Investigation of the effects of a high fish diet on inflammatory cytokines, blood pressure, and lipids in healthy older Australians

BACKGROUND: Aging is a condition of chronic inflammation. In healthy Australians ≥64 years, the primary aim was to determine whether four servings/week of mixed fish (FISH) improves serum cytokines (i.e. C-reactive protein (CRP), IL-1, IL-6, TNF-α) compared to a diet low in fish (<1 serving/week, CONTROL); the secondary aims were to assess the effect of the diet on blood pressure and serum lipids (TC, HDL-C, TG, calculated LDL-C). METHODS: An 8-week randomized, parallel study, stratified by CRP (<3 mg/L vs. ≥3 mg/L) on entry to the study. Compliance was measured using 3-day weighed food records in weeks 1 and 7 of the study. A 12-h fasting blood sample was taken at baseline and 8-weeks for erythrocyte fatty acids as confirmation of compliance, and measurement of serum cytokines and lipids. Blood pressure was measured at both time points. RESULTS: EIGHTY PARTICIPANTS COMPLETED THE STUDY (MEAN (SD) AGE: 69.6 (5.8) years). During week 1 of the study, mean ± SEM daily dietary intake of very long chain omega-3 polyunsaturated fatty acids (VLCN n-3 PUFA) in FISH vs. CONTROL was 1,676±129 mg vs. 27±5 mg (p<0.001). Mean (SD) gram intake of study fish and meat was 121 (45) g and 123 (78) g, for those allocated to FISH and CONTROL, respectively. Mean ± SEM percentage VLCN n-3 PUFA in erythrocytes at 8-weeks was higher in those allocated to FISH vs. CONTROL (10.2±0.2% vs. 8.2±0.3%, p<0.001). There was no between-group difference in CRP (n=80), IL-1β (n=33) or IL-6 (n=21) concentrations, blood pressure, or lipids, at 8-weeks. CONCLUSIONS: Eight weeks consumption of four servings/week fish did not affect serum cytokine concentrations, blood pressure or lipids compared to a diet low in fish. In healthy older adults with low inflammatory burden, our results do not support that short-term consumption of mixed fish has a beneficial effect on selected cardiovascular biomarkers.Jessica A. Grieger, Michelle D. Miller, and Lynne Cobi

Beverage intake and obesity in Australian children

Extent: 11p.BACKGROUND: There have been increases in the obesity and overweight rates in Australian children over the past 25 years and it has been suggested that sugar sweetened beverages (SSB) have played a role in this increase. OBJECTIVE: The objectives of this study were to: (1) examine SSB intakes in the 2007 Australian Children’s Nutrition and Physical Activity Survey (2) relate SSB intake to rates of overweight and obesity, socio-economic status (SES), TV viewing time, and activity levels and (3) compare 2007 SSB intakes with data from the 1995 National Nutrition Survey. DESIGN: A computer assisted 24 h dietary recall in 4,400 children aged 2-16 years was performed. RESULTS: In the 2007 survey 47% of all children reported drinking SSBs with 25% consuming sugar sweetened soft drinks on the day of the survey. The mean consumption of soft drink was 436 g/d/consumer. Activity levels were unrelated to SSB consumption. Television viewing was positively related to soft drink consumption with a difference of 55 g/day from bottom to top tertile of time spent TV viewing (p = 0.015) in children aged 9-16 years. 55% of SSB consumption occurred at home and 10% occurred at school. Lower SES status was associated with a greater prevalence of SSB consumption- 30% for the lowest SES quartile vs 19% in the highest quartile. The proportion of overweight who consumed SSBs (which excludes 100% fruit) was not different from the nonoverweight children although the proportion of SSB consumers in the 6% of children who were obese was significant compared with the non-overweight children (59% vs 47%, p < 0.05). In the 2007 survey 23% of children were overweight (17%) or obese (6%) while in the 1995 survey this figure was 21%. The proportion of children consuming SSBs in 1995 and 2007 for selected age groups were: 2-3 years - 25.8% and 12.8% respectively and 4-7 years - 33.6% and 20.5% respectively (p < 0.001 for both). CONCLUSIONS: This cross-sectional data set provides evidence that SSB consumption for Australian children is still high despite the decrease since 1995 in some age groups. It provides little support to conclude that overweight in children is currently being driven by excessive SSB consumption although it may be factor in some obese children. Conclusions are limited by the cross sectional nature of the study.Peter M. Clifton, Lily Chan, Chelsea L. Moss, Michelle D. Miller and Lynne Cobia

Impact of the 2003 to 2018 Population Salt Intake Reduction Program in England A Modeling Study

The United Kingdom was among the first countries to introduce a salt reduction program in 2003 to reduce cardiovascular disease (CVD) incidence risk. Despite its initial success, the program has stalled recently and is yet to achieve national and international targets. We used age- and sex-stratified salt intake of 19 to 64 years old participants in the National Diet and Nutrition Surveys 2000 to 2018 and a multistate life table model to assess the effects of the voluntary dietary salt reduction program on premature CVD, quality-adjusted survival, and health care and social care costs in England. The program reduced population-level salt intake from 9.38 grams/day per adult (SE, 0.16) in 2000 to 8.38 grams/day per adult (SE, 0.17) in 2018. Compared with a scenario of persistent 2000 levels, assuming that the population-level salt intake is maintained at 2018 values, by 2050, the program is projected to avoid 83 140 (95% CI, 73 710–84 520) premature ischemic heart disease (IHD) cases and 110 730 (95% CI, 98 390–112 260) premature strokes, generating 542 850 (95% CI, 529 020–556 850) extra quality-adjusted life-years and £1640 million (95% CI, £1570–£1660) health care cost savings for the adult population of England. We also projected the gains of achieving the World Health Organization target of 5 grams/day per adult by 2030, which by 2050 would avert further 87 870 (95% CI, 82 050–88 470) premature IHD cases, 126 010 (95% CI, 118 600–126 460) premature strokes and achieve £1260 million (95% CI, £1180–£1260) extra health care savings compared with maintaining 2018 levels. Strengthening the salt reduction program to achieve further reductions in population salt intake and CVD burden should be a high priority

The modelled impact of increases in physical activity: the effect of both increased survival and reduced incidence of disease

Physical activity can affect ‘need’ for healthcare both by reducing the incidence rate of some diseases and by increasing longevity (increasing the time lived at older ages when disease incidence is higher). However, it is common to consider only the first effect, which may overestimate any reduction in need for healthcare. We developed a hybrid micro-simulation lifetable model, which made allowance for both changes in longevity and risk of disease incidence, to estimate the effects of increases in physical activity (all adults meeting guidelines) on measures of healthcare need for diseases for which physical activity is protective. These were compared with estimates made using comparative risk assessment (CRA) methods, which assumed that longevity was fixed. Using the lifetable model, life expectancy increased by 95 days (95% uncertainty intervals: 68–126 days). Estimates of the healthcare need tended to decrease, but the magnitude of the decreases were noticeably smaller than those estimated using CRA methods (e.g. dementia: change in person- years, -0.6%, 95% uncertainty interval -3.7% to +1.6%; change in incident cases, -0.4%, -3.6% to +1.9%; change in person-years (CRA methods), -4.0%, -7.4% to -1.6%). The pattern of results persisted under different scenarios and sensitivity analyses. For most diseases for which physical activity is protective, increases in physical activity are associated with decreases in indices of healthcare need. However, disease onset may be delayed or time lived with disease may increase, such that the decreases in need may be relatively small and less than is sometimes expected.Oliver Mytton is supported by a Welcome Trust clinical doctoral fellowship (RG73907). Marko Tainio is funded by the Centre for Diet and Activity Research (CEDAR), which receives funding from UK Clinical Research Collaboration. David Ogilvie and Jenna Panter are supported by the Medical Research Council [Unit Programme number MC_UU_12015/6]. Jenna Panter was supported by an NIHR post-doctoral fellowship [PDF-2012-05-157]. Linda Cobiac is supported by an NHMRC Sidney Sax Early Career Research Fellowship (Grant ID: 1036771). James Woodcock is funded by an MRC Population Health Scientist Fellowship

Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study

BackgroundReducing automobile dependence and improving rates of active transport may reduce the impact of obesogenic environments, thereby decreasing population prevalence of obesity and other diseases where physical inactivity is a risk factor. Increasing the relative cost of driving by an increase in fuel taxation may therefore be a promising public health intervention for obesity prevention.MethodsA scoping review of the evidence for obesity or physical activity effect of changes in fuel price or taxation was undertaken. Potential health benefits of an increase in fuel excise taxation in Australia were quantified using Markov modelling to simulate obesity, injury and physical activity related health impacts of a fuel excise taxation intervention for the 2010 Australian population. Health adjusted life years (HALYs) gained and healthcare cost savings from diseases averted were estimated. Incremental cost-effectiveness ratios (ICERs) were reported and results were tested through sensitivity analysis.ResultsLimited evidence on the effect of policies such as fuel taxation on health-related behaviours currently exists. Only three studies were identified reporting associations between fuel price or taxation and obesity, whilst nine studies reported associations specifically with physical activity, walking or cycling. Estimates of the cross price elasticity of demand for public transport with respect to fuel price vary, with limited consensus within the literature on a probable range for the Australian context. Cost-effectiveness modelling of a AUD0.10 per litre increase in fuel excise taxation using a conservative estimate of cross price elasticity for public transport suggests that the intervention would be cost-effective from a limited societal perspective (237 HALYs gained, AUD2.6 M in healthcare cost savings), measured against a comparator of no additional increase in fuel excise. Under &ldquo;best case&rdquo; assumptions, the intervention would be more cost-effective (3181 HALYs gained, AUD34.2 M in healthcare cost savings).ConclusionsExploratory analysis suggests that an intervention to increase fuel excise taxation may deliver obesity and physical activity related benefits. Whilst such an intervention has significant potential for cost-effectiveness, potential equity and acceptability impacts would need to be minimised. A better understanding of the effectiveness and cost-effectiveness of a range of transport interventions is required in order to achieve more physically active transport environments.<br /

Structural characterization of acylated starches with increased delivery of short-chain fatty acids.

Short-chain fatty acids (SCFA), mainly acetic, propionic and butyric acids, are produced during fermentation of carbohydrates in the human colon and are critical for the maintenance of bowel health and colonic function (Topping and Clifton, 2001). However, an increased delivery of specific SCFA to the large bowel can also be obtained by acylation of carbohydrates, using a CSIRO proprietary technology. Understanding the effects of structure on functionality is essential for the design and manufacture of acylated starches with specific health and therapeutic effects. The aim of the present study is to determine the effects of the level of acylation (degree of substitution), the molecular size of the esterified acid and the composition of the base maize starch on the structure of the acylated starch. Low and high amylose maize starches acylated with acetic, propionic and butyric acids at three degrees of substitution were compared with the structure of the unmodified maize starches.RACI Cereal Chemistry Divisio

Butyrylated starch is less susceptible to enzymic hydrolysis and increases large-bowel butyrate more than high-amylose maize starch in the rat

Large-bowel fermentation of resistant starch produces SCFA that are believed to be important in maintaining visceral function. High-amylose maize starch (HAMS) and acylated starches are sources of resistant starch and are an effective means of increasing colonic SCFA. Cooking increases digestibility of starches but its effects on the capacity of these starches to raise large-bowel SCFA are unknown. We have examined the effects of cooking of HAMS and butyrylated HAMS (HAMSB) on amylolysis in vitro and their capacity to raise caeco-colonic SCFA in rats. The starches were boiled in excess water and microwaved, followed by drying at 100°C. Cooking increased in vitro glucose release for both starches but significantly less from HAMSB. Rat growth rates were unaffected when fed cooked resistant starch. Digesta pH was increased in the caecum and proximal colon of rats fed cooked HAMS. Distal colonic pH was highest in rats fed cooked HAMSB. Factorial analyses (2×2) of caecal SCFA pools showed significant differences between HAMS and HAMSB, and that cooking significantly lowered caecal butyrate pools. Portal venous butyrate concentrations were higher in both HAMSB groups than those fed HAMS. The data suggest that HAMSB is less susceptible to in vitro amylolysis than HAMS following cooking and delivers more butyrate to rat caecum than HAMS. This attribute may be useful in food applications for specific delivery of SCFA to the colon. Preparation of carbohydrates to simulate human food in animal experiments may be important to assess nutritional and physiological effects accurately.Balázs H. Bajka, David L. Topping, Lynne Cobiac and Julie M. Clark

Follow-up plasma apolipoprotein E levels in the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing (AIBL) cohort

Introduction: Alzheimer's disease (AD) is a growing socioeconomic problem worldwide. Early diagnosis and prevention of this devastating disease have become a research priority. Consequently, the identification of clinically significant and sensitive blood biomarkers for its early detection is very important. Apolipoprotein E (APOE) is a well-known and established genetic risk factor for late-onset AD; however, the impact of the protein level on AD risk is unclear. We assessed the utility of plasma ApoE protein as a potential biomarker of AD in the large, well-characterised Australian Imaging, Biomarkers and Lifestyle Study of Ageing (AIBL) cohort. Methods: Total plasma ApoE levels were measured at 18-month follow-up using a commercial bead-based enzyme-linked immunosorbent assay: the Luminex xMAP human apolipoprotein kit. ApoE levels were then analysed between clinical classifications (healthy controls, mild cognitive impairment (MCI) and AD) and correlated with the data available from the AIBL cohort, including but not limited to APOE genotype and cerebral amyloid burden. Results: A significant decrease in ApoE levels was found in the AD group compared with the healthy controls. These results validate previously published ApoE protein levels at baseline obtained using different methodology. ApoE protein levels were also significantly affected, depending on APOE genotypes, with ε2/ε2 having the highest protein levels and ε4/ε4 having the lowest. Plasma ApoE levels were significantly negatively correlated with cerebral amyloid burden as measured by neuroimaging. Conclusions: ApoE is decreased in individuals with AD compared with healthy controls at 18-month follow-up, and this trend is consistent with our results published at baseline. The influence of APOE genotype and sex on the protein levels are also explored. It is clear that ApoE is a strong player in the aetiology of this disease at both the protein and genetic levels

Follow-up Plasma Apolipoprotein e Levels In The Australian Imaging, Biomarkers And Lifestyle Flagship Study of Ageing (AIBL) Cohort

Introduction: Alzheimer\u27s disease (AD) is a growing socioeconomic problem worldwide. Early diagnosis and prevention of this devastating disease have become a research priority. Consequently, the identification of clinically significant and sensitive blood biomarkers for its early detection is very important. Apolipoprotein E (APOE) is a well-known and established genetic risk factor for late-onset AD; however, the impact of the protein level on AD risk is unclear. We assessed the utility of plasma ApoE protein as a potential biomarker of AD in the large, well-characterised Australian Imaging, Biomarkers and Lifestyle Study of Ageing (AIBL) cohort. Methods: Total plasma ApoE levels were measured at 18-month follow-up using a commercial bead-based enzyme-linked immunosorbent assay: the Luminex xMAP human apolipoprotein kit. ApoE levels were then analysed between clinical classifications (healthy controls, mild cognitive impairment (MCI) and AD) and correlated with the data available from the AIBL cohort, including but not limited to APOE genotype and cerebral amyloid burden. Results: A significant decrease in ApoE levels was found in the AD group compared with the healthy controls. These results validate previously published ApoE protein levels at baseline obtained using different methodology. ApoE protein levels were also significantly affected, depending on APOE genotypes, with ε2/ε2 having the highest protein levels and ε4/ε4 having the lowest. Plasma ApoE levels were significantly negatively correlated with cerebral amyloid burden as measured by neuroimaging. Conclusions: ApoE is decreased in individuals with AD compared with healthy controls at 18-month follow-up, and this trend is consistent with our results published at baseline. The influence of APOE genotype and sex on the protein levels are also explored. It is clear that ApoE is a strong player in the aetiology of this disease at both the protein and genetic levels. © 2015 Gupta et al.; licensee BioMed Central

Effects of high-amylose maize starch and butyrylated high-amylose maize starch on azoxymethane-induced intestinal cancer in rats

Colorectal cancer (CRC) is a major cause of death worldwide. Studies suggest that dietary fibre offers protection perhaps by increasing colonic fermentative production of butyrate. This study examined the importance of butyrate by investigating the effects of resistant starch (RS) and butyrylated-RS on azoxymethane (AOM)-induced CRC in rats. Four groups (n = 30 per group) of Sprague–Dawley rats were fed AIN-93G-based diets containing a standard low-RS maize starch (LAMS), LAMS + 3% tributyrin (LAMST), 10% high-amylose maize starch (HAMS) and 10% butyrylated HAMS (HAMSB) for 4 weeks. Rats were injected once weekly for 2 weeks with 15 mg/kg AOM, maintained on diets for 25 weeks and then killed. Butyrate concentrations in large bowel digesta were higher in rats fed HAMSB than other groups (P < 0.001); levels were similar in HAMS, LAMS and LAMST groups. The proportion of rats developing tumours were lower in HAMS and HAMSB than LAMS (P < 0.05), and the number of tumours per rat were lower in HAMSB than LAMS (P < 0.05). Caecal digesta butyrate pools and concentrations were negatively correlated with tumour size (P < 0.05). Hepatic portal plasma butyrate concentrations were higher (P < 0.001) in the HAMSB compared with other groups and negatively correlated with tumour number per rat (P < 0.009) and total tumour size for each rat (P = 0.05). HAMSB results in higher luminal butyrate than RS alone or tributyrin. This is associated with reduced tumour incidence, number and size in this rat model of CRC supporting the important protective role of butyrate. Interventional strategies designed to maximize luminal butyrate may be of protective benefit in humans