Search

Background There are few published studies addressing food insecurity and eating disorders in lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) individuals. Objective The primary objective of this study was to describe the proportion of food insecurity and eating disorder behaviors in a volunteer sample of LGBTQ+ individuals aged 18 to 35 years. Design This study was a cross-sectional analysis of questionnaire data collected from 253 participants between March 2018 and March 2019. Participants and setting To be included in the study, participants had to be aged 18 to 35 years and identify as being LGBTQ+. Main outcome measures Food security score, Eating Attitudes Test score, Eating Disorder Examination Self-Report Questionnaire score, anxiety score (Beck), and depressive symptoms score. Statistical analyses performed The χ2 test was used to analyze the categorical outcomes. One-way analysis of variance was used to compare continuous variables across gender identity groups. All P values Results The proportion of participants identifying as a woman, trans male, gender nonconforming, and a man were 39%, 24%, 24%, and 13%, respectively. Food insecurity was reported by 54.4% of respondents with trans males reporting the highest proportions (64.8%). High levels of depressive symptoms were reported by 68.2% of men, 89.8% of women, 91.4% of trans males, and 95.5% of gender-nonconforming respondents (P = 0.009). High anxiety was reported by 20.5%. Eating Disorder Examination Self-Report Questionnaire scores were significantly higher (P Conclusions Members of the LGBTQ+ community are at greater risk for food insecurity, eating disorders, and depression, particularly those who identify as trans males. These findings denote the need to focus future research efforts on effective prevention and treatment strategies that are specific to sexual and gender identity groups within the LGBTQ+ community.

Tea flavonoids have been suggested to offer potential benefits to cardiovascular health. This review synthesized the evidence on the relation between tea consumption and risks of cardiovascular disease (CVD) and all-cause mortality among generally healthy adults. PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, Food Science and Technology Abstracts, and Ovid CAB Abstract databases were searched to identify English-language publications through 1 November 2019, including randomized trials, prospective cohort studies, and nested case-control (or case-cohort) studies with data on tea consumption and risk of incident cardiovascular events (cardiac or peripheral vascular events), stroke events (including mortality), CVD-specific mortality, or all-cause mortality. Data from 39 prospective cohort publications were synthesized. Linear meta-regression showed that each cup (236.6 mL) increase in daily tea consumption (estimated 280 mg and 338 mg total flavonoids/d for black and green tea, respectively) was associated with an average 4% lower risk of CVD mortality, a 2% lower risk of CVD events, a 4% lower risk of stroke, and a 1.5% lower risk of all-cause mortality. Subgroup meta-analysis results showed that the magnitude of association was larger in elderly individuals for both CVD mortality (n = 4; pooled adjusted RR: 0.89; 95% CI: 0.83, 0.96; P = 0.001), with large heterogeneity (I(2) = 72.4%), and all-cause mortality (n = 3; pooled adjusted RR: 0.92; 95% CI: 0.90, 0.94; P < 0.0001; I(2) = 0.3%). Generally, studies with higher risk of bias appeared to show larger magnitudes of associations than studies with lower risk of bias. Strength of evidence was rated as low and moderate (depending on study population age group) for CVD-specific mortality outcome and was rated as low for CVD events, stroke, and all-cause mortality outcomes. Daily tea intake as part of a healthy habitual dietary pattern may be associated with lower risks of CVD and all-cause mortality among adults.

The 2015 Dietary Guidelines Advisory Committee indicated that magnesium was a shortfall nutrient that was underconsumed relative to the Estimated Average Requirement (EAR) for many Americans. Approximately 50% of Americans consume less than the EAR for magnesium, and some age groups consume substantially less. A growing body of literature from animal, epidemiologic, and clinical studies has demonstrated a varied pathologic role for magnesium deficiency that includes electrolyte, neurologic, musculoskeletal, and inflammatory disorders; osteoporosis; hypertension; cardiovascular diseases; metabolic syndrome; and diabetes. Studies have also demonstrated that magnesium deficiency is associated with several chronic diseases and that a reduced risk of these diseases is observed with higher magnesium intake or supplementation. Subclinical magnesium deficiency can exist despite the presentation of a normal status as defined within the current serum magnesium reference interval of 0.75-0.95 mmol/L. This reference interval was derived from data from NHANES I (1974), which was based on the distribution of serum magnesium in a normal population rather than clinical outcomes. What is needed is an evidenced-based serum magnesium reference interval that reflects optimal health and the current food environment and population. We present herein data from an array of scientific studies to support the perspective that subclinical deficiencies in magnesium exist, that they contribute to several chronic diseases, and that adopting a revised serum magnesium reference interval would improve clinical care and public health.

OBJECTIVES: Most studies used serum magnesium concentration and total urine magnesium as nutrition biomarkers of magnesium, but whether these biomarkers are sensitive to changes in dietary intake of magnesium is uncertain. Whole blood ionized magnesium (iMg(2+)) is the free bioactive form of magnesium in the body, and therefore it could be more sensitive to the changes in magnesium intake. Thus, we aimed to compare the responses of iMg(2+), serum magnesium concentration, and total urine magnesium following an oral dose of magnesium. METHODS: Healthy adults participated in a randomized, single-blind, placebo-controlled crossover trial. They were randomly assigned to 300 mg of magnesium chloride (MgCl(2), ReMag®) or placebo, taken with a low-magnesium breakfast after 8-hours of fasting. Timed blood and urine samples were obtained beginning 15-minutes before breakfast, and then at 0, 0.5, 1, 2, 4, 6, 8, and 24-hours timepoints following breakfast. Pharmacokinetic analyses included area under the curve (AUC), the maximum concentration (C(max)), and the time to maximum concentration (T(max)) for iMg(2+), serum magnesium concentration, and total urine magnesium. Data were analyzed using paired t-test and Wilcoxon signed-rank test, and reported as mean ± standard deviation, or as median and range, depending on normality. RESULTS: Seventeen participants were included in the data analyses. Responses were observed following MgCl(2) compared to placebo for iMg(2+) (AUC = 1.51 ± 0.96 vs. 0.84 ± 0.82, and C(max) = 1.38 ± 0.13 vs. 1.32 ± 0.07, both P 0.05. CONCLUSIONS: The response of iMg(2+) to a single oral dose of magnesium was more pronounced than the responses of serum magnesium concentration and total urine magnesium. Therefore, iMg(2+) may be a more sensitive nutrition biomarker for magnesium intake. FUNDING SOURCES: Funding for this study was provided through an unrestricted educational grant from Think Healthy Group Inc.

OBJECTIVES: Micronutrient inadequacies are common in older adults. We sought to assess if multivitamin/multimineral supplement (MVM) use improved micronutrient intake and biomarker status among older adults enrolled in NHANES. METHODS: The National Cancer Institute Method was used to estimate usual intakes of 18 micronutrients stratified by age and frequency of MVM use. Insufficiency and deficiency prevalence were evaluated using nutrient biomarkers. RESULTS: Compared with food alone, MVM use was associated with higher nutrient intake and lower prevalence of inadequacies of almost all micronutrients exam- ined and improved nutrient biomarker status of folate, iodine, selenium, and vitamins B6, B12, and D. Regular MVM use (!16days/month) decreased the odds of clinical deficiency (defined by biomarker status) of vitamins B6 and D but increased the proportion exceeding the tolerable upper intake level of folic acid. Vitamin B6 deficiency in MVM non-users was common and increased with age. CONCLUSIONS: Recommending MVM in the middle-aged and older adult population in the US may help to ensure opti- mal long-term nutritional status and contribute to health maintenance. FUNDING SOURCES: GSK Consumer Healthcare.

OBJECTIVES: Menopause represents a period in which bone deterioration is accelerated; thus, primary prevention strategies to address age-related bone loss are crucial. Dairy products contain more than a dozen essential nutrients, including calcium, phosphorus, vitamin D, and high-quality protein, as well as bioactive compounds that may promote bone mineralization. However, the relationship between dairy consumption and bone health across the menopause transition remains largely unknown. The purpose of this analysis was to estimate the change in lumbar spine and femoral neck bone mineral density and the risk of bone fracture by the frequency of dairy intakes among women across the menopausal transition using the publicly available data from the Study of Women's Health Across the Nation. METHODS: A general linear model was used to estimate the association of dairy intake with the 10-year bone mineral density loss rate and a linear mixed model was used to estimate the annualized bone mineral density loss rate of the femoral neck and lumbar spine. A Cox proportional hazard model was applied to calculate hazard ratios and 95% confidence intervals of the nontraumatic fractures. A Poisson regression model with a log link function was used to determine the relative risks and 95% confidence intervals of the nontraumatic fractures. The models were controlled for race/ethnicity, age, height, weight, smoking status, physical activity, alcohol consumption, calcium use, menopausal status, and total caloric intake. RESULTS: No significant differences in bone mineral density change were observed, regardless of baseline menopausal status. No significant differences in the risk of nontraumatic fracture were observed. CONCLUSIONS: In this group of US women undergoing the menopausal transition, dairy food intake was not associated with femoral and spine bone mineral density loss nor the risk of fractures. FUNDING SOURCES: National Dairy Council.

In the United States, dietary reference intakes describe the relations between nutrient intakes and indicators of adequacy, prevention of disease, and avoidance of excessive intakes among healthy populations for essential nutrients but not dietary bioactive components (DBCs), whose absence from the diet is presumably not deleterious to health (i.e., does not cause a deficiency syndrome). An appropriate framework is needed for establishing recommended intakes for which public health messages and food labeling for DBCs can be derived, because their putative health benefits may not be readily defined in the context of nutritional essentiality. In addition, a myriad of factors make determining their intake and status and investigating their discrete contributions to health particularly challenging. Therefore, the ASN Dietary Bioactive Components Research Interest Section felt it worthwhile to convene a special “hot topic” session at the 2014 Experimental Biology meeting to discuss this issue and serve as a call for future scientific dialogue on establishing a framework for recommended intakes of DBCs. This session summary captures the discussions and presentations that transpired during this session.

OBJECTIVES: To estimate the annualized BMD changes of the lumbar spine and femoral neck by the use of calcium with or without vitamin D supplements in the Study of Women's Health Across the Nation (SWAN), a multi-center, multi-ethnic, community-based longitudinal cohort across the menopause transition. METHODS: Mixed model regression was used to estimate the 10 year annualized BMD change between the calcium with or without vitamin D supplements in SWAN women (n = 1564; aged 42 to 52 years at baseline) unadjusted and adjusted for time-varying covariates (age, menopausal status[pre-, early peri-, late peri- and post- menopausal], smoking, physical activity) and time-constant covariates (height, baseline alcohol). Models were also stratified by menopausal status at baseline. RESULTS: When combined by menopausal status, calcium with or without vitamin D supplement use was associated with less femoral neck BMD annualized loss across in all models (beta = 0.0038 vs −0.0048; P = 0.003). When stratified by pre- and peri- menopause at baseline, calcium with or without vitamin D supplement use was only significant in pre-menopausal women for both the lumbar spine (beta = 0.0067 vs −0.0082; P = 0.02) and femoral neck (beta = −0.0037 vs −0.0052; P = 0.002). CONCLUSIONS: The use of calcium with or without vitamin D supplements is associated with less BMD loss of the lumbar spine and femoral neck, especially in premenopausal women. FUNDING SOURCES: Funding for this study was provided through an unrestricted educational grant from Pfizer. The funding body had no influence on the study design; the collection, analysis, and interpretation of data; the writing of the report; and the decision to submit the paper for publication.

OBJECTIVES: To conduct a systematic review and meta-analysis evaluating the effects of tea flavonoids on cardiovascular (CVD) and all-cause mortality outcomes. METHODS: Searches across five databases including PubMed and Embase were conducted through November 2018 to identify randomized controlled trials (RCTs) and prospective cohort studies reporting cardiovascular and all-cause mortality outcomes. Two investigators independently conducted abstract and full-text screenings, data extractions, and risk of bias (ROB) assessments using the Nutrition Evidence Library Bias Assessment Tool (NEL BAT). Mixed-effects dose-response meta-regression and standard random-effects meta-analyses for outcomes with ≥4 studies were performed. RESULTS: 0 RCTs and 38 prospective cohort studies were included in the systematic review. NEL BAT scores ranged from 0–15 (0 being the lowest risk). Our linear meta-regression model showed that each cup increase in daily tea consumption (about 280 mg and 338 mg of total flavonoids for black and green tea, respectively) was associated with 3–4% lower risk of CVD mortality (predicted adjusted RR = 0.96; CI 0.93–0.99 for green tea and RR = 0.97; CI 0.94–0.99 for black tea). Furthermore, each cup increase in daily tea consumption was associated a 2% lower risk of all-cause mortality (predicted adjusted relative risk (RR) = 0.98; 95% CI 0.97–0.99 for black tea and RR = 0.98; CI 0.96–0.99 for green tea, respectively). Two studies reported multivariable Cox regression analysis results for the relationship between black tea intake and risks of all-cause mortality outcomes. The results from these two studies were combined with our linear meta-regression result in a random-effects model meta-analysis and showed that each cup increase in daily black tea consumption was associated with an average of 3% lower risk of all-cause mortality (pooled adjusted RR = 0.97; 95% CI 0.87–1.00) with large heterogeneity (I(2 )= 81.4%; p = 0.005). CONCLUSIONS: Current evidence indicates that increased tea consumption may reduce CVD and all-cause mortality in a dose-response manner. This systematic review was registered on PROSPERO. FUNDING SOURCES: Funding for this study was provided through an unrestricted educational grant from Unilever. The funding body had no influence on the study design; the collection, analysis, and interpretation of data; the writing of the report; and the decision to submit the paper for publication.

A group of academic and industry experts in the fields of nutrition, cardiology, epidemiology, food science, bone health, and integrative medicine examined the data on the relationship between calcium supplement use and risk of cardiovascular events, with an emphasis on 4 of the Bradford Hill criteria for causal inference: strength, consistency, dose-response, and biological plausibility. Results from 2 epidemiological studies and a meta-analysis of randomized, controlled clinical trials, including a subgroup analysis from the Women's Health Initiative, have prompted concern about a potential association between calcium supplement use and a small increase in the risk of adverse cardiovascular events. However, a number of issues with the studies, such as inadequate compliance with the intervention, use of nontrial calcium supplements, potential bias in event ascertainment, and lack of information on and adjustment for known cardiovascular risk determinants, suggest that bias and confounding cannot be excluded as explanations for the reported associations. Findings from other cohort studies also suggest no detrimental effect of calcium from diet or supplements, with or without vitamin D, on cardiovascular disease risk. In addition, little evidence exists for plausible biological mechanisms to link calcium supplement use with adverse cardiovascular outcomes. The authors do not believe that the evidence presented to date regarding the hypothesized relationship between calcium supplement use and increased cardiovascular disease risk is sufficient to warrant a change in the Institute of Medicine recommendations, which advocate use of supplements to promote optimal bone health in individuals who do not obtain recommended intakes of calcium through dietary sources.

Anthocyanins are a group of abundant and widely consumed flavonoid constituents that occur ubiquitously in the plant kingdom, providing the bright red-orange to blue-violet colors present in many fruit- and vegetable-based food products. Their intake has been estimated to be up to 9-fold higher than that of other dietary flavonoids. Anthocyanins have become increasingly important to the food industry as their use as natural alternatives to artificial colors has become widespread and knowledge of their health-promoting properties has become more evident. Epidemiological studies suggest that increased consumption of anthocyanins lowers the risk of cardiovascular disease (CVD), the most common cause of mortality among men and women. Anthocyanins frequently interact with other phytochemicals, exhibiting synergistic biological effects but making contributions from individual components difficult to decipher. Over the past 2 decades, many peer-reviewed publications have demonstrated that in addition to their noted in vitro antioxidant activity, anthocyanins may regulate different signaling pathways involved in the development of CVD. This review summarizes the latest developments on the bioavailability/bioactivity and CVD preventative activities of anthocyanins, including results from in vitro cell culture and in vivo animal model systems as related to their multiple proposed mechanisms of action. Limited yet promising data from epidemiological studies and human clinical trials are also presented. Future studies aimed at enhancing the absorption of anthocyanins and characterizing their metabolic and/or breakdown products are necessary to ultimately evaluate their use for protection/prevention against the development of CVD.