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To formulate precision nutrition prescriptions, it is essential to understand the relationship between dietary assessment, ethnicity and cardiometabolic disease. Erythrocyte (RBC) fatty acid (FA) profiles reflect long-term dietary fat intake but have not been rigorously compared with short-term FA intake in women of African ancestry who have paradoxically low triglycerides with high fat intake. We compared the type of dietary fat consumed (proportion of total fat) using food records with fasting RBC FA (mol%) determined by gas chromatography in 130 female, healthy, federal employees without diabetes (12% African Immigrants (AI), 47% African Americans (AA), 41% White Americans (WA)); mean age 43+10 y and BMI 30 + 6 kg/m2). Diet quality and home prepared meals were similar across ethnicities. AI reported the lowest energy intake. Regardless of absolute energy intake, macronutrient distributions were similar. Fat intake differed by ethnicity; WA had the highest saturated FA (SFA) and lowest eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and omega-3 index (EPA + DHA), while AI and AA had similar SFA, EPA and DHA intake. AI women had the highest RBC DHA and omega-3 index. Associations between FA intake and RBC profiles were significant for DHA (r=0.3, p Disclosure A. B. Courville: None. S. T. Chung: None. S. Yang: None. L. Mabundo: None. C. K. Cravalho: None. S. Matta: None. A. Villalobos-perez: None. J. M. Dawson: None. A. H. Lichtenstein: None. A. E. Sumner: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases

Erythrocyte membrane fatty acids (RBC FA) may be a useful biomarker of dietary fat type to assess its impact on health and disease. Our objective was to examine the association of dietary fat type and RBC FA composition in 2 groups of women of African descent (blacks) compared to whites. Dietary fat type was assessed with food records (5±2 days [mean±SD]) and RBC FA composition (mol%) by gas chromatography in 1federally employed women (53% African American, 14% African immigrants, 33% white; age 44±9y, range 24-62y, BMI 30.5±5.9 kg/m2, range 20.3-45.2 kg/m2). Dietary fat type (SFA, MUFA, n-3 PUFA, n-6 PUFA, and trans FA) was calculated as a proportion of total dietary fat. Blacks reported consuming higher SFA and n-6 PUFA (all P0.05). Spearman correlations were calculated to determine the relationship between dietary FA and RBC FA. There was a positive correlation between dietary FA and RBC n-6 PUFA (r=0.3, P In summary, RBC FA was a good marker of n-6 PUFA intake, however, food records appeared to provide a more informative assessment of overall dietary fat type exposure. Disclosure A.B. Courville: None. S. Bernstein: None. M. Galvan-De La Cruz: None. A. Onuzuruike: None. N.R. Matthan: None. A.H. Lichtenstein: None. A.E. Sumner: None. S.T. Chung: None.

A 2009 American Heart Association scientific statement titled “Dietary Sugars Intake and Cardiovascular Health” (1) concluded that current intake of added sugars among Americans greatly exceeds discretionary calorie allowances based on the 2005 U.S. Dietary Guidelines (2). For this reason, the American Heart Association Nutrition Committee recommended population-wide reductions in added sugars intake. The present statement from the American Heart Association and the American Diabetes Association addresses the potential role of nonnutritive sweeteners (NNS) in helping Americans to adhere to this recommendation in the context of current usage and health perspectives. By definition, NNS, otherwise referred to as very low-calorie sweeteners, artificial sweeteners, noncaloric sweeteners, and intense sweeteners, have a higher intensity of sweetness per gram than caloric sweeteners such as sucrose, corn syrups, and fruit juice concentrates. As a caloric sweetener replacement, they are added in smaller quantities; hence, they provide no or few calories. In our current food supply, NNS are widely used in thousands of beverages and other food products such as diet soft drinks, yogurts, desserts, and gum. Food manufacturers often use a blend of NNS or use a blend of sugar and NNS to improve the flavor acceptability of NNS. In developing this scientific statement, the writing group reviewed issues pertaining to NNS in the context of data on consumer attitudes, consumption patterns, appetite, hunger and energy intake, body weight, and components of cardiometabolic syndrome. The objective was to review the literature to determine whether there were adequate data to provide guidance for the use of NNS. The focus of the statement is on the 6 NNS that are described in Table 1. Aspartame, acesulfame-K, neotame, saccharin, and sucralose are regulated as food additives by the U.S. Food and Drug Administration and therefore had to be approved as safe before being marketed. Regarding stevia, …

Medical nutrition therapy (MNT) is important in preventing diabetes, managing existing diabetes, and preventing, or at least slowing, the rate of development of diabetes complications. It is, therefore, important at all levels of diabetes prevention. MNT is also an integral component of diabetes self-management education (or training). This position statement provides evidence-based recommendations and interventions for diabetes MNT. The previous position statement with accompanying technical review was published in 2002 and modified slightly in 2004. This statement updates previous position statements, focuses on key references published since the year 2000, and uses grading according to the level of evidence available...

OBJECTIVE—A systematic review of the effect of chromium supplementation on glucose metabolism and lipid levels. RESEARCH DESIGN AND METHODS—A literature search was conducted in MEDLINE and the Commonwealth Agricultural Bureau. Eligible studies were English language randomized controlled trials of chromium supplement intake ≥3 weeks, with ≥10 participants receiving chromium. All trials with glucose metabolism outcomes and trials of individuals with diabetes or glucose intolerance for lipid outcomes were included. Meta-analyses were performed as appropriate. RESULTS—Forty-one studies met criteria, almost half of which were of poor quality. Among participants with type 2 diabetes, chromium supplementation improved glycosylated hemoglobin levels by −0.6% (95% CI −0.9 to −0.2) and fasting glucose by −1.0 mmol/l (−1.4 to −0.5) but not lipids. There was no benefit in individuals without diabetes. There were some indications of dose effect and differences among chromium formulations. Larger effects were more commonly observed in poor-quality studies. The evidence was limited by poor study quality, heterogeneity in methodology and results, and a lack of consensus on assessment of chromium status. CONCLUSIONS—No significant effect of chromium on lipid or glucose metabolism was found in people without diabetes. Chromium supplementation significantly improved glycemia among patients with diabetes. However, future studies that address the limitations in the current evidence are needed before definitive claims can be made about the effect of chromium supplementation.

OBJECTIVE—We sought to assess the intra- and interindividual variability of glycemic index value determinations for white bread using glucose as the reference food. RESEARCH DESIGN AND METHODS—A total of 23 healthy adults (aged 20–70 years) completed up to three sets of two visits per set. Each pair of visits assessed the glycemic response to 50 g available carbohydrates from commercial white bread and glucose, administered in random order. Glycemic index values were calculated by dividing the 2-h incremental area under the serum glucose response curve after each commercial white bread challenge by the mean area under the curve (AUC) for glucose. RESULTS—The mean ± SE ratio of the AUC after white bread intake by the AUC after glucose intake for the first set of determinations was 78 ± 15 (n = 23; coefficient of variation [CV] 94%). When using glycemic index values calculated with the subset of participants who completed three sets of tests (n = 14), glycemic index values for each of the three sets of determinations were 78 ± 10, 60 ± 5, and 75 ± 10, respectively. CVs were 50, 28, and 50%, respectively. The mean glycemic index value of these three sets was 71 ± 6, with a CV of 30%. When an ANOVA approach was applied to these data, the interindividual CV was 17.8%, and the intra-individual variation was 42.8%. CONCLUSIONS—These data suggest that in response to a challenge of white bread relative to glucose, within-individual variability is a greater contributor to overall variability than among-individual variability. Further understanding of all the sources of variability would be helpful in better defining the utility of glycemic index values.

We thank Kleefstra et al. for their comments (1) on our review (2), and we appreciate the opportunity to respond. We agree that the available trials on chromium supplementation are of poor quality and have heterogeneous results. Our approach toward systematic review is to not exclude studies based on what are inevitably subjective decisions about quality, applicability, or heterogeneity. A subanalysis of the chromium picolinate trials excluding Anderson et al. (3), because of its …