Archive

Research Area: Body Weight/Satiety

Cross-sectional assessment of nut consumption and obesity, metabolic syndrome and other cardiometabolic risk factors: The PREDIMED study.

Ibarrola-Jurado, N, M. Bulló, M. Guasch-Ferré, E. Ros, M.A. Martínez-González, D. Corella, M. Fiol, J. Wärnberg, R. Estruch, P. Román, F. Arós, E. Vinyoles, L. Serra-Majem, X. Pintó, M.I. Covas, J. Basora, J. Salas-Salvadó, on behalf of the PREDIMED Study Investigators, 2013. Cross-sectional assessment of nut consumption and obesity, metabolic syndrome and other cardiometabolic risk factors: The PREDIMED study. PLoS ONE 8(2): e57367. doi:10.1371/journal.pone.0057367.

Introduction: Prospective studies have consistently suggested that nut consumption is inversely related to fatal and nonfatal coronary heart disease. Limited data are available on the epidemiological associations between nut intake and cardiometabolic risk factors. Objective: To evaluate associations between frequency of nut consumption and prevalence of cardiometabolic risk factors [obesity, metabolic syndrome (MetS), type-2 diabetes, hypertension, and dyslipidemia] in a Mediterranean population at high cardiovascular risk. Materials and Methods: Cross-sectional study of 7,210 men and women (mean age, 67 y) recruited into the PREDIMED study. MetS was defined by the harmonized ATPIII and IDF criteria. Diabetes and hypertension were assessed by clinical diagnosis and dyslipidemia (high triglycerides, low HDL-cholesterol, and hypercholesterolemia) by lipid analyses. Nut consumption was assessed using a validated food frequency questionnaire and categorized as <1, 1–3, and >3 servings/wk. Control of confounding was done with multivariate logistic regression. Results: Compared to participants consuming <1 serving/wk of nuts, those consuming >3 servings/wk had lower adjusted odds ratios (OR) for obesity (0.61, 95% confidence interval 0.54 to 0.68; P-trend <0.001), MetS (0.74, 0.65 to 0.85; P-trend, 0.001), and diabetes (0.87, 0.78 to 0.99; P-trend = 0.043). Higher nut consumption was also associated with lower risk of the abdominal obesity MetS criterion (OR 0.68, 0.60 to 0.79; P-trend <0.001). No significant associations were observed for the MetS components high blood pressure, dyslipidemia, or elevated fasting glucose. Conclusions: Nut consumption was inversely associated with the prevalence of general obesity, central obesity, MetS, and diabetes in subjects at high cardiovascular risk.

 

A 14-Item Mediterranean diet assessment tool and obesity indexes among high-risk subjects: The PREDIMED Trial.

Martínez-González, M.A., A. García-Arellano, E. Toledo, J. Salas-Salvado´, P. Buil-Cosiales, D. Corella, M.I. Covas, H. Schrőder, F. Arós, E. Gómez-Gracia, M. Fiol, V. Ruiz-Gutiérrez, J. Lapetra, R.M. Lamuela-Raventos, L. Serra-Majem, X. Pintó, M.A. Muñoz, J. Wärnberg, E. Ros, R. Estruch, for the PREDIMED Study Investigators, 2012. A 14-Item Mediterranean diet assessment tool and obesity indexes among high-risk subjects: The PREDIMED Trial. PLoS ONE 7(8): e43134. doi:10.1371/journal.pone.0043134

Objective: Independently of total caloric intake, a better quality of the diet (for example, conformity to the Mediterranean diet) is associated with lower obesity risk. It is unclear whether a brief dietary assessment tool, instead of full-length comprehensive methods, can also capture this association. In addition to reduced costs, a brief tool has the interesting advantage of allowing immediate feedback to participants in interventional studies. Another relevant question is which individual items of such a brief tool are responsible for this association. We examined these associations using a 14-item tool of adherence to the Mediterranean diet as exposure and body mass index, waist circumference and waist-to-height ratio (WHtR) as outcomes. Design: Cross-sectional assessment of all participants in the ‘‘PREvención con DIeta MEDiterránea’’ (PREDIMED) trial. Subjects: 7,447 participants (55–80 years, 57% women) free of cardiovascular disease, but with either type 2 diabetes or ≥3 cardiovascular risk factors. Trained dietitians used both a validated 14-item questionnaire and a full-length validated 137-item food frequency questionnaire to assess dietary habits. Trained nurses measured weight, height and waist circumference. Results: Strong inverse linear associations between the 14-item tool and all adiposity indexes were found. For a two-point increment in the 14-item score, the multivariable-adjusted differences in WHtR were -.0066 (95% confidence interval, –0.0088 to -0.0049) for women and –0.0059 (–0.0079 to –0.0038) for men. The multivariable-adjusted odds ratio for a WHtR>0.6 in participants scoring ≥10 points versus ≤7 points was 0.68 (0.57 to 0.80) for women and 0.66 (0.54 to 0.80) for men. High consumption of nuts and low consumption of sweetened/carbonated beverages presented the strongest inverse associations with abdominal obesity. Conclusions: A brief 14-item tool was able to capture a strong monotonic inverse association between adherence to a good quality dietary pattern (Mediterranean diet) and obesity indexes in a population of adults at high cardiovascular risk.

Health benefits of nut consumption with special reference to body weight control.

Vadivel, V., C.N. Kunyanga, H.K. Biesalski, 2012. Health benefits of nut consumption with special reference to body weight control. Nutrition.  28:1089–1097.

Nuts are an integral part of the Mediterranean food patterns, and their incorporation into the regular diets of human beings is believed to provide many health benefits. The recent recognition of nuts as “heart-healthy” foods by the U.S. Food and Drug Administration has given a major boost to the positive image of nuts. Nut consumption has been associated with several health benefits, such as antioxidant, hypocholesterolemic, cardioprotective, anticancer, anti-inflammatory, and antidiabetic benefits, among other functional properties. However, although nuts possess these many health benefits, their consumption has been hampered by a lack of adequate information regarding those benefits. In addition, because nuts are energy-dense foods with high-fat content, there is a misconception among consumers that increased consumption may lead to unwanted gain in body weight with the risk of developing overweight/obesity. Nonetheless, available epidemiologic studies and short-term controlled feeding trials have supported the theory that the inclusion of nuts in the typical diet does not induce weight gain, despite an expected increase in total caloric intake. To address the misperception about nuts and body weight gain, the present review focuses mainly on the relation between nut consumption and body weight gain, in the context of the many health benefits of nuts.

Health benefits of almonds beyond cholesterol reduction.

Kamil, A., C.-Y. O. Chen, 2012. Health benefits of almonds beyond cholesterol reduction. J. Agric. Food Chem. 60:6694−6702.

Almonds are rich in monounsaturated fat, fiber, α-tocopherol, minerals such as magnesium and copper, and phytonutrients, albeit being energy-dense. The favorable fat composition and fiber contribute to the hypocholesterolemic benefit of almond consumption. By virtue of their unique nutrient composition, almonds are likely to benefit other modifiable cardiovascular and diabetes risks, such as body weight, glucose homeostasis, inflammation, and oxidative stress. This paper briefly reviews the nutrient composition and hypocholesterolemic benefits; the effects of almond consumption on body weight, glucose regulation, oxidative stress, and inflammation, based on the data of clinical trials, will then be discussed. Although more studies are definitely warranted, the emerging evidence supports that almond consumption beneficially influences chronic degenerative disease risk beyond cholesterol reduction, particularly in populations with metabolic syndrome and type 2 diabetes mellitus.

Nuts for diabetes prevention and management.

Kamil, A., C.-Y. O. Chen, 2012. Nuts for diabetes prevention and management. Journal of Food and Drug Analysis. 20(Suppl.1): 323-327.

Type 2 diabetes mellitus is an important preventable disease and a growing public health problem. Epidemiologic and clinical studies suggest that healthy eating, physical activity, and BW control are the main driving forces to reduce diabetes risk. Owing to their low available carbohydrate content, favorable fat and protein profile as well as phytonutrient content, nut consumption has been associated with a reduced risk of development and management of diabetes. Nuts, by virtue of its cardioprotective actions, have also been shown to reduce biomarkers of risk factors for diabetic complications. Although more studies are warranted, the emerging picture is that nut consumption beneficially influences diabetes risk and management beyond blood glucose control.

Salutary effects of adiponectin on colon cancer: in vivo and in vitro studies in mice.

Moon, H.-S., X. Liu, J.M. Nagel, J.P. Chamberland, K.N. Diakopoulos, M.T. Brinkoetter, M. Hatziapostolou, Y. Wu, S.C. Robson, D. Iliopoulos, C.S. Mantzoros, 2012. Salutary effects of adiponectin on colon cancer: in vivo and in vitro studies in mice. Gut. doi:10.1136/gutjnl-2012-302092.

Background: Obesity and a high-fat diet are associated with the risk and progression of colon cancer. Low adiponectin levels may play an important role in the development of colon and other obesity-related malignancies. No previous studies have directly investigated the mechanistic effects of adiponectin on colon cancer in the settings of obesity, a high-fat diet and/or adiponectin deficiency. Objective: To investigate the effects of adiponectin on the growth of colorectal cancer in adiponectin-deficient or wild-type-C57BL/6 mice fed a low-fat or high-fat diet. Results: Mice fed a high-fat-diet gained more weight and had larger tumours than mice fed a low-fat-diet. Adiponectin administration suppressed implanted tumour growth, causing larger central necrotic areas. Adiponectin treatment also suppressed angiogenesis assessed by CD31 staining and VEGFb and VEGFd mRNA expression in tumours obtained from mice fed a high-fat diet and from adiponectin-deficient mice. Adiponectin treatment decreased serum insulin levels in mice on a high-fat-diet and increased serum-interleukin (IL)-12 levels in adiponectin-deficient mice. In vitro, it was found that adiponectin directly controls malignant potential (cell proliferation, adhesion, invasion and colony formation) and regulates metabolic (AMPK/S6), inflammatory (STAT3/VEGF) and cell cycle (p21/p27/p53/cyclins) signalling pathways in both mouse MCA38 and human HT29, HCT116 and LoVo colon cancer cell lines in a LKB1-dependent way. Conclusion: These new mechanistic and pathophysiology studies provide evidence for an important role of adiponectin in colon cancer. The data indicate that adiponectin or analogues might be useful agents in the management or chemoprevention of colon cancer.

A randomized trial of the effects of an almond-enriched, hypocaloric diet in the treatment of obesity.

Foster, G.D., K.L. Shantz, S.S.Vander Veur, T.L. Oliver, M.R. Lent, A. Virus, P.O. Szapary, D.J. Rader, B.S. Zemel, A. Gilden-Tsai, 2012. A randomized trial of the effects of an almond-enriched, hypocaloric diet in the treatment of obesity. Am J Clin Nutr. 96:249–54.

Background: Increased consumption of nuts has been advocated because of their health benefits, but the role of nuts in the treatment of obesity is unclear given their high energy density. Objective: This study was designed to evaluate the effects of a hypocaloric, almond-enriched diet (AED) compared with a hypocaloric nut-free diet (NFD) on body weight and cardiovascular disease risk factors in the context of an 18-mo behavioral weight-management program. Design: Overweight and obese individuals [n = 123; age = 46.8 y, BMI (in kg/m2) = 34.0] were randomly assigned to consume an AED or NFD and instructed in traditional behavioral methods of weight control. Anthropometric and metabolic measurements were made at baseline, 6 mo, and 18 mo. Results: Those in the AED group lost slightly but significantly less weight than did those in the NFD group at 6 mo (25.5 compared with 27.4 kg; P = 0.04), but there were no differences at 18 mo. No significant differences in body composition were found between the groups at 6 or 18 mo. The AED, compared with the NFD, was associated with greater reductions in total cholesterol (P = 0.03), total:HDL cholesterol (P = 0.02), and triglycerides (P = 0.048) at 6 mo, and no differences were observed between the groups at 18 mo. Conclusions: The AED and NFD groups  experienced clinically significant and comparable weight loss at 18 mo. Despite smaller weight loss in the AED group at 6 mo, the AED group experienced greater improvements in lipid profiles.

Pistachio nuts: composition and potential health benefits.

Dreher, M.L., 2012. Pistachio nuts: composition and potential health benefits. Nutrition Reviews. Vol.70(4):234–240.

The pistachio is a nutrient-dense nut with a heart-healthy fatty-acid profile as well as protein, dietary fiber, potassium, magnesium, vitamin K, γ-tocopherol, and a number of phytochemicals. The pistachio’s unique green and purple kernel color is a result of its lutein and anthocyanin content. Among nuts, pistachios contain the highest levels of potassium, γ-tocopherol, vitamin K, phytosterols, and xanthophyll carotenoids. Five published randomized cardiovascular trials have shown that pistachios promote heart-healthy blood lipid profiles. Exploratory clinical studies suggest that pistachios help maintain healthy antioxidant and anti-inflammatory activity, glycemic control, and endothelial function. When consumed in moderation, pistachios may help control body weight because of their satiety and satiation effects and their reduced net metabolizable energy content. One study with subjects in a weight-loss program demonstrated lower body mass index and triglyceride levels in individuals who consumed pistachios compared with those who consumed an isocaloric pretzel snack. Emerging research suggests that the addition of pistachios to high-glycemic meals may lower the overall postprandial glycemic response. This review examines the nutrients and phytochemicals in pistachios as well as the potential health effects of these nuts.

Effects of pistachios on body weight in Chinese subjects with metabolic syndrome.

Wang, X., Z. Li, Y. Liu, X. Lv, W. Yang, 2012. Effects of pistachios on body weight in Chinese subjects with metabolic syndrome. Nutrition Journal. 11:20.

Background: Studies have shown that pistachios can improve blood lipid profiles in subjects with moderate hypercholesterolemia which could reduce the risk of cardiovascular disease. However, there is also a widely perceived view that eating nuts can lead to body weight gain due to their high fat content. Purpose: To investigate the impact of different dosages of pistachios on body weight, blood pressure, blood lipids, blood glucose and insulin in subjects with metabolic syndrome. Methods: Ninety subjects with metabolic syndrome (consistent with 2005 International Diabetes Federation metabolic syndrome standard without diabetes) were enrolled in three endocrinology outpatient clinics in Beijing. All subjects received dietary counseling according to the guidelines of the American Heart Association Step I diet. After a 4 week run-in, subjects were randomized to consume either the recommended daily serving of 42 g pistachios (RSG), a higher daily serving of 70 g pistachio (HSG) or no pistachios (DCG) for 12 weeks. Results: Subjects in all three groups were matched at baseline for BMI: DCG 28.03 ± 4.3; RSG 28.12 ± 3.22; and HSG 28.01 ± 4.51 kg/m2. There were no significant changes in body weight or BMI in any groups during the study nor any change from baseline at any time point in any group. During the entire study, there were no significant differences in waist-to-hip ratio among the groups or any change from baseline in any group (DCG -0.00 ± 0.03, RSG -0.01 ± 0.02 and HSG 0.01 ± 0.04). There were no significant differences detected among groups in triglycerides, fasting glucose and 2 hour postprandial glucose following a 75 gram glucose challenge. Exploratory analyses demonstrated that glucose values 2 h after a 75 gm glucose challenge were significantly lower at week 12 compared with baseline values in the HSG group (-1.13 ± 2.58 mmol/L, p = 0.02), and a similar trend was noted in the RSG group (-0.77 ± 2.07 mmol/L, p = 0.06), while no significant change was seen in the DCG group (-0.15 ± 2.27 mmol/L, p = 0.530). At the end of study, serum triglyceride levels were significantly lower compared with baseline in the RSG group (-0.38 ± 0.79 mmol/L, p = 0.018), but no significant changes were observed in the HSG or DCG groups. Conclusion: Despite concerns that pistachio nut consumption may promote weight gain, the daily ingestion of either 42 g or 70 g of pistachios for 12 weeks did not lead to weight gain or an increase in waist-to-hip ratio in Chinese subjects with metabolic syndrome. In addition, pistachio consumption may improve the risk factor associated with the metabolic syndrome.

Association between a healthy lifestyle and general obesity and abdominal obesity in an elderly population at high cardiovascular risk.

Bulló, M., M. Garcia-Aloy, M.A. Martínez-González, D. Corella, J.D. Fernández-Ballart, M. Fiol, E. Gómez-Gracia, R. Estruch, M. Ortega-Calvo, S. Francisco, G. Flores-Mateo, L. Serra-Majem, X. Pintó,  M.–I. Covas, E. Ros, R. Lamuela-Raventós, J. Salas-Salvadó, 2011. Association between a healthy lifestyle and general obesity and abdominal obesity in an elderly population at high cardiovascular risk. Preventive Medicine. 53:155–161.

Background: Diet, smoking and physical activity are important modifiable lifestyle factors that can influence body weight and fat accumulation. We assessed the relationship between lifestyle and obesity risk in a baseline analysis of the PREDIMED study, a randomized dietary primary prevention trial conducted in Spain. Methods: 7000 subjects at high cardiovascular risk were assessed cross-sectionally. A healthy lifestyle pattern (HLP) was determined using a score including: adherence to the Mediterranean diet, moderate alcohol consumption, expending  ≥ 200 kcal/day in leisure-time physical activity, and non-smoking. Results: Inverse linear trends were observed between the HLP-score and body-mass-index (BMI) or waist circumference (p<0.001). The BMI and waist circumference of participants with a HLP-score = 4 were, respectively, 1.3 kg/m2 (95% CI: 0.9 to 1.7) and 4.3 cm (3.1 to 5.4) lower than those of subjects with an HLP ≤ 1. The odds ratios of general obesity and abdominal obesity for an HLP score of 4 compared to an HPL score ≤ 1were 0.50 (0.42 to 0.60) and 0.51 (0.41 to 0.62), respectively. Conclusion: A combination of four healthy lifestyle behaviors was associated with a lower prevalence of general obesity and abdominal obesity in Mediterranean elderly subjects at high cardiovascular risk.