Hassan Vatanparast

Impact of the dietary fatty acid intake on C-reactive protein levels in US adults

Abstract Growing evidence suggests that the effects of diet on cardiovascular disease (CVD) occur through mechanisms involving subclinical inflammation. We assessed whether reported dietary fatty acid intake correlates with a serum high-sensitivity C-reactive protein (hs-CRP) concentration in a population-based sample of US men and women. In this cross-sectional analysis, participants were selected from the US National Health and Nutrition Examination Survey (NHANES) and restricted to those with available data on dietary intake, biochemical and anthropometric measurements from 2001 to 2010. All statistical analyses accounted for the survey design and sample weights by using SPSS Complex Samples v22.0 (IBM Corp, Armonk, NY). Of the 17,689 participants analyzed, 8607 (48.3%) were men. The mean age was 45.8 years in the overall sample, 44.9 years in men, and 46.5 years in women (P = 0.047). The age-, race-, and sex-adjusted mean dietary intakes of total polyunsaturated fatty acids (PUFAs), PUFAs 18:2 (octadecadienoic), and PUFAs 18:3 (octadecatrienoic) monotonically decreased across hs-CRP quartiles (P < 0.001), whereas dietary cholesterol increased across hs-CRP quartiles (P < 0.001) This study provides further evidence of an association between fatty acid intake and subclinical inflammation markers. hs-CRP concentrations are likely modulated by dietary fatty acid intake. However, the causality of this association needs to be demonstrated in clinical trials.

Impact of probiotic administration on serum C-reactive protein concentrations: systematic review and meta-analysis of randomized control trials

We conducted this systematic review and meta-analysis of prospective studies to determine the effect of probiotic administration on serum C-reactive protein (CRP) concentrations. We searched PubMed-Medline, Web of Science, the Cochrane, and Google Scholar databases (until May 2016) to identify prospective studies evaluating the impact of probiotic administration on CRP. We used a random effects models and generic inverse variance methods to synthesize quantitative data, followed by a leave-one-out method for sensitivity analysis. The systematic review registration number was: CRD42016039457. From a total of 425 entries identified via searches, 20 studies were included in the final analysis. The meta-analysis indicated a significant reduction in serum CRP following probiotic administration with a weighted mean difference (WMD) of −1.35 mg/L, (95% confidence interval (CI) −2.15 to −0.55, I2 65.1%). The WMDs for interleukin 10 (IL10) was −1.65 pg/dL, (95% CI −3.45 to 0.14, I2 3.1%), and −0.45 pg/mL, (95% CI −1.38 to 0.48, I2 10.2%) for tumor necrosis factor alpha (TNF-α). These findings were robust in sensitivity analyses. This meta-analysis suggests that probiotic administration may significantly reduce serum CRP while having no significant effect on serum IL10 and TNF-α.

Vitamin D Deficiency and Its Predictors in a Country with Thirteen Months of Sunshine: The Case of School Children in Central Ethiopia

Studies examining vitamin D status among children living in sunny climates indicated that children did not receive adequate vitamin D, however, this has not been looked at among children living in Ethiopia. In this study, we determined vitamin D deficiency and its predictors among school children aged 11–18 years, examining circulating 25-hydroxy vitamin D [25(OH)D]. The school-based cross-sectional study was conducted in schools in Adama Town (n = 89) and in rural Adama (n = 85) for a total sample of 174. Students were randomly selected using multi-stage stratified sampling method from both settings. Socioeconomic status of parents and demographic, anthropometric, sun exposure status and blood 25(OH)D levels were obtained. Vitamin D deficiency, defined as circulating levels of 25(OH)D <50 nmol/L, was found in 42% of the entire study participants. Prevalence of deficiency was significantly higher among students in urban setting compared to rural (61.8% vs 21.2%, respectively, p<0.001). After controlling for potential confounders using multivariable logistic regression model, duration of exposure to sunlight, amount of body part exposed to sunlight, place of residence, maternal education, body fatness, having TV/computer at home and socioeconomic status were significant predictors of vitamin D deficiency. The findings suggest that Vitamin D deficiency was prevalent in healthy school children living both in urban and rural areas of a country with abundant year round sunshine providing UVB, with the prevalence of deficiency being significantly higher among urban school children who were less exposed to sunlight. Behaviour change communication to enhance exposure to ultraviolet light is critical to prevent vitamin D deficiency in tropical country like Ethiopia. Further study is required to assess the deleterious effect of its deficiency on bone mineral homeostasis of growing children in Ethiopia during their most critical period of bone development.

Effect of statins on serum vitamin D concentrations: a systematic review and meta‐analysis

We conducted a systematic review and meta‐analysis to assess the effects of statin therapy on serum vitamin D concentrations.

Impact of the removal of chocolate milk from school milk programs for children in Saskatoon, Canada.

Studies in the United States report inclusion of flavoured milk in the diets of children and youth improves nutrient intakes. No research has investigated the contribution of flavoured milk to overall milk intake or the milk preferences of Canadian children. The objective of the study was to measure milk consumption (plain milk and flavoured milk) by children in an elementary school environment and investigate factors contributing to milk choice. A mixed-method research design was applied across 6 schools for 12 weeks. Milk waste was measured in grades 1-8 for 12 weeks. Weeks 1-4 (phase 1) and 9-12 (phase 3) provided both plain milk and flavoured milk as chocolate milk while weeks 5-8 (phase 2) provided plain milk only. Beverage Frequency Questionnaires were used in each phase (in grades 5-8 only) to assess usual beverage consumption. Statistical nutrient modelling was conducted to determine the effects of removing chocolate milk during phase 2 as a milk choice. Later, focus groups were conducted with students in grades 5-8 to determine what influences them to choose/not choose to drink milk. Total milk intake decreased by 12.3% when chocolate milk was removed from the schools (26.6% ± 5.2% to 14.31% ± 1.6%, p < 0.001). Milk choice was influenced by environmental factors as well as taste, cost, convenience, and variety. Total milk intake was associated with location (p = 0.035) and cost (p < 0.001), with rural students and/or those students receiving free milk drinking the greatest amount of milk. Nutrient modelling revealed chocolate milk is more cost-efficient and convenient at providing nutrients than alternative food/drink combinations.

The association between dietary inflammatory properties and bone mineral density and risk of fracture in US adults

Background/Objectives:To examine the associations of dietary inflammatory index (DII) with bone mineral density (BMD) and fracture risk in adult Americans.Subjects/Method:The United States National Health and Nutrition Examination Survey participants during 2005–2010 were included if they had measured data on dietary intake and BMD. DII scores were calculated from estimated micro- and macronutrients from a single 24-h dietary recall. BMD was measured using dual-energy X-ray absorptiometry densitometers. Risk of fractures was obtained from participant self-report (ever) based on doctor information. Analyze of covariance and χ2-tests were employed, while accounting for the complex survey design.Results:A total of 18 318 participants were included, with 51.3% (9397) being men. Age, sex, race, physical activity, smoking, C-reactive protein and body mass index-adjusted mean BMD (g/cm2) in different bodily sites significantly decreased across increasing quarters of the DII (all P<0.001). After further adjustment for calcium intake, the trend in BMD across DII quarters remained significant for total femur, femoral neck, trochanter and intertrochanter BMD (all P<0.001). Across increasing quarters of the DII, the proportion of fractures ranged from 1.1 to 1.5% for hip fracture (P=0.02), from 7.9 to 10.5% for wrist fracture (P<0.001) and from 2.2 to 2.7% for spine fracture (P=0.002. Prevalent wrist fractures significantly differed across DII quarters (P<0.0001), driven by high prevalence in the top quarter, while hip and spine fractures’ prevalence did not vary significantly.Conclusions:The current study provides evidence suggesting a potential adverse effect of pro-inflammatory diet on bone health; which may have implications for dietary approaches for those with history of abnormal bone health complications.

Food Security and Leukocyte Telomere Length in Adult Americans

Background and Purpose Leukocyte telomere length (LTL) is a biomarker of biologic age. Whether food security status modulates LTL is still unknown. We investigated the association between food security and LTL in participants of the 1999–2002 US National Health and Nutrition Examination Survey (NHANES). Methods Analysis of covariance (ANCOVA) was used to evaluate the association between food security categories and LTL controlling for sex, race, and education and accounting for the survey design and sample weights. Results We included 10,888 participants with 5228 (48.0%) being men. They were aged on average 44.1 years. In all, 2362 (21.7%) had less than high school, 2787 (25.6%) had achieved high school, while 5705 (52.5%) had done more than high school. In sex-, race-, and education-adjusted ANCOVA, average LTL (T/S ratio) for participants with high food security versus those with marginal, low, or very low food security was 1.32 versus 1.20 for the age group 25–35 years and 1.26 versus 1.11 for the 35–45 years, (p < 0.001). Conclusion The association between food insecurity and LTL shortening in young adults suggest that some of the future effects of food insecurity on chronic disease risk in this population could be mediated by telomere shortening.

Association between childcare educators’ practices and preschoolers’ physical activity and dietary intake: a cross-sectional analysis

Introduction Childcare educators may be role models for healthy eating and physical activity (PA) behaviours among young children. This study aimed to identify which childcare educators’ practices are associated with preschoolers’ dietary intake and PA levels. Methods This cross-sectional analysis included 723 preschoolers from 50 randomly selected childcare centres in two Canadian provinces. All data were collected in the fall of 2013 and 2014 and analysed in the fall of 2015. PA was assessed using Actical accelerometers during childcare hours for 5 consecutive days. Children’s dietary intake was measured at lunch on 2 consecutive days using weighed plate waste and digital photography. Childcare educators’ nutrition practices (modelling, nutrition education, satiety recognition, verbal encouragement and not using food as rewards) and PA practices (informal and formal PA promotion) were assessed by direct observation over the course of 2 days, using the Nutrition and Physical Activity Self-Assessment for Child Care tool. Associations between educators’ practices and preschoolers’ PA and dietary intake were examined using multilevel linear regressions. Results Overall, modelling of healthy eating was positively associated with children’s intake of sugar (β=0.141, 95% CI 0.03 to 0.27), while calorie (β=−0.456, 95% CI −1.46 to –0.02) and fibre intake (β=−0.066, 95% CI −0.12 to –0.01) were negatively associated with providing nutrition education. Not using food as rewards was also negatively associated with fat intake (β=−0.144, 95% CI −0.52 to –0.002). None of the educators’ PA practices were associated with children’s participation in PA. Conclusions Modelling healthy eating, providing nutrition education and not using food as rewards are associated with children’s dietary intake at lunch in childcare centres, highlighting the role that educators play in shaping preschoolers’ eating behaviours. Although PA practices were not associated with children’s PA levels, there is a need to reduce sedentary time in childcare centres.

Impact of replacing regular chocolate milk with the reduced-sugar option on milk consumption in elementary schools in Saskatoon, Canada

Excess sugar consumption in children has led to the removal of chocolate milk from some schools. Lower-sugar formulations, if accepted, would provide the benefits of milk consumption. In a cross-over trial, milk consumption was measured in 8 schools over 6 weeks in 2 phases: phase 1 provided standard 1% chocolate milk and plain 2% milk choices for the first 3 weeks, and phase 2 provided reduced-sugar 1% chocolate milk and plain 2% milk for the next 3 weeks. Milk selection and milk wasted were measured by sex and grade (1-8). Children chose chocolate milk more often than white milk in both phases (phase 1, 8.93% ± 0.75% vs. 0.87% ± 0.11% (p < 0.001), and phase 2, 5.76% ± 0.29% vs. 0.78% ± 0.14% (p < 0.001), respectively). Fewer children chose reduced-sugar chocolate milk in phase 2 (p < 0.001). A greater percentage of younger students (grades 1-4) than older students (grades 5-8) purchased milk in both phases (phase 1, 11.10% ± 0.81% vs. 8.36% ± 0.74%, p = 0.020, and phase 2, 8.47% ± 0.43% vs. 4.62% ± 0.40%, p < 0.001, respectively); older children drank more milk at lunch. Schoolchildren preferred chocolate milk over plain milk even when a reduced-sugar formula was offered; however, switching to reduced-sugar chocolate milk led to a decrease in the number of students choosing milk. Longer-duration studies are required to determine if students would purchase reduced-sugar chocolate milk at the same rate as they would purchase regular chocolate milk.

Breakfast in Canada: Prevalence of Consumption, Contribution to Nutrient and Food Group Intakes, and Variability across Tertiles of Daily Diet Quality. A Study from the International Breakfast Research Initiative

This study used 24-h recall data from the nationally representative 2015 Canadian Community Health Survey-Nutrition to assess breakfast intake among Canadians aged 6–12 years (n = 2331), 13–17 years (n = 2026), 18–54 years (n = 7651), and 55+ years (n = 6279). Overall, 90% consumed breakfast; breakfast consumers reported higher intakes of energy and key nutrients and had higher daily diet quality scores assessed using the Nutrient-Rich Foods Index 9.3 (NRF 9.3). Among breakfast consumers (n = 16,484), breakfast contributed a mean of 389 kcal (1628 kJ) and 21.6% of daily energy intake. Relative to its contribution to energy, breakfast contributed higher intakes of fruit, whole grains, and fluid milk, as well as associated nutrients (e.g., carbohydrate, total sugars, fiber, calcium, and vitamin D). Among breakfast consumers classified by daily dietary quality (NRF 9.3 score), energy intake at breakfast did not differ across tertiles for either children or adults. However, intakes of key nutrients, fiber, and total sugars increased across tertiles, and among adults, intakes of saturated fat and sodium decreased. Mean intakes of fruit, whole grains, and fluid milk also increased across tertiles, as did the proportion of individuals consuming these foods; higher fruit and milk intakes may explain higher sugar intakes as diet quality increased. Promoting the consumption of these foods at breakfast could contribute to improved diet quality among Canadians.