Intakes of Fish and Long-chain n-3 Polyunsaturated Fatty Acid Supplements During Pregnancy and Subsequent Risk of Type 2 Diabetes in a Large Prospective Cohort Study of Norwegian Women

<b></b>OBJECTIVE <br>To investigate associations between intakes of total fish, lean fish, fatty fish, and long chain n-3 polyunsaturated fatty acid (LCn-3PUFA) supplements and risk of type 2 diabetes in women after pregnancy. Furthermore, to compare the estimated intakes of methylmercury (MeHg) and sum of dioxins and dioxin-like polychlorinated biphenyls (dl-PCBs) to tolerable weekly intakes (TWI). <br>RESEARCH DESIGN AND METHODS <br>Women free of diabetes at baseline (n=60,831) who participated in the population-based Norwegian Mother, Father, and Child Cohort study (MoBa) were prospectively evaluated for incident type 2 diabetes identified through medication usage more than 90 days after delivery ascertained by the Norwegian Prescription Database. Dietary intake data was obtained by a validated 255-item food frequency questionnaire (FFQ) which assessed habitual diet during the first four to five months of pregnancy. MeHg and sum of dioxins and dl-PCBs intakes were derived using a contaminant database and the FFQ. <br>RESULTS <br>Median (IQR) age was 31 (27, 34) years at time of delivery and follow-up time was 7.5 (6.5, 8.5) years. Type 2 diabetes occurred in 683 (1.1%) participants. Multivariable Cox regression analyses identified lower risk of type 2 diabetes with increasing energy-adjusted lean fish intake per 25 g/1000 kcal (HR 0.71, 95% CI 0.53-0.95, p=0.022). However, in stratified analyses, a lower risk was found only in women with pre-pregnancy BMI ≥25 kg/m2. There were no associations between intake of total fish, fatty fish, or LCn-3PUFA supplements and type 2 diabetes. MeHg intake was low, but the sum of dioxins and dl-PCBs (pg TEQ/kg bw/wk) exceeded the TWI set by the European Food and Safety Authority (EFSA) for the majority of participants. <br>CONCLUSIONS <br>Intake of lean fish, but not fatty fish or LCn-3PUFA supplements, was associated with lower risk of pharmacologically treated type 2 diabetes in Norwegian women who were overweight or obese. Fatty fish, which contain dioxins and dl-PCBs, did not increase the risk of type 2 diabetes, but the exceedance of the EFSA TWI for dioxins and dl-PCBs is a health concern. <br>

Intakes of Fish and Long-chain n-3 Polyunsaturated Fatty Acid Supplements During Pregnancy and Subsequent Risk of Type 2 Diabetes in a Large Prospective Cohort Study of Norwegian Women

<b></b>OBJECTIVE <br>To investigate associations between intakes of total fish, lean fish, fatty fish, and long chain n-3 polyunsaturated fatty acid (LCn-3PUFA) supplements and risk of type 2 diabetes in women after pregnancy. Furthermore, to compare the estimated intakes of methylmercury (MeHg) and sum of dioxins and dioxin-like polychlorinated biphenyls (dl-PCBs) to tolerable weekly intakes (TWI). <br>RESEARCH DESIGN AND METHODS <br>Women free of diabetes at baseline (n=60,831) who participated in the population-based Norwegian Mother, Father, and Child Cohort study (MoBa) were prospectively evaluated for incident type 2 diabetes identified through medication usage more than 90 days after delivery ascertained by the Norwegian Prescription Database. Dietary intake data was obtained by a validated 255-item food frequency questionnaire (FFQ) which assessed habitual diet during the first four to five months of pregnancy. MeHg and sum of dioxins and dl-PCBs intakes were derived using a contaminant database and the FFQ. <br>RESULTS <br>Median (IQR) age was 31 (27, 34) years at time of delivery and follow-up time was 7.5 (6.5, 8.5) years. Type 2 diabetes occurred in 683 (1.1%) participants. Multivariable Cox regression analyses identified lower risk of type 2 diabetes with increasing energy-adjusted lean fish intake per 25 g/1000 kcal (HR 0.71, 95% CI 0.53-0.95, p=0.022). However, in stratified analyses, a lower risk was found only in women with pre-pregnancy BMI ≥25 kg/m2. There were no associations between intake of total fish, fatty fish, or LCn-3PUFA supplements and type 2 diabetes. MeHg intake was low, but the sum of dioxins and dl-PCBs (pg TEQ/kg bw/wk) exceeded the TWI set by the European Food and Safety Authority (EFSA) for the majority of participants. <br>CONCLUSIONS <br>Intake of lean fish, but not fatty fish or LCn-3PUFA supplements, was associated with lower risk of pharmacologically treated type 2 diabetes in Norwegian women who were overweight or obese. Fatty fish, which contain dioxins and dl-PCBs, did not increase the risk of type 2 diabetes, but the exceedance of the EFSA TWI for dioxins and dl-PCBs is a health concern. <br>

Moderate Consumption of Healthy Nordic Foods is Associated with Reduced Mortality in the Norwegian Women and Cancer Study: a Prospective Cohort Study

BackgroundHigh adherence to healthy Nordic diets may enhance longevity. However, optimal intake levels of healthy Nordic foods are not known. Hence, in a large prospective cohort of women in Norway we examined all-cause mortality in relation to intake of five food groups that are part of a healthy Nordic diet: Nordic fruits and vegetables, fatty fish, lean fish, wholegrain products, and low-fat dairy products. MethodsA total of 87 899 women who completed a food frequency questionnaire between 1996 and 2004 were followed for mortality until the end of 2018. Cox proportional hazards regression models were used to examine the associations between consumption of the Nordic food groups and all-cause mortality. The food groups were examined as categorical exposures, and all but wholegrain products also as continuous exposures in restricted cubic spline models.Results A total of 9 168 women died during the 20-year follow-up. Nordic fruits and vegetables, fatty fish and low-fat dairy products were not linearly associated with mortality (p < 0.05). The optimal intake levels and hazard ratios (HR) and 95% confidence intervals (CI) associated with these intakes were approximately 200 grams/day of Nordic fruits and vegetables (HR 0.84 (95% CI: 0.77–0.90)), 10–20 grams/day of fatty fish (HR 0.98 (95% CI: 0.92–1.03)) and 200 grams/day of low-fat dairy products (HR 0.94 (95% CI: 0.89–0.99)) compared to no consumption. High consumption of fatty fish (≥ 70 grams/day) was associated with increased mortality. Intake of wholegrain products of >120 grams/day was associated with lower mortality (HR 0.92 (95% CI: 0.85–0.99)) compared to < 60 grams per day. Lean fish consumption was not associated with mortality. After stratification by smoking status, the observed association for Nordic fruits and vegetables was only significant in ever smokers with the optimal intake level at 250 grams/day (HR 0.78 (95% CI: 0.71-0.86)).Conclusion Moderate intake of healthy Nordic foods seems to be better than low or high intake, and high consumption either does not add any beneficial effects or can compromise longevity. Stronger inverse associations for Nordic fruits and vegetables were observed in former and current smokers.

Dietary Data in the Malmö Offspring Study–Reproducibility, Method Comparison and Validation against Objective Biomarkers

Irregular dietary intakes impairs estimations from food records. Biomarkers and method combinations can be used to improve estimates. Our aim was to examine reproducibility from two assessment methods, compare them, and validate intakes against objective biomarkers. We used the Malmö Offspring Study (55% women, 18–71 y) with data from a 4-day food record (4DFR) and a short food frequency questionnaire (SFFQ) to compare (1) repeated intakes (n = 180), (2) intakes from 4DFR and SFFQ (n = 1601), and (3) intakes of fatty fish, fruits and vegetables, and citrus with plasma biomarkers (n = 1433) (3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid [CMPF], β-carotene and proline betaine). We also combined 4DFR and SFFQ estimates using principal component analysis (PCA). Moderate correlations were seen between repeated intakes (4DFR median ρ = 0.41, SFFQ median ρ = 0.59) although lower for specific 4DFR-items, especially fatty/lean fish (ρ ≤ 0.08). Between-method correlations (median ρ = 0.33) were higher for intakes of overall food groups compared to specific foods. PCA scores for citrus (proline betaine ρ = 0.53) and fruits and vegetables (β-carotene: ρ = 0.39) showed the highest biomarker correlations, whereas fatty fish intake from the SFFQ per se showed the highest correlation with CMPF (ρ = 0.46). To conclude, the reproducibility of SFFQ data was superior to 4DFR data regarding irregularly consumed foods. Method combination could slightly improve fruit and vegetable estimates, whereas SFFQ data gave most valid fatty fish intake.

Decreases in Concentrations and Human Dietary Intakes of Polychlorinated Biphenyls (PCBs) and Polybrominated Diphenyl Ethers (PBDEs) in Korean Seafood Between 2005 and 2017

Concentrations of PCBs and PBDEs were measured in 23 seafood species widely consumed by Korean population in 2005–2007, 2010–2011, and 2015–2017. The Σ82PCB and Σ19PBDE concentrations in the seafood samples of 2015–2017 were 0.06–6.69 ng/g wet weight and 0.01–1.60 ng/g wet weight, respectively. The Σ82PCB and Σ19PBDE concentrations in the samples were correlated significantly, and elevated PCB and PBDE concentrations were found in fatty fish such as herring, mackerel, and tuna. The current intakes of PCBs and PBDEs were much lower than a TDI or a LOAEL. The levels and human dietary intakes of PCBs and PBDEs in the 2015–2017 survey showed decreases of 17–73% and 57–86%, respectively, in relation to the 2005–2007 and 2010–2011 surveys. This indicates that global bans on PCBs and PBDEs have been effective, and their levels and exposure have been gradually declining.

Nutritional Importance of Selected Fresh Fishes, Shrimps and Mollusks to Meet Compliance with Nutritional Guidelines of n-3 LC-PUFA Intake in Spain

Fishery products are the main source of dietary n-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFA). Following the European Commission’s request to address the risks and benefits of seafood consumption, and taking into account the great variability of nutrient and contaminant levels in fishery products, the present work aims to estimate the n-3 LC-PUFA provided per serving of selected fishes, shrimps and mollusks that are commonly consumed in Spain. This would enable the establishment of a risk–benefit analysis of fish consumption and provide recommendations for fish intake to comply with nutritional guidelines of n-3 LC-PUFA intake. We confirmed high variation in the pattern and contents of fatty acids for different species. n-6 PUFA were minor fatty acids, whereas palmitic (C16:0), oleic (C18:1 n-9), and mainly eicosapentaenoic (C20:5 n-3) and docosahexaenoic (C22:6 n-3) acids were the major fatty acids in the sample. Therefore, consumption of 2–3 servings per week of a variety of fishery products may contribute to compliance with the recommended daily n-3 LC-PUFA intake while maintaining an adequate balance to avoid contaminant-derived potential risks (metals and others). Taking the fatty acid content of fishery products described in this study into consideration, it is advisable to include one serving of fatty fish per week in order to meet recommended n-3 LC-PUFA levels.

A Whole-Diet Approach Affects Not Only Fasting but Also Postprandial Cardiometabolic Risk Markers in Overweight and Obese Adults: A Randomized Controlled Trial

ABSTRACT Background Current dietary recommendations for cardiovascular disease (CVD) prevention focus more on dietary patterns than on single nutrients. However, randomized controlled trials using whole-diet approaches to study effects on both fasting and postprandial CVD risk markers are limited. Objective This randomized parallel trial compared the effects of a healthy diet (HD) with those of a typical Western diet (WD) on fasting and postprandial CVD risk markers in overweight and obese adults. Methods After a 2-wk run-in period, 40 men and women (50–70 y; BMI: 25–35 kg/m2) consumed the HD (high in fruit and vegetables, pulses, fibers, nuts, fatty fish, polyunsaturated fatty acids; low in salt and high-glycemic carbohydrates; n = 19) or the WD (less fruit, vegetables, and fibers; no nuts and fatty fish; and more saturated fatty acids and simple carbohydrates; n = 21) for 6 wk. Fasting and postprandial cardiometabolic risk markers were assessed as secondary outcome parameters during a 5-h mixed-meal challenge, and a per protocol analysis was performed using 1-factor ANCOVA or linear mixed models. Results Differences in diet-induced changes are expressed relative to the HD group. Changes in fasting plasma total cholesterol (–0.57 ± 0.12 mmol/L, P &lt; 0.001), LDL cholesterol (–0.41 ± 0.12 mmol/L, P &lt; 0.01), apolipoprotein B100 (–0.09 ± 0.03 g/L, P &lt; 0.01), and apolipoprotein A1 (–0.06 ± 0.03 g/L, P = 0.05) were significantly different between the diet groups. Changes in postprandial plasma triacylglycerol (diet × time, P &lt; 0.001) and apolipoprotein B48 (P &lt; 0.01) differed significantly between the groups with clear improvements on the HD, although fasting triacylglycerols (–0.24 ± 0.13 mmol/L, P = 0.06) and apolipoprotein B48 (1.04 ± 0.67 mg/L, P = 0.40) did not. Significant differences between the diets were also detected in fasting systolic (–6.9 ± 3.1 mmHg, P &lt; 0.05) and 24-h systolic (–5.0 ± 1.7 mmHg, P &lt; 0.01) and diastolic (–3.3 ± 1.1 mmHg, P &lt; 0.01) blood pressure. Conclusion A whole-diet approach targeted multiple fasting and postprandial CVD risk markers in overweight and obese adults. In fact, the postprandial measurements provided important additional information to estimate CVD risk. This trial is registered at clinicaltrials.gov as NCT02519127.