McManus, K., L. Antinoro, F. Sacks, 2001. A randomized controlled trial of a moderate fat, low energy diet compared with a low fat, low energy diet for weight loss in overweight adults. Int J Obesity.25:1503-11.
CONTEXT: Long-term success in weight loss with dietary treatment has been elusive. OBJECTIVE: To evaluate a diet moderate in fat based on the Mediterranean diet compared to a standard low-fat diet for weight loss when both were controlled for energy. DESIGN: A randomized, prospective 18 month trial in a free-living population. PATIENTS: A total of 101 overweight men and women (26.5 – 46 kg/m2). INTERVENTION: (1) Moderate-fat diet (35% of energy); (2) low-fat diet (20% of energy). MAIN OUTCOME MEASUREMENTS: Change in body weight. RESULTS: After 18 months, 31/50 subjects in the moderate-fat group, and 30/51 in the low fat group were available for measurements. In the moderate-fat group, there were mean decreases in body weight of 4.1 kg, body mass index of 1.6 kg/m2, and waist circumference of 6.9 cm, compared to increases in the low-fat group of 2.9 kg, 1.4 kg/m2 and 2.6 cm, respectively; P ≤ 0.001 between the groups. The difference in weight change between the groups was 7.0 kg. (95% CI 5.3, 8.7). Only 20% (10/51) of those in the low-fat group were actively participating in the weight loss program after 18 months compared to 54% (27/50) in the moderate-fat group, (P <0.002). The moderate-fat diet group was continued for an additional year. The mean weight loss after 30 months compared to baseline was 3.5 kg (n=19, P=0.03). CONCLUSIONS: A moderate-fat, Mediterranean-style diet, controlled in energy, offers an alternative to a low-fat diet with superior long-term participation and adherence, with consequent improvements in weight loss.
Noah, A., A.S. Truswell, 2001. There are many Mediterranean diets. Asia Pacific J Clin Nutr. 10(1):2-9.
Interest in Mediterranean diet began 30 years ago, when Ancel Keys published the results of the famous Seven Countries Study. Since 1945, almost 1.3 million people have come to Australia from Mediterranean countries as new settlers. There are 18 countries with coasts on the Mediterranean sea: Spain, southern France, Italy, Malta, Croatia, Bosnia, Albania, Greece, Cyprus, Turkey, Syria, Lebanon, Egypt, Libya, Malta, Tunisia, Algeria and Morocco. This study from which this report derives aims to investigate the influence of the food habits of immigrants from Mediterranean countries on Australian food intake. Here we look at the ‘traditional’ food habits of the above Mediterranean countries as told by 102 people we interviewed in Sydney, who came from 18 Mediterranean countries to Sydney. Most of the informants were women, their age ranged from 35 to 55 years. The interview was open-ended and held in the informant’s home. It usually lasted around 11/2 hours. The interview had three parts. Personal information was obtained, questions relating to the food habits of these people back in their original Mediterranean countries and how their food intake and habits have changed in Australia were also asked. From the interviews, we have obtained a broad picture of ‘traditional’ food habits in different Mediterranean countries. The interview data was checked with books of recipes for the different countries. While there were similarities between the countries, there are also important differences in the food habits of the Mediterranean countries. Neighboring countries’ food habits are closer than those on opposite sides of the Mediterranean Sea. We suggest that these food habits can be put into four groups. The data here refer to food habits in Mediterranean countries 20 or 30 years ago, as they were recovering from the Second World War. There is no single ideal Mediterranean diet. Nutritionists who use the concept should qualify the individual country and the time in history of their model Mediterranean diet.
Lin, B.H., E. Frazao, J. Allhouse, 2001. U.S. consumption patterns of tree nuts. Food Review 24(2):54-8.
Americans are more than a little nutty when it comes to their diets. Recent USDA food consumption data show that about 1 in every 10 consumers eats tree nuts (almonds, walnuts, pecans, pistachios, cashews, and others) on any given day, and the amount eaten is fairly small. On average, slightly more than 1 gram of tree nuts are eaten per person per day. Tree nut consumption is higher among wealthier consumers and Whites in the United States. More adults age 40 and above eat tree nuts than younger consumers. A smaller proportion of consumers living in the South and in rural areas consume tree nuts than other consumers.
Sacks, F.M., L.P. Svetkey, W.M. Vollmer, L.J. Appel, B.A. Bray, D. Harsha, E. Obarzanek, P.R. Conlin, E.R. Miller, D.G. Simons-Morton, N. Karanja, P. Lin, 2001. Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet. NEJM. 344(1):3-10.
Background The effect of dietary composition on blood pressure is a subject of public health importance. We studied the effect of different levels of dietary sodium, in conjunction with the Dietary Approaches to Stop Hypertension (DASH) diet, which is rich in vegetables, fruits, and low-fat dairy products, in persons with and in those without hypertension. Methods A total of 412 participants were randomly assigned to eat either a control diet typical of intake in the United States or the DASH diet. Within the assigned diet, participants ate foods with high, intermediate, and low levels of sodium for 30 consecutive days each, in random order. Results Reducing the sodium intake from the high to the intermediate level reduced the systolic blood pressure by 2.1 mm Hg (P<0.001) during the control diet and by 1.3 mm Hg (P=0.03) during the DASH diet. Reducing the sodium intake from the intermediate to the low level caused additional reductions of 4.6 mm Hg during the control diet (P<0.001) and 1.7 mm Hg during the DASH diet (P<0.01). The effects of sodium were observed in participants with and in those without hypertension, blacks and those of other races, and women and men. The DASH diet was associated with a significantly lower systolic blood pressure at each sodium level; and the difference was greater with high sodium levels than with low ones. As compared with the control diet with a high sodium level, the DASH diet with a low sodium level led to a mean systolic blood pressure that was 7.1 mm Hg lower in participants without hypertension, and 11.5 mm Hg lower in participants with hypertension. Conclusions The reduction of sodium intake to levels below the current recommendation of 100 mmol per day and the DASH diet both lower blood pressure substantially, with greater effects in combination than singly. Long-term health benefits will depend on the ability of people to make long-lasting dietary changes and the increased availability of lower-sodium foods.
Kris-Etherton, P.M., G. Zhao, A.E. Binkoski, S.M. Coval, T.D. Etherton, 2001. The effects of nuts on coronary heart disease risk. Nutr Rev. 59:103.
Epidemiologic studies have consistently demonstrated beneficial effects of nut consumption on coronary heart disease (CHD) morbidity and mortality in different population groups. Clinical studies have reported total and low-density lipoprotein cholesterol-lowering effects of heart-healthy diets that contain various nuts or legume peanuts. It is evident that the favorable fatty acid profile of nuts (high in unsaturated fatty acids and low in saturated fatty acids) contributes to cholesterol lowering and, hence, CHD risk reduction. Dietary fiber and other bioactive constituents in nuts may confer additional cardioprotective effects.
Ellsworth, J.L., L.H. Kushi and A.R. Folsom, 2001. Frequent nut intake and risk of death from coronary heart disease and all causes in postmenopausal women: The Iowa Women’s Health Study. Nutr Metab Cardiovasc Dis. 11:372-7.
BACKGROUND AND AIM: Recent epidemiological studies suggest that there is an inverse association between the frequent consumption of nuts and the risk of coronary heart disease (CHD), and clinical investigations suggest that diets high in nuts may reduce serum cholesterol levels. This study assessed whether the risk of death due to CHD and all causes is reduced in postmenopausal women who frequently consume nuts. METHODS AND RESULTS: In 1986, 34,111 postmenopausal women with no known cardiovascular disease reported the frequency of their consumption of nuts and other foods, as well as other CHD risk factors. During approximately 12 years of follow-up, 3726 women died, 657 from CHD. After adjustment for multiple risk factors for CHD and dietary variables, there was an inverse but not statistically significant association between frequent nut consumption (two or more 28.5 g servings per week compared with less than one serving per month) and death from CHD (relative risk 0.81; 95% confidence interval: 0.60-1.11). There was also a weak inverse association between frequent nut intake and all-cause mortality (relative risk 0.88; 95% confidence interval: 0.77-0.99, p for trend = 0.047). CONCLUSIONS: Frequent nut consumption may offer postmenopausal women modest protection against the risk of death from all causes and CHD.
de Lorgeril, M., P. Salen, F. Laporte, F. Boucher, J. De Leiri, 2001. Potential use of nuts for the prevention and treatment of coronary heart disease: From natural to functional foods. Nutr Metab Cardiovasc Dis. 11:362-71.
This editorial discusses the research on nuts and coronary heart disease (CHD) and suggests that before using food technology to develop new and artificial foods to help patients follow what they think would be an “optimal diet,” scientists and physicians should first refer to the traditional diets of populations with low CHD rates. Studying the effect of natural or whole foods, such as nuts, should be a priority. According to the authors, natural foods are still the preferred functional foods because they may provide a better nutrient profile than any recomposed food, and the proportions of the various nutrients and non-nutrients are the result of a natural, and biologically compatible, evolution and not of an industrial process.
Sicherer, S.H., H.A. Sampson, 2000. Peanut and tree nut allergy. Curr Opin Pediatr. 12:567–573.
Among foods causing allergic reactions in children, peanut (a legume) and tree nuts (ie, walnut, hazel nut, Brazil nut, pecan) have attracted considerable attention for several reasons. Allergies to these foods are common, frequently have an onset in the first few years of life, generally persist, and account for severe and potentially fatal allergic reactions. Furthermore, the ubiquity of these foods in the diet makes avoidance difficult and accidental ingestions, with reactions, common. This review discusses recent and emerging information on the prevalence, clinical characteristics, natural history, genetic basis, and current treatment of these allergies. In addition, recent advances in the molecular and immunologic characteristics of these allergens, and novel therapeutic options under investigation in animal models, are reviewed.
Rodriguez, J., J.F. Crespo, A. Lopez-Rubio, J. de la Cruz-Bertolo, P. Ferrando-Vivas, R. Vives, P. Daroca, 2000. Clinical cross-reactivity among foods of the Rosaceae family. J Allergy Clin Immunol. 106:183-189.
Background: Foods from the Rosaceae botanical family have been increasingly reported as causes of allergic reaction. Patients frequently have positive skin tests or radioallergosorbent test results for multiple members of this botanical family. Objective: Our purpose was to investigate the clinical crossreactivity assessed by double-blind, placebo-controlled food challenge (DBPCFC) of Rosaceae foods (apricot, almond, plum, strawberry, apple, peach, and pear). Methods: Thirty-four consecutive adult patients complaining of adverse reactions to Rosaceae were included in the study. Skin prick tests and CAP System (FEIA) were performed with Rosaceae foods in all patients. Clinical reactivity to Rosaceae was systematically evaluated by open food challenges (OFCs), unless there was a convincing history of a recent severe anaphylaxis. Positive reactions on OFCs were subsequently evaluated by DBPCFCs. Results: Twenty-six and 24 patients had positive skin prick tests and CAP FEIA with Rosaceae, respectively; from these 88% and 100% had positive tests with ≥2. No evidence of clinical reactivity was found in 66% percent of positive skin prick tests and 63% of positive specific IgE determinations to fruits. A total of 226 food challenges (including OFC and DBPCFC) were performed in the 28 patients with positive skin prick tests or CAP System FEIA. Of 182 initial OFCs carried out, 26 (14%) reactions were confirmed by DBPCFCs. Overall, 40 reactions were considered positive in 22 patients with positive skin tests or CAP FEIA. Thirty-eight reactions had been previously reported, the remaining two were detected by systematic challenges. Most reactions were caused by peach (22 patients), apple (6), and apricot (5). Ten patients (46%) were clinically allergic to peach and other Rosaceae. Conclusion: Positive skin test and CAP System FEIA should not be taken as the only guide for multi-species dietary restrictions. Nevertheless, the potential clinical allergy to other Rosaceae should not be neglected. If the reported reaction is confirmed, current tolerance to other Rosaceae should be precisely established unless there has been ingestion without symptoms after the reaction.
Eigenmann, P.A., A.-M. Calza, 2000. Diagnosis of IgE-mediated food allergy among Swiss children with atopic dermatitis. Pediatr Allergy Immunol. 11: 95-100.
Diagnosis of food allergy in children with atopic dermatitis (AD) relies on a good knowledge of the prevalence of the disease and of the foods most frequently involved. Our objective was to define these characteristics in a population of Swiss children with AD. Patients referred to a pediatric allergist or a dermatologist for AD were routinely tested by skin-prick test (SPT) to seven common food allergens (milk, egg, peanut, wheat, soy, fish, and nuts), and to all other foods suspected by history. Patients with positive SPTs were further evaluated for speci®c serum immunoglobulin E (IgE) antibodies (by using the CAP System FEIA™). CAP values were interpreted following previously published predictive values for clinical reactivity. Patients with inconclusive results (between the 95% negative predictive value [NPV] and the 95% positive predictive value [PPV]) were challenged with the suspected food. A total of 74 children with AD were screened for food allergies. Negative SPTs excluded the diagnosis in 30 subjects. Nineteen patients were diagnosed by histories suggestive of recent anaphylactic reactions to foods and/or CAP values above the 95% PPV. Forty-three food challenges (35 open challenges and eight double-blind, placebo-controlled in children with persistent lesions of AD despite aggressive topical skin treatment) were performed in patients with positive SPTs but with inconclusive CAP values. Six patients were diagnosed as positive to 15 foods. Challenges were not performed to high-allergenic foods in young children (under 12 months of age for egg and ®sh, and under 3 years of age for peanuts and nuts). Altogether, 33.8% (25 of 74) of the AD patients were diagnosed with food allergy. The prevalence of food allergy was 27% (seven of 25) in the group referred to the dermatologist for primary care of AD. The foods most frequently incriminated were egg, milk, and peanuts. The prevalence of food allergy in our population was comparable to that in other westernized countries, suggesting an incidence of food allergy in approximately one-third of children with persistent lesions of AD. Together with milk and eggs, peanuts were most frequently involved in allergic reactions.
