Lisa Jahns

Obesity, diet, and poverty: trends in the Russian transition to market economy

Objective: To examine trends in macronutrient intake, overweight, and obesity.Design: Cross-sectional samples—collected nine times between 1992 and 2000—from the Russian Longitudinal Monitoring Survey provide interviewer-administered 24-h diet recalls and measured height and weight, together with detailed information regarding income and expenditures.Setting: The Russian Federation.Subjects: Women and men, aged 19–55 y.Interventions: None.Methods: A nationally representative sample of working-age Russian adults was stratified by gender and income (per cent of regional poverty level). Secular trends in mean energy and macronutrient intake, as well as prevalence of overweight and obesity in the population are described over the first 8 y of the Russian Federation.Results: Overall, energy intake increased slightly. Fat, as a percentage of energy (E%), decreased from 39.6 to 31.6% and protein, as a per cent of energy, decreased from 14.3 to 12.5%. Overweight (determined by body mass index (BMI) ≥25 kg/m2) prevalence remained relatively stable at about 50% and obesity (BMI ≥30 kg/m2) prevalence increased from 13.3 to 16.0% of the adult population. Women consumed less energy than men and displayed higher prevalences of overweight and obesity in all time periods. There was an income effect among men in all time periods, with higher-income men consuming more calories, fat, and protein than lower-income men; this effect was not apparent in women except in the proportion of fat and protein intake.Conclusions: The adult Russian population appears to have escaped macronutrient privation during economic reform and has experienced increasing rates of obesity.Sponsorship: US National Institutes of Health (R01-HD30880 and R01-HD38700)

Issues of Fish Consumption for Cardiovascular Disease Risk Reduction

Increasing fish consumption is recommended for intake of omega-3 (n-3) fatty acids and to confer benefits for the risk reduction of cardiovascular disease (CVD). Most Americans are not achieving intake levels that comply with current recommendations. It is the goal of this review to provide an overview of the issues affecting this shortfall of intake. Herein we describe the relationship between fish intake and CVD risk reduction as well as the other nutritional contributions of fish to the diet. Currently recommended intake levels are described and estimates of fish consumption at a food disappearance and individual level are reported. Risk and benefit factors influencing the choice to consume fish are outlined. The multiple factors influencing fish availability from global capture and aquaculture are described as are other pertinent issues of fish nutrition, production, sustainability, and consumption patterns. This review highlights some of the work that needs to be carried out to meet the demand for fish and to positively affect intake levels to meet fish intake recommendations for CVD risk reduction.

Barriers and Facilitators for Consumer Adherence to the Dietary Guidelines for Americans: The HEALTH Study

The majority of the US population does not meet recommendations for consumption of milk, whole grains, fruit, and vegetables. The goal of our study was to understand barriers and facilitators to adherence to the Dietary Guidelines for Americans for four nutrient-rich food groups in fifth-grade children and unrelated adult caregivers across six sites in a multistate study. A total of 281 unrelated adult caregivers (32% African American, 33% European American, and 35% Hispanic American) and 321 children (33% African American, 33% European American, and 34% Hispanic American) participated in 97 Nominal Group Technique sessions. Nominal Group Technique is a qualitative method of data collection that enables a group to generate and prioritize a large number of issues within a structure that gives everyone an equal voice. The core barriers specific to unrelated adult caregivers were lack of meal preparation skills or recipes (whole grains, fruit, vegetables); difficulty in changing eating habits (whole grains, fruit, vegetables), cost (milk, whole grains, fruit, vegetables), lack of knowledge of recommendation/portion/health benefits (milk, vegetables), and taste (milk, whole grains, vegetables). Specific to children, the core barriers were competing foods (ie, soda, junk foods, sugary foods [whole grains, milk, fruit, vegetables]), health concerns (ie, milk allergy/upset stomach [milk]), taste/flavor/smell (milk, whole grains, fruit, vegetables), forget to eat them (vegetables, fruit), and hard to consume or figure out the recommended amount (milk, fruit). For both unrelated adult caregivers and children, reported facilitators closely coincided with the barriers, highlighting modifiable conditions that could help individuals to meet the Dietary Guidelines for Americans.

Resonance Raman spectroscopic evaluation of skin carotenoids as a biomarker of carotenoid status for human studies

Resonance Raman spectroscopy (RRS) is a non-invasive method that has been developed to assess carotenoid status in human tissues including human skin in vivo. Skin carotenoid status has been suggested as a promising biomarker for human studies. This manuscript describes research done relevant to the development of this biomarker, including its reproducibility, validity, feasibility for use in field settings, and factors that affect the biomarker such as diet, smoking, and adiposity. Recent studies have evaluated the response of the biomarker to controlled carotenoid interventions, both supplement-based and dietary [e.g., provision of a high-carotenoid fruit and vegetable (F/V)-enriched diet], demonstrating consistent response to intervention. The totality of evidence supports the use of skin carotenoid status as an objective biomarker of F/V intake, although in the cross-sectional setting, diet explains only some of the variation in this biomarker. However, this limitation is also a strength in that skin carotenoids may effectively serve as an integrated biomarker of health, with higher status reflecting greater F/V intake, lack of smoking, and lack of adiposity. Thus, this biomarker holds promise as both a health biomarker and an objective indicator of F/V intake, supporting its further development and utilization for medical and public health purposes.

Skin and plasma carotenoid response to a provided intervention diet high in vegetables and fruit: uptake and depletion kinetics

BACKGROUND Objective biomarkers are needed to assess adherence to vegetable and fruit intervention trials. Blood carotenoids are considered the best biomarker of vegetable and fruit intake, but collecting blood is invasive and the analyses are relatively expensive for population studies. Resonance Raman spectroscopy (RRS) is an innovative method for assessing carotenoids in skin noninvasively. OBJECTIVE Our objective was to compare blood carotenoid concentrations with skin carotenoid assessments by RRS during a controlled feeding intervention. DESIGN Twenty-nine participants consumed low-carotenoid diets (6 wk, phases 1 and 3), a provided diet containing 6-cup equivalents (1046 g/d) of vegetables and fruit (8 wk, phase 2), and usual diet (final 8 wk, phase 4). RESULTS At baseline, skin and plasma total carotenoid values were correlated (r = 0.61, P < 0.001). Skin and plasma carotenoid values decreased (P < 0.001) 36% and 30%, respectively, from baseline to the end of phase 1 and then increased (P < 0.001) by >200% at the end of phase 2. Plasma carotenoids returned to baseline concentrations by the middle of phase 3 and skin carotenoid concentrations by the middle of phase 4. Skin carotenoid status predicted plasma values by using a mixed linear model including all time points (r = 0.72, P < 0.001), which indicates that changes in skin carotenoid status closely follow changes in plasma across a broad range of intakes. At the individual level, skin carotenoids predicted plasma values (r = 0.70, P < 0.001) over all time points. CONCLUSION Skin carotenoid status assessed by resonance Raman spectroscopy is a noninvasive, objective biomarker of changes in vegetable and fruit intake.

Docosahexaenoic acid: measurements in food and dietary exposure.

The Dietary Reference Intakes (DRIs) were established to be an indicator of adequacy of dietary nutrients as well as providing levels for adequacy in reducing risk of chronic diseases such as neurodegenerative diseases, cardiovascular diseases, cancers, diabetes mellitus, etc. One particular nutrient that is increasingly discussed as a potential candidate for the generation of a DRI is the omega-3 (n-3) fatty acid docosahexaenoic acid (DHA) due to its potential benefits in reducing risk for cardiovascular disease, role in resolution of inflammation, its importance in cognitive function in infants and inhibiting the progression of neurodegenerative diseases in the elderly. Each reference value refers to and is predicated on estimates of daily nutrient intake and the goal of this paper is to review these intakes. The confidence of these values is critical in establishing dose-response relationships. This paper reports intake values for DHA and examines how these data were generated and the relative confidence in these values. The adult US population is estimated to consume 80-100 mg/d of DHA based on a nationally representative sample of > 8400 individuals as part of the National Health and Nutrition Examination Survey (NHANES). This value and those presented for women and men at various ages appear reasonable and should be used as the basis for establishing an Adequate Intake (AI) for DHA.

Intake of seafood in the US varies by age, income, and education level but not by race-ethnicity.

Current US federal dietary guidance recommends regular consumption of seafood (fish + shellfish) to promote health; however, little is known about how well Americans meet the guideline, particularly population subgroups that may be at risk for inadequate intake. The purposes of this study were to describe the prevalence of seafood consumption and, among consumers, the amounts of seafood eaten by sex, age group, income and education level, and race-ethnicity. Data from 15,407 adults aged 19+ participating in the 2005–2010 National Health and Nutrition Examination Surveys were analyzed using methods to account for sporadic intake of seafood. Over 80% of Americans reported consuming any seafood over the past 30 days, 74% reported consuming fish, and 54% reported eating shellfish. The percentages varied by socio-demographic group. Younger age and lower income and education levels were associated with lower odds of being a seafood consumer (p < 0.0001). Among those who reported eating seafood, the average amount eaten of any seafood was 158.2 ± 5.6 g/week. Among seafood consumers, women and individuals of lower age and education levels consumed less seafood. Approximately 80%–90% of seafood consumers did not meet seafood recommendations when needs were estimated by energy requirements. A great deal of work remains to move Americans toward seafood consumption at current recommended levels.

Evaluating the relationship between plasma and skin carotenoids and reported dietary intake in elementary school children to assess fruit and vegetable intake.

Accurate assessment of dietary intake of children can be challenging due to the limited reliability of current dietary assessment methods. Plasma carotenoid concentration has been used to assess fruit and vegetable intake, but this testing is rarely conducted in school settings in children. Resonance Raman spectroscopy (RRS) is emerging as a useful method to objectively assess fruit and vegetable intake. This methodology has been validated in adults, but limited work has been done in children, particularly in the school setting. The purpose of this research is to further validate the RRS methodology in children. Children (9-12 year) participating in a school-based intervention were recruited. Plasma carotenoids were quantified using HPLC, skin carotenoid status was measured using RRS, and dietary intake of carotenoids was measured with the Block Food Frequency Questionnaire Ages 8-17. Total plasma carotenoid concentrations and skin carotenoid intensities were strongly correlated (r=0.62, p<0.001, n=38). Reported total carotenoid intake correlated with skin carotenoids (r=0.40, p<0.0001, n=128). Skin carotenoid status as measured by RRS can be a strong predictor of plasma carotenoid status and dietary intake of carotenoids in children. RRS may be used as a valid, non-invasive, and useful method to assess fruit and vegetable intakes in this population.

Supplemental Nutrition Assistance Program Participation and Health: Evidence from Low‐Income Individuals in Tennessee

We investigate the factors that contribute to participation in the Supplemental Nutrition Assistance Program (SNAP, formerly known as the Food Stamp Program) and the effects of such participation on self‐assessed health (SAH). Our estimation approach consists of an endogenous switching ordered probability model, using the copula approach, for a sample of current and former Temporary Assistance for Needy Families (TANF) recipients in Tennessee. Results indicate that sociodemographic characteristics play a role in SNAP participation. Interestingly, we find that participation in SNAP is inversely related to SAH.

Relationship of the Reported Intakes of Fat and Fatty Acids to Body Weight in US Adults

Dietary fat composition may modulate energy expenditure and body weight. Little is known about the relationship between fatty acid intake and body weight at a population level. The purposes of this study were to compare intakes of energy, macronutrients, and individual fatty acids across BMI categories (1) for the US adult population and, (2) by sociodemographic groups. Reported dietary intake data from the National Health and Nutrition Examination Survey (NHANES) and What We Eat in America (WWEIA) surveys in the years 2005–2012 were analyzed. Overall, we found that the reported intake of carbohydrate, protein, total fat, total saturated fat (as well as long-chain saturated fatty acids 14:0–18:0), and monounsaturated fatty acids (MUFAs) were positively associated with BMI; while lauric acid (a medium-chain saturated fatty acid, 12:0) and total polyunsaturated fatty acids (PUFAs) (as well as all individual PUFAs) were not associated with BMI. Non-Hispanic black individuals demonstrated a negative association between BMI and energy intake and a positive association between total PUFAs, linoleic acid (LA), α-linolenic acid (ALA) and BMI. Individuals with less than a high school education showed a negative association between BMI and DHA. Mexican-Americans reported intakes with no association between BMI and energy, any macronutrient, or individual fatty acids. These findings support those of experimental studies demonstrating fatty acid-dependent associations between dietary fatty acid composition and body weight. Notably, we observed divergent results for some sociodemographic groups which warrant further investigation.