The 3-Year Effect of the Mediterranean Diet Intervention on Inflammatory Biomarkers Related to Cardiovascular Disease.
The intervention with the Mediterranean diet (MD) pattern has evidenced short-term anti-inflammatory effects, but little is known about its long-term anti-inflammatory properties at molecular level. This study aims to investigate the 3-year effect of MD interventions compared to low-fat diet (LFD) on changes on inflammatory biomarkers related to atherosclerosis in a free-living population with a high-risk of cardiovascular disease (CD). Participants (n = 285) in the PREDIMED trial were randomly assigned into three intervention groups: MD with extra-virgin olive oil (EVOO) or MD-Nuts, and a LFD. Fourteen plasma inflammatory biomarkers were determined by Luminex assays. An additional pilot study of gene expression (GE) was determined by RT-PCR in 35 participants. After 3 years, both MDs showed a significant reduction in the plasma levels of IL-1β, IL-6, IL-8, TNF-α, IFN-γ, hs-CRP, MCP-1, MIP-1β, RANTES, and ENA78 (p < 0.05; all). The decreased levels of IL-1β, IL-6, IL-8, and TNF-α after MD significantly differed from those in the LFD (p < 0.05). No significant changes were observed at the gene level after MD interventions, however, the GE of CXCR2 and CXCR3 tended to increase in the control LFD group (p = 0.09). This study supports the implementation of MD as a healthy long-term dietary pattern in the prevention of CD in populations at high cardiovascular risk. https://doi.org/10.3390/biomedicines9080862
Is a Handful an Effective Way to Guide Nut Recommendations?
Dietary guidelines recommend consuming 30 g of nuts per day to reduce the risk of chronic disease. A 'handful' is commonly used to guide consumers. Research is lacking on how this translates into actual gram amounts. This study quantified the grams of nuts represented by different portion size measures, including a 'handful' and '30 g serving' among 120 participants. Each participant was randomised to a sequence where they received three of six different nut types (from almonds, cashews, hazelnuts, macadamias, peanuts, and walnuts) and were instructed to take a: 'usual serving', 'handful', 'small handful', 'large handful', and '30 g serving' of each. Combining all nut types, the median 'handful' was 36.3 g, compared to 28.7 g for the estimated '30 g serving' and 24.8 for the 'usual serving'. The 'large handful' was approximately double the 'handful' (61.3 g), whereas the 'small handful' was about half (16.7 g). Eighty-three percent of portions chosen were at least 80% of the recommended 30 g intake when participants were asked to take a 'handful', compared to 63% for the '30 g serving'. It appears a 'handful' can be used as a practical tool to guide recommended nut intakes, and increases the amount selected compared to instructions to take a '30 g serving'. https://doi.org/10.3390/ijerph18157812
Tree nut consumption is associated with higher sex hormone-binding globulin levels in premenopausal US women.
Low levels of sex hormone-binding globulin (SHBG) are associated with many diseases including hypertension, diabetes, and polycystic ovarian syndrome. Walnuts increased circulating SHBG in 31 women complicated with polycystic ovarian syndrome. However, whether tree nuts increase SHBG in women in a general population is unknown. It was hypothesized in this study that consumption of tree nuts was positively associated with SHBG levels in women in a general population. This cohort study included 2699 adult women from the 2013- to 2016 US National Health and Nutrition Examination Survey. Tree nut consumers were defined as those who consumed tree nuts on either of the 2 24-hours recall days. Associations of tree nut consumption with SHBG were assessed using least squares regression. Among the 2699 women, 234 were consuming tree nuts. The median SHBG concentrations were 67.1 and 59.3 nmol/L among tree nut consumers and non-consumers, respectively. Tree nut consumption was positively associated with circulating SHBG (β = 0.041, P = .018) but not testosterone nor estradiol after adjustment for all tested confounders. Sub-analyses showed that the positive association of tree nuts with SHBG presented in premenopausal women but not in postmenopausal women. Tree nut consumption remained independently associated with higher circulating levels of SHBG in premenopausal women when tree nut consumption was expressed as percentage of energy derived from tree nuts or when tree nut consumption was defined as a tree nut intake of ≥0.25 ounce per day. Future research will verify the effectiveness of using tree nuts to treat low SHBG in premenopausal women in the general population. https://doi.org/10.1016/j.nutres.2021.07.003
Pecan-enriched diets decrease postprandial lipid peroxidation and increase total antioxidant capacity in adults at-risk for cardiovascular disease.
Pecans are a rich source of antioxidants, but the effect of regular consumption on post-meal responses is unknown. The objective of this study was to examine the impact of daily pecan consumption for 8 weeks on fasting and postprandial lipid peroxidation, total antioxidant capacity (TAC), and tocopherols in adults at higher risk for cardiovascular disease (CVD) (hypercholesterolemia or elevated adiposity). We hypothesized that daily pecan consumption would result in increased fasting γ-tocopherol, increased fasting and postprandial TAC, and decreased fasting and postprandial lipid peroxidation. This was a randomized, parallel, controlled trial with 3 treatments: two pecan groups and a nut free control (n = 16). The ADD group (n = 15) consumed pecans as part of a free-living diet, and the SUB group (n = 16) substituted the pecans for isocaloric foods from their habitual diet. At the pre- and post-intervention, a high saturated fat breakfast shake was consumed with postprandial blood draws over 2h. In the ADD and SUB groups, postprandial lipid peroxidation was suppressed (iAUC: 0.9 ± 1.3 to -2.9 ± 2.0 and 4.5 ± 1.7 to 0.7 ± 1.1 µM/2h, respectively; P <0.05) and TAC was elevated (iAUC: -240.8 ± 110.2 to 130.9 ± 131.7 and -227.6 ± 131.2 to 208.7 ± 145.7 µM Trolox Equivalents/2h, respectively; P <0.01) from pre- to post-intervention. Furthermore, there was an increase in γ-tocopherol from pre- to post-intervention within the ADD (1.4 ± 0.1 to 1.8 ± 0.1 µg/mL; P <0.001) and SUB groups (1.8 ± 0.2 to 2.1 ± 0.2 µg/mL; P <0.05). There were no changes in any variable within the control group. These findings suggest that daily pecan consumption protects against oxidative stress that occurs following a high-fat meal in adults at risk for CVD. https://doi.org/10.1016/j.nutres.2021.07.004
Gut Microbiota Composition is Associated with Responses to Peanut Intervention in Multiple Parameters Among Adults with Metabolic Syndrome Risk.
Scope: Peanuts are widely consumed as a meal ingredient and a snack, and are commonly considered as a healthy food based on their nutrient profile. Peanut consumption has been associated with a lower risk of metabolic syndrome (MetS) in epidemiological studies. In this study, we aimed to investigate whether consuming peanuts affects the gut microbiota in adults with risk of metabolic syndrome and whether the intervention effect of peanuts is associated with gut microbiota composition. Methods and results: We analyzed the gut microbiota of subjects from a 12-week randomized clinical trial comparing consumption of either peanuts or isocaloric carbohydrate bars. We observed that there was high inter-individual variability on multiple clinical and anthropometrical parameters in response to peanut consumption. Meanwhile, the gut microbiota composition was also highly person-specific and had minor changes when compared laterally or longitudinally. We employed a machine-learning algorithm and established prediction models using the microbiome data and the responsiveness data of different parameters in subjects with peanut intervention. As a result, we found that the improvement of MetS risk and numerous parameters including diastolic blood pressure, body weight, waist circumference, and fasting blood glucose level could be predicted for responsiveness with high accuracy that had a value of area under curve over 0.70 by receiver operating characteristic analysis. Conclusion: Together, our findings suggest that individual gut microbiota configuration may modulate host metabolism and alter an individual's response to peanut intervention, thus highlighting the importance of personalized nutrition. https://doi.org/10.1002/mnfr.202001051
The nutritional impact of replacing dietary meat with meat alternatives in the UK: A modelling analysis using nationally representative data.
Dietary patterns high in meat compromise both planetary and human health. Meat-alternatives may help facilitate meat reduction, however the nutritional implications of displacing meat with meat-alternatives does not appear to have been evaluated. Here, data from the 9th cycle of the National Diet and Nutrition Survey was used as the basis of models to assess the effect of meat substitution on nutritional intake. We implemented three models; model 1 progressively replaced 25%, 50%, 75%, or 100% of the current meat intake with a weighted mean of meat-alternatives available in the UK market. Model 2 compared different ingredient categories of meat-alternative; vegetable, mycoprotein, a combination of bean and pea, tofu, nut and soy. Model 3 compared fortified versus unfortified meat-alternatives. The models elicited significant shifts in nutrients. Overall, there were increases in carbohydrate, fibre, sugars and sodium, whereas reductions were found for protein, total and saturated fat, iron and B12. The greatest effects were seen for; vegetable-based (+24.63g/day carbohydrates), mycoprotein-based (−6.12g/day total fat), nut-based (−19.79g/day protein, +10.23g/day fibre; −4.80g/day saturated fat, +7.44g/day sugars), soy-based (+495.98mg/day sodium), and tofu-based (+7.63mg/day iron, −2.02μg/day B12). Our results suggest meat-alternatives can be a healthful replacement for meat if chosen correctly. Consumers should seek out meat-alternatives which are low in sodium and sugar, high in fibre, protein and with high micronutrient density, to avoid compromising nutritional intake if reducing their meat intake. Manufacturers and policy makers should consider fortification of meat-alternatives with nutrients such as iron and B12 and focus on reducing sodium and sugar content. https://doi.org/10.1017/S0007114521002750
Effects of extra virgin olive oil and pecan nuts on plasma fatty acids in patients with stable coronary artery disease.
Objective: The primary objective of this study was to determine the effects of a healthy diet supplemented with extra virgin olive oil or pecan nuts on plasma fatty acid (PFA) in patients with stable coronary artery disease (CAD). Research Methods & Procedures: Patients aged 40 to 80 years were randomized to one of three dietary interventions (allocation ratio 1: 1: 1): healthy diet based on guidelines (control group [CG]), healthy diet supplemented with 30 g/day of pecan nuts (PNG), or a healthy diet supplemented with 30 mL/day of extra virgin olive oil (OOG). PFA were identified at baseline and at the end of follow-up (12 weeks), and correlations between dietary fatty acids intake, PFA, and clinical biomarkers of the lipid profile were also assessed before and after the interventions. Results: Among 149 participants included in the analysis (CG: n = 43; PNG: n = 51; OOG: n = 55), correlations were observed between food intake, PFA, and lipid profile before and after interventions independent of statins used, but all correlations were considered weak. At the end of the study, the OOG showed increased concentrations of oleic fatty acid independently of the type of statin in use (1.49%, 95% confidence interval 0.08 – 2.89; P = 0.029); however, there were no significant differences between the groups regarding the final mean values of oleic fatty acid or in the other PFAs. Conclusions: In patients with stable CAD, there were no significant differences in PFA after 12 weeks according to dietary interventions evaluated. https://doi.org/10.1016/j.nut.2021.111411
Tree nut consumption and prevalence of carotid artery plaques: The National Heart, Lung, and Blood Institute Family Heart Study.
Purpose. While tree nut consumption has been shown to be cardioprotective, a few studies have examined the relationship between tree nut consumption and carotid atherosclerosis. We tested the hypothesis that tree nut consumption would be inversely related with carotid atherosclerosis in adults.
Methods. We cross-sectionally analyzed data from 4536 participants of the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study conducted in the United States. Dietary patterns among participants were variable, tree nut consumption was self-reported using the Food Frequency Questionnaire (FFQ), and B-mode ultrasound of the carotid arteries was used to assess for the presence of carotid artery plaques (primary outcome) and carotid intima media thickness (cIMT). Multivariable logistic regression was used to estimate odds ratio (95% confidence interval) of prevalent carotid artery plaques and linear regression was used to estimate adjusted mean cIMT across categories of nut consumption. Results. The mean age was 52.3 years (SD = 13.6), 95.6% of the participants were white, and 54% were female. The median tree nut intake was 1–3 servings/month. Odds ratios (95% CI) for prevalent carotid artery plaques were 1.0 (reference), 1.03 [0.86, 1.4], 0.89 [0.70, 1.13], and 0.96 [0.73, 1.26] for tree nut consumption of almost never, 1–3 times/month, 1/week, and 2+/week, respectively, adjusting for age, sex, race, field center, BMI, smoking status, alcohol consumption, creatinine, energy intake, fruit and vegetable consumption, exercise, and education. In secondary analysis, there was a suggestive inverse association of tree nut consumption with cIMT in the internal carotid artery, but not the common carotid or bifurcation. Conclusion. Our data showed no association between tree nut consumption and prevalence of carotid artery plaques in adults. https://doi.org/10.1007/s00394-021-02640-x
A remarkable food allergy in children: cashew nut allergy.
Objective: The prevalence of cashew nut allergy is increasing. Clinical reaction to cashew nuts may be severe, including anaphylaxis. In this study, we aimed to evaluate the frequency of cashew nut sensitivity in a group of children with food allergy and the clinical features and course of cashew nut allergy. Material and methods: A retrospective chart review was performed on 516 children who presented with food allergy at a pediatric allergy department. Individuals sensitized to cashew nuts were examined. Results: Cashew nut sensitization was detected in 17 (64.7% male; mean age of symptom onset, 14 months) of 516 patients with food allergy. Skin symptoms were the most frequent clinical presentation, followed by gastrointestinal symptoms. Overall, 29.4% of the patients presented with anaphylaxis. All anaphylactic reactions were developed after the first consumption of cashew nuts. Of the cashew nut-sensitized patients, 82.3% were diagnosed with moderate-to-severe atopic dermatitis, and all of them had multiple food allergies. During the follow-up, 90% of the patients who had cashew nut sensitization and co-existing food allergies to cow's milk and/or hen's egg developed tolerance to cow's milk and/or hen's egg, but none of the patients could tolerate cashew nut ingestion. Conclusion: Cashew nut is a potent allergen, causing severe allergic reactions that persist long term compared with other food allergies. Early onset of moderate-to-severe atopic dermatitis and multiple food allergies are remarkable co-existing conditions in children who have been diagnosed with cashew nut allergy. Pediatricians should be aware of this emerging food allergy.
Peanut can be used as a reference allergen for hazard characterization in food allergen risk management: A rapid evidence assessment and meta-analysis.
Regional and national legislation mandates the disclosure of "priority" allergens when present as an ingredient in foods, but this does not extend to the unintended presence of allergens due to shared production facilities. This has resulted in a proliferation of precautionary allergen ("may contain") labels (PAL) which are frequently ignored by food-allergic consumers. Attempts have been made to improve allergen risk management to better inform the use of PAL, but a lack of consensus has led to variety of regulatory approaches and non-uniformity in the use of PAL by food businesses. One potential solution would be to establish internationally-agreed "reference doses", below which no PAL would be needed. However, if reference doses are to be used to inform the need for PAL, then it is essential to characterize the hazard associated with these low-level exposures. For peanut, there are now published data relating to over 3000 double-blind, placebo-controlled challenges in allergic individuals, but a similar level of evidence is lacking for other priority allergens. We present the results of a rapid evidence assessment and meta-analysis for the risk of anaphylaxis to low-level allergen exposure for priority allergens. On the basis of this analysis, we propose that peanut can and should be considered an exemplar allergen for the hazard characterization at low-level allergen exposure. https://doi.org/10.1016/j.jaip.2021.08.008