Restricted carbohydrate diets below 45% energy are not associated with risk of mortality in the National Health and Nutrition Examination Survey, 1999-2018.

Introduction: Cardiometabolic diseases (CMD) are the leading causes of death for people living in the United States. Dietary strategies, such as restricting carbohydrate intake, are becoming popular strategies for improving health status. However, there is limited and often contradictory evidence on whether restricting carbohydrate intake is related to all-cause, CMD, or cardiovascular disease (CVD) mortality. Methods: The objective of the present study was to evaluate the association between restricted carbohydrate diets (<45%en) and mortality from all-causes, CMD, and CVD, stratified by fat amount and class. Data were acquired using the National Health and Nutrition Examination Survey (1999-2018) linked with mortality follow-up until December 31, 2019 from the Public-use Linked Mortality Files. Multivariable survey-weighted Cox proportional hazards models estimated hazard ratios for 7,958 adults (≥20 y) that consumed <45%en from carbohydrates and 27,930 adults that consumed 45-65%en from carbohydrates. Results: During the study period a total of 3,780 deaths occurred, including 1,048 from CMD and 1,007 from CVD, during a mean follow-up of 10.2 y. Compared to individuals that met carbohydrate recommendations (45-65%en), those that consumed carbohydrate restricted diets (<45%en) did not have significantly altered risk of mortality from all-causes (HR: 0.98; 95% CI: 0.87, 1.11), CMD (1.18; 0.95, 1.46), or CVD (1.20; 0.96, 1.49). These findings were maintained when the restricted carbohydrate diet group was stratified by intake of total fat, saturated fat (SFA), monounsaturated fat (MUFA), and polyunsaturated fat (PUFA). Discussion: Carbohydrate restriction (<45%en) was not associated with mortality from all-causes, CVD, or CMD. Greater efforts are needed to characterize the risk of mortality associated with varied degrees of carbohydrate restriction, e.g., low (<26%en) and high (>65%en) carbohydrate diets separately.

Micronutrient intake from three popular diet patterns in the United States: modeled replacement of foods highest in added sugar and sodium using the National Health and Nutrition Examination Survey, 2005-2018.

Introduction: Fifty-two percent of adults in the United States reported following a popular diet pattern in 2022, yet there is limited information on daily micronutrient intakes associated with these diet patterns. The objective of the present study was to model the impact on micronutrient intake when foods highest in added sugar and sodium were replaced with healthier alternatives to align with the Dietary Guidelines for Americans recommendations. Methods: Dietary data were acquired from 34,411 adults ≥ 20 y in the National Health and Nutrition Examination Survey, 2005-2018. The National Cancer Institute methodology was used to estimate usual dietary intake at baseline of 17 micronutrients using information from up to two dietary recalls per person. A food substitution model was used to evaluate the impact on micronutrient intake when three servings of foods highest in added sugar and sodium were substituted with healthier alternatives. Results: Dietary modeling to replace foods highest in added sugar with healthier alternatives increased the mean intake of fat-soluble vitamins (0.15% for vitamin A to 4.28% for vitamin K), most water-soluble vitamins (0.01% for vitamin B1 to 12.09% for vitamin C), and most minerals (0.01% for sodium to 4.44% for potassium) across all diet patterns. Replacing foods highest in sodium had mixed effects on the mean intake of micronutrients. The intake of most fatsoluble vitamins increased by 1.37-6.53% (particularly vitamin A and D), yet while the intake of some water-soluble vitamins and minerals increased by 0.18-2.64% (particularly vitamin B2, calcium, and iron) others decreased by 0.56-10.38% (notably vitamin B3 and B6, magnesium, sodium, and potassium). Discussion: Modeled replacement of foods highest in added sugar led to more favorable changes in mean micronutrient intake compared to modeled replacement of foods highest in sodium. Due to the composite nature of mixed dishes that include multiple ingredients, food substitutions may result in both favorable and unfavorable changes in micronutrient intake. These findings highlight the challenges of making singleitem food substitutions to increase micronutrient intake and call for further research to evaluate optimal combinations of replacement foods to maximize the intake of all micronutrients simultaneously.

Fat Intake Modifies the Association between Restricted Carbohydrate Diets and Prevalent Cardiometabolic Diseases among Adults in the United States: National Health and Nutrition Examination Survey, 1999-2018.

Background: Cardiometabolic diseases (CMDs), which include heart disease, stroke, and diabetes, account for over one-third of the mortality burden in the United States annually. Nearly one-half of all deaths from CMD are attributable to suboptimal diet quality, and many Americans are turning to special diets for general health improvement. Among the most popular of these diets restrict daily carbohydrate intake to <45% of energy, yet their association with CMD is not well understood. Objectives: This study evaluated the association between restricted carbohydrate diets and prevalent CMD, stratified by fat intake. Methods: Dietary and CMD data were retrieved from 19,078 participants aged ≥20 y in the National Health and Nutrition Examination Survey, 1999-2018. The National Cancer Institute methodology was used to assess usual dietary intake. Results: Compared to participants that met recommendations for all macronutrients, those that consumed restricted carbohydrate diets were 1.15 (95% CI: 1.14, 1.16) times as likely to have CMD; and those that met recommendations for carbohydrates, but not all macronutrients, were 1.02 (95% CI: 1.02, 1.03) times as likely to have CMD. Higher intakes of saturated and polyunsaturated fat were associated with greater prevalence of CMD in restricted and recommended carbohydrate intake groups. Higher intake of monounsaturated fat was associated with lower prevalence of CMD among participants that met carbohydrate, but not all macronutrient, recommendations. Conclusions: To our knowledge, this is the first nationally representative study to evaluate the relationship between carbohydrate restriction and CMD, stratifying by fat intake. Greater efforts are needed to understand longitudinal relationships between carbohydrate restriction and CMD.

Carbohydrate Intakes Below Recommendations With a High Intake of Fat Are Associated With Higher Prevalence of Metabolic Syndrome.

BACKGROUND: More than one-third of adults in the United States have metabolic syndrome, and dietary carbohydrate intake may modify the likelihood of developing this condition. Currently, there is a lack of consistent evidence demonstrating the relationship between carbohydrate intake that falls below recommendations and metabolic syndrome. Not accounting for the differences in fatty acid classes of these dietary patterns may be a reason for inconsistent findings. OBJECTIVE: This study evaluated the association between a carbohydrate intake below recommendations and metabolic syndrome stratified by fat quantity and fatty acid classes in a nationally representative sample of US adults. DESIGN: This cross-sectional study acquired data on food and nutrient intake and markers of metabolic syndrome from respondents in the National Health and Nutrition Examination Survey 1999-2018. PARTICIPANTS/SETTING: This study included 19,078 respondents who were aged 20 years or older, had reliable and complete data on food and nutrient intake and markers of metabolic syndrome, and were not pregnant or breastfeeding. MAIN OUTCOME MEASURES: The main outcome was prevalence of metabolic syndrome. STATISTICAL ANALYSES PERFORMED: Usual dietary intake was estimated using the National Cancer Institute's usual intake methodology. Multivariable logistic regression models assessed the relative odds of prevalent metabolic syndrome between those who had a carbohydrate intake below recommendations and those who met carbohydrate recommendations. RESULTS: Those who had a carbohydrate intake below recommendations had 1.067 (95% CI 1.063 to 1.071) times greater odds of having metabolic syndrome compared with those who met carbohydrate recommendations (P < 0.001). High intake of fat of any class was associated with higher odds of metabolic syndrome (total fat: 1.271, 95% CI 1.256 to 1.286; saturated fatty acid: 1.072, 95% CI 1.060 to 1.085; monounsaturated fatty acid: 1.317, 95% CI 1.300 to 1.333; polyunsaturated fatty acid: 1.056, 95% CI 1.047 to 1.066; P < 0.001 for all comparisons) in those who had a carbohydrate intake below recommendations. CONCLUSIONS: The odds of prevalent metabolic syndrome were higher among individuals who had a carbohydrate intake below recommendations compared with individuals who met carbohydrate recommendations.

Consumption of Key Food Groups by Individuals Consuming Popular Diet Patterns: Mixed Effects of Replacing Foods High in Added Sugar, Sodium, Saturated Fat, and Refined Grains.

Adults in the United States are increasingly following 'popular' diet patterns that restrict food groups, macronutrients, or eating time. However, the intake of food groups associated with these diet patterns has not been well characterized. The objectives of this study were to (1) characterize the mean intake of food groups among consumers of popular diet patterns in the US, and (2) model the effect of targeted food substitutions on the intake of food groups. Data were acquired from the National Health and Nutrition Examination Survey, 2005-2018 (n = 34,411). A diet model was developed to assess the effects of replacing one serving each of foods highest in added sugar, sodium, saturated fat, and refined grains with healthy alternatives on the intake of key food groups for each diet pattern. Modeled replacement resulted in increased intake of fruit and whole grains and decreased intake of dairy for most diet patterns, while the effects on the intake of vegetables, protein foods, and oils were variable across diet patterns. The complexity of the natural eating environment, in which many people consume mixed dishes that include both healthy and less healthy ingredients, produces a challenge for health professionals when providing dietary counseling. Nevertheless, this substitution approach may help improve adherence to dietary guidelines, especially if used as a steppingstone for further dietary improvement.

Quality of Popular Diet Patterns in the United States: Evaluating the Effect of Substitutions for Foods High in Added Sugar, Sodium, Saturated Fat, and Refined Grains.

Background: Many Americans have adopted popular diet patterns for general health improvement that restrict specific foods, macronutrients, or eating time. However, there is limited evidence to characterize the quality of these diet patterns. Objectives: This study 1) evaluated the quality of popular diet patterns in the United States and 2) modeled the effect of targeted food substitutions on diet quality. Methods: Dietary data from 34,411 adults ≥20 y old were acquired from the NHANES, 2005-2018. Dietary intake was assessed using the National Cancer Institute's usual intake methodology, and the Healthy Eating Index-2015 was used to evaluate diet quality. A diet model was used to evaluate the effect of targeted food substitutions on diet quality. Results: A pescatarian diet pattern had the highest diet quality (65.2; 95% CI: 64.0, 66.4), followed by vegetarian (63.0; 95% CI: 62.0, 64.0), low-grain (62.0; 95% CI: 61.6, 62.4), restricted-carbohydrate (56.9; 95% CI: 56.6, 57.3), time-restricted (55.2; 95% CI: 54.8, 55.5), and high-protein (51.8; 95% CI: 51.0, 62.7) diet patterns. Modeled replacement of ≤3 daily servings of foods highest in added sugar, sodium, saturated fat, and refined grains with alternative foods led to an increase in diet quality and a decrease in energy intake for most diet patterns. Conclusions: Low diet quality was observed for all popular diet patterns evaluated in this study. Modeled dietary shifts that align with recommendations to choose foods lower in added sugar, sodium, saturated fat, and refined grains led to modest improvements in diet quality and larger reductions of energy intake. Greater efforts are needed to encourage the adoption of dietary patterns that emphasize consumption of a variety of high-quality food groups.

Consumption of a high-fat diet alters transcriptional rhythmicity in liver from pubertal mice.

Introduction: Childhood obesity is associated with adult obesity, which is a risk factor for chronic diseases. Obesity, as an environmental cue, alters circadian rhythms. The hypothesis of this study was that consumption of a high-fat diet alters metabolic rhythms in pubertal mice. Methods: Weanling female C57BL/6NHsd mice were fed a standard AIN93G diet or a high-fat diet (HFD) for 3 weeks. Livers were collected from six-week-old mice every 4 h over a period of 48 h for transcriptome analysis. Results and discussion: The HFD altered rhythmicity of differentially rhythmic transcripts in liver. Specifically, the HFD elevated expression of circadian genes Clock, Per1, and Cry1 and genes encoding lipid metabolism Fads1 and Fads2, while decreased expression of circadian genes Bmal1 and Per2 and lipid metabolism genes Acaca, Fasn, and Scd1. Hierarchical clustering analysis of differential expression genes showed that the HFD-mediated metabolic disturbance was most active in the dark phase, ranging from Zeitgeber time 16 to 20. The Kyoto Encyclopedia of Genes and Genomes enrichment analysis of differentially expressed genes showed that the HFD up-regulated signaling pathways related to fatty acid and lipid metabolism, steroid and steroid hormone biosynthesis, amino acid metabolism and protein processing in the endoplasmic reticulum, glutathione metabolism, and ascorbate and aldarate metabolism in the dark phase. Down-regulations included MAPK pathway, lipolysis in adipocytes, Ras and Rap1 pathways, and pathways related to focal adhesion, cell adhesion molecules, and extracellular matrix-receptor interaction. In summary, the HFD altered metabolic rhythms in pubertal mice with the greatest alterations in the dark phase. These alterations may disrupt metabolic homeostasis in puberty and lead to metabolic disorders.

Superior inhibitory efficacy of butyrate over propionate and acetate against human colon cancer cell proliferation via cell cycle arrest and apoptosis: linking dietary fiber to cancer prevention.

Intake of dietary fiber may protect against colon cancer. The anticancer property is associated with an increased production of short chain fatty acids (SCFAs), including acetate, propionate and butyrate, during dietary fiber fermentation in the colon. However, the mechanisms remain to be determined. We hypothesized that butyrate exhibits a stronger inhibitory potential against colon cancer cell proliferation compared with acetate and propionate. We determined the half maximal inhibitory concentrations (IC50) of SCFAs in HCT116 human colon cancer cell proliferation by examining cell growth curves. At 24- and 48-hour time points, IC50 (mmol/L) concentrations of acetate, propionate, and butyrate were [66.0 and 29.0], [9.2 and 3.6], and [2.5 and 1.3], respectively. Consistent with the greater anti-proliferative effect, butyrate exhibits >3-fold stronger potential for inducing cell cycle arrest at the G2 phase with a drop in S-phase fraction (including c-Myc/p21 signaling) and apoptosis when compared with acetate and propionate. Subsequently, we focused on the effect of butyrate on apoptotic gene expression. Using a PCR array analysis, we identified 17 pro-apoptotic genes, 6 anti-apoptotic genes, and 4 cellular mediator genes with >1-fold increase or decrease in mRNA levels out of 93 apoptosis related genes in butyrate-treated HCT116 cells when compared with untreated HCT116 cells. These genes were mainly involved in the TNF, NFκB, CARD, and BCL-2 regulated pathways. Taken together, our data indicate a greater inhibitory efficacy of butyrate over propionate and acetate against human colon cancer cell proliferation via cell cycle arrest and apoptosis.

High-Fat Diet Alters Circadian Rhythms in Mammary Glands of Pubertal Mice.

Childhood obesity in girls is associated with early puberty and menarche. Breast tissue exhibits circadian rhythms. These rhythms may be altered by environmental factors. We hypothesized that a high-fat diet (HFD) disrupts circadian rhythms in pubertal mammary glands. Weanling female C57BL/6 mice were fed the standard AIN93G diet or a HFD (providing 16% or 45% of energy from soybean oil) for 3 weeks. Mammary glands were harvested from 6-week-old mice every 4 h on Zeitgeber time over a 48-h period; rhythmic expressions of circadian genes and genes encoding estrogen receptor and progesterone receptor were analyzed by using the Cosinor model. HFD, compared to AIN93G diet, altered diurnal oscillations of circadian genes in pubertal mammary glands. These included changes in amplitude of Per2, Cry1 (reduced), Clock, Rev-erbα, and Per1 (elevated), a delay in acrophase (the hour at which the rhythm peaks) of Bmal1 by 2.2 h, and changes in mesor (the mean of the rhythm from peak to trough) of Bmal1, Per2, Cry1 (reduced), Rev-rebα, and Per1 (elevated). Furthermore, HFD altered diurnal expression of estrogen receptor and progesterone receptor at both mRNA and protein levels. These findings indicate that HFD alters circadian regulation in pubertal mammary glands, which may contribute to the disturbance of hormonal homeostasis and lead to early development and growth of mammary glands in pubertal mice.

Reported nutrient intake over 7 years after Roux-en-Y gastric bypass in the Longitudinal Assessment of Bariatric Surgery-3 (LABS-3) psychosocial study.

BACKGROUND: Bariatric surgery is the most effective therapy for severe obesity. It reduces gastric capacity and may modify regulation of appetite, satiety, insulin, and other physiologic processes, resulting in weight loss. OBJECTIVE: Long-term data on postsurgical nutrient intake are lacking. SETTING: The Longitudinal Assessment of Bariatric Surgery-3 psychosocial study. METHODS: Reported dietary intake was assessed in a subset of participants (n = 72) of the Longitudinal Assessment of Bariatric Surgery-3 psychosocial study who underwent Roux-en-Y gastric bypass surgery. Two 24-hour diet recalls at presurgery and annual assessments over 7 years were obtained. Reported diets were evaluated for energy, macro- and micronutrient intake, and assessed for adequacy by comparison to the dietary reference intakes. RESULTS: After surgery, reported intake of total energy, and all macronutrients were significantly reduced. At least a quarter of participants reported protein intake below the recommended dietary allowance. Over half of participants reported intake of several vitamins (C, D, A, E, thiamin, folate) and minerals (zinc, calcium) below recommended levels over 7 years. Compared with presurgery, reported energy intake was reduced over 7 years. This study was registered at ClinicalTrials.gov as NCT02495142. CONCLUSIONS: The reduction in energy resulted in intakes below the dietary reference intakes for many micronutrients among the majority of participants and below the recommended dietary allowance for protein in a substantial subgroup. These data support continued long-term nutrition education, monitoring, and supplementation.

Butyrate Inhibits Deoxycholic-Acid-Resistant Colonic Cell Proliferation via Cell Cycle Arrest and Apoptosis: A Potential Pathway Linking Dietary Fiber to Cancer Prevention.

SCOPE: Butyrate, an intestinal microbiota metabolite of dietary fiber, exhibits colon cancer preventive effects. In contrast, a high fat intake increases fecal secondary bile acids, such as deoxycholic acid (DCA, a potential cancer promoter), which selectively enrich mutant epithelial cells with an abnormally high resistance to DCA-induced apoptosis in the colon. This study is conducted to test the hypothesis that physiological concentrations of butyrate inhibit DCA-resistant colonic cell proliferation. METHODS AND RESULTS: With human HCT-116 cells as parental colonic cells, a human DCA-resistant colonic cell line (DCA-RCL) is developed. DCA treatment increases apoptosis and intracellular reactive oxygen species (an apoptotic trigger) at a rate threefold greater in HCT-116 cells than in DCA-RCL cells. Subsequently, 41 apoptosis related genes (including signaling pathways) with greater than onefold (mRNA) change in DCA-RCL cells are identified compared with HCT-116 cells. Moreover, butyrate treatment inhibits DCA-RCL cell proliferation with similar efficacy when compared with HCT116 cells via cellular myelocytomatosis oncogene (c-Myc)/p38 mitogen-activated protein kinase pathway. CONCLUSION: It is demonstrated that butyrate inhibits DCA-RCL cell proliferation at the cellular and molecular level. These data provide a proof of concept that butyrate can protect against colon carcinogenesis through a specific targeting of DCA-resistant colonic cells.

Concurrent validity of skin carotenoid status as a concentration biomarker of vegetable and fruit intake compared to multiple 24-h recalls and plasma carotenoid concentrations across one year: a cohort study.

BACKGROUND: Biological markers of vegetable and fruit (VF) intake are needed both for nutrition surveillance and for the evaluation of nutrition interventions. Optically assessed skin carotenoid status (SCS) has been proposed as a marker of intake but there are few published validity studies to date. Therefore, the objective of the study was to examine the concurrent validity of multiple methods of assessing VF intake cross-sectionally and seasonally over one year and to discuss the relative merits and limitations of each method. METHODS: Fifty-two 40-60 y old women completed a 1-year longitudinal study that included 1) SCS assessment using resonance Raman spectroscopy (RRS) and using pressure-mediated reflection spectroscopy (RS) at 12 timepoints, 2) thirty-six 24-h recalls using the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24; total 1866 recalls), and 3) plasma carotenoid concentrations measured every 3 months. Pearson correlation coefficients and mixed linear models were used to estimate pairwise correlations between RRS, RS, ASA24, and plasma carotenoids. RESULTS: RS and RRS were strongly correlated at baseline and over the year (r = 0.86 and 0.76; respectively, P < 0.001). RS was strongly correlated with plasma carotenoids at baseline (r = 0.70) and moderately across the year (r = 0.65), as was RRS (r = 0.77 and 0.69, respectively, all P < 0.001). At baseline, self-reported VF was weakly correlated with RRS (r = 0.33; P = 0.016), but not with RS or plasma carotenoids. Across the year, self-reported VF intake was weakly correlated with both RS (r = 0.37; P = 0.008), RRS (r = 0.37; P = 0.007), and with plasma carotenoids (r = 0.36; P < 0.008). CONCLUSIONS: SCS as measured by RS and RRS is moderately to strongly correlated with plasma carotenoid concentrations both cross-sectionally and longitudinally, indicating that it can be a powerful tool to assess carotenoid-rich VF intake in populations. CLINICAL TRIAL REGISTRY: This trial was registered at ClinicalTrials.gov as NCT01674296.

Recognition of Federal Dietary Guidance Icons Is Associated with Greater Diet Quality.

BACKGROUND: Although the purpose of federal dietary guidance is to improve eating habits, few studies have described awareness of guidance and concurrent diet quality. OBJECTIVE: The objective of the current study was to examine the prevalence of individuals who reported hearing of dietary guidance icons and to describe the association between having heard of the icons and diet quality. DESIGN: This study was a cross-sectional survey. PARTICIPANTS/SETTING: Participants (n=23,343) were from the National Health and Nutrition Examination-What We Eat in America survey 2005-2014 cycles. MAIN OUTCOME MEASURES: Awareness of the Food Guide Pyramid, MyPyramid, or MyPlate icons by sociodemographic characteristics and diet quality were measured using Healthy Eating Index (HEI) scores derived from 24-hour recall data. STATISTICAL ANALYSES PERFORMED: Global Wald tests were used to test for differences in awareness of the icons within sociodemographic groups. Total HEI scores were calculated using the population-ratio method. Z-scores were used to test differences in HEI total scores between those with knowledge of the icons and those who responded negatively. RESULTS: In all cycles, those with less than a high school diploma were the least likely to report having heard of the icons (P<0.001). In every wave except 2011 to 2012, participants with low or marginal food security status were less likely to report affirmatively (P<0.001), and Supplemental Nutrition Assistance Program (SNAP) participants and SNAP-eligible nonparticipants were least likely to report having heard of the icons (P<0.001) except for 2005 to 2006. HEI scores were higher among those who had heard of MyPyramid in 2007-2012 (P<0.05) and MyPlate in 2013-2014 (P<0.001) compared with those who had not heard of the icon. CONCLUSIONS: Recognition of federal dietary guidance icons was associated with higher diet quality recently, but the cross-sectional nature of the data precludes conclusions of causality. Further research is needed to identify barriers and promoters for translating awareness of the federal dietary guidance icons into healthful food purchasing and food consumption decisions.

Capacity of the US Food System to Accommodate Improved Diet Quality: A Biophysical Model Projecting to 2030.

BACKGROUND: Increasing Americans' diet quality will require changes to the food supply. Due to the complex nature of the food system, this is not as straightforward as simply increasing the production of healthy foods and decreasing the production of unhealthy foods. Little is known about whether the US food system can produce enough food, given finite agricultural resources, to support shifts toward healthier eating patterns. OBJECTIVE: The aim of this study was to model the capacity of the US food system to accommodate a shift toward a healthier diet by 2030. METHODS: A biophysical simulation model estimated the proportion of the US population that could be fed a given diet based on food system constraints, currently and projected to 2030. The model accepted data inputs on food intake, crop yields, and population size. Linear and nonlinear regression models were used to estimate projected food intake and crop yields based on recent historical data (1980-2014). Diet quality was estimated using the Healthy Eating Index-2015. RESULTS: The US agricultural system can produce enough food to feed 146% of the population by 2030. A greater proportion of the population can be fed a high-quality diet than a low-quality diet (178% compared to 119%). To accommodate increased diet quality, substantial increases in cropland acreage would be needed for fruits (P < 0.001), vegetables (P = 0.002), legumes (P = 0.002), and nuts (P = 0.007); and decreased cropland acreage would be needed for grains (P = 0.002) and sweeteners (P < 0.001). CONCLUSIONS: The US can produce more than enough food to accommodate a shift toward a healthier diet pattern, but even moderate shifts in diet quality would require major transitions in cropland use. The success of this transition is dependent on several factors, like individuals' ease of entry into the agricultural sector, producers' ability to shift production to other crops, and modifications to the food supply chain.

Nutrient intake disparities in the US: modeling the effect of food substitutions.

BACKGROUND: Diet quality among federal food assistance program participants remains low, and little research has assessed the diet quality of food insecure non-participants. Further research is needed to assess the extent to which food substitutions can improve the nutritional status of these vulnerable populations. Substituting egg dishes for other commonly consumed dishes at certain eating occasions may be an effective strategy for improving the daily nutrient intake among these groups. Eggs are rich in many important nutrients, and are low-cost and part of a wide range of cultural food menus, which are important considerations for low-income and ethnically diverse populations. To help guide the focus of targeted nutrition interventions and education campaigns for vulnerable populations, the present work begins by 1) estimating the prevalence of nutrient inadequacy among these groups, and then models the effect of consuming egg dishes instead of commonly consumed dishes at each eating occasion on 2) the prevalence of nutrient inadequacy, and 3) the mean intake of nutrients. METHODS: Dietary data from 34,741 adults ≥ 20 y were acquired from the National Health and Nutrition Examination Survey, 2001-2014. Diet pattern modeling was used to substitute commonly consumed egg dishes for commonly consumed main dishes at breakfast, lunch, and dinner. National Cancer Institute usual intake methods were used to estimate the prevalence of inadequate intake of 31 nutrients pre- and post-substitution, and a novel index was used to estimate change in intake of all nutrients collectively. RESULTS: Substituting eggs for commonly consumed main dishes at lunch or dinner did not change total daily nutrient intake for each group (P > 0.05), but decreased the prevalence of vitamin D inadequacy by 1-4 percentage points (P < 0.01). Substituting eggs for commonly consumed foods at breakfast increased the prevalence of folate inadequacy by 8-12 percentage points among each group (P < 0.01). CONCLUSIONS: When making food substitutions to increase nutrient intake, eating occasion should be an important consideration. Further research is needed to better understand how food substitutions affect diet costs, which may be an important driver of food purchasing decisions among low income individuals with limited food budgets.

A diet high in carotenoid-rich vegetables and fruits favorably impacts inflammation status by increasing plasma concentrations of IFN-α2 and decreasing MIP-1ß and TNF-α in healthy individuals during a controlled feeding trial.

The health benefits of vegetable and fruit (VF) intake include benefits for diseases that have an inflammatory component, although the relationship between VF intake and systemic inflammatory status is unclear due to the lack of comprehensive analysis of inflammatory markers in most studies. Therefore, our hypothesis was that the consumption of carotenoid-rich vegetables and fruits in the diet would have a beneficial effect on systemic inflammation status. In this study, we determined the association between varying doses of carotenoid-rich VF intake, plasma carotenoids, and a broad array of markers including 26 cytokines and high-sensitivity C-reactive protein. Data were derived from a single-arm controlled clinical feeding trial in which healthy, nonobese individuals received a low-carotenoid prescription for 6 weeks and then consumed a provided high-VF diet for 8 weeks. Proinflammatory cytokines and plasma carotenoids were measured at baseline, at 6 weeks, and at the end of the 8-week feeding period. Maximum likelihood estimation was used to calculate overall correlations between total plasma carotenoid concentrations and the cytokines. Plasma carotenoids decreased during the low-carotenoid treatment and increased during the feeding treatment. Of the inflammatory markers measured, we found increased plasma concentrations of interferon α-2 (P = .003) and decreased macrophage inflammatory protein-1ß (P = .027) and tumor necrosis factor-α (P = .012) after consumption of the carotenoid-rich diet. These results indicate that consumption of VF may be important in the maintenance of beneficial inflammatory homeostasis.

Mineral content of eggs differs with hen strain, age, and rearing environment.

Egg nutrient quality is strongly influenced by hen diet but is also affected by rearing environment, hen strain, and hen age. The objective of the current study was to determine the effect of: 1) conventional battery cages, 2) enrichable cage systems, 3) enriched colony housing, 4) cage-free, and 5) free-range rearing systems on mineral concentrations of whole, dried egg (yolk and albumen combined) from TA Tetra White (TW) and Hy-Line Brown (HB) hens at 44, 68, and 88 wk of age. We hypothesized that mineral concentration of eggs would differ among rearing systems but not between strains or with hen age. Hens held in enriched colony housing systems produced eggs with 10% lower Mg and 11% lower Mn levels than conventional hens. Concentrations of Ca and Cu were higher (7 and 8%, respectively) in eggs from TW hens than from HB hens. Eggs from HB hens had 8% higher concentrations of Fe, 6% higher Mg and 5% higher Mn than TW hens. Mn was higher in eggs from 44-wk hens than from 68- or 88-wk hens (16 and 11%, respectively). Interaction effects between rearing environment and hen age were observed for K and Mn concentrations. Eggs from 68-wk hens in conventional rearing systems contained 14 to 21% more K than eggs from conventional hens at 44- and 88 wk and 14 to 18% more than eggs from 68-wk hens in other rearing systems. At 88 wk of age, hens in conventional rearing systems produced eggs with higher Mn concentration than hens in enrichable or enriched colony housing systems (22 and 23%, respectively). Interactions between rearing environment, hen strain, and hen age were observed for egg Zn levels among 44- and 68-wk hens but were not detectable among 88-wk hens regardless of rearing system or hen strain. Observed differences in egg mineral content in our study were small and are unlikely to have substantial impact on human nutrition.

Smokers report lower intake of key nutrients than nonsmokers, yet both fall short of meeting recommended intakes.

Smoking is a major risk factor in the development of preventable disease which may be due to a poorer diet and the reduced nutrient intake of smokers. Our objective was to compare and evaluate the reported intake of current smokers with that of nonsmokers among participants of a study evaluating stress and smoking. We hypothesized (1) that overall energy and nutrient intake would be reduced in smokers compared with nonsmokers and (2) that smokers would have increased noncompliance with Dietary Reference Intakes (DRIs). Men and women (smokers n=138, nonsmokers n=46) completed a 3-day diet record at baseline. Mean energy and nutrient intakes were stratified by smoking status and compared with DRI levels. The mean body mass index was 28.3±0.5kg/m2 for smokers and 27.2±1.0kg/m2 for nonsmokers. Compared with nonsmokers, the smokers reported lower intakes of energy, total polyunsaturated fatty acids, linolenic acid, docosahexaenoic acid, total sugars, calcium, iron, magnesium, phosphorus, potassium, vitamin C, riboflavin, niacin, pantothenic acid, vitamin B6, folate, vitamin A, and vitamin E. Smokers reported reduced compliance with the DRIs for iron, phosphorus, vitamin C, riboflavin, and folate compared with nonsmokers. Unlike other evaluations of smokers vs nonsmokers, we observed no difference in body weight between groups. Smokers and nonsmokers alike reported dietary intakes lower than the DRIs for many nutrients. However, the reported nutrient intake of the smokers was substantially lower than nonsmokers for key nutrients, and they were more likely to not comply with the DRIs for essential nutrients, placing them at increased risk of chronic disease.

Relationship of the Reported Intakes of Fat and Fatty Acids to Body Weight in US Adults.

Dietary fat composition may modulate energy expenditure and body weight. Little is known about the relationship between fatty acid intake and body weight at a population level. The purposes of this study were to compare intakes of energy, macronutrients, and individual fatty acids across BMI categories (1) for the US adult population and, (2) by sociodemographic groups. Reported dietary intake data from the National Health and Nutrition Examination Survey (NHANES) and What We Eat in America (WWEIA) surveys in the years 2005-2012 were analyzed. Overall, we found that the reported intake of carbohydrate, protein, total fat, total saturated fat (as well as long-chain saturated fatty acids 14:0-18:0), and monounsaturated fatty acids (MUFAs) were positively associated with BMI; while lauric acid (a medium-chain saturated fatty acid, 12:0) and total polyunsaturated fatty acids (PUFAs) (as well as all individual PUFAs) were not associated with BMI. Non-Hispanic black individuals demonstrated a negative association between BMI and energy intake and a positive association between total PUFAs, linoleic acid (LA), α-linolenic acid (ALA) and BMI. Individuals with less than a high school education showed a negative association between BMI and DHA. Mexican-Americans reported intakes with no association between BMI and energy, any macronutrient, or individual fatty acids. These findings support those of experimental studies demonstrating fatty acid-dependent associations between dietary fatty acid composition and body weight. Notably, we observed divergent results for some sociodemographic groups which warrant further investigation.

Diet Quality Is Lower and Energy Intake Is Higher on Weekends Compared with Weekdays in Midlife Women: A 1-Year Cohort Study.

BACKGROUND: Differences in energy and macronutrient intakes by weekday and weekend have been reported, but there are few data on differences in food group consumption and indices of diet quality. OBJECTIVE: The aim of this study was to describe dietary intake by day and on weekends compared with weekdays. DESIGN: This study utilized a longitudinal cohort design with self-reported dietary intake collected using the Automated Self-Administered 24-Hour Dietary Assessment Tool. PARTICIPANTS/SETTING: Participants were ambulatory women with access to high-speed internet, body mass index between 18 and 35, and aged 40 to 60 years from the Life in All Seasons study (n=52) conducted in Grand Forks, ND, between July 2012 and July 2014. Each woman completed an Automated Self-Administered 24-Hour Dietary Assessment Tool diet recall every 10 days for 1 year. MAIN OUTCOME MEASURES: Primary outcome measures were total and energy intake from macronutrients, food groups (per 1,000 kcal), and Healthy Eating Index-2010 (HEI-2010) scores from 1,866 24-hour recalls. STATISTICAL ANALYSES PERFORMED: Effects of weekend on energy and macronutrient intake, energy-adjusted food groups, and HEI-2010 scores and component scores were tested using mixed linear models. RESULTS: Participants (n=52) completed 1,080 recalls on weekdays and 786 on weekends. Seventy-five percent of women reported consuming more energy on weekends than on weekdays, with a higher mean intake of 158 kcal on weekends (P<0.01). The percentage of energy from carbohydrate (P<0.01) and protein (P<0.01) were both lower on weekends, and percentage of energy from alcohol higher (P<0.01). There was no difference in the percentage of energy from fat (P=0.07). Reported energy intake was greatest on Saturdays and lowest on Tuesdays. On weekends, women had reduced diet quality with more alcoholic beverages, solid fat, and potatoes, and less yogurt, whole fruits, dark green and orange vegetables, poultry, nuts and seeds, and whole grains per 1,000 kcal than on weekdays. HEI-2010 scores were lower on weekends than weekdays (P<0.01). Component scores were lower for whole fruits (P<0.01), greens and beans (P=0.02), whole grains (P<0.01), and dairy (P<0.01). CONCLUSIONS: Midlife women should be encouraged to maintain diet quality during weekends to improve overall diet quality scores.