Heather E. Rasmussen

Position of the Academy of Nutrition and Dietetics: Dietary Fatty Acids for Healthy Adults

It is the position of the Academy of Nutrition and Dietetics (the Academy) that dietary fat for the healthy adult population should provide 20% to 35% of energy, with an increased consumption of n-3 polyunsaturated fatty acids and limited intake of saturated and trans fats. The Academy recommends a food-based approach through a diet that includes regular consumption of fatty fish, nuts and seeds, lean meats and poultry, low-fat dairy products, vegetables, fruits, whole grains, and legumes. These recommendations are made within the context of rapidly evolving science delineating the influence of dietary fat and specific fatty acids on human health. In addition to fat as a valuable and calorically dense macronutrient with a central role in supplying essential nutrition and supporting healthy body weight, evidence on individual fatty acids and fatty acid groups is emerging as a key factor in nutrition and health. Small variations in the structure of fatty acids within broader categories of fatty acids, such as polyunsaturated and saturated, appear to elicit different physiological functions. The Academy recognizes that scientific knowledge about the effects of dietary fats on human health is young and takes a prudent approach in recommending an increase in fatty acids that benefit health and a reduction in fatty acids shown to increase risk of disease. Registered dietitian nutritionists are uniquely positioned to translate fat and fatty acid research into practical and effective dietary recommendations.

Polyphenols, Inflammation, and Cardiovascular Disease

Polyphenols are compounds found in foods such as tea, coffee, cocoa, olive oil, and red wine and have been studied to determine if their intake may modify cardiovascular disease (CVD) risk. Historically, biologic actions of polyphenols have been attributed to antioxidant activities, but recent evidence suggests that immunomodulatory and vasodilatory properties of polyphenols may also contribute to CVD risk reduction. These properties will be discussed, and recent epidemiological evidence and intervention trials will be reviewed. Further identification of polyphenols in foods and accurate assessment of exposures through measurement of biomarkers (i.e., polyphenol metabolites) could provide the needed impetus to examine the impact of polyphenol-rich foods on CVD intermediate outcomes (especially those signifying chronic inflammation) and hard endpoints among high risk patients. Although we have mechanistic insight into how polyphenols may function in CVD risk reduction, further research is needed before definitive recommendations for consumption can be made.

Repression of Proinflammatory Gene Expression by Lipid Extract of Nostoc commune var sphaeroides Kützing, a Blue-green Alga, via Inhibition of Nuclear Factor-κB in RAW 264.7 Macrophages

We investigated whether lipid extract from a blue-green alga, N commune, modulates proinflammatory gene expression in RAW 264.7 macrophages. The cells were incubated with N commune lipid extract (0-100 microg/mL) and subsequently activated by LPS (100 ng/mL). Quantitative real-time PCR analysis showed that mRNA abundance of proinflammatory mediators, including TNF-alpha, COX-2, IL-1beta, IL-6, and iNOS, was significantly reduced by N commune lipid extract in a dose-dependent manner. Secretion of TNF-alpha and IL-1beta into cell culture medium was also significantly decreased by N commune lipid extract. Thin-layer chromatography-densitometry analysis showed that N commune lipid extract contained approximately 15% of fatty acids. To determine whether the inhibition of proinflammatory mediator production by N commune lipid extract is primarily conferred by fatty acids in the lipid extract, macrophages were incubated with 100 microg/mL of N commune lipid extract or 15 microg/mL of a fatty acid mixture, which was formulated to reflect the fatty acid composition of N commune lipid extract. The fatty acid mixture significantly reduced RNA abundance of TNF-alpha and COX-2, but to a lesser extent than did the N commune lipid extract, suggesting the presence of additional bioactive compounds with an antiinflammatory property in the lipid extract. As NF-kappaB is a major regulator for the proinflammatory gene expression, we measured its DNA-binding activity. DNA-binding activity of NF-kappaB was significantly reduced by N commune lipid extract. In conclusion, our study suggests that N commune lipid extract represses the expression of proinflammatory genes in RAW 264.7 macrophages, at least in part, by inhibiting the activation of NF-kappaB pathway.

Vitamin B12 Deficiency in Relation to Functional Disabilities

This study was designed to assess whether symptoms, functional measures, and reported disabilities were associated with vitamin B12 (B12) deficiency when defined in three ways. Participants, aged 60 or more years of age, in 1999–2002 National Health and Nutrition Examination Surveys (NHANES) were categorized in relation to three previously used definitions of B12 deficiency: (1) serum B12 < 148 pmol/L; (2) serum B12 < 200 pmol/L and serum homocysteine > 20 μmol/L; and (3) serum B12 < 258 pmol/L or serum methylmalonic acid > 0.21 μmol/L. Functional measures of peripheral neuropathy, balance, cognitive function, gait speed, along with self-reported disability (including activities of daily living) were examined with standardized instruments by trained NHANES interviewers and technicians. Individuals identified as B12 deficient by definition 2 were more likely to manifest peripheral neuropathy OR (odds) (95% confidence intervals), p value: 9.70 (2.24, 42.07), 0.004 and report greater total disability, 19.61 (6.22, 61.86) 0.0001 after adjustments for age, sex, race, serum creatinine, and ferritin concentrations, smoking, diabetes, and peripheral artery disease. Smaller, but significantly increased, odds of peripheral neuropathy and total disability were also observed when definition 3 was applied. Functional measures and reported disabilities were associated with B12 deficiency definitions that include B12 biomarkers (homocysteine or methylmalonic acid). Further study of these definitions is needed to alert clinicians of possible subclinical B12 deficiency because functional decline amongst older adults may be correctable if the individual is B12 replete.

Comparison of recycling outcomes in three types of recycling collection units

Commercial institutions have many factors to consider when implementing an effective recycling program. This study examined the effectiveness of three different types of recycling bins on recycling accuracy by determining the percent weight of recyclable material placed in the recycling bins, comparing the percent weight of recyclable material by type of container used, and examining whether a change in signage increased recycling accuracy. Data were collected over 6 weeks totaling 30 days from 3 different recycling bin types at a Midwest University medical center. Five bin locations for each bin type were used. Bags from these bins were collected, sorted into recyclable and non-recyclable material, and weighed. The percent recyclable material was calculated using these weights. Common contaminates found in the bins were napkins and paper towels, plastic food wrapping, plastic bags, and coffee cups. The results showed a significant difference in percent recyclable material between bin types and bin locations. Bin type 2 was found to have one bin location to be statistically different (p=0.048), which may have been due to lack of a trash bin next to the recycling bin in that location. Bin type 3 had significantly lower percent recyclable material (p<0.001), which may have been due to lack of a trash bin next to the recycling bin and increased contamination due to the combination of commingled and paper into one bag. There was no significant change in percent recyclable material in recycling bins post signage change. These results suggest a signage change may not be an effective way, when used alone, to increase recycling compliance and accuracy. This study showed two or three-compartment bins located next to a trash bin may be the best bin type for recycling accuracy.

Gene-environment interaction of body mass index and apolipoprotein E ε4 allele on cognitive decline.

Genetic variation alone may not account for common chronic disease susceptibility. Rather, an interaction between genetic and environmental factors may clarify the underlying disease mechanism. Hence, we tested whether body mass index (BMI) modified the genetic association of the apolipoprotein E &egr;4 allele with cognitive decline. The data came from a longitudinal population-based sample of 4055 participants interviewed at 3-year intervals from 1993 to 2012. Cognitive function was assessed using a standardized global cognitive score and BMI was assessed at baseline and classified as normal, overweight, and obese. There were 1374 (34%) participants with the &egr;4 allele. In normal BMI participants, cognitive decline was 0.048 units/y without the &egr;4 allele, and increased by an additional 0.031 units/y with the &egr;4 allele. In overweight participants, cognitive decline was 0.038 units/y without the &egr;4 allele, and increased by an additional 0.026 units/y with the &egr;4 allele. Finally, in obese participants, cognitive decline was 0.038 units/y without the &egr;4 allele, and increased by an additional 0.014 units/y with the &egr;4 allele. The association of &egr;4 allele with cognitive decline was significantly lower in obese participants compared with normal BMI participants (P=0.003), thereby suggesting significant gene-environment interaction on cognitive decline.

Unsaturated fatty acids repress the expression of ATP-binding cassette transporter A1 in HepG2 and FHs 74 Int cells

Adenosine triphosphate-binding cassette transporter A1 (ABCA1) plays a critical role in the formation and metabolism of high-density lipoproteins (HDLs). Adenosine triphosphate-binding cassette transporter A1 in the liver and small intestine, in particular, accounts for approximately 90% of plasma HDL cholesterol. Therefore, any alterations in the hepatic and intestinal expression of ABCA1 could have a large impact on HDL biogenesis. We tested the hypothesis that ABCA1 expression is regulated differentially by different types of fatty acids in the liver and small intestine. Human hepatoma HepG2 and human small intestine epithelial FHs 74 Int cells were used as an in vitro model. Cells were incubated with saturated and unsaturated fatty acids in the presence or absence of T0901317, a synthetic agonist of liver X receptor. Unsaturated fatty acids decreased ABCA1 protein levels at 100 μmol/L of concentration regardless of the agonist with a minimal effect on messenger RNA abundance. Incubation of HepG2 and FHs 74 Int cells with rottlerin, a protein kinase C δ (PKCδ) inhibitor, increased ABCA1 protein but did not abolish linoleic acid-induced decrease in ABCA1 protein levels. Depletion of PKCδ using small interfering RNA showed decreased ABCA1 protein levels in control, palmitic acid-, and linoleic acid-treated cells; but the repressive effect of linoleic acid was sustained. In conclusion, our results indicate that unsaturated fatty acids regulate ABCA1 expression in HepG2 and FHs 74 Int cells at the posttranscriptional level and PKCδ is likely to be involved in maintaining ABCA1 protein levels.

Alteration of the gastrointestinal microbiota of mice by edible blue-green algae

Aims:  To characterize the effect of edible blue‐green algae (cyanobacteria) on the gastrointestinal microbiota of mice.

Knowledge, use and perceptions of probiotics and prebiotics in hospitalised patients

Aim Little is known about inpatient probiotic and prebiotic consumption or beliefs, despite their increase in availability. Therefore, the purpose of this research was to assess inpatient knowledge, use and perceptions of probiotics and prebiotics. Methods All subjects were inpatients at two urban medical centres on general medical/surgical floors. Patients were randomly selected to complete a verbally administered questionnaire inquiring about probiotic and prebiotic knowledge, use and perceptions. Patient responses were recorded directly into Survey Monkey (Palo Alto, CA, USA) on a computer. Results Patients (n = 200) were 58% were women and 56% were Caucasian with a mean age of 56 years. More patients were familiar with the term ‘probiotic’ (43%) compared with ‘prebiotic’ (11%); however, only 20% and 7% could correctly define probiotics and prebiotics, respectively, from a list of responses. More patients were consuming probiotics (53%) than prebiotics (38%). The most common probiotic and prebiotic products consumed were yogurts (72%) and cereals/granola bars (55%), respectively. Patients believed probiotics and prebiotics most beneficial for ‘digestion or gut health’, but the most common reason to consume these products was ‘to taste or try’ (36% and 43%, respectively). Overall, patients believed probiotics and prebiotics to be safe; however, they also believed that health claims could only somewhat be trusted. Conclusions This research found that many patients are consuming probiotic and prebiotic products despite limited awareness of the true meaning of these terms. As probiotic and prebiotic use is more common, it is important that clinicians are aware of increased use and provide patients with recommendations based on recent research.

Starch-entrapped microsphere fibers improve bowel habit but do not exhibit prebiotic capacity in those with unsatisfactory bowel habits: a phase I, randomized, double-blind, controlled human trial

Approximately one-third of individuals in the United States experience unsatisfactory bowel habits, and dietary intake, especially one low in fiber, could be partly responsible. We hypothesized that intake of a fermentable fiber (starch-entrapped microspheres, SM) that has a delayed, slow fermentation profile in vitro would improve bowel habit while exhibiting prebiotic capacity in those with self-described unsatisfactory bowel habits, all with minimal adverse effects. A total of 43 healthy volunteers completed a 3-month, double-blind, parallel-arm randomized clinical trial to assess the ability of a daily dose (9 or 12 g) of SM vs psyllium (12 g) to improve bowel habit, including stool consistency and frequency, and modify gut milieu through changes in stool microbiota and short-chain fatty acids while remaining tolerable through minimal gastrointestinal symptoms. All outcomes were compared before and after fiber treatment. Stool frequency significantly improved (P=.0003) in all groups after 3 months, but stool consistency improved only in both SM groups compared with psyllium. In addition, all groups self-reported a similar improvement in overall bowel habit with fiber intake. Both SM and psyllium resulted in minimal changes in microbiota composition and short-chain fatty acid concentrations. The present study suggests that supplementation with a delayed and slow-fermenting fiber in vitro may improve bowel habit in those with constipation, but further investigation is warranted to determine capacity to alter microbiota and fermentation profiles in humans. This trial was registered at ClinicalTrials.gov as NCT01210625.