Diet-disease relationships : recent advances in nutritional epidemiology

Nutritional epidemiology currently studies the diet-disease relationships. In order to evaluate these associations, an accurate estimation of nutritional exposure is essential. Traditional dietary questionnaires are being complemented with the measurement of nutritional biomarkers. New methodologies, including the use of new dietary assessments, metabolomics for increasing the quantity and quality of biomarkers, and statistical approaches to combine both techniques, are required to move forward in this field. In this review, we have selected five of the more relevant accomplishments in this field as examples of the importance of dietary factors in the prevention of non-communicable diseases. This theoretical knowledge needs to be finally translated by public health experts into dietary recommendations to the general population

Wanted: specific nutritional biomarkers for food consumption for the study of its protective role in health.

Nutritional epidemiology focuses on an understanding of the relationship between diet and disease risk. The assessment of dietary and nutritional exposure is a complex methodological challenge. Traditionally, diet evaluations have been made by means of dietary data, such as 24-h recalls and food frequency or diet history questionnaires. However, all of these methods have some inherent weaknesses or limitations due to the limited accuracy in measuring the intake of food, nutrients or phytochemicals. Nowadays, nutritional biomarkers have become an attractive alternative approach. According to conventional definition..

Dietary intake of total polyphenol and polyphenol classes and the risk of colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) Cohort

Polyphenols may play a chemopreventive role in colorectal cancer (CRC); however, epidemiological evidence supporting a role for intake of individual polyphenol classes, other than flavonoids is insufficient. We evaluated the association between dietary intakes of total and individual classes and subclasses of polyphenols and CRC risk and its main subsites, colon and rectum, within the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The cohort included 476,160 men and women from 10 European countries. During a mean follow-up of 14 years, there were 5991 incident CRC cases, of which 3897 were in the colon and 2094 were in the rectum. Polyphenol intake was estimated using validated centre/country specific dietary questionnaires and the Phenol-Explorer database. In multivariable-adjusted Cox regression models, a doubling in total dietary polyphenol intake was not associated with CRC risk in women (HRlog2 = 1.06, 95% CI 0.99–1.14) or in men (HRlog2 = 0.97, 95% CI 0.90–1.05), respectively. Phenolic acid intake, highly correlated with coffee consumption, was inversely associated with colon cancer in men (HRlog2 = 0.91, 95% CI 0.85–0.97) and positively associated with rectal cancer in women (HRlog2 = 1.10, 95% CI 1.02–1.19); although associations did not exceed the Bonferroni threshold for significance. Intake of other polyphenol classes was not related to colorectal, colon or rectal cancer risks. Our study suggests a possible inverse association between phenolic acid intake and colon cancer risk in men and positive with rectal cancer risk in women

Resveratrol metabolite profiling in clinical nutrition research-from diet to uncovering disease risk biomarkers: epidemiological evidence

Resveratrol is a bioactive plant compound that has drawn scientific and media attention owing to its protective effects against a wide variety of illnesses, including cardiovascular diseases and cancer. In the last two decades, a plethora of preclinical studies have shown these beneficial effects, and some of them have been supported by clinical trials. However, there are few epidemiological studies assessing these relationships, showing mostly inconsistent results among them. This could be partially due to the difficulty of accurately estimating dietary resveratrol exposure. The development of Phenol-Explorer, a database containing resveratrol food-composition data, will facilitate the estimation of resveratrol intake. Moreover, the discovery and validation of a nutritional biomarker of this exposure, urinary resveratrol metabolite profile, will allow a more accurate assessment of dietary resveratrol exposure. Few epidemiological studies have assessed the potential health effects of resveratrol. Resveratrol was not associated with total mortality, cancer, or cardiovascular events, but it was associated with an improvement of serum glucose and triglyceride levels and a decrease in heart rate. Together, these findings suggest a potential cardioprotective effect of resveratrol in epidemiological studies, although the evidence is still scarce

An Overview of Global Flavonoid Intake and its Food Sources

Dietary patterns and food availability differ greatly between regions and countries around the world. As a result, there is a large variability in the intake of total flavonoids and flavonoid subclasses, and subsequently in their major food sources. However, we need to be aware of certain methodological issues when we compare studies on flavonoid intake

Resveratrol, a new biomarker of moderate wine intake?

In a recent study published in the British Journal of Nutrition, Spencer et al. (1) reviewed the strengths and the limitations of the biomarkers of dietary polyphenol intake, since nutritional biomarkers may be a better measure of dietary exposure than self-reported dietary data. These authors identified the criteria that must be considered in the development of such biomarkers as the following..

Perceptual blindless in nutrition: We are in a critical time to be connected

Our health and well-being are affected by our food systems. The new nutrition reality has been linked to complex food systems, interrelated with several pathways and determinants, including physical, socioeconomic, environmental, and ecological, and lately, has been strongly associated with population health, the increase in chronic diseases, and climate change. We briefly comment on four pillars, namely food environments, food security, food supply, and safety and nutritional epidemiology, all of which are key determinants of food systems. We overview some highlights, challenges, and methodologies with a view to advancing food and nutrition science as an integrated field of research. By modifying food systems, we are able to improve the aging and well-being of populations and the health of the planet. Trusted science, nutritional education, new scientific-public communication, integrated policy, investment, food availability, and cultural strategies are all essential for creating better food systems. Perceptual blindness in nutrition must be transformed

Effects of a (poly)phenol-rich supplement on anthropometric, biochemical, and inflammatory parameters in participants with morbid obesity: Study protocol for a randomised controlled trial

Background: Morbid obesity (body mass index >= 40 kg/m2) represents a severe health risk and implies the need of urgent therapeutic action. (Poly)phenols may play a relevant role in the management of this disease modulating physiological and molecular pathways involved in energy metabolism and adiposity. The purpose of this double -blinded, placebo-controlled, randomised trial is to determine if (poly)phenol supplementation, in combination with a dietary intervention, can improve anthropometric and cardiometabolic parameters in participants with morbid obesity. Methods: Adults (n = 40) with morbid obesity, bariatric surgery candidates, will be recruited from the Bellvitge University Hospital, Spain, and randomly assigned (stratified by sex) to intervention (poly)phenol-rich supple-ment 1,200 mg/day + hypocaloric diet) or control group (placebo + hypocaloric diet) for 12 weeks. The primary outcome is body weight. Secondary outcomes are: other anthropometric markers and body composition measured through standardized methods and a bioimpedance analysis, cardiometabolic and inflammatory bio-markers, metabolic pathways, and gut microbiota diversity. Anthropometric parameters, dietary, physical ac-tivity and lifestyle questionnaires, blood pressure, and blood and urine samples will be collected at baseline, 6 weeks, and 12 weeks. Faecal samples will be collected at baseline and at 12 weeks. Informed consent of par-ticipants will be obtained before the start of the study.Discussion:: The present study is expected to provide evidence on the effects of a combination of (poly)phenols on several well-established obesity and cardiometabolic markers, and to unravel possible underlying mechanisms by metabolomic analyses. Gut microbiota diversity will be considered as a potential future endpoint. The study will contribute to future strategies for prevention or treatment of obesity and related conditions

Wholegrain Consumption and Risk Factors for Cardiorenal Metabolic Diseases in Chile: A Cross-Sectional Analysis of 2016-2017 Health National Survey

Abstract: Wholegrain (WG) consumption has been associated with reduced risk factors for cardiorenal metabolic diseases (CRMD). In Latin-America. WG intake is low and scarce studies on this subject have been found. We aimed to evaluate the association between WG consumption and risk factors for CRMD in the 2016-2017 Chilean-National Health Survey. This cross-sectional study included 3110 participants representative of a total population of 11,810,647 subjects > 18 y, not taking insulin and with complete data on CRMD risk factors. Outcomes were metabolic syndrome and its components, albuminuria, and impaired glomerular filtration rate (GFR). WG consumption was categorized as regular (≥every two days), sporadic (≥once a month), and non-consumers. Associations were analyzed by multivariable logistic regressions adjusted for confounders taking into account the complex sample design of the survey. Regular WG consumers showed a lower risk of high blood pressure (OR: 0.61, 95%CI: 0.41-0.91) compared to non-consumers in fully-adjusted models. Although inverse associations were noticed with other metabolic syndrome components and impaired GFR, none was statistically significant. The association between WG and BP remained robust in the sensitivity analysis. In conclusion regular WG consumption was associated with a 39% lower risk of high blood pressure in Chilean adults. Keywords: wholegrain; cardiovascular disease; metabolic syndrome; chronic kidney disease; Latin Americ

Consumption of Sweet Beverages and Cancer Risk. A Systematic Review and Meta-Analysis of Observational Studies

The consumption of sweet beverages, including sugar-sweetened beverages (SSB), artificial-sweetened beverages (ASB) and fruit juices (FJ), is associated with the risk of different cardiometabolic diseases. It may also be linked to the development of certain types of tumors. We carried out a systematic review and meta-analysis of observational studies aimed at examining the association between sweet beverage intake and cancer risk. Suitable articles published up to June 2020 were sourced through PubMed, Web of Science and SCOPUS databases. Overall, 64 studies were identified, of which 27 were selected for the meta-analysis. This was performed by analyzing the multivariable-adjusted OR, RR or HR of the highest sweet beverage intake categories compared to the lowest one. Random effects showed significant positive association between SSB intake and breast (RR: 1.14, 95% CI: 1.01-1.30) and prostate cancer risk (RR: 1.18, 95% CI: 1.10-1.27) and also between FJs and prostate cancer risk (RR: 1.03, 95% CI: 1.01-1.05). Although the statistically significant threshold was not reached, there tended to be positive associations for the following: SSBs and colorectal and pancreatic cancer risk; FJs and breast, colorectal and pancreatic cancer risk; and ASBs and pancreatic cancer risk. This study recommends limiting sweet beverage consumption. Furthermore, we propose to establish a homogeneous classification of beverages and investigate them separately, to better understand their role in carcinogenesis