Diet Changes and Underlying Motives in Cancer Patients.

With rising cancer incidence rates and numbers of long-term cancer survivors, diet increasingly comes into view of patients as well as healthcare providers. The aim was to analyze cancer patients' concepts of nutrition, changes in diet and reasons for these changes. This study is a cross-sectional single-center study. Data was collected 12/2017 - 01/2019 using a questionnaire. The study was set at an outpatient department at a German university hospital. 102 patients (male n = 47, female n = 54; age 34 to 86 years [mean = 62.3]) with cancer were included in the study. Statistical calculation was performed with Mann-Whitney-U-Test and Wilcoxon-signed-rank. p < 0.05 was considered significant. Patients were more concerned with diet after their diagnosis than before (p < 0.01). Seventy-one (70%) patients reported that they changed their diet or planned to do so. Some changes included an increased intake of vegetables or fruits. Patients who changed their diet more often were convinced that there was a positive influence of diet on the course of cancer (p < 0.05). Diet is an important topic for many cancer patients. Some patients seem to have a lack of information regarding the effect of diet on health. Physicians and dietitians should provide more education on healthy and safe diets for cancer patients.

Molecular effects of the consumption of margarine and butter varying in trans fat composition: a parallel human intervention study.

BACKGROUND: Whereas the dietary intake of industrial trans fatty acids (iTFA) has been specifically associated with inflammation, cardiovascular disease, and type 2 diabetes, understanding the impact of dietary fats on human health remains challenging owing to their complex composition and individual effects of their lipid components on metabolism. The aim of this study is to profile the composition of blood, measured by the fatty acid (FAs) profile and untargeted metabolome of serum and the transcriptome of blood cells, in order to identify molecular signatures that discriminate dietary fat intakes. METHODS: In a parallel study, the molecular effects of consuming dairy fat containing ruminant TFA (rTFA) or margarine containing iTFA were investigated. Healthy volunteers (n = 42; 45-69 y) were randomly assigned to diets containing margarine without TFA as major source of fat (wTFA control group with 0.4 g TFA per 100 g margarine), margarine with iTFA (iTFA group with 4.1 g TFA per 100 g margarine), or butter with rTFA (rTFA group with 6.3 g TFA per 100 g butter) for 4 weeks. The amounts of test products were individually selected so that fat intake contributed to 30-33% of energy requirements and TFA in the rTFA and iTFA groups contributed to up to 2% of energy intake. Changes in fasting blood values of lipid profiles (GC with flame-ionization detection), metabolome profiles (LC-MS, GC-MS), and gene expression (microarray) were measured. RESULTS: Eighteen FAs, as well as 242 additional features measured by LC-MS (185) and GC-MS (54) showed significantly different responses to the diets (PFDR-adjusted < 0.05), mainly distinguishing butter from the margarine diets while gene expression was not differentially affected. The most abundant TFA in the butter, i.e. TFA containing (E)-octadec-11-enoic acid (C18:1 t11; trans vaccenic acid), and margarines, i.e. TFA containing (E)-octadec-9-enoic acid (C18:1 t9; elaidic acid) were reflected in the significantly different serum levels of TFAs measured after the dietary interventions. CONCLUSIONS: The untargeted serum metabolome differentiates margarine from butter intake although the identification of the discriminating features remains a bottleneck. The targeted serum FA profile provides detailed information on specific molecules differentiating not only butter from margarine intake but also diets with different content of iTFAs in margarine. TRIAL REGISTRATION: ClinicalTrials.gov NCT00933322.

Dynamic dot displays reveal material motion network in the human brain.

There is growing research interest in the neural mechanisms underlying the recognition of material categories and properties. This research field, however, is relatively more recent and limited compared to investigations of the neural mechanisms underlying object and scene category recognition. Motion is particularly important for the perception of non-rigid materials, but the neural basis of non-rigid material motion remains unexplored. Using fMRI, we investigated which brain regions respond preferentially to material motion versus other types of motion. We introduce a new database of stimuli - dynamic dot materials - that are animations of moving dots that induce vivid percepts of various materials in motion, e.g. flapping cloth, liquid waves, wobbling jelly. Control stimuli were scrambled versions of these same animations and rigid three-dimensional rotating dots. Results showed that isolating material motion properties with dynamic dots (in contrast with other kinds of motion) activates a network of cortical regions in both ventral and dorsal visual pathways, including areas normally associated with the processing of surface properties and shape, and extending to somatosensory and premotor cortices. We suggest that such a widespread preference for material motion is due to strong associations between stimulus properties. For example viewing dots moving in a specific pattern not only elicits percepts of material motion; one perceives a flexible, non-rigid shape, identifies the object as a cloth flapping in the wind, infers the object's weight under gravity, and anticipates how it would feel to reach out and touch the material. These results are a first important step in mapping out the cortical architecture and dynamics in material-related motion processing.

Expectations affect the perception of material properties.

Many objects that we encounter have typical material qualities: spoons are hard, pillows are soft, and Jell-O dessert is wobbly. Over a lifetime of experiences, strong associations between an object and its typical material properties may be formed, and these associations not only include how glossy, rough, or pink an object is, but also how it behaves under force: we expect knocked over vases to shatter, popped bike tires to deflate, and gooey grilled cheese to hang between two slices of bread when pulled apart. Here we ask how such rich visual priors affect the visual perception of material qualities and present a particularly striking example of expectation violation. In a cue conflict design, we pair computer-rendered familiar objects with surprising material behaviors (a linen curtain shattering, a porcelain teacup wrinkling, etc.) and find that material qualities are not solely estimated from the object's kinematics (i.e., its physical [atypical] motion while shattering, wrinkling, wobbling etc.); rather, material appearance is sometimes "pulled" toward the "native" motion, shape, and optical properties that are associated with this object. Our results, in addition to patterns we find in response time data, suggest that visual priors about materials can set up high-level expectations about complex future states of an object and show how these priors modulate material appearance.

Shatter and splatter: The contribution of mechanical and optical properties to the perception of soft and hard breaking materials.

Research on the visual perception of materials has mostly focused on the surface qualities of rigid objects. The perception of substance like materials is less explored. Here, we investigated the contribution of, and interaction between, surface optics and mechanical properties to the perception of nonrigid, breaking materials. We created novel animations of materials ranging from soft to hard bodies that broke apart differently when dropped. In Experiment 1, animations were rendered as point-light movies varying in dot density, as well as "full-cue" optical versions ranging from translucent glossy to opaque matte under a natural illumination field. Observers used a scale to rate each substance on different attributes. In Experiment 2 we investigated how much shape contributed to ratings of the full-cue stimuli in Experiment 1, by comparing ratings when observers were shown movies versus one frame of the animation. The results showed that optical and mechanical properties had an interactive effect on ratings of several material attributes. We also found that motion and static cues each provided a lot of information about the material qualities; however, when combined, they influenced observers' ratings interactively. For example, in some conditions, motion dominated over optical information; in other conditions, it enhanced the effect of optics. Our results suggest that rating multiple attributes is an effective way to measure underlying perceptual differences between nonrigid breaking materials, and this study is the first to our knowledge to show interactions between optical and mechanical properties in a task involving judgments of perceptual qualities.

Perceptual dimensions underlying lightness perception in homogeneous center-surround displays.

Lightness judgments of targets embedded in a homogeneous surround exhibit abrupt steps in perceived lightness at points at which the targets transition from being increments to decrements. This "crispening effect" and the general difficulty of matching low-contrast targets embedded in homogeneous surrounds suggest that a second perceptual dimension in addition to lightness may contribute to the appearance of test patches in these displays. The present study explicitly tested whether two dimensions (lightness and transmittance) could lead to more satisfactory matches than lightness alone in an asymmetric matching task. We also examined whether transmittance matches were more strongly associated with task instructions that had observers match perceived transparency or the perceived edge contrast of the target relative to the surround. We found that matching target lightness in a homogeneous display to that in a textured or rocky display required varying both lightness and transmittance of the test patch on the textured display to obtain the most satisfactory matches. However, observers primarily varied transmittance when instructed to match the perceived contrast of targets against homogeneous surrounds, but not when instructed to match the amount of transparency perceived in the displays. The results suggest that perceived target-surround edge contrast differs between homogeneous and textured displays. Varying the midlevel property of transparency in textured displays provides a natural means for equating both target lightness and the unique appearance of the edge contrast in homogeneous displays.

Inflammatory and metabolic responses to high-fat meals with and without dairy products in men.

Postprandial inflammation is an important factor for human health since chronic low-grade inflammation is associated with chronic diseases. Dairy products have a weak but significant anti-inflammatory effect on postprandial inflammation. The objective of the present study was to compare the effect of a high-fat dairy meal (HFD meal), a high-fat non-dairy meal supplemented with milk (HFM meal) and a high-fat non-dairy control meal (HFC meal) on postprandial inflammatory and metabolic responses in healthy men. A cross-over study was conducted in nineteen male subjects. Blood samples were collected before and 1, 2, 4 and 6 h after consumption of the test meals. Plasma concentrations of insulin, glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol, TAG and C-reactive protein (CRP) were measured at each time point. IL-6, TNF-α and endotoxin concentrations were assessed at baseline and endpoint (6 h). Time-dependent curves of these metabolic parameters were plotted, and the net incremental AUC were found to be significantly higher for TAG and lower for CRP after consumption of the HFM meal compared with the HFD meal; however, the HFM and HFD meals were not different from the HFC meal. Alterations in IL-6, TNF-α and endotoxin concentrations were not significantly different between the test meals. The results suggest that full-fat milk and dairy products (cheese and butter) have no significant impact on the inflammatory response to a high-fat meal.

Health Risks Associated with Meat Consumption: A Review of Epidemiological Studies.

Recent evidence from large prospective US and European cohort studies and from meta-analyses of epidemiological studies indicates that the long-term consumption of increasing amounts of red meat and particularly of processed meat is associated with an increased risk of total mortality, cardiovascular disease, colorectal cancer and type 2 diabetes, in both men and women. The association persists after inclusion of known confounding factors, such as age, race, BMI, history, smoking, blood pressure, lipids, physical activity and multiple nutritional parameters in multivariate analysis. The association has not always been noted with red meat, and it has been absent with white meat. There is evidence of several mechanisms for the observed adverse effects that might be involved, however, their individual role is not defined at present. It is concluded that recommendations for the consumption of unprocessed red meat and particularly of processed red meat should be more restrictive than existing recommendations. Restrictive recommendations should not be applied to subjects above about 70 years of age, as the studies quoted herein did not examine this age group, and the inclusion of sufficient protein supply (e. g. in the form of meat) is particularly important in the elderly.

Short communication: dairy consumption among middle-aged and elderly adults in Switzerland.

Different studies have shown that people are aware of the benefits of dairy products, but a sizeable part of the world's population still does not consume the recommended amount of dairy produce. The aims of the present research were to determine which dairy products are consumed by the middle-aged and elderly (50-81yr old) living in Switzerland and to explore why some of this population segment are actually reducing their consumption of dairy products. On average, older Swiss adults consumed 2.6 portions of dairy products per day, which is slightly less than the recommended 3 to 4 portions a day. Additionally, about one-quarter of the respondents indicated that they have reduced their milk or dairy consumption. The main reasons given for this decision were to reduce fat or cholesterol. A reported difficulty in digesting some dairy products may be a further reason for limiting dairy intake, particularly cheese. It follows that a need for the propagation of appropriate nutritional information about dairy products to the middle-aged and elderly exists.

Do surface reflectance properties and 3-D mesostructure influence the perception of lightness?

A series of experiments were conducted to assess how the reflectance properties and the complexity of surface "mesostructure" (small-scale 3-D relief) influence perceived lightness. Experiment 1 evaluated the role of surface relief and gloss on perceived lightness. For surfaces with visible mesostructure, lightness constancy was better for targets embedded in glossy than matte surfaces. The results for surfaces that lacked surface relief were qualitatively different than the 3-D surrounds, exhibiting abrupt steps in perceived lightness at points at which the targets transition from being increments to decrements. Experiments 2 and 4 compared the matte and glossy 3-D surrounds to two control displays, which matched either pixel histograms or a phase-scrambled power spectrum, respectively. Although some improved lightness constancy was observed for the 3-D gloss display over the histogram-matched display, this benefit was not observed for phase-scrambled variants of these images with equated power spectrums. These results suggest that the improved lightness constancy observed with 3-D surfaces can be well explained by the distribution of contrast across space and scale, independently of explicit information about surface shading or specularity whereas the putatively "simpler" flat displays may evoke more complex midlevel representations similar to that evoked in conditions of transparency.

Material category of visual objects computed from specular image structure.

Recognizing materials and their properties visually is vital for successful interactions with our environment, from avoiding slippery floors to handling fragile objects. Yet there is no simple mapping of retinal image intensities to physical properties. Here, we investigated what image information drives material perception by collecting human psychophysical judgements about complex glossy objects. Variations in specular image structure-produced either by manipulating reflectance properties or visual features directly-caused categorical shifts in material appearance, suggesting that specular reflections provide diagnostic information about a wide range of material classes. Perceived material category appeared to mediate cues for surface gloss, providing evidence against a purely feedforward view of neural processing. Our results suggest that the image structure that triggers our perception of surface gloss plays a direct role in visual categorization, and that the perception and neural processing of stimulus properties should be studied in the context of recognition, not in isolation.

The role of meat fat in the human diet.

Food fat plays an important role in the human diet. On the one hand, fats provide the body with energy, contribute to the absorption of fat-soluble vitamins, and act as structural elements of cell walls. On the other hand, a high fat intake is associated with obesity, type 2 diabetes, cancer, and coronary heart disease. Animal fats, which contain a high proportion of saturated fatty acids, are often the focus of attention when it comes to reducing the share of fat in the diet. The present overview of the literature describes the amount of total fat and the percentage of individual fatty acid groups in meat and meat products, documents the contribution of meat and meat products to fat intake, and investigates the connection between meat fat and various diseases. The information given is based mainly on data material from Switzerland; data from other countries have been included for comparison.

GutSelf: Interindividual Variability in the Processing of Dietary Compounds by the Human Gastrointestinal Tract.

Nutritional research is currently entering the field of personalized nutrition, to a large extent driven by major technological breakthroughs in analytical sciences and biocomputing. An efficient launching of the personalized approach depends on the ability of researchers to comprehensively monitor and characterize interindividual variability in the activity of the human gastrointestinal tract. This information is currently not available in such a form. This review therefore aims at identifying and discussing published data, providing evidence on interindividual variability in the processing of the major nutrients, i.e., protein, fat, carbohydrates, vitamins, and minerals, along the gastrointestinal tract, including oral processing, intestinal digestion, and absorption. Although interindividual variability is not a primary endpoint of most studies identified, a significant number of publications provides a wealth of information on this topic for each category of nutrients. This knowledge remains fragmented, however, and understanding the clinical relevance of most of the interindividual responses to food ingestion described in this review remains unclear. In that regard, this review has identified a gap and sets the base for future research addressing the issue of the interindividual variability in the response of the human organism to the ingestion of foods.

Effect of dietary alpine butter rich in conjugated linoleic acid on milk fat composition of lactating sows.

Multiparous sows (n 17) were included in a controlled cross-over-study in order to investigate the influence of a natural source of conjugated linoleic acid (CLA) (alpine butter) on the milk fatty acid composition of lactating sows (as an animal model for lactating women) and on the growth performance of their progeny. The usual fat source of a standard lactation diet was replaced by either CLA-rich alpine butter or margarine (control diet). Compared with the margarine diet, feeding the alpine butter-supplemented diet increased (P 0.05) affected. Growth performance of the progeny was similar for both dietary treatments. In summary, the findings show that adding alpine butter to the diet does not provoke a milk fat depression and does not alter the composition of total SFA, MUFA and PUFA in sow milk but increases its CLA concentration.

Fermented Food and Non-Communicable Chronic Diseases: A Review.

Fermented foods represent a significant fraction of human diets. Although their impact on health is positively perceived, an objective evaluation is still missing. We have, therefore, reviewed meta-analyses of randomized controlled trials (RCT) investigating the relationship between fermented foods and non-transmissible chronic diseases. Overall, after summarizing 25 prospective studies on dairy products, the association of fermented dairy with cancer was found to be neutral, whereas it was weakly beneficial, though inconsistent, for specific aspects of cardio-metabolic health, in particular stroke and cheese intake. The strongest evidence for a beneficial effect was for yoghurt on risk factors of type 2 diabetes. Although mechanisms explaining this association have not been validated, an increased bioavailability of insulinotropic amino acids and peptides as well as the bacterial biosynthesis of vitamins, in particular vitamin K2, might contribute to this beneficial effect. However, the heterogeneity in the design of the studies and the investigated foods impedes a definitive assessment of these associations. The literature on fermented plants is characterized by a wealth of in vitro data, whose positive results are not corroborated in humans due to the absence of RCTs. Finally, none of the RCTs were specifically designed to address the impact of food fermentation on health. This question should be addressed in future human studies.

A German national prevalence study on the cost of intensive care: an evaluation from 51 intensive care units.

INTRODUCTION: Intensive care unit (ICU) costs account for up to 20% of a hospital's costs. We aimed to analyse the individual patient-related cost of intensive care at various hospital levels and for different groups of disease. METHODS: Data from 51 ICUs all over Germany (15 primary care hospitals and 14 general care hospitals, 10 maximal care hospitals and 12 focused care hospitals) were collected in an observational, cross-sectional, one-day point prevalence study by two external study physicians (January-October 2003). All ICU patients (length of stay > 24 hours) treated on the study day were included. The reason for admission, severity of illness, surgical/diagnostic procedures, resource consumption, ICU/hospital length of stay, outcome and ICU staffing structure were documented. RESULTS: Altogether 453 patients were included. ICU (hospital) mortality was 12.1% (15.7%). The reason for admission and the severity of illness differed between the hospital levels of care, with a higher amount of unscheduled surgical procedures and patients needing mechanical ventilation in maximal care hospital and focused care hospital facilities. The mean total costs per day were euro 791 +/- 305 (primary care hospitals, euro 685 +/- 234; general care hospitals, euro 672 +/- 199; focused care hospitals, euro 816 +/- 363; maximal care hospitals, euro 923 +/- 306), with the highest cost in septic patients (euro 1,090 +/- 422). Differences were associated with staffing, the amount of prescribed drugs/blood products and diagnostic procedures. CONCLUSION: The reason for admission, the severity of illness and the occurrence of severe sepsis are directly related to the level of ICU cost. A high fraction of costs result from staffing (up to 62%). Specialized and maximum care hospitals treat a higher proportion of the more severely ill and most expensive patients.

Factors predicting meat and meat products consumption among middle-aged and elderly people: evidence from a consumer survey in Switzerland.

Background: An adequate diet contributes to health and wellbeing in older age. This is nowadays more important than ever since in industrialised countries the elderly population is growing continually. However, information regarding the consumption behaviour of older persons in Switzerland is limited. Objective: The objective of this investigation was to explore how middle-aged and elderly Swiss view animal products in relation to diet and health, and what factors predict consumption frequency. Design: A representative consumer survey among 632 people over the age of 50 years, living in the German-, French- and Italian-speaking regions of Switzerland was conducted. Results: This paper presents the results related to meat and meat products consumption. Most participants consumed meat and meat products regularly. The majority of participants with low meat intake indicated that eating small amounts would be enough. Respondents judged fresh meat (except pork) to be healthier than meat products, and poultry to be the healthiest meat. Overall meat consumption frequency was predicted by language region, gender, household size, and BMI. Furthermore, participants' opinion about healthiness, taste and safety of meat but not their adherence to the Swiss food pyramid was found to be correlated to the consumption frequency of individual types of meat. Conclusion: Several factors have an impact on consumption frequency of meat and meat products in the middle-aged and elderly Swiss population and the importance varies according to the individual types of meat and meat products. The results show that the traditional food pyramid is not one of these factors for which reason new tools must be explored to support elderly people in regard to a healthy dietary behaviour.

Short-term effects of trans fatty acids from ruminant and industrial sources on surrogate markers of cardiovascular risk in healthy men and women: A randomized, controlled, double-blind trial.

Objective The aim of this study was to determine short-term effects of trans fatty acid (TFA) intake from ruminant and industrial sources on surrogate markers of cardiovascular risk in the context of a balanced diet with 30-36% of daily energy from fat. Design Prospective, randomized, double-blind, parallel-design study. Methods In this study, 142 healthy volunteers aged 45 to 69 years were randomly allocated to three different diets: either a diet enriched with 2% of daily energy intake from ruminant TFA (rTFA) or with industrial TFA (iTFA), or a diet without TFA (wTFA), for a duration of four weeks. The primary outcome parameter was endothelial function measured by brachial artery flow mediated dilation (FMD). Secondary outcome parameters included biomarkers for inflammation, coagulation and endothelial function and lipid profiles. One hundred and twenty-nine participants completed the study. Results Neither alpine butter with TFA from ruminant source nor margarine with industrially produced TFA showed significant effects on brachial artery FMD (FMD% differences: rTFA vs. iTFA 0.04 (95% confidence interval 0.91 to 0.98), rTFA vs. wTFA -0.98 (-2.00 to 0.04) and iTFA vs. wTFA -1.04 (-2.38 to 0.30). With rTFA, there was a small but significant increase of total cholesterol: rTFA over wTFA 1.04 (1.00 to 1.07 mmol/l) and LDL-cholesterol: rTFA over wTFA 1.08 (1.03 to 1.14 mmol/l) without concomitant increase of biomarkers for inflammation or coagulation. Conclusions Short-term intake of TFA at 2% of total daily energy intake from neither ruminant nor industrially produced sources does not have any negative impact on brachial artery FMD, inflammation and coagulation markers in healthy subjects.

Nutrition behavior of the middle-aged and elderly: Compliance with dietary recommendations of the food pyramid.

BACKGROUND & AIMS: During the aging process, human physiology changes noticeably, mostly to the disadvantage of the individual. A healthy lifestyle that includes sufficient physical activity as well as a balanced and diverse diet contributes to healthy aging. One key factor that elderly people need to be aware of is compliance with nutritional recommendations. There is very little data concerning eating patterns, consumption behavior, and compliance with food guides (food pyramid) and nutritional recommendations among the Swiss, particularly for the middle-aged and elderly. The objective of this study was to gather new and representative information about these issues, concentrating on people aged 50+ and living in Switzerland. METHODS: A questionnaire in online and written form was distributed to a representative sample of middle-aged and elderly people living in Switzerland. RESULTS: In total, 632 people returned the survey. Of those respondents, 71% knew the Swiss Food Pyramid but only 38% said they comply with it. Based on self-reports, only a few participants met the recommendations for the different food groups listed in the food pyramid, whether in the pyramid-comply or pyramid-non-comply group. CONCLUSION: The survey shows that the middle-aged and elderly living in Switzerland need more nutritional guidance to help them to meet dietary recommendations. As usage and understanding of food guides seem limited among this population group, new tools must be explored for transfer of recommendations to real applications.

Hospital resources consumed for surgical morbidity: effects of preoperative arginine and omega-3 fatty acid supplementation on costs.

OBJECTIVE: Costs related to postoperative complications continue to be a major burden on any health care system. The aim of the present study was to calculate hospital costs for postoperative complications and to evaluate whether preoperative supplementation with omega-3 fatty acids and arginine (specialized diet) might lead to cost savings in patient care. METHODS: Blind analysis of costs performed on data gathered from a randomized clinical trial carried out on 305 patients with gastrointestinal cancer showed that an oral preoperative specialized diet decreased postoperative morbidity compared with conventional treatment (no supplementation). Estimates of complication costs were based on resources used for treatment and on additional length of hospital stay. Cost-comparison and cost-effectiveness analyses were then carried out. RESULTS: The mean cost of postoperative complications was 4492 pounds sterlings. The greatest amount of resources was consumed by 19 anastomotic leaks (159,803 pounds sterlings), 18 abdominal abscesses (112,921 pounds sterlings), and 18 pancreatic fistulae (106,516 pounds sterlings). The mean costs per complication were 6178 pounds sterlings in the conventional group and 4639 pounds sterlings in the preoperative group (P = 0.05). The mean total costs of patients with complications were 10,494 pounds sterlings in the conventional group and 8793 pounds sterlings in the preoperative group. The mean cost per randomized patient was 3122 pounds sterlings in the conventional group versus 1872 pounds sterlings in the preoperative group (P = 0.04). Effectiveness values were 50.0% in the conventional group and 62.8% in the preoperative group (P = 0.03). Total costs consumed 93% of the diagnosis-related group reimbursement rate in the conventional group and 78% in the preoperative group. CONCLUSIONS: The costs of postoperative morbidity consumed a large amount of the diagnosis-related group reimbursement rate. Preoperative supplementation with the specialized diet appears to be a cost-effective treatment.