Fish consumption, does it beneficially affect markers of colorectal carcinogenesis?

Background: Fish consumption is possibly associated with a decreased risk of colorectal cancer, as has been shown in several observational studies. However, most of these studies did not discriminate between the effects of oil-rich and lean fish. To date, no randomized controlled trials (RCTs) have examined the possible beneficial effects of fish intake on colorectal cancer risk. Aim: The aim of this thesis was to investigate whether fish consumption beneficially affects markers of colorectal carcinogenesis. Methods and Results: In a case control study (363 cases, 498 controls), we studied the association of serum n 3 polyunsaturated fatty acid (PUFA) levels as a marker of oil rich fish intake with colorectal adenomas, a precursor lesion of colorectal cancer. We found that individuals with high serum long chain n 3 PUFA levels had a decreased risk of colorectal adenomas (odds ratio (OR) 0.67, 95% confidence interval (CI) 0.46; 0.96), whereas individuals with high serum n 6 PUFA levels had an increased risk of colorectal adenomas (OR 1.68, 95% CI 1.17; 2.42). In an RCT, we studied the effects of 3.5g/d fish oil (~1.5g/d n 3 PUFA) for 12 weeks on 19 serum inflammation markers in 77 healthy subjects and found that serum levels of these cytokines and chemokines were not changed. Finally, we studied the effects of increasing fish consumption compared with no additional fish, on markers of colorectal carcinogenesis in an RCT. Subjects (n=242), at an increased risk of colorectal cancer and those with no macroscopic signs of disease, were randomly allocated to receive dietary advice (DA) plus either two additional weekly portions of oil rich fish (salmon, ~1.4g/d n 3 PUFA) or lean fish (cod, ~0.09 g/d n 3 PUFA), or only DA for six months. We observed no change in apoptotic and mitotic cell numbers after the 6 months intervention with either salmon or cod compared with DA. Furthermore, colorectal genotoxicity, levels of cytokines and chemokines in colonic biopsies and feces, and fecal calprotectin were also not markedly changed after fish consumption. Only serum C reactive protein (CRP) levels were statistically significantly decreased after consumption of salmon ( 0.5 mg/l, 95% CI 0.9; 0.2) and cod ( 0.4 mg/l, 95% CI 0.7; 0.0) compared with DA. Conclusion: The results of this thesis do not provide strong evidence for beneficial effects of fish consumption on markers of colorectal carcinogenesis. <br/

The timing of the evening meal: how is this associated with weight status in UK children?

There is some evidence from studies in adults and limited evidence from studies in children that eating later in the day may increase the risk of overweight and obesity. In this cross-sectional study, we investigated associations between evening meal timing in children and their weight status and energy intake. Dietary data obtained from the UK's National Diet and Nutrition Survey Rolling Programme (2008-2012) for 768 children aged 4-10 years and 852 children aged 11-18 years were analysed. We tested for an association between evening meal timing (consuming the evening meal before or after 20.00 hours) and risk of overweight and/or obesity, adjusting for relevant confounding variables. We also explored whether evening meal timing was associated with overall nutrient intake. We found no association between evening meal timing and risk of obesity or risk of overweight and obesity combined in either the 4-10 years age group (obesity: OR 1.43; 95 % CI 0.49, 4.13; obesity and overweight combined: OR 1.33; 95 % CI 0.53, 3.33) or the 11-18 years age group (obesity: OR 0.50; 95 % CI 0.24, 1.02; obesity and overweight combined: OR 0.83; 95 % CI 0.50, 1.38), split by sex or as combined. No significant associations were found between evening meal timing and energy intake, and no clear patterns in variation of nutrient intakes with evening meal times were identified. In conclusion, we found no evidence that, for children aged 4-18 years in the UK, eating the evening meal after 20.00 hours was associated with excess weight or increased energy intake

Meal irregularity and cardiometabolic consequences: results from observational and intervention studies

Studying irregular meal patterns fits in with the latest research focusing not only on what people eat but also when they eat, also called chrono-nutrition. Chrono-nutrition involves studying the impact of nutrition on metabolism via circadian patterns, including three aspects of time: (ir)regularity, frequency and clock time. The present paper aimed to narratively review research on irregular meal patterns and cardiometabolic consequences. Only few cross-sectional studies and prospective cohort studies were identified, and most of these suggested that eating meals irregularly is associated with a higher risk of the metabolic syndrome and cardiometabolic risk factors, including BMI and blood pressure. This was supported by two randomised controlled intervention studies showing that consuming meals regularly for 2 weeks v. an irregular meal pattern, led to beneficial impact on cardiometabolic risk factors as lower peak insulin, lower fasting total and LDL-cholesterol, both in lean and obese women. In conclusion, the limited evidence on meal regularity and cardiometabolic consequences supports the hypothesis that consuming meals irregularly is adversely associated with cardiometabolic risk. However, it also highlights the need for more large-scale studies, including detailed dietary assessment to further advance the understanding of the impact of chrono-nutrition on public health

Irregular consumption of energy intake in meals is associated with a higher cardiometabolic risk in adults of a British birth cohort

Background/Objectives:A potential risk factor for cardiometabolic diseases is irregular or inconsistent eating, however, research on this topic is scarce. We aimed to study associations between irregular consumption of energy intake in meals and cardiometabolic risk factors.Subject and Methods:Dietary intake data were derived from 5-day estimated diet diaries of 1768 participants of the National Survey of Health and Development. Energy intakes during predefined meals (breakfast, lunch, dinner, between meals) and daily totals were analyzed using a score for irregularity based on the deviation from the 5-day mean energy intake. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for having the metabolic syndrome or one of its components. Models were adjusted for sex, physical activity, socioeconomic status, marital status and smoking.Results:Irregularity scores of energy intake ranged from 0-160 and were highest for between meals. An increased risk of the metabolic syndrome was associated with more irregular energy intake during breakfast (OR=1.34 (0.99, 1.81); P trend=0.04) and between meals (OR=1.36 (1.01, 1.85); P trend=0.04). Moreover, increased waist circumference was associated with irregular energy intake during breakfast (OR=1.90 (1.47, 2.45); P trend <0.01), evening meal (OR=1.36 (1.06, 1.75); P trend=0.02) and daily total (OR=1.34 (1.04, 1.72); P trend=0.01). No significant associations were found for the other components of the metabolic syndrome.Conclusions:Individuals with a more irregular intake of energy, especially during breakfast and between meals, appeared to have an increased cardiometabolic risk

Evaluation of the psychometric properties of the main meal quality index when applied in the UK population

Background/Objectives:The aim of this study was to evaluate the validity and reliability of the Main Meal Quality Index when applied on the UK population.Subjects/Methods:The indicator was developed to assess meal quality in different populations, and is composed of 10 components: fruit, vegetables (excluding potatoes), ratio of animal protein to total protein, fiber, carbohydrate, total fat, saturated fat, processed meat, sugary beverages and desserts, and energy density, resulting in a score range of 0–100 points. The performance of the indicator was measured using strategies for assessing content validity, construct validity, discriminant validity and reliability, including principal component analysis, linear regression models and Cronbach’s alpha.Results:The indicator presented good reliability.Conclusions:The Main Meal Quality Index has been shown to be valid for use as an instrument to evaluate, monitor and compare the quality of meals consumed by adults in the United Kingdom.European Journal of Clinical Nutrition advance online publication, 14 September 2016; doi:10.1038/ejcn.2016.175

Development of the Eating Choices Index (ECI): a four-item index to measure healthiness of diet

Objective Current indices of diet quality generally include intakes of specific foods or nutrients. We sought to develop an index that discriminates healthy and unhealthy eating choices for use in large surveys as a short questionnaire and as a measure in existing studies with adequate dietary data. Design The Eating Choices Index (ECI) score included four components: (i) consumption of breakfast, (ii) consumption of two portions of fruit per day, (III) type of milk consumed and (iv) type of bread consumed, each providing a score from 1 to 5. In analysis of 5 d food records, the ECI score was examined in relation to macronutrients, fibre, vitamin C, Fe, Ca and folate using Pearson correlations. Variation with sex, BMI, socio-economic status, marital status, smoking status and physical activity were also investigated. Setting Medical Research Council National Survey of Health and Development. Subjects Individuals (n 2256) aged 43 years. Results The ECI score (mean 12·3 (sd 3·5)) was significantly positively associated with protein, carbohydrate, fibre, vitamin C, Fe, Ca and folate (r = 0·2-0·5; P < 0·001) and significantly negatively associated with fat intake (r = -0·2; P < 0·001); ECI scores were not correlated with total energy intake. Individuals with a lower ECI score were more likely to be men (P < 0·001), overweight or obese (P < 0·001), have lower socio-economic status (P < 0·001), smoke more (P < 0·001) and be less physically active (P < 0·001). Conclusions ECI scores correlated with nutrient profiles consistent with a healthy diet. It provides a simple method to rank diet healthiness in large observational studies

Chrono-nutrition: a review of current evidence from observational studies on global trends in time-of-day of energy intake and its association with obesity.

The importance of the circadian rhythm in regulating human food intake behaviour and metabolism has long been recognised. However, little is known as to how energy intake is distributed over the day in existing populations, and its potential association with obesity. The present review describes global trends in time-of-day of energy intake in the general population based on data from cross-sectional surveys and longitudinal cohorts. Evidence of the association between time-of-day of energy intake and obesity is also summarised. Overall, there were a limited number of cross-sectional surveys and longitudinal cohorts that provided data on time-of-day of energy intake. In the identified studies, a wide variation in time-of-day of energy intake was observed, with patterns of energy distribution varying greatly by country and geographical area. In relation to obesity, eight cross-sectional surveys and two longitudinal cohorts were identified. The association between time-of-day of energy intake and obesity varied widely, with several studies reporting a positive link between evening energy intake and obesity. In conclusion, the current review summarises global trends in time-of-day of energy intake. The large variations across countries and global regions could have important implications to health, emphasising the need to understand the socio-environmental factors guiding such differences in eating patterns. Evidence of the association between time-of-day of energy intake and BMI also varied. Further larger scale collaborations between various countries and regions are needed to sum data from existing surveys and cohorts, and guide our understanding of the role of chrono-nutrition in health

Chrono-nutrition: A review of current evidence from observational studies on global trends in time-of-day of energy intake and its association with obesity

The importance of the circadian rhythm in regulating human food intake behaviour and metabolism has long been recognised. However, little is known as to how energy intake is distributed over the day in existing populations, and its potential association with obesity. The present review describes global trends in time-of-day of energy intake in the general population based on data from cross-sectional surveys and longitudinal cohorts. Evidence of the association between time-of-day of energy intake and obesity is also summarised. Overall, there were a limited number of cross-sectional surveys and longitudinal cohorts that provided data on time-of-day of energy intake. In the identified studies, a wide variation in time-of-day of energy intake was observed, with patterns of energy distribution varying greatly by country and geographical area. In relation to obesity, eight cross-sectional surveys and two longitudinal cohorts were identified. The association between time-of-day of energy intake and obesity varied widely, with several studies reporting a positive link between evening energy intake and obesity. In conclusion, the current review summarises global trends in time-of-day of energy intake. The large variations across countries and global regions could have important implications to health, emphasising the need to understand the socio-environmental factors guiding such differences in eating patterns. Evidence of the association between time-of-day of energy intake and BMI also varied. Further larger scale collaborations between various countries and regions are needed to sum data from existing surveys and cohorts, and guide our understanding of the role of chrono-nutrition in health. © The Authors 2016