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Diet is a modifiable risk factor for chronic disease and a potential modulator of telomere length (TL). The study aim was to investigate associations between diet quality and TL in Australian adults after a 12-week dietary intervention with an almond-enriched diet (AED). Participants (overweight/obese, 50–80 years) were randomised to an AED (n62) or isoenergetic nut-free diet (NFD,n62) for 12 weeks. Diet quality was assessed using a Dietary Guideline Index (DGI), applied to weighed food records, that consists of ten components reflecting adequacy, variety and quality of core food components and discretionary choices within the diet. TL was measured by quantitative PCR in samples of lymphocytes, neutrophils, and whole blood. There were no significant associations between DGI scores and TL at baseline. Diet quality improved with AED and decreased with NFD after 12 weeks (change from baseline AED + 9·8 %, NFD − 14·3 %;P< 0·001). TL increased in neutrophils (+9·6 bp,P= 0·009) and decreased in whole blood, to a trivial extent (–12·1 bp,P= 0·001), and was unchanged in lymphocytes. Changes did not differ between intervention groups. There were no significant relationships between changes in diet quality scores and changes in lymphocyte, neutrophil or whole blood TL. The inclusion of almonds in the diet improved diet quality scores but had no impact on TL mid-age to older Australian adults. Future studies should investigate the impact of more substantial dietary changes over longer periods of time.

Individual responses to diet vary but causes other than genetics are poorly understood. This study sought to determine whether baseline values of homeostasis model assessment (HOMA-IR) was related to changes in small, dense low-density lipoprotein (sdLDL, i.e., LDL4, d = 1.044–1.063 g/mL) amounts quantified by isopycnic density profiling, in mildly hypercholesterolemic subjects (n = 27) consuming one of three low saturated fatty acid (SFA) diets: Dietary Approaches to Stop Hypertension (DASH), Beef in an Optimal Lean Diet (BOLD) and BOLD plus extra protein (BOLD+) when compared to a higher-SFA healthy American diet (HAD). The diets were consumed in random order for 5 wk, with 1 wk between diets. BOLD+ reduced fractional abundance (%) LDL4 (p < 0.05) relative to HAD, DASH and BOLD, and reductions in % LDL4 correlated with reductions in triglycerides (p = 0.044), total cholesterol (p = 0.014), LDL cholesterol (p = 0.004) and apolipoprotein B (p < 0.001). Responses to the four diets were similar (~12% decrease in % LDL4, p = 0.890) in the lower (p = 0.013), in which % LDL4 was reduced with BOLD+ (−11%), was unchanged in BOLD and increased with the HAD (8%) and DASH (6%) diets (p < 0.05 for BOLD+ vs. HAD). Individual responses to diet interventions are influenced by presence and degree of insulin resistance as measured by HOMA-IR.

Long term nut consumption is associated with reduced risk of coronary heart disease and better cognitive function. This study examined supplementing habitual diets with almonds or carbohydrate-rich snack foods (providing 15% energy) on biomarkers of cardiovascular and metabolic health, mood and cognitive performance. Participants (overweight/obese, 50&ndash, 80 years) were randomised to an almond-enriched diet (AED) or isocaloric nut-free diet (NFD) for 12 weeks. Body weight, blood lipids, glucose, insulin, blood pressure (BP), arterial stiffness, cell adhesions molecules, C reactive protein (CRP), mood, and cognitive performance (working memory primary outcome), dietary profiles and energy intake/expenditure were measured at baseline and Week 12 in 128 participants (n = 63 AED, n = 65 NFD). Compared with NFD, AED was associated with altered macro and micronutrient profiles, but no differences in energy intake or expenditure. The AED significantly reduced triglycerides and SBP but there were no other changes in cardiometabolic biomarkers, mood, or cognitive performance. The inclusion of almonds in the diet improves aspects of cardiometabolic health without affecting cognitive performance or mood in overweight/obese adults.

Longitudinal studies report that regular nut consumption is associated with reduced risk of coronary heart disease and better cognitive function. Thus, nuts may improve cardiovascular and neurocognitive health – especially in ‘at-risk’ populations (e.g. overweight/obese). This study examined the effect of supplementing habitual diets of overweight/obese individuals for 12 weeks with either almonds or carbohydrate rich (CHO-rich) snack foods on biomarkers of cardiovascular and metabolic health, mood and cognitive performance. Participants (n = 151; overweight/obese, 50–80 years) were randomised to replace 15% energy intake with either almonds (Almond) or isocaloric CHO-rich snack foods (Comparator). Body weight, blood lipids, glucose, insulin, blood pressure (BP), arterial stiffness, mood and cognitive performance (memory, executive function, speed of processing) were measured at baseline and 12 weeks. One hundred and twenty eight participants (78F:50M, n = 63 almond, n = 65 control) completed the intervention (M ± SD: age 64 ± 8years, BMI 30.3 ± 3.6kg/m2, stable medication use: 32% BP and 19% lipid lowering). Compared with the CHO-rich comparator foods, there were a number of significant improvements associated with almond consumption. These included reduced serum triglycerides (M ± SEM, almond: 1.30 ± 0.062 to 1.16 ± 0.062 mmol/L vs CHO-rich 1.13 ± 0.061 to 1.17 ± 0.061 mmol/L, p = 0.005 whole population). In those with cholesterol below the ATPIII cut point of < 6.2mmol/L (84% of sample), almond consumption reduced total cholesterol (almond: 5.12 ± 0.13 to 4.93 ± 0.12 mmol/L vs CHO-rich 5.24 ± 0.13 to 5.21 ± 0.11 mmol/L, p < 0.001) and LDL-cholesterol (almond: 3.03 ± 0.11 to 2.87 ± 0.11 mmol/L vs CHO-rich 2.98 ± 0.10 to 3.07 ± 0.10 mmol/L, p = 0.002).). Additionally in a non-BP medicated subgroup only (n = 87, 68% of sample), there was a reduction in systolic BP (almond: 130.73 ± 2.19 to 127.02 ± 2.19 mmHg vs control:128.63 ± 2.32 to 129.48 ± 2.32mmHg, p = 0.035; and improved self-rated alertness (almond 54.73 ± 2.32 to 58.64 ± 2.32 vs CHO-rich 61.75 ± 2.28 to 61.13 ± 2.28, p = 0.048). The inclusion of almonds in the diet has the ability to improve aspects of cardiometabolic health and mood in overweight/obese adults. The lack of change in cognitive performance may reflect the fact that the study population was cognitively high performing at baseline. Future research should be directed at examining the effects of this relatively simple, cost-effective nutritional intervention in populations at greater risk of cardiometabolic and cognitive decline.

Background: Postprandial hyperlipidemia is associated with impaired endothelial function. Peanut consumption favorably affects the lipid and lipoprotein profile; however, the effects on endothelial function remain unclear. Objective: The purpose of the study was to evaluate the effects of acute peanut consumption as part of a high-fat meal on postprandial endothelial function. Methods: We conducted a randomized, controlled, crossover postprandial study to evaluate the effect of acute peanut consumption on postprandial lipids and endothelial function as assessed by flow-mediated dilatation (FMD) of the brachial artery in 15 healthy overweight or obese men [mean age: 26.7 y; mean body mass index (in kg/m2): 31.4]. Participants consumed, in a randomized order, a peanut meal containing 3 ounces (85 g) ground peanuts (1198 kcal; 40.0% carbohydrate, 47.7% fat, 19.4% saturated fat, 13.2% protein) and a control meal matched for energy and macronutrient content. Meals were in the form of a shake, scheduled ≥1 wk apart. Lipids, lipoproteins, glucose, and insulin were measured at baseline (0 min) and at 30, 60, 120, and 240 min after shake consumption. FMD was measured at baseline and at 240 min. Results: Acute peanut consumption blunted the serum triglyceride (TG) response 120 and 240 min after consumption compared with the control meal (means ± SEMs—120 min: 188.9 ± 19.4 compared with 197.5 ± 20.7 mg/dL; 240 min: 189.9 ± 24.3 compared with 197.3 ± 18.4 mg/dL; P < 0.05 for both). Total, LDL, and HDL cholesterol and glucose and insulin responses were similar between the test meals. Compared with baseline, only the control meal significantly decreased FMD at 240 min (control: −1.2% ± 0.5%; P = 0.029; peanut: −0.6% ± 0.5%; P = 0.3). Participants with higher baseline total (>150 mg/dL) and LDL (>100 mg/dL)-cholesterol concentrations showed a significant decrease in FMD after the control meal (−1.8%, P = 0.017; −2.0%, P = 0.038), whereas the peanut meal maintained endothelial function in all participants irrespective of total- and LDL-cholesterol concentrations. Conclusion: The inclusion of 85 g peanuts (3 ounces) as part of a high-fat meal improved the postprandial TG response and preserved endothelial function in healthy overweight or obese men. This trial was registered at clinicaltrials.gov as NCT01405300.

Vascular stiffness can be measured using numerous techniques including assessments of central haemodynamics, aortic arterial stiffness, and indices of aortic wave reflection and endothelial dilatation. Impaired vascular function is associated with increased risk of cardiovascular disease (CVD). Epidemiological studies indicate that regular nut consumption reduces CVD risk, with one of the proposed mechanisms being via improvements in vascular function. This narrative review summarizes the evidence from a systematic search of the literature of the effects of tree nut and peanut consumption on measures of vascular function excluding flow mediated dilatation. A total of 16 studies were identified, with a mix of acute controlled studies (n = 3), an uncontrolled pre/post chronic study (n = 1), chronic crossover (n = 7) and parallel studies (n = 5). Nut types tested included almonds, peanuts, pine nuts, pistachios and walnuts, with dose and length of supplementation varying greatly across studies. Most studies (n = 13) included individuals at risk for CVD, according to various criteria. Findings were inconsistent, with ten studies reporting no significant changes in vascular function and six studies (one acute and five chronic studies) reporting improvements in at least one measure of vascular function. In summary, nuts have the potential to improve vascular function and future studies should consider the population, dose and length of nut supplementation as well as suitability of the different vascular function techniques. Refereed/Peer-reviewed

Chronic obstructive pulmonary disease (COPD) is a progressive disease of the airways, underpinned by inflammation and worsening lung function. Omega-3 polyunsaturated fatty acids (n-3PUFA) can modulate inflammatory mechanisms and may therefore impact lung function in people with COPD. This observational, cross-sectional study of 577 adults in the Whyalla Intergenerational Study of Health (WISH), conducted during 2008–09 in regional South Australia, explored associations between fish and PUFA intakes (from food frequency questionnaires) and lung function (spirometry). It also included a nested case-control study which compared fish and PUFA intakes and plasma phospholipid PUFA levels between 40 people with COPD and 80 age-sex matched controls. In the whole population, linear regression models adjusted for age, sex, smoking status and education demonstrated a weak negative association between lung function (FEV1% predicted) and consumption of fried fish (OR -0.12, 95% CI -0.22, −0.01, P = 0.026) but not fish prepared by other cooking methods or estimated intakes of PUFA. There was no association between fish or PUFA intakes and COPD risk. Compared to age and sex matched controls, cases had poorer lung function and a higher rate of smoking prevalence but did not differ in their intakes of fish or PUFA or their PUFA levels in plasma phospholipids. In this sub-population, we found a marginally significant association between COPD risk and total long chain n-3PUFA levels in plasma phospholipids (OR 1.22 95% CI 1.00–1.49, P = 0.046). Given the relatively small number of cases in this analysis, this finding should be interpreted with caution, especially given the lack of association with other markers of n-3PUFA intake or status. Taken together, our data suggest that n-3PUFA intake and status are not determinants of improved lung function in this regional Australian population. Keywords: Lung function, Chronic obstructive pulmonary disease, COPD, Polyunsaturated fatty acid, PUFA

Context: The anti-inflammatory activity of long-chain n-3 polyunsaturated fatty acids (PUFAs) has been established in several chronic inflammatory diseases but has yet to be demonstrated in inflammatory lung diseases such as chronic obstructive pulmonary disease (COPD). Objective: The aim of this systematic review was to investigate, using PRISMA guidelines, the relationship between the intake of long-chain n-3 PUFAs and the prevalence, severity, and health outcomes of COPD. Data Sources: Eight health databases and the World Health Organization’s international clinical trial registry were searched for relevant studies. Study Selection: Experimental or observational studies that were published in English and that assessed long-chain n-3 PUFA intake (by determining habitual consumption and/or tissue levels) in adults with COPD were included. Data Extraction: Publication demographics, participant characteristics, type of intervention or exposure, long-chain n-3 PUFA intake, pulmonary function, COPD mortality, and COPD severity were independently extracted from each article by 2 authors using a prospectively designed data extraction tool. Data Synthesis: All 11 of the studies included in the review were observational. Approximately equal numbers of studies reported significant (n = 6, 5 inverse) relationships or no significant relationships (n = 5) between either consumption of long-chain n-3 PUFAs or levels of long-chain n-3 PUFAS in tissue and a COPD outcome. Conclusions: Current evidence of a relationship between long-chain n-3 PUFA intake and COPD is limited and conflicting, with studies having wide methodological variation. Registration number: PROSPERO 2013:CRD42013004085

Anthocyanins are of interest due to their anti-oxidative and vasodilatory properties. Earlier reviews have shown that berries and other anthocyanin rich foods or extracts can improve vascular health, however the effect of anthocyanins on vascular function has not yet been reviewed. To address this gap in the literature, we conducted a systematic review and meta-analysis of randomised-controlled trials examining anthocyanin-rich foods or extracts on measures of vascular reactivity and/or stiffness in adults. Data from 24 studies were pooled as standardized mean difference (SMD) with 95% confidence intervals (CI). Anthocyanin consumption significantly improved flow-mediated dilation (FMD) following acute (SMD: 3.92%, 95% CI: 1.47, 6.38, p = 0.002; I 2 = 91.8%) and chronic supplementation (SMD: 0.84%, 95% CI: 0.55, 1.12, p = 0.000; I 2 = 62.5%). Pulse wave velocity was improved following acute supplementation only (SMD: −1.27 m/s, 95% CI: −1.96, −0.58, p = 0.000; I 2 = 17.8%). These results support the findings of previous reviews that anthocyanin rich foods or extracts may indeed improve vascular health, particularly with respect to vascular reactivity measured by FMD. More research is required to determine the optimal dosage, and the long-term effects of consumption. Refereed/Peer-reviewed

Background: A Step I diet with lean beef compared with lean white meat both decrease LDL cholesterol. To our knowledge, no studies have evaluated a low–saturated fatty acid (SFA) (2.8 mmol/L) were randomly assigned to consume each of the 4 diets (HAD: 33% total fat, 12% SFA, 17% protein, and 20 g beef/d), DASH (27% total fat, 6% SFA, 18% protein, and 28 g beef/d), BOLD (28% total fat, 6% SFA, 19% protein, and 113 g beef/d), and BOLD+ (28% total fat, 6% SFA, 27% protein, and 153 g beef/d) for 5 wk. Results: There was a decrease in total cholesterol (TC) and LDL-cholesterol concentrations (P < 0.05) after consumption of the DASH (−0.49 ± 0.11 and −0.37 ± 0.09 mmol/L, respectively), BOLD (−0.48 ± 0.10 and −0.35 ± 0.9 mmol/L, respectively), and BOLD+ (−0.50 ± 0.10 and −0.345 ± 0.09 mmol/L, respectively) diets compared with after consumption of the HAD (−0.22 ± 0.10 and −0.14 ± 0.10 mmol/L, respectively). Apolipoprotein A-I, C-III, and C-III bound to apolipoprotein A1 particles decreased after BOLD and BOLD+ diets compared with after the HAD, and there was a greater decrease in apolipoprotein B after consumption of the BOLD+ diet than after consumption of the HAD (P < 0.05 for both). LDL cholesterol and TC decreased after consumption of the DASH, BOLD, and BOLD+ diets when the baseline C-reactive protein (CRP) concentration was 1 mg/L with the BOLD and BOLD+ diets. Conclusions: Low-SFA, heart-healthy dietary patterns that contain lean beef elicit favorable effects on cardiovascular disease (CVD) lipid and lipoprotein risk factors that are comparable to those elicited by a DASH dietary pattern. These results, in conjunction with the beneficial effects on apolipoprotein CVD risk factors after consumption of the BOLD and BOLD+ diets, which were greater with the BOLD+ diet, provide support for including lean beef in a heart-healthy dietary pattern. This trial was registered at clinicaltrials.gov as NCT00937898.

Consumption of long-chainn-3 PUFA, particularly DHA, has been shown to improve cardiovascular risk factors but the intake required to achieve benefits is unclear. We sought to determine the relationship between DHA intake, increases in erythrocyte DHA content and changes in blood lipids. A total of sixty-seven subjects (thirty-six male, thirty-one female, mean age 53 years) with fasting serum TAG ≥ 1·1 mmol/l and BMI>25 kg/m2completed a 12-week, randomized, double-blind, placebo-controlled parallel intervention. Subjects consumed 2, 4 or 6 g/d of DHA-rich fish oil (26 % DHA, 6 % EPA) or a placebo (Sunola oil). Fasting blood lipid concentrations and fatty acid profiles in erythrocyte membranes were assessed at baseline and after 6 and 12 weeks. For every 1 g/d increase in DHA intake, there was a 23 % reduction in TAG (mean baseline concentration 1·9 (sem0·1) mmol/l), 4·4 % increase in HDL-cholesterol and 7·1 % increase in LDL-cholesterol. Erythrocyte DHA content increased in proportion to the dose of DHA consumed (r0·72,P r− 0·38,P r0·39,P r0·33,P r0·30,P = 0·02). The close association between incorporation of DHA in erythrocytes and its effects on serum lipids highlights the importance of erythrocyte DHA as an indicator of cardiovascular health status.

CVD is associated with a cellular inflammatory/immune response.n-3 PUFA and moderate aerobic exercise independently alter cytokine production and leucocyte function. There is limited evidence for the combined effect of these treatments on immune function, particularly in patients with risk factors for CVD. We hypothesised that exercise would enhance the anti-inflammatory effects ofn-3 PUFA. In a randomised, placebo-controlled study, fifty volunteers were allocated double-blind to consume either sunflower oil (6 g/d, placebo) or DHA-rich fish oil (6 g/d; about 2 gn-3 PUFA; 1·6 g DHA /d) for 12 weeks. Volunteers were further randomised to undertake regular exercise (walking 3 d/week for 45 min at 75 % of maximum heart rate) or maintain their usual physical activity for 12 weeks. Immune functions were assessed in blood taken initially and after 12 weeks. There was no effect on cytokine production by T cells and monocytes. Superoxide anion production from stimulated blood neutrophils was decreased by fish oil (19·5 (sem8·5) %,P = 0·016) but not by exercise, and this change was negatively correlated with the incorporation of DHA into erythrocytes (r–0·385,P = 0·047). Participation in regular exercise maintained neutrophil bactericidal activity, which decreased in non-exercising subjects (2·9 (sem0·7) %,P = 0·013). Neutrophil chemotaxis and adherence were not significantly affected by exercise, oil, or the combination of the two. Thus the combination of moderate exercise and fish-oil supplementation, which reduces cardiovascular risk, may also help to counteract inflammation.

Background: Food-based dietary patterns emphasizing plant protein that were evaluated in the Dietary Approaches to Stop Hypertension (DASH) and OmniHeart trials are recommended for the treatment of metabolic syndrome (MetS). However, the contribution of plant protein to total protein in these diets is proportionally less than that of animal protein. Objective: This study compared 3 diets varying in type (animal compared with plant) and amount of protein on MetS criteria. Design: Sixty-two overweight adults with MetS consumed a healthy American diet for 2 wk before being randomly allocated to either a modified DASH diet rich in plant protein (18% protein, two-thirds plant sources, n = 9 males, 12 females), a modified DASH diet rich in animal protein (Beef in an Optimal Lean Diet: 18.4% protein, two-thirds animal sources, n = 9 males, 11 females), or a moderate-protein diet (Beef in an Optimal Lean Diet Plus Protein: 27% protein, two-thirds animal sources, n = 10 males, 11 females). Diets were compared across 3 phases of energy balance: 5 wk of controlled (all foods provided) weight maintenance (WM), 6 wk of controlled weight loss (minimum 500-kcal/d deficit) including exercise (WL), and 12 wk of prescribed, free-living weight loss (FL). The primary endpoint was change in MetS criteria. Results: All groups achieved ∼5% weight loss at the end of the WL phase and maintained it through FL, with no between-diet differences (WM compared with WL, FL, P < 0.0001; between diets, P = NS). All MetS criteria decreased independent of diet composition (main effect of phase, P < 0.01; between diets, P = NS). After WM, all groups had a MetS prevalence of 80–90% [healthy American diet (HAD) compared with WM, P = NS], which decreased to 50–60% after WL and was maintained through FL (HAD, WM vs WL, FL, P < 0.01). Conclusions: Weight loss was the primary modifier of MetS resolution in our study population regardless of protein source or amount. Our findings demonstrate that heart-healthy weight-loss dietary patterns that emphasize either animal or plant protein improve MetS criteria similarly. This study was registered at clinicaltrials.gov as {"type":"clinical-trial","attrs":{"text":"NCT00937638","term_id":"NCT00937638"}}NCT00937638.

Background: Higher whole-grain (WG) intake is associated with a lower prevalence of metabolic syndrome (MetS); however, there is inconsistent clinical evidence with regard to the benefit of WGs compared with refined grains (RGs) on MetS. Conclusions: Replacing RGs with WGs within a weight-loss diet does not beneficially affect abdominal AT loss and has modest effects on markers of MetS. WGs appear to be effective at normalizing blood glucose concentrations, especially in those individuals with prediabetes. This trial was registered at www.clinicaltrials.gov as NCT00924521. Design: A randomized, controlled, open-label parallel study was conducted in 50 overweight and obese individuals with increased waist circumference and one or more other MetS criteria. Participants consumed a controlled weight-loss diet containing either WG or RG (control) products for 12 wk. Body composition, MetS criteria and related markers, and plasma alkylresorcinols (compliance marker of WG intake) were measured at baseline and at 6 and 12 wk. A subgroup (n = 28) underwent magnetic resonance imaging to quantify subcutaneous and visceral adipose tissue (AT). Objective: We hypothesized that consuming WGs in the place of RGs would improve MetS criteria in individuals with or at risk of MetS. Results: Baseline variables were not significantly different between groups; however, the RG group tended to have higher triglycerides and lower HDL cholesterol (P = 0.06). Alkylresorcinols increased with consumption of the WG diet and did not change with consumption of the RG diet (time 3 treatment, P , 0.0001), which showed dietary compliance. There were no differences in anthropometric changes between groups; however, weight, body mass index, and percentage of body AT decreased at both 6 and 12 wk (P , 0.05), and reductions in percentage of abdominal AT occurred by 6 wk and did not change between 6 and 12 wk (P = 0.09). Both glucose (P = 0.02) and high-density lipoprotein (HDL) cholesterol (P = 0.04) were lower with the consumption of the WG compared with the RG diet. However, when noncompliant individuals (n = 3) were removed, the glucose effect was stronger (P = 0.01) and the HDL-cholesterol effect was no longer significant (P = 0.14). Refereed/Peer-reviewed

There is evidence to support the use of supplementation with long-chain omega-3 polyunsaturated fatty acids (LCn-3PUFA) from oily fish or fish oil for the treatment of various inflammatory diseases such as rheumatoid arthritis. Chronic obstructive pulmonary disease (COPD) is a progressive, terminal disease characterized by persistent airflow limitation, lung and systemic inflammation. To date, one randomized controlled trial has been published that assessed the efficacy of LCn-3PUFA in people with this condition. The aim of this article is to discuss the feasibility of conducting a trial to evaluate fish oil supplementation as adjunct therapy in people with COPD., The study is supported by a University of South Australia, Division of Health Sciences grant (DRDG 2011 (round 2)).

Purpose of the review: Healthy lifestyle practices play a key role in preventing and treating cardiovascular disease, and central to such strategy is a recommended dietary pattern. Current Dietary Guidelines from the US Department of Agriculture and the American Heart Association advocate a food-based diet for optimal health and prevention of chronic disease. Considerable research has focused on implementing these guidelines for maximal cardiovascular risk reduction, and this review will discuss the role of specific dietary strategies and select nutrition supplements in achieving this goal. Recent findings: Food-based guidelines are reflected in specific dietary approaches to improve cardiovascular risk factors, such as the Dietary Approaches to Stop Hypertension diet and Therapeutic Lifestyle Changes, which have shown to effectively benefit hypertension and hypercholesterolemia, respectively. These diets, therefore, significantly reduce coronary heart disease risk. Although such dietary approaches ensure that nutrient requirements are met through foods, nutrition supplement use in the United States is at an all time high. Summary: The Dietary Approaches to Stop Hypertension diet and Therapeutic Lifestyle Changes Diet are effective in decreasing cardiovascular morbidity and mortality risk, and such dietary strategies are endorsed by many organizations, including the American Heart Association and the National Heart, Lung and Blood Institute. In contrast, although some dietary supplements, such as fish oil and niacin, have shown promising cardiovascular effects, justifying their widespread use in clinical practice for some patients, there is insufficient evidence for others. Clinicians should carefully evaluate the claims made for new diet therapies, supplements, or both when counseling at-risk individuals Refereed/Peer-reviewed

This article discusses specific dietary factors as well as dietary patterns that affect the major coronary heart disease (CHD) lipid risk factors (ie, LDL-C, HDL-C, and TG). Based on a very large evidence base, it is clear that diet and lifestyle practices can markedly affect these major CHD lipid risk factors, and consequently decrease CHD risk substantively. Refereed/Peer-reviewed

The aim of this study was to determine the accuracy of dual-energy X-ray absorptiometry (DXA)-derived percentage fat estimates in obese adults by using four-compartment (4C) values as criterion measures. Differences between methods were also investigated in relation to the influence of fat-free mass (FFM) hydration and various anthropometric measurements. Six women and eight men (age 22-54 years, BMI 28.7-39.9 kg/m2, 4C percent body fat (%BF) 31.3-52.6%) had relative body fat (%BF) determined via DXA and a 4C method that incorporated measures of body density (BD), total body water (TBW), and bone mineral mass (BMM) via underwater weighing, deuterium dilution, and DXA, respectively. Anthropometric measurements were also undertaken: height, waist and gluteal girth, and anterior-posterior (A-P) chest depth. Values for both methods were significantly correlated (r2 = 0.894) and no significant difference (P = 0.57) was detected between the means (DXA = 41.1%BF, 4C = 41.5%BF). The slope and intercept for the regression line were not significantly different (P > 0.05) from 1 and 0, respectively. Although both methods were significantly correlated, intraindividual differences between the methods were sizable (4C-DXA, range = -3.04 to 4.01%BF) and significantly correlated with tissue thickness (chest depth) or most surrogates of tissue thickness (body mass, BMI, waist girth) but not FFM hydration and gluteal girth. DXA provided cross-sectional %BF data for obese adults without bias. However, individual data are associated with large prediction errors (4.2%BF). This error appears to be associated with tissue thickness indicating that the DXA device used may not be able to accurately account for beam hardening in obese cohorts. Refereed/Peer-reviewed

he practice of good nutrition is guided by a "foodfirst" approach. Registered dietitians, both in the United States and globally, have long championed a food-based approach for achieving nutrient adequacy and preventing and treating diseases. Consistent with this guiding principle is the position of the American Dietetic Association (ADA) on fortification and nutritional supplements (1). "It is the position of the ADA that the best nutritional strategy for promoting optimal health and reducing the risk of chronic disease is to wisely choose a wide variety of foods. Additional nutrients from fortified foods and/or supplements can help some people meet their nutritional needs as specified by science-based nutrition strategies such as the Dietary Reference Intakes." Inherent to this position is that a variety of nutrientdense foods be consumed in moderation as the basis for a healthful diet. This is a key message echoed by the Dietary Guidelines for Americans 2005, which states, "Consume a variety of nutrient-dense foods and beverages within and among the basic food groups. . . ." and "Meet recommended intakes within energy needs by adopting a balanced eating pattern . . ." (2).

To evaluate metabolic effects of epigallocatechin gallate (EGCG) supplementation when combined with a program of regular aerobic exercise in overweight/obese post-menopausal women.Thirty-eight overweight or obese postmenopausal women exercised at moderate intensity, viz. walking three times per week for 45 min at 75% of age-predicted maximum heart rate (HR), and took a 150 mg capsule of EGCG (Teavigo) or placebo (lactose) twice daily for 12 weeks. Blood parameters (lipids, glucose and insulin), blood pressure, heart rate, arterial function and anthropometry were assessed at 0, 6 and 12 wk. At wk 0 and 12, body composition was assessed by dual energy X-ray absorptiometry (DXA) and abdominal fat was assessed by DXA and computed tomography (CT).Waist circumference (p0.01), total body fat (p0.02), abdominal fat (by DXA) (p0.01) and intra abdominal adipose tissue (by CT) (p0.01) were reduced in both treatment groups, with no difference between placebo and Teavigo. Teavigo significantly decreased resting HR (p0.01) and reduced plasma glucose in subjects with impaired glucose tolerance (p0.05).Moderate consumption of EGCG can improve the health status of overweight individuals undergoing regular exercise by reducing HR and plasma glucose concentrations. Loss of body fat, however, may require a higher intake of EGCG, other catechins or addition of metabolic stimulants.

BACKGROUND Regular exercise and consuming long-chain n-3 fatty acids (FAs) from fish or fish oil can independently improve cardiovascular and metabolic health, but combining these lifestyle modifications may be more effective than either treatment alone. OBJECTIVE We examined the individual and combined effects of n-3 FA supplements and regular exercise on body composition and cardiovascular health. DESIGN Overweight volunteers [body mass index (BMI; in kg/m(2)): >25] with high blood pressure, cholesterol, or triacylglycerols were randomly assigned to one of the following interventions: fish oil (FO), FO and exercise (FOX), sunflower oil (SO; control), or SO and exercise (SOX). Subjects consumed 6 g tuna FO/d ( approximately 1.9 g n-3 FA) or 6 g SO/d. The exercise groups walked 3 d/wk for 45 min at 75% age-predicted maximal heart rate. Plasma lipids, blood pressure, and arterial function were assessed at 0, 6, and 12 wk. Body composition was assessed by dual-energy X-ray absorptiometry at 0 and 12 wk only. RESULTS FO supplementation lowered triacylglycerols, increased HDL cholesterol, and improved endothelium-dependent arterial vasodilation (P

HILL, ALISON M., JOE LAFORGIA, ALISON M. COATES, JONATHAN D. BUCKLEY, AND PETER R.C. HOWE. Estimating abdominal adipose tissue with DXA and anthropometry. Obesity. 2007;15:504–510. Objective: To identify an anatomically defined region of interest (ROI) from DXA assessment of body composition that when combined with anthropometry can be used to accurately predict intra-abdominal adipose tissue (IAAT) in overweight/obese individuals. Research Methods and Procedures: Forty-one postmenopausal women (age, 49 to 66 years; BMI, 26 to 37 kg/m 2 ) underwent anthropometric and body composition assessments. ROI were defined as quadrilateral boxes extending 5 or 10 cm above the iliac crest and laterally to the edges of the abdominal soft tissue. A single-slice computed tomography (CT) scan was measured at the L3 to L4 intervertebral space, and abdominal skinfolds were taken. Results: Forward step-wise regression revealed the best predictor model of IAAT area measured by CT (r 2 0.68, standard error of estimate 17%) to be: IAAT area (centimeters squared) 51.844 DXA 10-cm ROI (grams) (0.031) abdominal skinfold (millimeters) (1.342). Interobserver reliability for fat mass (r 0.994; coefficient of variation, 2.60%) and lean mass (r 0.986, coefficient of variation, 2.67%) in the DXA 10-cm ROI was excellent. Discussion: This study has identified a DXA ROI that can be reliably measured using prominent anatomical landmarks, in this case, the iliac crest. Using this ROI, combined with an abdominal skinfold measurement, we have derived an equation to predict IAAT in overweight/obese postmenopausal women. This approach offers a simpler, safer, and more cost-effective method than CT for assessing the efficacy of lifestyle interventions aimed at reducing IAAT. However, this warrants further investigation and validation with an independent cohort.