FTO genetic variants, dietary intake and body mass index: insights from 177 330 individuals

FTO is the strongest known genetic susceptibility locus for obesity. Experimental studies in animals suggest the potential roles of FTO in regulating food intake. The interactive relation among FTO variants, dietary intake and body mass index (BMI) is complex and results from previous often small-scale studies in humans are highly inconsistent. We performed large-scale analyses based on data from 177 330 adults (154 439 Whites, 5776 African Americans and 17 115 Asians) from 40 studies to examine: (i) the association between the FTO-rs9939609 variant (or a proxy single-nucleotide polymorphism) and total energy and macronutrient intake and (ii) the interaction between the FTO variant and dietary intake on BMI. The minor allele (A-allele) of the FTO-rs9939609 variant was associated with higher BMI in Whites (effect per allele = 0.34 [0.31, 0.37] kg/m2, P = 1.9 × 10−105), and all participants (0.30 [0.30, 0.35] kg/m2, P = 3.6 × 10−107). The BMI-increasing allele of the FTO variant showed a significant association with higher dietary protein intake (effect per allele = 0.08 [0.06, 0.10] %, P = 2.4 × 10−16), and relative weak associations with lower total energy intake (−6.4 [−10.1, −2.6] kcal/day, P = 0.001) and lower dietary carbohydrate intake (−0.07 [−0.11, −0.02] %, P = 0.004). The associations with protein (P = 7.5 × 10−9) and total energy (P = 0.002) were attenuated but remained significant after adjustment for BMI. We did not find significant interactions between the FTO variant and dietary intake of total energy, protein, carbohydrate or fat on BMI. Our findings suggest a positive association between the BMI-increasing allele of FTO variant and higher dietary protein intake and offer insight into potential link between FTO, dietary protein intake and adiposit

Long-range Angular Correlations On The Near And Away Side In P-pb Collisions At √snn=5.02 Tev

7191/Mar294

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3�6 . Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55 of the global rise in mean BMI from 1985 to 2017�and more than 80 in some low- and middle-income regions�was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing�and in some countries reversal�of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories. © 2019, The Author(s)

Intake of very long chain n-3 fatty acids from fish and the incidence of heart failure: the Rotterdam Study

Aims: Evidence is accumulating for a cardioprotective effect of fish or its n-3 fatty acids, eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA). We examined EPA plus DHA and fish intake in relation to incident heart failure in the population-based Rotterdam Study. Methods and results: The analysis comprised 5299 subjects (41% men, age 68 years) free from heart failure for whom dietary data were available. During 11.4 years of follow-up, 669 subjects developed heart failure. The relative risk (RR) of heart failure in the top vs. bottom quintile of EPA plus DHA intake was 0.89 (95% CI 0.69–1.14), after adjustment for lifestyle and dietary factors. For fish intakes 20 g/day, the RR was 0.96 (0.78–1.18) compared with no fish intake. In sex-specific analysis, a high EPA plus DHA intake tended to be protective in women (RR = 0.75, 0.54–1.04) but not in men (RR = 1.00, 0.73–1.36). An inverse association for EPA plus DHA was also observed in diabetics (RR = 0.58, 0.32–1.06), which was borderline statistically significant. Conclusion: Our findings do not support a major role for fish intake in the prevention of heart failure. The potentially protective effect of EPA plus DHA in diabetic patients, however, warrants further investigatio

Intake of very long chain n-3 fatty acids from fish and the incidence of heart failure: the Rotterdam Study

Aims: Evidence is accumulating for a cardioprotective effect of fish or its n-3 fatty acids, eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA). We examined EPA plus DHA and fish intake in relation to incident heart failure in the population-based Rotterdam Study. Methods and results: The analysis comprised 5299 subjects (41% men, age 68 years) free from heart failure for whom dietary data were available. During 11.4 years of follow-up, 669 subjects developed heart failure. The relative risk (RR) of heart failure in the top vs. bottom quintile of EPA plus DHA intake was 0.89 (95% CI 0.69–1.14), after adjustment for lifestyle and dietary factors. For fish intakes 20 g/day, the RR was 0.96 (0.78–1.18) compared with no fish intake. In sex-specific analysis, a high EPA plus DHA intake tended to be protective in women (RR = 0.75, 0.54–1.04) but not in men (RR = 1.00, 0.73–1.36). An inverse association for EPA plus DHA was also observed in diabetics (RR = 0.58, 0.32–1.06), which was borderline statistically significant. Conclusion: Our findings do not support a major role for fish intake in the prevention of heart failure. The potentially protective effect of EPA plus DHA in diabetic patients, however, warrants further investigatio

Homocysteine-lowering effect of 500 ug folic acid every other day versus 250 ug/day

Elevated plasma total homocysteine (tHcy) concentrations are a risk factor for neural tube defects and vascular diseases. Supplementation with folic acid decreases tHcy. We investigated whether supplementation with 500 ?g folic acid every other day is as effective in lowering tHcy as 250 ?g folic acid each day. Methods: In a 4-week intervention study, 22 healthy young women (18-40 years old) took either 500 ?g folic acid every other day (500-?g/2d group) or 250 ?g folic acid each day (250-?g/d group). Fasting blood was collected on days 0 and 28. Results: Plasma folate concentrations increased by 11.4 nmol/l (6.8-15.9) in the 250-?g/d group and by 9.1 nmol/l (95␌l 1.9-16.3) in the 500-?g/2d group. These increases were not significantly different from each other. THcy concentrations decreased by 1.52 ?mol/l (95␌l -2.09 to -0.95; p < 0.001) in the 250-?g/d group and by 0.88 ?mol/l (-1.53 to -0.23; p < 0.05) in the 500-?g/2d group. The difference in decrease between the 250-?g/d group and the 500-?g/2d group was 0.64 ?mol/l (p = 0.11). Conclusion: Although not conclusive, this study suggests that supplying subjects with folic acid each day decreases tHcy more effectively than a double dose every other day

Routine use of the confusion assessment method for the intensive care unit: a multicenter study

Item does not contain fulltextRATIONALE: Delirium is often unrecognized in ICU patients and associated with poor outcome. Screening for ICU delirium is recommended by several medical organizations to improve early diagnosis and treatment. The Confusion Assessment Method for the ICU (CAM-ICU) has high sensitivity and specificity for delirium when administered by research nurses. However, test characteristics of the CAM-ICU as performed in routine practice are unclear. OBJECTIVES: To investigate the diagnostic value of the CAM-ICU in daily practice. METHODS: Teams of three delirium experts including psychiatrists, geriatricians, and neurologists visited 10 ICUs twice. Based on cognitive examination, inspection of medical files, and Diagnostic and Statistic Manual of Mental Disorders, 4th edition, Text Revision criteria for delirium, the expert teams classified patients as awake and not delirious, delirious, or comatose. This served as a gold standard to which the CAM-ICU as performed by the bedside ICU-nurses was compared. Assessors were unaware of each other's conclusions. MEASUREMENTS AND MAIN RESULTS: Fifteen delirium experts assessed 282 patients of whom 101 (36%) were comatose and excluded. In the remaining 181 (64%) patients, the CAM-ICU had a sensitivity of 47% (95% confidence interval [CI], 35%-58%); specificity of 98% (95% CI, 93%-100%); positive predictive value of 95% (95% CI, 80%-99%); and negative predictive value of 72% (95% CI, 64%-79%). The positive likelihood ratio was 24.7 (95% CI, 6.1-100) and the negative likelihood ratio was 0.5 (95% CI, 0.4-0.8). CONCLUSIONS: Specificity of the CAM-ICU as performed in routine practice seems to be high but sensitivity is low. This hampers early detection of delirium by the CAM-ICU