Abstract Background & Aims Vitamin K has been associated with various health outcomes, including non-fatal cardiovascular diseases (CVD) and cancer. However, little is known about the association ...between vitamin K intake and all-cause and cause specific mortality. This study aims to investigate the association between vitamin K intake and all-cause and cause-specific mortality. Methods This prospective cohort study included 33,289 participants from the EPIC-NL cohort, aged 20-70 years at baseline and recruited between 1993 and 1997. Dietary intake was assessed at baseline with a validated food frequency questionnaire and intakes of phylloquinone, and total, short chain and long chain menaquinones were calculated. Information on vital status and causes of death was obtained through linkage to several registries. The association between the different forms of vitamin K intake and mortality was assessed with Cox proportional hazards, adjusted for risk factors for chronic diseases and nutrient intake. Results During a mean follow-up of 16.8 years, 2,863 deaths occurred, including 625 from CVD (256 from coronary heart disease (CHD)), 1,346 from cancer and 892 from other causes. After multivariable adjustment, phylloquinone and menaquinones were not associated with all-cause mortality with hazard ratios for the upper vs. the lowest quartile of intake of 1.04 (0.92;1.17) and 0.94 (0.82;1.07) respectively. Neither phylloquinone intake nor menaquinone intake was associated with risk of CVD mortality. Higher intake of long chain menaquinones was borderline significantly associated (ptrend = 0.06) with lower CHD mortality with a HR10μg of 0.86 (0.74;1.00). None of the forms of vitamin K intake were associated with cancer mortality or mortality from other causes. Conclusions Vitamin K intake was not associated with all-cause mortality, cancer mortality and mortality from other causes.
Summary
The objective was to study the relationship between body mass index (BMI) and body fat per cent (BF%) in different population groups of Asians. The study design was a literature overview with ...special attention to recent Asian data. Specific information is provided on Indonesians (Malays and Chinese ancestry), Singaporean Chinese, Malays and Indians, and Hong Kong Chinese. The BMI was calculated from weight and height and the BF% was determined by deuterium oxide dilution, a chemical‐for‐compartment model, or dual‐energy X‐ray absorptiometry. All Asian populations studied had a higher BF% at a lower BMI compared to Caucasians. Generally, for the same BMI their BF% was 3–5% points higher compared to Caucasians. For the same BF% their BMI was 3–4 units lower compared to Caucasians. The high BF% at low BMI can be partly explained by differences in body build, i.e. differences in trunk‐to‐leg‐length ratio and differences in slenderness. Differences in muscularity may also contribute to the different BF%/BMI relationship. Hence, the relationship between BF% and BMI is ethnic‐specific. For comparisons of obesity prevalence between ethnic groups, universal BMI cut‐off points are not appropriate.
Objective
Patients with rheumatoid arthritis (RA) have a significantly increased risk of mortality compared with the general population. One of the most important predictors for mortality is somatic ...comorbidity. Moreover, studies have demonstrated that comorbid depression is associated with mortality. Which specific comorbidities are associated with mortality is less investigated. The purpose of this study was to investigate the association of a wide range of comorbidities with mortality in patients with RA.
Methods
Longitudinal data over a 14‐year period were collected from 882 patients with RA. Data were assessed with questionnaires. The mortality status was obtained from the Statistics Netherlands for the period 1996–2011 for 99% of the patients. Somatic comorbidity was assessed in 1997, 1998, 1999, and 2008 and measured by a national population‐based questionnaire including 20 chronic diseases. Comorbid depression was assessed in 1997, 1998, and 1999 and measured with the Center for Epidemiologic Studies Depression Scale. Cox regression was used to study the relationship between comorbidity and mortality.
Results
At baseline, 72% of the patients were women. The mean ± SD age was 59.3 ± 14.8 years, and the median (interquartile range) disease duration was 5.0 (2.0–14.0) years. A total of 345 patients died during the study period. Comorbidities that were associated with mortality were circulatory conditions (hazard ratio HR 1.60 95% confidence interval (95% CI) 1.15–2.22), respiratory conditions (HR 1.43 95% CI 1.09–1.89), cancer (HR 2.00 95% CI 1.28–3.12), and depression (HR 1.35 95% CI 1.06–1.72).
Conclusion
Comorbid circulatory conditions, respiratory conditions, cancer, and depression are associated with mortality among patients with RA. Careful monitoring of these comorbidities during the course of the disease and adequate referral may improve health outcomes and chances of surviving.
Cocoa consumption has beneficial cardiometabolic effects, but underlying mechanisms remain unclear. Epicatechin, the cocoa major monomeric flavan-3-ol, is considered to contribute to these ...cardio-protective effects. We investigated effects of pure epicatechin supplementation on gene expression profiles of immune cells in humans. In a double blind, placebo-controlled cross-over trial, 32 (pre)hypertensive subjects aged 30 to 80, received two 4-week interventions, i.e. epicatechin (100mg/day) or placebo with a 4-week wash-out between interventions. Gene expression profiles of peripheral blood mononuclear cells were determined before and after both interventions. Epicatechin regulated 1180 genes, of which 234 differed from placebo. Epicatechin upregulated gene sets involved in transcription and tubulin folding and downregulated gene sets involved in inflammation, PPAR signalling and adipogenesis. Several negatively enriched genes within these gene sets were involved in insulin signalling. Most inhibited upstream regulators within the epicatechin intervention were cytokines or involved in inflammation. No upstream regulators were identified compared to placebo. Epicatechin, a cocoa flavan-3-ol, reduces gene expression involved in inflammation, PPAR-signalling and adipogenesis in immune cells. Effects were mild but our findings increase our understanding and provide new leads on how epicatechin rich products like cocoa may affect immune cells and exert cardiometabolic protective effects.
Taste is a key driver of food choice and intake. Taste preferences are widely studied, unlike the diet's taste profile. This study assessed dietary taste patterns in the Netherlands by sex, BMI, age ...and education. A taste database, containing 476 foods' taste values, was combined with 2-d 24-h recalls in two study populations. The percentage of energy intake from six taste clusters was assessed in the Dutch National Food Consumption Survey (DNFCS 2007-2010; n 1351) and in an independent observational study: the Nutrition Questionnaires plus (NQplus) study (2011-2013; n 944). Dietary taste patterns were similar across study populations. Men consumed relatively more energy from 'salt, umami and fat' (DNFCS; 24 % energy, NQplus study; 23 %)- and 'bitter' (7 %)-tasting foods compared with women (21 %, P<0·001, 22 %, P=0·005; 3 %, P<0·001, 4 %, P<0·001, respectively). Women consumed more % energy from 'sweet and fat' (15 %)- and 'sweet and sour' (13 %, 12 %, respectively)-tasting foods compared with men (12 %, P<0·001, 13 %, P=0·001; 10 %, P<0·001). Obese individuals consumed more % energy from 'salt, umami and fat'- and less from 'sweet and fat'-tasting foods than normal-weight individuals ('salt, umami and fat', men; obese both studies 26 %, normal-weight DNFCS 23 %, P=0·037, NQplus 22 %, P=0·001, women; obese 23 %, 24 %, normal weight 20 %, P=0·004, P=0·011, respectively, 'sweet and fat', men; obese 11 %, 10 %, normal weight 13 %, P<0·05, 14 %, P<0·01, women; obese 14 %, 15 %, normal weight 16 %, P=0·12, P=0·99). In conclusion, our taste database can be used to deepen our understanding of the role of taste in dietary intake in the Netherlands by sex, BMI, age and education.
This article questions the informative content of some recent applications of metabolomics to human nutrition and provides ideas for its future applications. Our critical view does not exclude that ...metabolomics may hold the potential to add to our knowledge, e.g., to identify diagnostically informative biomarkers. Our present disenchantment about metabolomics is explained by its so far poor applications to nutrition research. Although we admire and understand the spirit of discovery, we consider some present research activities in this area as a “Metabolomic fashion” rather than an achievement.
This study aimed to assess the effects of insoluble dietary fiber (IDF) from feijoa supplementation on the physicochemical and functional properties of wheat bread. The results showed that feijoa IDF ...(FJI) had the typical structures of hydrolysis fiber, polysaccharide functional groups, and crystal structure of cellulose. The gradual increase of FJI levels (from 2 to 8%) in wheat bread resulted in increased total DF, ash, and protein contents, accompanied by a reduction in moisture, carbohydrates, and energy value. The inclusion of FJI in the bread crumb caused a rise in both redness (a*) and yellowness (b*) values while decreasing the brightness (L*) relative to the control specimen. In addition, adding FJI up to 2% significantly increased total phenolic and flavonoid contents and antioxidant activity, as well as flavor score of supplemented bread samples, while additions above 2% resulted in undesirable taste and texture. FJI addition caused higher bile acid, NOsup.2−, and cholesterol adsorption capacities. Moreover, FJI addition up to 4% significantly reduced glucose adsorption capacities at different in vitro starch digestion intervals. The findings revealed that FJI offers great potential as an ideal functional ingredient in food processing.
Aging results in chronic systemic inflammation that can alter neuroinflammation of the brain. Specifically, microglia shift to a pro-inflammatory phenotype predisposing them to hyperactivation upon ...stimulation by peripheral immune signals. It is proposed that certain nutrients can delay brain aging by preventing or reversing microglial hyperactivation. Butyrate, a short-chain fatty acid (SCFA) produced primarily by bacterial fermentation of fiber in the colon, has been extensively studied pharmacologically as a histone deacetylase inhibitor and serves as an attractive therapeutic candidate, as butyrate has also been shown to be anti-inflammatory and improve memory in animal models. In this study, we demonstrate that butyrate can attenuate pro-inflammatory cytokine expression in microglia in aged mice. It is still not fully understood, however, if an increase in butyrate-producing bacteria in the gut as a consequence of a diet high in soluble fiber could affect microglial activation during aging. Adult and aged mice were fed either a 1% cellulose (low fiber) or 5% inulin (high fiber) diet for 4 weeks. Findings indicate that mice fed inulin had an altered gut microbiome and increased butyrate, acetate, and total SCFA production. In addition, histological scoring of the distal colon demonstrated that aged animals on the low fiber diet had increased inflammatory infiltrate that was significantly reduced in animals consuming the high fiber diet. Furthermore, gene expression of inflammatory markers, epigenetic regulators, and the microglial sensory apparatus (i.e., the sensome) were altered by both diet and age, with aged animals exhibiting a more anti-inflammatory microglial profile on the high fiber diet. Taken together, high fiber supplementation in aging is a non-invasive strategy to increase butyrate levels, and these data suggest that an increase in butyrate through added soluble fiber such as inulin could counterbalance the age-related microbiota dysbiosis, potentially leading to neurological benefits.
A high sugar intake is a subject of scientific debate due to the suggested health implications and recent free sugar recommendations by the WHO. The objective was to complete a food composition table ...for added and free sugars, to estimate the intake of total sugars, free sugars, and added sugars, adherence to sugar guidelines and overall diet quality in Dutch children and adults. In all, 3817 men and women (7-69 years) from the Dutch National Food Consumption Survey 2007-2010 were studied. Added and free sugar content of products was assigned by food composition tables and using labelling and product information. Diet was assessed with two 24-h recalls. Diet quality was studied in adults with the Dutch Healthy Diet-index. Total sugar intake was 22% Total Energy (%TE), free sugars intake 14 %TE, and added sugar intake 12 %TE. Sugar consumption was higher in children than adults. Main food sources of sugars were sweets and candy, non-alcoholic beverages, dairy, and cake and cookies. Prevalence free sugar intake <10 %TE was 5% in boys and girls (7-18 years), 29% in women, and 33% in men. Overall diet quality was similar comparing adults adherent and non-adherent to the sugar guidelines, although adherent adults had a higher intake of dietary fiber and vegetables. Adherence to the WHO free sugar guidelines of <5 %TE and <10 %TE was generally low in the Netherlands, particularly in children. Adherence to the added and free sugar guidelines was not strongly associated with higher diet quality in adults.
In observational studies, individuals with elevated levels of plasma homocysteine tend to have moderately increased risk of coronary heart disease (CHD). The MTHFR 677C-->T polymorphism is a genetic ...alteration in an enzyme involved in folate metabolism that causes elevated homocysteine concentrations, but its relevance to risk of CHD is uncertain.
To assess the relation of MTHFR 677C-->T polymorphism and risk of CHD by conducting a meta-analysis of individual participant data from all case-control observational studies with data on this polymorphism and risk of CHD.
Studies were identified by searches of the electronic literature (MEDLINE and Current Contents) for relevant reports published before June 2001 (using the search terms MTHFR and coronary heart disease), hand searches of reference lists of original studies and review articles (including meta-analyses) on this topic, and contact with investigators in the field.
Studies were included if they had data on the MTHFR 677C-->T genotype and a case-control design (retrospective or nested case-control) and involved CHD as an end point. Data were obtained from 40 (34 published and 6 unpublished) observational studies involving a total of 11 162 cases and 12 758 controls.
Data were collected on MTHFR 677C-->T genotype, case-control status, and plasma levels of homocysteine, folate, and other cardiovascular risk factors. Data were checked for consistency with the published article or with information provided by the investigators and converted into a standard format for incorporation into a central database. Combined odds ratios (ORs) for the association between the MTHFR 677C-->T polymorphism and CHD were assessed by logistic regression.
Individuals with the MTHFR 677 TT genotype had a 16% (OR, 1.16; 95% confidence interval CI, 1.05-1.28) higher odds of CHD compared with individuals with the CC genotype. There was significant heterogeneity between the results obtained in European populations (OR, 1.14; 95% CI, 1.01-1.28) compared with North American populations (OR, 0.87; 95% CI, 0.73-1.05), which might largely be explained by interaction between the MTHFR 677C-->T polymorphism and folate status.
Individuals with the MTHFR 677 TT genotype had a significantly higher risk of CHD, particularly in the setting of low folate status. These results support the hypothesis that impaired folate metabolism, resulting in high homocysteine levels, is causally related to increased risk of CHD.