Drewnowski, A., 2005. Concept of a nutritious food: toward a nutrient density score. Am J Clin Nutr.82:721-32.
The American diet is said to be increasingly energy-rich but nutrient poor. To help improve the nutrient-to-energy ratio, the 2005 Dietary Guidelines for Americans recommend that consumers replace some foods in their diets with more nutrient-dense options. Such dietary guidance presupposes the existence of a nutrient density standard. However, a review of the literature shows that the concept of a nutritious food is not based on any consistent standards or criteria. In many cases, healthful foods are defined by the absence of problematic ingredients—fat, sugar, and sodium—rather than by the presence of any beneficial nutrients they might contain. Past attempts to quantify the nutrient density of foods have been based on a variety of calories-to-nutrient scores, nutrients-per-calorie indexes, and nutrient-to-nutrient ratios. The naturally nutrient rich (NNR) score, which is based on mean percentage daily values (DVs) for 14 nutrients in 2000 kcal food, can be used to assign nutrient density values to foods within and across food groups. Use of the NNR score allows consumers to identify and select nutrient-dense foods while permitting some flexibility where the discretionary calories are concerned. This approach has implications for food labeling, nutritional policy making, and consumer education. The Food and Drug Administration has considered approving nutrient claims based on the ratio of a beneficial nutrient to the food’s energy content, as opposed to a specified minimum amount of a nutrient per serving size. Given the current dietary trends, the nutrient density approach can be a valuable tool for nutrition education and dietary guidance.
Chai, W., M. Liebman, 2005. Oxalate content of legumes, nuts and grain-based flours. Journal of Food Composition and Analysis. 18:723-29.
About 75% of all kidney stones are composed primarily of calcium oxalate and hyperoxaluria is a primary risk factor for this disorder. Since absorbed dietary oxalate can make a significant contribution to urinary oxalate levels, oxalate from legumes, nuts, and different types of grain-based flours was analyzed using both enzymatic and capillary electrophoresis (CE) methods. Total oxalate varied greatly among the legumes tested, ranging from 4 to 80 mg/100 g of cooked weight. The range of total oxalate of the nuts tested was 42-469 mg/100 g. Total oxalate of analyzed flours ranged from 37 to 269 mg/100 g. The overall data suggested that most legumes, nuts, and flours are rich sources of oxalate.
Nash, S.D., M. Westpfal, 2005. Cardiovascular benefits of nuts. American Journal of Cardiology. 963-65.
This review article highlights some of the cardiovascular benefits of nuts. The authors conclude by writing, “Simply stated, at a time of spiraling costs for medical care, public and professional concerns about drug safety, and in an age of fad diets, it is reassuring to have a “nutty alternative.”
Mukuddem-Petersen, J., W. Oosthuizen, J. C. Jerling. 2005. A systematic review of the effects of nuts on blood lipid profiles in humans. J. Nutr. 135; 2082-2089.
The inverse association of nut consumption and risk markers of coronary heart disease (lipids) has sparked the interest of the scientific and lay community. The objective of this study was to conduct a systematic review to investigate the effects of nuts on the lipid profile. Medline and Web of Science databases were searched from the start of the database to August 2004 and supplemented by cross-checking reference lists of relevant publications. Human intervention trials with the objective of investigating independent effects of nuts on lipid concentrations were included. From the literature search, 415 publications were screened and 23 studies were included. These papers received a rating based upon the methodology as it appeared in the publication. No formal statistical analysis was performed due to the large differences in study designs of the dietary intervention trials. The results of 3 almond (50-100 g/d), 2 peanut (35-68 g/d), 1 pecan nut (72 g/d), and 4 walnut (40-84 g/d) studies showed decreases in total cholesterol between 2 and 16% and LDL cholesterol between 2 and 19% compared with subjects consuming control diets. Consumption of macadamia nuts (50-100 g/d) produced less convincing results. In conclusion, consumption of ~50-100 g (~1.5-3.5 servings) of nuts ≥5 times/wk as part of a heart healthy diet with total fat content (high in mono- and/or polyunsaturated fatty acids) of ~35% of energy may significantly decrease total cholesterol and LDL cholesterol in normo- and hyperlipidemic individuals.
Lapointe, A., J. Goulet, C. Couillard, B. Lamarche, S. Lemieux, 2005. A nutritional intervention promoting the Mediterranean food pattern is associated with a decrease in circulating oxidized LDL particles in healthy women from the Québec City metropolitan area. J. Nutr. 135:410-15.
The aim of the present study was to evaluate the effect of a nutritional intervention promoting the Mediterranean food pattern under free-living conditions on circulating oxidized LDL (ox-LDL) in a group of 71 healthy women from the Quebec City metropolitan area. The 12-wk nutritional intervention consisted of 2 courses on nutrition and 7 individual sessions with a dietitian. A score based on the 11 components of the Mediterranean pyramid was established to determine the women’s adherence to the Mediterranean food pattern. Plasma ox-LDL concentrations were measured by a monoclonal antibody mAb-4E6–based competition ELISA. Among all women, plasma ox-LDL decreased by 11.3% after 12 wk of nutritional intervention (P < 0.0001) despite a lack of change in plasma LDL cholesterol (LDL-C). Also, an increase in the Mediterranean dietary score was significantly correlated with a decrease in ox-LDL concentrations (r=-0.30; P< 0.01). More specifically, increases in servings of fruits (r= –0.25; P<0.05) and vegetables (r= –0.24; P< 0.05) were associated with decreases in ox-LDL concentrations. Changes in the food pattern in response to a nutritional intervention promoting the Mediterranean food pattern were accompanied by beneficial effects in circulating ox-LDL concentrations in healthy women.
Lairon, D., N. Arnault, S. Bertrais, R. Planells, E. Clero, S. Hercberg, M.-C. Boutron-Ruault, 2005. Dietary fiber intake and risk factors for cardiovascular disease in French adults. Am J Clin Nutr. 82:1185-94.
Background: Increased consumption of dietary fiber is widely recommended to maintain or improve health, but knowledge of the relation between dietary fiber sources and cardiovascular disease risk factors is limited. Objective: We examined the relation between the source or type of dietary fiber intake and cardiovascular disease risk factors in a cohort of adult men and women. Design: In a cross-sectional study, quintiles of fiber intake were determined from dietary records, separately for 2532 men and 3429 women. Age- and multivariate-controlled logistic models investigated the odds ratios of abnormal markers for quintiles 2-5 of fiber intake compared with the lowest quintile. Results: The highest total dietary fiber and nonsoluble dietary fiber intakes were associated with a significantly (P<0.05) lower risk of overweight and elevated waist-to-hip ratio, blood pressure, plasma apolipoprotein (apo) B, apo B:apo A-I, cholesterol, triacylglycerols, and homocysteine. Soluble dietary fiber was less effective. Fiber from cereals was associated with a lower body mass index, blood pressure, and homocysteine concentration; fiber from vegetables with a lower blood pressure and homocysteine concentration; and fiber from fruit with a lower waist-to-hip ratio and blood pressure. Fiber from dried fruit or nuts and seeds was associated with a lower body mass index, waist-to-hip ratio, and fasting apo B and glucose concentrations. Fiber from pulses had no specific effect. Conclusion: Dietary fiber intake is inversely correlated with several cardiovascular disease risk factors in both sexes, which supports its protective role against cardiovascular disease and recommendations for its increased consumption.
Maguire, L.S., S.M. O’Sullivan, K. Galvin, T.P. O’Connor, N.M. O’Brien, 2004. Fatty acid profile, tocopherol, squalene and phytosterol content of walnuts, almonds, peanuts, hazelnuts and the macadamia nut. Int J Food Sci Nutr. 55(3):171-178.
Nuts are high in fat but have a fatty acid profile that may be beneficial in relation to risk of coronary heart disease. Nuts also contain other potentially cardioprotective constituents including phytosterols, tocopherols and squalene. In the present study, the total oil content, peroxide value, composition of fatty acids, tocopherols, phytosterols and squalene content were determined in the oil extracted from freshly ground walnuts, almonds, peanuts, hazelnuts and the macadamia nut. The total oil content of the nuts ranged from 37.9 to 59.2%, while the peroxide values ranged from 0.19 to 0.43 meq O2/kg oil. The main monounsaturated fatty acid was oleic acid (C18:1) with substantial levels of palmitoleic acid (C16:1) present in the macadamia nut. The main polyunsaturated fatty acids present were linoleic acid (C18:2) and linolenic acid (C18:3). alpha-Tocopherol was the most prevalent tocopherol except in walnuts. The levels of squalene detected ranged from 9.4 to 186.4 microg/g. beta-Sitosterol was the most abundant sterol, ranging in concentration from 991.2 to 2071.7 microg/g oil. Campesterol and stigmasterol were also present in significant concentrations. Our data indicate that all five nuts are a good source of monounsaturated fatty acid, tocopherols, squalene and phytosterols.
Pumphrey, R., 2004. Anaphylaxis: can we tell who is at risk of a fatal reaction? Curr Opin Allergy Clin Immunol. 4:285–290.
Purpose of review: Anaphylaxis is frightening and patients commonly fear their next reaction will be fatal. This review looks at the characteristics of fatal reactions to find if a fatal recurrence is predictable. Recent findings: Most publications on fatal anaphylaxis are case reports that do not help predict risks. Most epidemiological studies focus on non-fatal reactions. The UK fatal anaphylaxis register demonstrates that over two-thirds of those dying from sting reactions and over four-fifths dying from drug anaphylaxis had no previous indication of their allergy, whereas those dying from food allergy had usually had previous reactions but these were typically not severe. Recent reports of anaphylaxis epidemiology based on diagnostic coding or attendance for treatment may be biased by differences in health service resource utilization according to the cause and course of the reaction. Summary: Most fatal anaphylactic reactions are unpredictable. The appropriate management after recovery from a severe reaction may be protective against a fatal recurrence. An accurate identification of the cause and effective avoidance is a crucial part of this management, together with effective treatment of asthma for those with food allergy, immunotherapy for sting allergy, the avoidance of drugs that potentiate anaphylaxis, and effective training in self-treatment.
Moneret-Vautrin, D.A., G. Kanny, 2004. Update on threshold doses of food allergens: implications for patients and the food industry. Curr Opin Allergy Clin Immunol. 4:215–219.
The purpose of this review is to bring the reader up to date on the importance of assessing a food’s lowest observed adverse effect level (LOAEL) with two aims. Firstly, to help industry choose tests with a level of sensitivity capable of detecting food allergens hidden in industrial products. Secondly, to specify protective measures for highly allergic individuals in order to prevent recurrent severe anaphylaxis. The review also seeks to highlight the present issues and unsolved questions. Recent findings Thanks to standardized oral-provocation tests (double-blind placebo-controlled food challenges), LOAELs have been identified for many IgE-dependent food allergies. Most studies concern the pediatric population. Data is available for milk, egg, peanut, wheat flour, and sesame. The LOAELs are commonly in the range of 1–2 mg of natural foods, representing a few hundred micrograms of protein. These minimal reactive doses characterize about 1% of people allergic to milk, egg, or peanut. The level at which no observed adverse effect is seen might be a few tens of micrograms of protein for peanut. At the present time, allergy to oil seems to be restricted to unrefined cold-pressed oils. Summary Concerning IgE-dependent food allergies, the threshold dose inducing symptoms is now known to vary a great deal according to the individual. A reactive dose of less than 65 mg characterizes 16 and 18% of patients allergic to egg or peanut. Less than 30 mg of milk proteins characterizes 5% of those allergic to milk. For milk, egg, and peanut, 1% of patients have a very low threshold, about 1 mg. Such data emphasize the necessity of using detection tests with a sensitivity better than 10 parts per million. The modifications of allergenicity undergone by protein ingredients that are now commonly introduced into industrially made products are not yet sufficiently known. A better knowledge of the reactive doses of these proteins is needed.
Hand, S., C. Darke, J. Thompson, C. Stingl, S. Rolf, K.P. Jones, B.H. Davies, 2004. Human leucocyte antigen polymorphisms in nut-allergic patients in South Wales. Clin Exp Allergy. 34:720–724.
Background: Peanuts and tree nuts are among the most common foods provoking severe allergic reactions including fatal anaphylaxis. However, little is known of the underlying genetic and immunological mechanisms involved. Objective: Based on findings in other allergic diseases, we have investigated whether specific human leucocyte antigens (HLA) are associated with nut allergy. Method Eighty-four patients presenting at the allergy clinic with symptoms of nut allergy were typed for the HLA Class I (HLA-A and B) and Class II (HLA-DRB1 and DQB1) loci by PCR using sequence-specific primers. Carriage frequencies were compared with 82 atopic non-nut-allergic subjects and 1798 random blood donors. Results: The frequency of HLA-B*07 (28.57%) and DRB1*11 (15.48%) was increased in the nutallergic patients compared to the atopic controls (12.20% and 3.66%, respectively) but not when compared to the blood donors (28.86% and 10.12%). DRB1*13 and DQB1*06 were both increased in frequency in the nut allergy patients over both the atopic and blood donor controls. However, none of these increased frequencies were significant when corrected for the number of comparisons undertaken. Conclusion: At HLA ‘2-digit resolution’ and with undifferentiated patients with nut allergy, there are no major disturbances in the frequency of HLA-A, B, DRB1 or DQB1 types. However, the difference in frequency of HLA-DRB1*11 between the nut allergy patients and the atopic controls merits further investigation as this may represent an important phenotypic relationship.
