PHIT for Duty, a Mobile Application for Stress Reduction, Sleep Improvement, and Alcohol Moderation.

Post-traumatic stress and other problems often occur after combat, deployment, and other military operations. Because techniques such as mindfulness meditation show efficacy in improving mental health, our team developed a mobile application (app) for individuals in the armed forces with subclinical psychological problems as secondary prevention of more significant disease. Based on the Personal Health Intervention Toolkit (PHIT), a mobile app framework for personalized health intervention studies, PHIT for Duty integrates mindfulness-based relaxation, behavioral education in sleep quality and alcohol use, and psychometric and psychophysiological data capture. We evaluated PHIT for Duty in usability and health assessment studies to establish app quality for use in health research. Participants (N = 31) rated usability on a 1 (very hard) to 5 (very easy) scale and also completed the System Usability Scale (SUS) questionnaire (N = 9). Results were (mean ± SD) overall (4.5 ± 0.6), self-report instruments (4.5 ± 0.7), pulse sensor (3.7 ± 1.2), sleep monitor (4.4 ± 0.7), sleep monitor comfort (3.7 ± 1.1), and wrist actigraphy comfort (2.7 ± 0.9). The average SUS score was 85 ± 12, indicating a rank of 95%. A comparison of PHIT-based assessments to traditional paper forms demonstrated a high overall correlation (r = 0.87). These evaluations of usability, health assessment accuracy, physiological sensing, system acceptability, and overall functionality have shown positive results and affirmation for using the PHIT framework and PHIT for Duty application in mobile health research.

DEER Sensitivity between Iron Centers and Nitroxides in Heme-Containing Proteins Improves Dramatically Using Broadband, High-Field EPR.

This work demonstrates the feasibility of making sensitive nanometer distance measurements between Fe(III) heme centers and nitroxide spin labels in proteins using the double electron-electron resonance (DEER) pulsed EPR technique at 94 GHz. Techniques to measure accurately long distances in many classes of heme proteins using DEER are currently strongly limited by sensitivity. In this paper we demonstrate sensitivity gains of more than 30 times compared with previous lower frequency (X-band) DEER measurements on both human neuroglobin and sperm whale myoglobin. This is achieved by taking advantage of recent instrumental advances, employing wideband excitation techniques based on composite pulses and exploiting more favorable relaxation properties of low-spin Fe(III) in high magnetic fields. This gain in sensitivity potentially allows the DEER technique to be routinely used as a sensitive probe of structure and conformation in the large number of heme and many other metalloproteins.

Folic Acid supplementation and pregnancy: more than just neural tube defect prevention.

Folate (vitamin B(9)) is an essential nutrient that is required for DNA replication and as a substrate for a range of enzymatic reactions involved in amino acid synthesis and vitamin metabolism. Demands for folate increase during pregnancy because it is also required for growth and development of the fetus. Folate deficiency has been associated with abnormalities in both mothers (anemia, peripheral neuropathy) and fetuses (congenital abnormalities). This article reviews the metabolism of folic acid, the appropriate use of folic acid supplementation in pregnancy, and the potential benefits of folic acid, as well as the possible supplementation of l-methylfolate for the prevention of pregnancy-related complications other than neural tube defects.

A review of dietary fiber and health: focus on raisins.

Fibers vary in their physiologic effects. For example, viscous fibers may delay gastric emptying of ingested foods into the small intestine, creating a sensation of fullness; reduce blood glucose concentrations; and potentially benefit insulin sensitivity. They also improve blood cholesterol levels. Insoluble fibers are poorly absorbed and are known to improve fecal bulk and laxation and ameliorate constipation. Despite these numerous benefits, most Americans do not get enough of either kind of fiber in the diet. Some have argued that fiber-rich foods are not appetizing and therefore avoided. Raisins contain both forms of fiber and have a sweet flavor. This review provides support for consuming adequate fiber in the diet and suggests a role for raisins to help increase total dietary fiber.

Omega-3 Fatty acids and pregnancy.

Omega-3 fatty acids are essential fatty acids that must be consumed in the diet. Adequate consumption of omega-3 fatty acids is vitally important during pregnancy as they are critical building blocks of fetal brain and retina. Omega-3 fatty acids may also play a role in determining the length of gestation and in preventing perinatal depression. The most biologically active forms of omega-3 fatty acids are docosahexaenoic acid and eicosapentaenoic acid, which are primarily derived from marine sources such as seafood and algae. Recent surveys, however, indicate that pregnant women in the United States and in other countries eat little fish and therefore do not consume enough omega-3 fatty acids, primarily due to concern about the adverse effects of mercury and other contaminants on the developing fetus. This review discusses the benefits of omega-3 fatty acid consumption during pregnancy and provides guidelines for obstetricians advising patients.

Do dietary supplements help promote weight loss?

As two-thirds of the US population is overweight or obese, new strategies are needed to help individuals safely and effectively lose weight. One option is to use dietary supplements, but not all supplements that are touted for weight loss have published clinical support for efficacy. The purpose of this article was to identify all published articles on dietary supplements for weight loss. Effectiveness of these supplements was defined as promoting 1-2 lb of weight loss each week. Although several dozen different dietary supplements are sold, only 14 published studies were identified. Four individual ingredients and three blends of ingredients were considered to be effective. Additionally, we compared weight loss from these dietary supplements to over-the-counter (OTC) orlistat (alli™, GlaxoSmithKline, Brentford, UK). Five single ingredients and three blends of ingredients produced more weight loss than OTC orlistat. Persons who use dietary supplements for weight management, counsel patients on how to lose weight, and retailers who sell dietary supplements, should become familiar with those supplements only that are effective at producing weight loss to assure the best results.

How safe is vitamin E supplementation?

The safety of large doses of vitamin E went virtually unquestioned until the early 2000s, when several studies were published showing that consumption of vitamin E from dietary supplements increased mortality, as well as the risk of gastrointestinal cancer and heart failure. These studies prompted numerous letters to the editors of medical journals and widespread coverage in the media. Both the medical community and the general public became confused and concerned about the use of vitamin E supplements. The purpose of this article is to review the medical literature and to explain these unusual findings. First we provide an overview of the earlier literature on vitamin E. Second, we provide a critical assessment of three meta-analyses that were neutral or negative toward vitamin E supplementation. Third, we review the limitations of meta-analyses in general. Fourth, we assess the individual studies that comprised one of the three meta-analyses. Since all three meta-analyses used many of the same studies, the individual critique should further the understanding of the limitations of these meta-analyses, and the meta-analysis approach in general. Lastly, we offer some guidance for healthcare professionals to give to the general, healthy public and those with chronic conditions who are no doubt left puzzled as to what to do regarding vitamin E supplementation.

Omega-3 Fatty Acid supplementation during pregnancy.

Omega-3 fatty acids are essential and can only be obtained from the diet. The requirements during pregnancy have not been established, but likely exceed that of a nonpregnant state. Omega-3 fatty acids are critical for fetal neurodevelopment and may be important for the timing of gestation and birth weight as well. Most pregnant women likely do not get enough omega-3 fatty acids because the major dietary source, seafood, is restricted to 2 servings a week. For pregnant women to obtain adequate omega-3 fatty acids, a variety of sources should be consumed: vegetable oils, 2 low-mercury fish servings a week, and supplements (fish oil or algae-based docosahexaenoic acid).

Use of tryptophan-fortified hydrolyzed collagen for nutritional support.

Protein is essential for the maintenance of optimal health. Without adequate amounts of amino acids, organs become dysfunctional and ultimately death can result. Protein deficiency is a common problem in both adults and children. Numerous nutritional supplements have been developed to help optimize protein intake. The purpose of this paper is to describe the use of tryptophan-fortified hydrolyzed collagen for nutritional support in malnourished patients.

Health implications of milk containing beta-casein with the A2 genetic variant.

Milk from dairy cows has long provided a high quality source of protein and selected micronutrients such as calcium to most populations. Recently, a relationship between disease risk and consumption of a specific bovine ss-casein fraction either A1 or A2 genetic variants has been identified. Populations, which consume milk containing high levels of ss-casein A2 variant, have a lower incidence of cardiovascular disease and type 1 diabetes. Furthermore, consumption of milk with the A2 variant may be associated with less severe symptoms of autism and schizophrenia. The mechanism of action focuses on ss-casein A1 and related forms preferentially that are able to produce a bioactive opioid peptide, ss-casomorphin-7 (ss-CM-7) during digestion. Infants may absorb ss-CM-7 due to an immature gastrointestinal tract. Adults, on the other hand, appear to reap the biological activity locally on the intestinal brush boarder. ss-CM-7 can potentially affect numerous opioid receptors in the nervous, endocrine, and immune systems. Whether there is a definite health benefit to milk containing the A2 genetic variant is unknown and requires further investigation.

The zone diet: an anti-inflammatory, low glycemic-load diet.

The Zone Diet was developed on the concept that the hormonal responses of macronutrients could be orchestrated to maintain key hormones within therapeutic zones to control inflammatory responses. In particular, the two hormonal systems that are directly affected by dietary macronutrients are (1) the insulin/glucagon axis and (2) eicosanoids. Each of these hormonal systems can have a significant impact on the inflammatory process. This hormonal approach to optimizing an anti-inflammatory diet has significant ramifications in treatment of those chronic diseases (obesity, type 2 diabetes, and cardiovascular disease) that are known to produce inflammatory responses. On the other hand, an inappropriate balance of macronutrients (especially high glycemic- load carbohydrates) can lead to increased inflammation. A primary example of this is the promotion of the United States Department of Agriculture's Food Guide Pyramid. Since its adoption, the prevalence of obesity and type 2 diabetes has risen substantially. Both conditions also demonstrate a significant increase in inflammatory markers. The purpose of this article is to review the historical factors that led to the development of the Zone Diet, to understand how the Zone Diet can alter inflammatory responses, and to review the published literature on its ability to affect hormonal and metabolic responses.

Low-glycemic-load diets: impact on obesity and chronic diseases.

Historically, carbohydrates have been thought to play only a minor role in promoting weight gain and in predicting the risk of development of chronic disease. Most of the focus had been on reducing total dietary fat. During the last 20 years, fat intake decreased, while the number of individuals who were overweight or developed a chronic conditions have dramatically increased. Simultaneously, the calories coming from carbohydrate have also increased. Carbohydrates can be classified by their post-prandial glycemic effect, called the glycemic index or glycemic load. Carbohydrates with high glycemic indexes and high glycemic loads produce substantial increases in blood glucose and insulin levels after ingestion. Within a few hours after their consumption, blood sugar levels begin to decline rapidly due to an exaggerated increase in insulin secretion. A profound state of hunger is created. The continued intake of high-glycemic load meals is associated with an increased risk of chronic diseases such as obesity, cardiovascular disease, and diabetes. In this review, the terms glycemic index and glycemic load are defined, coupled with an overview of short- and long-term changes that occur from eating diets of different glycemic indexes and glycemic loads. Finally, practical strategies for how to design low-glycemic-load diets consisting primarily of low-glycemic carbohydrates are provided.

A proposal for a new national diet: a low-glycemic load diet with a unique macronutrient composition.

BACKGROUND: A science-based diet approach to achieving a healthy diet began in the early 1900s, and this led to the development of the United States Department of Agriculture's (USDA's) Food Guide Pyramid. Since its adoption, the prevalence of overweight and type 2 diabetes has risen substantially. Whether the two are related is unknown, but a change may be needed in the way the government recommends that Americans eat. METHODS: The purpose of this review is to propose a new diet that is based on two novel strategies: a low-glycemic load (GL) diet and a unique macronutrient composition. Most of the carbohydrates in the proposed diet have low-glycemic indexes (GIs), which creates a diet that has a low-GL. In contrast, the USDA's Food Guide Pyramid diet recommends consuming a high carbohydrate diet (i.e., >55% of the energy), which is rich in grains and other complex carbohydrates that have high-GIs. In clinical studies, low-GL diets produced less hunger, promoted more weight loss, and improved markers of glycemic control and cardiovascular disease risk compared to the usual, high-GL diet under eucaloric conditions. The other feature of the proposed diet is its unique macronutrient composition of 40% of the energy from carbohydrate, and 30% of the energy each from protein and fat. RESULTS: The diet recommended now has a macronutrient percentage of >55% of the energy coming from carbohydrate, 15% of the energy from protein, and <30% of the energy from fat. Compared to the USDA's Food Guide Pyramid diet, clinical studies using the proposed unique macronutrient percentages have shown increases in metabolic rate, dietary theromogenesis, and nitrogen balance. CONCLUSIONS: The advantages of the proposed diet should benefit all Americans, but more long-term studies are needed before it can be adopted as the national diet.

A functional food product for the management of weight.

More than half of Americans have a body mass index of 25 kg/m2 or more, which classifies them as overweight or obese. Overweight or obesity is strongly associated with comorbidities such as type 2 diabetes mellitus, hypertension, heart disease, gall bladder disease, and sleep apnea. Clearly, this is a national health concern, and although about 30 to 40% of the obese claim that they are trying to lose weight or maintain weight after weight loss, current therapies appear to have little effect. None of the current popular diets are working, and there is room for innovation. With the advancing science of nutrition, several nutrients - low-glycemic-index carbohydrates, 5-hydroxytryptophan, green tea extract, and chromium - have been identified that may promote weight loss. The first two nutrients decrease appetite, green tea increases the 24-h energy expenditure, and chromium promotes the composition of the weight lost to be fat rather than lean tissue. These have been assembled in efficacious doses into a new functional food product and described in this review. The product is undergoing clinical testing; each component has already been shown to promote weight loss in clinical trials.