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.
Mann, J.I., 2000. Optimizing the plant-based diet. Asia Pacific J Clin Nutr. 9(suppl):S60-4.
Any attempt to optimize a plant-based diet necessitates an identification of the features of the diet which confer benefit as well as any which may be associated with detrimental effects. The former task is more difficult than might be assumed as there is no doubt that some of the apparent health benefits observed amongst vegetarians are a consequence of environmental determinants of health which characterize groups of people who choose vegetarian diets, rather than dietary practices. This review will consider the major health benefits of plant-based diets, the specific foods or nutrients which confer the benefits as far as can be ascertained from present knowledge, potential nutrient deficiencies associated with a plant-based diet and nutritional strategies that can be employed to prevent any such deficiencies.
Lino, M., K. Marcoe, J.M. Dinkins, H. Hiza, R. Anand, 2000. USDA Center for Nutrition Policy and Promotion. The role of nuts in a healthy diet. Insight 23, December.
While not a staple in the American diet, nuts are consumed by many Americans. This Nutrition Insight examines the contribution nuts can make to a diet, consumption of nuts, characteristics of people who eat nuts, and the association of nut consumption with diet quality.
Colquhoun, D.M., 2000. Food for prevention of coronary heart disease: Beyond the low fat, low cholesterol diet. Asia Pacific J Clin Nutr. 9(suppl):S86-90.
The single major cause of death throughout the world is coronary heart disease. Prevalence is stable or decreasing in North America, Australasia and most of Europe, while rapidly increasing in eastern Europe, Asia and Africa. Atherosclerosis is the underlying pathology. This is one of the classic lifestyle diseases on the background of genetic susceptibility. Diet plays a key role in the initiation and progression of coronary heart disease. A low total fat diet is almost universally recommended throughout the world. However, the most successful secondary prevention diet trials have used modification of fat, rather than decrease in total fat per se. Successful diet trials suggest that diet modification is as effective as accepted drug therapy to prevent recurrent coronary events, and importantly is very cost effective. Marine lipid supplementation has been demonstrated beyond reasonable doubt to decrease total mortality and in particular sudden death in patients who have survived their first myocardial infarction. Large-scale diet intervention trials are indicated to improve the scientific basis for dietary recommendations to prevent initial and recurrent coronary heart disease.
Bruce, B., G.A. Spiller, L.M. Klevay, S.K. Gallagher, 2000. A diet high in whole and unrefined foods favorably alters lipids, antioxidant defenses and colon function. J Clin Nutr. 19(1): 61-7.
OBJECTIVE: Diets rich in whole and unrefined foods, like whole grains, dark green and yellow/orange-fleshed vegetables and fruits, legumes, nuts and seeds, contain high concentrations of antioxidant phenolics, fibers and numerous other phytochemicals that may be protective against chronic diseases. This study compared the effects of a phytochemical-rich diet versus a refined-food diet on lipoproteins, antioxidant defenses and colon function. METHODS: Twelve hyperlipidemic women followed two diets for four weeks starting with a refined-food diet. Subjects then directly crossed over to the phytochemical-rich diet. Duplicate, fasting serum lipids and single, fasting antioxidant enzymes were measured at the end of the four-week refined-food diet period (baseline) and again at the end of the phytochemical-rich diet period. RESULTS: Total energy and total fat intake were similar during both diet periods, but there was a decrease in saturated fat (SFA) of 61% in the phytochemical-rich diet group. Dietary fiber, vitamin E, vitamin C and carotene intakes were 160%, 145%, 160% and 500% more, respectively, than during the refined-food diet period. The phytochemical-rich diet induced a drop of 13% in total cholesterol (TC) (p < 0.05) and 16% (p < 0.001) in low density lipoprotein-cholesterol (LDL-C). Erythrocyte superoxide dismutase decreased 69% (p < 0.01) and glutathione peroxidase dropped 35% (p < 0.01). Colon function was improved on the phytochemical-rich diet. CONCLUSIONS: A diet abundant in phytochemically-rich foods beneficially affected lipoproteins, decreased need for oxidative defense mechanisms and improved colon function.
Sicherer SH, A. Muñoz-Furlong, A.W. Burks, H.A. Sampson, 1999. J Allergy Clin Immunol. 103(4):559-562.
Allergy to peanuts and tree nuts (TNs) is one of the leading causes of fatal and near-fatal food-induced allergic reactions. These allergies can be lifelong and appear to be increasing in prevalence. Despite the seriousness of these allergies, the prevalence of peanut and TN allergy in the general population is unknown. OBJECTIVE: We sought to determine the prevalence of peanut and TN allergy among the general population of the United States. METHODS: We used a nationwide, cross-sectional, random digit dial telephone survey with a standardized questionnaire. RESULTS: A total of 4374 households contacted by telephone participated (participation rate, 67%), representing 12,032 individuals. Peanut or TN allergy was self-reported in 164 individuals (1.4%; 95% confidence interval [CI], 1.2%-1.6%) in 151 households (3.5%; 95% CI, 2.9%-4.0%). The prevalence of reported allergy in adults (1.6%) was higher than that found in children under 18 years of age (0.6%). In 131 individuals, details of the reactions were obtained. When applying criteria requiring reactions to be typical of IgE-mediated reactions (hives, angioedema, wheezing, throat tightness, vomiting, and diarrhea) within an hour of ingestion, 10% of these subjects were excluded. Among the remaining 118 subjects, allergic reactions involved 1 organ system (skin, respiratory, or gastrointestinal systems) in 50 subjects, 2 in 45 subjects, and all 3 in 23 subjects. Forty-five percent of these 118 respondents reported more than 5 lifetime reactions. Only 53% of these 118 subjects ever saw a physician for the allergic reaction, and only 7% had self-injectable epinephrine available at the time of the interview. The prevalence of peanut and TN allergy was adjusted by assuming that 10% of the remaining 33 subjects without a description of their reactions would also be excluded and correcting for a 7% false-positive rate for the survey instrument. A final “corrected” prevalence estimate of 1.1% (95% CI, 1.0%-1.4%) was obtained. CONCLUSIONS: Peanut and/or TN allergy affects approximately 1.1% of the general population, or about 3 million Americans, representing a significant health concern. Despite the severity of reactions, about half of the subjects never sought an evaluation by a physician, and only a few had epinephrine available for emergency use.
