The energy density of the diet (i.e. available energy per unit weight) is one indicator of diet quality. Lean meats, fish, low-fat dairy products and fresh vegetables and fruit provide fewer calories per unit weight than do fast foods, sweets, candy and desserts. Energy dense foods provide more calories per unit weight but tend to be nutrient-poor.

Diets of low energy density and high nutrient content have been associated with less weight gain and with lower rates of obesity, type 2 diabetes, cardiovascular disease and some forms of cancer. In contrast, energy-dense diets have been linked to higher obesity rates and higher disease risk. Improving diet quality by lowering its energy density is standard advice for weight control, cancer prevention and better health.

The 164 participants (103 women and 61 men) recorded their usual frequency of consumption of 152 foods and 22 beverages and indicated portion size. They also provided four-day dietary records and completed demographic and behavioral questionnaires.

For both men and women, higher dietary energy density was associated with higher intakes of total fat and saturated fat and with lower intakes of dietary fiber, potassium and vitamins A and C. Daily diet cost ($/day) was slightly higher for men ($6.72/day) than women ($6.21/day), reflecting the fact that men ate more than women. However, the difference reversed after adjusting for energy. For each 2,000 kcal of dietary energy, men spent $7.43 compared to $8.12 spent by women. Diets that were more costly in terms of $/2000 kcal were also lower in energy density and contained higher levels of nutrients.

Higher quality diets were not only more costly per 2000 kcal but were associated with higher household incomes and education of study participants. Education, rather than incomes was the dominant factor. More highly educated respondents reported higher quality and therefore more costly diets, independent of household income level.

Writing in the article, Pablo Monsivais, PhD MPH, and Adam Drewnowski, PhD, both of the University of Washington, Seattle, conclude, “The finding that higher-quality diets were consumed by women of higher (socioeconomic status) and more costly per 2000 kcal has implications for epidemiologic studies of diet and chronic disease. Nutritional epidemiology has historically been based on the premise that nutrient exposures are directly linked to health outcomes. However, nutritional status is also intimately linked to socioeconomic status, and the findings reported here raise the possibility that the higher monetary cost of nutritious diets may provide one explanation for these observations. Future studies, based on more representative samples, will be needed to elucidate the connections between diet quality and diet cost across socioeconomic strata.”

Journal reference:

1. Monsivais et al. Lower-Energy-Density Diets Are Associated with Higher Monetary Costs per Kilocalorie and Are Consumed by Women of Higher Socioeconomic Status. Journal of the American Dietetic Association, 2009; 109 (5): 814

(ScienceDaily.com)

By 2020, as many as 3 million Americans are expected to have late-stage age-related macular degeneration (AMD), according to background information in one of the articles. AMD is the leading cause of severe vision loss among individuals older than 65 in the developed world. Established risk factors include age, genetic markers and smoking (the only consistently reported modifiable risk factor).

In one report, Jennifer S.L. Tan, M.B.B.S., B.E., of Westmead Hospital, University of Sydney, Australia, and colleagues studied 2,454 participants in the Blue Mountains Eye Study, which began in 1992 to 1994. At that time, participants completed a food frequency questionnaire that was analyzed to determine their intake of various fatty acids. Digital photographs of the retina were used to assess the development of AMD five and 10 years later.

After adjusting for age, sex and smoking, eating one serving of fish per week was associated with a 31 percent lower risk of developing early AMD. The association was stronger among individuals with a lower intake of linoleic acid, an unsaturated omega-6 fatty acid found primarily in vegetable oils. Eating one to two servings of nuts per week was associated with a 35 percent lower risk of early AMD.

“In conclusion, our findings support the hypothesis that increased intake of omega-three polyunsaturated fatty acids and regular consumption of fish and/or nuts in the diet may protect against the development of early AMD,” the authors write. These fatty acids may protect the eyes by preventing the buildup of plaque in the arteries or reducing inflammation, blood vessel formation and oxygen-related cell damage in the retina.

Joint effects of protection against AMD were suggested between the consumption of these foods and other factors, such as smoking, intake of unsaturated omega-6 fatty acids or beta carotene and the ratio of total blood cholesterol to HDL or “good” cholesterol. “These findings also suggest that an appropriate balance among various nutrients is essential for maximizing nutritional benefit,” they continue. Further studies are needed to determine whether changing an individual’s diet or recommending supplementation could prevent or delay the development of AMD.

In the other report, Elaine W.-T. Chong, M.D., Ph.D., M.Epi., of the Centre for Eye Research Australia, and colleagues analyzed data from 6,734 individuals age 58 to 69. Between 1990 and 1994, participants’ nutrient intakes were assessed from a food frequency questionnaire, and they were tracked for the development of AMD between 2003 and 2006. During the follow-up period, 2,872 cases of early AMD and 88 cases of late AMD developed.

Individuals who consumed higher levels of trans-unsaturated fats—found in baked goods and processed foods—were more likely to have late AMD, whereas those who consumed the most omega-three fatty acids were less likely to have early AMD. “Olive oil intake (100 milliliters or more per week vs. less than 1 milliliter per week) was associated with decreased prevalence of late AMD,” the authors write. “No significant associations with AMD were observed for intakes of fish, total fat, butter or margarine.”

Trans-unsaturated fatty acids have been shown to increase the risk of coronary heart disease through their effects on cholesterol levels and possibly through inflammation. In contrast, omega-three fatty acids are believed to protect against damage to the retina, thereby reducing risk for AMD. Although the primary fats found in olive oil (oleic acid and monounsaturated fatty acids) were not associated with AMD risk, olive oil contains other components that may have a protective effect, such as the antioxidants and anti-inflammatory compounds.

“Our findings suggest that people who follow a diet low in processed foods high in trans-unsaturated fatty acids and rich in omega-three fatty acids and olive oil might enjoy some protection from developing AMD,” the authors conclude.

Journal reference:

1. Tan et al. Dietary Fatty Acids and the 10-Year Incidence of Age-Related Macular Degeneration: The Blue Mountains Eye Study. Archives of Ophthalmology, 2009; 127 (5): 656

(ScienceDaily.com)

Ninety-six low-income black and Hispanic mothers, who chose to formula feed exclusively, were enrolled in the study. Data was collected during an initial interview and three home visits at 3, 6, and 12 months. During the home visits, feedings were observed, the mothers were interviewed, and the child’s weight was measured. Feeding diaries were also checked for omissions or clarifications.

A number of characteristics that predicted infant weight gain from birth to 3 months were included in the analysis. These were birth weight, gender, race/ethnicity, maternal age, education, country of origin, body mass index (BMI) before pregnancy, and weight gain during pregnancy. For the 3 to 6 month period, birth weight, maternal BMI, infant weight gain from birth to 3 months, infant length gain from birth to 3 months, the estimated number of feeds per day, the month that solid food was introduced, and the mothers’ sensitivity to the infants’ signals at 3 months were included. And, finally, for the 6 to 12 month period, birth weight, maternal BMI, infant weight gain from 3 to 6 months, infant length gain from 3 to 6 months, maternal sensitivity to infant signals at 6 months, and the estimated number of feeds/day at 6 months were entered as the independent variables.

None of these variables served to predict infant weight gain over the first 3 months, or similarly, from 3 to 6 months. However, the number of feeds per day at 6 months approached significance in predicting weight gain from 6 to 12 months, and maternal sensitivity to the infants’ signals reached predictive significance, but in a negative direction—indicating that mothers who were less sensitive to satiety cues had infants who gained more weight.

Writing in the article, John Worobey, PhD; Maria Islas Lopez, MA; and Daniel J. Hoffman, PhD, state, “More frequent feedings, particularly with formula, are an easy culprit on which to assign blame. But maternal sensitivity to the infant’s feeding state, as reflected by the Feeding Scale scores, suggests that an unwillingness to slow the pace of feeding or terminate the feeding when the infant shows satiation cues may be overriding the infant’s ability to self-regulate its intake.”

However, the researchers warn that, “To use this knowledge to better inform low-income/educated mothers, indeed, mothers of any background who have settled on a feeding method, could pose a daunting challenge. Feeding an infant is a primal behavior, and to suggest to a new mother that she is feeding her infant too often, too much, or worse yet, is not very good at reading her infant’s signals, would require an extremely skilled nurse or social worker. Giving counsel after watching a mother feed her infant might be seen as threatening, or at the very least meddling, and just pointing it out could be construed as an accusation of ‘poor mothering.’”

Journal reference:

1. Worobey et al. Maternal Behavior and Infant Weight Gain in the First Year. Journal of Nutrition Education and Behavior, 2009; 41 (3): 169

(ScienceDaily.com)

The author of the thesis is Ms Elizabeth Hijona Muruamendiaraz, a graduate in Biochemistry specialising in Dietetics and Nutrition, and has entitled her PhD, Effect of resveratrol on simple, non-alcoholic hepatic esteatosis in a murine model.*

Molecule of plant origin

Resveratrol has antioxidant capacities and it is found in many fruits such as grape, walnuts, peanuts, etc. The aim of the thesis was to investigate if resveratrol reduces ESNA in a model of esteatosis in rats.

To this end, three experimental groups of rats were studied. The first is a control group with free access to food and water. The second is a group affected by esteatosis and that was subjected to a diet high in carbohydrates, lipid-free and with periods of fasting. The third group, also affected by esteatosis, was kept under the same conditions as group two with the difference that their members were supplied daily with 10 mg of resveratrol.

Alter four weeks, samples of liver and blood were taken from individuals of the three different groups for their subsequent analysis. It was shown that in the third group – the one treated with resveratrol -, infiltration of liver fat dropped in comparison with group two. After this and a number of other analyses, the researcher concluded that resveratrol reduces the severity of ESNA in models with rats because, in the animals treated with resveratrol, the percentage of the cells of affected liver cells was notably less in non-treated animals.

Cell oxidation

Moreover, Ms Hijona was able to see that, when the resveratrol was administered, the production of pro-oxidant substances — favouring cell oxidation — was reduced, and natural antioxidants of the liver were better conserved. Thus it was concluded that resveratrol is capable of maintaining the balance between antioxidant and pro-oxidant substances.

Finally, the administration of resveratrol reduces the number of Kupffer cells in the liver — the presence of these cells is associated with the progression of ESNA —, and so can inhibit the development of other injuries to the liver, such as fibrosis.

Food habits

According to Ms Elizabeth Hijona, the results of the study show that we should be careful with food habits, given that a simple change in the periods of fasting, combined with a diet rich in carbohydrates, can manage to cause serious liver problems. This is why the administration of natural antioxidants such as resveratrol — two glasses of wine a day, for example— helps to considerably reduce the accumulation of fat in the liver.

*The director of the thesis was Luis Bujanda Fernández de Piérola from the department of Physiology at the Faculty of Medicine and Odontology at the UPV/EHU. Ms Elizabeth Hijona is currently working as a researcher in Digestive Systems at the Hospital Donostia.

(ScienceDaily.com)

In one study, a team of psychologists used a longitudinal approach to gain a better idea of what to expect after traumatic brain injury (TBI). The researchers found that severe TBI can cause many lasting problems with day-to-day functioning. Some children may recover academically but then start acting up; other children do surprisingly well for unknown reasons.

In the second study, the first systematic meta-analysis summarizing the collective results of many single studies, the researchers found that problems lasted over time and, in some cases, worsened with more serious injury. Some children with severe TBI started to fall even further behind their peers than one would normally expect, in a snowball effect that requires further study.

The Centers for Disease Control in 2000 cited traumatic brain injury as the single most common cause of death and disability in children and adolescents.

Long-Term Study Digs Out Individual Differences

In the first study, researchers at The Ohio State University, Case Western Reserve University, and hospitals in Columbus and Cleveland followed 37 children after severe TBI, 40 children after moderate TBI, and 44 children after musculoskeletal injury (a common way to control for trauma and the hospital experience). All of the children were injured between the ages of 6 and 12, and assessed six months, 12 months, and three to five years following their injuries.

As expected, the children with severe brain injuries showed greater problems than children with other injuries in the areas of mental processing, learning and memory, behavior, adaptation and academics. Children whose comas were longer and more severe had more, and more serious, problems.

Some children seemed at first to be doing all right on cognitive tests and in the classroom, but then developed significant behavioral problems. Parents and doctors should watch children who’ve had traumatic brain injury closely because something may come up later – perhaps, the authors suggested, as a secondary reaction to the disruption caused by the injury, or because the family has not functioned very well, especially in response to the injury.

Generally, one year after injury, nearly 60 percent of the severe TBI group had problems in at least one area, compared with 25 percent of the controls. Four years after injury, 40 percent of children suffering severe TBI and 20 percent of the controls showed deficits. At both intervals, the share of brain-injured children with cognitive problems was at least twice that of the control group members with problems.

Even so, the researchers were intrigued that many children with moderate to severe TBI showed no significant weaknesses from six months to four years after the injury, in one or more of the areas measured.

Perhaps, they speculated, that was because in previous long-term studies, group averages may have hidden the fact that some individual children can do well over time. This team, by tracking individuals, revealed that some children are more mentally resilient. If researchers can learn why, they may be able to help more children to recover more fully from this type of injury.

“It’s probably a complex interplay of child, family and broader environmental/cultural factors. The care and treatment children receive may make a difference, such as whether they have access to rehabilitation and special-education services,” said co-author Keith Yeates, PhD, who also mentioned genetic differences in the brain’s ability to heal itself.

Meta-Analysis Shows Problems Grow Over Time

In the second study, conducted by Talin Babikian, PhD, and Robert Asarnow, PhD, at the University of California-Los Angeles, the authors analyzed 28 carefully selected articles published between 1988 and 2007. The children were sorted by TBI severity and time since injury. Severity levels were mild, moderate or severe TBI, and follow-ups were on average 0-5 months, 6-23 months, or 24+ months, for 14 key aspects of neurocognition.

According to their analysis:

* The worse the injury, the worse the neurocognitive outcome, especially on measures of general intellectual functioning and processing speed.
* Time didn’t heal all. The moderate and severe groups were even more similar by the third time band, especially on general intellectual functioning and attention/executive skills.
* Most problems stick. Despite modest recovery in intellectual functioning and attention, weaknesses in many children with moderate TBI persist even two years after the injury, compared to the children in control groups.
* Memory and visual-spatial skills seemed more or less normal by two-plus years, with even the moderately injured performing in the same range as controls.
* Children with severe TBI needed more help, showing robust and significant problems within months on IQ, executive functioning (processing speed, attention), and verbal memory (both immediate and delayed). After two or more years, all areas studied were impaired.

“It appears that there are significant, persistent neurocognitive impairments in a subset of children with severe TBI,” the authors concluded. Despite some recovery during the first two years, children in this group not only failed to catch up to peers, but appeared to fall further behind over time. Thus, severe traumatic brain injury may throw off children’s normal developmental timetable. The authors noted that well-controlled longitudinal studies evaluating the same children over time are necessary to confirm these findings.

That makes severe brain injuries at younger ages a “double hazard,” the authors noted. Because younger children have more development ahead of them, the same injury can affect a 4-year-old and a 12-year-old very differently. This finding highlights the importance of targeted treatment developed specifically for children with severe TBI.

Journal references:

1. Fay et al. Predicting longitudinal patterns of functional deficits in children with traumatic brain injury.. Neuropsychology, 2009; 23 (3): 271 DOI: 10.1037/a0014936
2. Babikian et al. Neurocognitive outcomes and recovery after pediatric TBI: Meta-analytic review of the literature.. Neuropsychology, 2009; 23 (3): 283 DOI: 10.1037/a0015268

(sciencedaily.com)

“The findings show that trauma from a mother’s past, which does not directly impact her pregnancy, will affect her offspring’s emotional and social behavior. We should consider whether such effects occur in humans too,” stated Prof. Micah Leshem, who carried out the study.

The effects of trauma that a mother experienced in the course of pregnancy are known from earlier research, but until now the influence of adversity before conception has not been examined. The present research, carried out by Prof. Micah Leshem and Alice Shachar-Dadon of the University of Haifa and Prof. Jay Schulkin of the Georgetown University School of Medicine, is the first to examine these influences.

The researchers chose to investigate rats, as social mammals with cerebral activity that is similar in many ways to that of humans. The present study examined three groups of rats: one group was put through a series of stress-inducing activities two weeks before mating, allowing the female time to recover before becoming pregnant; the second group was similarly treated over the course of a week immediately prior to mating; and the third, control group, were not given any form of stress. When the rats’ offspring reached maturity (at 60 days), the researchers examined their emotional behavior – anxiety and depression – and social behavior.

The main finding revealed that trauma experienced by the females prior to conception had varied effects on the offspring. According to Prof. Leshem, these effects varied between groups and between male and female offspring; but their behavior was without doubt different from that of the rats from the control group.

All the offspring of stressed mothers showed reduced social contact compared with that of the control mothers’ offspring: these rats spent less time with one another and interacted less. In other tests, there were important sex differences. The female rats displayed more symptoms of anxiety, while the males exhibited less anxiety. Finally, those rats whose mothers became pregnant immediately after being stressed were hyperactive, indicating that how long before pregnancy adversity is experienced, is also important.

“Everyone knows that smoking harms the fetus and therefore a mother must not smoke during pregnancy. The findings of the present study show that adversity from a mother’s past, even well before her pregnancy, does affect her offspring, even when they are adult. We should be prepared for analogous effects in humans: for example, in children born to mothers who may have been exposed to war well before becoming pregnant,” Prof. Leshem concluded.

Journal reference:
Shachar-Dadon, Alice; Schulkin, Jay; Leshem, Micah. Adversity before conception will affect adult progeny in rats.. Developmental Psychology, 2009; 45 (1): 9 DOI: 10.1037/a0014030

(Sciencedaily.com)

Insulin resistance is the most common metabolic complication associated with obesity and is associated with an increased risk of developing non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes. Although an energy-deficit diet is the cornerstone of therapy for obesity, the most appropriate macronutrient composition of diet therapy needed to improve metabolic health remains controversial.

“Our data underscore the complexity of the metabolic effects of calorie restricition with diets that differ in macronutrient composition, and demonstrate differences among organ systems in the response to calorie restriction and subsequent weight loss,” said Samuel Klein, MD, of the Washington University School of Medicine and lead author of the study. “Our findings help explain the rapid improvement in glucose levels observed after low-calorie diet therapy and bariatric surgery,” he added.
In the present study, 22 obese patients were randomized to a high-carbohydrate or low-carbohydrate energy-deficit diet. A euglycemic-hyperinsulinemic clamp, muscle biopsies and magnetic resonance spectroscopy were used to determine insulin action, cellular insulin signaling and intrahepatic triglyceride (IHTG) content before, after 48 hours and after ~11 wks (7 percent weight loss) of diet therapy. An euglycemic-hyperinsulinemic clamp is a widely used experimental procedure for the determination of insulin sensitivity.

Researchers found that short-term CR caused a rapid decrease in IHTG content, an increase in hepatic insulin sensitivity and a decrease in endogenous glucose production rate, whereas longer-term CR and a moderate 7 percent weight loss improved skeletal muscle insulin sensitivity in conjunction with an increase in cellular insulin signaling. The effect of moderate CR in obese patients with either a low-fat or low-carbohydrate diet on metabolic function is a continuum, with differential effects on specific organ systems (Science Daily).

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