafy greens? As you can see I am eating 600g of dark leafy greens every day which should be a good amount by normal standards, but I fear it is not enough from an optimal nutrition standpoint. Some more notes about my diet: The evoo is 600+ ppm polyphenols which I buy 24 bottles of and store for 12 months in my fridge at 2 degree Celcius I supplement with b12, iodine and vitamin D3 Berries are my only fruit source because of taste and they are more nutritious than other fruit I avoid animal products and grains in favor of more nutritious food groups: vegetables, fruits, seeds and legumes I limit my fat sources to evoo, flaxseeds and occasional avocado to maximize my MUFA/PUFA ratio and limit my O6 intake to ~10g I drink coffee made from 30-40g beans and 5-10g of Sencha green tea every day I avoid cocoa like the plague since it left me anxious, irritable and burned out for weeks This is a post about vegetables but any diet related discussion is welcomed.
  4. Dean Pomerleau

    Near Perfect Diet Study

    All, Over on this thread about the hazards and benefits of a fruitarian diet we've talked (and debunked) about the concern that some so-called nutrition experts have about fructose, even in whole fruit. I was surprised to see that neither in that thread nor anywhere else I could find have we discussed this study [1]. With this post I will remedy that. It's a real winner and I don't mean that facetiously. My only complaint is that it was a small study, involving only 10 people (8 men and 2 women) who were "prepared to eat a large amount of leafy vegetables" - perhaps they couldn't find too many subjects... The participants were healthy folks, average age ~38 and average BMI ~25. That had each subject follow three different diets for two weeks each - "Vegetable Diet", "Starch Diet" and "Low-fat Therapeutic Diet" so as to serve as their own controls. All meals were prepared for each subject and delivered in pre-weighed quantities to them twice weekly. Here are the specific foods eaten for the three diets: Note for the "Vegetable Diet", there were three different days of meals that subjects ate in rotation, while for the other two diets subjects ate the same thing every day for the entire two weeks. Also note that it's not clear from the text whether the olive oil in the starch or low-fat therapeutic diets was extra virgin or not. Here is a high level nutrition breakdown of the three diets: What's noteworthy is that the Vegetable diet looks remarkably similar to my own, whole food, plant-based diet - except for the fact that I eat a wider variety of fruits and vegetables, as well as more nuts, and therefore more fat & calories. Here are a few facts about the vegetable diet from the full text of the paper: This very high intake of fruit and vegetables translated into 63 servings per day for a 2,500 kcal diet (Table 1) It was 18% protein (entirely from plant sources), 22% fat (half from MUFA), and 60% carbs It contained almost 140g of fiber per day The total weight of food was 5.1 kg / day (~11 lbs) The fecal weight during the vegetable diet was over 900g/day (~2lbs) Yup, that's a diet after my own heart. In fact, I'd consider it nearly perfect except I'd replace some of the "chunky" veggies with "leafy" ones, add some omega-3 from walnuts/flax, and of course someone eating this way would need to supplement with at least B12 in the long term. So what did they find? Not surprisingly (to me anyway) the starch diet beat the low-fat therapeutic diet, but the vegetable diet kicked both their butts when it came to markers of cardiovascular health - which was the focus of the study. Here is the time course of changes to total cholesterol, Tot-chol:HDL , LDL:HDL, and APOB over the two weeks on each of the three diets: As you can see from those graphs, and the summary changes below, on nearly every metric the vegetable diet beat the other two: The only thing that the vegetable diet didn't excel at was reducing triglycerides. Note that it didn't raise triglycerides, despite all that fructose, but it didn't reduce them like it reduced all the other CVD indicators. Finally, one more thing the vegetable diet excelled at - satiety: With the maximum satiety rating as 3.0, satiety ratings were highest on the vegetable-based diet (3.0) compared with the starch-based (1.9) and low-fat diets (0.7) and related to the daily weight of food consumed (vegetable-based, 5.1 kg/d; starch-based, 1.9 kg/d; and low-fat therapeutic diet, 2.0 kg/d). So if you are ever asked how you know your crazy whole food, plant-based diet is healthy, or how you know that all that fructose isn't spiking your triglycerides and trashing your liver, beyond sharing your own blood tests, I'd say this is the best study I've found to offer as evidence. --Dean ---------- [1] Metabolism. 2001 Apr;50(4):494-503. Effect of a very-high-fiber vegetable, fruit, and nut diet on serum lipids and colonic function. Jenkins DJ(1), Kendall CW, Popovich DG, Vidgen E, Mehling CC, Vuksan V, Ransom TP, Rao AV, Rosenberg-Zand R, Tariq N, Corey P, Jones PJ, Raeini M, Story JA, Furumoto EJ, Illingworth DR, Pappu AS, Connelly PW. Full text: http://sci-hub.cc/10.1053/meta.2001.21037 We tested the effects of feeding a diet very high in fiber from fruit and vegetables. The levels fed were those, which had originally inspired the dietary fiber hypothesis related to colon cancer and heart disease prevention and also may have been eaten early in human evolution. Ten healthy volunteers each took 3 metabolic diets of 2 weeks duration. The diets were: high-vegetable, fruit, and nut (very-high-fiber, 55 g/1,000 kcal); starch-based containing cereals and legumes (early agricultural diet); or low-fat (contemporary therapeutic diet). All diets were intended to be weight-maintaining (mean intake, 2,577 kcal/d). Compared with the starch-based and low-fat diets, the high-fiber vegetable diet resulted in the largest reduction in low-density lipoprotein (LDL) cholesterol (33% +/- 4%, P <.001) and the greatest fecal bile acid output (1.13 +/- 0.30 g/d, P =.002), fecal bulk (906 +/- 130 g/d, P <.001), and fecal short-chain fatty acid outputs (78 +/- 13 mmol/d, P <.001). Nevertheless, due to the increase in fecal bulk, the actual concentrations of fecal bile acids were lowest on the vegetable diet (1.2 mg/g wet weight, P =.002). Maximum lipid reductions occurred within 1 week. Urinary mevalonic acid excretion increased (P =.036) on the high-vegetable diet reflecting large fecal steroid losses. We conclude that very high-vegetable fiber intakes reduce risk factors for cardiovascular disease and possibly colon cancer. Vegetable and fruit fibers therefore warrant further detailed investigation. PMID: 11288049
  5. FrederickSebastian

    Green Leafy Vegetables as Staple Food

    Hi All, Just wondering -- Are green leafy vegetables considered a good "staple" food for CR dieters? I remember posting a question earlier and getting "Sweet Potatoes" as an answer many times... Do green leafy vegetables count as a staple-food? Just Wordering, Fred.
  6. All, Dr. Greger has an interesting video out today on "Paleo-Poop", discussing the evidence from fossilized human feces that our ancestors ate a very high fiber diet, > 100g of fiber per day vs. < 20g for most people today eating a standard American diet. This wasn't particularly new news to me, or to anyone reading this I suspect. But what I found most interesting about the video was at 2:30, where he discusses what was the likely source of all that fiber. In particular, whether ancestral humans were folivores (foliage / vegetable eaters), frugivores (fruit eaters) or faunivores (meat eaters). Its pretty clear from lots of evidence that we're not primarily meat eaters, and it has only been relatively recently in our evolutionary heritage that meat and other animal products became a large part of our diet. So we can knock faunivores out of the running - at least when considering deep evolutionary time. What was most interesting was the distinction between the other two categories - folivores vs. frugivores. The evidence he shows in the video is from [1], and it is a plot of organism body size (x-axis) vs. density of gut mucosa (y-axis). Apparently the three categories (folivores, frugivores and faunivores) fall into distinct clusters. Here is the graph, with the range at which humans fall as the intersection of the horizontal and vertical lines with the label "Homo Sapiens": As you can see, humans of today fall squarely in the cluster of frugivores, which the authors interpret to indicate that our distant ancestors were primarily fruit eaters. Obviously we're omnivorous now, and have been for quite a while, especially since we expanded out of Africa into environments where fruit isn't readily available in large quantities or year-round, and since we develop cooking and other processing techniques to make meat (as well as other parts of plants) more digestible, and more palatable! But being a fruit-lover myself, I thought it interesting to know that at least our distant ancestors appear to have been heavy fruit eaters like orangutan (who apparently also love durian!), rather than folivores like gorillas. --Dean --------- [1] Claude Marcel Hladik, Patrick Pasquet. The human adaptations to meat eating: a reappraisal. Human Evolution, Springer Verlag, 2002, 17, pp.199-206. Free full text Abstract In this paper we discuss the hypothesis, proposed by some authors, that man is a habitual meat-eater. Gut measurements of primate species do not support the contention that human digestive tract is specialized for meat-eating, especially when taking into account allometric factors and their variations between folivores, frugivores and meat-eaters. The dietary status of the human species is that of an unspecialized frugivore, having a flexible diet that includes seeds and meat (omnivorous diet). Throughout the various time periods, our human ancestors could have mostly consumed either vegetable, or large amounts of animal matter (with fat and/or carbohydrate as a supplement), depending on the availability and nutrient content of food resources. Some formerly adaptive traits (e. g. the “thrifty genotype”) could have resulted from selective pressure during transitory variations of feeding behavior linked to environmental constraints existing in the past. Key Words: meat eating, hominids, gut allometry, thrifty genotype
  7. Michael and Saul will be happy about this one, since I'm going to criticize Dr. Greger's latest video (embedded below), about happiness titled Which Foods Increase Happiness? I'm also curious what Sthira might have to say :-), if he's still out there...?! In the video, Dr. Greger reviews studies of the link between fruit/vegetable (FV) intake and happiness. In the first part of the video, he reviews a number of studies that have (not surprisingly) found a positive association between FV consumption and positive mood / happiness. Then, to his credit, he asks the perennial question for these kinds of observational studies, namely the direction of causality. Does FV intake increase happiness, or do happy people eat more FVs? He points to evidence for the latter. For example, study [1] found that people in a good mood are more likely than unhappy people to prefer healthy food alternatives (e.g. grapes) over unhealthy ones (e.g. M&Ms) when given the choice. But then he goes on to argue for causality in the other direction (FV intake -> happiness) as well, based in large part on study [2]. Here is where my criticism comes in. In [2], researchers tracked (via an internet questionnaire) the FV intake and mood of nearly 300 young adults (avg. age of 20), for three weeks. Affect was gauged each day by having them rate how closely their current mood matched each of 9 positive and 9 negative adjectives (e.g. relaxed, excited, happy, ... vs. depressed, anxious, sad, ...) on a 1-5 scale. The self-rated scores for the positive (and negative) adjectives were averaged together to form a positive (and negative) affect score for each subject each day. These details will be important below, in case you are wondering why I'm going into so much detail... What they found was that higher reported FV intake on a given day was associated with a better mood on the same day. No surprise there, but also no insight as to causality. To try to get at causality, they then looked at FV intake on one day vs. mood on the next day, and visa versa - mood on one day vs. FV intake on the next day. What the found was that FV intake on one day predicted better mood on the next day, but better mood on one day didn't predict more FV intake on the next. So case closed right? Doesn't this tells us that it is FV intake that causes (future) happiness? That's (more or less) Dr. Greger's conclusion. But the key comes in the last few seconds of the video, when Dr. Greger says: How many fruits and vegetables [to increase happiness]? Seems we need to consume approximately 7.2 daily servings of fruit or 8.2 servings of vegetables to notice a meaningful change. So what does that somewhat ambiguous last statement actually mean, and how does it relate to the findings in the rest of the paper? That last statement is based on this sentence from [2]: Because the typical daily consumption in our sample was 1.7 servings of fruit and 2.5 servings of vegetables, our data suggest that young adults would need to consume approximately 7.2 daily servings of fruit or 8.2 servings of vegetables to notice a meaningful change in positive affect. In other words, because of the small size of the effect, the researchers found that a person would need to eat about 5.5 extra servings of FVs per day relative to their normal intake to experience a "meaningful change" in happiness level. What do they consider a "meaningful change"? Here is the footnote from the paper on their definition: A meaningful change in positive affect was defined as an increase in 0.16 points (i.e., increasing from the mean of 2.59 –> 2.75 points on the positive affect scale). A change of 0.16 points reflects a Cohen’s d of 0.20, a small effect, which was computed by the formula 0.20 = (2.75–2.59)/0.80, where 0.80 equals the average within-person standard deviation in positive affect. So they're defining a "meaningful change" as going from 2.59 to 2.75 on a 1-5 scale. Now if you ask me, that is a pretty tiny improvement from eating an extra 5.5 helpings of FVs. I looked up the Cohen's d measure they used a metric for effects size. Interesting statistical stuff. It seems like in the same way statisticians have agreed that P < 0.05 in a student t-test is 'significant', they've also (sorta supposedly) agreed on a definition for 'small', 'medium' and 'large' effects based on this "Cohen's d" metric. The authors of [2] equated a "meaningful change" with a "small effect" as measured by Cohen's d, which is basically defined as a change in a variable by 25% of one standard deviation in its data. Below is a helpful graphic to give you a feel for what that kind of "meaningful change" would really look like: Imagine the dark grey gaussian represents the distribution of a single individual's happiness over time on a 1-5 scale - most days they felt a middling amount of happiness, but on a smaller number of days they were happier, and on a smaller number of days they were sadder. The extreme tails would represent the (very rare) best and worst days of their life. Hence the gaussian distribution. The "meaningful change" the authors are postulating that would result from eating an additional 5.5 servings of FVs per day equates to shifting the happiness gaussian from the dark grey rightward to the light blue gaussian. I may be a curmudgeon, and you can judge for yourself, but to me this seems like a pretty small shift in happiness as a result of eating a whole lot more fruits and vegetables. So while Dr. Greger's portrayal of the relationship between FV intake and happiness isn't incorrect per se, he may be tilting the interpretation of the data in favor of fruits and vegetables, sort of like the authors of the apples and mortality study may have done in favor of apples. This perspective appears to be shared by the authors of [2], as reflected in the title they gave to their paper (my emphasis): "Many apples a day keep the blues away - ..." And to their credit (the authors of [2] that is, not Dr. Greger), they do say in the discussion that they agree with the authors of the review article [3], which observed that double-blind, randomized control trials are needed to definitively determine if eating more FVs really does indeed lead to improvements in mood: Of course, inferences about causality should be considered tentative until replicated with an experiment. Although our design allowed us to conduct lagged analyses, and these analyses suggested that fruit and vegetable consumption might be influencing positive affect, we agree that future research needs to include randomized controlled trials (RCTs) evaluating the influence of high fruit and vegetable intake on affect and well-being [3]. Sadly, Dr. Greger doesn't mention the randomized trials of FV intake and mood that have been done. Although small and not double (or single) blinded, this one [4] was encouraging. It found that, among 100 students randomly assigned to eat either a piece of fruit or a serving of "chocolate/crisps" each afternoon for 10 days, the fruit-eaters reported a better mood at the end of the study. But in truly double-blind randomized control trials of various fruit juices (i.e. blueberry [5], cranberry [6] and grape [7] juice), the effect of fruit juice intake on mood was at best small and non-significant [5], or missing altogether [6][7]. This is yet another example of where careful reading of the whole published paper, and looking at its results in the context of other research findings, is important for getting a more complete understanding of the research... --Dean ----------- [1] Fedorikhin, Alexander and Patrick, Vanessa M., Positive Mood and Resistance to Temptation: The Interfering Influence of Elevated Arousal (2010). Journal of Consumer Research, Vol. 37, No. 4, 2010. Available at SSRN: http://ssrn.com/abstract=2086834 ----------- [2] Br J Health Psychol. 2013 Nov;18(4):782-98. doi: 10.1111/bjhp.12021. Epub 2013 Jan 24. Many apples a day keep the blues away--daily experiences of negative and positive affect and food consumption in young adults. White BA(1), Horwath CC, Conner TS. Full text: http://sci-hub.io/10.1111/bjhp.12021 OBJECTIVES: Prior research has focused on the association between negative affect and eating behaviour, often utilizing laboratory or cross-sectional study designs. These studies have inherent limitations, and the association between positive affect and eating behaviour remains relatively unexplored. Therefore, the objective of this study was to investigate the bidirectional relationships between daily negative and positive affective experiences and food consumption in a naturalistic setting among healthy young adults. DESIGN: Daily diary study across 21 days (microlongitudinal, correlational design). METHODS: A total of 281 young adults with a mean age of 19.9 (± 1.2) years completed an Internet-based daily diary for 21 consecutive days. Each day they reported their negative and positive affect, and their consumption of five specific foods. Hierarchical linear modelling was used to test same-day associations between daily affect and food consumption, and next-day (lagged) associations to determine directionality. Moderating effects of BMI and gender were also examined in exploratory analyses. RESULTS: Analyses of same-day within-person associations revealed that on days when young adults experienced greater positive affect, they reported eating more servings of fruit (p = .002) and vegetables (p < .001). Results of lagged analysis showed that fruits and vegetables predicted improvements in positive affect the next day, suggesting that healthy foods were driving affective experiences and not vice versa. Meaningful changes in positive affect were observed with the daily consumption of approximately 7-8 servings of fruit or vegetables. CONCLUSIONS: Eating fruit and vegetables may promote emotional well-being among healthy young adults. PMID: 23347122 --------------- [3] Blanchflower, D., Oswald, A., & Stewart-Brown, S. (2012). Is psychological well-being linked to the consumption of fruit and vegetables? Social Indicators Research. Advance online publication. doi:10.1007/s11205-012-0173-y. Free full text: Abstract Humans run on a fuel called food. Yet economists and other social scientists rarely study what people eat. We provide simple evidence consistent with the existence of a link between the consumption of fruit and vegetables and high well-being. In crosssectional data, happiness and mental health rise in an approximately dose-response way with the number of daily portions of fruit and vegetables. The pattern is remarkably robust to adjustment for a large number of other demographic, social and economic variables. Well-being peaks at approximately 7 portions per day. We document this relationship in three data sets, covering approximately 80,000 randomly selected British individuals, and for seven measures of well-being (life satisfaction, WEMWBS mental well-being, GHQ mental disorders, self-reported health, happiness, nervousness, and feeling low). Reverse causality and problems of confounding remain possible. We discuss the strengths and weaknesses of our analysis, how government policy-makers might wish to react to it, and what kinds of further research -- especially randomized trials -- would be valuable. ------------ [4] Front Nutr. 2014 Jul 16;1:10. doi: 10.3389/fnut.2014.00010. eCollection 2014. Positive effects of a healthy snack (fruit) versus an unhealthy snack (chocolate/crisps) on subjective reports of mental and physical health: a preliminary intervention study. Smith AP(1), Rogers R(1). Author information: (1)School of Psychology, Cardiff University , Cardiff , UK. BACKGROUND/AIMS: Recent research has shown associations between type of snack and wellbeing. These studies have been cross-sectional and the aim of the present research was to examine this topic using an intervention study. METHODS: A between-subjects intervention study was carried out. Volunteers (100 students, mean age = 19.00 years; 27 male, 73 female) completed online questionnaires measuring anxiety and depression, fatigue, somatic symptoms, cognitive difficulties, and distress at baseline. They were then randomly assigned to one of two snacking conditions - chocolate/crisps or fruit. Volunteers consumed one snack item in the mid-afternoon each day for 10 days. At the end of the intervention, the volunteers completed the questionnaires again. RESULTS: Analyses of the baseline data confirmed that consumption of chocolate was associated with greater emotional eating and depression. Analyses of covariance, with the baseline data as covariates, were carried out on the post-intervention responses. The results showed that consumption of fruit was associated with lower anxiety, depression, and emotional distress than consumption of crisps/chocolate. Similarly, scores for somatic symptoms, cognitive difficulties, and fatigue were greater in the crisps/chocolate condition. CONCLUSION: These results extend findings from cross-sectional studies and give a clearer indication of causal effects of different types of snacks on wellbeing. PMCID: PMC4428353 PMID: 25988113 ------------ [5] J Agric Food Chem. 2010 Apr 14;58(7):3996-4000. doi: 10.1021/jf9029332. Blueberry supplementation improves memory in older adults. Krikorian R(1), Shidler MD, Nash TA, Kalt W, Vinqvist-Tymchuk MR, Shukitt-Hale B, Joseph JA. Author information: (1)Department of Psychiatry, University of Cincinnati Academic Health Center, Cincinnati, Ohio 45267-0559, USA. robert.krikorian@uc.edu The prevalence of dementia is increasing with expansion of the older adult population. In the absence of effective therapy, preventive approaches are essential to address this public health problem. Blueberries contain polyphenolic compounds, most prominently anthocyanins, which have antioxidant and anti-inflammatory effects. In addition, anthocyanins have been associated with increased neuronal signaling in brain centers, mediating memory function as well as improved glucose disposal, benefits that would be expected to mitigate neurodegeneration. This study investigated the effects of daily consumption of wild blueberry juice in a sample of nine older adults with early memory changes. At 12 weeks, improved paired associate learning (p = 0.009) and word list recall (p = 0.04) were observed. In addition, there were trends suggesting reduced depressive symptoms (p = 0.08) and lower glucose levels (p = 0.10). We also compared the memory performances of the blueberry subjects with a demographically matched sample who consumed a berry placebo beverage in a companion trial of identical design and observed comparable results for paired associate learning. The findings of this preliminary study suggest that moderate-term blueberry supplementation can confer neurocognitive benefit and establish a basis for more comprehensive human trials to study preventive potential and neuronal mechanisms. PMCID: PMC2850944 PMID: 20047325 -------- [6] J Altern Complement Med. 2005 Apr;11(2):305-9. A double-blinded, placebo-controlled, randomized trial of the neuropsychologic efficacy of cranberry juice in a sample of cognitively intact older adults: pilot study findings. Crews WD Jr(1), Harrison DW, Griffin ML, Addison K, Yount AM, Giovenco MA, Hazell J. Author information: (1)Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA. wdcrewsjr@aol.com OBJECTIVES: The aim of this research was to conduct the first known clinical trial of the short-term (i.e., 6 weeks) efficacy of cranberry juice on the neuropsychologic functioning of cognitively intact older adults. PARTICIPANTS: Fifty (50) community-dwelling, cognitively intact volunteers, > or = 60 years old, who reported no history of dementia or significant neurocognitive impairments, participated in this study. DESIGN: A 6-week, double-blind, placebo-controlled, randomized, parallel-group, clinical trial was utilized. Participants were randomly assigned to receive either 32 ounces/day of a beverage containing 27% cranberry juice per volume (n = 25) or placebo (n = 25) for 6 weeks, and administered a series of neuropsychologic tests at both pretreatment baseline and again after 6 weeks of either cranberry juice or placebo treatment to assess treatment-related changes. OUTCOME MEASURES: Efficacy measures consisted of participants' raw scores on the following standardized neuropsychologic tests: Selective Reminding Test, Wechsler Memory Scale-III Faces I and Faces II subtests, Trail Making Test (Parts A and B), Stroop Color and Word Test, and the Wechsler Adult Intelligence Scale- III Digit Symbol-Coding subtest. A subjective Follow-up Self-report Questionnaire was also administered to participants at the conclusion of the end-of-treatment phase assessments. RESULTS: Two-factor, mixed analyses of variance (ANOVA) revealed no significant group (cranberry juice and placebo) by trial (pretreatment baseline and end-of-treatment assessments) interactions across all of the neuropsychologic tests and measures utilized in this study when a Bonferroni corrected alpha level was used to correct for multiple comparisons (i.e., .05/17 group by trial comparisons = .003). Pearson Chi-Square analyses of the groups' self-reported changes over the 6-week treatment phase in their abilities to remember, thinking processes, moods, energy levels, and overall health on the Follow-up Self-report Questionnaire revealed no significant relationships. However, a nonsignificant trend (X2(1) = 2.373, p = 0.123) was noted for participants' self-reported overall abilities to remember from pretreatment baseline to the end-of-treatment assessment. Specifically, more than twice as many participants in the cranberry group (n = 9, 37.5%) rated their overall abilities to remember by treatment end as "improved" as compared to placebo controls (n = 4, 17.4%). CONCLUSIONS: Taken together, no significant interactions were found between the cranberry and placebo groups and their pretreatment baseline and end-of-treatment phase (after 6 weeks) standardized neuropsychologic assessments. A nonsignificant trend was noted, however, on a subjective, self-report questionnaire where twice as many participants in the cranberry group rated their overall abilities to remember by treatment end as "improved" compared to placebo controls. PMID: 15865497 ----------- [7] Br J Nutr. 2010 Mar;103(5):730-4. doi: 10.1017/S0007114509992364. Epub 2009 Dec 23. Concord grape juice supplementation improves memory function in older adults with mild cognitive impairment. Krikorian R(1), Nash TA, Shidler MD, Shukitt-Hale B, Joseph JA. Author information: (1)Department of Psychiatry, University of Cincinnati Academic Health Center, Cincinnati, OH, USA. robert.krikorian@uc.edu Concord grape juice contains polyphenol compounds, which have antioxidant and anti-inflammatory properties and influence neuronal signalling. Concord grape juice supplementation has been shown to reduce inflammation, blood pressure and vascular pathology in individuals with CVD, and consumption of such flavonoid-containing foods is associated with a reduced risk for dementia. In addition, preliminary animal data have indicated improvement in memory and motor function with grape juice supplementation, suggesting potential for cognitive benefit in ageing humans. In this initial investigation of neurocognitive effects, we enrolled twelve older adults with memory decline but not dementia in a randomised, placebo-controlled, double-blind trial with Concord grape juice supplementation for 12 weeks. We observed significant improvement in a measure of verbal learning and non-significant enhancement of verbal and spatial recall. There was no appreciable effect of the intervention on depressive symptoms and no effect on weight or waist circumference. A small increase in fasting insulin was observed for those consuming grape juice. These preliminary findings suggest that supplementation with Concord grape juice may enhance cognitive function for older adults with early memory decline and establish a basis for more comprehensive investigations to evaluate potential benefit and assess mechanisms of action. PMID: 20028599
  8. In his latest video (embedded below), everyone's favorite ☺ nutrition expert, Dr. Michael Greger talks about a topic near and dear to my own heart - dietary diversity when it comes to plant foods. He cites several studies including [1] which found different specific fruits and vegetables were protective against the development of cancer in different regions of the colon (i.e. proximal vs. distal). Study [2] found variety of fruits & vegetables consumed (independent of quantity) was associated with reduced risk of lung cancer in smokers. But study [3] was perhaps the most interesting. Researchers followed 7000 people for 11 years to see how their reported (via 7-day food diary) dietary quantity and variety of fruits and vegetables correlated with the development of type 2 diabetes (T2D). They found eating more quantity of F&V was associated with a 21% reduced risk of subsequent T2D. But eating a greater variety of F&V trumped the benefits of quantity - being associated with a 39% reduction in subsequent risk of T2D. Every different kind of F&V a person ate per week was associated with a 4% reduction in T2D. Since I eat almost 50 different F&Vs at every meal, I should have low enough risk to protect both me and anyone standing nearby☺. Dr. G. points to the fact that the body appears to have receptors specifically (and perhaps serendipitously?) tuned to bind with specific phytochemicals in different fruits & vegetables, as an explanation for why eating a greater variety of F&V conveys health benefits. He doesn't mention the other important motivation in my book for eating a wide variety of fruits, vegetables, and other healthy plant foods. Namely, you minimize the risk of detrimental effects from eating too much of any one of them, be it a result of pesticides, contaminants, or unknown anti-nutrients. --Dean -------------- [1] J Am Diet Assoc. 2011 Oct;111(10):1479-90. doi: 10.1016/j.jada.2011.07.008. Fruit and vegetable consumption and the risk of proximal colon, distal colon, and rectal cancers in a case-control study in Western Australia. Annema N(1), Heyworth JS, McNaughton SA, Iacopetta B, Fritschi L. Author information: (1)Western Australian Institute for Medical Research, Australia. Comment in J Am Diet Assoc. 2011 Oct;111(10):1476-8. J Am Diet Assoc. 2011 Oct;111(10):1472-5. J Acad Nutr Diet. 2012 May;112(5):610; author reply 610-1. BACKGROUND: Fruits and vegetables (F/V) have been examined extensively in nutrition research in relation to colorectal cancer (CRC). However, their protective effect is subject to debate, possibly because of different effects on different subsites of the large bowel. OBJECTIVE: To determine whether any association between F/V consumption and risk of CRC differed by subsite of the bowel (proximal colon, distal colon, and rectum). DESIGN: The Western Australian Bowel Health Study is a population-based, case-control study conducted between June 2005 and August 2007. Complete food frequency questionnaire data were analysed from 834 CRC cases and 939 controls. Logistic regression analysis was used to estimate the effects of quartiles of F/V intake on risk of CRC at different subsites. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for CRC overall and for the three separate subsites. RESULTS: Risk of proximal colon cancer and rectal cancer was not associated with intakes of total F/V, total vegetable, or total fruit. Brassica vegetable intake was inversely related with proximal colon cancer (Q4 vs Q1 OR 0.62; 95% CI 0.41 to 0.93). For distal colon cancer, significant negative trends were seen for total F/V, and total vegetable intake. Distal colon cancer risk was significantly decreased for intake of dark yellow vegetables (Q4 vs Q1 OR 0.61; 95% CI 0.41 to 0.92) and apples (Q4 vs Q1 OR 0.51; 95% CI 0.34 to 0.77). An increased risk for CRC was found to be associated with intake of fruit juice (Q4 vs Q1 OR 1.74; 95% CI 1.24 to 2.45). CONCLUSIONS: Our results suggest that different F/V may confer different risks for cancer of the proximal colon, distal colon, or rectum. Future studies might consider taking into account the location of the tumor when examining the relation between F/V consumption and risk of CRC. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved. PMID: 21963014 --------- [2] Cancer Epidemiol Biomarkers Prev. 2010 Sep;19(9):2278-86. doi: 10.1158/1055-9965.EPI-10-0489. Epub 2010 Aug 31. Variety in fruit and vegetable consumption and the risk of lung cancer in the European prospective investigation into cancer and nutrition. Büchner FL(1), Bueno-de-Mesquita HB, Ros MM, Overvad K, Dahm CC, Hansen L, Tjønneland A, Clavel-Chapelon F, Boutron-Ruault MC, Touillaud M, Kaaks R, Rohrmann S, Boeing H, Nöthlings U, Trichopoulou A, Zylis D, Dilis V, Palli D, Sieri S, Vineis P, Tumino R, Panico S, Peeters PH, van Gils CH, Lund E, Gram IT, Braaten T, Sánchez MJ, Agudo A, Larrañaga N, Ardanaz E, Navarro C, Argüelles MV, Manjer J, Wirfält E, Hallmans G, Rasmuson T, Key TJ, Khaw KT, Wareham N, Slimani N, Vergnaud AC, Xun WW, Kiemeney LA, Riboli E. Author information: (1)National Institute ofPublicHealth and the Environment, Bilthoven, The Netherlands. frederike.buchner@rivm.nl BACKGROUND: We investigated whether a varied consumption of vegetables and fruits is associated with lower lung cancer risk in the European Prospective Investigation into Cancer and Nutrition study. METHODS: After a mean follow-up of 8.7 years, 1,613 of 452,187 participants with complete information were diagnosed with lung cancer. Diet diversity scores (DDS) were used to quantify the variety in fruit and vegetable consumption. Multivariable proportional hazards models were used to assess the associations between DDS and lung cancer risk. All models were adjusted for smoking behavior and the total consumption of fruit and vegetables. RESULTS: With increasing variety in vegetable subgroups, risk of lung cancer decreases [hazard ratios (HR), 0.77; 95% confidence interval (CI), 0.64-0.94 highest versus lowest quartile; P trend = 0.02]. This inverse association is restricted to current smokers (HR, 0.73; 95% CI, 0.57-0.93 highest versus lowest quartile; P trend = 0.03). In continuous analyses, in current smokers, lower risks were observed for squamous cell carcinomas with more variety in fruit and vegetable products combined (HR/two products, 0.88; 95% CI, 0.82-0.95), vegetable subgroups (HR/subgroup, 0.88; 95% CI, 0.79-0.97), vegetable products (HR/two products, 0.87; 95% CI, 0.79-0.96), and fruit products (HR/two products, 0.84; 95% CI, 0.72-0.97). CONCLUSION: Variety in vegetable consumption was inversely associated with lung cancer risk among current smokers. Risk of squamous cell carcinomas was reduced with increasing variety in fruit and/or vegetable consumption, which was mainly driven by the effect in current smokers. IMPACT: Independent from quantity of consumption, variety in fruit and vegetable consumption may decrease lung cancer risk. ©2010 AACR. PMID: 20807832 ------------- [3] Diabetes Care. 2012 Jun;35(6):1293-300. doi: 10.2337/dc11-2388. Epub 2012 Apr 3. A prospective study of the association between quantity and variety of fruit and vegetable intake and incident type 2 diabetes. Cooper AJ(1), Sharp SJ, Lentjes MA, Luben RN, Khaw KT, Wareham NJ, Forouhi NG. Author information: (1)MRCEpidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, U.K. OBJECTIVE: The association between quantity of fruit and vegetable (F&V) intake and risk of type 2 diabetes (T2D) is not clear, and the relationship with variety of intake is unknown. The current study examined the association of both quantity and variety of F&V intake and risk of T2D. RESEARCH DESIGN AND METHODS: We examined the 11-year incidence of T2D in relation to quantity and variety of fruit, vegetables, and combined F&V intake in a case-cohort study of 3,704 participants (n = 653 diabetes cases) nested within the European Prospective Investigation into Cancer and Nutrition-Norfolk study, who completed 7-day prospective food diaries. Variety of intake was derived from the total number of different items consumed in a 1-week period. Multivariable, Prentice-weighted Cox regression was used to estimate hazard ratios (HRs) and 95% CIs. RESULTS: A greater quantity of combined F&V intake was associated with 21% lower hazard of T2D (HR 0.79 [95% CI 0.62-1.00]) comparing extreme tertiles, in adjusted analyses including variety. Separately, quantity of vegetable intake (0.76 [0.60-0.97]), but not fruit, was inversely associated with T2D in adjusted analysis. Greater variety in fruit (0.70 [0.53-0.91]), vegetable (0.77 [0.61-0.98]), and combined F&V (0.61 [0.48-0.78]) intake was associated with a lower hazard of T2D, independent of known confounders and quantity of intake comparing extreme tertiles. CONCLUSIONS: These findings suggest that a diet characterized by a greater quantity of vegetables and a greater variety of both F&V intake is associated with a reduced risk of T2D. PMCID: PMC3357245 PMID: 22474042
  9. All, CR appears to reduce our susceptibility to upper respiratory tract infections (e.g. colds and flu) - we've known this for quite some time based on personal anecdotes, backed up by our recent poll on the topic, and confirmed a study of anorexics by Luigi Fontana discussed in this post. But the immunity story for CR practitioners may not be quite so cut and dried. As discussed in this post, CR may make it harder for us to fight off infections once we do get sick. Plus, you've got to die of something (at least for the foreseeable future :-) ), and flu/pneumonia are the 3rd leading killer of centenarians. So it was heartening to see today's video by Dr. Greger (embedded below) which reports on the strong evidence that eating lots of fruits and vegetables, which virtually all of us do, helps to boost the immune system. Perhaps the most interesting sound-bite from the video comes from this study [1], which found that obesity, low physical activity, and low fruit/vegetable consumption were all associated with higher rates of hospitalizations for acute upper respiratory infections. But low fruits/veggies intake edged out the other two as the most predictive lifestyle factor for increased URI risk. So eat your fruits and veggies! --Dean ----------- [1] Influenza Other Respir Viruses. 2013 Sep;7(5):718-28. doi: 10.1111/irv.12019. Epub 2012 Nov 8. Relationship between community prevalence of obesity and associated behavioral factors and community rates of influenza-related hospitalizations in the United States. Charland KM(1), Buckeridge DL, Hoen AG, Berry JG, Elixhauser A, Melton F, Brownstein JS. Author information: (1)Children's Hospital Informatics Program, Children's Hospital Boston, Boston, MA, USA. katia.charland@mcgill.ca BACKGROUND: Findings from studies examining the association between obesity and acute respiratory infection are inconsistent. Few studies have assessed the relationship between obesity-related behavioral factors, such as diet and exercise, and risk of acute respiratory infection. OBJECTIVE: To determine whether community prevalence of obesity, low fruit/vegetable consumption, and physical inactivity are associated with influenza-related hospitalization rates. METHODS: Using data from 274 US counties, from 2002 to 2008, we regressed county influenza-related hospitalization rates on county prevalence of obesity (BMI ≥ 30), low fruit/vegetable consumption (<5 servings/day), and physical inactivity (<30 minutes/month recreational exercise), while adjusting for community-level confounders such as insurance coverage and the number of primary care physicians per 100,000 population. RESULTS: A 5% increase in obesity prevalence was associated with a 12% increase in influenza-related hospitalization rates [adjusted rate ratio (ARR) 1.12, 95% confidence interval (CI) 1.07, 1.17]. Similarly, a 5% increase in the prevalence of low fruit/vegetable consumption and physical inactivity was associated with an increase of 12% (ARR 1.12, 95% CI 1.08, 1.17) and 11% (ARR 1.11, 95% CI 1.07, 1.16), respectively. When all three variables were included in the same model, a 5% increase in prevalence of obesity, low fruit/vegetable consumption, and physical inactivity was associated with 6%, 8%, and 7% increases in influenza-related hospitalization rates, respectively. CONCLUSIONS: Communities with a greater prevalence of obesity were more likely to have high influenza-related hospitalization rates. Similarly, less physically active populations, with lower fruit/vegetable consumption, tended to have higher influenza-related hospitalization rates, even after accounting for obesity. © 2012 John Wiley & Sons Ltd. PMID: 23136926 Dr. Greger references on fruits/veggies & immunity B Watzi, A Bub, K Briviba, G Rechkemmer. Supplementation of a low-carotenoid diet with tomato or carrot juice modulates immune functions in healthy men. Ann Nutr Metab. 2003;47(6):255-61. L Li, M M Werler. Fruit and vegetable intake and risk of upper respiratory tract infection in pregnant women. Public Health Nutr. 2010 Feb;13(2):276-82. NA. The blood film in meningococcal disease. Med J Aust. 1983 May 28;1(11):502. H M Averill, J E Averill. The effect of daily apple consumption on dental caries experience, oral hygiene status and upper respiratory infections. N Y State Dent J. 1968 Aug-Sep;34(7):403-9. K M Charland, D L Buckeridge, A G Hoen, J G Berry, A Elixhauser, F Melton, J S Brownstein. Relationship between community prevalence of obesity and associated behavioral factors and community rates of influenza-related hospitalizations in the United States. Influenza Other Respir Viruses. 2013 Sep;7(5):718-28. B Watzi, A Bub, B R Brandstetter, G Rechkemmer. Modulation of human T-lymphocyte functions by the consumption of carotenoid-rich vegetables. Br J Nutr. 1999 Nov;82(5):383-9. N Acs, F Banhidy, E Horvath-Puho, A E Czeizel. Population-based case-control study of the common cold during pregnancy and congenital abnormalities. Eur J Epidemiol. 2006;21(1):65-75. K Kurppa, P C Holmberg, E Kuosma, T Aro, L Saxen. Anencephaly and maternal common cold. Teratology. 1991 Jul;44(1):51-5. J Zhang, W W Cai. Association of the common cold in the first trimester of pregnancy with birth defects. Pediatrics. 1993 Oct;92(4):559-63. M Veldhoen, V Bruchlacher-Waldert. Dietary influences on intestinal immunity. Nat Rev Immunol. 2012 Oct;12(10):696-708. A Gibson, J D Edgar, C E Neville, S E Gilchrist, M C McKinley, C C Patterson, I S Young, J V Woodside. Effect of fruit and vegetable consumption on immune function in older people: a randomized controlled trial. Am J Clin Nutr. 2012 Dec;96(6):1429-36.
  10. Your mom didn't know how right she was when she told you to eat your fruits & vegetables (F/V), at least if you are a girl... This new study [1] in the journal Circulation assessed the diets of 2500 young black and white men and women (~25 years of age, 62% female) and then measured their level of artery calcification 20 years later using computed tomography - arguably the 'gold standard' for assessing artery health. It found that people eating the most F/V (highest tertile - 7-9 servings / day) were 25% less likely 20 years later to have developed calcified arteries relative to the lowest F/V eaters (2-4 servings / day). From the full text, here are a few of the highlights, including one kicker: Fruits and vegetables were about equally protective Including legumes in with the vegetable category kept the association about the same - i.e. legumes were about as good for arteries as fruits & veggies. Of course people eating lots of F/V had healthier diets in other ways as well, but the inverse association between F/V and artery calcification was still significant even after controlling for these other dietary factors. Shockingly left out of the abstract was the fact that the inverse relationship between F/V intake and artery calcification (CAC) was only observed in women! To quote the full text: [R]eported intake of F/V did not appear to be associated with prevalent CAC among men: OR (95% CI) 1.0 (ref), 0.77 (0.52-1.12), 0.89 (0.60-1.31), p-value for trend 0.67 Here was their explanation for this surprising results: The lack of association between F/V intake and CAC in men in our study may be due to a lack of power, as our study included only 935 male participants. However, a less significant association between CVD and F/V intake in men has been seen in other studies. Data from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study demonstrated a 15% (95% CI: 6% to 23%) lower risk for CHD mortality per 80gram/day increase in fruit and vegetable intake in women, but a non-significant 2% (95% CI: -2% to +2%) CHD mortality reduction in men (p-value for heterogeneity 0.007) [2] Similar findings were reported in a cohort of Japanese women and men.3 In the CHD risk factor study INTERHEART, the 3 lifestyle behaviors associated with a lower risk of CHD were F/V intake, exercise, and moderate alcohol consumption, and the protective effects of exercise and moderate alcohol consumption were larger in women compared to men with a trend towards F/V intake being more protective in women as well.[3] So why did the researchers leave out this surprising lack of inverse relationship between F/V intake and later artery calcification in men from both the abstract and from the popular press coverage of this study? Perhaps so as to avoid undermining the credibility of their (laudable) public health message, as summarized in the concluding sentence of the abstract: Our results reinforce the importance of establishing a high intake of F/V as part of a healthy dietary pattern early in life. Somehow I was unaware of the attenuated CVD benefits men seem to get from eating lots fruits and vegetables. --Dean ---------- [1] Circulation. 2015 Oct 26. pii: CIRCULATIONAHA.114.012562. [Epub ahead of print] The Association of Fruit and Vegetable Consumption During Early Adulthood With the Prevalence of Coronary Artery Calcium After 20 Years of Follow-Up: The CARDIA Study. Miedema MD(1), Petrone A(2), Shikany JM(3), Greenland P(4), Lewis CE(3), Pletcher MJ(5), Gaziano JM(2), Djousse L(2). Free full text: http://circ.ahajournals.org/content/early/2015/10/14/CIRCULATIONAHA.114.012562.long BACKGROUND: -The relationship between intake of fruits and vegetables (F/V) during young adulthood and coronary atherosclerosis later in life is unclear. METHODS AND RESULTS: -We studied participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of young, healthy black and white individuals at baseline (1985-1986). Intake of F/V at baseline was assessed using a semi-quantitative interview administered diet history and CAC was measured at year 20 (2005-2006) using computed tomography. We used logistic regression to adjust for relevant variables and estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) across energy-adjusted, sex-specific tertiles of total servings of F/V per day. Among our sample (n=2,506), the mean (SD) age at baseline was 25.3 (3.5) years and 62.7% were female. After adjustment for demographics and lifestyle variables, higher intake of F/V was associated with a lower prevalence of CAC: OR (95% CI) =1.00 (reference), 0.78 (0.59-1.02), and 0.74 (0.56-0.99), from the lowest to the highest tertile of F/V, p-value for trend <0.001. There was attenuation of the association between F/V and CAC after adjustment for other dietary variables but the trend remained significant: OR (95% CI): 1.00 (reference), 0.84 (0.63-1.11), and 0.92 (0.67-1.26), p-value for trend <0.002]. CONCLUSIONS: -In this longitudinal cohort study, higher intake of F/V during young adulthood was associated with lower odds of prevalent CAC after 20 years of follow-up. Our results reinforce the importance of establishing a high intake of F/V as part of a healthy dietary pattern early in life. PMID: 26503880 ------------ [2] Eur Heart J. 2011;32:1235–1243. Fruit and vegetable intake and mortality from ischaemic heart disease: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study. Crowe FL, Roddam AW, Key TJ, Appleby PN, Overvad K, Jakobsen MU, Tjønneland A, Hansen L, Boeing H, Weikert C, Linseisen J, Kaaks R, Trichopoulou A, Misirli G, Lagiou P, Sacerdote C, Pala V, Palli D, Tumino R, Panico S, Bueno-de-Mesquita HB, Boer J, van Gils CH, Beulens JW, Barricarte A, Rodríguez L, Larrañaga N, Sánchez MJ, Tormo MJ, Buckland G, Lund E, Hedblad B, Melander O, Jansson JH, Wennberg P, Wareham NJ, Slimani N, Romieu I, Jenab M, Danesh J, Gallo V, Norat T, Riboli E; ------------ [3] Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L; INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): casecontrol study. Lancet. 2004;364:937–952.
  11. In my exploration of nutrigenomics, I came across this interesting recent study [1] that looked at the interaction between a particular gene polymorphism (rs4977574 - available on 23andMe) and cardiovascular disease (CVD), as mediated by consumption of either vegetables or wine. The researchers followed 24,000 people for 15 years, during which time about 3000 of them developed cardiovascular disease. So it was a pretty big cohort, with lots of people experiencing the outcome in question - cardiovascular disease. Across the entire population, eating more veggies and drinking more wine resulted in less CVD - not too surprising given previous research on the health benefits of these foods. Things got more interesting when the researchers looked at polymorphisms of SNP rs4977574. Having one or two of the risk alleles (G worse than A) for this SNP on chromosome 9 has been previously shown to be associated with an increased risk of CVD [2]. For example, study [3] found for every G allele one carries, one has about a 13% increased risk of CVD. Study [2] was similar - in the 20-25% of the population that carry two G alleles for this SNP, risk of CVD was increased 30-40% relative to people with AA for rs4977574. This new study [1] found something very similar - for each additional G allele at rs4977574, people were 16% more likely to develop CVD. And these polymorphisms are quite common, ~30% of the study population were AA for rs4977574, 50% were AG, and 20% were GG. But things got really interesting when they looked at how vegetable and wine consumption influenced with the link between this polymorphism and CVD. For people with two 'normal' alleles for rs4977574 (AA), increasing vegetable intake was associated with lower CVD, just like in the population as a whole - no surprise. But for people with either one or two G's for rs4977574, higher vegetable intake didn't help! In other words, compared with high consumers of vegetables who carried two A's for rs4977574 (the reference group), people with AG for rs4977574 were 20-30% more likely to develop CVD, and people with GG for rs4977574 were 40-50% more likely to develop CVD, regardless of how many vegetables they ate! The opposite was true for wine. Wine didn't help reduce risk of CVD in AA carriers for rs4977574, but it did reduce risk in AG and GG carriers, by ~30% and ~40% respectively! In fact, drinking wine appeared to nearly entirely counteract the baseline increased risk of CVD in AG and GG carriers, relative to AA carriers. Here is the relevant table of results from the paper for those interested in the precise details: In summary, this study suggests that if you have one or (especially) two G alleles for rs4977574, you are at higher risk for cardiovascular disease, and that consuming wine, but not vegetables, can help lower your risk. FYI, 23andMe shows I've got one G allele for rs4977574 - which is a bummer since I love veggies and don't drink alcohol. :( Of course its only one study, and one gene locus, so the results should be taken with a grain of salt. I don't plan to eat fewer veggies or take up drinking as a result of this study, particularly since alcoholism runs in my family. I figure my good cholesterol numbers and healthy diet/lifestyle make it unlikely I'll die of CVD anyway. But it seems like another interesting example how genes and diet/lifestyle can interact to influence health in significant and sometimes surprising ways. --Dean ------------------------------------------- [1] BMC Med Genet. 2014 Dec 31;15(1):1220. [Epub ahead of print] The chromosome 9p21 variant interacts with vegetable and wine intake to influence the risk of cardiovascular disease: a population based cohort study. Hindy G, Ericson U, Hamrefors V, Drake I, Wirfält E, Melander O, Orho-Melander M. Full Text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4331503/pdf/12881_2014_Article_138.pdf AbstractBackgroundChromosome 9p21 variants are associated with cardiovascular disease (CVD) but not with any of its known risk markers. However, recent studies have suggested that the risk associated with 9p21 variation is modified by a prudent dietary pattern and smoking. We tested if the increased risk of CVD by the 9p21 single nucleotide polymorphism rs4977574 is modified by intakes of vegetables, fruits, alcohol, or wine, and if rs4977574 interacts with environmental factors on known CVD risk markers.MethodsMultivariable Cox regression analyses were performed in 23,949 individuals from the population-based prospective Malmö Diet and Cancer Study (MDCS), of whom 3,164 developed CVD during 15 years of follow-up. The rs4977574 variant (major allele: A; minor allele: G) was genotyped using TaqMan® Assay Design probes. Dietary data were collected at baseline using a modified diet history method. Cross-sectional analyses were performed in 4,828 MDCS participants with fasting blood levels of circulating risk factors measured at baseline.ResultsEach rs4977574 G allele was associated with a 16% increased incidence of CVD (95% confidence interval (CI), 1.10¿1.22). Higher vegetable intake (hazard ratio (HR), 0.95 [CI: 0.91¿0.996]), wine intake (HR, 0.91 [CI: 0.86¿0.96]), and total alcohol consumption (HR, 0.92 [CI: 0.86¿0.98]) were associated with lower CVD incidence. The increased CVD incidence by the G allele was restricted to individuals with medium or high vegetable intake (Pinteraction¿=¿0.043), and to non- and low consumers of wine (Pinteraction¿=¿0.029). Although rs4977574 did not associate with any known risk markers, stratification by vegetable intake and smoking suggested an interaction with rs4977574 on glycated hemoglobin and high-density lipoprotein cholesterol (Pinteraction¿=¿0.015 and 0.049, respectively).ConclusionsOur results indicate that rs4977574 interacts with vegetable and wine intake to affect the incidence of CVD, and suggest that an interaction may exist between environmental risk factors and rs4977574 on known risk markers of CVD. PMID: 25551366 --------------------- [2] Science. 2007 Jun 8;316(5830):1488-91. Epub 2007 May 3. A common allele on chromosome 9 associated with coronary heart disease. McPherson R1, Pertsemlidis A, Kavaslar N, Stewart A, Roberts R, Cox DR, Hinds DA, Pennacchio LA, Tybjaerg-Hansen A, Folsom AR, Boerwinkle E, Hobbs HH, Cohen JC. Author information AbstractCoronary heart disease (CHD) is a major cause of death in Western countries. We used genome-wide association scanning to identify a 58-kilobase interval on chromosome 9p21 that was consistently associated with CHD in six independent samples (more than 23,000 participants) from four Caucasian populations. This interval, which is located near the CDKN2A and CDKN2B genes, contains no annotated genes and is not associated with established CHD risk factors such as plasma lipoproteins, hypertension, or diabetes. Homozygotes for the risk allele make up 20 to 25% of Caucasians and have a approximately 30 to 40% increased risk of CHD. PMID: 17478681 --------------------------------- [3] J Intern Med. 2013 Sep;274(3):233-40. doi: 10.1111/joim.12063. Epub 2013 Mar 25. Chromosome 9p21 genetic variation explains 13% of cardiovascular disease incidence but does not improve risk prediction. Gränsbo K1, Almgren P, Sjögren M, Smith JG, Engström G, Hedblad B, Melander O. Author information AbstractOBJECTIVES:To evaluate the proportion of cardiovascular disease (CVD) incidence that is explained by genetic variation at chromosome 9p21 and to test whether such variation adds incremental information with regard to CVD prediction, beyond traditional risk factors. DESIGN, SETTING AND PARTICIPANTS:rs4977574 on chromosome 9p21 was genotyped in 24 777 subjects from the Malmö Diet and Cancer study who were free from CVD prior to the baseline examination. Association between genotype and incident CVD (n = 2668) during a median follow-up of 11.7 years was evaluated in multivariate Cox proportional hazard models. Analyses were performed in quartiles of baseline age, and linear trends in effect size across age groups were estimated in logistic regression models. RESULTS:In additive models, chromosome 9p21 significantly predicted CVD in the entire population (hazard ratio 1.17 per G allele, 95% confidence interval 1.11-1.23, P < 0.001). Effect estimates increased from the highest (Q4) to the lowest quartile (Q1) of baseline age, but this trend was not significant. The overall population attributable risk conferred by chromosome 9p21 in fully adjusted models was 13%, ranging from 17% in Q1 to 11% in Q4. Addition of chromosome 9p21 to traditional risk factors only marginally improved predictive accuracy. CONCLUSION:The high population attributable risk conferred by chromosome 9p21 suggests that future interventions interfering with downstream mechanisms of the genetic variation may affect CVD incidence over a broad range of ages. However, variation of chromosome 9p21 alone does not add clinically meaningful information in terms of CVD prediction beyond traditional risk factors at any age.
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