Systemic Lupus Erythematosus and the Ratio of Omega-3 to Omega-6 Fatty Acids Consumption among Women in the Adventist Health Study-2.

OBJECTIVE: To assess the associations of omega-3 and omega-6 fatty acids consumption, and the ratio between the two, with self-reported doctor told Systemic Lupus Erythematosus (SLE) diagnosis. Further, to assess whether initiation of omega-3 supplements intake was related to time/year of SLE diagnosis. METHODS: Data from 42,398 women in the Adventist Health Study-2 cohort were used for this cross-sectional study. Unconditional logistic regression modeling was used for all analyses with the following candidate covariates: age, race, education, smoking, and body mass index (BMI). RESULTS: Compared to non-cases, participants with a diagnosis of SLE reported higher intakes of total omega-3 fatty acids and about the same intakes of omega-6 fatty acids. Overall, they had higher ratios of omega-3 to omega-6 fatty acids. When assessing odds ratios of SLE diagnosis by quartiles of omega-3 to omega-6 and DHA+EPA to omega-6, there was a positive significant trend (p trend = 0.005). Additionally, among those reporting intake of fish oil, 87% had initiated fish oil consumption around the time of SLE diagnosis. SLE was more likely to occur among Black women compared to White women, among ever smokers compared to never smokers, among overweight women compared to women with normal/underweight, and among women 50-59 years compared to those 30-49 year old. When a smaller 6 year follow-up study identified 64 incident SLE cases and assessed their omega-3 intake at baseline (6 years earlier and before the SLE diagnosis) their intake of omega-3 and fish oil was no different than among non-cases. CONCLUSION: We observed a significant positive association between the ratio of omega-3 to omega-6 fatty acids consumption and prevalence of SLE. Among those with prevalent SLE, their year of starting supplementation of omega-3 and fish oil was closely linked to year of SLE diagnosis. Further, baseline intake of omega-3 fatty acids was not increased among 64 incident SLE cases identified during 6 years of follow-up. Our surprising finding can best be explained by reverse causation. This could be an example of how public health information is assimilated and acted upon by a health conscious public.

Effect of Walnut Supplementation on Dietary Polyphenol Intake and Urinary Polyphenol Excretion in the Walnuts and Healthy Aging Study.

Among all tree nuts, walnuts contain the highest total polyphenols by weight. This secondary data analysis examined the effect of daily walnut supplementation on the total dietary polyphenols and subclasses and the urinary excretion of total polyphenols in a free-living elderly population. In this 2-year prospective, randomized intervention trial (ID NCT01634841), the dietary polyphenol intake of participants who added walnuts daily to their diets at 15% of daily energy were compared to those in the control group that consumed a walnut-free diet. Dietary polyphenols and subclasses were estimated from 24 h dietary recalls. Phenolic estimates were derived from Phenol-Explorer database version 3.6. Participants in the walnut group compared to the control group had a higher intake of total polyphenols, flavonoids, flavanols, and phenolic acids in mg/d (IQR): 2480 (1955, 3145) vs. 1897 (1369, 2496); 56 (42,84) vs. 29 (15, 54); 174 (90, 298) vs. 140 (61, 277); and 368 (246, 569) vs. 242 (89, 398), respectively. There was a significant inverse association between dietary flavonoid intake and urine polyphenol excretion; less urinary excretion may imply that some of the polyphenols were eliminated via the gut. Nuts had a significant contribution to the total polyphenols in the diet, suggesting that a single food like walnuts added to habitual diet can increase the polyphenol intake in a Western population.

Are total omega-3 and omega-6 polyunsaturated fatty acids predictors of fatal stroke in the Adventist Health Study 2 prospective cohort?

INTRODUCTION: The effects of omega-3 (n-3) and omega-6 (n-6) polyunsaturated fatty acids (PUFA) on cerebrovascular disease remain unsettled. However, most studies have focused on marine sourced n-3 PUFA rather than total n-3 PUFA, of which the majority in the American diet is plant derived. This study therefore intended to investigate these effects in a cohort for which the vegetarian diet was more prevalent than the general public. METHODS: Cox proportional hazards with fatal stroke as the outcome was performed on the approximately 96,000 subject Adventist Health Study 2 prospective cohort. Stratification by race and sex was performed on models with a priori covariables, comparing 90th to 10th percentile daily intakes of energy-adjusted total n-3 PUFA, total n-6 PUFA, and the n-6 / n-3 PUFA ratio as variables of interest. RESULTS: For the main analytical group (78,335 subjects), the hazard ratio (95% confidence interval) for total n-3 PUFA was 0.65 (0.51-0.83), and for total n-6 PUFA was 1.37 (1.02-1.82), while adjusting for both fatty acids in the model. The n-6 / n-3 PUFA ratio was harmful with a HR of 1.40 (1.16-1.69), whereas the inclusion of total n-3 PUFA slightly attenuated the HR to 1.33(1.02-1.74). Effects were similar for the non-black sex-combined and sex-specific analyses. CONCLUSION: In most analytic groups, subjects with greater total n-3 PUFA intakes have lower risk of fatal stroke, and those with a higher n-6 / n-3 PUFA ratio had higher risk. However, the n-6 / n-3 PUFA ratio remains statistically significant even after adjusting for total n-3 PUFA or total n-6 PUFA, suggesting that the ratio is of epidemiologic interest for cerebrovascular disease research.

Food and Nutrient Displacement by Walnut Supplementation in a Randomized Crossover Study.

The aim of this article is to evaluate the effect of a daily supplement of walnuts on the overall daily diet and nutrient profile of healthy adults. A randomized controlled trial with crossover design was conducted for two 6-month diet periods in southeast Californian communities. Subjects were randomized to receive a control diet or a walnut-supplemented diet, then switched. The walnut supplement represented approximately 12% of their daily energy intake. Trained nutritionists collected seven 24 h dietary recalls from each participant (a total of 14 recalls for both periods). Ninety participants were able to complete the study, including 50 females and 40 males. The average age of the participants was 54.3 years. Diets in the walnut period had significantly higher vegetable protein, total fat, total PUFA, PUFA 18:2, PUFA 22:6, and total dietary fiber (p < 0.05), while also exhibiting significantly lower PUFA 20:5. All mineral levels were higher on the walnut-supplemented diet. Calcium, phosphorus, magnesium, and zinc were, particularly, significantly higher among the walnut-supplemented group (p < 0.05). Displacement occurred in more than one-third of the entire nuts and seeds group; four-fifths of the non-alcoholic beverages and desserts groups; and the majority of the candy, sugar, and sweets group. Walnut supplementation can lead to favorable modifications in nutrient and food intake profiles that may contribute to chronic disease prevention. Nutrient and food displacement may be a mechanism to explain the favourable association between walnut intake and improved diet.

One-year dietary supplementation with walnuts modifies exosomal miRNA in elderly subjects.

PURPOSE: Epidemiological studies and clinical trials support the association of nut consumption with a lower risk of prevalent non-communicable diseases, particularly cardiovascular disease. However, the molecular mechanisms underlying nut benefits remain to be fully described. MicroRNAs (miRNAs) are post-transcriptional regulators of gene expression and play a pivotal role in health and disease. Exosomes are extracellular vesicles released from cells and mediate intercellular communication. Whether nut consumption modulates circulating miRNAs (c-miRNAs) transported in exosomes is poorly described. METHODS: Cognitively healthy elderly subjects were randomized to either control (n = 110, abstaining from walnuts) or daily supplementation with walnuts (15% of their total energy, ≈30-60 g/day, n = 101) for 1-year. C-miRNAs were screened in exosomes isolated from 10 samples, before and after supplementation, and identified c-miRNA candidates were validated in the whole cohort. In addition, nanoparticle tracking analysis and lipidomics were assessed in pooled exosomes from the whole cohort. RESULTS: Exosomal hsa-miR-32-5p and hsa-miR-29b-3p were consistently induced by walnut consumption. No major changes in exosomal lipids, nanoparticle concentration or size were found. CONCLUSION: Our results provide novel evidence that certain c-miRNAs transported in exosomes are modulated by walnut consumption. The extent to which this finding contributes to the benefits of walnuts deserves further research.

Effects of Supplementing the Usual Diet with a Daily Dose of Walnuts for Two Years on Metabolic Syndrome and Its Components in an Elderly Cohort.

Accumulating evidence links nut consumption with an improved risk of metabolic syndrome (MetS); however, long-term trials are lacking. We examined the effects of a daily dose of walnuts for two years on MetS in a large elderly cohort. A total of 698 healthy elderly participants were randomly assigned to either a walnut supplemented or a control diet. The participants in the walnut group were provided with packaged walnuts (1, 1.5, or 2 oz. or ~15% of energy) and asked to incorporate them into their daily habitual diet. The participants in the control group were asked to continue with their habitual diet and abstain from eating walnuts and other tree nuts. Intake of n-3 fatty acid supplements was not permitted in either group. Fasting blood chemistries, blood pressure, and anthropometric measurements were obtained at baseline and at the end of intervention. A total of 625 participants (67% women, mean age 69.1 y) completed this two-year study (90% retention rate). Triglycerides decreased in both walnut (-0.94 mg/dl) and control (-0.96 mg/dl) groups, with no significant between-group differences. There was a non-significant decrease in systolic and diastolic blood pressure in the walnut group (-1.30 and -0.71 mm Hg, respectively) and no change in the control group. Fasting blood glucose decreased by ~1 point in both the walnut and control groups. There were no significant between-group differences in the development or reversion of MetS. In conclusion, supplementing the diet of older adults with a daily dose of walnuts had no effect on MetS status or any of its components, although the walnut group tended to have lower blood pressure.

Effect of Altering Dietary n-6:n-3 Polyunsaturated Fatty Acid Ratio with Plant and Marine-Based Supplement on Biomarkers of Bone Turnover in Healthy Adults.

Although there is accumulating evidence for a protective role of n-3 polyunsaturated fatty acids (n-3 PUFAs) on bone health, there are limited studies that examine the effect of altering dietary n-6:n-3 PUFA ratio with plant and marine sources of n-3 PUFA on bone health. Healthy adults (n = 24) were randomized into an eight-week crossover study with a four-week washout between treatments, with each subject consuming three of four diets. The four diets differed in the dietary n-6:n-3 PUFA ratios and either had an algal oil supplement added or not: (Control diet (10:1); α-linolenic acid (ALA) diet (2:1); Eicosapentaenoic acid/Docosahexaenoic acid (EPA/DHA) diet (10:1 plus supplement (S) containing EPA/DHA; Combination diet (2:1 + S)). The supplement was microalgae oil that provided 1 g EPA + DHA/day. Flaxseed oil and walnuts provided 8.6 g of ALA/day in the 2:1 diets. Serum levels of c-telopeptide (CTX), procollagen Type I N-terminal peptide, and osteocalcin showed significant correlation with age but none of the bone markers or peroxisomal proliferator-activated receptor-γ mRNA expression was significantly different between the diets. Serum CTX was negatively associated with red blood cell membrane linoleic acid and ALA and positively associated with membrane DHA. Neither altering dietary n-6:n-3 PUFA ratio from a 10:1 to a 2:1 ratio nor adding EPA/DHA supplement significantly changed bone turnover in the short term in healthy adults.

Favourable nutrient intake and displacement with long-term walnut supplementation among elderly: results of a randomised trial.

Older adults tend to require fewer energy content and higher levels of nutrients to promote and maintain optimal health. Regrettably, dietary variety and quality are known to decline with advancing age. We conducted a 2-year prospective, randomised, dietary intervention trial where we asked free-living elderly subjects (63-79 years) on self-selected habitual diets to incorporate walnuts daily into their diet (15 % energy). We then compared their nutrient intake with that of a similar group of concurrent participants on self-selected habitual diets but abstaining from walnut consumption (control). No recipes or advice on use of nuts were provided. Dietary intake was assessed by multiple unannounced 24-h telephone dietary recalls. On average, walnut supplement consumption was 43 g/d or 1171·5 kJ (281 kcal). The mean daily energy intake was 954 kJ (228 kcal) higher in the walnut group than in the control group (P<0·001). Compared with control, participants in the walnut group reported significantly higher intake of total protein, vegetable protein, total PUFA and n-3 and n-6 PUFA; and significantly lower intake of total carbohydrate, animal protein, SFA, and Na. An estimated 19 % of total energy and 25 % of total fat from other food sources was displaced. Displacement of MUFA and total PUFA was 21 and 16 %, respectively. Thus adding a daily supplement of walnuts to an ad libitum diet of older adults can induce favourable modifications to the nutrient profile in a way that addresses declining nutrient intake associated with aging.

Prospective study on the effects of regular and decaffeinated coffee on urinary symptoms in young and healthy volunteers.

AIMS: Coffee reduction has been a strategy to prevent urinary symptoms with conflicting evidence. We aimed to study the effects of regular and decaffeinated coffee on urinary symptoms among low and frequent coffee users, who were young and healthy. METHODS: We conducted a double-blinded parallel study on subjects, who were restricted from consuming caffeinated items outside the study. After subjects completed 5 days of caffeine abstinence they consumed regular coffee (450 mg/d caffeine content) or decaffeinated coffee (12 mg/d caffeine content) for 5 days. Previous caffeine use and urinary symptoms were assessed by a diet survey, urogenital distress inventory, and interstitial cystitis problem and symptom indices (ICPI, ICSI). RESULTS: Forty nine subjects completed the study. When assessing the submeasures "frequency" and "urgency" on ICPI and ICSI subjects drinking coffee reported a significant increase in urgency (P < 0.05) and frequency (P < 0.05), whereas subjects drinking decaffeinated coffee experienced no difference in those submeasures in comparison to no caffeine intake. However, previous "low coffee users" experienced the largest increase of urinary symptoms, whereas previous "frequent coffee users" showed fewer symptoms when exposed to regular coffee. CONCLUSIONS: The study suggests that avoiding high-dosage coffee consumption prevents urgency and frequency, which supports recommendations to limit caffeinated beverages. The study differentiates between subjects having a history of low and frequent coffee use. Subjects, who are not used to regular coffee consumption, seem to be more vulnerable to the effects of coffee on urinary symptoms. Better understanding of the effects of coffee on urinary symptoms may improve patients counseling. Neurourol. Neurourol. Urodynam. 36:432-437, 2017. © 2015 Wiley Periodicals, Inc.

Nuts in the prevention and treatment of metabolic syndrome.

Nuts are rich in many bioactive compounds that can exert beneficial effects on cardiovascular health. We reviewed the evidence relating nut consumption and the metabolic syndrome (MetS) and its components. Nuts reduce the postprandial glycemic response; however, long-term trials of nuts on insulin resistance and glycemic control in diabetic individuals are inconsistent. Epidemiologic studies have shown that nuts may lower the risk of diabetes incidence in women. Few studies have assessed the association between nuts and abdominal obesity, although an inverse association with body mass index and general obesity has been observed. Limited evidence suggests that nuts have a protective effect on blood pressure and endothelial function. Nuts have a cholesterol-lowering effect, but the relation between nuts and hypertriglyceridemia and high-density lipoprotein cholesterol is not well established. A recent pooled analysis of clinical trials showed that nuts are inversely related to triglyceride concentrations only in subjects with hypertriglyceridemia. An inverse association was found between the frequency of nut consumption and the prevalence and the incidence of MetS. Several trials evaluated the effect of nuts on subjects with MetS and found that they may have benefits in some components. Compared with a low-fat diet, a Mediterranean diet enriched with nuts could be beneficial for MetS management. The protective effects on metabolism could be explained by the modulation of inflammation and oxidation. Further trials are needed to clarify the role of nuts in MetS prevention and treatment.

Effects of supplementing n-3 fatty acid enriched eggs and walnuts on cardiovascular disease risk markers in healthy free-living lacto-ovo-vegetarians: a randomized, crossover, free-living intervention study.

BACKGROUND: Plant and marine n-3 fatty acids (FA) may favorably modify select markers of cardiovascular disease risk. Whether supplementing the habitual diet of lacto-ovo-vegetarians (LOV) with walnuts (containing α-linolenic acid, ALA) and n-3 FA enriched eggs (containing primarily docosahexaenoic acid, DHA and ALA) would have equivalent effects on CVD risk factors is explored in this study. METHODS: In this study, 20 healthy free-living LOVs following their habitual diet were randomly assigned in a crossover design to receive one of three supplements: n-3 FA enriched egg (6/week), walnuts (28.4 g, 6/week) or a standard egg, 6/week (control) for 8 weeks each with 4-wk washout between treatments. Erythrocyte membrane fatty acids, serum lipids and inflammatory markers were measured at the end of each treatment. RESULTS: Dietary compliance was observed by an expected increase in erythrocyte membrane ALA following the walnut treatment and in DHA following the n-3 FA enriched egg treatment. Walnut treatment lowered serum triacylglycerol, total cholesterol and Apo B (p < 0.05) compared to the standard egg but not the n-3 FA enriched egg treatment. However, walnut treatment significantly reduced total: HDL cholesterol ratio compared to both egg treatments. There were no differences between treatments for any of the inflammatory markers. CONCLUSIONS: For LOV, a direct source of DHA such as n-3 FA enriched eggs seems necessary to increase membrane levels of DHA. However for producing an overall favorable blood lipid profile, daily consumption of a handful of walnuts rich in ALA may be a preferred option for lacto-ovo vegetarian.

Effects of walnut consumption on cognitive performance in young adults.

Walnuts contain a number of potentially neuroprotective compounds like vitamin E, folate, melatonin, several antioxidative polyphenols and significant amounts of n-3 α-linolenic fatty acid. The present study sought to determine the effect of walnuts on verbal and non-verbal reasoning, memory and mood. A total of sixty-four college students were randomly assigned to two treatment sequences in a crossover fashion: walnuts-placebo or placebo-walnuts. Baseline data were collected for non-verbal reasoning, verbal reasoning, memory and mood states. Data were collected again after 8 weeks of intervention. After 6 weeks of washout, the intervention groups followed the diets in reverse order. Data were collected once more at the end of the 8-week intervention period. No significant increases were detected for mood, non-verbal reasoning or memory on the walnut-supplemented diet. However, inferential verbal reasoning increased significantly by 11.2 %, indicating a medium effect size (P = 0.009; d = 0.567). In young, healthy, normal adults, walnuts do not appear to improve memory, mood or non-verbal reasoning abilities. However, walnuts may have the ability to increase inferential reasoning.

Decreasing the linoleic acid to alpha-linolenic acid diet ratio increases eicosapentaenoic acid in erythrocytes in adults.

The n-6/n-3 fatty acid (FA) ratio has increased in the Western-style diet to approximately 10-15:1 during the last century, which may have contributed to the rise in cardiovascular disease (CVD). Prior studies have evaluated the effects on CVD risk factors of manipulating the levels of n-6 and n-3 FA using food and supplements or investigated the metabolic fate of linoleic acid (LNA) and alpha-linolenic acid (ALA) by varying the n-6/n-3 ratios. However, no previous studies have investigated the potential interaction between diet ratios and supplementation with eicosapentaenoic acid (EPA, 20:5n-3) and docosahexaenoic acid (DHA, 22:6n-3). We used a factorial design approach with adults (n = 24) in a controlled feeding trial to compare the accretion of EPA and DHA into red blood cell membranes (RBC) by adding a direct source (algal oil supplement) of EPA and DHA in a diet with a 10:1 versus 2:1 ratio of n-6/n-3 FA. Subjects were randomized into 8-week crossover diet sequences and each subject consumed three of four diets [10:1, 10:1 plus supplement (10:1 + S), 2:1 and 2:1 + S]. LNA and ALA intakes were 9.4 and 7.7%, and 1.0 and 3.0% during the low and high ALA diets, respectively. Compared to the Western-style 10:1 diet, the 2:1 diet increased EPA by 60% (P < 0.0001) in RBC membranes without the direct EPA source and a 34% increase (P = 0.027) was observed with the 10:1 + S diet; however, DHA levels increased in both diet ratios only with a direct DHA source. Shifting towards a 2:1 diet is a valid alternative to taking EPA-containing supplements.

Walnuts and fatty fish influence different serum lipid fractions in normal to mildly hyperlipidemic individuals: a randomized controlled study.

BACKGROUND: Increased consumption of n-3 (omega-3) fatty acids decreases the incidence of coronary heart disease (CHD). OBJECTIVE: The objective was to determine whether walnuts (plant n-3 fatty acid) and fatty fish (marine n-3 fatty acid) have similar effects on serum lipid markers at intakes recommended for primary prevention of CHD. DESIGN: In a randomized crossover feeding trial, 25 normal to mildly hyperlipidemic adults consumed 3 isoenergetic diets ( approximately 30% total fat and <10% saturated fat) for 4 wk each: a control diet (no nuts or fish), a walnut diet (42.5 g walnuts/10.1 mJ), or a fish diet (113 g salmon, twice/wk). Fasting blood was drawn at baseline and at the end of each diet period and analyzed for serum lipids. RESULTS: Serum total cholesterol and LDL cholesterol concentrations in adults who followed the walnut diet (4.87 +/- 0.18 and 2.77 +/- 0.15 mmol/L, respectively) were lower than in those who followed the control diet (5.14 +/- 0.18 and 3.06 +/- 0.15 mmol/L, respectively) and those who followed the fish diet (5.33 +/- 0.18 and 3.2 +/- 0.15 mmol/L, respectively; P < 0.0001). The fish diet resulted in decreased serum triglyceride and increased HDL-cholesterol concentrations (1.0 +/- 0.11 and 1.23 +/- 0.05 mmol/L, respectively) compared with the control diet (1.12 +/- 0.11 and 1.19 +/- 0.05 mmol/L, respectively) and the walnut diet (1.11 +/- 0.11 mmol/L, P < 0.05, and 1.18 +/- 0.05 mmol/L, P < 0.001, respectively). The ratios of total cholesterol:HDL cholesterol, LDL cholesterol:HDL cholesterol, and apolipoprotein B:apolipoprotein A-I were lower (P < 0.05) in those who followed the walnut diet compared with those who followed the control and fish diets. CONCLUSION: Including walnuts and fatty fish in a healthy diet lowered serum cholesterol and triglyceride concentrations, respectively, which affects CHD risk favorably.

Relative validity of a food frequency questionnaire used to assess food intake during a dietary intervention study.

To develop a cost-effective alternative for evaluating dietary intake in large-scale intervention trials of cancer and cardiovascular disease outcomes, we designed and validated a semiquantitative food frequency questionnaire (FFQ). We collected 6 to 8 of the 24-hr dietary recalls from 87 adults (ages 30-72 yr) who were randomly assigned to a walnut-supplemented diet or a control diet in a 6-mo dietary intervention trial. Relative validity of a 171-item FFQ in assessing intake of selected foods and the prescribed intervention (intake > or =25 g/day or intake < 2 g of walnuts) was determined using 24-h dietary recalls as the reference. De-attenuated correlations between FFQ and dietary recalls were .82 for walnuts, .80 for fruits, .79 for grains, .77 for vegetables, .63 for water, .44 for sweets, and .36 for dairy/eggs. High within-person variation did not allow de-attenuation for the remaining foods, but uncorrected correlations were high (> .7) for the beverage variables. The FFQ correctly classified 86 out of 87 subjects in the 2 prescribed intervention groups. The FFQ can provide an accurate measure of a food-based intervention (i.e., walnut supplementation) in a trial setting and can also accurately estimate a number of other food groups consumed during the trial.

Lack of effect of walnuts on serum levels of prostate specific antigen: a brief report.

OBJECTIVE: To examine whether the short-term consumption of walnuts, a food rich in alpha-linolenic acid, affects levels of serum prostate-specific antigen (PSA), a marker of prostate enlargement, inflammation, and cancer. METHODS: Using data from a 12-month randomized crossover study examining the effect of walnut consumption on body composition, we examined whether increased walnut consumption (mean 35 grams daily, 12% total energy) affected serum PSA levels among 40 middle-aged men. RESULTS: There was no significant difference between mean PSA level at the conclusion of the 6-month walnut-supplemented diet (1.05 mug/L, 95% CI [0.81, 1.37]) and the conclusion of the 6-month control diet (1.06 mug/L, 95% CI [0.81, 1.38]) (P = 0.86) (or a mean proportional decrease in PSA of -1%). CONCLUSIONS: Our results suggest that short-term consumption of walnuts is unlikely to affect PSA levels adversely among otherwise normal men.

Validation of a food-frequency questionnaire for measurement of nutrient intake in a dietary intervention study.

OBJECTIVE: To validate a 171-item semi-quantitative food-frequency questionnaire (FFQ) for measurement of nutrient intake in an intervention trial based on walnut supplementation. DESIGN AND SETTING: Free-living adults from Southern California were randomly assigned to either an intervention (walnut-supplemented) or a control diet. The prescribed 6-month intervention was > or = 28 g of walnuts per day for the walnut-supplemented group and > or = 2 g of walnuts per day for the control group. Participants provided at least six 24-hour dietary recalls and completed a self-administered FFQ. SUBJECTS: Eighty-seven adults aged 30-72 years (48 females, 39 males). RESULTS: Our findings from validation (by correlation with six diet recall measures) of the measurement of 32 nutrients by the FFQ are as follows. We found significant positive correlations (corrected for measurement error) between the FFQ and diet recalls for total energy (r = 0.34), total carbohydrate (r = 0.42), vegetable protein (r = 0.43), total fat (r = 0.51), polyunsaturated fat (r = 0.77), total fibre (r = 0.60), linoleic acid (r = 0.78) and alpha-linolenic acid (r = 0.79) - the last nutrient being an excellent nutrient biomarker of the intervention (walnut supplementation). Significant positive correlations were also found for vitamin C (r = 0.96) and certain minerals (r = 0.46-0.80 for calcium, phosphorus, magnesium, iron and potassium). Uncorrected correlations were also high (r>0.40) for retinol, beta-carotene, folate and alcohol. Both diet recalls and FFQ showed a similar significant difference in alpha-linolenic acid content between the walnut-supplemented and control diets. CONCLUSIONS: The FFQ demonstrated good relative validity in the estimation intake of some of the major nutrients in a dietary intervention trial and was a particularly valid estimate of an important nutrient biomarker of walnut supplementation.

Plasma and dietary vitamin C levels and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST).

Vitamin C is an antioxidant and inhibitor of carcinogenic N-nitroso compound production in the stomach. Higher dietary vitamin C consumption is associated with decreased risk of gastric cancer (GC) in numerous case-control studies, but data from prospective studies are limited, particularly so for blood measures of vitamin C. The objective of this study was to determine the association of plasma and dietary vitamin C levels with the risk of GC in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 European countries. Using a fluorometric method, vitamin C was measured in pre-diagnostic plasma from 215 GC cases (matched controls = 416). Conditional logistic regression models adjusted by body mass index, total energy intake, smoking status/duration/intensity and Helicobacter pylori infection status were used to estimate relative cancer risks. No association with GC risk was observed for dietary vitamin C, whereas an inverse GC risk was observed in the highest versus lowest quartile of plasma vitamin C [odds ratio (OR) = 0.55, 95% confidence interval (CI) = 0.31-0.97, P(trend) = 0.043], which was maintained after exclusion of cases with

Does regular walnut consumption lead to weight gain?

Studies consistently show the beneficial effects of eating nuts, but as high-energy foods, their regular consumption may lead to weight gain. We tested if daily consumption of walnuts (approximately 12 % energy intake) for 6 months would modify body weight and body composition in free-living subjects. Ninety participants in a 12-month randomized cross-over trial were instructed to eat an allotted amount of walnuts (28-56 g) during the walnut-supplemented diet and not to eat them during the control diet, with no further instruction. Subjects were unaware that body weight was the main outcome. Dietary compliance was about 95 % and mean daily walnut consumption was 35 g during the walnut-supplemented diet. The walnut-supplemented diet resulted in greater daily energy intake (557 kJ (133 kcal)), which should theoretically have led to a weight gain of 3.1 kg over the 6-month period. For all participants, walnut supplementation increased weight (0.4 (se 0.1) kg), BMI (0.2 (se 0.1) kg/m(2)), fat mass (0.2 (se 0.1) kg) and lean mass (0.2 (se 0.1) kg). But, after adjusting for energy differences between the control and walnut-supplemented diets, no significant differences were observed in body weight or body composition parameters, except for BMI (0.1 (se 0.1) kg/m(2)). The weight gain from incorporating walnuts into the diet (control-->walnut sequence) was less than the weight loss from withdrawing walnuts from the diet (walnut-->control sequence). Our findings show that regular walnut intake resulted in weight gain much lower than expected and which became non-significant after controlling for differences in energy intake.

Long-term almond supplementation without advice on food replacement induces favourable nutrient modifications to the habitual diets of free-living individuals.

Epidemiological and metabolic studies have shown that regular nut consumption may protect against risk of heart disease and diabetes. None has investigated the effect of adding nuts to a self-selected habitual diet (containing little or no nuts) on dietary patterns. The present study evaluated the impact of long-term almond supplementation in healthy men (n 43) and women (n 38) aged 25-70 years on nutrient profile and nutrient displacement. All subjects were followed for 1 year. During the first 6 months, subjects followed their habitual diets; in the second 6 months, subjects added almonds to their diets. Diets were assessed by seven random 24 h telephone diet recalls during each diet period. On average, the almond supplement was 52 g/d (about forty-two nuts) containing 1286 kJ. When subjects changed from their habitual diet to the almond-supplemented diet, the intakes of MUFA, PUFA, fibre, vegetable protein, alpha-tocopherol, Cu and Mg significantly (P<0.05) increased by 42, 24, 12, 19, 66, 15 and 23% respectively; the intakes of trans fatty acids, animal protein, Na, cholesterol and sugars significantly (P<0.05) decreased by 14, 9, 21, 17 and 13% respectively. These spontaneous nutrient changes closely match the dietary recommendations to prevent cardiovascular and other chronic diseases. Displacement estimates for total energy, total protein, total fat, SFA, MUFA, PUFA, total fibre, Ca, Fe, Mg, P, K, Zn and alpha-tocopherol ranged from 16 to 98%; the estimates for total food weight, carbohydrate, sugars and Se were >245%. A daily supplement of almonds can induce favourable nutrient modifications for chronic disease prevention to an individual's habitual diet.