Archive

Research Area: Consumption

Identifying usual food choice combinations with walnuts: Analysis of a 2005-2015 clinical trial cohort of overweight and obese adults.

Guan, V., E. Neale, L. Tapsell, Y. Probst, 2020. Identifying usual food choice combinations with walnuts: Analysis of a 2005-2015 clinical trial cohort of overweight and obese adults. Front Nutr. 7:149. doi:10.3389/fnut.2020.00149.

Consumption of nuts has been associated with a range of favorable health outcomes. Evidence is now emerging to suggest that walnuts may also play an important role in supporting the consumption of a healthy dietary pattern. However, limited studies have explored how walnuts are eaten at different meal occasions. The aim of this study was to explore the food choices in relation to walnuts at meal occasions as reported by a sample of overweight and obese adult participants of weight loss clinical trials. Baseline usual food intake data were retrospectively pooled from four food-based clinical trials (n=758). A nut-specific food composition database was applied to determine walnut consumption within the food intake data. The Apriori algorithm of association rules was used to identify food choices associated with walnuts at different meal occasions using a nested hierarchical food group classification system. The proportion of participants who were consuming walnuts was 14.5% (n=110). The median walnut intake was 5.14 (IQR 1.10 – 11.45) grams per day. A total of 128 food items containing walnuts were identified for walnut consumers. The proportion of participants who reported consuming unsalted raw walnut was 80.5% (n=103). There were no identified patterns to food choices in relation to walnut at the breakfast, lunch or dinner meal occasions. A total of 24 clusters of food choices related to walnuts were identified at others (meals). By applying a novel food composition database, the present study was able to map the precise combinations of foods associated with walnuts intakes at mealtimes using data mining. This study offers insights into the role of walnuts for the food choices of overweight adults and may support guidance and dietary behavior change strategies.

Metabolic syndrome features and excess weight were inversely associated with nut consumption after 1-year follow-up in the PREDIMED-Plus study.

Julibert, A., M. del Mar Bibiloni, L. Gallardo-Alfaro, M. Abbate, M.Á. Martínez-González, J. Salas-Salvadó, D. Corella, M. Fitó, J.A. Martínez, Á.M. Alonso-Gómez, J. Wärnberg, J. Vioque, D. Romaguera, J. Lopez-Miranda, R. Estruch, F.J. Tinahones, J. Lapetra, L. Serra-Majem, N. Cano-Ibañez, V. Martín-Sánchez, X. Pintó, J.J. Gaforio, P. Matía-Martín, J. Vidal, C. Vázquez, L. Daimiel, E. Ros, C. Sayon-Orea, N. Becerra-Tomás, I.M. Gimenez-Alba, O. Castañer, I. Abete, L. Tojal-Sierra, J. Pérez-López, L. Notario-Barandiaran, A. Colom, A. Garcia-Rios, S. Castro-Barquero, R. Bernal, J.M. Santos-Lozano, C.I. Fernández-Lázaro, P. Hernández-Alonso, C. Saiz, M.D. Zomeño, M.A. Zulet, M.C. Belló-Mora, J. Basterra-Gortari, S. Canudas, A. Goday, J.A. Tur, PREDIMED-PLUS investigators, 2020. Metabolic syndrome features and excess weight were inversely associated with nut consumption after 1-year follow-up in the PREDIMED-Plus study. J Nutr. 00:1–10.

Background: High nut consumption has been previously associated with decreased prevalence of metabolic syndrome (MetS) regardless of race and dietary patterns. Objectives: The aim of this study was to assess whether changes in nut consumption over a 1-y follow-up are associated with changes in features of MetS in a middle-aged and older Spanish population at high cardiovascular disease risk. Methods: This prospective 1-y follow-up cohort study, conducted in the framework of the PREvención con DIeta MEDiterránea (PREDIMED)-Plus randomized trial, included 5800 men and women (55-75 y old) with overweight/obesity [BMI (in kg/m2) ≥27 and <40] and MetS. Nut consumption (almonds, pistachios, walnuts, and other nuts) was assessed using data from a validated FFQ. The primary outcome was the change from baseline to 1 y in features of MetS [waist circumference (WC), glycemia, HDL cholesterol, triglyceride (TG), and systolic and diastolic blood pressure] and excess weight (body weight and BMI) according to tertiles of change in nut consumption. Secondary outcomes included changes in dietary and lifestyle characteristics. A generalized linear model was used to compare 1-y changes in features of MetS, weight, dietary intakes, and lifestyle characteristics across tertiles of change in nut consumption. Results: As nut consumption increased, between each tertile there was a significant decrease in WC, TG, systolic blood pressure, weight, and BMI (P < 0.05), and a significant increase in HDL cholesterol (only in women, P = 0.044). The interaction effect between time and group was significant for total energy intake (P < 0.001), adherence to the Mediterranean diet (MedDiet) (P < 0.001), and nut consumption (P < 0.001). Across tertiles of increasing nut consumption there was a significant increase in extra virgin olive oil intake and adherence to the MedDiet; change in energy intake, on the other hand, was inversely related to consumption of nuts. Conclusions: Features of MetS and excess weight were inversely associated with nut consumption after a 1-y follow-up in the PREDIMED-Plus study cohort. This trial was registered at isrctn.com as ISRCTN89898870.

Barriers and facilitators to nut consumption: A narrative review.

Neale, E.P., G. Tran, R.C. Brown, 2020. Barriers and facilitators to nut consumption: A narrative review. Int. J. Environ. Res. Public Health. 17, 9127; doi:10.3390/ijerph17239127

Habitual nut intake is associated with a range of health benefits; however, population consumption data suggests that most individuals do not meet current recommendations for nut intake. The literature has highlighted a range of barriers and facilitators to nut consumption, which should be considered when designing strategies to promote nut intake. Common barriers include confusion regarding the effects of nut consumption on body weight, perceptions that nuts are high in fat, or too expensive, and challenges due to dentition issues or nut allergies. Conversely, demographic characteristics such as higher education and income level, and a healthier lifestyle overall, are associated with higher nut intakes. Health professionals appear to play an important role in promoting nut intake; however, research suggests that knowledge of the benefits of nut consumption could be improved in many health professions. Future strategies to increase nut intake to meet public health recommendations must clarify misconceptions of the specific benefits of nut consumption, specifically targeting sectors of the population known to have lower nut consumption, and educate health professionals to promote nut intake. In addition, given the relatively small body of evidence exploring barriers and facilitators to nut consumption, further research exploring these factors is justified.

The consumption of nuts is associated with better dietary and lifestyle patterns in polish adults: Results of WOBASZ and WOBASZ II Surveys.

Witkowska, A.M., A. Wa´skiewicz, M.E. Zujko, D. Szczes´niewska, W. S´migielski, U. Stepaniak, A. Paja, W. Drygas, 2019. The consumption of nuts is associated with better dietary and lifestyle patterns in polish adults: Results of WOBASZ and WOBASZ II Surveys. Nutrients. 11, 1410; doi:10.3390/nu11061410.

In recent years, the concept of the health benefits of synergistic dietary patterns as opposed to individual foods or food constituents has been developed. The aim of this study was to determine whether nut consumption is associated with healthier nutrition and lifestyle. The research was based on complete data obtained during two Polish National Multi-Centre Health Examination Surveys—WOBASZ (2003–2005) and WOBASZ II (2013–2014). Of the 12,946 participants who completed dietary assessments, 299 subjects reported consuming any quantity of whole nuts. A control group of 1184 non-nut consumers from both surveys was randomly selected for the study, with age, gender, study (WOBASZ, WOBASZ II), educational level, and season-related interactions taken into account. In this study, nut consumption was associated with favorable food and lifestyle choices, excluding smoking. Better dietary quality consisted of having a higher Healthy Diet Indicator score, an increased intake of polyphenols and antioxidants, lower intake of red meat, but higher of poultry and fruit, more frequent consumption of antiatherogenic food products, and less frequent consumption of processed meats. There was also greater interest in special diets, such as weight-loss diet. In addition, nut eaters were more physically active in their leisure time. While limited by 24-h recall of nut intake and possible misclassification of nut/non-nut consumer status, this research supports the synergistic health-promoting attitudes of those who were classified as nut consumers.

Trends in dietary carbohydrate, protein, and fat intake and diet quality among US adults, 1999-2016.

Shan, Z., C.D. Rehm, G. Rogers, M. Ruan, D.D.Wang, F.B. Hu, D. Mozaffarian, F.F. Zhang, S.N. Bhupathiraju, 2019. Trends in dietary carbohydrate, protein, and fat intake and diet quality among US adults, 1999-2016. JAMA. 322(12):1178-1187.

IMPORTANCE: Changes in the economy, nutrition policies, and food processing methods can affect dietary macronutrient intake and diet quality. It is essential to evaluate trends in dietary intake, food sources, and diet quality to inform policy makers. OBJECTIVE: To investigate trends in dietary macronutrient intake, food sources, and diet quality among US adults. DESIGN, SETTING, AND PARTICIPANTS: Serial cross-sectional analysis of the US nationally representative 24-hour dietary recall data from 9 National Health and Nutrition Examination Survey cycles (1999-2016) among adults aged 20 years or older. EXPOSURE: Survey cycle. MAIN OUTCOMES AND MEASURES: Dietary intake of macronutrients and their subtypes, food sources, and the Healthy Eating Index 2015 (range, 0-100; higher scores indicate better diet quality; a minimal clinically important difference has not been defined). RESULTS: There were 43,996 respondents (weighted mean age, 46.9 years; 51.9% women). From 1999 to 2016, the estimated energy from total carbohydrates declined from 52.5% to 50.5% (difference, −2.02%; 95% CI, −2.41% to −1.63%), whereas that of total protein and total fat increased from 15.5%to 16.4% (difference, 0.82%; 95% CI, 0.67%-0.97%) and from 32.0%to 33.2%(difference, 1.20%; 95% CI, 0.84%-1.55%), respectively (all P < .001 for trend). Estimated energy from low-quality carbohydrates decreased by 3.25% (95% CI, 2.74%-3.75%; P < .001 for trend) from 45.1%to 41.8%. Increases were observed in estimated energy from high-quality carbohydrates (by 1.23% [95% CI, 0.84%-1.61%] from 7.42% to 8.65%), plant protein (by 0.38% [95%CI, 0.28%-0.49%] from 5.38%to 5.76%), saturated fatty acids (by 0.36% [95% CI, 0.20%-0.51%] from 11.5% to 11.9%), and polyunsaturated fatty acids (by 0.65% [95% CI, 0.56%-0.74%] from 7.58%to 8.23%) (all P < .001 for trend). The estimated overall Healthy Eating Index 2015 increased from 55.7 to 57.7 (difference, 2.01; 95% CI, 0.86-3.16; P < .001 for trend). Trends in high- and low-quality carbohydrates primarily reflected higher estimated energy from whole grains (0.65%) and reduced estimated energy from added sugars (−2.00%), respectively. Trends in plant protein were predominantly due to higher estimated intake of whole grains (0.12%) and nuts (0.09%). CONCLUSIONS AND RELEVANCE: From 1999 to 2016, US adults experienced a significant decrease in percentage of energy intake from low-quality carbohydrates and significant increases in percentage of energy intake from high-quality carbohydrates, plant protein, and polyunsaturated fat. Despite improvements in macronutrient composition and diet quality, continued high intake of low-quality carbohydrates and saturated fat remained.

Health benefits of nut consumption in middle‐aged and elderly population.

Rusu, M.E., A. Mocan, I.C.F.R. Ferreira, D.-S. Popa, 2019. Health benefits of nut consumption in middle‐aged and elderly population. Antioxidants. 8, 302; doi:10.3390/antiox8080302.

Aging is considered the major risk factor for most chronic disorders. Oxidative stress and chronic inflammation are two major contributors for cellular senescence, downregulation of stress response pathways with a decrease of protective cellular activity and accumulation of cellular damage, leading in time to age‐related diseases. This review investigated the most recent clinical trials and cohort studies published in the last ten years, which presented the influence of tree nut and peanut antioxidant diets in preventing or delaying age‐related diseases in middle‐aged and elderly subjects (≥55 years old). Tree nut and peanut ingestion has the possibility to influence blood lipid count, biochemical and anthropometric parameters, endothelial function and inflammatory biomarkers, thereby positively affecting cardiometabolic morbidity and mortality, cancers, and cognitive disorders, mainly through the nuts’ healthy lipid profile and antioxidant and anti-inflammatory mechanisms of actions. Clinical evidence and scientific findings demonstrate the importance of diets characterized by a high intake of nuts and emphasize their potential in preventing age‐related diseases, validating the addition of tree nuts and peanuts in the diet of older adults. Therefore, increased consumption of bioactive antioxidant compounds from nuts clearly impacts many risk factors related to aging and can extend health span and lifespan.

Mechanisms underlying the cardiometabolic protective effect of walnut consumption in obese subjects: a cross‐over, randomized, double‐blinded, controlled inpatient physiology study.

Tuccinardi, D., O.M. Farr, J. Upadhyay, S.M. Oussaada, M.I. Klapa, M. Candela, S. Rampelli, S. Lehoux, I. Lázaro, A. Sala‐Vila, P. Brigidi, R.D. Cummings, C.S. Mantzoros, 2019. Mechanisms underlying the cardiometabolic protective effect of walnut consumption in obese subjects: a cross‐over, randomized, double‐blinded, controlled inpatient physiology study. Diabetes Obes Metab. 21(9):2086-2095.

Aims: To assess the effects of walnuts on cardiometabolic outcomes in obese subjects and to explore underlying mechanisms using novel methods including metabolomic, lipidomic, glycomic, and microbiome analysis integrated with lipid particle fractionation, appetite-regulating hormones and hemodynamic measurements. Materials and Methods: 10 obese subjects were enrolled in this cross-over, randomized, double-blind, placebo-controlled clinical trial. Patients participated in two 5-day inpatient stays during which they consumed a smoothie containing 48g walnuts or a macronutrient-matched placebo smoothie without nuts, with a one-month washout period between the two visits. Results: Walnut consumption improved aspects of the lipid profile, i.e. reduced fasting small and dense LDL particles (p<.02) and increased postprandial large HDL particles (p<.01). Lipoprotein Insulin Resistance Score, glucose and insulin AUC decreased significantly after walnut consumption (p<.01, p<.02, p<.04, respectively). Consuming walnuts significantly increased 10 N-glycans, with 8 of them carrying a fucose core. Lipidomic analysis showed a robust reduction in harmful ceramides, hexosylceramides and sphingomyelins, which have been shown to mediate effects on cardiometabolic risk. Peptide YY AUC significantly increased after walnut consumption (p<.03). No major significant changes in hemodynamic, metabolomic analysis or in host health-promoting bacteria such as Faecalibacterium were found. Conclusions: These data provide a more comprehensive mechanistic perspective of the effect of dietary walnut consumption on cardiometabolic parameters. Lipidomic and lipid nuclear magnetic resonance spectroscopy analysis showed an early but significant reduction in ceramides and other atherogenic lipids with walnut consumption that may explain the longer-term benefits of walnuts on insulin resistance, cardiovascular risk and mortality.

The resulting variation in nutrient intake with the inclusion of walnuts in the diets of adults at risk for type 2 diabetes: A randomized, controlled, crossover trial.

Njike, V.Y., V.C. Costales, P. Petraro, A. Annam, N. Yarandi, D.L. Katz, 2019. The resulting variation in nutrient intake with the inclusion of walnuts in the diets of adults at risk for type 2 diabetes: A randomized, controlled, crossover trial. Am J Health Promot. 33(3):430-438.

Purpose: We previously demonstrated that including walnuts in the diets of adults at risk for type 2 diabetes mellitus (T2DM) led to improved overall diet quality. This report examines the specific changes in their nutrient intake. Design: This was a randomized, controlled, modified Latin square parallel design trial with 2 treatment arms. Participants were randomized to walnut intake with, or without, dietary advice to regulate caloric intake. Within each treatment arm, they were further randomized to one of 2 sequence permutations (walnut-included/walnut-excluded or walnut-excluded/walnut-included diet), with a 3-month washout between treatment phases. Setting: Community hospital in Lower Naugatuck Valley in Connecticut. Participants: Cohort of 112 participants (31 men and 81 women) at risk for T2DM. Intervention: Participants included 56 g (366 kcal) of walnuts in their daily diets for 6 months. Measures: Nutrient intake was assessed using web-based Automated Self-Administered 24-Hour Dietary Assessment. Analysis: Data were analyzed using generalized linear models. Results: Walnut inclusion led to increased intake of total fat, calcium, magnesium, thiamin, total saturated fatty acids, and monounsaturated and polyunsaturated fatty acids (379.0 ± 90.3 g vs -136.5 ± 92.7 g, P < .01; 230.7 ± 114.2 mg vs -95.2 ± 117.4 mg, P = .05; 111.0 ± 33.9 mg vs -32.3 ± 34.9 mg, P < .01; 0.28 ± 0.2 mg vs -0.47 ± 0.2 mg, P = .02; 8.6 ± 3.4 g vs -1.1 ± 3.5 g, P =.05; 6.3 ± 3.9 g vs -6.3 ± 4.0 g, P = .03; and 25.4 ± 4.0 vs -6.6 ± 4.2 g, P < .01, respectively). Vitamin C intake decreased (-65.3 ± 55.3 mg vs 98.9 ± 56.8 mg, P = .04). Protein intake increased from baseline with the inclusion of walnuts (20.0 ± 8.8 g, P < .05). Walnut inclusion led to an increase in total calories consumed when caloric intake is not regulated. Conclusion: Including walnuts in the diets of these adults led to increased dietary intake of some nutrients associated with lower risk of developing T2DM and other cardiometabolic risk factors.

Dietary walnut altered gene expressions related to tumor growth, survival, and metastasis in breast cancer patients: a pilot clinical trial.

Hardman, W.E., D.A. Primerano, M.T. Legenza, J. Morgan, J. Fan, J. Denvir, 2019. Dietary walnut altered gene expressions related to tumor growth, survival, and metastasis in breast cancer patients: a pilot clinical trial. Nutr Res. 66:82-94.

Consumption of walnuts has slowed breast cancer growth and/or reduced the risk of mammary cancer in mice. The benefit against cancer was associated with altered expression of genes for cancer growth and survival. We hypothesized that walnut consumption would alter gene expression in pathologically confirmed breast cancers of women in a direction that would be expected to decrease breast cancer growth and survival, as was seen in mice. The study was a non-placebo, two-arm, clinical trial. Women with breast lumps large enough for research and pathology biopsies were recruited and randomized to walnut consuming or control groups. Immediately after biopsy collection, women in the walnut group began to consume two ounces of walnuts per day until follow-up surgery. Pathological studies confirmed that lumps were breast cancer in all women who remained in the trial. At surgery, about two weeks after biopsy, additional specimens were taken from the breast cancers. Changes in gene expression in the surgical specimen compared to baseline were determined in each individual woman in walnut-consuming (n=5) and control (n=5) groups. RNA-Seq expression profiling revealed that expression of 456 identified genes was significantly changed in the tumor due to walnut consumption. Ingenuity Pathway Analysis showed activation of pathways that promote apoptosis and cell adhesion, and inhibition of pathways that promote cell proliferation and migration. These results support the hypothesis that, in humans, walnut consumption could suppress growth and survival of breast cancers.

The Alternative Healthy Eating Index and physical function impairment in men.

Hagan, K.A., F. Grodstein, 2019. The Alternative Healthy Eating Index and physical function impairment in men. J Nutr Health Aging. 23(5):459-465.

Objectives: Physical function is increasingly recognized as integral to healthy aging, in particular as a core component of mobility and independent living in older adults. Thus, it is important to identify strategies for the prevention of physical function decline. Design: Longitudinal cohort study. Setting and Participants: A total of 12,658 men from the Health Professionals Follow-Up Study were followed from 2008–2012. Measurements: We examined the association between the Alternative Healthy Eating Index-2010 (AHEI), a measure of diet quality combining 11 dietary components (vegetables, fruits, nuts and legumes, red and processed meats, sugar-sweetened beverages and fruit juices, alcohol, whole grains, omega-3 fatty acids, polyunsaturated fatty acids, trans fatty acids, sodium), and impairment in physical function, as measured by the SF-36. Multivariable logistic regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (CI) of impairment in physical function. Results: In the multivariable-adjusted model, each 10-point increase in total AHEI score was associated with a 10% lower odds of impairment in physical function (OR=0.90, 95% CI: 0.86,0.95), and in the categorical analysis, men with AHEI scores in the top quintile had a 26% lower odds (OR=0.74, 95% CI:0.63,0.86) compared with men in the bottom quintile. For individual AHEI components, higher intake of vegetables (p-trend=0.01), nuts and legumes (p-trend<0.01), polyunsaturated fatty acids (p-trend<0.01) and lower intake of red and processed meats (p-trend=0.03) and sugar-sweetened beverages (p-trend=0.01) were significantly associated with lower odds of physical impairment. For specific foods, higher consumption of lettuce, broccoli, blueberries, peanuts, walnuts and other nuts were associated with lower odds of impairment. Conclusions: In this large cohort of older men, better overall diet quality was significantly associated with a lower odds of impairment in physical function. Given the value of physical function to healthy aging and quality of life, this may represent a particularly compelling public health rationale for older men to improve their diet.