Satya S. Jonnalagadda

Accuracy of Energy Intake Data Estimated by a Multiplepass, 24-hour Dietary Recall Technique

OBJECTIVE This study examined the accuracy of a multiple-pass, 24-hour dietary recall method for estimating energy intakes of men and women by comparing it with energy intake required for weight maintenance. DESIGN Three-day, multiple-pass, 24-hour recalls were obtained on randomly selected days during a self-selected diet period when subjects were preparing their own meals and during a controlled diet period when all meals were provided by the study. During the dietary intervention, weight was maintained; body weight and dietary intake were monitored closely, thereby allowing estimation of the energy intake required for weight maintenance. SUBJECTS/SETTING Seventy-eight men and women (22 to 67 years old) from the Dietary Effects on Lipoprotein and Thrombogenic Activity (DELTA) study participated in this study. All 24-hour recalls were collected using a computer-assisted, interactive, multiple-pass telephone interview technique. Energy requirements for each individual were determined by the energy content of the DELTA study foods provided to maintain weight. STATISTICAL ANALYSIS Paired and independent t tests were conducted to examine differences among study variables. Agreement between recalled energy intake and weight maintenance energy intake was analyzed using the Bland-Altman technique. RESULTS Compared with weight maintenance energy intake, during the self-selected diet period men and women underestimated energy intake by 11% and 13%, respectively. During the controlled diet period, men underestimated energy intake by 13%, whereas women overestimated energy by 1.3%. APPLICATIONS/CONCLUSIONS Men had a tendency to under-estimate energy intake irrespective of the recording period. The accuracy of the recalled energy intake of women may be influenced by recording circumstances. Researchers should examine the factors influencing underreporting and overreporting by individuals and their impact on macronutrient and micronutrient intakes. Also, strategies need to be developed to minimize underreporting and overreporting.

Putting the Whole Grain Puzzle Together: Health Benefits Associated with Whole Grains—Summary of American Society for Nutrition 2010 Satellite Symposium

The symposium “Putting the Whole Grain Puzzle Together: Health Benefits Associated with Whole Grains” sponsored by the ASN brought together researchers to review the evidence regarding the health benefits associated with whole grains. Current scientific evidence indicates that whole grains play an important role in lowering the risk of chronic diseases, such as coronary heart disease, diabetes, and cancer, and also contribute to body weight management and gastrointestinal health. The essential macro- and micronutrients, along with the phytonutrients present in whole grains, synergistically contribute to their beneficial effects. Current evidence lends credence to the recommendations to incorporate whole grain foods into a healthy diet and lifestyle program. The symposium also highlighted the need for further research to examine the role of whole grain foods in disease prevention and management to gain a better understanding of their mechanisms of action.

Whole-Grain Ready-to-Eat Oat Cereal, as Part of a Dietary Program for Weight Loss, Reduces Low-Density Lipoprotein Cholesterol in Adults with Overweight and Obesity More than a Dietary Program Including Low-Fiber Control Foods

OBJECTIVE Weight loss and consumption of viscous fibers both lower low-density lipoprotein (LDL) cholesterol levels. We evaluated whether or not a whole-grain, ready-to-eat (RTE) oat cereal containing viscous fiber, as part of a dietary program for weight loss, lowers LDL cholesterol levels and improves other cardiovascular disease risk markers more than a dietary program alone. DESIGN Randomized, parallel-arm, controlled trial. SUBJECTS/SETTING Free-living, overweight and obese adults (N=204, body mass index 25 to 45) with baseline LDL cholesterol levels 130 to 200 mg/dL (3.4 to 5.2 mmol/L) were randomized; 144 were included in the main analysis of participants who completed the trial without significant protocol violations. INTERVENTION Two portions per day of whole-grain RTE oat cereal (3 g/day oat b-glucan) or energy-matched low-fiber foods (control), as part of a reduced energy ( approximately 500 kcal/day deficit) dietary program that encouraged limiting consumption of foods high in energy and fat, portion control, and regular physical activity. MAIN OUTCOME MEASURES Fasting lipoprotein levels, waist circumference, triceps skinfold thickness, and body weight were measured at baseline and weeks 4, 8, 10, and 12. RESULTS LDL cholesterol level was reduced significantly more with whole-grain RTE oat cereal vs control (-8.7+/-1.0 vs -4.3+/-1.1%, P=0.005). Total cholesterol (-5.4+/-0.8 vs -2.9+/-0.9%, P=0.038) and non-high-density lipoprotein-cholesterol (-6.3+/-1.0 vs -3.3+/-1.1%, P=0.046) were also lowered significantly more with whole-grain RTE oat cereal, whereas high-density lipoprotein and triglyceride responses did not differ between groups. Weight loss was not different between groups (-2.2+/-0.3 vs -1.7+/-0.3 kg, P=0.325), but waist circumference decreased more (-3.3+/-0.4 vs -1.9+/-0.4 cm, P=0.012) with whole-grain RTE oat cereal. Larger reductions in LDL, total, and non-high-density lipoprotein cholesterol levels and waist circumference were evident as early as week 4 in the whole-grain RTE oat cereal group. CONCLUSIONS Consumption of a whole-grain RTE oat cereal as part of a dietary program for weight loss had favorable effects on fasting lipid levels and waist circumference.

Whole-grain wheat consumption reduces inflammation in a randomized controlled trial on overweight and obese subjects with unhealthy dietary and lifestyle behaviors: role of polyphenols bound to cereal dietary fiber

BACKGROUND Epidemiology associates whole-grain (WG) consumption with several health benefits. Mounting evidence suggests that WG wheat polyphenols play a role in mechanisms underlying health benefits. OBJECTIVE The objective was to assess circulating concentration, excretion, and the physiologic role of WG wheat polyphenols in subjects with suboptimal dietary and lifestyle behaviors. DESIGN A placebo-controlled, parallel-group randomized trial with 80 healthy overweight/obese subjects with low intake of fruit and vegetables and sedentary lifestyle was performed. Participants replaced precise portions of refined wheat (RW) with a fixed amount of selected WG wheat or RW products for 8 wk. At baseline and every 4 wk, blood, urine, feces, and anthropometric and body composition measures were collected. Profiles of phenolic acids in biological samples, plasma markers of metabolic disease and inflammation, and fecal microbiota composition were assessed. RESULTS WG consumption for 4-8 wk determined a 4-fold increase in serum dihydroferulic acid (DHFA) and a 2-fold increase in fecal ferulic acid (FA) compared with RW consumption (no changes). Similarly, urinary FA at 8 wk doubled the baseline concentration only in WG subjects. Concomitant reduction in plasma tumor necrosis factor-α (TNF-α) after 8 wk and increased interleukin (IL)-10 only after 4 wk with WG compared with RW (P = 0.04) were observed. No significant change in plasma metabolic disease markers over the study period was observed, but a trend toward lower plasma plasminogen activator inhibitor 1 with higher excretion of FA and DHFA in the WG group was found. Fecal FA was associated with baseline low Bifidobacteriales and Bacteroidetes abundances, whereas after WG consumption, it correlated with increased Bacteroidetes and Firmicutes but reduced Clostridium. TNF-α reduction correlated with increased Bacteroides and Lactobacillus. No effect of dietary interventions on anthropometric measurements and body composition was found. CONCLUSIONS WG wheat consumption significantly increased excreted FA and circulating DHFA. Bacterial communities influenced fecal FA and were modified by WG wheat consumption. This trial was registered at clinicaltrials.gov as NCT01293175.

Total dietary fiber intakes in the US population are related to whole grain consumption: results from the National Health and Nutrition Examination Survey 2009 to 2010.

Whole grain (WG) foods have been shown to reduce chronic disease risk and overweight. Total dietary fiber is associated with WG and its health benefits. The purpose was to determine whether associations exist between WG intake (no-WG intake, 0 ounce equivalent [oz eq]; low, >0-<3 oz eq; high, ≥3 oz eq) and total dietary fiber intake among Americans 2 years and older. One-day food intake data from the US National Health and Nutrition Examination Survey 2009 to 2010 (n = 9042) showed that only 2.9% and 7.7% of children/adolescents (2-18 years) and adults (≥19 years) consumed at least 3 WG oz eq/d, respectively. For children/adolescents and adults, individuals in the high WG intake group were 59 and 76 times more likely to fall in the third fiber tertile, respectively, compared with those with no-WG intake. Total dietary fiber intake from food sources varied by WG intake group for children/adolescents and adults with more total dietary fiber consumed from ready-to-eat (RTE) and hot cereals and yeast breads/rolls in the high WG intake group compared with the no-WG intake group. Major WG sources for children/adolescents and adults included yeast bread/rolls (24% and 27%, respectively), RTE cereals (25% and 20%, respectively), and oatmeal (12% and 21%, respectively). Among those with the highest WG intake, WG RTE cereal with no added bran was the greatest contributor to total dietary fiber compared with other RTE cereal types. Whole grain foods make a substantial contribution to total dietary fiber intake and should be promoted to meet recommendations.

Developing a Standard Definition of Whole-Grain Foods for Dietary Recommendations: Summary Report of a Multidisciplinary Expert Roundtable Discussion

Although the term “whole grain” is well defined, there has been no universal standard of what constitutes a “whole-grain food,” creating challenges for researchers, the food industry, regulatory authorities, and consumers around the world. As part of the 2010 Dietary Guidelines for Americans, the U.S. Dietary Guidelines Technical Advisory Committee issued a call to action to develop definitions for whole-grain foods that could be universally accepted and applied to dietary recommendations and planning. The Committee’s call to action, and the lack of a global whole-grain food definition, was the impetus for the Whole Grain Roundtable held 3–5 December 2012 in Chicago, Illinois. The objective was to develop a whole-grain food definition that is consistent with the quartet of needs of science, food product formulation, consumer behavior, and label education. The roundtable’s expert panel represented a broad range of expertise from the United States and Europe, including epidemiology and dietary intervention researchers, consumer educators, government policy makers, and food and nutrition scientists from academia and the grain food industry. Taking into account the totality, quality, and consistency of available scientific evidence, the expert panel recommended that 8 g of whole grain/30 g serving (27 g/100 g), without a fiber requirement, be considered a minimum content of whole grains that is nutritionally meaningful and that a food providing at least 8 g of whole grains/30-g serving be defined as a whole-grain food. Having an established whole-grain food definition will encourage manufacturers to produce foods with meaningful amounts of whole grain, allow consistent product labeling and messaging, and empower consumers to readily identify whole-grain foods and achieve whole-grain dietary recommendations.

Fatty acid consumption pattern of Americans: 1987–1988 USDA Nationwide Food Consumption Survey

Abstract This study characterized the fatty acid intake pattern and the contribution of different food groups to the fatty acid intake of Americans using the U.S. Department of Agricultures 1987–1988 Nationwide Food Consumption Survey. The fatty acid intake was estimated using three-day food consumption data for children age 6–11 and for males and females age 12–19, 20–39 and 40 and older. Palmitic acid was the predominant saturated fatty acid (SFA) in the diet for all age sex groups, contributing 52–57% of SFA intake. Oleic acid was the primary monounsaturated fatty acid (MUFA) for all age sex groups, comprising 91–95% of MUFA intake. Linoleic acid was the principle polyunsaturated fatty acid (PUFA) for all age sex groups, contributing 87–92% of PUFA intake. The Milk and Milk Products group was the major contributor of the short chain SFA and lauric and myristic acids. Meat, Poultry and Meat Mixtures were the main sources of palmitic and stearic acids. Grain Products contributed appreciably to the long chain SFA intake. Oleic acid was obtained mainly from Meat, Poultry, Fish and Mixtures. Yeast breads, rolls, cakes, cookies and pastries were the main contributors of linoleic acid intake. A variety of animal and vegetable products contributed to the linolenic acid and C 18:4+20:4 intake, while fish and shellfish were the main sources of C 20:5+22:6 fatty acids. The contribution of the various food groups to intake of individual fatty acids was similar for both males and females. The results of the present study indicate that a wide variety of food groups contribute to the total fat intake Americans.

Soy consumption, adhesion molecules, and pro-inflammatory cytokines: a brief review of the literature.

Given the interest in the vascular effects of both soyfoods and soy isoflavones, the purpose of this short review is to evaluate clinical trials that have examined the effects of isoflavone-rich soy products on the novel cardiovascular risk factors, cellular adhesion molecules, and pro-inflammatory cytokines. A total of 14 randomized clinical studies were assessed. From the data evaluated, evidence suggests that neither soyfoods nor soy isoflavones affect IL-6 or TNF-alpha expression. In contrast, the effects of soy on cellular adhesion molecules are mixed. Study design characteristics possibly contributing to the inconsistent data are discussed and recommendations for future research in this area are presented.

Contribution of meals and snacks to nutrient intake of male and female elite figure skaters during peak competitive season

Objective:To examine the contribution of breakfast, lunch, dinner and snack to the macronutrient and micronutrient intake of elite male and female figure skaters during their competitive season. Subjects:Male (n = 46) and female (n = 48) figure skaters who participated in the 1999 U.S. National Figure Skating Championships completed the study. Methods:Each athlete completed three-day food records, during the athlete’s competitive season. Food records were analyzed using Nutritionist V software. Macronutrient and micronutrient contributions from meals were assessed. Result:Lunch and dinner meals were the main contributors to the total calorie intake of these skaters (27% and 32%, respectively). Likewise, lunch and dinner were the main contributors to the total protein (27% and 41%), carbohydrate (26% and 29%), fat (30% and 32%), saturated fat (29% and 32%) and polyunsaturated fat (31% and 32%) intakes. Dinner was the main source of the monounsaturated fat (34%), cholesterol (40%) and dietary fiber (34%). Breakfast was the main source of dietary folate (36%), whereas iron and calcium intakes were mainly contributed by breakfast and dinner (29% and 32%, 27% and 29%, respectively). Conclusions:These elite figure skaters appear to be starting their day with low energy reserves and therefore need to be educated about the benefits of consuming breakfast. These athletes also need to be educated about consuming adequate calories throughout the day in order to meet the energy needs of their activity. It is thus important to monitor eating patterns throughout the day to ensure adequate energy intake to sustain the physical and mental aspects of the athletes’ training and performance.

Effect of whole grains on markers of subclinical inflammation

The reduction of subclinical inflammation has been suggested as a potential mechanism to explain the favorable association between whole-grain consumption and reduced risk for cardiovascular disease, diabetes, and certain cancers. This review examines evidence for the effects of whole-grain consumption on markers of subclinical inflammation derived from 13 epidemiological and 5 interventional studies retrieved from a search of the PubMed database. Epidemiological studies provide reasonable support for an association between diets high in whole grains and lower C-reactive protein (CRP) concentrations. After adjusting for other dietary factors, each serving of whole grains is estimated to reduce CRP concentrations by approximately 7%. In contrast to epidemiological studies, interventional studies do not demonstrate a clear effect of increased whole-grain consumption on CRP or other markers of inflammation. Issues related to insufficient length of intervention, extent of dietary control, population selection, types of whole grains, and lack of a direct anti-inflammatory effect may underlie these discrepant findings. Additional carefully controlled interventional studies are needed to clarify the effects of whole grains on subclinical inflammation.