European Journal of Nutrition (v.47, #6)

Diets enriched with dietary cholesterol, frequently from eggs, have been shown to produce a small but variable increase in plasma low density lipoprotein (LDL) cholesterol. There is evidence to suggest that energy-restricted diets, that may contain a relatively high proportion of fat and cholesterol, can attenuate the cholesterol-raising effect of dietary cholesterol on plasma LDL.To determine the combined effects of increased dietary cholesterol and weight loss produced by energy restriction on plasma LDL cholesterol and lipoproteins.A randomized, controlled, parallel study was performed in two groups of free-living volunteers on an energy-restricted diet for 12 weeks, one group was instructed to consume two eggs a day (n = 24), the other, to exclude eggs (n = 21). Dietary advice on energy restriction was based on the British Heart Foundation guidelines on how to lose weight for men and women.Energy intake fell by 25 and 29% in the egg-fed and non-egg-fed groups, resulting in a moderate weight loss of 3.4 kg (P < 0.05) and 4.4 kg (P < 0.05), respectively. The daily intake of dietary cholesterol increased significantly in the egg-fed group from 278 to 582 mg after 6 weeks. The concentration of plasma LDL cholesterol decreased in the non-egg-fed groups after 6 weeks (P < 0.01) and in the egg-fed and non-egg-fed at 12 weeks relative to baseline. There were no other significant changes in plasma lipoproteins or LDL particle size.An increased intake of dietary cholesterol from two eggs a day, does not increase total plasma or LDL cholesterol when accompanied by moderate weight loss. These findings suggest that cholesterol-rich foods should not be excluded from dietary advice to lose weight on account of an unfavorable influence on plasma LDL cholesterol.
Keywords: dietary cholesterol; LDL cholesterol; energy restriction; weight loss

Several factors can affect glycemic and insulinemic responses from cereal foods. Some suggested factors lowering the responses are; intact botanical structure, high amylose/high ß-glucan cereal varieties, organic acid produced during fermentation and food processes inducing retrogradation of starch.To evaluate the impact of fermented whole grain cereal kernels with high content of amylose (40%) and/or β-glucan (4.6%) on postprandial glucose and insulin responses in healthy adults.Thirteen healthy volunteers (4 men and 9 women) were given 25 g available carbohydrate portions of: glucose solution; tempe fermented whole-grain barley and tempe fermented whole-grain oat. Blood samples were collected directly before the meal (fasting) and 15, 30, 45, 60, 90 and 120 min after the start of the meal. The GI (glycemic index) and II (insulin index) of meals were calculated for each subject according to FAO/WHO standards.Peak glucose response was lowest after the tempe meal with high-amylose/ high-ß-glucan barley tempe while insulin response was lowest after the meal with high β-glucan oat tempe. The mean blood glucose responses for both the barley and the oat tempe meals were significantly lower than from the reference glucose load (P < 0.0001) during the first 60 min. The calculated GI:s for barley and oat tempe were 30 and 63, respectively. Mean serum insulin responses from barley and oat tempe were significantly lower compared with the glucose load (P < 0.002) during the first 60 min, and the calculated II was lower for oat tempe (21) compared with barley tempe (55).The results suggest that cereal products with beneficial influence on postprandial plasma glucose and insulin responses can be tailored by fermentation and enclosure of high-amylose and/or high-β-glucan barley and oat kernels.
Keywords: glycemic; insulin; amylose; β-glucan; tempe fermentation

Genotoxic effect of bile acids on human normal and tumour colon cells and protection by dietary antioxidants and butyrate by Patrizia Rosignoli; Roberto Fabiani; Angelo De Bartolomeo; Raffaela Fuccelli; Maria Antonietta Pelli; Guido Morozzi (301-309).
Colorectal cancer is the second cause of death for tumour worldwide. Among the risk factors for this disease the dietary habits seem to have a pivotal role. An elevated intake of fats causes a high release in the gut lumen of bile acids that are positively correlated with colorectal cancer, since they act as detergents and proliferation promoters. Recently, it was evidenced that bile acids can also be able to induce DNA damage.In this study the genotoxicity of deoxycholic acid (DCA) and chenodeoxycholic acid CDCA) has been evaluated in human normal colonocytes derived from 60 colon biopsies and in tumour cells. The involvement of reactive oxygen species (ROS) and the oxidative DNA damage was assessed. In addition, the protective effect exerted by both two well-known antioxidants commonly present in the diet, β-carotene and α-tocopherol, and butyrate which is known to be involved in the regulation of several cellular functions, has also been tested.The DNA damage was evaluated by the “comet assay” or single cell gel electrophoresis (SCGE) both in its conventional use and by the Endonuclease III modified method, which allow to detect the presence of oxidized pyrimidines.Bile acids (CDA and CDCA) resulted genotoxic on both normal and tumour human colon cells. The inclusion of the endonuclease III digestion step in the comet assay demonstrated that bile acids induced an oxidative DNA damage. In addition, treatment of colonocytes with bile acids in the presence of the antioxidants (β-carotene, α-tocopherol) and Na-butyrate caused a reduction of DNA damage.Our results suggest that bile acids may be involved in the tumour initiation by inducing a DNA oxidative damage, and so add further evidences to the preventive properties of antioxidants present in the Mediterranean diet.
Keywords: bile acids; oxidative DNA damage; antioxidants; Na-butyrate; normal colonocytes; tumour cell line

Several studies were carried out to study the prevalence of overweight and obesity among Saudi children, but those assessed the association between eating habits, socio-demographic differentials and obesity in these children are scarce.To assess the magnitude of obesity and overweight among male primary schoolchildren and to find the possible association between obesity/overweight with dietary habits and socio-demographic differentials among them.A cross-sectional descriptive study including 1,139 Saudi male enrolled in the fifth and sixth grades in public primary schools in Al Hassa, KSA, through a multistage random sampling technique, submitted to interview using Youth and Adolescent Food Frequency Questionnaire, gathering data regarding dietary intake, some dietary habits, followed by anthropometric measurements with calculation of body mass index, the interpretation of which was based on using Cole’s tables for standard definition of overweight and obesity. Socio-demographics data were collected through parental questionnaire form. Data analysis was carried out using SPSS 12 (SPSS Inc. Chicago, IL, USA), univariate as well as multivariate analyses were conducted.The age ranged from 10 to 14 years. The prevalence of overweight among the included subjects was 14.2% while obesity was 9.7%, more in urban, older age students, mothers of obese and overweight were less educated, more working. Missing and or infrequent intake of breakfast at home, frequent consumption of fast foods, low servings of fruits, vegetables, milk and dairy product per day, with frequent consumption of sweets/candy and carbonated drinks were all predictors of obesity and overweight among the included male schoolchildren.The prevalence of childhood obesity is escalating and approaching figures reported in the developed countries. Less healthy dietary habits and poor food choices may be responsible for this high prevalence.
Keywords: childhood obesity; body mass index; dietary habits; Saudi Arabia

Effects of fatty and lean fish intake on blood pressure in subjects with coronary heart disease using multiple medications by Arja T. Erkkilä; Ursula S. Schwab; Vanessa D. F. de Mello; Tiina Lappalainen; Hanna Mussalo; Seppo Lehto; Virpi Kemi; Christel Lamberg-Allardt; Matti I. J. Uusitupa (319-328).
Intake of fish and long-chain n-3 fatty acids has been of wide interest due to their beneficial effects on cardiovascular risk factors and lower coronary heart disease (CHD) risk.The aim of this pilot study was to examine the effects of fatty fish and lean (white) fish on fatty acid composition of serum lipids and cardiovascular risk factors in subjects with CHD using multiple drugs for this condition.The study was an 8-week controlled, parallel intervention. Inclusion criteria were myocardial infarction or unstable ischemic attack, age under 70 years, use of betablockers and presence of sinus rhythm. The subjects were randomized to one of the following groups: 4 meals/week fatty fish (n = 11), 4 meals/week lean fish (n = 12) and control diet including lean meat (n = 10).The mean (±SD) of reported fish meals per week was 4.3 ± 0.4, 4.7 ± 1.1 and 0.6 ± 0.4 in the groups, respectively. The proportions of eicosapentaenoic and docosahexaenoic acids in serum lipids increased in the fatty fish group only (P < 0.05). Systolic and diastolic blood pressure levels decreased in the lean fish group (0 vs. 8 week: 3.5 ± 3.2 and 4.6 ± 3.6%, respectively, P < 0.05). Serum total triglyceride concentration did not significantly change. HDL cholesterol concentration change differed among groups but without significant post hoc differences. Apolipoprotein A-1 concentration decreased in the control group (0 vs. 8 week, P < 0.05). Coagulation factors, 25-hydroxy vitamin D, and heart rate variability (24 h Holter) did not change among the groups.Our results suggest that intake of lean fish at least four times per week could reduce blood pressure levels in CHD patients.
Keywords: fish; n-3 fatty acids; serum lipids; blood pressure; arrhythmia; coagulation

No effects of olive oils with different phenolic content compared to corn oil on 1,2-dimethylhydrazine-induced colon carcinogenesis in rats by Angelo Pietro Femia; Piero Dolara; Maurizio Servili; Sonia Esposto; Agnese Taticchi; Stefania Urbani; Augusto Giannini; Maddalena Salvadori; Giovanna Caderni (329-334).
Some epidemiological and experimental studies suggest that olive oil, despite its elevated caloric content, may have protective activity against colon cancer, partially due to its phenolic content. However, little experimental evidence exists to support this claim in vivo.To test the effect of olive oils with different phenolic content in a well-characterized model of colon carcinogenesis, comparing them with corn oil (CO).F344 rats were fed AIN-76 based diets for the entire experimental period; the diets contained 23% (w/w) of lipids from three different sources: extra-virgin olive oil rich in phenolic compounds (EV), rectified olive oil (ROO) with the same fatty acid composition but devoid of phenolic compounds and CO as a control diet. One week later, rats were induced with 1,2-dimethylhydrazine (DMH) (150 mg/kg b.w. × 2 times) to measure preneoplastic lesions (aberrant crypt foci (ACF) and mucin depleted foci (MDF)) and tumours in the intestine.Thirteen weeks after DMH, the numbers of ACF and MDF were similar in the different groups (ACF/colon were 344.9 ± 27.0, 288.6 ± 28.5 and 289.8 ± 21.4 in CO, EV and ROO groups, respectively, means ± SE; MDF/colon were 8.83 ± 1.2, 8.41 ± 1.5 and 8.75 ± 1.6 in CO, EV and ROO groups, respectively, means ± SE). Thirty-two weeks after DMH, the incidence of tumours (rats with tumours/rats in the group) did not differ among the different groups (20/21, 18/19 and 20/20 in the CO, EV, and ROO groups, respectively). Similarly, the number of tumours/ rat in the colorectum (both adenomas and cancers) was not different in the three different groups (2.33 ± 0.26, 2.42 ± 0.41 and 2.25 ± 0.40 in CO, EV and ROO groups, respectively, means ± SE).Olive oil, irrespective of its phenolic content, does not affect DMH-induced colon carcinogenesis in F344 rats compared with CO.
Keywords: colon carcinogenesis; olive oil; corn oil; phenolic compounds; diet and cancer

Low total plasma carotenoids are independent predictors of mortality among older persons by Fulvio Lauretani MD; Richard D. Semba; Margaret Dayhoff-Brannigan; Anna Maria Corsi; Angelo Di Iorio; Eva Buiatti; Stefania Bandinelli; Jack M. Guralnik; Luigi Ferrucci (335-340).
Plasma carotenoids are considered a valid biological marker for fruit and vegetable dietary intake. Recent studies show that low carotenoid levels are associated with a high risk of inflammation, cancer, and cardiovascular disease.To determine whether low plasma carotenoids are associated with increased mortality among older adults.Longitudinal study among 1,043 adults, 65 years and older, in the InCHIANTI study, a population-based cohort of adults living in the community in the Tuscany region, Italy.Mean total carotenoid concentration was 1.80 µmol/l. During eight years of follow-up, 310 (29.7%) of participants died. Eight-year survival was lower in the lowest compared with the highest tertile of total serum carotenoids (P < 0.0001 by Mantel-Haenszel chi-square). In a multivariate Cox proportional hazards model adjusted for age, education, smoking, body mass index, energy intake, and chronic diseases, adults in the highest tertile of plasma carotenoids at enrollment had lower mortality compared to those in the lowest tertile (Hazards Ratio obtained by considering carotenoids level as an ordinal variable 0.81, 95%; CI 0.65–0.99; P for trend = 0.046).Low plasma carotenoids are an independent risk factor for mortality among older adults living in the community.
Keywords: aging; carotenoids; fruits; mortality; vegetables

Dietary folate intake during pregnancy and birth weight in Japan by Hiroko Watanabe; Hideoki Fukuoka; Takashi Sugiyama; Yasushi Nagai; Kayoko Ogasawara; Nobuo Yoshiike (341-347).
Inadequate folate status has been associated with many negative reproductive outcomes, such as neural tube defects (NTD), low birth weight and placental abruption.The objectives of this study were to evaluate the levels of dietary folate intake during pregnancy in Japanese women and the subsequent birth weight of their babies.A longitudinal prospective study was conducted with 197 women with a singleton pregnancy in 2005. Dietary folate was investigated 3 times: in the first trimester at 12 weeks, in the second trimester at 20 weeks and in third trimester at 32 weeks using a diet history questionnaire (DHQ). Non fasting blood samples were collected from the women for measurement of homocysteine, hemoglobin, ferritin, unbound iron-binding capacity (UIBC) and total iron-binding capacity (TIBC).Energy intake increased as pregnancy advanced, but not significantly. The daily intake of folate increased from 248.5 ± 113.1 µg/d in the first trimester to 275.4 ± 100.2 µg/d in the third trimester (P = 0.04). This was well below the recommended level of 440 µg/d and only 10% of mothers were above the levels. In the third trimester, plasma homocysteine concentration was significantly higher in the low folate group of less than 250 µg/d (P = 0.02), but not the first and second trimesters. Dietary folate intake and plasma homocysteine concentrations were not likely to be predictors of birth weight in our subjects.Our study shows that Japanese women’s energy and folate intakes do not meet their energy needs during pregnancy and are at an extremely low recommended dietary allowance level throughout pregnancy.
Keywords: dietary folate intake; pregnancy; maternal nutrition; birth weight