Association between dietary phylloquinone intake and peripheral metabolic risk markers related to insulin resistance and diabetes in elderly subjects at high cardiovascular risk

Background: Vitamin K has been related to glucose metabolism, insulin sensitivity and diabetes. Because inflammation underlies all these metabolic conditions, it is plausible that the potential role of vitamin K in glucose metabolism occurs through the modulation of cytokines and related molecules. The purpose of the study was to assess the associations between dietary intake of vitamin K and peripheral adipokines and other metabolic risk markers related to insulin resistance and type 2 diabetes mellitus. Methods: Cross-sectional and longitudinal assessments of these associations in 510 elderly participants recruited in the PREDIMED centers of Reus and Barcelona (Spain). We determined 1-year changes in dietary phylloquinone intake estimated by food frequency questionnaires, serum inflammatory cytokines and other metabolic risk markers. Results: In the cross-sectional analysis at baseline no significant associations were found between dietary phylloquinone intake and the rest of metabolic risk markers evaluated, with exception of a negative association with plasminogen activator inhibitor-1. After 1-year of follow-up, subjects in the upper tertile of changes in dietary phylloquinone intake showed a greater reduction in ghrelin (-15.0%), glucose-dependent insulinotropic peptide (-12.9%), glucagon-like peptide-1 (-17.6%), IL-6 (-27.9%), leptin (-10.3%), TNF (-26.9%) and visfatin (-24.9%) plasma concentrations than those in the lowest tertile (all p<0.05). Conclusion: These results show that dietary phylloquinone intake is associated with an improvement of cytokines and other markers related to insulin resistance and diabetes, thus extending the potential protection by dietary phylloquinone on chronic inflammatory diseases.

The cumulative effect of core lifestyle behaviours on the prevalence of hypertension and dyslipidemia

Background: Most cardiovascular disease (CVD) occurs in the presence of traditional risk factors, including hypertension and dyslipidemia, and these in turn are influenced by behavioural factors such as diet and lifestyle. Previous research has identified a group at low risk of CVD based on a cluster of inter-related factors: body mass index (BMI) < 25 Kg/m2, moderate exercise, alcohol intake, non-smoking and a favourable dietary pattern. The objective of this study was to determine whether these factors are associated with a reduced prevalence of hypertension and dyslipidemia in an Irish adult population. Methods: The study was a cross-sectional survey of 1018 men and women sampled from 17 general practices. Participants completed health, lifestyle and food frequency questionnaires and provided fasting blood samples for analysis of glucose and insulin. We defined a low risk group based on the following protective factors: BMI <25 kg/m2; waist-hip ratio (WHR) <0.85 for women and <0.90 for men; never smoking status; participants with medium to high levels of physical activity; light alcohol consumption (3.5–7 units of alcohol/week) and a "prudent" diet. Dietary patterns were assessed by cluster analysis. Results: We found strong significant inverse associations between the number of protective factors and systolic blood pressure, diastolic blood pressure and dyslipidemia. The prevalence odds ratio of hypertension in persons with 1, 2, 3, ≥ 4 protective factors relative to those with none, were 1.0, 0.76, 0.68 and 0.34 (trend p < 0.01). The prevalence odds ratio of dyslipidemia in persons with 1, 2, 3, ≥ 4 protective factors relative to those with none were 0.83, 0.98, 0.49 and 0.24 (trend p = 0.001). Conclusion: Our findings of a strong inverse association between low risk behaviours and two of the traditional risk factors for CVD highlight the importance of 'the causes of the causes' and the potential for behaviour modification in CVD prevention at a population level.

A posteriori-derived dietary patterns and retinal vessel caliber in an elderly population

Purpose. To examine the association between a posteriori–derived dietary patterns (DP) and retinal vessel caliber in an elderly population.

Methods. This was a cross-sectional study of 288 elderly adults (>65 years) who participated in the European Eye study (EUREYE) Northern Irish cohort. DP were extracted using principal component analysis from completed food frequency questionnaires. Semi-automated computer grading was used to determine the mean retinal vessel diameters (central retinal arteriole equivalent [CRAE] and central retinal venule equivalent [CRVE]) from digitized visual field one images using a standard measurement protocol.

Results. Three major DP were identified in this population, which accounted for 21% of the total variance: a “healthy” pattern with high factor loadings for oily fish, fruits and vegetables, and olive oil; an “unhealthy” pattern with high factor loadings for red and processed meat, refined grains, eggs, butter, sugar and sweets; and a “snack and beverage” pattern with high factor loading for pizza, nuts, and coffee. Multivariable linear regression analysis indicated no significant association between major identified DP and mean CRAE or CRVE in all models.

Conclusions. This is the first study to investigate associations between a posteriori–derived DP and retinal vessel caliber. There was no evidence of a relationship between extracted DP and retinal vessel measurements in this population. However, it is possible that potentially important relationships exist between single nutrients or foods and vessel diameters that cannot be identified using a DP approach. Further studies to examine the role of dietary factors in the microcirculation are required.

Intakes of dietary folate and other B vitamins are associated with risks of esophageal adenocarcinoma, Barrett's esophagus, and reflux esophagitis

Folate is implicated in carcinogenesis via effects on DNA synthesis, repair, and methylation. Efficient folate metabolism requires other B vitamins and is adversely affected by smoking and alcohol. Esophageal adenocarcinoma (EAC) may develop through a process involving inflammation [reflux esophagitis (RE)] leading to metaplasia [Barrett’s esophagus (BE)] and carcinoma. Within a population-based, case-control study, we investigated associations between dietary folate and related factors and risks of EAC, BE, and RE. EAC and BE cases had histologically confirmed disease; RE cases had endoscopically visible inflammation. Controls, age-sex frequency matched to EAC cases, were selected through population and general practice registers. Participants underwent structured interviews and completed food-frequency questionnaires. Multivariate ORs and 95% CIs were computed using logistic regression. A total of 256 controls and 223 EAC, 220 BE, and 219 RE cases participated. EAC risk decreased with increasing folate intake (OR highest vs. lowest = 0.56; 95% CI: 0.31, 1.00; P-trend < 0.01). Similar trends were found for BE (P-trend < 0.01) and RE (P-trend = 0.01). Vitamin B-6 intake was significantly inversely related to risks of all 3 lesions. Riboflavin intake was inversely associated with RE. Vitamin B-12 intake was positively associated with EAC. For EAC, there was a borderline significant interaction between folate intake and smoking (P-interaction = 0.053); compared with nonsmokers with high (≥median) folate intake, current smokers with low intakes (<median) had an 8-fold increased risk (OR: 8.15; 95% CI: 3.61, 18.40). The same group had increased BE risk (OR: 2.93; 95% CI: 1.24, 6.92; P-interaction = 0.12). Folate and other dietary methyl-group factors are implicated in the etiology of EAC and its precursors.

Human biomonitoring : biomarkers, individual susceptibility, and nutrigenetics

Tese de doutoramento, Biologia (Genética), Universidade de Lisboa, Faculdade de Ciências, 2015

Psychosocial Quality-of-Life, Lifestyle and Adiposity: A Longitudinal Study in Pre-schoolers (Ballabeina Study).

PURPOSE: In obesity prevention, understanding psychosocial influences in early life is pivotal. Reviews reported contradictory results and a lack of longitudinal studies focusing on underlying lifestyle factors. This study tested whether psychosocial Quality-Of-Life (QOL) was associated with pre-schoolers' lifestyle and adiposity changes over one school year and whether lifestyle moderated the latter. It was hypothesised that QOL might not impact adiposity in everybody but that this might depend on preceding lifestyle. METHOD: Longitudinal data from 291 Swiss pre-schoolers (initially 3.9-6.3 years) was available. The following measures were used in longitudinal regressions: psychosocial QOL by PedsQL, adiposity (BMI z-score, waist, fat%), diet (food frequency), sedentary time and accelerometer-based activity. RESULTS: Concerning lifestyle, low psychosocial QOL was only related to unfavourable changes in diet (less fruit β = 0.21 and more fat intake β = -0.28) and lower physical activity (β = 0.21). Longitudinal QOL-adiposity relations appeared only after moderation by lifestyle factors (beta-range 0.13-0.67). Low psychosocial QOL was associated with increased adiposity in children with an unhealthy diet intake or high sedentary time. By contrast, low psychosocial QOL was associated with decreasing adiposity in high fruit consumers or more physically active pre-schoolers. CONCLUSION: Results emphasise the need for testing moderation in the QOL-adiposity relation. An unhealthy diet can be a vulnerability factor and high physical activity a protective factor in QOL-related adiposity. Consequently, QOL and lifestyle should be targeted concurrently in multi-factorial obesity prevention. The environment should be an 'activity encouraging, healthy food zone' that minimises opportunities for stress-induced eating. In addition, appropriate stress coping skills should be acquired.

Association entre l'insécurité alimentaire et les apports en nutriments chez les Premières Nations de la Colombie-Britannique

Cette étude a pour but de vérifier l’association entre l’insécurité alimentaire et les apports nutritionnels des Premières Nations vivant sur les réserves de la Colombie-Britannique, ainsi que la présence d’interactions de la nourriture traditionnelle dans la relation entre l’insécurité alimentaire et les apports nutritionnels. Un rappel de 24h et le questionnaire sur l’insécurité alimentaire du HFSSM adapté par Santé Canada provenant de la First Nations Food, Nutrition and Environment Study (FNFNES) ont servi pour les analyses statistiques chez 493 femmes et 356 hommes dans 21 communautés de Premières Nations de la Colombie-Britannique. Aucune association entre l’insécurité alimentaire et les apports nutritionnels totaux n’a été observée dans notre échantillon. Par contre, la nourriture traditionnelle interagissait dans la relation entre l’insécurité alimentaire et les apports nutritionnels pour plusieurs nutriments chez les hommes et chez les femmes. Chez les femmes, la qualité nutritionnelle pourrait jouer un rôle important dans la relation entre l’insécurité alimentaire et les apports nutritionnels. Chez les hommes, des différences dans les comportements alimentaires pourraient être associées au manque de nourriture traditionnelle chez ceux ayant manifesté une insécurité alimentaire grave. Enfin, les interactions de la nourriture traditionnelle dans la relation entre l’insécurité alimentaire et les apports nutritionnels laissent croire que les hommes et les femmes souffrant peu ou pas d’insécurité alimentaire ajoutent ce type d’alimentation à leurs apports quotidiens. À l’inverse, ceux et celles qui souffrent d’insécurité alimentaire grave utiliseraient la nourriture traditionnelle pour remplacer la nourriture commerciale.

Ingestão de água e relação com o conteúdo em água da dieta numa população saudável

Os vários estudos sobre a importância da água na fisiologia humana têm demonstrado que a quantidade de água presente nos alimentos e a produzida por via metabólica, não são suficientes para suprir as necessidades diárias deste nutriente. A água ingerida em função do reflexo da sede ou por vontade do próprio varia entre os indivíduos e, ao contrário de outros nutrientes fundamentais, não existe para a água uma definição clara sobre as necessidades diárias. Este facto pode ser parcialmente explicado pelo conjunto altamente sensível de adaptações neurofisiológicas que se fazem sentir com vista a manter a osmolaridade e a hidratação do organismo. Afim de avaliar a quantidade total de água consumida, os voluntários foram questionados sobre a quantidade de água/infusões/chás que consumiam diariamente. Com base num inquérito de frequência alimentar foi possível calcular o valor de 2,5l/dia consumo/conteúdo total de água da dieta da população em estudo. Os dados revelados pelo presente estudo, estão de acordo, com a literatura publicada, justificando o interesse no aprofundamento do tema, de modo a contribuir para o conhecimento sobre a importância da água no contexto dos nossos hábitos alimentares, na fisiologia normal.

Increased whole grain consumption does not affect blood biochemistry, body composition or gut microbiology in healthy low habitual whole grain consumers

Background Whole grain (WG) foods have been suggested to reduce the risk of cardiovascular disease, but studies are inconsistent and effects on cardiovascular risk markers are not clear. Objective The objective of this study was to assess the impact of increasing WG consumption to at least 80 g/d on overall dietary intake, body composition, blood pressure (BP), blood lipids, blood glucose, gastrointestinal microbiology and gastrointestinal symptoms in healthy, middle-age adults with habitual WG intake < 24 g/d. The trial was registered as ISRCTN36521837. Methods Eligible subjects (12 men, 21 women, aged 40-65 y and BMI 20-35 kg/m2) were identified using food frequency questionnaires and subsequently completed 3-day food diaries (3DFD) to confirm habitual WG consumption. Subjects consumed diets high in WG (> 80 g/d) or low in WG (< 16 g/d, refined grain [RG] diet) in a crossover study, with 6-week intervention periods, separated by a 4-week washout. Adherence was achieved by specific dietary advice and provision of a range of cereal food products. The 3DFD, diet compliance diaries and plasma alkylresorcinols (ARs) were used to verify compliance. Results On the WG intervention, consumption increased from 28 g/d to 168 g/d (P < 0.001), accompanied by an increase in plasma ARs (P < 0.001) and total fiber intake (P < 0.001), without any effect on energy or other macronutrients. While there were no effects on studied parameters, there were trends towards increased 24 h fecal weight (P = 0.08) and reduction in body weight (P = 0.10) and BMI (P = 0.08) during the WG compared to the RG period. Conclusion A combination of dietary advice and provision of commercially available food items enabled subjects with a low-moderate habitual consumption of WG to substantially increase their WG intake, but there was little effect on blood biochemical parameters, body composition, BP, fecal measurements or gut microbiology.

DEVELOPMENT AND VALIDITY OF THE DISORDERED EATING ATTITUDE SCALE (DEAS)

The aim of this study was to develop and validate the Disordered Eating Attitude Scale to measure disordered eating attitudes, defined as abnormal beliefs, thoughts, feelings, behaviors, and relationship regarding food. Exploratory factor analysis was performed and internal consistency assessed in a sample of female university students (N=196). Convergent validity was acceptable based on statistically significant correlations with the Eating Attitude Test-26 and Restraint Scale. Known-groups validity was determined by comparing the student sample`s mean scores against scores of an eating disorder group (N=51). The Disordered Eating Attitude Scale comprises 25 questions and five subscales explaining 54.3% of total variance. The total scores differentiated student, bulimia, and anorexia groups. The scale should prove useful for evaluating eating attitudes in various population groups and eating disordered patients.

Incidência de hipertensão arterial pelo consumo de álcool : é modificável pela raça?

A associação entre consumo de bebidas alcoólicas e a incidência de hipertensão pode ser dependente do padrão de consumo e raça. Em um estudo de coorte de base populacional, foram entrevistados no domicílio 1089 adultos, selecionados ao acaso. A pressão arterial e medidas antropométricas foram aferidas de acordo com recomendações padronizadas. A quantidade de álcool consumida foi avaliada por um questionário de quantidade-freqüência. Binge drinking foi definido pelo consumo de 5 ou mais drinques em uma ocasião para homens ou 4 drinques para mulheres, e abuso de álcool, por consumo de 30 ou mais gramas por dia em homens ou 15 g ou mais em mulheres. Os entrevistadores classificaram a cor da pele dos participantes em brancos e não-brancos. Casos incidentes de hipertensão foram caracterizados por PA ≥ 140/90 mmHg ou uso de medicamento anti-hipertensivo. A razão de risco (RR) para incidência de hipertensão arterial foi computada em modelo de Cox. Entre os 589 indivíduos normotensos na entrevista basal, foram identificados 127 casos incidentes de hipertensão, após um seguimento de 5,6 ± 1,1 anos. Não houve associação de binge drinking e dependência de álcool (CAGE) com a incidência de hipertensão. A RR ajustada (idade, educação) para a incidência de hipertensão (IC 95% ) foi significativa apenas para indivíduos não-brancos que consumiam 30 g ou mais de etanol por dia: 7,3 (1,4 - 39,3). A pressão arterial sistólica aumentou entre os abusadores não brancos 16,1 ± 3,5 mmHg, em comparação com 4,9 ± 1,5 mmHg entre os abusadores brancos (P= 0,004). Indivíduos com ancestrais africanos que consumisam grandes quantidades de álcool apresentaram maior risco de desenvolverem hipertensão arterial. Este risco não foi explicado por binge drinking ou dependência de álcool.

Prospective Evaluation of Dietary Treatment in Childhood Constipation: High Dietary Fiber and Wheat Bran Intake Are Associated With Constipation Amelioration

Objectives: The aim of the study was to evaluate, over 24 months, the intake of dietary fiber (DF) and the bowel habit (BH) of constipated children advised a DF-rich diet containing wheat bran.Patients and Methods: BH and dietary data of 28 children with functional constipation defined by the Boston criteria were obtained at visit 1 (V1, n = 28) and at 4 follow-up visits (V2-V5, n = 80). At each visit the BH was rated BAD (worse/unaltered; improved but still complications) or RECOVERY (REC) (improved, no complications; asymptomatic), and a food intake questionnaire was applied. DF intake was calculated according to age (year)+5 to 10 g/day and bran intake according to international tables. Nonparametric statistics were used.Results: Median age (range) was 7.25 years (0.25-15.6 years); 21 children underwent bowel washout (most before V1/V2), and 14 had the last visit at V3/V4. DF intake, bran intake, and the BH rate significantly increased at V2 and remained higher than at V1 through V2 to V5. At V1, median DF intake was 29.9% below the minimum recommended and at the last visit 49.9% above it. Twenty-four children accepted bran at 60 visits, at which median bran intake was 20 g/day and median proportion of DF due to bran 26.9%. Children had significantly higher DF and higher bran intake at V2 to V5 at which they had REC than at those at which they presented BAD BH. DF intake > age+10 g/day was associated with bran acceptance and REC. At the last visit 21 children presented REC (75%); 20 of them were asymptomatic and 18 were off washout/laxatives.Conclusions: High DF and bran intake are feasible in constipated children and contribute to amelioration of constipation.

Avaliação da ingestão dietética de cálcio em indivíduos adultos portadores de hipertensão arterial idiopática

Foi estudada a relação entre a ingestão dietética de cálcio e os demais parâmetros alimentares e antropométricos em 60 indivíduos adultos, portadores de hipertensão arterial idiopática (10 homens e 50 mulheres), com média etária de 48,6 anos, seguidos no Centro de Hipertensão Arterial do Hospital das Clínicas da Faculdade de Medicina de Botucatu (SP), Brasil. Foram utilizados três métodos diferentes de inquérito aumentar em três diferentes ocasiões: recordatório de 24h, questionário de freqüência alimentar, dirigido para ingestão de cálcio, e registro alimentar de 3 dias. As médias de ingestão de cálcio, extraídas desses inquéritos, foram semelhantes, mostrando que, em relação á ingestão de cálcio, esses métodos de inquérito alimentar podem ser utilizados indistintamente com o objetivo de se mensurar à ingestão de cálcio de um grupo de indivíduos. Além da ingestão de cálcio, foi avaliada a ingestão protéico-calórica e de diversos outros nutrientes, assim como realizada a antropometria desse grupo de hipertensos em três ocasiões diferentes, com intervalos variando de duas semanas a 15 meses. Quando comparado a um grupo de referência local, constituído de indivíduos sadios, com média etária semelhante, o grupo de hipertensos mostrou ter menor ingestão média de cálcio. Comparados por sexo, os homens dos dois grupos exibiram perfis nutricional e antropométrico semelhantes. em relação às mulheres, houve diferenças quanto à ingestão protéico-calórica, o que se supõe ser devido à ingestão menor do leite e derivados entre as hipertensas. Estas estavam mais pesadas que as mulheres do grupo de referências, à custa de maior massa muscular, provavelmente devido a maior atividade física. Concluiu-se que o cálcio dietético foi o principal item alimentar que distinguiu hipertensos de normotensos. Como existem estudos clínicos comprovando o efeito benéfico da suplementação de cálcio na redução dos níveis pressóricos de indivíduos hipertensos, sugere-se a repetição deste tipo de trabalho, em outros locais, visando ao embasamento de programa nacional de suplementação de cálcio dietético entre indivíduos hipertensos idiopáticos.

Efeitos da frequência de fornecimento do volumoso e concentrado no comportamento ingestivo de vacas e novilhas em confinamento

Este estudo foi conduzido com o objetivo de avaliar a influência da frequência no fornecimento de volumoso e concentrado e/ou da categoria animal sobre o comportamento ingestivo de bovinos. Foram utilizadas 16 novilhas e 16 vacas com idade média inicial de 20 e 66 meses e peso médio inicial de 338 e 432 kg, respectivamente. Os tratamentos foram representados pelas frequências de fornecimento do volumoso e do concentrado: 2 V/C - volumoso e concentrado duas vezes ao dia; 1 V/C - volumoso e concentrado uma vez ao dia; 1 V/2 C - volumoso uma vez ao dia e concentrado duas vezes ao dia; 1 V/3 C - volumoso uma vez ao dia e concentrado três vezes ao dia, ofertadas às categorias vacas e novilhas. A dieta foi composta de 60% de silagem de milho e 40% de concentrado com base na matéria seca (MS). O delineamento experimental foi inteiramente casualizado em arranjo fatorial 4 × 2 (frequências × categorias). Os dados foram submetidos à análise de variância e as médias, comparadas pelo teste t. A interação frequência de fornecimento e categoria animal foi significativa para as características tempo de ruminação e ócio, eficiência de ruminação da matéria seca e da fibra detergente neutro, número de bolos diário e tempo diário de mastigação. em relação às vacas, as novilhas apresentaram maiores tempos de ócio e mastigação quando receberam a alimentação uma vez ao dia. A frequência de fornecimento da dieta não influenciou o tempo de consumo. As vacas apresentaram maior tempo consumindo alimento e taxa de ingestão em comparação às novilhas (4,38 vs 4,09 horas e 2,91 vs 2,35 kg de MS/hora de consumo, respectivamente). O aumento na frequência da alimentação estimula os animais a maior ingestão de alimento no momento do fornecimento.

Frequência alimentar e taxa de alimentação para Kinguio criado em hapa: desempenho produtivo e avaliação econômica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)