Associations between dietary patterns and the metabolic syndrome in older adults in New Zealand: the REACH study.

The metabolic syndrome is common in older adults and may be modified by the diet. The aim of this study was to examine associations between a posteriori dietary patterns and the metabolic syndrome in an older New Zealand population. The REACH study (Researching Eating, Activity, and Cognitive Health) included 366 participants (aged 65-74 years, 36 % male) living independently in Auckland, New Zealand. Dietary data were collected using a 109-item FFQ with demonstrated validity and reproducibility for assessing dietary patterns using principal component analysis. The metabolic syndrome was defined by the National Cholesterol Education Program Adult Treatment Panel III. Associations between dietary patterns and the metabolic syndrome, adjusted for age, sex, index of multiple deprivation, physical activity, and energy intake were analysed using logistic regression analysis. Three dietary patterns explained 18 % of dietary intake variation - 'Mediterranean style' (salad/leafy cruciferous/other vegetables, avocados/olives, alliums, nuts/seeds, shellfish and white/oily fish, berries), 'prudent' (dried/fresh/frozen legumes, soya-based foods, whole grains and carrots) and 'Western' (processed meat/fish, sauces/condiments, cakes/biscuits/puddings and meat pies/hot chips). No associations were seen between 'Mediterranean style' (OR = 0·75 (95 % CI 0·53, 1·06), P = 0·11) or 'prudent' (OR = 1·17 (95 % CI 0·83, 1·59), P = 0·35) patterns and the metabolic syndrome after co-variate adjustment. The 'Western' pattern was positively associated with the metabolic syndrome (OR = 1·67 (95 % CI 1·08, 2·63), P = 0·02). There was also a small association between an index of multiple deprivation (OR = 1·04 (95 % CI 1·02, 1·06), P < 0·001) and the metabolic syndrome. This cross-sectional study provides further support for a Western dietary pattern being a risk factor for the metabolic syndrome in an older population.

Bioequivalence of long-chain omega-3 polyunsaturated fatty acids from foods enriched with a novel vegetable-based omega-3 delivery system compared to gel capsules: a randomized controlled cross-over acute trial.

PURPOSE: To evaluate bioavailability of omega-3 long-chain polyunsaturated fatty acids (LCPUFA) from foods enriched with novel vegetable-based encapsulated algal oil across Australian and Singaporean populations. METHODS: 27 men (n = 12 Australian European; n = 15 Singaporean Chinese), 21-50 yr; 18-27.5 kg/m2, with low habitual intake of omega-3 LCPUFA completed a multicentre randomised controlled acute 3-way cross-over single-blind trial. They consumed, in random order 1-week apart after an overnight fast, standard breakfast meals including 400 mg docosahexanoic acid (DHA) from either extruded rice snacks or soup both containing cauliflower-encapsulated HiDHA® algal oil or gel capsules containing HiDHA® algal oil. Blood samples for analysis of plasma DHA and eicosapentaenoic acid (EPA) were taken pre-meal and after 2, 4, 6, 8 and 24 h. Primary analyses comparing 24-h incremental area under the plasma DHA, EPA and DHA + EPA concentration (µg/ml) curves (iAUC0-24 h) between test foods were performed using linear mixed models by including ethnicity as an interaction term. RESULTS: Plasma iAUC0-24 h did not differ significantly between test foods (adjusted mean [95% CI] plasma DHA + EPA: extruded rice snack, 8391 [5550, 11233] µg/mL*hour; soup, 8862 [6021, 11704] µg/mL*hour; capsules, 11,068 [8226, 13910] µg/mL*hour, P = 0.31) and did not differ significantly between Australian European and Singaporean Chinese (treatment*ethnicity interaction, P = 0.43). CONCLUSION: The vegetable-based omega-3 LCPUFA delivery system did not affect bioavailability of omega-3 LCPUFA in healthy young Australian and Singaporean men as assessed after a single meal over 24 h, nor was bioavailability affected by ethnicity. This novel delivery system may be an effective way to fortify foods/beverages with omega-3 LCPUFA. TRIAL REGISTRATION: The trial was registered with clinicaltrials.gov (NCT04610983), date of registration, 22 November 2020.

Dietary patterns and cognitive function in older New Zealand adults: the REACH study.

PURPOSE: The global population is ageing. Evidence show dietary patterns may be associated with cognitive status in older adults. This cross-sectional study investigated associations between dietary patterns and cognitive function in older adults in New Zealand. METHODS: The REACH study (Researching Eating, Activity, and Cognitive Health) included 371 participants (65-74 years, 36% male) living independently in Auckland, New Zealand. Valid and reproducible dietary patterns were derived, using principal component analysis, from dietary data collected by a 109-item validated food frequency questionnaire. Six cognitive domains (global cognition, attention and vigilance, executive function, episodic memory, working memory, and spatial memory) were tested using COMPASS (Computerised Mental Performance Assessment System). Associations between dietary patterns and cognitive scores, adjusted for age, sex, education, physical activity, energy, and Apolipoprotein E-ε4 status were analysed using multiple linear regression analysis. RESULTS: Three dietary patterns explained 18% of dietary intake variation-'Mediterranean style' (comprising: salad vegetables, leafy cruciferous vegetables, other vegetables, avocados and olives, alliums, nuts and seeds, white fish and shellfish, oily fish, and berries); 'Western' (comprising: processed meats, sauces and condiments, cakes, biscuits and puddings, meat pies and chips, and processed fish); and 'Prudent' (comprising: dried legumes, soy-based foods, fresh and frozen legumes, whole grains, and carrots). No associations between any cognitive domain and dietary pattern scores were observed. Global cognitive function was associated with being younger and having a university education. CONCLUSION: In this cohort of community-dwelling, older adults in New Zealand, current dietary patterns were not associated with cognitive function.

Study protocol: associations between dietary patterns, cognitive function and metabolic syndrome in older adults - a cross-sectional study.

BACKGROUND: Loss of cognitive function is a significant issue as the world's population ages. Preserving cognitive function maintains independence in older adults bringing major societal and financial benefits. Lifestyle factors such as diet are modifiable risk factors, which may help preserve cognitive function. Most nutrition research aimed at preserving cognitive function and metabolic health has focussed on individual nutrients and foods, not allowing for food combinations and interactions. A dietary pattern approach considers the entire diet including its complexity. Previous research investigating dietary patterns and cognitive function has not always considered relevant covariates such as physical activity and the Apolipoprotein E genotype, which are known to have associations with cognitive function. The aim of the REACH (Researching Eating, Activity and Cognitive Health) study is to investigate associations between dietary patterns, cognitive function and metabolic syndrome, accounting for a range of covariates. METHODS: This cross-sectional study design will recruit older, community-living adults (65-74 years) from Auckland, New Zealand. Dietary data will be collected via a 109-item food frequency questionnaire validated using a 4-day food record. Cognitive function will be assessed using the Montreal Cognitive Assessment (paper based) and the Computerised Mental Performance Assessment System (COMPASS) - a testing suite covering six domains. Additional data will include genetic (Apolipoprotein E ε4) and biochemical markers (fasting glucose, HbA1c, lipids profile), anthropometric measurements (weight, height, waist and hip circumference, body composition using dual X-ray absorptiometry), blood pressure, physical activity (International Physical Activity Questionnaire - short form) and health and demographics (questionnaire). Dietary patterns will be derived by principal component analysis. Associations between cognitive function and dietary patterns will be examined using multiple regression analysis. Covariates and interaction factors will include age, education, socio-economic status, physical activity, Apolipoprotein E ε4 genotype, family history of dementia or cognitive impairment, and lifestyle factors. Differences between participants with and without metabolic syndrome will also be examined. DISCUSSION: This study will bring new knowledge regarding associations between dietary patterns and cognitive function and metabolic health in older adults living in New Zealand. This is important for developing nutrition related recommendations to help older adults maintain cognitive function.

Impact of phenolic-rich olive leaf extract on blood pressure, plasma lipids and inflammatory markers: a randomised controlled trial.

PURPOSE: Dietary polyphenols have been demonstrated to favourably modify a number of cardiovascular risk markers such as blood pressure (BP), endothelial function and plasma lipids. We conducted a randomised, double-blind, controlled, crossover trial to investigate the effects of a phenolic-rich olive leaf extract (OLE) on BP and a number of associated vascular and metabolic measures. METHODS: A total of 60 pre-hypertensive [systolic blood pressure (SBP): 121-140 mmHg; diastolic blood pressure (DBP): 81-90 mmHg] males [mean age 45 (±SD 12.7 years, BMI 26.7 (±3.21) kg/m2] consumed either OLE (136 mg oleuropein; 6 mg hydroxytyrosol) or a polyphenol-free control daily for 6 weeks before switching to the alternate arm after a 4-week washout. RESULTS: Daytime [-3.95 (±SD 11.48) mmHg, p = 0.027] and 24-h SBP [-3.33 (±SD 10.81) mmHg, p = 0.045] and daytime and 24-h DBP [-3.00 (±SD 8.54) mmHg, p = 0.025; -2.42 (±SD 7.61) mmHg, p = 0.039] were all significantly lower following OLE intake, relative to the control. Reductions in plasma total cholesterol [-0.32 (±SD 0.70) mmol/L, p = 0.002], LDL cholesterol [-0.19 (±SD 0.56) mmol/L, p = 0.017] and triglycerides [-0.18 (±SD 0.48), p = 0.008] were also induced by OLE compared to control, whilst a reduction in interleukin-8 [-0.63 (±SD 1.13) pg/ml; p = 0.026] was also detected. Other markers of inflammation, vascular function and glucose metabolism were not affected. CONCLUSION: Our data support previous research, suggesting that OLE intake engenders hypotensive and lipid-lowering effects in vivo.

TaqIB polymorphism in the cholesteryl ester transfer protein (CETP) gene influences lipid responses to the consumption of kiwifruit in hypercholesterolaemic men.

Fruit and vegetables are key elements of a cardioprotective diet, but benefits on plasma lipids, especially HDL-cholesterol (HDL-C), are inconsistent both within and between studies. In the present study, we investigated whether four selected HDL-C-related polymorphisms (cholesteryl ester transfer protein (CETP) Taq1B, APOA1 - 75G/A, hepatic lipase (LIPC) - 514C â†’ T, and endothelial lipase (LIPG) I24582) modulate the plasma lipid response to a kiwifruit intervention. This is a retrospective analysis of data collected during a 12-week randomised controlled cross-over trial. A total of eighty-five hypercholesterolaemic men completed a 4-week healthy diet run-in period before being randomised to one of two 4-week intervention sequences of two green kiwifruit/d plus healthy diet (kiwifruit intervention) or healthy diet alone (control intervention). The measurement of anthropometric parameters and collection of fasting blood samples were carried out at baseline 1 and after the run-in (baseline 2) and intervention periods. At baseline 2, B1/B1 homozygotes of the CETP Taq1B gene had significantly higher total cholesterol:HDL-C, TAG:HDL-C, and apoB:apoA1 ratios and small-dense LDL concentrations than B2 carriers. A significant CETP Taq1B genotype × intervention interaction was observed for the TAG:HDL-C ratio (P= 0·03). B1/B1 homozygotes had a significantly lower TAG:HDL-C ( - 0·23 (sd 0·58) mmol/l; P= 0·03) ratio after the kiwifruit intervention than after the control intervention, whereas the ratio of B2 carriers was not affected. The lipid response was not affected by other gene polymorphisms. In conclusion, the significant decrease in the TAG:HDL-C ratio in B1/B1 homozygotes suggests that regular inclusion of green kiwifruit as part of a healthy diet may improve the lipid profiles of hypercholesterolaemic men with this genotype.

Kiwifruit consumption favourably affects plasma lipids in a randomised controlled trial in hypercholesterolaemic men.

The unique composition of green kiwifruit has the potential to benefit CVD risk. The aim of the present study was to investigate the effect of consuming two green kiwifruits daily in conjunction with a healthy diet on plasma lipids and other metabolic markers and to examine response according to APOE genotype in hypercholesterolaemic men. After undergoing a 4-week healthy diet, eighty-five hypercholesterolaemic men (LDL-cholesterol (LDL-C) > 3.0 mmol/l and TAG < 3 mmol/l) completed an 8-week randomised controlled cross-over study of two 4-week intervention sequences of two green kiwifruits per d plus healthy diet (intervention) or healthy diet alone (control). Anthropometric measures, blood pressure (BP) and fasting blood samples (plasma lipids, serum apoA1 and apoB, insulin, glucose, high-sensitivity C-reactive protein (hs-CRP)) were taken at baseline, and at 4 and 8 weeks. After the kiwifruit intervention, plasma HDL-cholesterol (HDL-C) concentrations were significantly higher (mean difference 0.04; 95% CI 0.01, 0.07 mmol/l; P = 0.004) and the total cholesterol (TC):HDL-C ratio was significantly lower (mean difference 20.5; 95% CI 20.24, 20.05 mmol/l; P = 0.002) compared with the control. In carriers of the APOE4 allele, TAG decreased significantly (mean difference -0.18; 95% CI -0.34, -0.02 mol/l; P = 0.03) with kiwifruit compared with control. There were no significant differences between the two interventions for plasma TC, LDL-C, insulin, glucose, hs-CRP and BP. The small but significant increase in HDL-C and decrease in TC:HDL-C ratio and TAG (in APOE4 carriers) suggest that the regular inclusion of green kiwifruit as part of a healthy diet may be beneficial in improving the lipid profiles of men with high cholesterol.

Suboptimal iron status and associated dietary patterns and practices in premenopausal women living in Auckland, New Zealand.

PURPOSE: To investigate associations between dietary patterns and suboptimal iron status in premenopausal women living in Auckland, New Zealand. METHODS: Premenopausal women (n = 375; 18-44 years) were included in this cross-sectional analysis. Suboptimal iron status was defined as serum ferritin <20 µg/L. Participants completed a 144-item iron food frequency questionnaire (FeFFQ) and a questionnaire on dietary practices to assess dietary intake over the past month. Factor analysis was used to determine dietary patterns from the FeFFQ. Logistic regression was used to determine associations between these dietary patterns and iron status. RESULTS: Seven dietary patterns were identified: refined carbohydrate and fat; Asian; healthy snacks; meat and vegetable; high tea and coffee; bread and crackers; and milk and yoghurt. Logistic regression suggested that following a "meat and vegetable" dietary pattern reduced the risk of suboptimal iron status by 41 % (95 % CI: 18, 58 %; P = 0.002) and following a "milk and yoghurt" pattern increased the risk of suboptimal iron status by 50 % (95 % CI: 15, 96 %; P = 0.003). CONCLUSIONS: These results suggest that dietary patterns characterized by either a low intake of meat and vegetables or a high intake of milk and yoghurt are associated with an increased risk of suboptimal iron status. Dietary pattern analysis is a novel and potentially powerful tool for investigating the relationship between diet and iron status.

Kiwifruit: our daily prescription for health.

Kiwifruit are unequalled, compared with other commonly consumed fruit, for their nutrient density, health benefits, and consumer appeal. Research into their health benefits has focussed on the cultivars Actinidia deliciosa 'Hayward' (green kiwifruit) and Actinidia chinensis 'Hort 16A', ZESPRI(®) (gold kiwifruit). Compared with other commonly consumed fruit, both green and gold kiwifruit are exceptionally high in vitamins C, E, K, folate, carotenoids, potassium, fibre, and phytochemicals acting in synergy to achieve multiple health benefits. Kiwifruit, as part of a healthy diet, may increase high-density lipoprotein cholesterol, and decrease triglycerides, platelet aggregation, and elevated blood pressure. Consuming gold kiwifruit with iron-rich meals improves poor iron status, and green kiwifruit aids digestion and laxation. As a rich source of antioxidants, they may protect the body from endogenous oxidative damage. Kiwifruit may support immune function and reduce the incidence and severity of cold or flu-like illness in at-risk groups such as older adults and children. However, kiwifruit are allergenic, and although symptoms in most susceptible individuals are mild, severe reactions have been reported. While many research gaps remain, kiwifruit with their multiple health benefits have the potential to become part of our "daily prescription for health."

The New Zealand PUFA semiquantitative food frequency questionnaire is a valid and reliable tool to assess PUFA intakes in healthy New Zealand adults.

The health benefits of PUFA are well established. There is no valid tool or complete fatty acid database to assess PUFA intake in New Zealand (NZ). This study aimed to develop, validate, and test the reproducibility of a NZ-specific PUFA FFQ. A semiquantitative NZ PUFA FFQ was developed based on a validated Australian PUFA FFQ. The Australian fatty acid database was adapted to include NZ-specific data for major PUFA sources. Healthy participants from Auckland, NZ (n = 48) provided fasting blood samples for erythrocyte PUFA analysis, completed the NZ PUFA FFQ and a 3-d weighed food record (WFR), and repeated the NZ PUFA FFQ 3 mo later (n = 42). Relative validity was evaluated by assessing the triangular relationship among the NZ PUFA FFQ, WFR, and erythrocyte PUFA using the methods of triads [EPA, DHA, total omega-3 (n-3) long-chain (LC) PUFA only] and by comparing, correlating, cross-classifying into quintiles and assessing agreement using Bland-Altman plots of intakes between the NZ PUFA FFQ and WFR. Reproducibility was assessed by comparing and correlating intakes between repeat administrations of the NZ PUFA FFQ. The NZ PUFA FFQ effectively estimated EPA [ρ(QT) = 0.72 (95% CI: 0.49, 0.89)], DHA [ρ(QT) = 0.72 (95% CI: 0.53, 0.95)], and total (n-3) LCPUFA [ρ(QT) = 0.68 (95% CI: 0.47, 0.89)] intakes and was comparable with the WFR for other PUFA except docosapentaenoic acid. Repeated implementation of the NZ PUFA FFQ showed agreement for PUFA intakes. The NZ PUFA FFQ is a valid and reliable tool to measure PUFA intake in healthy NZ adults.

Iron status and self-perceived health, well-being, and fatigue in female university students living in New Zealand.

OBJECTIVE: To determine the relationship between iron depletion and self-perceived health, well-being, and fatigue in a female university student population living in New Zealand. METHODS: A total of 233 women aged 18-44 years studying at Massey University, Auckland, were included in this cross-sectional analysis. Serum ferritin (SF), hemoglobin (Hb), and C-reactive protein (CRP) were analyzed from a venipuncture blood sample. Participants completed the SF-36v2 General Health Survey (SF-36) and the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) questionnaire, and anthropometric measurements (height and weight) and data on demographics, lifestyle, and medical history were obtained. Characteristics of iron-sufficient (SF ≥ 20 µg/L, Hb ≥ 120 g/L) and iron-depleted (SF < 20 µg/L, Hb ≥ 120 g/L) participants were compared, and multiple regression analyses were carried out to determine predictors of health, well-being, and fatigue using a p value of <0.01 to indicate statistical significance because multiple comparisons were being made. RESULTS: There were no significant differences in self-perceived health and well-being determined using the SF-36 questionnaire between women who were iron sufficient and women who were iron depleted. Although MFSI-SF physical fatigue was significantly lower in those with iron depletion (p = 0.008), it was not predicted by current iron status in a multivariate model controlling for factors expected to be associated with iron status and fatigue (p = 0.037). However, smoking, a history of suboptimal iron status, and having a current medical condition were significant (negative) predictors of MFSI-SF physical fatigue, explaining 22.5% of the variance (p < 0.001). There were no significant differences in the other measures of fatigue determined using the MFSI-SF between women who were iron sufficient and those who were iron depleted. CONCLUSIONS: Women with iron depletion did not differ significantly from women who were iron sufficient with regard to self-perceived health, well-being, or fatigue. Future studies investigating fatigue should control for previous diagnosis of suboptimal iron status, smoking, and presence of a medical condition.

Avocado Consumption and Cardiometabolic Health: A Systematic Review and Meta-Analysis.

BACKGROUND: Avocados are a rich source of unsaturated fats and bioactives, however, their role in altering cardiometabolic risk factors is unclear. OBJECTIVE: The aim was to review the effects of consuming diets containing avocado compared with control diets containing no or low amounts of avocado on cardiometabolic risk factors in adults who were healthy, had clinical cardiovascular disease, or were at increased risk of cardiovascular disease. METHODS: Five electronic databases were searched (PubMed, Web of Science, Scopus, ProQuest, and a Clinical Trials Registry) along with Google Scholar to identify studies published between January 1990 and November 10, 2021. Randomized controlled trials ≥3 weeks and prospective cohort studies were included. Ten studies-9 randomized controlled trials (n = 503 participants) and 1 prospective observational study (n = 55,407)-met the inclusion criteria. Outcomes assessed by means of meta-analysis were low-density lipoprotein cholesterol (LDL-C) (primary), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides. Outcomes assessed by narrative review were TC to HDL-C ratio, non-HDL-C, apolipoprotein B, blood pressure, body weight, body mass index (calculated as kg/m2), waist circumference, waist-to-hip ratio, body composition, and blood glucose and insulin concentrations. Risk of bias was assessed using the Cochrane Risk of Bias tool, version 2.0 and Newcastle-Ottawa Scale; quality of evidence was examined using the Grading of Recommendations, Assessment, Development and Evaluation method. Random-effects models meta-analyses were performed when there were ≥3 studies of the same design (ie, randomized controlled trial) and reporting the same outcome. Statistical heterogeneity was assessed by calculating χ2 and I2 statistics and publication bias was assessed by funnel plots. RESULTS: Overall, there was a small, significant reduction in TC (-5.08 mg/dL [to convert to mmol/L, divide by 38.67]; 95% CI -9.29 to -0.87 mg/dL; P = .02) in avocado vs the control groups and no significant difference in LDL-C, HDL-C, or triglycerides. Subgroup analysis demonstrated significant reductions in LDL-C (-9.4 mg/dL [to convert to mmol/L, divide by 38.67]; 95% CI -10.84 to -7.95 mg/dL; P < .00001) and TC (-7.54 mg/dL; 95% CI -9.40 to -5.68 mg/dL; P < .00001) in avocado vs control groups in hypercholesterolemic populations, and no differences were seen in normocholesterolemic populations. However, the certainty in the findings was graded as low to very low. Body weight and composition were not negatively affected by avocado consumption. CONCLUSIONS: Avocado consumption may reduce TC and LDL-C in people with hypercholesterolemia. Avocado consumption does not negatively impact body weight. Larger, well-conducted studies are needed to have greater confidence in the role of avocado consumption on cardiovascular disease risk factors.

Krill oil improved osteoarthritic knee pain in adults with mild to moderate knee osteoarthritis: a 6-month multicenter, randomized, double-blind, placebo-controlled trial.

BACKGROUND: Osteoarthritis (OA) is a major cause of chronic pain and disability worldwide. Treatment generally focuses on symptom relief through nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics, which may incur side effects. Krill oil, rich in anti-inflammatory long-chain (LC) omega-3 ( ω-3) PUFAs and astaxanthin, may be a safe and effective alternative treatment. OBJECTIVES: This study sought to investigate the effects of a commercially available krill oil supplement on knee pain in adults with mild to moderate knee OA. Secondary outcomes were knee stiffness; physical function; NSAID use; Omega-3 Index; and lipid, inflammatory, and safety markers. METHODS: Healthy adults (n = 235, 40-65 y old, BMI >18.5 to <35 kg/m2), clinically diagnosed with mild to moderate knee OA, regular knee pain, and consuming <0.5 g/d LC ω-3 PUFAs, participated in a 6-mo double-blind, randomized, placebo-controlled, multicenter trial. Participants consumed either 4 g krill oil/d (0.60 g EPA/d, 0.28 g DHA/d, 0.45 g astaxanthin/d) or placebo (mixed vegetable oil). Knee outcomes were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) numeric scale (normalized to scores of 0-100). Outcomes were assessed at baseline, 3 mo, and 6 mo. RESULTS: Omega-3 Index increased with the krill oil supplement compared with placebo (from 6.0% to 8.9% compared with from 5.5% to 5.4%, P < 0.001). Knee pain score improved in both groups with greater improvements for krill oil than for placebo (difference in adjusted mean change between groups at 6 mo: -5.18; 95% CI: -10.0, -0.32; P = 0.04). Knee stiffness and physical function also had greater improvements with krill oil than with placebo (difference in adjusted mean change between groups at 6 mo: -6.45; 95% CI: -12.1, -0.9 and -4.67; 95% CI: -9.26, -0.05, respectively; P < 0.05). NSAID use, serum lipids, and inflammatory and safety markers did not differ between groups. CONCLUSIONS: Krill oil was safe to consume and resulted in modest improvements in knee pain, stiffness, and physical function in adults with mild to moderate knee OA.This trial was registered at clinicaltrials.gov as NCT03483090.

Gold kiwifruit consumed with an iron-fortified breakfast cereal meal improves iron status in women with low iron stores: a 16-week randomised controlled trial.

Ascorbic acid, and more recently, the carotenoids lutein and zeaxanthin have been shown to enhance Fe absorption. However, it is not clear whether Fe status improves when foods high in ascorbic acid and carotenoids are consumed with Fe-fortified meals. The present study aimed to investigate whether consuming high v. low ascorbic acid-, lutein- and zeaxanthin-rich fruit (gold kiwifruit v. banana) with Fe-fortified breakfast cereal and milk improved Fe status in women with low Fe stores. Healthy women aged 18-44 years (n 89) with low Fe stores (serum ferritin ≤ 25 µg/l and Hb ≥ 115 g/l) were randomly stratified to receive Fe-fortified breakfast cereal (16 mg Fe as ferrous sulfate), milk and either two gold kiwifruit or one banana (164 mg v. not detectable ascorbic acid; 526 v. 22·90 µg lutein and zeaxanthin, respectively) at breakfast every day for 16 weeks. Biomarkers of Fe status and dietary intake were assessed at baseline and end in the final sample (n 69). Median serum ferritin increased significantly in the kiwifruit group (n 33) compared with the banana group (n 36), with 10·0 (25th, 75th percentiles 3·0, 17·5) v. 1·0 (25th, 75th percentiles - 2·8, 6·5) µg/l (P < 0·001). Median soluble transferrin receptor concentrations decreased significantly in the kiwifruit group compared with the banana group, with - 0·5 (25th, 75th percentiles - 0·7, - 0·1) v. 0·0 (25th, 75th percentiles - 0·3, 0·4) mg/l (P = 0·001). Consumption of an Fe-fortified breakfast cereal with kiwifruit compared with banana improved Fe status. Addition of an ascorbic acid-, lutein- and zeaxanthin-rich fruit to a breakfast cereal fortified with ferrous sulfate is a feasible approach to improve Fe status in women with low Fe stores.

Consumption of salmon v. salmon oil capsules: effects on n-3 PUFA and selenium status.

Salmon provides long-chain (LC) n-3 PUFA and Se, which are well recognised for their health benefits. The n-3 and Se status of the New Zealand population is marginal. The objective of the present study was to compare the effects of consuming salmon v. supplementation with salmon oil on LC n-3 and Se status. Healthy volunteers (n 44) were randomly assigned to one of four groups consuming 2 × 120 g servings of salmon/week or 2, 4 or 6 salmon oil capsules/d for 8 weeks. Linear regression analysis predictive models were fitted to the capsule data to predict changes in erythrocyte LC n-3 levels with intakes of LC n-3 from capsules in amounts equivalent to that consumed from salmon. Changes in Se status (plasma Se and whole-blood glutathione peroxidase) were compared between the groups consuming salmon and capsules (three groups combined). Salmon, 2, 4 and 6 capsules provided 0·82, 0·24, 0·47 and 0·69 g/d of LC n-3 fatty acids. Salmon provided 7 µg/d and capsules < 0·02 µg/d of Se. The predictive model (r(2) 0·31, P = 0·001) showed that increases in erythrocyte LC n-3 levels were similar when intakes of 0·82 g/d LC n-3 from salmon or capsules (1·92 (95 % CI 1·35, 2·49) v. 2·32 (95 % 1·76, 2·88) %) were consumed. Plasma Se increased significantly more with salmon than with capsules (12·2 (95 % CI 6·18, 18·12) v. 1·57 (95 % CI - 2·32, 5·45) µg/l, P = 0·01). LC n-3 status was similarly improved with consumption of salmon and capsules, while consuming salmon had the added benefit of increasing Se status. This is of particular relevance to the New Zealand population that has marginal LC n-3 and Se status.

Evaluating a novel dietary diversity questionnaire to assess dietary diversity and adequacy of New Zealand women.

OBJECTIVES: We sought to develop and evaluate the relative validity of a dietary diversity questionnaire (DDQ) that reflects food-group diversity, food variety, and micronutrient adequacy among New Zealand women. METHODS: A cross-sectional study included New Zealand women (Auckland based; ages 16-45 y, n = 101), completing a 7-d DDQ and 4-d weighed food record (reference method). The relative validity of the DDQ was evaluated by correlating nutritious and discretionary dietary diversity scores (DDSs; number of food groups) and food-variety scores (number of foods), calculated from both methods. The dietary mean adequacy ratio (MAR; micronutrient intakes relative to estimated average requirements) was calculated from the weighed food record and correlated to dietary diversity and food-variety scores from the DDQ to assess construct validity. Cross-tabulation was used to explore dietary diversity measures versus adequacy ratios. Significance was set at P < 0.05. RESULTS: The median (interquartile range) DDSs (maximum 25) from the DDQ-23 (21-23)-and the weighed food record-18 (17-19)-were significantly correlated (rs = 0.33, P < 0.001), as were the food-variety scores (maximum 237)-respectively, 75 (61-87) and 45 (37-52) (rs = 0.22, P < 0.03). A mean (± SD) MAR of 0.94 ± 0.04 suggested a near-adequate diet, but one-third of foods consumed were from discretionary sources. Nutritious DDS was significantly correlated with MAR for micronutrients (rs = 0.20, P ≤ 0.05). An inverse trend was observed between discretionary DDS and MAR. CONCLUSIONS: The DDQ is a quick, low-burden tool for describing nutritious and discretionary dietary diversity reflecting micronutrient adequacy in high-income settings. It requires further validation across different time frames, population groups, and settings.

Eucaloric diets enriched in palm olein, cocoa butter, and soybean oil did not differentially affect liver fat concentration in healthy participants: a 16-week randomized controlled trial.

BACKGROUND: Effects of dietary fat quality on liver fat remain to be elucidated. Inconsistent evidence may be influenced by fatty acid saturation, chain-length, and regio-specificity within triacylglycerol (TAG) molecules. OBJECTIVES: We aimed to compare eucaloric diets enriched in palm olein (POo), cocoa butter (COB), and soybean oil (SBO) on liver fat concentration in healthy participants. Secondary outcomes included visceral (VAT) and abdominal subcutaneous (aSCAT) adipose tissue, plus other obesity and cardiometabolic health outcomes. METHODS: Eighty-three healthy participants (20-45 y, BMI 18.5-27.5 kg/m2) commenced and 64 completed a 16-wk randomized parallel intervention, preceded by a 2-wk run-in. Participants consumed identical eucaloric background diets differing in test fats [contributing 20% total energy intake (%E)], providing 33%E total fat with the following ratios for PUFAs/SFAs/MUFAs: POo, 4.2/13.5/15%E; SBO, 14.4/8.8/9.4%E; COB, 2.3/19.5/11%E. Liver fat and abdominal adiposity were measured at weeks 0 and 16 using 1H-magnetic resonance spectroscopy/imaging; all other outcomes were measured at 0, 4, 8, 12, and 16 wk. RESULTS: Fat quality did not affect liver fat concentration, VAT, aSCAT, obesity indexes, blood pressure, liver enzymes, leptin, or fasting glucose. Body fat mass decreased with SBO and COB compared with POo. SBO decreased serum total cholesterol (TC), LDL cholesterol, and TC:HDL cholesterol relative to POo [estimated marginal mean (95% CI) differences: -0.57 (-0.94, -0.20) mmol/L; -0.37 (-0.68, -0.07) mmol/L; and -0.42 (-0.73, -0.11) mmol/L, respectively]. No diet differences were observed on HDL cholesterol, TAG, apoA1, apoB, apoB:apoA1, or fecal free fatty acids (FFAs), except for lower FFA pentadecanoic acid (15:0) with COB than with SBO and POo. CONCLUSIONS: In healthy adults, when consumed as part of eucaloric typical Australian diets, 3 different dietary fat sources did not differentially affect liver fat concentration and amounts of adipose tissue. Effects on serum lipids were inconsistent across lipid profiles. The findings must be confirmed in metabolically impaired individuals before recommendations can be made.

Almond consumption affects fecal microbiota composition, stool pH, and stool moisture in overweight and obese adults with elevated fasting blood glucose: A randomized controlled trial.

Regular almond consumption has been shown to improve body weight management, lipid profile and blood glucose control. We hypothesized that almond consumption would alter fecal microbiota composition, including increased abundance and activity of potentially beneficial bacterial taxa in adults who are overweight and obese with elevated fasting blood glucose. A total of 69 adults who were overweight or obese with an elevated plasma glucose (age: 60.8 ± 7.4, BMI ≥27 kg/m2, fasting plasma glucose ≥5.6 to <7.0 mmol/L) were randomized to daily consumption of either 2 servings of almonds (AS:56 g/day) or an isocaloric, high carbohydrate biscuit snack for 8 weeks. AS but not biscuit snack experienced significant changes in microbiota composition (P= .011) and increases in bacterial richness, evenness, and diversity (P< .01). Increases in both the relative and absolute abundance of operational taxonomic units in the Ruminococcaceae family, including Ruminiclostridium (false discovery rate P = .002), Ruminococcaceae NK4A214 (P = .002) and Ruminococcaceae UCG-003 (P = .002) were the principal drivers of microbiota-level changes. No changes in fecal short chain fatty acid levels, or in the carriage of the gene encoding butyryl-CoA:acetate CoA-transferase (an enzyme involved in butyrate synthesis) occurred. Almond consumption was not associated with reduced gut permeability, but fecal pH (P= .0006) and moisture content (P = .027) decreased significantly in AS when compared to BS. Regular almond consumption increased the abundance of potentially beneficial ruminococci in the fecal microbiota in individuals with elevated blood glucose. However, fecal short-chain fatty acid levels remained unaltered and the capacity for such microbiological effects to precipitate host benefit is not known.

Relative Validity and Reproducibility of a Food Frequency Questionnaire for Assessing Dietary Patterns and Food Group Intake in Older New Zealand Adults: The Researching Eating, Activity, and Cognitive Health Study.

BACKGROUND: Dietary pattern analysis considers the overall dietary intake and combinations of foods eaten. Valid and reproducible tools for determining dietary patterns are necessary to assess diet-disease relationships. OBJECTIVE: This study evaluated the relative validity and reproducibility of the Researching Eating, Activity, and Cognitive Health (REACH) Study food frequency questionnaire (FFQ) specifically designed to identify dietary patterns in older adults. DESIGN: A subset of participants from the REACH study completed two identical 109-item FFQs 1 month apart (FFQ1 and FFQ2) to assess reproducibility and a 4-day food record between FFQ administrations to assess relative validity. Foods from each dietary assessment tool were assigned to 57 food groups. Principal component analysis was applied to the food group consumption reported in each dietary assessment tool to derive dietary patterns. PARTICIPANTS AND SETTING: Dietary data were collected (2018 and 2019) from a subset of the REACH study (n = 294, 37% men) aged 65 to 74 years, living in Auckland, New Zealand. MAIN OUTCOME MEASURES: Daily intakes of 57 food groups and dietary patterns of older adults participating in REACH living in New Zealand. STATISTICAL ANALYSIS: Agreement of dietary pattern loadings were assessed using Tucker's congruence coefficient. Agreement of dietary pattern scores and food group intakes were assessed using Spearman correlation coefficients (acceptable correlation rho = 0.20 to 0.49), weighted kappa statistic (acceptable statistic κw = 0.20 to 0.60), and Bland-Altman analysis, including mean difference, limits of agreement, plots, and slope of bias. RESULTS: Three similar dietary patterns were identified from each dietary assessment tool: Mediterranean style, Western, and prudent. Congruence coefficients between factor loadings ranged from 0.54 to 0.80. Correlations of dietary pattern scores ranged from 0.47 to 0.59 (reproducibility) and 0.33 to 0.43 (validity) (all P values < 0.001); weighted kappa scores from 0.40 to 0.48 (reproducibility) and 0.27 to 0.37 (validity); limits of agreement from ± 1.79 to ± 2.09 (reproducibility) and ± 2.09 to ± 2.27 (validity); a negative slope of bias was seen in the prudent pattern for reproducibility and validity (P < 0.001). CONCLUSIONS: The REACH FFQ generated dietary patterns with acceptable reproducibility and relative validity and therefore can be used to examine associations between dietary patterns and health outcomes in older New Zealand adults.

Vitamin D supplementation reduces insulin resistance in South Asian women living in New Zealand who are insulin resistant and vitamin D deficient - a randomised, placebo-controlled trial.

Low serum 25-hydroxyvitamin D (25(OH)D) has been shown to correlate with increased risk of type 2 diabetes. Small, observational studies suggest an action for vitamin D in improving insulin sensitivity and/or insulin secretion. The objective of the present study was to investigate the effect of improved vitamin D status on insulin resistance (IR), utilising randomised, controlled, double-blind intervention administering 100 microg (4000 IU) vitamin D(3) (n 42) or placebo (n 39) daily for 6 months to South Asian women, aged 23-68 years, living in Auckland, New Zealand. Subjects were insulin resistant - homeostasis model assessment 1 (HOMA1)>1.93 and had serum 25(OH)D concentration < 50 nmol/l. Exclusion criteria included diabetes medication and vitamin D supplementation >25 microg (1000 IU)/d. The HOMA2 computer model was used to calculate outcomes. Median (25th, 75th percentiles) serum 25(OH)D(3) increased significantly from 21 (11, 40) to 75 (55, 84) nmol/l with supplementation. Significant improvements were seen in insulin sensitivity and IR (P = 0.003 and 0.02, respectively), and fasting insulin decreased (P = 0.02) with supplementation compared with placebo. There was no change in C-peptide with supplementation. IR was most improved when endpoint serum 25(OH)D reached > or = 80 nmol/l. Secondary outcome variables (lipid profile and high sensitivity C-reactive protein) were not affected by supplementation. In conclusion, improving vitamin D status in insulin resistant women resulted in improved IR and sensitivity, but no change in insulin secretion. Optimal vitamin D concentrations for reducing IR were shown to be 80-119 nmol/l, providing further evidence for an increase in the recommended adequate levels. Registered Trial No. ACTRN12607000642482.