Objective: These previous studies were conducted with the use of only HED snack foods. The purpose of this study was to determine whether these effects generalize to low-energy-density (LED) foods.

Design: Participants (n = 53) had food reinforcement and food liking tested at baseline and then again after 2 wk of daily consumption of 60-g portions of an HED (n = 26) or an LED (n = 27) snack food.

Results: We observed a decrease in food reinforcement in women with a lower body mass index (BMI) and an increase in food reinforcement in women with a higher BMI after 14 d of consumption of an HED snack food. Food liking decreased in all women, regardless of BMI, after repeated consumption of HED foods. Conversely, all women, regardless of BMI, showed a decrease in food reinforcement after 14 d of LED snack food consumption. Women with a lower BMI who consumed LED snacks also showed a decrease in liking, but women with a higher BMI who consumed LED foods reported no change in liking.

Conclusions: These findings suggest that changes in food reinforcement after daily snack food intake are influenced by both BMI and the energy density of the foods. In addition, changes in food reinforcement cannot be explained by changes in food liking.

Objective: The objective was to determine whether epigenetics and gene expression changes may play a role in weight-loss responsiveness.

Design: Overweight/obese postmenopausal women were recruited for a standard 6-mo caloric restriction intervention. Abdominal subcutaneous adipose tissue biopsy samples were collected before (n = 14) and after (n = 14) intervention, and the epigenomic and transcriptomic profiles of the high and low responders to dieting, on the basis of changes in percentage body fat, were compared by using microarray analysis.

Results: Significant DNA methylation differences at 35 loci were found between the high and low responders before dieting, with 3 regions showing differential methylation after intervention. Some of these regions contained genes known to be involved in weight control and insulin secretion, whereas others were localized in known imprinted genomic regions. Differences in gene expression profiles were observed only after dieting, with 644 genes being differentially expressed between the 2 groups. These included genes likely to be involved in metabolic pathways related to angiogenesis and cerebellar long-term depression.

Conclusions: These data show that both DNA methylation and gene expression are responsive to caloric restriction and provide new insights about the molecular pathways involved in body weight loss as well as methylation regulation during adulthood.

Objective: We aimed to evaluate the influence of common genetic variants identified by genome-wide association studies on overweight and the metabolic profile in adolescence.

Design: In a population-based cohort of 663 girls and 612 boys aged 16 y, weight, height, skinfold thicknesses, percentage body fat, waist circumference, blood pressure, glucose, insulin, lipid profile, and DNA were obtained. We defined overweight according to international criteria. We performed multiple linear and logistic regression analyses to assess the influence of candidate single nucleotide polymorphisms near the INSIG2, in the FTO, and near the MC4R genes and repeated-measures analyses of available body mass index (BMI) and skinfold thickness data across 3 visits at ages 11, 13.5, and 16 y.

Results: A total of 15.1% of participants were overweight or obese at age 16 y. No associations with INSIG2 were found. Common variation in the FTO gene was associated with sex-specific z scores of BMI (B: 0.11; 95% CI: 0.03, 0.19), sum of skinfold thicknesses (B: 0.12; 95% CI: 0.04, 0.20), percentage body fat (B: 0.11; 95% CI: 0.03, 0.19), waist circumference (B: 0.11; 95% CI: 0.03, 0.19), fasting glucose (B: 0.10; 95% CI: 0.00, 0.20), and overweight (odds ratio: 1.34; 95% CI: 1.06, 1.69) at age 16 y. Repeated-measures analyses confirmed the associations for BMI and sum of skinfold thicknesses, and physical activity did not modify these associations. Common variation near the MC4R gene was associated with BMI in cross-sectional (B: 0.11; 95% CI: 0.02, 0.20) and repeated-measures (B: 0.12; 95% CI: 0.03, 0.20) analyses.

Conclusions: Common variation in the FTO gene is associated with overall and abdominal adiposity. Variation near the MC4R gene is associated with BMI. These findings in adolescents strengthen and extend the results from previous research.

Objective: Our aim was to investigate the association of total dietary fiber, cereal fiber, and fruit and vegetable fiber with changes in weight and waist circumference.

Design: We conducted a prospective cohort study with 89,432 European participants, aged 20–78 y, who were free of cancer, cardiovascular disease, and diabetes at baseline and who were followed for an average of 6.5 y. Dietary information was collected by using validated country-specific food-frequency questionnaires. Multiple linear regression analysis was performed in each center studied, and estimates were combined by using random-effects meta-analyses. Adjustments were made for follow-up duration, other dietary variables, and baseline anthropometric, demographic, and lifestyle factors.

Results: Total fiber was inversely associated with subsequent weight and waist circumference change. For a 10-g/d higher total fiber intake, the pooled estimate was –39 g/y (95% CI: –71, –7 g/y) for weight change and –0.08 cm/y (95% CI: –0.11, –0.05 cm/y) for waist circumference change. A 10-g/d higher fiber intake from cereals was associated with –77 g/y (95% CI: –127, –26 g/y) weight change and –0.10 cm/y (95% CI: –0.18, –0.02 cm/y) waist circumference change. Fruit and vegetable fiber was not associated with weight change but had a similar association with waist circumference change when compared with intake of total dietary fiber and cereal fiber.

Conclusion: Our finding may support a beneficial role of higher intake of dietary fiber, especially cereal fiber, in prevention of body-weight and waist circumference gain.

Objective: Our objective was to examine the cross-sectional association of vitamin B-6 status with markers of inflammation and oxidative stress.

Design: We measured plasma pyridoxal-5'-phosphate (PLP), C-reactive protein (CRP), and an oxidative DNA damage marker, urinary 8-hydroxydeoxyguanosine (8-OHdG), in Puerto Rican adults who were living in Massachusetts (n = 1205, aged 45–75 y).

Results: There was a strong dose-response relation of plasma PLP concentration with plasma CRP. Increasing quartiles of PLP were significantly associated with lower CRP concentrations (geometric means: 4.7, 3.6, 3.1, and 2.5 mg/L; P for trend < 0.0001) and with lower urinary 8-OHdG concentrations (geometric means: 124, 124, 117, and 108 ng/mg creatinine; P for trend: 0.025) after multivariate adjustment. These negative associations persisted after plasma homocysteine was controlled for. Plasma PLP concentrations were significantly correlated with plasma fasting glucose (r = –0.1, P = 0.0006), glycated hemoglobin (r = –0.08, P = 0.006), and homeostasis model assessment of β cell function (r = 0.082, P = 0.005). Metabolic syndrome, obesity, and diabetes were also significantly associated with low plasma PLP concentrations (P = 0.011, 0.0007, and 0.004, respectively).

Conclusions: Low vitamin B-6 concentrations are associated with inflammation, higher oxidative stress, and metabolic conditions in older Puerto Rican adults. Our data suggest that vitamin B-6 may influence cardiovascular disease risk through mechanisms other than homocysteine and support the notion that nutritional status may influence the health disparities present in this population.

Objective: Our objective was to evaluate the reproducibility of ad libitum energy intake with the use of a computerized vending machine system.

Design: Twelve individuals (mean ± SD: 36 ± 8 y old; 41 ± 8% body fat) consumed a weight-maintaining diet for 3 d; subsequently, they self-selected all food with the use of a computerized vending machine system for an additional 3 d. Mean daily energy intake was calculated from the actual weight of foods consumed and expressed as a percentage of weight-maintenance energy needs (%WMEN). Subjects repeated the study multiple times during 2 y. The within-person reproducibility of energy intake was determined through the calculation of the intraclass correlation coefficients (ICCs) between visits.

Results: Daily energy intake for all subjects was 5020 ± 1753 kcal during visit 1 and 4855 ± 1615 kcal during visit 2. There were no significant associations between energy intake and body weight, body mass index, or percentage body fat while subjects used the vending machines, which indicates that intake was not driven by body size or need. Despite overconsumption (%WMEN = 181 ± 57%), the reproducibility of intake between visits, whether expressed as daily energy intake (ICC = 0.90), %WMEN (ICC = 0.86), weight of food consumed (ICC = 0.87), or fat intake (g/d; ICC = 0.87), was highly significant (P < 0.0001).

Conclusion: Although ad libitum energy intake exceeded %WMEN, the within-person reliability of this intake across multiple visits was high, which makes this a reproducible method for the measurement of ad libitum intake in subjects who reside in a research unit. This trial was registered at clinicaltrials.gov as NCT00342732.

Objective: The objective was to investigate whether having a choice between 2 vegetables enhances children's vegetable liking and consumption.

Design: Three hundred three children (age: 4–6 y) were randomly assigned to receive 1 of 3 dinner conditions in a restaurant setting. Two similarly liked vegetables were presented, after which the child had no choice, a premeal choice, or an at-meal choice. Subsequently, the dinner was consumed with one parent present. Comparisons between the 3 conditions regarding children's meal experience, vegetable liking, and vegetable consumption were made by using analysis of variance and Kruskal-Wallis tests.

Results: Children's vegetable consumption did not differ (P = 0.54) between the conditions as follows: 56 ± 45 g in the no-choice condition, 51 ± 46 g in the premeal-choice condition, and 49 ± 47 g in the at-meal-choice condition. In the no-choice condition, high-reactant children (who are more sensitive to psychological, persuasive pressure) consumed fewer vegetables (45 ± 42 g) than did low-reactant children (73 ± 43 g; P = 0.04). Vegetable liking was similar in all 3 conditions (P = 0.43). Children appreciated being able to choose in the premeal-choice condition.

Conclusions: A premeal choice between 2 vegetables was appreciated by the children but did not increase their vegetable liking and consumption. The no-choice condition decreased vegetable consumption in high-reactant children. Future research should investigate the effects of choice-offering in the long term and in more familiar eating settings. This trial was registered at controlled-trials.com as ISRCTN03035138.

Objective: Our objective was to examine the kinetics of methionine and its rate of transsulfuration and transmethylation in healthy women with advancing gestation.

Design: The whole-body rate of appearance (Ra) of methionine and phenylalanine was measured in healthy pregnant women during the first (n = 10), second (n = 5), and third (n = 10) trimesters of pregnancy. These data were compared with those for nonpregnant women (n = 8). Tracers [1-¹³C]methionine, [C²H₃]methionine, and [²H₅]phenylalanine were administered as prime-constant rate infusions. The effect of enteral high-protein, mixed-nutrient load on tracer-determined variables was also examined.

Results: In pregnant women, the Ra of phenylalanine was significantly (P < 0.05) lower in the first trimester than in the second and third trimesters and was significantly lower than that in nonpregnant women. A linear positive correlation was evident between gestational age and phenylalanine Ra. The fractional rate and total rate of transsulfuration of methionine was significantly (P < 0.05) higher during the first trimester, whereas the rate of transmethylation was higher during the third trimester. Plasma concentrations of total cysteine and homocysteine were lower during pregnancy.

Conclusions: Uncomplicated pregnancy in humans is associated with a higher rate of transsulfuration early in gestation and a higher rate of transmethylation of methionine in late gestation. These data may have implications for understanding the role of methionine and homocysteine in complications of pregnancy and for the nutritional care of pregnant women.

Objective: This study evaluated whether fasting or postprandial ghrelin or PYY is different between lactating and nonlactating postpartum women matched for age, body weight, and adiposity.

Design: Ten postpartum lactating women (mean ± SD: 28.1 ± 4.9 y of age, 69.2 ± 11.3 kg, 35.4 ± 6.6% body fat) and 8 nonlactating women (28.8 ± 7.6 y of age, 75.6 ± 13.7 kg, 37.5 ± 6.5% body fat) at 4–5 wk postpartum underwent measurements of body weight, body composition, and ghrelin and PYY responses to a standardized meal (350 kcal). Seven never-pregnant women served as control subjects (29.7 ± 4.1 y of age, 60.4 ± 4.8 kg, 25.5 ± 2.0% body fat).

Results: Ghrelin concentrations decreased, whereas PYY concentrations increased significantly (P < 0.05) in response to the meal, but fasting or meal-induced changes were not significantly different between lactating and nonlactating women. The fasting ghrelin concentration correlated with body mass index (r = –0.53, P < 0.05) and was significantly lower in postpartum than in control women (894.9 ± 247.7 compared with 1316.9 ± 241.0 pg/mL), even after adjustment for body mass index.

Conclusions: Our data do not support the notion that ghrelin, PYY, or both are plausible neuroendocrine signals that influence body weight regulation during lactation. They suggest, however, that ghrelin may change with increased adiposity in the postpartum state and may potentially play a role in body weight regulation after child birth.

Objective: The objective was to study whether a lifestyle intervention based on a brochure or on active education can improve dietary habits, increase physical activity (PA), and reduce GWG in obese pregnant women.

Design: In this randomized controlled trial, 195 white, obese pregnant women [age: 29 ± 4 y; body mass index (in kg/m²); 33.6 ± 4.2] were randomly assigned into 3 groups: a group that received nutritional advice from a brochure, a group that received the brochure and lifestyle education by a nutritionist, and a control group. Nutritional habits were evaluated every trimester through 7-d food records. PA was evaluated with the Baecke questionnaire.

Results: Energy intake did not change during pregnancy and was comparable in all groups. Fat intake, specifically saturated fat intake, decreased and protein intake increased from the first to the third trimester in the passive and active groups compared with an opposite change in the control group. Calcium intake and vegetable consumption increased during pregnancy in all groups. PA decreased in all groups, especially in the third trimester. No significant differences in GWG and obstetrical or neonatal outcome could be observed between the groups.

Conclusions: Both lifestyle interventions improved the nutritional habits of obese women during pregnancy. Neither PA nor GWG was affected.

Objective: We aimed to explore the association between adherence to a relative Mediterranean diet (rMED) and incident gastric adenocarcinoma (GC) within the European Prospective Investigation into Cancer and Nutrition study.

Design: The study included 485,044 subjects (144,577 men) aged 35–70 y from 10 European countries. At recruitment, dietary and lifestyle information was collected. An 18-unit rMED score, incorporating 9 key components of the Mediterranean diet, was used to estimate rMED adherence. The association between rMED and GC with respect to anatomic location (cardia and noncardia) and histologic types (diffuse and intestinal) was investigated. A calibration study in a subsample was used to control for dietary measurement error.

Results: After a mean follow-up of 8.9 y, 449 validated incident GC cases were identified and used in the analysis. After stratification by center and age and adjustment for recognized cancer risk factors, high compared with low rMED adherence was associated with a significant reduction in GC risk (hazard ratio: 0.67; 95% CI: 0.47, 0.94). A 1-unit increase in the rMED score was associated with a decreased risk of GC of 5% (95% CI: 0.91, 0.99). There was no evidence of heterogeneity between different anatomic locations or histologic types. The calibrated results showed similar trends (overall hazard ratio for GC: 0.93; 95% CI: 0.89, 0.99).

Conclusion: Greater adherence to an rMED is associated with a significant reduction in the risk of incident GC.

Objective: We investigated the efficacy of multivitamin supplements at single compared with multiple RDAs on decreasing the risk of adverse pregnancy outcomes among HIV-infected women.

Design: We conducted a double-blind, randomized controlled trial among 1129 HIV-infected pregnant women in Tanzania. Eligible women between 12 and 27 gestational weeks were randomly assigned to receive daily oral supplements of either single or multiple RDA multivitamins from enrollment until 6 wk after delivery.

Results: Multivitamins at multiple and single doses of the RDA had similar effects on the risk of low birth weight (11.6% and 10.2%, respectively; P = 0.75). We found no difference between the 2 groups in the risk of preterm birth (19.3% and 18.4%, respectively; P = 0.73) or small-for-gestational-age (14.8% and 12.0%, respectively; P = 0.18). The mean birth weights were similar in the multiple RDA (3045 ± 549 g) and single RDA multivitamins group (3052 ± 534 g; P = 0.83). There were no significant differences between the 2 groups in the risk of fetal death (P = 0.99) or early infant death (P = 0.19).

Conclusion: Multivitamin supplements at a single dose of the RDA may be as efficacious as multiple doses of the RDA in decreasing the risk of adverse pregnancy outcomes among HIV-infected women. This trial was registered at clinicaltrials.gov as NCT00197678.

Objective: To advance understanding about this fundamental concept, we examined the ability of serum myristic acid and linoleic acid, expressed as molecular percentages or as concentrations, to predict dietary fat and serum cholesterol concentrations.

Design: A cross-sectional analysis of a population-based survey of New Zealand adults (n = 2732) was undertaken. The association of myristic and linoleic acids in serum cholesterol ester and phospholipid with dietary fat or serum cholesterol was assessed.

Results: Intake of saturated fat, dairy fat, and polyunsaturated fat was predicted similarly with the use of both units of measurement. After adjustment for confounders, mean total cholesterol decreased by 0.18 mmol/L from the lowest to the highest quintile of serum cholesteryl-linoleate as a molecular percentage (P = 0.027). In contrast, mean total cholesterol increased by 1.09 mmol/L from the lowest to the highest quintile of serum cholesteryl-linoleate concentration (P < 0.001). The molecular percentage and concentration of serum cholesteryl-myristate were positively associated with total cholesterol (P < 0.001). Results for serum phospholipid fatty acids were similar.

Conclusion: Serum myristic acid and linoleic acid measured as molecular percentages, but not as concentrations, predict serum total cholesterol in a manner that distinguishes between the differential cholesterolemic effects of dietary saturated and polyunsaturated fats.

Objective: We examined the dietary net acid load [net endogenous acid production (NEAP)] for 229 worldwide historically studied hunter-gatherer societies to determine how differences in plant-to-animal (P:A) dietary subsistence patterns and differences in the percentage of body fat in prey animals affect the NEAP.

Design: With the use of 1) ethnographic data of dietary P:A ratios of hunter-gatherer populations, 2) established computational methods, and 3) knowledge that fat densities of animal foods consumed by hunter-gatherers varied between 3% and 20%, we computed the NEAP for the diets of 229 populations in 4 different models of animal fat densities (model A, 3%; model B, 10%; model C, 15%; model D, 20%).

Results: As P:A ratios decreased from 85:15 to 5:95, the NEAP increased from –178 to +181 mEq/d (model A) and from –185 to +120 mEq/d (models B and C). Approximately 50% of the diets consumed by the 229 worldwide hunter-gatherer populations were net acid producing (models B and C). In model D, 40% of the diets were net acid producing.

Conclusions: Our data confirm that the NEAP of hunter-gatherer diets becomes progressively more positive as P:A ratios decline. The high reliance on animal-based foods of a worldwide sample of historically studied hunter-gatherer populations renders their diets net acid producing in 40–60% of subgroups of P:A ratios. Only further investigations can show the implications of these findings in determining the NEAP of human ancestral diets.

Objectives: Our objectives were to systematically collate data on the sodium content of Australian processed food products and compare sodium values against maximum target levels established by the UK Food Standards Agency (UK FSA).

Design: Categories of processed foods that contribute the majority of salt to Australian diets were identified. Food-composition data were sought for all products in these categories, and the sodium content in mg/100 g (or mg/100 mL for liquids) was recorded for each. Mean sodium values were calculated for each grouping and compared with the UK FSA benchmarks.

Results: Sodium data were collected for 7221 products in 10 food groups, 33 food categories, and 90 food subcategories. The food groups that were highest in sodium were sauces and spreads (1283 mg/100 g) and processed meats (846 mg/100 g). Cereal and cereal products (206 mg/100 g) and fruit and vegetables (211 mg/100 g) were the lowest in sodium. Sixty-three percent of food categories had mean sodium concentrations above the UK FSA targets, and most had wide ranges between the most and least salty product.

Conclusions: Many products, particularly breads, processed meats, and sauces, have salt amounts above reasonable benchmarks. The variation in salt concentrations between comparable products suggests that reformulation is highly feasible for many foods.

Objective: The objective was to describe the dietary changes needed to achieve nutritional recommendations for each individual of a population.

Design: An individual diet model was specifically developed for each adult participating in the French national INCA (Enquête Individuelle et Nationale sur les Consommations Alimentaires) dietary survey (n = 1171). Starting from each individual weekly food intake (observed diets), an isocaloric modeled diet was designed by linear programming to simultaneously meet the French nutrient recommendations for 32 nutrients while deviating the least from the observed food intake. Modeled diets were paired with observed diets for statistical comparison.

Results: A new nutritionally adequate diet was obtained for each individual. In half the modeled diets, <5 of the foods usually consumed were replaced. The amount of foods selected in the modeled diets varied from individual to individual, and this variability followed that found in observed diets. Fruit, vegetables, grains, legumes, dried fruit, unsalted nuts, fresh dairy products, and fish were increased in modeled diets. Fatty fish and walnuts were added to each modeled diet. In contrast, red meats, deli meats, cheese, mixed dishes, and salted snacks were decreased. Sweets were also decreased but to a lesser extent.

Conclusions: This new individual diet modeling approach offers the possibility of translating nutrient recommendations into realistic food choices for all individuals from a representative population. The results showed that nutrient needs can be fulfilled in many different ways, depending on initial individual food patterns.

Objective: The objective was to assess the effectiveness of a large-scale program that distributes subsidized iron-fortified milk in Mexico on anemia and iron deficiency in children aged 12–30 mo.

Design: A double-blinded, group-randomized effectiveness trial was conducted in 12 milk distribution clusters assigned to consume iron-fortified (FM; n = 7) or nonfortified (NFM; n = 5) milk. A daily portion of FM contained 5.28 mg Fe (ferrous gluconate) and 48 mg sodium ascorbate.

Results: Overall treatment effects were documented at 6 and 12 mo for anemia and for iron deficiency assessed by both serum ferritin (SF) and serum soluble transferrin receptor (sTfR) (interaction: P < 0.10). Differential effects at 6 mo (P = 0.004) and 12 mo (P = 0.664) were documented only for sTfR. Estimated prevalences (EPs) of anemia (hemoglobin < 110 g/L) from baseline to 6 and 12 mo decreased from 42.6% to 19.7% and 9.4%, respectively, in the NFM group (n = 210) and from 44.5% to 12.7% and 4.0%, respectively, in the FM group (n = 357). EPs of SF < 12 µg/L from baseline to 6 and 12 mo changed from 36.0% to 41.8% and 17.1%, respectively, in the NFM group (n = 43) and from 29.8% to 18.6% and 5.7%, respectively, in the FM group (n = 144). EPs of sTfR > 3.3 mg/L from baseline to 6 and 12 mo decreased from 16.2% to 8.3% and 2.0%, respectively, in the NFM group (n = 114) and from 15.5% to 0.7% and 1.1%, respectively, in the FM group.

Conclusion: A large-scale iron-fortified subsidized-milk program was effective at reducing the rates of anemia and iron deficiency in Mexican children during 12 mo of implementation. This trial was registered at clinicaltrials.gov as NCT00508131.

Objective: We examined the risk of breast, colorectal, and prostate cancers relative to phytoestrogen intake on the basis of a comprehensive database.

Design: Demographic and anthropometric characteristics, a medical history, and 7-d records of diet were collected prospectively from participants (aged 40–79 y) in the European Prospective Investigation into Cancer and Nutrition–Norfolk (EPIC-Norfolk). Five hundred nine food items were analyzed by liquid chromatography–mass spectrometry/mass spectrometry, and ¹³C₃-labeled internal standards were analyzed for isoflavones (genistein, daidzein, glycitein, biochanin A, and formononetin), lignans (secoisolariciresinol and matairesinol), and enterolignans from gut microbial metabolism in animal food sources (equol and enterolactone). From the direct analysis, values for 10,708 foods were calculated. Odds ratios (ORs) for breast (244 cases, 941 controls), colorectal (221 cases, 886 controls), and prostate (204 cases, 812 controls) cancers were calculated relative to phytoestrogen intake.

Results: Phytoestrogen intake was not associated with breast cancer among women or colorectal cancer among men. Among women, colorectal cancer risk was inversely associated with enterolactone (OR: 0.33; 95% CI: 0.14, 0.74) and total enterolignans (OR: 0.32; 95% CI: 0.13, 0.79), with a positive trend detected for secoisolariciresinol (OR: 1.60; 95% CI: 0.96, 2.69). A positive trend between enterolignan intake and prostate cancer risk (OR: 1.27; 95% CI: 0.97, 1.66) was attenuated after adjustment for dairy intake (OR: 1.19; 95% CI: 0.77, 1.82).

Conclusion: Dietary phytoestrogens may contribute to the risk of colorectal cancer among women and prostate cancer among men.

Objective: We investigated the association between dietary folate intake and pancreatic cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) cohort.

Design: Dietary data were collected with the use of a self-administered food-frequency questionnaire (1998–2005). Among the 51,988 male and 57,187 female participants, aged 55–74 y at enrollment, with complete dietary and multivitamin information, 162 men and 104 women developed pancreatic cancer during follow-up (January 1998 to December 2006; median: 6.5 y). We used Cox proportional hazards regression with age as the time metric to calculate hazard ratios (HRs) and 95% CIs.

Results: The highest compared with the lowest quartile of food folate was associated with a significantly decreased pancreatic cancer risk among women (≥253.3 compared with ≤179.1 µg/d; HR = 0.47; 95% CI: 0.23, 0.94; P for trend: 0.09) but not among men (≥229.6 compared with ≤158.0 µg/d; HR = 1.20; 95% CI: 0.70, 2.04; P for trend: 0.67; P for interaction by sex: 0.03). There was also a significant inverse trend in risk of pancreatic cancer across increasing quartiles of total folate in women (P for trend: 0.04) but not in men (P for trend: 0.65). Folic acid supplements were not associated with pancreatic cancer.

Conclusion: These findings support an association between higher food and total folate intakes and decreased risk of pancreatic cancer in women but not in men.

Objective: We simultaneously examined associations between sodium and salted food consumption and the risk of cancer and CVD.

Design: During 1995–1998, a validated food-frequency questionnaire was administered to 77,500 men and women aged 45–74 y. During up to 598,763 person-years of follow-up until the end of 2004, 4476 cases of cancer and 2066 cases of CVD were identified.

Results: Higher consumption of sodium was associated with a higher risk of CVD but not with the risk of total cancer: multivariate hazard ratios for the highest compared with lowest quintiles of intake were 1.19 (95% CI: 1.01, 1.40; P for trend: 0.06) for CVD and 1.04 (95% CI: 0.93, 1.16; P for trend: 0.63) for total cancer. Higher consumption of salted fish roe was associated with higher risk of total cancer, and higher consumption of cooking and table salt was associated with higher risk of CVD. Similar results were seen for the risk of gastric or colorectal cancer and stroke.

Conclusions: Sodium intake as a whole salt equivalent may not increase the risk of cancer but may increase that of CVD. In contrast, salted food intake may increase the risk of cancer. Our findings support the notion that sodium and salted foods have differential influences on the development of cancer and CVD.

Objective: We investigated the relation of restaurant meal consumption to incidence of type 2 diabetes among African American women with the use of data from the prospective Black Women's Health Study.

Design: The participants have completed mailed follow-up questionnaires every 2 y since 1995, including food-frequency questionnaires that asked about the frequency of eating restaurant meals of various types. Cox proportional hazards models were used to calculate incidence rate ratios and 95% CIs for the association of type 2 diabetes incidence with various categories of consumption of each restaurant food relative to the lowest category, with adjustment for diabetes risk factors.

Results: Among 44,072 participants aged 30–69 y and free of diabetes at baseline, 2873 incident cases of type 2 diabetes occurred during 10 y of follow-up. Consumption of restaurant meals of hamburgers, fried chicken, fried fish, and Chinese food were independently associated with an increased risk of type 2 diabetes. Incidence rate ratios for ≥2 such meals per week relative to none were 1.40 (95% CI: 1.14, 1.73) for hamburgers and 1.68 (95% CI: 1.36, 2.08) for fried chicken. Control for body mass index greatly reduced the estimates, which suggests that the associations are mediated through weight gain and obesity.

Conclusion: The present study has identified a risk factor for type 2 diabetes that may be readily modifiable by dietary changes.

Objective: The objective was to examine the interaction between TCF7L2 rs7903146 and dietary fat and carbohydrate [high-fat, low-carbohydrate: 40–45% of energy as fat (HF); compared with low-fat, high-carbohydrate: 20–25% of energy as fat (LF)] in obese individuals’ responses to a 10-wk hypoenergetic diet (–600 kcal/d).

Design: European, obese participants (n = 771) were randomly assigned to receive an HF or an LF diet. Body weight, fat mass (FM), fat-free mass (FFM), waist circumference (WC), resting energy expenditure (REE), fasting fat oxidation in percentage of REE (FatOx), homeostasis model assessed insulin release (HOMA-β), and HOMA–insulin resistance (HOMA-IR) were determined at baseline and after the intervention; 739 individuals were genotyped for rs7903146.

Results: Average weight loss was 6.9 kg with the LF and 6.6 kg with the HF (difference between diets, NS) diet. Among individuals who were homozygous for the T-risk allele, those in the HF diet group experienced smaller weight losses (weight) (2.6 kg; P = 0.009; n = 622), smaller FFM (1.6 kg; P = 0.027; n = 609), smaller WC (3.3 cm; P = 0.010; n = 608), and a smaller HOMA-IR (1.3 units; P = 0.004; n = 615) than did the LF diet group. For C allele carriers, there were no differences between the HF and LF diet groups. For the HF diet group, each additional T allele was associated with a reduced loss of FM (0.67 kg; P = 0.019; n = 609). TCF7L2 rs7903146 was not associated with REE, FatOx, HOMA-β, or dropout.

Conclusion: Our results suggest that obese individuals who are homozygous for the TCF7L2 rs7903146 T-risk allele are more sensitive to LF than to HF weight-loss diets.

Objective: The objective of this study was to evaluate the effect of oral isoflavone supplementation on endothelial function, as measured by flow-mediated dilation (FMD), in postmenopausal women.

Design: A meta-analysis of randomized placebo-controlled trials was conducted to evaluate the effect of oral isoflavone supplementation on endothelial function in postmenopausal women. Trials were searched in PubMed, Embase, the Cochrane Library database, and reviews and reference lists of relevant articles. Summary estimates of weighted mean differences (WMDs) and 95% CIs were obtained by using random-effects models. Meta-regression and subgroup analyses were performed to identify the source of heterogeneity.

Results: A total of 9 trials were reviewed in the present meta-analysis. Overall, the results of the 9 trials showed that isoflavone significantly increased FMD (WMD: 1.75%; 95% CI: 0.83%, 2.67%; P = 0.0002). Meta-regression analysis indicated that the age-adjusted baseline FMD was inversely related to effect size. Subgroup analysis showed that oral supplementation of isoflavone had no influence on FMD if the age-adjusted baseline FMD was ≥5.2% (4 trials; WMD: 0.24%; 95% CI: –0.94%, 1.42%; P = 0.69). This improvement seemed to be significant when the age-adjusted baseline FMD levels were <5.2% (5 trials; WMD: 2.22%; 95% CI: 1.15%, 3.30%; P < 0.0001), although significant heterogeneity was still detected in this low-baseline-FMD subgroup.

Conclusions: Oral isoflavone supplementation does not improve endothelial function in postmenopausal women with high baseline FMD levels but leads to significant improvement in women with low baseline FMD levels.

Objective: We examined whether vitamin C supplements (1000 mg) and multivitamins containing vitamin C (60 mg) are associated with the incidence of age-related cataract extraction in a population-based, prospective cohort of women.

Design: Our study included 24,593 women aged 49–83 y from the Swedish Mammography Cohort (follow-up from September 1997 to October 2005). We collected information on dietary supplement use and lifestyle factors with the use of a self-administrated questionnaire. Cataract extraction cases were identified by linkage to the cataract extraction registers in the geographical study area.

Results: During the 8.2 y of follow-up (184,698 person-years), we identified 2497 cataract extraction cases. The multivariable hazard ratio (HR) for vitamin C supplement users compared with that for nonusers was 1.25 (95% CI: 1.05, 1.50). The HR for the duration of >10 y of use before baseline was 1.46 (95% CI: 0.93, 2.31). The HR for the use of multivitamins containing vitamin C was 1.09 (95% CI: 0.94, 1.25). Among women aged ≥65 y, vitamin C supplement use increased the risk of cataract by 38% (95% CI: 12%, 69%). Vitamin C use among hormone replacement therapy users compared with that among nonusers of supplements or of hormone replacement therapy was associated with a 56% increased risk of cataract (95% CI: 20%, 102%). Vitamin C use among corticosteroid users compared with that among nonusers of supplements and corticosteroids was associated with an HR of 1.97 (95% CI: 1.35, 2.88).

Conclusion: Our results indicate that the use of vitamin C supplements may be associated with higher risk of age-related cataract among women.