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By The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)July 18, 2022

By the time they were 18 months old, infants who began receiving taster portions of the new Nordic diet were eating 46% more vegetables than those who were fed a conventional diet.

Introducing infants and toddlers to a lower-protein Nordic-style diet that places an emphasis on plant-based foods could allow them to obtain healthy eating habits

New research recently presented at the 54th Annual Meeting of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)suggests that the key to healthier eating habits may be to introduce babies and toddlers to a lower protein Nordic-style diet with a greater focus on plant-based foods.

By the time they were 18 months old, infants who began receiving taster portions of the new Nordic diet, which includes fruit, berries, roots, and vegetables, along with breast or formula milk, were eating nearly twice as many vegetables (a 46 percent increase) as those who were fed a conventional diet.

As part of the OTIS experiment, researchers from the University of Umein Sweden, the Stockholm County Council Centre for Epidemiology, and the University of California in the United States studied two groups of infants from 4-6 months to 18 months. 250 infants in total participated, and 82% of them completed the study.

A graphic explaining the benefits of a Nordic-style diet. Credit: The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)

The toddlers in the 2 groups had quite different eating patterns, according to the study. Those who followed the new Nordic diet, who received Nordic home-made baby food recipes, protein-reduced baby food products, and social media support from other parents, ate 4245% more fruit and vegetables at 1218 months of age than those who followed the traditional diet currently advised by the Swedish Food Agency.

Although in the traditional diet group, fruit consumption remained constant, but between 12 and 18 months, infants receiving the traditional diet consumed 36% fewer vegetables.

Babies on the Nordic diet had an average protein intake 17-29% lower than those on the conventional diet at 12-18 months of age. This was still within recommended protein intake levels and the overall calorie count between the two groups was the same. The protein reduction in the Nordic diet group was replaced by more carbohydrates from vegetables, not more cereals, together with some extra fat from rapeseed oil.

Lead researcher Dr. Ulrica Johansson, a Medicine Doctor in pediatrics and registered dietitian at the University of Ume, Sweden, said there did not appear to be any negative effects from having a lower protein intake.

Commenting on the findings, Dr. Johansson says: A Nordic diet with reduced protein introduced to infants naive to this model of eating, increased the intake of fruit, berries, vegetables, and roots, establishing a preferable eating pattern lasting over a 12-month period.

There were no negative effects on breastfeeding duration, iron status or growth.

A Nordic diet reduced in protein is safe, feasible, and may contribute to sustainable and healthy eating during infancy and early childhood, she added.

The novel research could pave the way to broadening the taste spectrum in infants and potentially provide an effective strategy for instilling healthier eating habits early in life.

The Nordic diet has a higher intake of regionally and seasonally produced fruit, berries, vegetables, herbs, mushrooms, tubers, and legumes, as well as whole grains, vegetable fats and oils, fish and eggs, and a lower intake of sweets, desserts and dairy, meat, and meat products.

Typical Nordic fruits include lingonberry, buckthorn berry, cranberry, raspberry, and blueberry, as well as fiber-rich vegetables such as turnip, beets, swede, root celery, carrots, parsnip, cabbage, broccoli, cauliflower, and kale.

Chair of the ESPGHAN Nutrition Committee, Professor Jiri Bronsky, stated: The authors have shown a significant effect of the diet in 12 and 18 months of age of the children. The Nordic diet group consumed more fruit and vegetables and less protein than the control group. The Nordic diet was well tolerated and did not negatively affect the growth of the child or breastfeeding duration. Importantly, this research demonstrates that this diet is safe, feasible and exposes infants to a variety of flavors which may influence long-lasting food preferences.

Meeting: 54th Annual Meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)

See more here:
Research Shows a Lower Protein Diet Could Be the Key to Healthier Eating Habits - SciTechDaily

This transcript has been edited for clarity.

Hello. I'm Dr David Johnson, professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia. Welcome back to another GI Common Concerns.

All of us routinely see diet recommendations on the Internet like TikTok or in new books. Every possible diet seems to receive this promotional push, although the evidence behind them is often lacking.

So what do we mean when we talk about a "healthy diet"?

Today, I'd like to spend a few minutes updating you on the current evidence and how I discuss it with my patients so that you can perhaps do the same in your own patient discussions.

The Western diet has really cannibalized the health of the United States and Western civilizations.

This diet is typically characterized by high intakes of processed and prepacked food items, red meat, dairy, and grains, consisting of high-fat, high-protein, and low-fiber components. These food items have become diets of convenience as opposed to diets potentially promoting health.

They've led to an associated increase in so-called "diseases of civilization," including cardiovascular disease, obesity, and a variety of metabolic diseases and cancers.

Western diets have been also associated with a variety of microbial and gut integrity changes, which in turn, are associated with an assortment of bad outcomes. Specifically, they're associated with decreases in microbial diversity in the gut; upregulation of proinflammatory mediators, cytokines, and chemokines; and several changes to gut integrity, immunity, and pathways that are derivatives toward diseases and even promoting translocation of gut bacteria.

In contradistinction, we have the Mediterranean diet, which is often proffered as the good or healthy diet for most patients. This comprises a diet that's high in fiber and low in animal protein and saturated fat, and is characterized by a higher ingestion of vegetables, fruits, and healthy fat and a lower intake of red meat and dairy. The Dietary Guidelines for Americans recommend a Mediterranean diet for promoting health and minimizing disease.

The high fiber content of Mediterranean diets is a key reason behind that recommendation. Fiber comes in soluble and insoluble forms. Soluble fiber gets digested, whereas insoluble fiber moves through the gastrointestinal tract, bringing components of water absorption and promoting gut motility, particularly in the colon.

Insoluble fiber has a variety of ascribed benefits, particularly related to the changes in the gut production of short-chain fatty acids, which are incredibly important for optimizing intestinal function.

We know that short-chain fatty acids increase secretion of immunoglobulins, induce regulatory T-cell tissue repair, promote antimicrobial peptides and mucus production, and basically optimize intestinal function and the intestinal barrier integrity. This is all critically important in promoting health.

There are also some data on short-chain fatty acid production as it relates to crossing the blood-brain barrier. This association with the brain-gut axis potentially changes gut-related derivatives, driving mood and behavioral activities in the brain. Therefore, we can say that the short-chain fatty acid derivative from the intestinal microbiome does have central nervous systemrelated effects.

There are also some very interesting data in this area related to the progression of COVID to severe disease or long-haul COVID, or even the development of COVID. Enhanced microbial diversity seems to be somewhat protective and, if infected with COVID, predictive of a rapid response and resolution. Short-chain fatty acids also serve as a marker, particularly when they're reduced. Branch-chain shorty acid called L-isoleucine has been shown to be predictive of longer-term consequences and more-severe COVID. So diet may have a significant role in even in the COVID world.

There are other elements in the diet that may contribute to disease.

Some things commonly added to diets have been shown in animal models to have a significant impact in changing gut integrity. In particular, this is observed in prepacked foods that are often found in the Western diet, which incorporate things such as emulsifiers and food additives with a goal toward enhanced aesthetics and taste.

Some that we see routinely in popular food items are carboxymethyl cellulose and polysorbate-80. These are derivatives in a variety of dairy products. Interestingly, they decelerate the melting of ice cream. That may be good for your kids eating an ice cream cone in the backseat in the summer, but not so good potentially for the intestine.

The same is true as it relates to maltodextrin, which is a very common thickener and sweetener, but again decreases the mucosal layer thickness and increases gut permeability.

Carrageenan, which is made from red seaweed, is added to increase texture, primarily in dairy products and sauces. It also decreases gut integrity and permeability changes and antigenic translocation.

Another common food additive is high-fructose corn syrup, something we're seeing more and more data about. Its use in sugary beverages was once implied to have, and now clearly is associated with, an increased risk for nonalcoholic fatty liver disease, early colon cancer, and a variety of other cancer pathways. Recent animal model data have shown mechanistically how it contributes to colon cancer. It was also most recently associated with liver cancer in postmenopausal women ingesting one sugary beverage a day.

Almost all sugary beverages have shifted from using cane sugar to high-fructose corn syrup because it's cheaper and sweeter. Interestingly, as data have become more onerous regarding its disease associations, in 2012 the corn industry went to the US Food and Drug Administration and petitioned to change the name from high-fructose corn syrup to corn sugar. That term sounds a lot easier and maybe even sweeter when it comes to possible health implications, but the FDA said no.

Since then, the widespread use of high-fructose corn syrup has been described as a food public health crisis. High-fructose corn syrup is something that is very easy to avoid when you talk about sugary beverages.

When it comes to artificial sweeteners, the top three that have been studied to date are aspartame, saccharin, and sucralose (Splenda). They are not absorbed but rather are fermentable sugars that get to the gut and change the gut microbiome. In animal models, they have been shown to promote obesity and diabetes, which is very much paradoxical to what their advertised intent is. Again, this has only been studied for these three agents, and we also don't have data in lower-threshold exposures.

I think it's common sense to minimize the use of these things and instead ask patients to use natural sugars, consume water, and incorporate other strategies; that's what I discuss with my own patients.

We can go the wrong way and make our patients too rigid about reading nutritional labels. I want to caution you about emerging food restrictive disorders that very much can become an eating disorder. So we don't want to go the opposite way.

I tell my patients to be a good, conscientious thinker, look at your food, minimize the processed foods, and build your meals. The Western diet needs to go. The more we can use the Mediterranean diet, the better off we are. You can still have your occasional cheeseburger and French fries but use common sense.

The Mediterranean diet really is simple. I routinely recommend this to my patients with inflammatory bowel disease, obesity, nonalcoholic fatty liver disease, along with other inflammatory disease conditions. But I do think we can make this a general recommendation across all patients in our attempt to promote health and thereby prevent disease.

I hope this has been helpful.

I'm Dr David Johnson. Thanks for listening.

David A. Johnson, MD, a regular contributor to Medscape, is professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia, and a past president of the American College of Gastroenterology. His primary focus is the clinical practice of gastroenterology. He has published extensively in the internal medicine/gastroenterology literature, with principal research interests in esophageal and colon disease, and more recently in sleep and microbiome effects on gastrointestinal health and disease.

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Forget Fad Diets, Here's the One You Need - Medscape

It is widely accepted in modern culture that people should divide their daily diet into three large meals breakfast, lunch, and dinner for optimal health. This belief primarily stems from culture and early epidemiological studies.

In recent years, however, experts have begun to change their perspective, suggesting that eating smaller, more frequent meals may be best for preventing chronic disease and weight loss. As a result, more people are changing their eating patterns in favor of eating several small meals throughout the day.

Those who advocate for eating small, frequent meals suggest that this eating pattern can:

While a few studies support these recommendations, others show no significant benefit. In fact, some research suggests it may be more beneficial to stick with three larger meals.

Here is what the research says.

Early epidemiological studies suggest that increased meal frequency can improve blood lipid (fats) levels and reduce the risk of heart disease. As a result, many experts advise against eating fewer, larger meals a day.

Over the years, some studies have supported these findings, suggesting that people who report eating small, frequent meals have better cholesterol levels than those who consume fewer than three meals per day.

In particular, one 2019 cross-sectional study that compared eating fewer than three meals per day or more than four meals per day found that consuming more than four meals increases HDL (high-density lipoprotein) cholesterol and lowers fasting triglycerides more effectively. Higher levels of HDL are associated with a reduced risk of heart disease.

This study observed no differences in total cholesterol or LDL (low-density lipoprotein) cholesterol. It is important to note, however, that this is an observational study, meaning it can only prove association, not causation.

Additionally, one review published in the American Heart Associations journal Circulation concluded that greater eating frequency is associated with a reduced risk for diabetes and cardiovascular disease, according to epidemiological studies.

There is a commonly held notion that more frequent meals can help influence weight loss. However, the research on this remains mixed.

For example, one study compared eating three meals per day or six smaller, more frequent meals on body fat and perceived hunger. Both groups received adequate calories to maintain their current body weight using the same macronutrient distribution: 30% of energy from fat, 55% carbohydrate, and 15% protein.

At the end of the study, researchers observed no difference in energy expenditure and body fat loss between the two groups. Interestingly, those who consumed six smaller meals throughout the day had increased hunger levels and desire to eat compared to those who ate three larger meals per day.

Although calorie intake was controlled in both groups, researchers hypothesized that those who consumed frequent meals would be more likely to consume more daily calories than those who ate less frequently.

Results of another large observational study suggest that healthy adults may prevent long-term weight gain by:

Moreover, according to the United States Department of Agriculture (USDA) Scientific Report of the 2020 Dietary Guidelines Advisory Committee, due to inconsistencies and limitations in the current body of evidence, there is insufficient evidence to determine the relationship between meal frequency and body composition and the risk of overweight and obesity.

Small, frequent meals are often touted as a cure-all for obesity. Many believe that eating every 2 to 3 hours can help boost metabolism.

Digestion of food does require energy. This is known as the thermic effect of food (TEF). However, it does not appear that meal frequency plays a role in boosting metabolism.

In fact, some studies suggest fewer, larger meals may increase TEF more than eating frequent meals.

Although evidence to support increased meal frequency in the general population remains mixed, several experts believe that eating small, frequent meals can benefit athletes.

According to the International Society of Sports Nutrition, athletes who follow a reduced-calorie diet may benefit from eating small frequent meals with adequate protein because it can help preserve lean muscle mass.

When prioritizing total daily calorie intake, limited evidence suggests that, in athletes, a higher meal frequency may increase performance, support fat loss, and improve body composition.

People who eat more frequently are more likely to have better diet quality. Specifically, those who consume at least three meals per day are more likely to have a greater intake of vegetables, greens, legumes, fruit, whole grains, and dairy.

These individuals are also more likely to consume less sodium and added sugars than those who consume two meals per day.

Similarly, another 2020 study published in the British Journal of Nutrition found that increased meal frequency approximately three meals per day is associated with higher diet quality.

Researchers found that snack frequency and diet quality varied depending on the definition of snacks.

Based on the presented studies, no substantial evidence supports one eating pattern over the other. Yet many of these studies also have limitations.

For example, there is no universally accepted definition of what a meal or snack consists of. This can have an impact on study outcomes.

With that said, both eating patterns can be beneficial as long the primary focus is on healthful eating habits.

A review published in Nutrition in Clinical Practiceshows that certain populations may benefit from six to 10 small, frequent meals. These include people who:

If your goal is to lose weight, it is important to be mindful of your portion sizes. Be sure to stay within your allotted daily calorie needs and divide them among the number of meals you consume.

For example, if you need 1,800 calories to maintain your weight and choose to eat six small meals daily, each meal should be around 300 calories.

Small, frequent meals often come in the form of ultra-processed foods and snacks that fall short in many vital nutrients your body needs. Thus, it is essential to focus on the quality of the foods you consume.

People who may benefit from three larger meals per day include:

Again, keeping diet quality in mind and prioritizing whole foods is essential. Fewer meals mean fewer opportunities to get in key nutrients the body needs.

While we do not have strong evidence to support the importance of meal frequency, substantial evidence supports the overall health benefits of following a well-balanced, nutrient-rich diet.

According to the Dietary Guidelines for Americans 20202025, a healthy diet should:

Evidence is mixed about the importance of food frequency. While there is no solid evidence to suggest that one eating style is superior to the other, both can offer health and wellness benefits if you follow a healthy eating pattern.

Thus, it ultimately comes down to personal preference and which approach works best for you. Additionally, if you have certain health conditions, one style may benefit you over the other.

As always, consult your healthcare provider before making any significant changes to your diet.

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Meal frequency and portion size: What to know - Medical News Today

After suffering from the severe summer heatwaves, we all look forward to enjoying the monsoon season. And now the season has finally arrived, we look for the reasons to indulge in our favourite snacks with a piping hot cup of 'kadak chai' while enjoying the beautiful weather. Apart from this, there's one thing which we should never take for granted and that is our health. Monsoon season can really take a toll on your health, especially hampering immunity. So, it is mandatory to consume food that can make your immune system strong. A strong immune system can protect you from many unwanted diseases. Having said that, here we bring you a list of fruits that you must add to your diet to cope up with monsoon effects. Take a look.

Also read:Monsoon Diet Tips: 7 Low-Cal Fruits And Vegetables For Monsoon Diet (Recipes Inside)

According to the USDA data, jamun consists of 1.41 mg iron, 15 mg of calcium and 18 mg of vitamin C. Besides, this seasonal delight is also rich in antioxidants that help boost immunity and formulate collagen resulting in glowing skin. For more benefits of jamun and healthy recipes, click here.

You must have heard the very popular saying ''an apple a day keeps the doctor away'. Well, that's true! Apples are rich in Vitamin C and flavonoids called quercetin that help in improving the immunity, keeping any ailment at bay. To know more benefits of apples, click here.

This fruit is known for its juicy pearls and extraordinary taste. Besides, it is loaded with antioxidants that help improve gut-health and immune system as well. These are some factors that can also help you in losing some extra kilos. According to Celebrity nutritionist and life coach Luke Coutinho, pomegranate might help you detox better than green tea. You can read the complete detailed study, click here.

Bananas are high in Vitamin B6 that helps in keeping the immune system function properly. You can use this fruit as a base to prepare delicious smoothies and shakes. For more banana benefits, click here.

Besides plenty of fibre and potassium, pears are rich in Vitamin C and also contain anti-inflammatory flavonoids in their peels-so make sure you consume the skin for the super nutrient boost. Click here.

So, what are you waiting for? Stock up these seasonal treats and add them to the diet now.

See the rest here:
Monsoon Diet: 5 Immunity-Boosting Fruits You Must Add To The Diet - NDTV Food

When it was announced earlier this month that Diet Coke queen, Kate Moss, would finally be taking her well-deserved place on the Coca-Cola throne as the UK creative director of the diet variety, fans of the supermodel rejoiced. Long has Moss been a champion of the beverage, and after the position sat empty for a decade following Marc Jacobs stint in the role, Moss seemed like the perfect replacement. As for what she would do as the creative director, that part was unclear. I'm looking forward to inspiring fans and celebrating the brand's 40th birthday in style, Moss said in the brands announcement, which also stated that Moss would continue to showcase the positive attitude of Diet Coke drinkers, throughout the summer.

On Wednesday, Moss duties as the queen of the no calorie Coke became clear(er) when the model hosted an event at London's 180 The Strand. It was there that Moss unveiled four newly-designed cans, each of which were inspired by some of Moss most iconic looks from throughout the years. Of course, one of those cans includes a leopard motif, referencing the models love for the animal print. Its fitting, then, that for the event, Moss opted to wear a leopard print blouse, which she paired with black tapered trousers, a large black belt, and some gold sandals. She finished off the look with a lip color which can only be described as Coke red.

David M. Benett/Getty Images Entertainment/Getty Images

Unfortunately, it seems like Moss creative director duties only reach across the UK, meaning American fans will likely have to travel abroad if they want to get their hands on a Moss-designed can. But thanks to the wonderful world wide web, we can still enjoy her reign from here, and sip on our non-Moss Cokes as a consolation.

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Kate Moss Takes Her Place as the New Queen of Diet Coke in Leopard - W Magazine

The internet is rife with advice for keeping the brain sharp as we age, and much of it is focused on the foods we eat. Headlines promise that oatmeal will fight off dementia. Blueberries improve memory. Coffee can slash your risk of Alzheimers disease. Take fish oil. Eat more fiber. Drink red wine. Forgo alcohol. Snack on nuts. Dont skip breakfast. But definitely dont eat bacon.

One recent diet study got media attention, with one headline claiming, Many people may be eating their way to dementia. The study, published last December in Neurology, found that people who ate a diet rich in anti-inflammatory foods like fruits, vegetables, beans and tea or coffee had a lower risk of dementia than those who ate foods that boost inflammation, such as sugar, processed foods, unhealthy fats and red meat.

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But the study, like most research on diet and dementia, couldnt prove a causal link. And thats not good enough to make recommendations that people should follow. Why has it proved such a challenge to pin down whether the foods we eat can help stave off dementia?

First, dementia, like most chronic diseases, is the result of a complex interplay of genes, lifestyle and environment that researchers dont fully understand. Diet is just one factor. Second, nutrition research is messy. People struggle to recall the foods theyve eaten, their diets change over time, and modifying what people eat even as part of a research study is exceptionally difficult.

For decades, researchers devoted little effort to trying to prevent or delay Alzheimers disease and other types of dementia because they thought there was no way to change the trajectory of these diseases. Dementia seemed to be the result of aging and an unlucky roll of the genetic dice.

While scientists have identified genetic variants that boost risk for dementia, researchers now know that people can cut their risk by adopting a healthier lifestyle: avoiding smoking, keeping weight and blood sugar in check, exercising, managing blood pressure and avoiding too much alcohol the same healthy behaviors that lower the risk of many chronic diseases.

Diet is wrapped up in several of those healthy behaviors, and many studies suggest that diet may also directly play a role. But what makes for a brain-healthy diet? Thats where the research gets muddled.

Despite loads of studies aimed at dissecting the influence of nutrition on dementia, researchers cant say much with certainty. I dont think theres any question that diet influences dementia risk or a variety of other age-related diseases, says Matt Kaeberlein, who studies aging at the University of Washington in Seattle. But are there specific components of diet or specific nutritional strategies that are causal in that connection? He doubts it will be that simple.

In the United States, an estimated 6.5 million people, the vast majority of whom are over age 65, are living with Alzheimers disease and related dementias. Experts expect that by 2060, as the senior population grows, nearly 14 million residents over age 65 will have Alzheimers disease. Despite decades of research and more than 100 drug trials, scientists have yet to find a treatment for dementia that does more than curb symptoms temporarily (SN: 7/3/21 & 7/17/21, p. 8). Really what we need to do is try and prevent it, says Maria Fiatarone Singh, a geriatrician at the University of Sydney.

Forty percent of dementia cases could be prevented or delayed by modifying a dozen risk factors, according to a 2020 report commissioned by the Lancet. The report doesnt explicitly call out diet, but some researchers think it plays an important role. After years of fixating on specific foods and dietary components things like fish oil and vitamin E supplements many researchers in the field have started looking at dietary patterns.

That shift makes sense. We do not have vitamin E for breakfast, vitamin C for lunch. We eat foods in combination, says Nikolaos Scarmeas, a neurologist at National and Kapodistrian University of Athens and Columbia University. He led the study on dementia and anti-inflammatory diets published in Neurology. But a shift from supplements to a whole diet of myriad foods complicates the research. A once-daily pill is easier to swallow than a new, healthier way of eating.

Suspecting that inflammation plays a role in dementia, many researchers posit that an anti-inflammatory diet might benefit the brain. In Scarmeas study, more than 1,000 older adults in Greece completed a food frequency questionnaire and earned a score based on how inflammatory their diet was. The lower the score, the better. For example, fatty fish, which is rich in omega-3 fatty acids, was considered an anti-inflammatory food and earned negative points. Cheese and many other dairy products, high in saturated fat, earned positive points.

During the next three years, 62 people, or 6 percent of the study participants, developed dementia. People with the highest dietary inflammation scores were three times as likely to develop dementia as those with the lowest. Scores ranged from 5.83 to 6.01. Each point increase was linked to a 21 percent rise in dementia risk.

Such epidemiological studies make connections, but they cant prove cause and effect. Perhaps people who eat the most anti-inflammatory diets also are those least likely to develop dementia for some other reason. Maybe they have more social interactions. Or it could be, Scarmeas says, that people who eat more inflammatory diets do so because theyre already experiencing changes in their brain that lead them to consume these foods and what we really see is the reverse causality.

To sort all this out, researchers rely on randomized controlled trials, the gold standard for providing proof of a causal effect. But in the arena of diet and dementia, these studies have challenges.

Dementia is a disease of aging that takes decades to play out, Kaeberlein says. To show that a particular diet could reduce the risk of dementia, it would take two-, three-, four-decade studies, which just arent feasible. Many clinical trials last less than two years.

As a work-around, researchers often rely on some intermediate outcome, like changes in cognition. But even that can be hard to observe. If youre already relatively healthy and dont have many risks, you might not show much difference, especially if the duration of the study is relatively short, says Sue Radd-Vagenas, a nutrition scientist at the University of Sydney. The thinking is if youre older and you have more risk factors, its more likely we might see something in a short period of time. Yet older adults might already have some cognitive decline, so it might be more difficult to see an effect.

Many researchers now suspect that intervening earlier will have a bigger impact. We now know that the brain is stressed from midlife and theres a tipping point at 65 when things go sour, says Hussein Yassine, an Alzheimers researcher at the Keck School of Medicine of the University of Southern California in Los Angeles. But intervene too early, and a trial might not show any effect. Offering a healthier diet to a 50- or 60-year-old might pay off in the long run but fail to make a difference in cognition that can be measured during the relatively short length of a study.

And its not only the timing of the intervention that matters, but also the duration. Do you have to eat a particular diet for two decades for it to have an impact? Weve got a problem of timescale, says Kaarin Anstey, a dementia researcher at the University of New South Wales in Sydney.

And then there are all the complexities that come with studying diet. You cant isolate it in the way you can isolate some of the other factors, Anstey says. Its something that youre exposed to all the time and over decades.

In a clinical trial, researchers often test the effectiveness of a drug by offering half the study participants the medication and half a placebo pill. But when the treatment being tested is food, studies become much more difficult to control. First, food doesnt come in a pill, so its tricky to hide whether participants are in the intervention group or the control group.

Imagine a trial designed to test whether the Mediterranean diet can help slow cognitive decline. The participants arent told which group theyre in, but the control group sees that they arent getting nuts or fish or olive oil. What ends up happening is a lot of participants will start actively increasing the consumption of the Mediterranean diet despite being on the control arm, because thats why they signed up, Yassine says. So at the end of the trial, the two groups are not very dissimilar.

Second, we all need food to live, so a true placebo is out of the question. But what diet should the control group consume? Do you compare the diet intervention to peoples typical diets (which may differ from person to person and country to country)? Do you ask the comparison group to eat a healthy diet but avoid the food expected to provide brain benefits? (Offering them an unhealthy diet would be unethical.)

And tracking what people eat during a clinical trial can be a challenge. Many of these studies rely on food frequency questionnaires to tally up all the foods in an individuals diet. An ongoing study is assessing the impact of the MIND diet (which combines part of the Mediterranean diet with elements of the low-salt DASH diet) on cognitive decline. Researchers track adherence to the diet by asking participants to fill out a food frequency questionnaire every six to 12 months. But many of us struggle to remember what we ate a day or two ago. So some researchers also rely on more objective measures to assess compliance. For the MIND diet assessment, researchers are also tracking biomarkers in the blood and urine vitamins such as folate, B12 and vitamin E, plus levels of certain antioxidants.

Another difficulty is that these surveys often dont account for variables that could be really important, like how the food was prepared and where it came from. Was the fish grilled? Fried? Slathered in butter? Those things can matter, says dementia researcher Nathaniel Chin of the University of WisconsinMadison.

Plus there are the things researchers cant control. For example, how does the food interact with an individuals medications and microbiome? We know all of those factors have an interplay, Chin says.

The few clinical trials looking at dementia and diet seem to measure different things, so its hard to make comparisons. In 2018, Radd-Vagenas and her colleagues looked at all the trials that had studied the impact of the Mediterranean diet on cognition. There were five at the time. What struck me even then was how variable the interventions were, she says. Some of the studies didnt even mention olive oil in their intervention. Now, how can you run a Mediterranean diet study and not mention olive oil?

Another tricky aspect is recruitment. The kind of people who sign up for clinical trials tend to be more educated, more motivated and have healthier lifestyles. That can make differences between the intervention group and the control group difficult to spot. And if the study shows an effect, whether it will apply to the broader, more diverse population comes into question. To sum up, these studies are difficult to design, difficult to conduct and often difficult to interpret.

Kaeberlein studies aging, not dementia specifically, but he follows the research closely and acknowledges that the lack of clear answers can be frustrating. I get the feeling of wanting to throw up your hands, he says. But he points out that there may not be a single answer. Many diets can help people maintain a healthy weight and avoid diabetes, and thus reduce the risk of dementia. Beyond that obvious fact, he says, its hard to get definitive answers.

In July 2021, Yassine gathered with more than 30 other dementia and nutrition experts for a virtual symposium to discuss the myriad challenges and map out a path forward. The speakers noted several changes that might improve the research.

One idea is to focus on populations at high risk. For example, one clinical trial is looking at the impact of low- and high-fat diets on short-term changes in the brain in people who carry the genetic variant APOE4, a risk factor for Alzheimers. One small study suggested that a high-fat Western diet actually improved cognition in some individuals. Researchers hope to get clarity on that surprising result.

I get the feeling of wanting to throw up your hands.

Another possible fix is redefining how researchers measure success. Hypertension and diabetes are both well-known risk factors for dementia. So rather than running a clinical trial that looks at whether a particular diet can affect dementia, researchers could look at the impact of diet on one of these risk factors. Plenty of studies have assessed the impact of diet on hypertension and diabetes, but Yassine knows of none launched with dementia prevention as the ultimate goal.

Yassine envisions a study that recruits participants at risk of developing dementia because of genetics or cardiovascular disease and then looks at intermediate outcomes. For example, a high-salt diet can be associated with hypertension, and hypertension can be associated with dementia, he says. If the study shows that the diet lowers hypertension, we achieved our aim. Then the study could enter a legacy period during which researchers track these individuals for another decade to determine whether the intervention influences cognition and dementia.

One way to amplify the signal in a clinical trial is to combine diet with other interventions likely to reduce the risk of dementia. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, or FINGER, trial, which began in 2009, did just that. Researchers enrolled more than 1,200 individuals ages 60 to 77 who were at an elevated risk of developing dementia and had average or slightly impaired performance on cognition tests. Half received nutritional guidance, worked out at a gym, engaged in online brain-training games and had routine visits with a nurse to talk about managing dementia risk factors like high blood pressure and diabetes. The other half received only general health advice.

After two years, the control group had a 25 percent greater cognitive decline than the intervention group. It was the first trial, reported in the Lancet in 2015, to show that targeting multiple risk factors could slow the pace of cognitive decline.

Now researchers are testing this approach in more than 30 countries. Christy Tangney, a nutrition researcher at Rush University in Chicago, is one of the investigators on the U.S. arm of the study, enrolling 2,000 people ages 60 to 79 who have at least one dementia risk factor. The study is called POINTER, or U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk. The COVID-19 pandemic has delayed the research organizers had to pause the trial briefly but Tangney expects to have results in the next few years.

This kind of multi-intervention study makes sense, Chin says. One of the reasons why things are so slow in our field is were trying to address a heterogeneous disease with one intervention at a time. And thats just not going to work. A trial that tests multiple interventions allows for people to not be perfect, he adds. Maybe they cant follow the diet exactly, but they can stick to the workout program, which might have an effect on its own. The drawback in these kinds of studies, however, is that its impossible to tease out the contribution of each individual intervention.

Two major reports came out in recent years addressing dementia prevention. The first, from the World Health Organization in 2019, recommends a healthy, balanced diet for all adults, and notes that the Mediterranean diet may help people who have normal to mildly impaired cognition.

The 2020 Lancet Commission report, however, does not include diet in its list of modifiable risk factors, at least not yet. Nutrition and dietary components are challenging to research with controversies still raging around the role of many micronutrients and health outcomes in dementia, the report notes. The authors point out that a Mediterranean or the similar Scandinavian diet might help prevent cognitive decline in people with intact cognition, but how long the exposure has to be or during which ages is unclear. Neither report recommends any supplements.

Plenty of people are waiting for some kind of advice to follow. Improving how these studies are done might enable scientists to finally sort out what kinds of diets can help hold back the heartbreaking damage that comes with Alzheimers disease. For some people, that knowledge might be enough to create change.

One of the reasons why things are so slow in our field is were trying to address a heterogeneous disease with one intervention at a time. And thats just not going to work.

Inevitably, if youve had Alzheimers in your family, you want to know, What can I do today to potentially reduce my risk? says molecular biologist Heather Snyder, vice president of medical and scientific relations at the Alzheimers Association.

But changing long-term dietary habits can be hard. The foods we eat arent just fuel; our diets represent culture and comfort and more. Food means so much to us, Chin says.

Even if you found the perfect diet, he adds, how do you get people to agree to and actually change their habits to follow that diet? The MIND diet, for example, suggests people eat less than one serving of cheese a week. In Wisconsin, where Chin is based, thats a nonstarter, he says.

But its not just about changing individual behaviors. Radd-Vagenas and other researchers hope that if they can show the brain benefits of some of these diets in rigorous studies, policy changes might follow. For example, research shows that lifestyle changes can have a big impact on type 2 diabetes. As a result, many insurance providers now pay for coaching programs that help participants maintain healthy diet and exercise habits.

You need to establish policies. You need to change cities, change urban design. You need to do a lot of things to enable healthier choices to become easier choices, Radd-Vagenas says. But that takes meatier data than exist now.

More here:
How scientists are trying new ways to study diet and dementia - Science News Magazine

The pegan diet requires that 75% of your nutritional intake is plant-based and only 25% of products from animals that are raised naturally, pastured and grain-fed, and unprocessed, statesCleveland Clinic. Further simplified, it requires the dieter to eat a minimum of five cups of vegetables, four servings of carbohydrates, three proteins, two fats, and a dairy substitute daily, per Womens' Health Magazine.

Things that are prohibited in the pegan diet are beer, milk, and starchy vegetables with a high glycemic index. Beans, peas, and lentils, which are important protein sources for vegans, are not required in the pegan food regimen. Some believe, per Women's Health Magazine, gluten has no place in the pegan diet, but Dr. Hyman (via Forbes) states that not everything gluten-free is healthy. The restriction on grain foods deprives the body of fiber that is essential for the body's continued health. The necessary fats for the body come from unprocessed sources like olive oil, nuts, avocados, olives, and seeds (if rendered in the form of an oil that needs minimal processing), per WebMD.

Dr. Hyman, the physician and author credited with the pegan concept, sought after and created a middle ground between two extremes to form a diet that is more sustainable. As such, the paleo diet meets the vegan diet halfway, to form the pegan diet.

Read the rest here:
Everything You Need To Know About The Pegan Diet - Mashed

Colorectal cancer (CRC) is any cancer affecting the colon, hence colo, and rectum, hence rectal. It is the third most common and second deadliest diagnosed cancer in the United States, claiming over 50,000 lives every year.

Researchers from Brigham and Womens Hospital in Boston, MA recently observed that CRC tumors with high levels of pks+ E. coli bacteria correlate with diets rich in red and processed meats and empty calories.

They believe that unhealthy foods may stimulate the cancer-inducing activity of colibactin, a substance deriving from E. coli, in the gut.

Their findings appear in Gastroenterology.

Dr. Shuji Ogino, chief of the Molecular Pathological Epidemiology Program in the Department of Pathology at Brigham and Womens Hospital, was the studys corresponding author.

E. coli is a normal part of the gut microbiome. However, certain strains of this bacterium hold a distinct cluster of genes known as the polyketide synthase (pks) island.

These pks+ E. coli strains produce colibactin, a toxic metabolite that can damage DNA and trigger cellular mutations that promote CRC.

Consumption of a typical Western diet also sometimes called an American diet consisting mainly of red and processed meats, sugar, and refined carbohydrates, can cause intestinal and systemic inflammation, precursors to colorectal tumors.

A poor diet is also tied to an imbalance of intestinal microbiota, another factor related to CRC. Furthermore, prior studies have linked E. coli and other bacteria to this cancer.

Consequently, Dr. Ogino and his team suspected that a Western diet might induce a stronger risk for tumors with considerable amounts of pks+ E. coli. Up to this point, though, they did not know whether the diets correlation with CRC varies by gut bacteria.

The researchers combed through two nationwide studies to see how Western diets may influence intestinal microbe activity and the odds of CRC occurrences.

The Nurses Health Study included 121,700 women aged 30 to 55 at enrollment in 1976. The Health Professionals Follow-up Study included 51,529 males ages 40 to 75 years at enrollment in 1986.

These studies provided detailed insight into 30 years of medical and dietary history of its subjects. They presented a unique opportunity to examine long-term dietary patterns of individuals who had not known whether they would develop cancers or not in relation to CRC incidence subclassified by pks+ E. coli levels.

The data were adjusted for potential selection bias and factors such as body mass index (BMI), physical activity, tobacco and alcohol consumption, and family history of CRC.

A total of 134,775 of the two studies participants provided enough dietary information to be included in this analysis. Among these, the researchers found 3,200 CRC cases.

The team also extracted DNA from archived tissue sections of colorectal tumors to find pks+ E. coli strains.

The researchers admitted that their study comes with several limitations.

More studies are needed to confirm how the overall Western diet or specific foods and pks+ E. coli may work together to promote CRC.

Speaking with Medical News Today, Dr. Ogino acknowledged that the research population was mostly non-Hispanic Caucasian. However, he cited evidence of a growing trend of early-onset CRC among other ethnicities.

Dr. Ogino and fellow scientists found sex-specific differences in pks+ E. coli colorectal cancer occurrences, but the underlying mechanisms are still unclear.

Measurement errors and unintentional mixing of the effects of factors may have skewed some results as well.

While colibactin in CRC tumors encourages cancer growth, some researchers believe that a healthy gut microbiome may halt tumor progression.

University of Michigan scientists recently found that the metabolite reuterin, produced by the bacteria Lactobacillus reuteri, shows potent anticancer potential in CRC cell lines and in vivo.

At the National Comprehensive Cancer Network 2022 Annual Meeting, lead investigator Joshua Goyert, of the University of Michigan Medical School Rogel Cancer Center, said that the gut microbiome, and especially reuterin, can reduce oxidative stress in CRC cells and inhibit tumor proliferation and tumor volume in in vivo models.

Dr. Ogino said that this study is among the first to associate the Western diet with specific disease-causing bacteria in cancer.

Ultimately, he believes that this research demonstrates how dietary choices may help prevent CRC.

Dr. Ogino commented emphatically:

As a society, we do not generally recognize the importance of prevention. Rather, we always regret after harms happen (e.g., cancer occurs). We need to change our mindsets and become proactive. Media is very hot about new treatment for end-stage cancer patients, which may prolong life for a few months. While this is important, it is much better to prevent. If we can prevent 10% of colorectal cancer cases, 150,000 new CRC cases each year in the U.S. would become 135,000 new CRC cases. You can see 15,000 people each year do not need suffer side effects of treatment or surgery. This would be a big impact.

Read the rest here:
Western-style diet tied to higher risks of colorectal cancer - Medical News Today

Local nutrition coach Tony LoCicero created Get Toned Diet Coaching, a program working to help those who struggle with weight loss/gain, as well as building muscle mass and giving your body a balanced nutritional outlook.

I try to make it a customized diet that can be done long term. Weve got to figure out something that doesnt disrupt your life too much or come across as too extreme, LoCicero says.

I want to help people reach their goals. I want to educate people on food because I feel so many people are lost in what is good for you and what is not. Theres so much information today and it can be misleading. My goal is to help people understand and be there to answer any questions along the way.

Tony emphasizes that in order to understand fitness and nutrition, it has to be a lifestyle. It has to be a long term goal. You have to find ways to make it fit your lifestyle and reach those goals. Often times people set themselves up for failure when they try to set expectations way too high and be hard on themselves.

It doesnt need to be complicated. Its just food. Youre going to have to put in the time. Youre going to have to put in the effort. Theres going to be times where your family is going out for pizza and youre going to not be able to do that. Its all about training your mind.

Its not like a race. So many people are in such a hurry in life and thats not how it has to be. Its going to take time to lose the fat and become who you want to be.

LoCicero also says how he tells people that there really are no bad foods. Youve got to take it in moderation. If you cut out all the things you enjoy, then how long will you last? Not long. The process is understanding that you can have foods you enjoy, but its all about building that lifestyle and understanding what nutrition truly is.

Get Toned Diet Coaching with Tony LoCicero is available on Instagram @get_toned_diet_coaching and Tony is also available by Facebook.

The rest is here:
Local diet coach looking to change the way people see nutrition - River Valley Now

Bryant Stamford| Special to the Courier Journal

Lately, I have focused on good carbs versusbad carbs, and the champion of bad carbs is soft drinks.

A typical 12-ounce cola contains about 10 teaspoons of sugar, which exceeds the full daily allowance of sugar on a healthy diet. Thats bad news, of course, so why do so many Americans continue to indulge in the health destroying habit of consuming garbage colas like theyre going out of style?

One possible answer, according to some experts, is that sugar is addictive, psychologically and possibly physiologically, and the more sugar you take in, especially in high quantities all at once as occurs with soft drinks, the greater the power of the addiction. Another explanation is that folks are unaware of the adverse health impactbecause they have been consuming colas all their life and not paying a price for it yet.

One price associated with too much sugar intake thatis quite high is developing prediabetes. This occurs when the body stores too much fat, especially around the midsection, which can lead to insulin resistance. In other words, your pancreas gland is doing its job and releasing insulin when you consume sugar. In turn, insulin is required to escort sugar out of the bloodstream and into the cells. When there is resistance to insulin, sugar cannot enter the cells and it accumulates in the bloodstream, leading to a high blood sugar concentration.

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Experts contend that a whopping 35% of the adult American population has prediabetes, and if it worsens over time, which often is the case, it can morph into Type 2 diabetes, when the body has an extreme insulin resistance.

So, what can we do to prevent rising cases of prediabetes?

Its high time we reduced our daily intake of sugar. But we Americans dont give up our guilty pleasures easily, and will do all we can to find an acceptable alternative. In other words, we are not willing to sacrifice much, if at all. This leads us to artificial sweeteners, which are found in thousands of food products, and especially soft drinks.

At first glance, artificial sweeteners seem like a no-brainer, substituting zero calories (kcals) in a soft drink for the fully loaded 150 calories. This, of course, was the sales pitch when Aspartame, one of the leading artificial sweeteners, was approved by the U.S. Food and Drug Administration more than 40 years ago. Americans are fat and getting fatter year by year, and the biggest cause is excess intake of sugar. Therefore, the assumption was that folks would endeavor to reduce fat accumulation by shying away from sugar and toward diet foods, especially diet soft drinks. This, in turn, would help lessen the accelerating fatty trend in our population.

Oops, not so.

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Many who regularly consume soft drinks merely added a diet drink or two to their daily regimen, thinking that its a freebe with no consequences. Still others bit the bullet and shifted entirely to diet soft drinks, but even so, they kept getting fatter.

Consuming diet drinks and still getting fatter isnt fair, plus it makes no sense. Isnt it true that when you consume excess calories, the body gets fatter, and therefore if you consume fewer calories you should lose body fat? Yes, of course. Its the proverbial calories in versus calories out argument. When the out calories are greater, you enter a negative caloric balance and should lose body fat.

So, what went wrong? The answer may be found in the bodys response to insulin.

Recent research indicates that chronic use of diet soft-drinks can alter certain bacteria in the gastro-intestinal tract, which can contribute to insulin resistance. Typically, excess body fatness, especially around the midsection, is the prime factor in insulin resistance. However, chronic intake of diet drinks, even if they reduce calories and body fatness, can still contribute to insulin resistance.

Several years ago, before this topic gained much attention, one of my students conducted her senior thesis research study on this topic. She had two groups of subjects that were very similar (same age, gender, body composition, physical activity level, etc.), except that one group regularly consumed a large amount of Aspartame daily (Consumers), while the other group consumed little or none (Abstainers). Both groups underwent an oral glucose tolerance test (OGTT) that entailed being fasted for at least 12-hours, then they consumed 50 grams of glucose with blood samples taken every 15 minutes over 90 minutes to trace the impact on blood glucose concentration.

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When you take an OGTT test, the blood sugar (glucose) concentration suddenly spikes upward as sugar rushes from quick digestion into the blood stream. This causes a powerful insulin response from the pancreas gland to move sugar into the cells.In a healthy response, the blood sugar level soon peaks, then comes back down to the resting level. However, with insulin resistance, the blood sugar level remains elevated for a prolonged period.

Results from this study indicated that Abstainers demonstrated a better OGTT, with a lower peak blood glucose concentration and a much faster clearance of glucose from the blood. In other words, Abstainers responded in a healthy way to a glucose challenge, while the response of Consumers was compromised. These findings support the notion that Consumers were, to some degree, insulin resistant when compared with Abstainers.

Over time, this could contribute to increased body fatness that, in turn, could lead to prediabetes, and ultimately to Type 2 diabetes, plus the potential for other negative health implications. Since then, we have conducted several additional research studies on this topic in our lab, and others have as well, and the results support these findings.

The bottom line is, choosing between a sugary soft-drink versus a 'diet'soft-drink is a Sophies choice, meaning neither choice is good. A third and healthier alternative, like drinking water, is a much better way to go.

Reach Bryant Stamford, a professor of kinesiology and integrative physiology at Hanover College, at stamford@hanover.edu.

Go here to see the original:
Why diet soda is bad for you and not the answer if you're looking for quick weight loss - Courier Journal

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