scholarly journals Nutrient Composition Comparison between the Low Saturated Fat Swank Diet for Multiple Sclerosis and Healthy U.S.-Style Eating Pattern

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 616 ◽  
Author(s):  
Catherine A. Chenard ◽  
Linda M. Rubenstein ◽  
Linda G. Snetselaar ◽  
Terry L. Wahls

Multiple sclerosis (MS) is an incurable degenerative disease that attacks the central nervous system. Roy Swank proposed a low saturated fat diet to treat MS around 1950 and showed delayed disease progression in his patients. However, there is insufficient evidence to recommend this diet for MS and default dietary recommendations are the Dietary Guidelines for Americans (DGA). This study assessed the nutritional adequacy of seven-day menus developed by Swank and their compliance with the DGA; menus were modeled for comparison with the DGA Healthy US-Style Eating Pattern (HEP) for males and females 31–50 years. Swank recommended dietary supplements corrected menu shortfalls in vitamins D, E, calcium, folate and iron but not dietary fiber, potassium and choline. Healthy Eating Index-2015 score for Swank menus (93.2/100) indicated good compliance with the DGA. Nutritional adequacy of the Swank modeled diet was similar to HEP for 17 vitamins and minerals (Mean Adequacy Ratios ≥94%) with similar shortfall nutrients except magnesium (HEP males) and dietary fiber (Swank males). Alternate Healthy Eating Index-2010 scores for Swank male (90/110) and female (88/110) model diets were similar to HEP. Swank menus have similar nutritional adequacy as HEP. Inclusion of foods high in dietary fiber, potassium and choline may be advised as well as selection of foods to reduce sodium below the Tolerable Upper Intake Level.

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 537 ◽  
Author(s):  
Catherine Chenard ◽  
Linda Rubenstein ◽  
Linda Snetselaar ◽  
Terry Wahls

Multiple sclerosis (MS) is a demyelinating disease that attacks the central nervous system. Evidence-based dietary guidelines do not exist for MS; the default advice is to follow the Dietary Guidelines for Americans (DGA). A modified Paleolithic Wahls Elimination (WahlsElim) diet promoted for MS excludes grains and dairy and encourages 9+ cups fruits and vegetables (F/V) and saturated fat for cooking. This study evaluated the nutritional adequacy of seven-day menus and modeled them with varying amounts of F/V for comparison with the DGA Healthy US-Style Eating Pattern (HEP) for ages 31–50 years. WahlsElim menus had low added sugar and glycemic index. Nutritional adequacy of the menus and modeled versions were similar to HEP for 17 vitamins and minerals (mean adequacy ratio ≥92%). Nutrient shortfalls for the modeled diet with 60% F/V were identical to HEP for vitamin D, iron (females), magnesium (marginally males), choline and potassium; this modeled diet was also low in dietary fiber and calcium but met vitamin E requirements while HEP did not. WahlsElim-prescribed supplements corrected vitamin D and magnesium shortfalls; careful selection of foods are needed to meet requirements of other shortfall nutrients and reduce saturated fat and sodium. Doctors should monitor nutritional status, supplement doses, and possible contraindications to high vitamin K intake in individuals following the WahlsElim diet.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
See Ling Loy ◽  
Yin Bun Cheung ◽  
Colega Marjorelee ◽  
Airu Chia ◽  
Chad Yixian Han ◽  
...  

AbstractRecent evidence suggests that synchronizing eating-fasting schedules with body's circadian rhythms or day-night cycles is important for metabolic health. Besides food quantity and quality, food timing may contribute to weight regulation. However, it is unclear if this factor during pregnancy can influence maternal weight retention after childbirth. Using data from a prospective cohort, the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study, we examined the associations of maternal circadian eating pattern and diet quality in pregnancy with substantial postpartum weight retention (PPWR) at 18 months. We assessed 687 pregnant women for their circadian eating pattern (night-eating, night-fasting and eating episodes) and diet quality (Healthy Eating Index) based on information derived from 24-h dietary recall at 26–28 weeks’ gestation. Night-eating was defined as > 50% of total energy intake during 1900–0659 h; night-fasting duration was determined based on the longest fasting interval between consumption of a calorie-containing food or beverage during 1900–0659 h; eating episodes were defined as events that provided ≥ 210 kJ with time intervals between eating episodes of ≥ 15 min; diet quality was ascertained using the Healthy Eating Index which measures adherence to the Singapore dietary guidelines for pregnant women. PPWR was calculated by subtracting the weight at the first antenatal clinic visit from weight at 18-month postpartum. Substantial PPWR was defined as weight retention of 5 kg or more. Adjusting for maternal age, ethnicity, education, parity, night shift, mood, body mass index and total energy intake, multivariable binary logistic regression analysis was performed to estimate odds ratio (OR) of substantial PPWR in relation to circadian eating pattern and diet quality. Of 687 women, 110 (16%) had substantial PPWR. After confounders adjustment, night-eating (OR 1.95; 95% confidence interval 1.05, 3.62) and lower diet quality (1.91; 1.17, 3.10) were independently associated with higher odds of substantial PPWR. No associations with substantial PPWR were observed for night-fasting duration and number of eating episodes. During pregnancy, women with higher caloric consumption at night and lower diet quality had a greater likelihood of substantial PPWR. These findings suggest that aligning eating time with day-night cycles and adherence to dietary guidelines during pregnancy may help to alleviate overweight and obesity risk in postpartum life. There is a possibility that these eating patterns persist beyond pregnancy and pose implications for long-term obesity development. Further investigation on this area is required.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Jiaqi Wang ◽  
Danielle Haslam ◽  
Mengyuan Ruan ◽  
Fan Chen ◽  
Mengxi Du ◽  
...  

Abstract Objectives The 2015 Dietary Guidelines for Americans (DGA) recommend a healthy eating pattern for chronic disease prevention. This study aimed to prospectively evaluate diet quality by adherence to the 2015 DGA in association with mortality outcomes among a representative sample of US adults. Methods Using dietary data collected by 24-hour diet recalls among 29,098 US adults aged 20+ years from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2010, we estimated adherence to the 2015 DGA using the Healthy Eating Index-2015 (HEI-2015). Mortality from all cause, cardiovascular diseases (CVD), and cancer were obtained from linkage to the National Death Index Mortality data. Cox proportional-hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) after multivariable adjustments. Results The mean (SE) of total HEI-2015 was 50.1 (0.2). During a median follow-up of 6.2 years, 2861 total deaths occurred, including 726 CVD and 671 cancer deaths. Compared to individuals in the lowest quartile of HEI-2015, those in the highest quartile had a 16% lower risk of all-cause mortality (Q4 vs. Q1: HR = 0.84; 95% CI: 0.72–0.90; P-trend = 0.04) and a 31% lower risk of cancer mortality (Q4 vs. Q1: HR = 0.69; 95% CI: 0.50–0.95; P-trend = 0.06). The lower all-cause and cancer mortality among those with higher HEI-2015 scores was confined to individuals with comorbidity conditions at baseline (all-cause mortality: Q4 vs. Q1: HR = 0.79; 95% CI: 0.67–0.94; p-trend = 0.005; cancer mortality: Q4 vs. Q1: HR = 0.46; 95% CI: 0.30–0.69; p-trend = 0.001), former smokers (all-cause mortality: Q4 vs. Q1: HR = 0.65; 95% CI: 0.49–0.88; p-trend = 0.006; cancer mortality: Q4 vs. Q1: HR = 0.47; 95% CI: 0.29–0.74; p-trend = 0.005), and those with a body mass index of 18.5–25 kg/m2 (all-cause mortality: Q4 vs. Q1: HR = 0.60; 95% CI: 0.46–0.79; p-trend < 0.001; cancer mortality: Q4 vs. Q1: HR = 0.40; 95% CI: 0.22–0.70; p-trend = 0.001). Similar associations were found between men and women. No significant associations were observed between HEI-2015 and CVD mortality. Conclusions Better adherence to the 2015 Dietary Guidelines of Americans is associated with lower all-cause and cancer mortality among US adults. Funding Sources National Institute of Health/National Institute of Minority Health and Health Disparities. Supporting Tables, Images and/or Graphs    


2010 ◽  
Vol 13 (8) ◽  
pp. 1170-1177 ◽  
Author(s):  
Megan E Grimstvedt ◽  
Kathleen Woolf ◽  
Brandy-Joe Milliron ◽  
Melinda M Manore

AbstractObjectiveTo assess the dietary quality of older women with and without rheumatoid arthritis (RA) using the Healthy Eating Index-2005 (HEI-2005) to identify potential strategies to improve the nutritional status.DesignCross-sectional. Diet was assessed using 7 d food records and analysed for nutrient composition (Food Processor v. 7·11). Diet quality was determined using the HEI-2005, a measure of compliance with 2005 US Dietary Guidelines. Individuals with RA completed a self-reported evaluation of arthritis (pain scale and disability index). Independent two-tailed t tests or Mann–Whitney tests compared the differences between groups and correlations were computed between HEI-2005 and measures of disease reactivity.SettingArizona, USA.SubjectsOlder (≥ 55 years) women (n 108) with RA (n 52) and healthy controls (HC; n 56).ResultsThere were no differences between groups in age, weight, or BMI (kg/m2). HC participants had higher mean HEI-2005 scores for whole fruit (cups; P = 0·02), total fruit (cups; P = 0·05), whole grains (oz; P = 0·004), oil (g; P = 0·05) and total HEI score (P = 0·04) than the RA group. In the RA group, these same HEI components were inversely correlated with disability index (r = −0·20, P = 0·04). Participants with RA reported lower mean intakes of carbohydrate (g; P = 0·02), fibre (g; P = 0·01) and vitamin C (mg; P = 0·04).ConclusionsThis is the first study examining the dietary quality in older women with and without RA using the HEI-2005. Living with RA was associated with significantly lower dietary quality. Since even small changes in dietary quality can translate into better nutritional status, future interventions should focus on increasing dietary quality in this high-risk group.


2015 ◽  
Author(s):  
Elizabeth G Nabel

An unhealthy diet is a major risk factor for chronic diseases such as cardiovascular diseases, cancer, diabetes, and conditions related to obesity. In the 20th century, the average American diet shifted from one based on fresh, minimally processed vegetable foods to one based on animal products and highly refined, processed foods, leading to an increased consumption of calories, fat, cholesterol, refined sugar, animal protein, sodium, and alcohol and far less fiber and starch than was healthful. As a result, more than one third of US adults are obese, with an estimated medical cost of $147 billion. Physicians have an important role in educating patients about healthful nutrition and in providing dietary guidelines. This module discusses the role of energy in weight loss; the structure of fat and cholesterol, their effects on blood lipid levels and cardiovascular risk, and related dietary recommendations; carbohydrates; dietary fiber; proteins; vitamin and mineral consumption; water and food consumption; and the relationship between diet and health. Tables review the principles of a healthy diet; recommended daily intake of fat and other nutrients; types of dietary fiber and representative food sources; types of vitamins; essential minerals and trace elements; and dietary guidelines for healthy people. Figures include a graph showing the percentage of adults who are healthy weight, overweight, and obese and the structure of fat and cholesterol. This review contains 2 highly rendered figures, 6 tables, and 37 references.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Danielle Krobath ◽  
William Masters ◽  
Megan Mueller

Abstract Objectives This study concerns how the description of foods on restaurant menus relates to their nutrient content as disclosed on company websites. We aimed to test halo effects, regarding how claims about some desirable features might be associated with the presence of other attributes. Methods We used item descriptions and nutrient data for food items (n = 92,949) at the top-selling restaurant chains (n = 92) from 2012 through 2017 in the United States, compiled by the MenuStat project. We classified items into 4 types (mains, appetizers, desserts, sides) and claims into 3 groups using 29 search terms based on consumer interests in health (e.g., “nutritious”), product sourcing (e.g., “local” or “organic”), and vegetal items (vegetarian or vegan). Nutrient data focus on 4 dietary recommendations to limit sodium (mg), trans-fat (g) and saturated fats (% of energy), and to increase fiber (g). We also report calories per item (kcal) and its share from carbohydrates, protein and total fat (%). We used multiple regression to test whether nutrient content was associated with menu claims, controlling for year and restaurant brand, the item being marked as “shareable”, on a kid's menu, or regional and limited-time offerings. Methods and hypotheses were preregistered on As-Predicted.com. Results Contrary to our prediction, nutrient content was more often aligned with U.S. dietary guidelines when their description did include claims. With 3 claim types, 4 food types and 4 recommendations we test 48 possible cases. In 25 (52%) we found alignment between claims and nutrient recommendations, e.g., main dishes with health-related claims had 2% less calories from saturated fat (P < 0.01) and 142 mg less sodium (P < 0.01). In 3 of 48 cases (7%), claims were contrary to recommendations, all of which were desserts with sourcing claims which had more sodium, more trans-fat and more saturated fat than other desserts (all P < 0.01). In 20 of 48 cases (42%) there was no significant difference between items with and without claims. Conclusions Items described as vegetarian/vegan or with sourcing and health claims had nutrient contents that were more often aligned with dietary guidelines than other items. Menu labeling that communicates meal content more directly, such as nutrient fact panels, could inform choice and build trust in restaurant meals. Funding Sources None.


Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 519 ◽  
Author(s):  
Ingrid Richards Adams ◽  
Wilson Figueroa ◽  
Irene Hatsu ◽  
James Odei ◽  
Mercedes Sotos-Prieto ◽  
...  

A healthy diet is associated with lower risk of chronic disease. African Americans generally have poor diet quality and experience a higher burden of many chronic diseases. We examined the associations of demographic and psychosocial factors and barriers to diet quality among African American adults. This cross-sectional study included 100 African American adults in a southeastern metropolitan area. Psychosocial factors (social support, self-efficacy), and barriers to healthy eating were assessed with validated measures. Diet quality was assessed using the Healthy Eating Index (HEI-2010). Nested linear regressions were used to examine the association between the variables of interest and HEI scores. Participants reported having social support (M (mean) = 2.0, SD (standard deviation) = 0.6, range 0–3), high levels of self-efficacy (M = 3.1, SD = 0.7, range 1–4), and low barriers (M = 1.4, SD = 0.6, range 0–4) to engage in healthy eating but total mean HEI scores needed improvement (M = 54.8, SD = 10.9, range 27.1–70.0). Participants consumed significantly higher empty calories and lower whole fruits, dairy, and total protein foods than the national average. Barriers to healthy eating (b = −12.13, p = 0.01) and the interaction between age and barriers (b = 0.25, p = 0.02) were most strongly associated with lower HEI scores. Younger African Americans with the highest barriers to healthy eating had the lowest HEI scores. Culturally appropriate interventions targeting empty calories, barriers to healthy eating, and knowledge of the Dietary Guidelines for Americans are needed for African Americans.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Victoria Miller ◽  
Patrick Webb ◽  
Renata Micha ◽  
Dariush Mozaffarian

Abstract Objectives Meeting most of the UN Sustainable Development Goals (SGDs) will require a strong focus on tackling all forms of malnutrition─ addressing maternal and child health (MCH) as well as diet-related non-communicable diseases (NCDs). Yet, the optimal metrics to define a healthy diet remain unclear. Our aim was to comprehensively review diet metrics and assess the evidence on each metric's association with MCH and NCDs. Methods Using comprehensive searches and expert discussions, we identified metrics that i) are used in ≥3 countries to link diet to health, ii) quantify the number of foods/food groups consumed and/or iii) quantify recommended nutrient intakes. We reviewed and summarized each metric's development, components and scoring. For each identified metric, we systematically searched PubMed to identify meta-analyses or narrative reviews evaluating these metrics with nutrient adequacy and health outcomes. We assessed validity by grading the number of studies included and the consistency of the diet metric-disease relationship. Results We identified 6 MCH, 13 NCD and 0 MCH/NCD metrics. Most were developed for describing adherence to dietary guidelines or patterns, and others were developed for predicting micronutrient adequacy. On average, the metrics included 14 food groups/nutrients (range 4–45), with 10 food-group only metrics and 0 nutrient-only metrics. The most frequent metric components were grains/roots/tubers, fruits and vegetables. We identified 16 meta-analyses and 14 narrative reviews representing 102 metric-disease relationships (98 metric-NCD and 4 metric-MCH relationships, respectively). We found 5 metrics that have been consistently validated in meta-analyses and narrative reviews for NCDs, 1 metric with limited evidence for MCH, but 0 metrics for both. Of the metrics, the Alternative Healthy Eating Index (aHEI), Dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index (HEI), and Mediterranean Diet Score (MED) were most commonly validated, especially for all-cause mortality and cardiovascular disease (Figure 1). Conclusions Few diet metrics have been used in multiple countries to define a healthy diet. This suggests a serious gap in global analyses of diet quality relating to malnutrition in all its forms, which hinders effective policy action. Funding Sources Gates Foundation. Supporting Tables, Images and/or Graphs


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027846 ◽  
Author(s):  
Tesfaye Hailu Bekele ◽  
Jeanne JHM de Vries ◽  
Laura Trijsburg ◽  
Edith Feskens ◽  
Namukolo Covic ◽  
...  

IntroductionFood-based dietary guidelines (FBDGs) are used to promote and maintain healthy eating in a population, by providing country-specific guidance. However, many African countries like Ethiopia do not have FBDGs. This paper describes the methodology for the development of Ethiopian FBDGs and for creating and evaluating a Healthy Eating Index and a scoring tool that can be used to monitor the adherence of the population to FBDGs.Methods and analysisA multidisciplinary technical working group will be tasked to develop FBDGs for the general population above 2 years of age based on identification of priority diet-related public health problems and risk factors, and a systematic review of dietary patterns in relation to the identified priority health outcomes, following a multistep process. FBDGs will be translated into daily food choices for specific subpopulations by applying linear programming using data from the National Food Consumption Survey (NFCS) of 2011. FBDGs will be evaluated for cultural appropriateness, acceptability, consumer understanding and practicality. A dietary gap assessment will be conducted by comparing the national food supply with the country’s food demand. In addition an Ethiopian Healthy Eating Index (EHEI) will be developed based on the FBDGs using the NFCS data. The EHEI will be evaluated by comparing the EHEI Score based on 24 hours diet recall with that of the EHEI Score based on a Food Frequency Questionnaire, by analysing the association of the EHEI Score with population characteristics and micronutrient intake with or without additional adjustment for energy intake. Finally, a brief Food Quality Screening tool scoring for the important EHEI components will be developed to enable evaluation for counselling.Ethics and disseminationEthical approval is received from the Scientific and Ethical Review Office of the Ethiopian Public Health Institute. The findings will be disseminated through peer-reviewed publications.A dissemination workshop will be organised with key implementing sectors of the food system for a healthier diet (http://a4nh.cgiar.org/our-research/research-flagships/) and with key public and private partners. The findings from this study will be translated into FBDGs and shared through conferences, reports and the mass media (TV and radio).Trial registration numberNCT03394963; Pre-results.


2004 ◽  
Vol 7 (3) ◽  
pp. 443-452 ◽  
Author(s):  
Kylie Ball ◽  
Gita D Mishra ◽  
Christopher W Thane ◽  
Allison Hodge

AbstractObjective:To investigate the proportion of middle-aged Australian women meeting national dietary recommendations and its variation according to selected sociodemographic and behavioural characteristics.Design:This cross-sectional population-based study used a food-frequency questionnaire to investigate dietary patterns and compliance with 13 commonly promoted dietary guidelines among a cohort of middle-aged women participating in the Australian Longitudinal Study on Women's Health.Setting:Nation-wide community-based survey.Subjects:A total of 10 561 women aged 50–55 years at the time of the survey in 2001.Results:Only about one-third of women complied with more than half of the guidelines, and only two women in the entire sample met all 13 guidelines examined. While guidelines for meat/fish/poultry/eggs/nuts/legumes and ‘extra’ foods (e.g. ice cream, chocolate, cakes, potatoes, pizza, hamburgers and wine) were met well, large percentages of women (68–88%) did not meet guidelines relating to the consumption of breads, cereal-based foods and dairy products, and intakes of total and saturated fat and iron. Women working in lower socio-economic status occupations, and women living alone or with people other than a partner and/or children, were at significantly increased risk of not meeting guidelines.Conclusions:The present results indicate that a large proportion of middle-aged Australian women are not meeting dietary guidelines. Without substantial changes in their diets, and help in making these changes, current national guidelines appear unachievable for many women.


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