Claire Fyfe

Sustainable diets for the future: can we contribute to reducing greenhouse gas emissions by eating a healthy diet?

BACKGROUND Food systems account for 18-20% of UK annual greenhouse gas emissions (GHGEs). Recommendations for improving food choices to reduce GHGEs must be balanced against dietary requirements for health. OBJECTIVE We assessed whether a reduction in GHGEs can be achieved while meeting dietary requirements for health. DESIGN A database was created that linked nutrient composition and GHGE data for 82 food groups. Linear programming was used iteratively to produce a diet that met the dietary requirements of an adult woman (19-50 y old) while minimizing GHGEs. Acceptability constraints were added to the model to include foods commonly consumed in the United Kingdom in sensible quantities. A sample menu was created to ensure that the quantities and types of food generated from the model could be combined into a realistic 7-d diet. Reductions in GHGEs of the diets were set against 1990 emission values. RESULTS The first model, without any acceptability constraints, produced a 90% reduction in GHGEs but included only 7 food items, all in unrealistic quantities. The addition of acceptability constraints gave a more realistic diet with 52 foods but reduced GHGEs by a lesser amount of 36%. This diet included meat products but in smaller amounts than in the current diet. The retail cost of the diet was comparable to the average UK expenditure on food. CONCLUSION A sustainable diet that meets dietary requirements for health with lower GHGEs can be achieved without eliminating meat or dairy products or increasing the cost to the consumer.

Effect of a conjugated linoleic acid and omega-3 fatty acid mixture on body composition and adiponectin

This study aimed to determine the effect of supplementation with conjugated linoleic acids (CLAs) plus n‐3 long‐chain polyunsaturated fatty acids (n‐3 LC‐PUFAs) on body composition, adiposity, and hormone levels in young and older, lean and obese men. Young (31.4 ± 3.9 years) lean (BMI, 23.6 ± 1.5 kg/m2; n = 13) and obese (BMI, 32.4 ± 1.9 kg/m2; n = 12) and older (56.5 ± 4.6 years) lean (BMI, 23.6 ± 1.5 kg/m2; n = 20) and obese (BMI, 32.0 ± 1.6 kg/m2; n = 14) men participated in a double‐blind placebo‐controlled, randomized crossover study. Subjects received either 6 g/day control fat or 3 g/day CLA (50:50 cis‐9, trans‐11:trans‐10, cis‐12) and 3 g/day n‐3 LC‐PUFA for 12 weeks with a 12‐week wash‐out period between crossovers. Body composition was assessed by dual‐energy X‐ray absorptiometry. Fasting adiponectin, leptin, glucose, and insulin concentrations were measured and insulin resistance estimated by homeostasis model assessment for insulin resistance (HOMA‐IR). In the younger obese subjects, CLA plus n‐3 LC‐PUFA supplementation compared with control fat did not result in increased abdominal fat and raised both fat‐free mass (2.4%) and adiponectin levels (12%). CLA plus n‐3 LC‐PUFA showed no significant effects on HOMA‐IR in any group but did increase fasting glucose in older obese subjects. In summary, supplementation with CLA plus n‐3 LC‐PUFA prevents increased abdominal fat mass and raises fat‐free mass and adiponectin levels in younger obese individuals without deleteriously affecting insulin sensitivity, whereas these parameters in young and older lean and older obese individuals were unaffected, apart from increased fasting glucose in older obese men.

Appetite control and biomarkers of satiety with vegetarian (soy) and meat-based high-protein diets for weight loss in obese men: a randomized crossover trial

BACKGROUND There is limited evidence with regard to the effect of different sources of protein on appetite during weight loss. Vegetarian and meat-based high-protein diets may have contrasting effects on appetite and biomarkers of protein-induced satiety. OBJECTIVE The aim was to assess appetite response to meat or vegetarian high-protein weight-loss (HPWL) diets in obese men to monitor plasma amino acid profile and gut peptide response as potential satiety biomarkers. DESIGN Twenty obese [body mass index (in kg/m²): 34.8] men participated in a dietary intervention study. After 3 d of a maintenance diet, they were provided in a crossover design with either a vegetarian HPWL (Soy-HPWL) or a meat-based HPWL (Meat-HPWL) diet for 2 wk. Both diets comprised 30% protein, 30% fat, and 40% carbohydrate, provided to measured resting metabolic rate. Body weight and the motivation to eat were measured daily. Plasma satiety biomarkers were collected during a test-meal challenge (5 h) at the end of each diet period. RESULTS Over the 2 wk, subjects lost, on average, 2.41 and 2.27 kg with consumption of the Soy- and Meat-HPWL diets, respectively [P = 0.352; SE of the difference (SED): 0.1]. ANOVA confirmed that subjectively rated hunger (P = 0.569; SED: 3.8), fullness (P = 0.404; SED: 4.1), desire to eat (P = 0.356; SED: 3.7), preservation of lean body mass (P = 0.334; SED: 0.2), and loss of percentage fat mass (P = 0.179; SED: 0.2) did not differ between the 2 HPWL diets. There were differences in absolute concentrations of ghrelin and peptide YY between the 2 HPWL diets, although the response as net area under the curve was not different. CONCLUSIONS Appetite control and weight loss were similar for both HPWL diets. Gut hormone profile was similar between the diets, which suggests that vegetarian diets can be as effective as meat-based diets for appetite control during weight loss.

Effects of a high-protein, low-carbohydrate v . high-protein, moderate-carbohydrate weight-loss diet on antioxidant status, endothelial markers and plasma indices of the cardiometabolic profile

There are concerns that weight-loss (WL) diets based on very low carbohydrate (LC) intake have a negative impact on antioxidant status and biomarkers of cardiovascular and metabolic health. Obese men (n 16) participated in a randomised, cross-over design diet trial, with food provided daily, at approximately 8.3 MJ/d (approximately 70 % of energy maintenance requirements). They were provided with two high-protein diets (30 % of energy), each for a 4-week period, involving a LC (4 % carbohydrate) and a moderate carbohydrate (MC, 35 % carbohydrate) content. Body weight was measured daily, and weekly blood samples were collected. On average, subjects lost 6.75 and 4.32 kg of weight on the LC and MC diets, respectively (P < 0.001, SED 0.350). Although the LC and MC diets were associated with a small reduction in plasma concentrations of retinol, vitamin E (α-tocopherol) and β-cryptoxanthin (P < 0.005), these were still above the values indicative of deficiency. Interestingly, plasma vitamin C concentrations increased on consumption of the LC diet (P < 0.05). Plasma markers of insulin resistance (P < 0.001), lipaemia and inflammation (P < 0.05, TNF-α and IL-10) improved similarly on both diets. There was no change in other cardiovascular markers with WL. The present data suggest that a LC WL diet does not impair plasma indices of cardiometabolic health, at least within 4 weeks, in otherwise healthy obese subjects. In general, improvements in metabolic health associated with WL were similar between the LC and MC diets. Antioxidant supplements may be warranted if LC WL diets are consumed for a prolonged period.

Effects of conjugated linoleic acid plus n -3 polyunsaturated fatty acids on insulin secretion and estimated insulin sensitivity in men

Background/Objectives:Dietary addition of either conjugated linoleic acid (CLA) or n-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFAs) has been shown to alter adiposity and circulating lipids, risk markers of cardiovascular diseases. However, CLA may decrease insulin sensitivity, an effect that may be reversed by n-3 LC-PUFA. Thus, the potential of CLA plus n-3 LC-PUFA to affect insulin secretion and sensitivity in non-diabetic young and old, lean and obese subjects was tested.Subjects/Methods:CLA (3 g daily) plus n-3 LC-PUFA (3 g daily) or control oil (6 g daily) was given to lean (n=12; BMI 20–26 kg/m2) or obese (n=10; BMI 29–35 kg/m2) young (20–37 years old) or lean (n=16) or obese (n=11) older men (50–65 years) for 12 weeks. The study had a double-blind, placebo-controlled randomized crossover design, and primary end points were insulin secretion and sensitivity during a standardized meal test, evaluated by modeling glucose, insulin and C-peptide data.Results:The combination was well tolerated. There was no significant difference in fasting levels of glucose, insulin or C-peptide after CLA/n-3 LC-PUFA treatment compared with control oil. Neither insulin secretion nor estimated sensitivity was affected by CLA/n-3 LC-PUFA in lean or obese young subjects or in older lean subjects. However, in older obese subjects, estimated insulin sensitivity was reduced with CLA/n-3 LC-PUFA compared with control (P=0.024).Conclusions:The results do not support beneficial effects of CLA/n-3 LC-PUFA for β-cell dysfunction or insulin resistance in humans but suggest that insulin sensitivity in older obese subjects is reduced.

A randomized crossover study to assess the effect of an oat-rich diet on glycaemic control, plasma lipids and postprandial glycaemia, inflammation and oxidative stress in Type 2 diabetes

In the UK, lifestyle intervention is first‐line management in Type 2 diabetes. It is unclear what type of diet is most efficacious for improving glycaemic control. This study investigated the effects of an oat‐enriched diet on glycaemic control, postprandial glycaemia, inflammation and oxidative stress compared with standard dietary advice.

Diet Composition Is Associated with Endogenous Formation of N-Nitroso Compounds in Obese Men

Endogenous formation of carcinogenic N-nitroso compounds (NOC) occurs in the human gut. Red meat is considered the most important dietary component linked to NOC formation, although nitrate and vitamin C (VitC) also contribute. We previously showed that high-protein weight-loss diets increased fecal NOC and this was enhanced by simultaneous carbohydrate restriction. Although previous studies have focused on the effect of either 1 or 2 dietary components on endogenous NOC formation, no study to date has investigated the combined contribution of various dietary components. The current study therefore assessed the joint impact of several known dietary contributors to the endogenous formation of NOC in obese men. It also aimed to identify further novel contributors and investigate their role in explaining shifts in endogenous formation of NOC. Three dietary trials were conducted in obese men consuming body weight maintenance or weight-loss diets, with NOC measured in fecal samples. Consumption of meat-based weight-loss diets increased (P < 0.001) fecal NOC. Red meat intake was positively correlated with the fecal log NOC concentration (r = 0.60; P < 0.001). Dietary carbohydrate and sugar were negatively correlated with the fecal log NOC concentration (r = -0.66 for both; P < 0.001). Multiple regression analysis identified several dietary components that drive endogenous NOC formation, namely, red meat, nitrate, VitC, total energy, and nonstarch polysaccharides. We present a regression model that predicts endogenous NOC formation in obese men based on their dietary intakes. This model could improve the estimation of endogenous NOC formation, currently used in epidemiological studies into diet and cancer.

Responses in gut hormones and hunger to diets with either high protein or a mixture of protein plus free amino acids supplied under weight-loss conditions

High-protein diets are an effective means for weight loss (WL), but the mechanisms are unclear. One hypothesis relates to the release of gut hormones by either protein or amino acids (AA). The present study involved overweight and obese male volunteers (n 18, mean BMI 36·8 kg/m2) who consumed a maintenance diet for 7 d followed by fully randomised 10 d treatments with three iso-energetic WL diets, i.e. with either normal protein (NP, 15% of energy) or high protein (HP, 30%) or with a combination of protein and free AA, each 15% of energy (NPAA). Psychometric ratings of appetite were recorded hourly. On day 10, plasma samples were taken at 30 min intervals over two consecutive 5 h periods (covering post-breakfast and post-lunch) and analysed for AA, glucose and hormones (insulin, total glucose-dependent insulinotropic peptide, active ghrelin and total peptide YY (PYY)) plus leucine kinetics (first 5 h only). Composite hunger was 16% lower for the HP diet than for the NP diet (P<0·01) in the 5 h period after both meals. Plasma essential AA concentrations were greatest within 60 min of each meal for the NPAA diet, but remained elevated for 3-5 h after the HP diet. The three WL diets showed no difference for either fasting concentrations or the postprandial net incremental AUC (net AUCi) for insulin, ghrelin or PYY. No strong correlations were observed between composite hunger scores and net AUCi for either AA or gut peptides. Regulation of hunger may involve subtle interactions, and a range of signals may need to be integrated to produce the overall response.

Evaluating energy intake measurement in free-living subjects: when to record and for how long?

OBJECTIVE To nutritionally analyse mean energy intake (EI) from different 3 d intervals within a 7 d recording period and to evaluate the seasonal effect on energy and nutrient intake. DESIGN Cross-sectional study of dietary intake collected with 7 d food diaries. SETTING Aberdeen, north-east Scotland, UK, between 2002 and 2004. SUBJECTS Participants from two long-term trials were pooled. These trials, investigating genetic and environmental influences on body weight, were the Genotyping And Phenotyping (GAP) study and a cohort observational study, Rowett Assessment of Childhood Appetite and metaboLism (RASCAL). There were 260 Caucasian adults, BMI range 16.7-49.3 kg/m2, age range 21-64 years. RESULTS Mean EI for Wednesday, Friday and Saturday had the closest approximation to the 7 d mean (0.1 % overestimate). A gender x season interaction (P = 0.019) with a different intake pattern for females and males was observed. For females, lower mean (se) EI was recorded in summer (8117 (610) kJ) and autumn (7941 (699) kJ) compared with spring (8929 (979) kJ) and winter (8132 (1041) kJ). For males, higher mean (se) EI was recorded in summer (10 420 (736) kJ) and autumn (10 490 (1041) kJ) compared with spring (9319 (1441) kJ) and winter (9103 (1505) kJ). CONCLUSIONS The study results indicate that 3 d weighed intakes recorded from Wednesday, Friday and Saturday are most representative of 7 d habitual intake in free-living subjects. They also indicate that seasonality has a limited effect on EI and no effect on macronutrient intake.

Food Intake and Dietary Glycaemic Index in Free-Living Adults with and without Type 2 Diabetes Mellitus

A recent Cochrane review concluded that low glycaemic index (GI) diets are beneficial in glycaemic control for patients with type 2 diabetes mellitus (T2DM). There are limited UK data regarding the dietary GI in free-living adults with and without T2DM. We measured the energy and macronutrient intake and the dietary GI in a group (n = 19) of individuals with diet controlled T2DM and a group (n = 19) without diabetes, matched for age, BMI and gender. Subjects completed a three-day weighed dietary record. Patients with T2DM consumed more daily portions of wholegrains (2.3 vs. 1.1, P = 0.003), more dietary fibre (32.1 vs. 20.9 g, P < 0.001) and had a lower diet GI (53.5 vs. 57.7, P = 0.009) than subjects without T2DM. Both groups had elevated fat and salt intake and low fruit and vegetable intake, relative to current UK recommendations. Conclusions: Patients with T2DM may already consume a lower GI diet than the general population but further efforts are needed to reduce dietary GI and achieve other nutrient targets.