Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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    Effect of cheese consumption on blood lipids: a systematic review and meta-analysisi of randomized controlled trials
    Goede, J. de; Geleijnse, J.M. ; Ding, E.L. ; Soedamah-Muthu, S.S. - \ 2015
    Nutrition Reviews 73 (2015)5. - ISSN 0029-6643 - p. 259 - 275.
    coronary-heart-disease - low-density-lipoprotein - fecal fat excretion - cardiovascular-disease - serum-cholesterol - normolipidemic volunteers - clinical-trials - dietary-intake - dairy foods - milk-fat
    Context: Cheese may affect lipids and lipoproteins differently than other high-fat dairy foods. Objective: The present systematic review and meta-analysis was performed to evaluate randomized controlled trials that examined the effect of cheese consumption compared with another food product on blood lipids and lipoproteins. Data Sources: A systematic literature search of the MEDLINE, Embase, Scopus, CAB Abstracts, the Cochrane Controlled Trials Register, and the clinicaltrials.gov website was performed. Study Selection: A total of 12 randomized controlled trials (RCTs) were identified that examined the effect of cheese consumption on blood lipids and lipoproteins in healthy adults. Data Extraction: A meta-analysis of 5 RCTs that compared the effects of hard cheese and butter, both of which had a similar ratio of polyunsaturated fatty acids to saturated fatty acids (P/S ratio), was performed. Data Synthesis: Compared with butter intake, cheese intake (weighted mean difference: 145.0 g/d) reduced low-density lipoprotein cholesterol (LDL-C) by 6.5% (-0.22 mmol/l; 95%CI: -0.29 to -0.14) and high-density lipoprotein cholesterol (HDL-C) by 3.9% (-0.05 mmol/l; 95%CI: -0.09 to -0.02) but had no effect on triglycerides. Compared with intake of tofu or fat-modified cheese, cheese intake increased total cholesterol or LDL-C, as was expected on the basis of the P/S ratio of the diets. There was insufficient data to compare intake of cheese with intake of other foods. Conclusion: Despite the similar P/S ratios of hard cheese and butter, consumption of hard cheese lowers LDL-C and HDL-C when compared with consumption of butter. Whether these findings can be attributed to calcium, specific types of saturated fatty acids, or the food matrix of cheese warrants further research.
    Fructose consumption in the Netherlands: the Dutch national food consumption survey 2007-2010
    Sluik, D. ; Engelen, A.I.P. ; Feskens, E.J.M. - \ 2015
    European Journal of Clinical Nutrition 69 (2015). - ISSN 0954-3007 - p. 475 - 481.
    controlled feeding trials - fatty liver-disease - soft drink consumption - multiple source method - corn syrup - intake distributions - dietary-intake - metaanalysis - obesity - sugar
    Background/objectives: Despite the worldwide scientific and media attention, the actual fructose consumption in many non-US populations is not clear. The aim of this study was to estimate the fructose consumption and its main food sources in a representative sample of the general Dutch population. Subjects/methods: In all, 3817 children and adults aged 7–69 years from the Dutch National Food Consumption Survey 2007–2010 were studied. Values for fructose content of the products were assigned using several food composition tables. Diet was assessed with two nonconsecutive 24-h dietary recalls. The Multiple Source Method was used to take into account day-to-day variation and to estimate the habitual fructose consumption. Results: Median habitual fructose intake was 46¿g/day, with an interquartile range of 35–60¿g/day. In boys, the highest median intake was observed among 14- to 18-year olds: 61¿g/day. In girls, those aged 9–13 years reported the highest median intake: 56¿g/day. Of total fructose intake, 67% was consumed in the form of sucrose and 33% was consumed as free fructose. Soft drinks constituted the main food source of total fructose (13–29% across age and sex categories), followed by juices (9–12%), fruit (9–18%), cake and cookies (9–11%) and dairy products (6–10%). Conclusions: Fructose comprised 9% of the mean daily energy intake in the general Dutch population aged 7–69 years. The fructose consumption was somewhat lower than most recent figures from the US. The main food sources of fructose were soft drinks, juices and fruit.
    European developments following incidents with dioxins and PCBs in the food en feed chain
    Hoogenboom, L.A.P. ; Traag, W.A. ; Fernandes, A. ; Rose, M. - \ 2015
    Food Control 50 (2015). - ISSN 0956-7135 - p. 670 - 683.
    toxic equivalency factors - dibenzo-para-dioxins - contamination incident - polychlorinated dibenzofurans - dr-calux(r) bioassay - pcdd/f-contamination - dietary-intake - chicken eggs - citrus pulp - p-dioxins
    Incidents with dioxins and PCBs have resulted in a strategy within the EU to reduce the exposure of the population to these compounds. Maximum levels were set for food and feed products and criteria were developed for the analytical methods (both confirmatory and screening) used for official control measurements. Ideally, any analysis performed with the aim of comparing the result with the legal limits should be performed according to these criteria. It should also apply to monitoring, performed to estimate human exposure and trend analysis rather than compliance with limits, since risk assessments and EU-policies rely heavily on these data. In recent years, analytical capacity has largely increased to complement the additional testing. In line with the responsibility of producers for the safety of their products, self-control has strongly increased and has played an important role in the discovery of several of the incidents. However, the increased monitoring seems not to have resulted in a clear further decrease in the levels reported for food and feed in the last decade. This may in part be due to a lack of follow up when elevated levels (above action levels) are found, which would lead to a reduction of output from remaining sources. It may also be related to the sensitivity of applied methods and the data collected in databases. This paper reviews the incidents and developments that have taken place within the EU over the last 15 years in the area of dioxins and PCBs, including the role of applying screening and confirmatory methods for achieving the desired further reduction in the levels.
    Nudging children towards whole wheat bread: a field experiment on the influence of fun bread roll shape on breakfast consumption
    Kleef, E. van; Vrijhof, M.N. ; Polet, I.A. ; Vingerhoeds, M.H. ; Wijk, R.A. de - \ 2014
    BMC Public Health 14 (2014). - ISSN 1471-2458 - 11 p.
    dietary-intake - grain intake - food - acceptance
    Background: Many children do not eat enough whole grains, which may have negative health consequences. Intervention research is increasingly focusing on nudging as a way to influence food choices by affecting unconscious behavioural processes. The aim of this field study was to examine whether the shape of bread rolls is able to shift children’s bread choices from white to whole wheat during breakfast to increase whole grain intake. Methods: In a between-subjects experiment conducted at twelve primary schools in the Netherlands, with school as the unit of condition assignment, children were exposed to an assortment of white and whole wheat bread rolls, both varying in shape (regular versus fun). Children were free to choose the type and number of bread rolls and toppings to eat during breakfast. Consumption of bread rolls was measured at class level via the number of bread rolls before and after breakfast. In addition, children (N = 1113) responded to a survey including questions about the breakfast. Results: Results of the field experiment showed that about 76% of bread consumption consisted of white bread rolls. Consumption of white bread rolls did not differ according to shape (all P-values > 0.18). However, presenting fun-shaped whole wheat bread rolls almost doubled consumption of whole wheat bread (P = 0.001), particularly when the simultaneously presented white bread rolls had a regular shape (interaction P = 0.02). Survey results suggest that slight increases in perceived pleasure and taste are associated with these effects. Conclusions: Overall, presenting whole wheat bread in fun shapes may be helpful in increasing consumption of whole wheat bread in children. Future research could examine how improving the visual appeal of healthy foods may lead to sustained behaviour changes. Keywords: Nudge, Nudging, Whole grain, Whole-wheat bread, Children’s food preferences, Bread shape, Visual appeal
    A systematic review on micronutrient intake adequacy in adult minority populations residing in Europe: The need for action
    Ngo, J. ; Roman-Vinas, B. ; Ribas-Barba, L. ; Golsorkhi, M. ; Wharthon Medina, M. ; Bekkering, G.E. ; Cavelaars, A.J.E.M. ; Groot, C.P.G.M. de - \ 2014
    Journal of Immigrant and Minority Health 16 (2014)5. - ISSN 1557-1912 - p. 941 - 950.
    food-frequency questionnaires - vitamin-d deficiency - ethnic-groups - immigrant population - nutrient intake - african origin - dietary-intake - south-asians - risk-factors - east london
    This systematic review evaluated micronutrient intake inadequacy of ten micronutrients for adult ethnic minority populations residing in Europe. Pubmed was searched for studies, related references were checked and experts consulted. Ten studies were identified and six were included in the final analysis representing Albanian, Roma, Sub-Saharan African, South Asian and African-Caribbean minority groups. The Estimated Average Requirement cut point was applied to estimate inadequate intake. With the exception of a sub-Saharan African study, of seven micronutrients analysed, inadequate intakes were markedly elevated (>50 % of the population in most cases) in both genders for folate, vitamin B12, calcium and iron (the latter in females only). A pressing need exists for intake adequacy studies with sound methodologies addressing ethnic minority groups in Europe. These populations constitute a vulnerable population for inadequate intakes and results substantiate the need for further investigation, interventions and policy measures to reduce their nutritional risk
    Comined effects of smoking and alcohol on metabolic syndrome: the lifelines cohort study
    Slagter, S.N. ; Vliet-Ostaptchouk, J.V. ; Vonk, J.M. ; Boezen, H.M. ; Dullaart, R.P.F. ; Muller Kobold, A.C. ; Feskens, E.J.M. ; Beek, A.P. van; Klauw, M.M. van der; Wolffenbuttel, B.H.R. - \ 2014
    PLoS ONE 9 (2014)4. - ISSN 1932-6203 - 9 p.
    genome-wide association - nutrition examination survey - coronary-heart-disease - body-mass index - blood-pressure - waist circumference - cigarette-smoking - physical-activity - national-health - dietary-intake
    Introduction - The development of metabolic syndrome (MetS) is influenced by environmental factors such as smoking and alcohol consumption. We determined the combined effects of smoking and alcohol on MetS and its individual components. Methods - 64,046 participants aged 18–80 years from the LifeLines Cohort study were categorized into three body mass index (BMI) classes (BMI1 drink/day) and tobacco showed higher triglycerides levels. Up to 2 drinks/day was associated with a smaller waist circumference in overweight and obese individuals. Consumption of >2 drinks/day increased blood pressure, with the strongest associations found for heavy smokers. The overall metabolic profile of wine drinkers was better than that of non-drinkers or drinkers of beer or spirits/mixed drinks. Conclusion - Light alcohol consumption may moderate the negative associations of smoking with MetS. Our results suggest that the lifestyle advice that emphasizes smoking cessation and the restriction of alcohol consumption to a maximum of 1 drink/day, is a good approach to reduce the prevalence of MetS. Figures
    Socio-economic determinants of micronutrient intake and status in Europe: a systematic review
    Novakovic, R.N. ; Cavelaars, A.J.E.M. ; Geelen, A. ; Nikolic, M. ; Altaba, I.I. ; Vinas, B.R. ; Ngo, J. ; Golsorkhi, M. ; Medina, M. ; Brzozowska, A. ; Szczecinkska, A. ; Cock, D. de; Vansant, G. ; Renkema, J.M.S. ; Serra Majem, L. ; Moreno, L.A. ; Glibetic, M. ; Gurinovic, M. ; Veer, P. van 't; Groot, C.P.G.M. de - \ 2014
    Public Health Nutrition 17 (2014)5. - ISSN 1368-9800 - p. 1031 - 1045.
    life-style factors - food-habits - dietary-intake - maternal education - nutrient intake - population - nutrition - quality - adults - consumption
    OBJECTIVE: To provide the evidence base for targeted nutrition policies to reduce the risk of micronutrient/diet-related diseases among disadvantaged populations in Europe, by focusing on: folate, vitamin B12, Fe, Zn and iodine for intake and status; and vitamin C, vitamin D, Ca, Se and Cu for intake. DESIGN: MEDLINE and Embase databases were searched to collect original studies that: (i) were published from 1990 to 2011; (ii) involved >100 subjects; (iii) had assessed dietary intake at the individual level; and/or (iv) included best practice biomarkers reflecting micronutrient status. We estimated relative differences in mean micronutrient intake and/or status between the lowest and highest socio-economic groups to: (i) evaluate variation in intake and status between socio-economic groups; and (ii) report on data availability. SETTING: Europe. SUBJECTS: Children, adults and elderly. RESULTS: Data from eighteen publications originating primarily from Western Europe showed that there is a positive association between indicators of socio-economic status and micronutrient intake and/or status. The largest differences were observed for intake of vitamin C in eleven out of twelve studies (5-47 %) and for vitamin D in total of four studies (4-31 %). CONCLUSIONS: The positive association observed between micronutrient intake and socio-economic status should complement existing evidence on socio-economic inequalities in diet-related diseases among disadvantaged populations in Europe. These findings could provide clues for further research and have implications for public health policy aimed at improving the intake of micronutrients and diet-related diseases
    Evaluation of food and nutrient intake assessment using concentration biomarkers in European adolescents from the Healthy Lifestyle in Europe by Nutrition in Adolescence study
    Vandevijvere, S. ; Geelen, A. ; Gonzalez-Gross, M. ; Veer, P. van 't; Dallongeville, J. ; Mouratidu, T. ; Dekkers, A. ; Börnhorst, C. ; Breidenassel, C. - \ 2013
    The British journal of nutrition 109 (2013)4. - ISSN 0007-1145 - p. 736 - 747.
    serum cholesteryl esters - n-3 fatty-acids - dietary-intake - energy-intake - additional measurements - micronutrient intake - biochemical markers - adipose-tissue - vitamin-c - validation
    Accurate food and nutrient intake assessment is essential for investigating diet–disease relationships. In the present study, food and nutrient intake assessment among European adolescents using 24 h recalls (mean of two recalls) and a FFQ (separately and the combination of both) were evaluated using concentration biomarkers. Biomarkers included were vitamin C, ß-carotene, DHA+EPA, vitamin B12 (cobalamin and holo-transcobalamin) and folate (erythrocyte folate and plasma folate). For the evaluation of the food intake assessment 390 adolescents were included, while 697 were included for the nutrient intake assessment evaluation. Spearman rank and Pearson correlations, and validity coefficients, which are correlations between intake estimated and habitual true intake, were calculated. Correlations were higher between frequency of food consumption (from the FFQ) and concentration biomarkers than between mean food intake (from the recalls) and concentration biomarkers, especially for DHA+EPA (r 0·35 v. r 0·27). Most correlations were higher among girls than boys. For boys, the highest validity coefficients were found for frequency of fruit consumption (0·88) and for DHA+EPA biomarker (0·71). In girls, the highest validity coefficients were found for fruit consumption frequency (0·76), vegetable consumption frequency (0·74), mean fruit intake (0·90) and DHA+EPA biomarker (0·69). After exclusion of underreporters, correlations slightly improved. Correlations between usual food intakes, adjusted for food consumption frequency, and concentration biomarkers were higher than correlations between mean food intakes and concentration biomarkers. In conclusion, two non-consecutive 24 h recalls in combination with a FFQ seem to be appropriate to rank subjects according to their usual food intake
    Multiplex immunoassay for persistent organic pollutants in tilapia: comparison of imaging- and flow cytometry-based platforms using spectrally encoded paramagnetic microspheres
    Meimaridou, A. ; Haasnoot, W. ; Shelver, W.L. ; Franek, M. ; Nielen, M.W.F. - \ 2013
    Food Additives & Contaminants. Pt. A, Chemistry, Analysis, Control, Exposure & Risk Assessment 30 (2013)5. - ISSN 1944-0049 - p. 843 - 852.
    polybrominated diphenyl ethers - polycyclic aromatic-hydrocarbons - polychlorinated-biphenyls - dietary-intake - farmed salmon - food - fish - contaminants - pcbs - milk
    Recent developments in spectrally encoded microspheres (SEMs)-based technologies provide high multiplexing possibilities. Most SEMs-based assays require a flow cytometer with sophisticated fluidics and optics. A new imaging super-paramagnetic SEMs-based alternative platform transports SEMs with considerably less fluid volume into a measuring chamber. Once there SEMs are held in a monolayer by a magnet. Light-emitting diodes (LEDs) are focused on the chamber to illuminate the SEMs – instead of lasers and they are imaged by a charge-coupled device (CCD) detector, offering a more compact sized, transportable and affordable system. The feasibility of utilising this system to develop a 3-plex SEMs-based imaging immunoassay (IMIA) for the screening of persistent organic pollutants (POPs) was studied. Moreover the performance characteristics of 3-plex IMIA were critically compared with the conventional 3-plex flow cytometric immunoassay (FCIA). Both SEM technologies have potential for the multiplex analysis of polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and polycyclic aromatic hydrocarbons (PAHs) in buffer and fish extract with insignificant differences in assay sensitivities. Furthermore, we developed a faster and simpler, modified QuEChERS-like generic POPs extraction from tilapia fillet using sodium hydrogen carbonate as one of the salt additives and dispersive solid-phase extraction (dSPE) as a clean-up. Finally, a preliminary in-house validation using 40 different blank and spiked tilapia fillet samples was performed in both systems and the results obtained were critically compared. The lower-cost imaging SEMs-based system performed similarly to the original flow cytometer and, in combination with the new quicker QuEChERS-like extraction, it has high potential for future rapid screening of POPs in several other sample matrices such as other fish species, vegetable refined oils and environmental samples.
    N-6 and N-3 Fatty Acid Cholesteryl Esters in Relation to Fatal CHD in a Dutch Adult Population: A Nested Case-Control Study and Meta-Analysis
    Goede, J. de; Verschuren, W.M.M. ; Boer, J.M.A. ; Verberne, L.D.M. ; Kromhout, D. ; Geleijnse, J.M. - \ 2013
    PLoS ONE 8 (2013)5. - ISSN 1932-6203 - 9 p.
    coronary-heart-disease - alpha-linolenic acid - cardiovascular-disease - dietary-intake - erythrocyte-membranes - adipose-tissue - humans - risk - biomarkers - cohort
    Background: Dietary polyunsaturated fatty acids (PUFA) are inversely related to coronary heart disease (CHD) in epidemiological studies. We examined the associations of plasma n-6 and n-3 PUFA in cholesteryl esters with fatal CHD in a nested case-control study. Additionally, we performed a dose-response meta-analysis of similar prospective studies on cholesteryl ester PUFA. Methods: We used data from two population-based cohort studies in Dutch adults aged 20-65y. Blood and data collection took place from 1987-1997 and subjects were followed for 8-19y. We identified 279 incident cases of fatal CHD and randomly selected 279 controls, matched on age, gender, and enrollment date. Odds ratios (OR) were calculated per standard deviation (SD) increase of cholesteryl ester PUFA. Results: After adjustment for confounders, the OR (95% CI) for fatal CHD per SD increase in plasma linoleic acid was 0.89 (0.74-1.06). Additional adjustment for plasma total cholesterol and systolic blood pressure attenuated this association (OR:0.95; 95% CI: 0.78-1.15). Arachidonic acid was not associated with fatal CHD (OR per SD:1.11; 95% CI: 0.92-1.35). The ORs (95% CI) for fatal CHD for an SD increase in n-3 PUFA were 0.92 (0.74-1.15) for alpha-linolenic acid and 1.06 (0.88-1.27) for EPA-DHA. In the meta-analysis, a 5% higher linoleic acid level was associated with a 9% lower risk (relative risk: 0.91; 95% CI: 0.84-0.98) of CHD. The other fatty acids were not associated with CHD. Conclusion: In this Dutch population, n-6 and n-3 PUFA in cholesteryl esters were not significantly related to fatal CHD. Our data, together with findings from previous prospective studies, support that linoleic acid in plasma cholesteryl is inversely associated with CHD.
    N-6 and n-3 fatty acid cholesteryl esters in relation to incident stroke in a Dutch adult population: A nested case-control study
    Goede, J. de; Verschuren, W.M.M. ; Boer, J.M.A. ; Kromhout, D. ; Geleijnse, J.M. - \ 2013
    Nutrition, Metabolism & Cardiovascular Diseases 23 (2013)8. - ISSN 0939-4753 - p. 737 - 743.
    food frequency questionnaire - alpha-linolenic acid - cardiovascular-disease - dietary-intake - erythrocyte-membranes - adipose-tissue - fish intake - humans - risk - biomarkers
    Background and aims - There are few prospective studies on fatty acid status in relation to incident stroke, with inconsistent results. We assessed the associations of plasma n-6 and n-3 PUFA in cholesteryl esters with the risk of total stroke and stroke subtypes in Dutch adults. Methods and results - We conducted a nested case–control study using data from a population-based cohort study in adults aged 20–65 years. Blood sampling and data collection took place during 1993–1997 and subjects were followed for 8–13 years. We identified 179 incident cases of stroke and 179 randomly selected controls, matched on age, gender, and enrollment date. Odds ratios (OR) with 95% confidence intervals (95%CI) were calculated per standard deviation (SD) increase of PUFA in cholesteryl esters using multivariable conditional logistic regression. Cases comprised 93 ischemic, 50 hemorrhagic, and 36 unspecified strokes. The n-6 PUFA linoleic acid and arachidonic acid contributed ~55% and ~6.5% respectively to total plasma fatty acids, whereas the n-3 PUFA alpha-linolenic acid contributed ~0.5% and eicosapentaenoic acid plus docosahexaenoic acid (EPA-DHA) ~1.3%. After adjustment for confounders, n-6 and n-3 PUFA were not associated with incident total stroke or stroke subtypes. The OR (95% CI) for total stroke was 0.95 (0.74–1.23) per SD increase in linoleic acid and 1.02 (0.80–1.30) per SD increase in arachidonic acid. ORs (95% CI) for total stroke were 0.94 (0.72–1.21) for alpha-linolenic acid and 1.16 (0.94–1.45) for EPA-DHA. Conclusion - In the present study, plasma n-6 or n-3 fatty acids were not related to incident stroke or stroke subtypes.
    Dairy intake in relation to cardiovascular disease mortality and all-cause mortality: the Hoorn study
    Aerde, M.A. van; Soedamah-Muthu, S.S. ; Geleijnse, J.M. ; Snijder, M.B. ; Nijpels, G. ; Stehouwer, C.D.A. ; Dekker, J.M. - \ 2013
    European Journal of Nutrition 52 (2013)2. - ISSN 1436-6207 - p. 609 - 616.
    coronary-heart-disease - dietary-intake - blood-pressure - calcium intake - milk drinking - reduced risk - skim milk - vitamin-d - consumption - cohort
    Purpose Existing data from prospective cohort studies on dairy consumption and cardiovascular diseases are inconsistent. Even though the association between total dairy and cardiovascular diseases has been studied before, little is known about the effect of different types of dairy products on cardiovascular diseases (CVD). The objective of this study was to examine the relationship between (type of) dairy intake and CVD mortality and all-cause mortality in a Dutch population. Methods We examined the relationship between dairy intake and CVD mortality and all-cause mortality in 1956 participants of the Hoorn Study (aged 50–75 years), free of CVD at baseline. Hazard ratios with 95 % CIs were obtained for CVD mortality and all-cause mortality per standard deviation (SD) of the mean increase in dairy intake, with adjustment for age, sex, BMI, smoking, education, total energy intake, alcohol consumption, physical activity, and dietary intakes. Results During 12.4 years of follow-up, 403 participants died, of whom 116 had a fatal CVD event. Overall dairy intake was not associated with CVD mortality or all-cause mortality. Each SD increase in high-fat dairy intake was associated with a 32 % higher risk of CVD mortality (95 % CI; 7–61 %). Conclusion In this prospective cohort study, the intake of high-fat dairy products was associated with an increased risk of CVD mortality
    Proctection by Flavonal-Rich foods against vascular dysfunction and oxidative damage: 27th Hohenheim consensus conference
    Sies, H. ; Hollman, P.C.H. ; Grune, T. ; Stahl, W. - \ 2012
    Advances in Nutrition 3 (2012). - ISSN 2161-8313 - p. 217 - 221.
    antioxidant capacity assays - arterial stiffness - protein oxidation - dietary-intake - health claims - comet assay - polyphenols - disease - flavonoids - consumption
    Criteria for assessing the purported protection by flavanol-rich foods against vascular dysfunction and oxidative damage to biomolecules was the subject of the 27th Hohenheim Consensus Conference held on July 11, 2011. State-of-the-art evidence was put into perspective, focusing on several questions that were followed by a consensus answer. Among the topics addressed were the major sources of flavanols in the human diet, the bioavailability of flavanols, biomarkers for “health benefit,” and the biological function of flavanols. Consensus was reached on these topics. No conclusion was reached on the design of randomized, controlled trials for substantiation of health claims for flavanol-rich foods as to the necessity of a study arm with an isolated pharmacologically active compound, e.g., (-)-epicatechin.
    Alcohol consumption and risk of type 2 diabetes in European men and women: influence of beverage type and body size. The EPIC-InterAct study
    The InterAct Consortium, A. ; Feskens, E.J.M. - \ 2012
    Journal of Internal Medicine 272 (2012)4. - ISSN 0954-6820 - p. 358 - 370.
    randomized controlled-trial - insulin sensitivity - postmenopausal women - drinking patterns - physical-activity - dietary-intake - older women - cancer - cohort - intervention
    Objective: To investigate the association between alcohol consumption and type 2 diabetes, and determine whether this is modified by sex, body mass index (BMI) and beverage type. Design: Multicentre prospective case–cohort study. Setting: Eight countries from the European Prospective Investigation into Cancer and Nutrition cohort. Subjects: A representative baseline sample of 16 154 participants and 12 403 incident cases of type 2 diabetes. Interventions: Alcohol consumption assessed using validated dietary questionnaires. Main outcome measures: Occurrence of type 2 diabetes based on multiple sources (mainly self-reports), verified against medical information. Results: Amongst men, moderate alcohol consumption was nonsignificantly associated with a lower incidence of diabetes with a hazard ratio (HR) of 0.90 (95% CI: 0.78–1.05) for 6.1–12.0 versus 0.1–6.0 g day-1, adjusted for dietary and diabetes risk factors. However, the lowest risk was observed at higher intakes of 24.1–96.0 g day-1 with an HR of 0.86 (95% CI: 0.75–0.98). Amongst women, moderate alcohol consumption was associated with a lower incidence of diabetes with a hazard ratio of 0.82 (95% CI: 0.72–0.92) for 6.1–12.0 g day-1 (P interaction gender
    Nutrient-rich foods in relation to various measures of anthropometry
    Streppel, M.T. ; Groot, C.P.G.M. de; Feskens, E.J.M. - \ 2012
    Family Practice 29 (2012)Suppl. 1. - ISSN 0263-2136 - p. i36 - i43.
    dietary-intake - rotterdam - index - validation - density - obesity - disease
    Background. Nutrient quality systems, for example the nutrient-rich foods (NRF) index, measure the nutrient quality of individual foods and may be used to assess the nutrient density of the overall diet. It is not yet known whether the NRF index is helpful in weight management. We hypothesize that a nutrient-dense diet is associated with a lower body weight and waist circumference. Objective. The objective of the present study was to examine the association between the NRF index and various measures of anthropometry. Methods. This study was carried out in a sample of 2044 men and 2925 women, aged =55 years, participating in a community-based prospective cohort study in Rotterdam, The Netherlands. The NRF9.3 algorithms were used to estimate the nutrient density of the subjects’ diets. Linear regression was used to examine the association between the NRF index scores and body mass index (BMI), body weight, waist circumference, wait-to-hip ratio and waist-to-height ratio. Results. Subjects with a high NRF9.3 index score had a lower energy intake (EI) as compared to those with low NRF9.3 index score. However, after adjustment for age, gender and other confounders, the NRF9.3 index score as well as the Nutrient Rich 9 index score were positively associated with BMI, body weight, waist circumference and waist-to-height ratio. Conclusions. Although subjects with a high NRF9.3 index score had a lower EI than those subjects with a low index score, their BMI, body weight, waist circumference and waist-to-height ratio was higher. The association between nutrient quality and body composition is therefore complex
    Fish consumption does not prevent increase in waist circumference in European women and men
    Jakobsen, M.U. ; Due, K.M. ; Dethlefsen, C. ; Halkjaer, J. ; Holst, C. ; Forouhi, N.G. ; Tjonneland, A. ; Boeing, H. ; Buijsse, B. ; Palli, D. ; Masala, G. ; A, D. van der; Wareham, N.J. ; Feskens, E.J.M. ; Sorensen, T.I.A. ; Overvad, K. - \ 2012
    The British journal of nutrition 108 (2012)5. - ISSN 0007-1145 - p. 924 - 931.
    polyunsaturated fatty-acids - dietary-intake - epic project - cancer - obesity - participants - calibration - predictors - rationale - accuracy
    Fish consumption is the major dietary source of EPA and DHA, which according to rodent experiments may reduce body fat mass and prevent obesity. However, human studies have suggested that fish consumption has no appreciable association with body-weight gain. We investigated the associations between fish consumption and subsequent change in waist circumference. Sex, age and waist circumference at enrolment were considered as potential effect modifiers. Women and men (n 89 432) participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) were followed for a median of 5·5 years. Mixed-effect linear regression was used to investigate the associations between fish consumption and subsequent change in waist circumference. Among all participants, the average annual change in waist circumference was - 0·01 cm/10 g higher total fish consumption per d (95 % CI - 0·01, 0·00) and - 0·01 cm/10 g higher fatty fish consumption per d (95 % CI - 0·02, - 0·01), after adjustment for potential confounders. Lean fish consumption was not associated with change in waist circumference. Adjustment for potential over- or underestimation of fish consumption measurements did not systematically change the observed associations, but the 95 % CI became slightly wider. The results in subgroups from analyses stratified by sex, age or waist circumference at enrolment were not systematically different. In conclusion, the present study suggests that fish consumption does not prevent increase in waist circumference
    Effects of n-3 fatty acids on cognitive decline: A randomized double-blind, placebo-controlled trial in stable myocardial infarction patients
    Geleijnse, J.M. ; Giltay, E.J. ; Kromhout, D. - \ 2012
    Alzheimer's & Dementia 8 (2012)4. - ISSN 1552-5260 - p. 278 - 287.
    alpha-linolenic acid - cardiovascular risk-factors - alzheimer-disease - dietary-intake - cardiac-arrest - dementia risk - fish-oil - health - omega-3-fatty-acids - supplementation
    Background Epidemiological studies suggest a protective effect of n-3 fatty acids derived from fish (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) against cognitive decline. For a-linolenic acid (ALA) obtained from vegetable sources, the effect on cognitive decline is unknown. We examined the effect of n-3 fatty acid supplementation on cognitive decline in coronary heart disease patients. Methods The analysis included 2911 coronary patients (78% men) aged 60 to 80 years who participated in a double-blind placebo-controlled trial of n-3 fatty acids and cardiovascular diseases (Alpha Omega Trial). By using a 2 × 2 factorial design, patients were randomly assigned to margarines that provided 400 mg/d of EPA–DHA, 2 g/d of ALA, both EPA–DHA and ALA, or placebo for 40 months. Cognitive function was assessed by the Mini-Mental State Examination (MMSE) at baseline and after 40 months. The effect of n-3 fatty acids on change in MMSE score was assessed using analysis of variance. Logistic regression analysis was used to examine the effects on risk of cognitive decline, defined as a decrease of 3 or more points in MMSE score or incidence of dementia. Results Patients in the active treatment groups had an additional intake of 384 mg of EPA–DHA, 1.9 g of ALA, or both. The overall MMSE score in this cohort was 28.3 ± 1.6 points, which decreased by 0.67 ± 2.25 points during follow-up. Changes in MMSE score during intervention did not differ significantly between EPA–DHA and placebo (-0.65 vs -0.69 points, P = .44) or between ALA and placebo (-0.60 vs -0.74 points, P = .12). The risk of cognitive decline was 1.03 (95% confidence interval: 0.84–1.26, P = .80) for EPA–DHA (vs placebo) and 0.90 (0.74–1.10, P = .31) for ALA (vs placebo). Conclusion This large intervention study showed no effect of dietary doses of n-3 fatty acids on global cognitive decline in coronary heart disease patients. Keywords
    Factors Predicting Consumption of Fonio Grain (Digitaria exilis) among Urban Malian Women of Reproductive Age
    Fanou-Fogny, N.M.L. ; Dam, B. van; Koreissi, Y. ; Dossa, R.A.M. ; Brouwer, I.D. - \ 2011
    Journal of Nutrition Education and Behavior 43 (2011)4. - ISSN 1499-4046 - p. 219 - 228.
    health belief model - planned behavior - dietary-intake - iburua - acha
    Objective: To identify factors influencing intention to consume an indigenous nutritious grain, fonio (Digitaria exilis), among women in Mali. Design: A cross-sectional questionnaire survey based on the Theory of Planned Behavior and the Health Belief Model. Setting and Participants: One hundred and eight women (31.5 +/- 10.5 years), randomly selected by a 3-stage cluster sampling, Bamako, Mali. Main Outcome Measures: Model constructs scores, intention to consume fonio, and fonio consumption. Analysis: Correlation and multiple regression, Wilcoxon signed rank and Mann-Whitney tests for score comparison. Results: Attitudes toward behavior (beta = .32, P <.05) was the best predictor of intention to consume fonio, which was significantly correlated with fonio consumption (rho = .78, P <.001). Health value (beta = .23, P <.05) was a significant predictor of health behavior identity, which was significantly correlated with attitudes toward behavior (rho = .67, P <0.001) and perceived barriers (rho = .33, P <.001). The latter formed a significant interaction term between intention and behavior (beta = -.72, P <.05). Conclusions and Implications: Fonio consumption could be increased in Bamako through stimulation of positive attitudes, changing men's beliefs, influencing family and neighbors' opinions, and improving the processing and the skills of women who prepare fonio.
    Intake of total, animal and plant protein and subsequent changes in weight or waist circumference in European men and women: the Diogenes project
    Halkjaer, J. ; Olsen, A. ; Overvad, K. ; Jakobsen, M.U. ; Boeing, H. ; Buijsse, B. ; Palli, D. ; Tognon, G. ; Du, H. ; A, D.L. van der; Forouhi, N.G. ; Wareham, N.J. ; Feskens, E.J.M. ; Sorensen, T.I.A. ; Tjonneland, A. - \ 2011
    International Journal of Obesity 35 (2011)8. - ISSN 0307-0565 - p. 1104 - 1113.
    physical-activity - dietary-intake - nutrition - cancer - metaanalysis - obesity - gain - fat - epidemiology - association
    Background: As protein is considered to increase thermogenesis and satiety more than other macronutrients, it may have beneficial effects on prevention of weight gain and weight maintenance. Objective: The objective of this study is to assess the association between the amount and type of dietary protein, and subsequent changes in weight and waist circumference (WC). Methods: 89 432 men and women from five countries participating in European Prospective Investigation into Cancer and Nutrition (EPIC) were followed for a mean of 6.5 years. Associations between the intake of protein or subgroups of protein (from animal and plant sources) and changes in weight (g per year) or WC (cm per year) were investigated using gender and centre-specific multiple regression analyses. Adjustments were made for other baseline dietary factors, baseline anthropometrics, demographic and lifestyle factors and follow-up time. We used random effect meta-analyses to obtain pooled estimates across centres. Results: Higher intake of total protein, and protein from animal sources was associated with subsequent weight gain for both genders, strongest among women, and the association was mainly attributable to protein from red and processed meat and poultry rather than from fish and dairy sources. There was no overall association between intake of plant protein and subsequent changes in weight. No clear overall associations between intakes of total protein or any of the subgroups and changes in WC were present. The associations showed some heterogeneity between centres, but pooling of estimates was still considered justified. Conclusion: A high intake of protein was not found associated with lower weight or waist gain in this observational study. In contrast, protein from food items of animal origin, especially meat and poultry, seemed to be positively associated with long-term weight gain. There were no clear associations for waist changes. International Journal of Obesity (2011) 35, 1104-1113; doi:10.1038/ijo.2010.254; published online 7 December 2010
    Effects on n-3 fatty acids on depressive symptoms and dispositional optimism after myocardial infarction
    Giltay, E.J. ; Geleijnse, J.M. ; Kromhout, D. - \ 2011
    American Journal of Clinical Nutrition 94 (2011)6. - ISSN 0002-9165 - p. 1442 - 1450.
    coronary-heart-disease - randomized controlled-trial - placebo-controlled trial - major depression - fish consumption - omega-3-fatty-acid levels - general-population - dietary-intake - follow-up - metaanalysis
    Background: In patients who have experienced a myocardial infarction (MI), n-3 (omega-3) PUFA status is low, whereas the risk of depression is increased. Objective: The objective was to assess whether the plant-derived a-linolenic acid (ALA) and the fish fatty acids EPA and DHA would improve affective states. Design: In a secondary analysis of the randomized, double-blind, placebo-controlled Alpha Omega Trial, 4116 of 4837 (85.1%) patients (aged 60–80 y; 79.2% men) who had experienced an MI were included. Margarine spreads were used to deliver 400 mg EPA-DHA/d, 2 g ALA/d, both EPA-DHA and ALA, or a placebo for 40 mo. At 40 mo, the endpoints of depressive symptoms (15-item Geriatric Depression Scale) and dispositional optimism (a 4-item questionnaire and the Life Orientation Test–Revised) were analyzed by using a posttest-only design. Results: The 4 randomly assigned groups did not differ in baseline characteristics. ALA supplementation significantly increased plasma cholesteryl ester concentrations of ALA by 69%, and EPA-DHA supplementation increased plasma cholesteryl ester concentrations of EPA and DHA by 61% and 30%, respectively. Depressive symptoms or dispositional optimism did not differ between groups with the use of n-3 fatty acids compared with placebo at the 40-mo follow-up. The standardized mean (±SE) differences in depressive symptoms were as follows: for EPA-DHA plus ALA (n = 1009) compared with placebo (n = 1030), -0.025 ± 0.044 (P = 0.57); for EPA-DHA (n = 1007) compared with placebo, -0.048 ± 0.044 (P = 0.28); and for ALA (n = 1022) compared with placebo, -0.047 ± 0.044 (P = 0.29). Conclusions: In patients who had experienced an MI, low-dose EPA-DHA supplementation, ALA supplementation, or a combination of both did not affect depressive symptoms and dispositional optimism. These findings are in accord with those from previous trials in individuals without psychopathology or without severe depressive symptoms. This trial was registered at clinicaltrials.gov as NCT00127452
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