East-Greenland traditional nutrition: a reanalysis of the Høygaard et al. nutritional data (1936-1937).

Greenlandic traditional nutrition was unique in the arctic environment. The aim of the present study was to reanalyse the Høygaard et al. data, focusing on two micronutrients object of discussion, i.e. Ca and vitamin C. Høygaard et al. left Copenhagen in August 1936 and stayed in East-Greenland until August 1937. The members of the expedition recorded nutritional intake whilst residing in families. However, the nutritional intake was analysed on a household level. In total, thirty-five adults and fourty-one children participated. Median total energy expenditure in kcal per d was estimated at 2978 and 2627 for male and female adults, respectively, and 1997 for children and adolescents. Median (IQR) energy consumption in kcal per d was 3881 (1568) for male and 2910 (882) for female adults. This was 2442 (857) and 2023 (1122) for male and female children and adolescents. Median (IQR) Ca intake in mg.d-1 was 555 (1110) for male and 484 (883) for female adults. This was 458 (747) and 358 (838) for male and female children and adolescents. Median (IQR) vitamin C intake in mg.d-1 was 79 (77) for male and 59 (56) for female adults. This was 44 (47) and 60 (52) for male and female children and adolescents. In this study, the importance of traditional foods in reaching an acceptable energy balance was emphasised, together with the confirmation of a low Ca intake in East-Greenland traditional dietary pattern, and the important role of algae consumption in Inuit traditional dietary pattern to avoid scurvy.

Plant-based dietary patterns in Flemish adults: a 10-year trend analysis.

PURPOSE: Although the beneficial health effects of plant-based dietary patterns are evident, it is not clear if population-wide dietary patterns are shifting in a more plant-based direction. This study evaluated trends in dietary patterns among Flemish adults over a 10-year period. Furthermore, differences in socio-demographic characteristics between different dietary pattern groups were explored. METHODS: A time series design, during which five different representative cohorts (2011, 2013, 2016, 2018 and 2020; N = 4859) were surveyed through an online questionnaire, was used to evaluate trends in dietary patterns over the past decade. RESULTS: Findings show that the vast majority of participants were omnivorous as measured at the different time points. The proportion of flexitarians increased over time, while the opposite was true for omnivores. The proportion of vegetarians and vegans, on the other hand, remained stable. Eating more plant-based diet was associated with female sex, younger age, higher education and living in urban areas. CONCLUSIONS: In contrast to the stricter plant-based dietary patterns, a modest shift from the omnivorous towards the flexitarian dietary pattern was observed over the past decennium in the Flemish adult population. Campaigns might benefit from targeting older and lower educated male living in rural areas.

Efforts needed for preventing breast and colorectal cancer through changes in dietary patterns.

BACKGROUND: Prospective cohort studies on diet and cancer report risk associations as hazard ratios. But hazard ratios do not inform on the number of people who need to alter their dietary behaviours for preventing cancer. The objective of this study is to estimate the number of people that need to alter their diet for preventing one additional case of female breast or colorectal cancer. METHODS: Based on the largest prospective studies done in the USA and in Europe, we computed the number of subjects who need to alter their diet. RESULTS: For preventing one case of breast cancer, European women should increase their fruit consumption by 100 g/day during 33 000 person-years, and US women by 60 g/day during 10 600 person-years. For vegetables, European women should increase their consumption by 160 g/day during 26 900 person-years and US women by 100 g/day during 19 000 person-years. For preventing one case of colorectal cancer, European subjects should decrease their red meat consumption by 20 g/day during 26 100 person-years, and US subjects by 30 g/day during 8170 person-years. For processed meat, European subjects should decrease their consumption by 20 g/day during 17 400 person-years, and US subjects by 10 g/day during 7940 person-years. CONCLUSIONS: Large number of subjects would need to alter their intake of fruits, vegetables, red and processed meat during many years in order to prevent one additional breast or colorectal cancer.

Low 10-year reproducibility of glycaemic index and glycaemic load in a prospective cohort study.

When relating glycaemic index (GI) and glycaemic load (GL) to health outcomes, many prospective cohort studies assess the nutritional exposure only once in time, that is, at the start of the study, presuming a stability in nutritional consumption during the course of the study. The aim of this study is to investigate the reproducibility of GI and GL. This is a prospective cohort study in which 562 middle-aged Belgian adults noted all foods and drinks consumed during 3 d in 2002 and 2012. GI and GL were calculated after reference tables. The Pearson correlation coefficients between 2002 and 2012 were 0·27 for GI and 0·41 for GL. For GI, 33 % of the participants remained in the same quintile between 2002 and 2012, whereas 31 % moved to a non-adjacent quintile. For GL, this was 34 and 28 %, respectively. The lowest and the highest quintiles of GI were the most stable, with 40 and 44 % of the participants staying in the same quintile. This was only 22 % for the fourth quintile. The same tendency was present for GL - that is, the most extreme quintiles were the most stable. This study shows 10-year correlation coefficients for GI and GL below 0·50. Multiple nutritional assessments and limiting the analysis to the extreme quintiles of GI and GL will limit a possible misclassification in the prospective cohort studies owing to the low reproducibility.

The effect of a portion size intervention on French fries consumption, plate waste, satiety and compensatory caloric intake: an on-campus restaurant experiment.

BACKGROUND: One of the driving factors of dietary overconsumption throughout the last decennia is the increase of food portion sizes. Larger portions induce higher daily energy intake, so reducing portion size may reduce intake of excess calories. However, real-life studies about the effects of portion size reduction are lacking. Therefore, this study examined the effect of a French fries portion size reduction on French fries consumption, French fries plate waste, satiety and caloric intake during the subsequent afternoon among university students and employees in a Belgian on-campus restaurant setting. Moreover, this study evaluated consumers' perception about the portion size reduction. METHODS: The study took place over a two-time (i.e. baseline and intervention week) 4-day period (Tuesday-Friday) in the on-campus restaurant where ±1200 meals are served every day. French fries' portions were reduced by 20% by replacing the usual porcelain bowl served during the baseline week (±200 g) with smaller volume paper bags during the intervention week (±159 g) in a pre-post real-life experiment. French fries consumption and plate waste were measured in 2056 consumers at baseline and 2175 consumers at intervention. Additionally, interviews were conducted directly after lunch and again between 4 and 6 p.m. on the same day to assess satiety and caloric intake at pre and post in a small subsample of both French fries consumers (n = 19) and non-French fries consumers (n = 14). Post-intervention, the same subsample was interviewed about their perception of the portion size reduction (n = 28). RESULTS: Total French fries intake decreased by 9.1%, and total plate waste decreased by 66.4%. No differences were found in satiety or caloric intake between baseline and intervention week among the French fries' consumers. The majority (n = 24, 86%) of French fries consumers noticed the reduction in portion size during the intervention. Although most participants (n = 19, 68%) perceived the reduced portion size as sufficient, only a minority of participants (n = 9, 32%) indicated post-intervention that they would agree with a permanent implementation. CONCLUSIONS: Reducing portion size may lead to reduced caloric intake, without changing perceived levels of satiety.

Vegetarianism and meat consumption: A comparison of attitudes and beliefs between vegetarian, semi-vegetarian, and omnivorous subjects in Belgium.

High levels of meat consumption in Belgium may be contributing to increased risk of non-communicable diseases in this population. The objective of this study is to investigate the attitudes and beliefs about vegetarianism and meat consumption among the Belgian population, ultimately to better understand the motivations underlying these dietary behaviours. This cross-sectional study was initiated in March 2011. A total of 2436 individuals from a representative consumer panel from the Flemish and Brussels communities participated. The study sample was evenly distributed by education level and sex (1238 men and 1198 women). An online questionnaire with multiple-choice questions about vegetarianism and meat consumption was completed by all participants. Although representative of the prevalence of vegetarians in the population, the number of vegetarians in the study was low (n = 38); the number of semi-vegetarians (n = 288) and omnivores was high (n = 2031). Vegetarians were more likely than semi-vegetarians to agree that meat production is bad for the environment and that meat consumption is unhealthy. Important reasons for not being vegetarian included lack of interest and awareness, taste, and limited cooking skills. Encouragingly, health and discovering new tastes were seen as the most important motives for considering eating a more vegetarian-based diet. The results of this study highlight the motivations that can be used for encouraging the general public to reduce their meat consumption in favour of a plant-rich diet, and will help to inform more targeted health campaigns for reducing meat consumption in Belgium.

Relation between Breast Cancer and High Glycemic Index or Glycemic Load: A Meta-analysis of Prospective Cohort Studies.

Breast cancer is the commonest form of cancer in women worldwide. It has been suggested that chronic hyperinsulinemia associated with insulin resistance plays a role in breast cancer etiology. To test the hyperinsulinemia hypothesis, a dietary pattern associated with a high glycemic index and glycemic load, both proxies for chronic hyperinsulinemia, should be associated with an increased risk of breast cancer. A meta-analysis restricted to prospective cohort studies was undertaken using a random effects model with tests for statistical significance, publication bias and heterogeneity. The metric for analysis was the risk of breast cancer in the highest relative to the lowest glycemic index and glycemic load dietary pattern. A dietary pattern with a high glycemic index was associated with a summary relative risk (SRR) of 1.05 (95% CI: 1.00, 1.11), and a high glycemic load with a SRR of 1.06 (95% CI: 1.00, 1.13). Adjustments for body mass index [BMI], physical activity and other lifestyle factors did not influence the SRR, nor did menopausal status and estrogen receptor status of the tumor. In conclusion, the current evidence supports a modest association between a dietary pattern with high glycemic index or glycemic load and the risk of breast cancer.

Daily milk consumption and all-cause mortality, coronary heart disease and stroke: a systematic review and meta-analysis of observational cohort studies.

BACKGROUND: Observational studies and meta-analyses relating milk consumption by adults to all-cause mortality, coronary heart disease and stroke have obtained contradictory results. Some studies found a protective effect of milk consumption, whilst other found an increased risk. METHODS: We performed a systematic literature search until June 2015 on prospective studies that looked at milk consumption, all-cause mortality, coronary heart disease and stroke. Random-effect meta-analyses were performed with dose-response. RESULTS: Twenty-one studies involving 19 cohorts were included in this meta-analysis, 11 on all-cause mortality, 9 on coronary heart disease, and 10 on stroke. Milk intake ranged from 0 to 850 mL/d. The summary relative risk (SRR) for 200 mL/d milk consumption was 1.01 (95% CI: 0.96-1.06) for all-cause mortality, 1.01 (95% CI: 0.98-1.05) for fatal and non fatal coronary heart disease, and 0.91 (95% CI: 0.82-1.02) for fatal and non fatal stroke. Stratified analyses by age, Body Mass Index, total energy intake and physical acitivity did not alter the SRR estimates. The possibility of publication bias was found for all cause mortality and for stroke, indicating a gap in data that could have suggested a higher risk of these conditions with increased milk consumption. CONCLUSIONS: We found no evidence for a decreased or increased risk of all-cause mortality, coronary heart disease, and stroke associated with adult milk consumption. However, the possibility cannot be dismissed that risks associated with milk consumption could be underestimated because of publication bias.

Relation between dietary pattern analysis (principal component analysis) and body mass index: a 5-year follow-up study in a Belgian military population.

INTRODUCTION: Increasing body mass index (BMI) has been related to many chronic diseases. Knowledge of nutritional determinants of BMI increase may be important to detect persons at risk. METHODS: A longitudinal prospective study design was used in 805 Belgian soldiers. Daily nutrition was recorded with a validated food-frequency questionnaire. Weight and height were recorded from medical military data and principal component analysis was used to detect dietary patterns. RESULTS: During the 5 years follow-up, mean BMI increased from 25.8 (±3.3) kg/m(2) to 27.1 (±3.6) kg/m(2) (p<0.05). Consequently, the prevalence of being overweight and obesity increased from 46.2% and 9.6% to 51.6% and 19.9% (p<0.05), respectively. Mean (SD) weight gain differed between the BMI categories at baseline with a respective weight gain of 3.8 (±3.1) kg for normal weight at baseline, 4.2 (±3.2) kg for overweight and 5.1 (±3.4) kg for obesity (p for trend <0.05). Three dietary patterns were detected by principal component analysis: Meat, Sweet and Healthy dietary pattern. In energy-unadjusted and adjusted linear regressions, no dietary pattern was associated with BMI increase. CONCLUSIONS: No specific dietary pattern was related to BMI increase. Prevention of obesity should focus on total energy intake at all BMI categories.

Cross-sectional study on the relationship between the Mediterranean Diet Score and blood lipids.

BACKGROUND: Blood lipids are cardiovascular health indicators. High LDL cholesterol values and/or high total cholesterol (TC)/HDL cholesterol ratios are positively related with cardiovascular mortality. Evidence suggests that a Mediterranean diet can reduce the incidence of cardiovascular diseases. Adherence to the Mediterranean diet is often measured by the Mediterranean Diet Score (MDS). However, the association between the Mediterranean diet and blood lipid profiles seems still inconclusive. The aim of this study was to investigate the relationship between the MDS, its different components and blood lipid profiles. METHODS: A sample of 506 women and 707 men (aged 18-75 years) was recruited. Three-day diet records were used to calculate the MDS. Blood samples were analyzed for serum TC, LDL and HDL cholesterol. ANOVA was used to analyze blood lipids across the MDS tertiles. A multivariate linear regression analysis was performed to investigate the associations between the MDS, its components and blood lipids, adjusted for several confounders. All analyses were stratified by gender. RESULTS: Few gender-specific associations were found between the MDS, its components and blood lipids. Only in men, the total MDS was negatively related with LDL cholesterol and the ratio TC/HDL cholesterol while positively with HDL cholesterol. In women, respectively two (MUFA/SFA and cereals) and in men three (fruits & nuts, meat and alcohol) of the nine MDS components were related with blood lipids. CONCLUSIONS: Analyses investigating the relationship between the MDS, its components and blood lipid profiles indicate only limited influence of the Mediterranean diet on blood lipids. More associations were detected in men compared to women.

Impact of a Special Operations Forces Basic Training on Body Composition and Energy Expenditure.

INTRODUCTION: The Belgian Special Operations Regiment undergoes an 8-week basic training course (SOF Basic Course) following the Military Initiation Phase. The aims of the present study were to estimate energy expenditure and changes in body composition during SOF Basic Course. MATERIALS AND METHODS: A multi frequency body composition analyser assessed baseline and endpoint body composition. For the purpose of estimating energy expenditure, 41 participants were fitted with triaxial accelerometers. T-tests were performed on paired and unpaired samples in order to estimate statistical significance. Effect size was estimated with Cohen's d. RESULTS: SOF Basic Course was completed by 88 out of 126 participants. The participants' mean (SD) age was 25.0 (4.1) years, weight was 77.6 (8.6) kg, and body fat percentage was 15.3% (3.3). Body weight of completers decreased from 78.3 (8.8) kg to 76.4 (8.0) kg (P = 0.01). Also, body fat decreased by 3.1 (1.8) kg (P = 0.01), and muscle mass increased by 1.2 (1.7) kg (P = 0.01). There was a decrease in body fat percentage from 15.3% (3.3) to 11.6% (3.4) (P = 0.01), with a Cohen's effect size of 1.86.The loss of 3.1 kg of body fat corresponds to a loss of 21,700.0 kcal (90.3 MJ) or 362.0 kcal.d-1 (1.5 MJ.d-1). The mean (SD) energy expenditure by physical activity was 1,943.0 (653.8) kcal.d-1 (14.6 [2.7] MJ.d-1). The average (SD) total energy expenditure was 4,088.0 (710.0) kcal.d-1 (36.8 [3.8] MJ.d-1). CONCLUSION: Tactical athletes must perform in hypo-energetic environment. Research in the future should investigate the impact of increased energy intake on body composition.

Ultra-processed foods and human health: An umbrella review and updated meta-analyses of observational evidence.

BACKGROUND & AIMS: Ultra-processed food (UPF) intake has increased sharply over the last few decades and has been consistently asserted to be implicated in the development of non-communicable diseases. We aimed to evaluate and update the existing observational evidence for associations between ultra-processed food (UPF) consumption and human health. METHODS: We searched Medline and Embase from inception to March 2023 to identify and update meta-analyses of observational studies examining the associations between UPF consumption, as defined by the NOVA classification, and a wide spectrum of health outcomes. For each health outcome, we estimated the summary effect size, 95% confidence interval (CI), between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias. These metrics were used to evaluate evidence credibility of the identified associations. RESULTS: This umbrella review identified 39 meta-analyses on the associations between UPF consumption and health outcomes. We updated all meta-analyses by including 122 individual articles on 49 unique health outcomes. The majority of the included studies divided UPF consumption into quartiles, with the lowest quartile being the reference group. We identified 25 health outcomes associated with UPF consumption. For observational studies, 2 health outcomes, including renal function decline (OR: 1.25; 95% CI: 1.18, 1.33) and wheezing in children and adolescents (OR: 1.42; 95% CI: 1.34, 1.49), showed convincing evidence (Class I); and five outcomes were reported with highly suggestive evidence (Class II), including diabetes mellitus, overweight, obesity, depression, and common mental disorders. CONCLUSIONS: High UPF consumption is associated with an increased risk of a variety of chronic diseases and mental health disorders. At present, not a single study reported an association between UPF intake and a beneficial health outcome. These findings suggest that dietary patterns with low consumption of UPFs may render broad public health benefits.

Serum insulin and C-peptide concentration and breast cancer: a meta-analysis.

PURPOSE: Chronic hyperinsulinemia may play a role in breast cancer etiology. We performed a meta-analysis examining whether serum concentrations of insulin and C-peptide are associated with increased breast cancer risk. METHODS: We restricted our analyses to prospective studies. After a systematic literature search, we computed summary relative risks (SRRs) and 95 % confidence intervals (95 % CIs) using random effect models applied to the relative risk associated with the highest versus lowest quantile of serum concentrations. We also graphically examined results in order to identify whether dose-response relationships were present. RESULTS: Six articles including 1,890 cases were retrieved for serum insulin levels and five for serum C-peptide levels including 1,759 cases. SRR and 95 % CI were 1.08 (0.66-1.78) for insulin and 1.04 (0.77-1.41) for C-peptide. Heterogeneity of results between studies was high for insulin and inexistent for C-peptide. Restricting the analysis to women diagnosed with breast cancer before or after menopause did not alter results. In insulin studies, SRR computed from relative risks not adjusted for body mass index (and other risk factors) was 1.22 (0.91-1.63). The SRR fell to 1.02 (0.53-1.97) in studies that adjusted for body mass index and other factors. Similar drops occurred in C-peptide studies, from 1.11 (0.87-1.41) to 1.06 (0.70-1.61). No consistent dose-response relationship was apparent in either pre- or post-menopausal cancers. CONCLUSIONS: Our meta-analysis of observational studies found no evidence of an association between serum insulin or C-peptide concentrations and breast cancer risk. Increased risk found by some studies may have been due to inadequate control for adiposity.

Blood glucose concentrations and breast cancer risk in women without diabetes: a meta-analysis.

PURPOSE: Some studies have suggested an increased risk of breast cancer associated with elevated fasting serum glucose in nondiabetic subjects. Given how common both breast cancer and impaired glucose tolerance are in our aging societies, this is an important issue for public health. METHODS: We performed a systematic review of prospective cohort studies that examined the association between elevated serum glucose levels in nondiabetic subjects (levels below 7.0 mml/L) and the subsequent risk of breast cancer. We performed a systematic literature search and extracted relevant data in a standard way. We then computed summary relative risks (SRR) and 95 % confidence intervals using a random effects model applied on the risk of highest versus lowest quantile of serum glucose concentrations. RESULTS: Ten cohort studies were retrieved. The SRR for all studies was 1.11 (1.00-1.23), with no evidence of heterogeneity or publication bias. The SRR was not affected when the analysis was restricted to the 8 studies that reported results for fasting subjects (SRR = 1.11; 95 % CI 0.98-1.25). Three studies provided BMI-unadjusted and BMI-adjusted SRRs of 1.24 (95 % CI 0.60-2.56) and 1.20 (95 % CI 0.63-2.27), respectively. Similar magnitudes of associations were observed in sensitivity analyses, but statistical significance was lost. CONCLUSION: In nondiabetic subjects, the risk of breast cancer associated with fasting serum glucose levels seems to be small. Potential limitations to this meta-analysis include the fact that not all studies reported risks adjusted for adiposity and that serum glucose levels of comparison groups were variable across studies.

Dietary pattern analysis: a comparison between matched vegetarian and omnivorous subjects.

BACKGROUND: Dietary pattern analysis, based on the concept that foods eaten together are as important as a reductive methodology characterized by a single food or nutrient analysis, has emerged as an alternative approach to study the relation between nutrition and disease. The aim of the present study was to compare nutritional intake and the results of dietary pattern analysis in properly matched vegetarian and omnivorous subjects. METHODS: Vegetarians (n = 69) were recruited via purposeful sampling and matched non-vegetarians (n = 69) with same age, gender, health and lifestyle characteristics were searched for via convenience sampling. Two dietary pattern analysis methods, the Healthy Eating Index-2010 (HEI-2010) and the Mediterranean Diet Score (MDS) were calculated and analysed in function of the nutrient intake. RESULTS: Mean total energy intake was comparable between vegetarians and omnivorous subjects (p > 0.05). Macronutrient analysis revealed significant differences between the mean values for vegetarians and omnivorous subjects (absolute and relative protein and total fat intake were significantly lower in vegetarians, while carbohydrate and fibre intakes were significantly higher in vegetarians than in omnivorous subjects). The HEI and MDS were significantly higher for the vegetarians (HEI = 53.8.1 ± 11.2; MDS = 4.3 ± 1.3) compared to the omnivorous subjects (HEI = 46.4 ± 15.3; MDS = 3.8 ± 1.4). CONCLUSIONS: Our results indicate a more nutrient dense pattern, closer to the current dietary recommendations for the vegetarians compared to the omnivorous subjects. Both indexing systems were able to discriminate between the vegetarians and the non-vegetarians with higher scores for the vegetarian subjects.

Determinants and nutritional implications associated with low-fat food consumption.

OBJECTIVES: the objective was to study determinants and nutritional implications associated with low-fat food consumption. METHODS: a cross-sectional design was used, 5,000 military men were contacted and 1,852 participated. Using mailed questionnaires, the low-fat food consumption frequency was recorded and stratified in number of portions a day. The following low-fat food items were included: mayonnaise, yoghurt, milk, cheese, cottage cheese and meat. RESULTS: the two most daily consumed low-fat foods were meat and yoghurt by, respectively, 21.7% and 17.3% of the participants. Only 3.5% consumed a daily portion of low-fat cheese, and 7.4% consumed one or more daily portions of low-fat milk. After adjustment, Body Mass Index (BMI), physical activity and non-smoking were associated with an increasing consumption of low-fat foods. Consumption of low-fat foods was associated with a decreased daily total and saturated fat intake, from respectively, 37.9 and 14.7 energy-percent for low consumption to 30.5 and 11.6 energy-percent for high consumption. This decrease was compensated by an increased intake in carbohydrates and sugar, respectively, 42.5 and 16.7 energy-percent to 46.5 and 22.6 energy-percent. CONCLUSIONS: age, BMI, physical activity and non-smoking were associated with an increasing consumption of low-fat foods. The fact that low-fat foods consumers had a higher intake of carbohydrates and proteins question the efficacy of these items in energy reducing programs.