Daily 100% watermelon juice consumption and vascular function among postmenopausal women: A randomized controlled trial.

BACKGROUND AND AIMS: Watermelon juice is a rich food source of cardioprotective compounds such as arginine, citrulline, and lycopene. Preventative interventions are warranted as risk of cardiovascular disease increases among women after menopause, and age alone is an independent risk factor for vascular dysfunction. Thus, this study evaluated the effects of 100% watermelon juice on measures of vascular function. METHODS AND RESULTS: In this randomized, double-blind, placebo-controlled, crossover trial, 21 healthy postmenopausal women were randomized to consume two 360 mL servings of 100% watermelon juice per day or an isocaloric placebo for four weeks. Following a two-week washout period, they consumed the other beverage for an additional four weeks. Before and after each treatment arm, a fasting blood sample was taken for measurement of serum arginine, citrulline, lycopene, glucose, and insulin. Assessments of vascular function included pulse pressure, pulse wave velocity, 24-h ambulatory blood pressure, and flow-mediated dilation. General linear mixed models with intent-to-treat analyses were used to examine the effects of the intervention. Despite a significant treatment effect for circulating lycopene (p = 0.002), no changes in arginine, citrulline, or any vascular measures were observed. Although the juice intervention resulted in a slight but significant increase in fasting serum glucose (p = 0.001), changes in glucose homeostasis were not clinically significant. CONCLUSION: In contrast to findings from previous studies in younger adults and those with pre-existing hypertension, measures of vascular function in this cohort of healthy postmenopausal women were not impacted by supplemental watermelon juice. CLINICALTRIALS. GOV IDENTIFIER: NCT03626168.

Influence of mouth rinse use on the enterosalivary pathway and blood pressure regulation: A systematic review.

The enterosalivary nitrate-nitrite-nitric oxide (NO) pathway results in systemic generation of NO from dietary inorganic nitrate to promote vasodilation and blood pressure regulation. Commensal bacteria in the oral cavity with nitrate-reducing properties underpin the efficiency of this pathway, as they facilitate the reduction of nitrate to nitrite-a critical activation step preceding NO formation. However, common antibacterial mouth rinses rid the oral cavity of these bacteria and, thus, may have local and systemic consequences. The purpose of this systematic review was to investigate the relationship between mouth rinse use and salivary or plasma nitrates/nitrites, as well as blood pressure. A systematic review was conducted utilizing PubMed and EBSCOhost databases to identify publications evaluating mouth rinse use on salivary and/or plasma nitrate/nitrite concentrations and blood pressure. In addition to inclusion of the aforementioned outcome measures, studies must have been published in scholarly, peer-reviewed journals. Data extraction and quality assessment were independently conducted by the Authors with tools created by the Academy of Nutrition and Dietetics. Methods were registered with the International Prospective Register of Systematic Reviews (CRD42019125081). Eight studies were identified for critical appraisal, including 5 human crossover studies and 3 animal studies with controls, published between 2009 and 2016. All human studies and two of the three animal studies revealed deleterious effects of an antibacterial mouth rinse on at least one of the outcome measures. For example, in human studies comparing antibacterial mouth rinses to control, 5 of 5 studies and 3 of 5 studies reported reduced salivary and plasma nitrite concentrations, respectively, and 4 of 5 studies observed increased blood pressure. Likewise, 2 of 3 animal studies reported reduced plasma nitrite compared to control as well as increased blood pressure. Differential effects on outcome measures were noted in mouth rinses of varying strengths and compositions. Results suggest that the utilization of an antibacterial mouth rinse negatively alters concentrations of salivary and plasma nitrate/nitrite with a concomitant rise in blood pressure. Acknowledging the rising prevalence of hypertension, future research is warranted to develop functional mouth rinses that support oral and cardiovascular health, as well as nutrition interventions to optimize the enterosalivary pathway for blood pressure regulation.

Fruits, vegetables, and health: A comprehensive narrative, umbrella review of the science and recommendations for enhanced public policy to improve intake.

Fruit and vegetables (F&V) have been a cornerstone of healthy dietary recommendations; the 2015-2020 U.S. Dietary Guidelines for Americans recommend that F&V constitute one-half of the plate at each meal. F&V include a diverse collection of plant foods that vary in their energy, nutrient, and dietary bioactive contents. F&V have potential health-promoting effects beyond providing basic nutrition needs in humans, including their role in reducing inflammation and their potential preventive effects on various chronic disease states leading to decreases in years lost due to premature mortality and years lived with disability/morbidity. Current global intakes of F&V are well below recommendations. Given the importance of F&V for health, public policies that promote dietary interventions to help increase F&V intake are warranted. This externally commissioned expert comprehensive narrative, umbrella review summarizes up-to-date clinical and observational evidence on current intakes of F&V, discusses the available evidence on the potential health benefits of F&V, and offers implementation strategies to help ensure that public health messaging is reflective of current science. This review demonstrates that F&V provide benefits beyond helping to achieve basic nutrient requirements in humans. The scientific evidence for providing public health recommendations to increase F&V consumption for prevention of disease is strong. Current evidence suggests that F&V have the strongest effects in relation to prevention of CVDs, noting a nonlinear threshold effect of 800 g per day (i.e., about 5 servings a day). A growing body of clinical evidence (mostly small RCTs) demonstrates effects of specific F&V on certain chronic disease states; however, more research on the role of individual F&V for specific disease prevention strategies is still needed in many areas. Data from the systematic reviews and mostly observational studies cited in this report also support intake of certain types of F&V, particularly cruciferous vegetables, dark-green leafy vegetables, citrus fruits, and dark-colored berries, which have superior effects on biomarkers, surrogate endpoints, and outcomes of chronic disease.

Homemade infant formula recipes may contain harmful ingredients: a quantitative content analysis of blogs.

OBJECTIVE: When breast-feeding is not possible, commercially made human milk substitute is recommended. Some consumers would prefer to make their own homemade infant formula (HIF) and may seek information on this practice from internet sources. The purpose of the current study was to investigate the content of blogs posting HIF recipes. DESIGN: Blog postings were identified through a comprehensive search conducted using the Google search engine and the following search terms along with the term 'blog': 'Make Your Own Baby Formula', 'Homemade Baby Formula', 'Do It Yourself (DIY) Baby Formula', 'DIY Baby Formula', 'Baby Formula Recipe' and 'All Natural Baby Formula'. A quantitative content analysis of blogs offering recipes for HIF was completed. Blogs that met the inclusion criteria were reviewed for disclaimers, blogger's credentials, rationale for HIF use, advertisement or sale of recipe ingredients and recipe ingredients. SETTING: Worldwide Web. RESULTS: Fifty-nine blogs, featuring one hundred forty-four recipes, met inclusion criteria. Among reviewed blogs, 33·9 % did not provide a disclaimer stating breast milk is the preferred option, 25·4 % recommended consulting a healthcare professional before using, and 76·3 % and 20·3 % either advertised or sold ingredients or recipe kits, respectively. Credentials of bloggers varied and only seven bloggers identified themselves as 'nutritionists'. The three most frequently mentioned recipe ingredients were whole raw cow's milk (24·3 %), raw goat's milk (23·6 %) and liver (14·5 %). CONCLUSIONS: Clinicians should be aware of this trend, discuss source of formula with parents, advocate for appropriate infant feeding practices and monitor for side effects.

Anti-Apoptotic Effects of Carotenoids in Neurodegeneration.

Apoptosis, programmed cell death type I, is a critical part of neurodegeneration in cerebral ischemia, Parkinson's, and Alzheimer's disease. Apoptosis begins with activation of pro-death proteins Bax and Bak, release of cytochrome c and activation of caspases, loss of membrane integrity of intracellular organelles, and ultimately cell death. Approaches that block apoptotic pathways may prevent or delay neurodegenerative processes. Carotenoids are a group of pigments found in fruits, vegetables, and seaweeds that possess antioxidant properties. Over the last several decades, an increasing number of studies have demonstrated a protective role of carotenoids in neurodegenerative disease. In this review, we describe functions of commonly consumed carotenoids including lycopene, ß-carotene, lutein, astaxanthin, and fucoxanthin and their roles in neurodegenerative disease models. We also discuss the underlying cellular mechanisms of carotenoid-mediated neuroprotection, including their antioxidant properties, role as signaling molecules, and as gene regulators that alleviate apoptosis-associated brain cell death.

Dietary Quality Assessed by the HEI-2010 and Biomarkers of Cardiometabolic Disease: An Exploratory Analysis.

Objectives: This study explores relationships between cardiometabolic measures of antioxidant capacity or inflammation and diet quality assessed by the Healthy Eating Index (HEI)-2010 which measures conformity to Dietary Guidelines for Americans. This cross-sectional study was an ancillary analysis of baseline data for a randomized controlled trial with older adults at risk for cardiometabolic disease (ClinicalTrials.gov #NCT00955903). Methods: Community-dwelling older adults (n = 133, 49% male, 70.4 ± 4.8 years) with a body mass index of 30-40 kg/m2 provided a fasted blood sample for measurement of antioxidant capacity, high-sensitivity C-reactive protein, tumor necrosis factor-alpha, and interleukin-6. Dietary data were generated from the mean of three 24-hour recalls. Results: After adjustment for potential confounders, HEI-2010 composite scores were not significantly associated with decreased inflammation or greater antioxidant capacity. In analysis of the 12 components composing the HEI-2010, significant positive association was observed between total dairy and total serum antioxidant capacity (0.043; 95% CI, 0.008-0.069). Significant associations observed in inflammatory markers were between total vegetable and tumor necrosis factor-alpha (-0.078; 95% CI, -0.151 to -0.005), sodium and interleukin-6 (0.091; 95% CI, 0.023-0.158), and scores for combined calories from solid fats, alcoholic beverages, and added sugars and interleukin-6 (0.139; 95% CI, 0.027-0.252). In models adjusting for HEI-2010 composite score when significant associations were observed between component scores and biomarkers, two of six associations were strengthened by adding the composite score as a potential confounder. Conclusions: Largely null findings along with those inconsistent with scientific expectations suggest caution in extrapolating adherence to the HEI-2010 with an individual's inflammatory or antioxidant status. Results merit additional investigation with other biomarkers of chronic disease and emphasis on dietary patterns given potential synergy within food combinations.

Alpha-Tocotrienol Prevents Oxidative Stress-Mediated Post-Translational Cleavage of Bcl-xL in Primary Hippocampal Neurons.

B-cell lymphoma-extra large (Bcl-xL) is an anti-apoptotic member of the Bcl2 family of proteins, which supports neurite outgrowth and neurotransmission by improving mitochondrial function. During excitotoxic stimulation, however, Bcl-xL undergoes post-translational cleavage to ∆N-Bcl-xL, and accumulation of ∆N-Bcl-xL causes mitochondrial dysfunction and neuronal death. In this study, we hypothesized that the generation of reactive oxygen species (ROS) during excitotoxicity leads to formation of ∆N-Bcl-xL. We further proposed that the application of an antioxidant with neuroprotective properties such as α-tocotrienol (TCT) will prevent ∆N-Bcl-xL-induced mitochondrial dysfunction via its antioxidant properties. Primary hippocampal neurons were treated with α-TCT, glutamate, or a combination of both. Glutamate challenge significantly increased cytosolic and mitochondrial ROS and ∆N-Bcl-xL levels. ∆N-Bcl-xL accumulation was accompanied by intracellular ATP depletion, loss of mitochondrial membrane potential, and cell death. α-TCT prevented loss of mitochondrial membrane potential in hippocampal neurons overexpressing ∆N-Bcl-xL, suggesting that ∆N-Bcl-xL caused the loss of mitochondrial function under excitotoxic conditions. Our data suggest that production of ROS is an important cause of ∆N-Bcl-xL formation and that preventing ROS production may be an effective strategy to prevent ∆N-Bcl-xL-mediated mitochondrial dysfunction and thus promote neuronal survival.

The Drug Burden Index Is Associated With Measures of Cognitive Function Among Older Adults in the Health, Aging, and Body Composition Study.

BACKGROUND: Anticholinergic and sedative medications affect cognition among older adults. The Drug Burden Index (DBI) is a validated measure of exposure to these medications, with higher DBI scores indicating higher drug burden. This ancillary analysis investigated the association between DBI and cognition assessed by the Modified Mini-Mental State Examination (3MS) and the Digit Symbol Substitution Test (DSST). METHODS: The Health, Aging, and Body Composition Study was a prospective study of community-dwelling adults aged 70-79 years at enrollment. Using data from years 1, 5, and 10, DBI was calculated using medication data per participant. Linear mixed modeling was used to assess cross-sectional and longitudinal effects of DBI on 3MS and DSST. Adjusted models included biological sex, race, education level, APOE status, and death. Sensitivity analyses included testing the strength of the associations for each year and testing attrition due to death as a possible confounding factor via Cox-Proportional Hazard models. RESULTS: After adjustment, DBI was inversely associated with 3MS and DSST scores. These associations became stronger in each subsequent year. Neither DBI at year 1 nor within-person change in DBI were predictive of longitudinal declines in either cognitive measure. Sensitivity analyses indicated that DBI, 3MS, and DSST were associated with a greater risk of attrition due to death. CONCLUSIONS: Results suggest that in years when older adults had a higher DBI scores, they had significantly lower global cognition and slower processing speed. These findings further substantiate the DBI as a useful pharmacological tool for assessing the effect of medication exposure.

Functional sugar-free chewing gum infused with spices bolsters antioxidant capacity and phenolic content of saliva.

Oral and vascular diseases are seemingly disparate conditions, yet individuals with poor oral health are at increased risk for cardiovascular events. Spice-derived bioactive polyphenols with antioxidant functionality may attenuate mechanisms linking the diseases, namely oxidative stress and inflammation. Acknowledging that novel approaches to increase antioxidant intake are warranted, the purpose of this study was to evaluate the influence of two functional sugar-free gums infused with spices on antioxidant capacity and phenolic content of saliva using the oxygen radical absorbance capacity and Folin-Ciocalteu assays, respectively. Unstimulated followed by stimulated saliva was collected according to a validated method across a prescribed five minute chewing period. Both gums significantly increased hydrophilic, lipophilic, and total antioxidant capacity of saliva (p < 0.05) yet to varying extents. Phenolic content of saliva was significantly higher (p < 0.001) post-chew for both gums. Results suggest spices infused into sugar-free chewing gum bolster the antioxidant capacity of saliva, thereby promoting oral health. Research evaluating the sublingual absorption of spice-derived antioxidants in functional gums and their influence on systemic oxidative stress is warranted.

Application of Umami Tastants for Sodium Reduction in Food: An Evidence Analysis Center Scoping Review.

BACKGROUND: Sodium chloride intake far exceeds the guidelines from health and regulatory agencies. Acknowledging the positive relationship between sodium intake and blood pressure, interest in substances that assist in sodium reduction, while contributing a savory taste such as umami, are highly investigated. OBJECTIVE: The objective of this scoping review was to identify and characterize studies investigating umami tastants on sodium reduction in food, with the goal of informing future research. METHODS: A literature search was conducted in Ovid MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews, EBSCO PsycInfo, PROSPERO, National Institutes of Health RePORTER, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform and completed in March 2022 to identify peer-reviewed publications among adults (18 years and older) with interventions focusing on umami tastants to reduce sodium content. RESULTS: The literature search identified 52 studies, among which monosodium glutamate was the most studied umami tastant or food. Furthermore, most of the research on umami was represented through cross-sectional sensory studies to determine acceptability of foods with part of the original sodium chloride replaced with umami tastants. Only 1 study investigated the use of an umami tastant on overall daily sodium intake. CONCLUSIONS: To assist individuals in adhering to sodium reduction intake goals set forth by regulatory agencies and their guiding policies, these findings indicated that additional research on umami tastants, including systematic reviews and prospective trials, is warranted. In these prospective studies, both intermediate outcomes (ie, dietary pattern changes, daily dietary intake of sodium, and blood pressure) and hard outcomes (ie, incidence of hypertension or stroke, as well as cardiovascular composite outcomes) should be considered.

Relationship between Non-Energy-Adjusted and Energy-Adjusted Dietary Inflammatory Index and the Healthy Eating Index-2015: an analysis of the National Health and Nutrition Examination Survey (NHANES) 2015-2018.

OBJECTIVES: Acknowledging the association between diet and systemic inflammation, the Dietary Inflammatory Index (DII®) and the Energy-Adjusted DII (E-DIITM) were developed to categorize diet from anti- to pro-inflammatory. The purpose of this study was to evaluate differences in the relationship between DII and E-DII against the Healthy Eating Index (HEI) to assess the use of energy-adjustment when analyzing the inflammatory potential of the diet. METHODS: This cross-sectional secondary data analysis included 5289 adults participating in the National Health and Nutrition Examination Survey (NHANES) between 2015 and 2018. DII and E-DII scores were calculated and grouped into quartiles. Multivariable linear regression was used to evaluate the association between HEI with DII and E-DII separately, adjusting for age, gender, race/ethnicity, education, family-to-poverty ratio and body mass index. Bootstrap methods were used to estimate the difference between coefficients for E-DII and DII from their respective models. RESULTS: Results suggest that HEI scores were significantly lower between quartile 2 and quartile 1 of DII scores (Q2 vs. Q1: ß(SE) = -7.45(0.54), p < 0.05) and quartile 3 and quartile 4 against quartile 1 of E-DII scores (Q3 vs. Q1: ß(SE) = -16.56(0.65), p < 0.05 and Q4 vs. Q1: ß(SE) = -24.93(0.87), p < 0.05) in unadjusted models. Similar results were observed in adjusted models (HEI and DII Q3 vs. Q1: ß(SE) = -10.68(0.82), p = 0.049; HEI and E-DII Q2 vs. Q1: ß(SE) = -9.14(0.64) and Q3 vs. Q1: ß(SE) = -15.76(0.44) and Q4 vs. Q1: ß(SE) = -23.77(0.58), p < 0.05). Further, 52% of the variance in HEI scores was explained by the E-DII in both adjusted and unadjusted models (R2 = 0.52). In contrast, 17% of the variance in HEI score is explained by the DII in the unadjusted model (R2 = 0.17), yet this increased to 26% of the variance in the adjusted model (R2 = 0.26). The difference between HEI scores for the first versus the fourth quartile of DII scores (-15.64) was significantly larger than the difference between HEI scores for the first versus the fourth quartile of E-DII scores (-25.90; bootstrap estimated 95% CI: 53.41-62.41). CONCLUSIONS: Use of an inflammatory index along with the HEI may provide further understanding into relationships between dietary quality by nutrient and food group consumption on the inflammatory potential of the diet.

Significant inverse associations exist between HEI and both DII® and E-DII^TM scores among a sample of American adults using NHANES 2015­2018 data.HEI scores were the highest in the first E-DII quartile compared to the first DII quartile.Use of an inflammatory index along with the HEI provides further understanding of the associations between diet quality as described by nutrient content and consumption of specific food groups on inflammation and inflammatory-related chronic diseases.

Changes in adiponectin:leptin ratio among older adults with obesity following a 12-month exercise and diet intervention.

BACKGROUND: Excess adiposity is characterized by alterations in adipokine secretion such that circulating leptin concentrations are increased with reductions in adiponectin. An emerging biomarker for the assessment of this adipose tissue (AT) dysfunction is the adiponectin:leptin (AL) ratio. A low AL ratio may be suggestive of dysfunctional AT and, consequently, a heightened cardiometabolic disease risk. This ancillary study investigated the relationship between the AL ratio and cardiometabolic health among community-dwelling older adults with obesity, as well as the effects of a 12-month exercise and diet intervention on changes in the AL ratio. METHODS: Participants (n = 163, 70.2 ± 4.7 years, 38.0% male) were randomized to the exercise only group, exercise + nutrient-dense weight maintenance group (exercise + weight maintenance), or exercise + nutrient-dense caloric restriction of 500 kcal/d group (exercise + intentional weight loss) (clinicaltrials.gov #NCT00955903). Total and regional adiposity as determined by magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry (DXA), anthropometrics, and cardiometabolic biomarkers were assessed at baseline and 12 months. RESULTS: The AL ratio was significantly (p < 0.05) inversely correlated with body mass index, waist circumference, measures of adiposity, and insulin among all participants at baseline. Among females only, significant positive and inverse correlations were also observed between this ratio and high-density lipoprotein cholesterol and the inflammatory biomarkers high sensitivity C-reactive protein and interleukin-6, respectively. While controlling for biological sex, a significant time by intervention group interaction effect (p < 0.05) was observed such that the AL ratio significantly increased from baseline to study completion among participants in the exercise + weight maintenance group and exercise + intentional weight loss group. Post hoc analysis revealed that the exercise + intentional weight loss group exhibited a significantly greater AL ratio at study completion compared to other groups (p < 0.05 all). CONCLUSIONS: Results are in support of the AL ratio as a measure of AT dysfunction among older adults. Furthermore, results suggest that a 12-month exercise and diet intervention with intentional weight loss assists in improving the AL ratio in this population.

Direct Yet Opposite Effects of Stress-related and Mindful Eating on Diet Quality.

OBJECTIVE: Examine the relationships among dietary quality, mindful eating, and constructs of the Transactional Model of Stress and Coping. METHODS: In this cross-sectional study, women (n = 67) aged 25-50 years, with a body mass index of 25-40 kg/m2 completed 3 days of 24-hour recalls and a survey that included the Perceived Stress Scale, Eating and Appraisal Due to Emotions and Stress Questionnaire, and the Mindful Eating Questionnaire. Structural equation modeling assessed relationships among all constructs with the dependent variable, the Healthy Eating Index-2015. RESULTS: Mindful Eating Questionnaire (ß = 0.60, P = 0.001) and Emotion and Stress-related Eating scores from Eating and Appraisal Due to Emotions and Stress Questionnaire (ß = -0.69, P < 0.001) (r2 = 0.50) were directly associated with Healthy Eating Index-2015, but no indirect effects were identified. CONCLUSIONS AND IMPLICATIONS: Overall dietary quality is associated with greater mindful eating but more emotion and stress-related eating scores among women who were overweight or obese. Future studies could assess model constructs using other diet quality scores and including additional coping mechanisms such as substance use, physical activity, and meditation.

Relative fat mass assessment estimates changes in adiposity among female older adults with obesity after a 12-month exercise and diet intervention.

BACKGROUND/OBJECTIVES/INTRODUCTION: It is imperative to accurately estimate whole body fat percentage (%fat) to understand the deleterious nature of excess adiposity on cardiometabolic disease risk. Cost and accessibility often preclude the use of advanced imaging methods like dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI). Relative fat mass (RFM) is an emerging estimator of whole body %fat based on waist circumference, height, and biological sex. The purpose of this ancillary study was to examine the relationship between RFM and gold-standard measures of adiposity among community-dwelling older adults with obesity and to evaluate if changes in RFM reflect changes in %fat following a 12-month lifestyle intervention (clinicaltrials.gov #NCT00955903). PATIENTS/MATERIALS AND METHODS: Participants (N = 163, 37.4% male, 70.3 ± 4.7 years) were randomized to the exercise only group, exercise + nutrient-dense weight maintenance group, or exercise + nutrient-dense energy restriction of 500 kcal/d group. Total and regional adiposity assessed by DXA and MRI, as well as anthropometrics, were evaluated at baseline and 12 months. RESULTS: RFM was significantly positively correlated with DXA whole body %fat and DXA trunk %fat at baseline. Equivalence testing revealed that RFM was considered equivalent to DXA whole body %fat for females only. Additionally, from baseline to 12 months, a significant reduction in RFM was observed among female participants in the exercise + energy restriction group only. Changes in RFM were significantly correlated with changes in DXA whole body %fat, DXA trunk fat, and total abdominal fat tissue determined by MRI. CONCLUSION: Results support the use of RFM as an estimate of whole body %fat where advanced imaging techniques are not feasible. Furthermore, results suggest that this index is sensitive to changes in fat mass over 12 months in female older adults with obesity. KEY MESSAGESRelative fat mass (RFM), an emerging estimator of whole body %fat based on waist circumference, height, and biological sex, was intentionally developed to be a simple estimate of adiposity that overcomes limitations of measures like body mass index.In the current study, results from correlations and agreement analyses support the use of RFM to estimate whole-body fat percentage in a community-dwelling older adult population with obesity when advanced methods, namely dual-energy X-ray absorptiometry, are not feasible.Significant reductions in RFM were also observed over a 12-month period that was significantly correlated with changes in whole body fat percentage; thus, supporting the sensitivity of RFM to lifestyle changes.

Flavan-3-ols and Cardiometabolic Health: First Ever Dietary Bioactive Guideline.

Guideline recommendation for a plant bioactive such as flavan-3-ols is a departure from previous recommendations because it is not based on deficiencies but rather improvement in health outcomes. Nevertheless, there is a rapidly growing body of clinical data reflecting benefits of flavan-3-ol intake that outweigh potential harms. Thus, the objective of the Expert Panel was to develop an intake recommendation for flavan-3-ols and cardiometabolic outcomes to inform multiple stakeholders including clinicians, policymakers, public health entities, and consumers. Guideline development followed the process set forth by the Academy of Nutrition and Dietetics, which includes use of the Evidence to Decision Framework. Studies informing this guideline (157 randomized controlled trials and 15 cohort studies) were previously reviewed in a recently published systematic review and meta-analysis. Quality and strength-of-evidence along with risk-of-bias in reporting was reviewed. In drafting the guideline, data assessments and opinions by authoritative scientific bodies providing guidance on the safety of flavan-3-ols were considered. Moderate evidence supporting cardiometabolic protection resulting from flavan-3-ol intake in the range of 400-600 mg/d was supported in the literature. Further, increasing consumption of dietary flavan-3-ols can help improve blood pressure, cholesterol concentrations, and blood sugar. Strength of evidence was strongest for some biomarkers (i.e., systolic blood pressure, total cholesterol, HDL cholesterol, and insulin/glucose dynamics). It should be noted that this is a food-based guideline and not a recommendation for flavan-3-ol supplements. This guideline was based on beneficial effects observed across a range of disease biomarkers and endpoints. Although a comprehensive assessment of available data has been reviewed, evidence gaps identified herein can inform scientists in guiding future randomized clinical trials.

Alpha-tocotrienol enhances arborization of primary hippocampal neurons via upregulation of Bcl-xL.

Alpha-tocotrienol (α-TCT) is a member of the vitamin E family. It has been reported to protect the brain against various pathologies including cerebral ischemia and neurodegeneration. However, it is still unclear if α-TCT exhibits beneficial effects during brain development. We hypothesized that treatment with α-TCT improves intracellular redox homeostasis supporting normal development of neurons. We found that primary hippocampal neurons isolated from rat feti grown in α-TCT-containing media achieved greater levels of neurite complexity compared to ethanol-treated control neurons. Neurons were treated with 1 µM α-TCT for 3 weeks, and media were replaced with fresh α-TCT every week. Treatment with α-TCT increased α-TCT levels (26 pmol/mg protein) in the cells, whereas the control neurons did not contain α-TCT. α-TCT-treated neurons produced adenosine triphosphate (ATP) at a higher rate and increased ATP retention at neurites, supporting formation of neurite branches. Although treatment with α-TCT alone did not change neuronal viability, neurons grown in α-TCT were more resistant to death at maturity. We further found that messenger RNA and protein levels of B-cell lymphoma-extra large (Bcl-xL) are increased by α-TCT treatment without inducing posttranslational cleavage of Bcl-xL. Bcl-xL is known to enhance mitochondrial energy production, which improves neuronal function including neurite outgrowth and neurotransmission. Therefore α-TCT-mediated Bcl-xL upregulation may be the central mechanism of neuroprotection seen in the α-TCT-treated group. In summary, treatment with α-TCT upregulates Bcl-xL and increases ATP levels at neurites. This correlates with increased neurite branching during development and with protection of mature neurons against oxidative stress.

Changes in Cardiometabolic Risk Among Older Adults with Obesity: An Ancillary Analysis of a Randomized Controlled Trial Investigating Exercise Plus Weight Maintenance and Exercise Plus Intentional Weight Loss by Caloric Restriction.

BACKGROUND: Obesity imposes risk to cardiometabolic health; however, intentional weight loss among older adults with obesity remains controversial. OBJECTIVE: To explore the influence of exercise plus weight maintenance and exercise plus intentional weight loss by caloric restriction on changes in cardiometabolic risk among older adults with obesity assessed by four risk-scoring tools. DESIGN: Using longitudinal data from the Calorie Restriction and Changes in Body Composition, Disease, Function, and Quality of Life in Older Adults study (CROSSROADS) (ClinicalTrials.gov identifier: NCT00955903; May 2009 to October 2014), scores were calculated using baseline and 12-month data according to criteria from the International Diabetes Federation, National Cholesterol Education Program's Adult Treatment Panel, Framingham Risk Score, and Cardiometabolic Disease Staging. PARTICIPANTS AND SETTING: Participants (39% men, 23% African American, aged 70.2 ± 4.7 years) were randomized to exercise (n = 48), exercise plus nutrient-dense weight maintenance diet (n = 44), or exercise plus weight loss by moderate caloric restriction (n = 42). MAIN OUTCOME MEASURES: To evaluate effects of exercise plus weight maintenance and exercise plus intentional weight loss on changes in cardiometabolic risk. STATISTICAL ANALYSES PERFORMED: Generalized estimating equations were used to assess changes in risk with ethnicity, biological sex, and age as covariates. RESULTS: Group-time interaction was only significant for Framingham and Cardiometabolic Disease Staging (P = 0.005 and 0.041, respectively). Upon post hoc analysis, significant within-group improvements in Framingham scores were observed for exercise plus weight maintenance (P < 0.001; r = -1.682) and exercise plus weight loss (P = 0.020; r = -0.881). In analysis of between-group differences in Framingham scores, significant decreases were observed in the exercise plus weight maintenance group (P = 0.001; r = -1.723) compared with the exercise group. For Cardiometabolic Disease Staging, the exercise plus weight loss group had significant within-group improvements (P = 0.023; r = -0.102). For between-group differences in Cardiometabolic Disease Staging, the exercise plus weight loss group showed significant risk reduction (P = 0.012; r = -0.142) compared with the exercise group. CONCLUSIONS: Among risk scores evaluated, Framingham and Cardiometabolic Disease Staging showed significantly greater sensitivity to change in cardiometabolic risk. Older adults with obesity can significantly lower cardiometabolic risk through exercise plus weight maintenance or exercise plus weight loss by moderate caloric restriction.

Systemic and Adipose Tissue Redox Status in Sprague-Dawley Rats Fed Normal- and High-Fat Diets Supplemented with Lycopene.

Dietary patterns high in fat influence local and systemic oxidative stress through adipose tissue (AT) accrual and increased reactive oxygen species generation. Lycopene, a carotenoid with antioxidant functionality, may mitigate excess oxidative stress, yet the lipophilic nature of this compound may limit its functionality if sequestered by AT. Thus, it is critical to elucidate whether lycopene's efficacy is limited based on adiposity. The purpose of this study was to investigate the influence of lycopene-supplemented normal- and high-fat diets on systemic and AT redox status. Male Sprague-Dawley rats (n = 18) were fed a 30% normal-fat (NFD) or 60% high-fat (HFD) purified diet supplemented with 100 mg of lycopene/day. Body weight and visceral AT mass, as well as serum and AT lycopene, lipid peroxides, and antioxidant capacity (AC), were assessed after 3, 7, and 10 weeks of supplementation. At week 10, AT mass was significantly higher (P = .028) in the HFD group, yet there were no significant differences in serum or AT lycopene concentrations or lipid peroxides between groups. Additionally, AT in the HFD group exhibited significantly greater lipophilic AC (27.6% higher, P = .031). Results suggest that excess adiposity did not negatively influence circulating lycopene, nor did it limit its antioxidant functionality.

100% Watermelon Juice as a Food-First Intervention to Improve Cognitive Function: Ancillary Findings from a Randomized Controlled Trial.

Lycopene exhibits neuroprotective properties due to its antioxidant and anti-inflammatory functionality. As watermelon is a rich source of lycopene, pasteurized watermelon juice provides lycopene in its most bioavailable form. This study examined relationships between circulating lycopene, cognitive performance, and biomarkers of oxidative stress and inflammation in response to pasteurized 100% watermelon juice supplementation. A placebo-controlled, randomized, double-blind, crossover trial was conducted with postmenopausal women (n = 16, 60 + 4.1 years). Participants consumed two 360 mL servings of pasteurized 100% watermelon juice or a placebo beverage for 4 weeks. Fasting blood samples were collected, and cognitive tests were administered to assess various neurocognitive domains. Statistical analyses included mixed models and Spearman correlations. Serum lycopene exhibited a significant treatment effect (p = 0.002) with a mean increase of 81%. However, this increase was not associated with changes in oxidative stress, inflammation, or cognitive function. Additional research is warranted to determine dose-durational effects for promoting cognition.

Vitamin A Status and Deposition in Neonatal and Weanling Rats Reared by Mothers Consuming Normal and High-Fat Diets with Adequate or Supplemented Vitamin A.

The circulating level of vitamin A (VA; retinol) was reported to be lower in obese adults. It is unknown if maternal obesity influences the VA status of offspring. The objective of the study was to determine the VA status and deposition of neonatal and weanling rats reared by mothers consuming a normal or high-fat diet (NFD or HFD) with or without supplemented VA. Pregnant Sprague-Dawley rats were randomized to an NFD or HFD with 2.6 mg/kg VA. Upon delivery, half of the rat mothers in the NFD or HFD cohort were switched to an NFD or HFD with supplemented VA at 129 mg/kg (NFD+VA and HFD+VA group). The other half remained on their original diet (NFD and HFD group). At postnatal day 14 (P14), P25, and P35, pups (n = 4 or 3/group/time) were euthanized. The total retinol concentration in the serum, liver, visceral white adipose tissue (WAT), and brown adipose tissue (BAT) was measured. At P14, the HFD+VA group showed a significantly lower serum VA than the NFD+VA group. At P25, both the VA concentration and total mass in the liver, WAT, and BAT were significantly higher in the HFD+VA than the NFD+VA group. At P35, the HFD group exhibited a significantly higher VA concentration and mass in the liver and BAT compared with the NFD group. In conclusion, maternal HFD consumption resulted in more VA accumulation in storage organs in neonatal and/or weanling rats, which potentially compromised the availability of VA in circulation, especially under the VA-supplemented condition.