Nutrition

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Normally the human gastrointestinal tract digests and absorbs dietary nutrients with remarkable efficiency.

A typical Western diet ingested by an adult in one day includes approximately 100 g of fat, 400 g of carbohydrate, 100 g of protein, 2 L of fluid, and the required sodium, potassium, chloride, calcium, vitamins, and other elements.

It is estimated that the average person in the United States consumes around 19.5 teaspoons, or 82 grams (g) of sugar, per day:

That is over double the amount recommended by the American Heart Association (AHA), which is 9 teaspoons per day for men and 6 teaspoons for women.

Indigenous humans living in the wild generally do not develop obesity, diabetes, hypertension, coronary artery disease, or other chronic noncommunicable diseases prevalent in modern society.

Nutritional needs should be met primarily from foods.

The world produces more than three times the meat and more than double the milk as it did 50 years ago.

 

In some cases, fortified foods and dietary supplements may be useful in providing one or more nutrients that otherwise may be consumed in less-than-recommended amounts.

Poor diet quality is identified as among the leading causes of premature deaths and disability in the US.

Clinical trials suggest less than 1% of US consume an ideal diet.

Less than  5% of the US population meets dietary fiber recommendations due to inadequate plant-based food intake.

Plant-based diets are associated with reduced incidence of chronic diseases  such as obesity, cardiovascular disease, diabetes, chronic kidney disease, and cancer.

Poor diet is estimated to be the leading cause of death and the third leading cause of disability adjusted life-year loss.

Poor diet is a major contributor to chronic diseases that include: diabetes, heart disease, stroke,cancer, and obesity accounting for substantial morbidity and premature mortality.

Diets at early ages shape lifelong food preferences and health outcomes.

Diet quality and dietary protein intake are vital for maintaining body composition and muscle mass, as well as improving physical performance 

 

Consuming less than the protein RDA results in significant declines in muscle mass, strength, and function in older populations.

Dietary factors are responsible for more than 40% of the most common cardiometabolic related deaths in the US.

 

6 in 10 young people aged 2 to 19 years and 5 in 10 adults consume a sugary drink on a given day.

 

A poor diet outranks smoking as the leading cause of death worldwide and in the US.

Healthy dietary patterns are associated with lower risk of all-causemortality, cardiovascular disease, type two diabetes, weight gain, depression, cognitive decline, and cancer.

A healthy diet has been linked to reduce the risk of physical frailty and functional impairment.

It is possible that improved diets could prevent more than one in five deaths worldwide each year.

A healthy diet is associated with less functional deterioration, prevents or delays the development of disabilities and is paramount to achieve healthy aging.

Diet affects the concentrations of circulating blood lipids.

Diet can alter the immune and inflammatory processes that is present in the epithelium that impacts the pathophysiology of atherosclerotic plaque.

Better quality diet patterns in adulthood are associated with better performance cognitively in mid life.

Calorie demands are mainly supplied by three macronutrients: carbohydrate, fat, and protein.

Extended increases in consumption of one macro nutrient often leads to decreases in another.

Ischemic heart disease, influenced markedly by dietary factors is the process most responsible for years of life lost due to premature death.

Nearly 80% of Americans age 6 years and older are not at risk of deficiencies in any of the seven vitamins examined by biomarkers, A, B6, B12, C, D, E, and folate.

Approximately 1000 kcal available in muscles, liver and the bloodstream as glucose or glycogen daily.

Most of the US population is not at risk of nutritional deficiencies, nor do they have nutritional deficiencies and associated diseases.

NHANES/USDA data suggests that popular food such as pizza, fast food sandwiches and burgers, and food categorized as snacks and desserts contribute an estimated 41% of consumed of energy intake.

In most populations, most energy intake comes from refined starches, sugar, potatoes, and fats that are highly saturated or partially hydrogenated. 

When 41% of total energy intake is composed of food with low nutrient density, it is unlikely that diet and nutrient needs can be met from the remaining 59% of energy intake.

Memory-based dietary assessments bear little relation to actual energy or nutrient consumption.

National Health and Nutrition Exam Survey finds suboptimal intake dietary factors est 45% of cardiometabolic deaths.

It is estimated that the health effects of diet around the world are responsible for 20% of all deaths related to such dietary risk factors as excess sodium and inadequate intake of fruit and fiber.

Diet has a profound effect on the development of heart failure in US adults without coronary disease: a plant-based diet lead to 41% less congestive heart failure.

PURE-Prospective Urban and Rural Epidemiological study following 135,330 participants since 2003 revealed higher carbohydrate diet had adverse affects on long-term survival and cardiovascular health.

Low-carb diets cause people to burn more calories

Most people regain the weight they lose from dieting within one or two years, in part because the body adapts by slowing metabolism and burning fewer calories.

Eating fewer carbohydrates increases the number of calories burned: Framingham State Food Study

Low-carb diets can help people maintain weight loss, making obesity treatment more effective.

There is a significant inverse association between fruit and vegetable consumption and mortality, with benefits apparent in equal or greater than seven daily portions.

When comparing fruit and vegetable consumption, vegetables are more nutritious.

Processed carbohydrates during the low-fat era have raised insulin levels, driving fat cells to store excessive calories.

With fewer calories available to the rest of the body, hunger increases and metabolism slows, causing weight gain.

Participants were then randomized to follow high-, moderate- or low-carbohydrate diets, with carbs comprising 60, 40 and 20 percent of total calories, respectively.

The goal was to compare energy expenditure?how the different groups burned calories at the same weight.

Over the 20 weeks, total energy expenditure was significantly greater on the low-carbohydrate diet versus the high-carbohydrate diet.

Participants who consumed the low-carb diet burned about 250 kilocalories a day more than those on the high-carb diet.

In people with the highest insulin secretion at baseline, the difference in calorie expenditure between the low- and high-carb diets was even greater, about 400 kilocalories per day.

Ghrelin, reduces calorie burning, was significantly lower on the low- versus high-carb diet.

The study suggested low-carb diets also decrease hunger, which could help with weight loss in the long term.

PURE study found higher fat diets improved outcomes and that processed foods, principally added sugars and refined grains are driving increased mortality with high carbohydrate intakes.

PURE study showed that vegetable, fruit, and legume consumption was associated with lower mortality risk, with maximal mortality benefit noted with 4servings daily.

 

The quality of the calories consumed matters, not necessarily whether you are vegan, vegetarian, or neither.

 

EPIC-Oxford Study: The authors categorized the participants into meat eaters, fish eaters, vegetarians and vegans, involving over 48,000 participants.

The researchers found that vegetarians/vegans had a lower risk of heart attack and heart disease than those who ate land animal protein.

Compared to those who consumed land animal protein, lacto-ovo vegetarians and vegans were 20% more likely to have a stroke of any kind, and 43% more likely to have a hemorrhagic stroke.

Study members who did not eat land animal protein had lower circulating levels of B12, vitamin D, certain amino acids, and omega-3 fatty acids, but had slightly lower BMI and better cholesterol and blood pressure scores, which may partially explain the difference in risk of heart attack versus stroke.

 

Vegans obtain all their protein from plants, omnivores usually a third, and ovo-lacto vegetarians half.

 

Vegetarian diets typically contain limited amounts of DHA, and vegan diets typically contain no DHA.

Solid fat and added sugar intake dietary components are most highly predictive of all cause mortality.

The recommendation that we eat three meals a day with some snacking on top is mainly based on studies of diabetics, but it intermittent fasting actually improves glucose regulation.

The epidemic of obesity has occurred occurred in the past 40 years with the eating pattern of three meals a day plus snacks.

Diets containing large amounts of fat, particularly animal fat, are tied to the development of atherosclerosis with subsequent development of myocardial infarction and stroke.

Simple carbohydrates with high glycemic indices, sugar, wheat flour, and rice, might be as important as causative factors in the development of atherosclerosis as fatty diets.

Individuals who consume more than one-third of their daily calories as solid fats have more than three times the risk of dying from any cause over an average age of 18 years of follow-up compared with individuals who eat less than 28.5% of calories as solid fats and between 3.5% and 9.1%as added sugars (Shah N).

Americans take in an average of more than 17 teaspoons of sugar, equivalent to about 290 calories, a day from added sugars, often in sweetened beverages.

Sugar is added to countless food products, including breads, condiments, dairy-based foods, nut butters, salad dressings, and sauces.

Sugar is added to impart sweetness, and also used to extend shelf life and adjust attributes like the texture, body, color, and browning capability of food.

Sugar-sweetened beverages contribute about half of the total added sugar in the U.S. food supply.

The source of the sugar in most products is high-fructose corn syrup.

Sugary drinks include:

regular soda

juice drinks, like fruit punch

energy drinks

sports drinks

sweet tea

sweetened coffee drinks

sweetened water

any other beverages with sucrose or high-fructose corn syrup added to enhance sweetness.

Whole juices contain only the sugars in the juice extracted from the fruit or vegetable.

 

Nutritional Pearls: Fruit Juice and Heart Disease

The effects of drinking 100% fruit juice compared to placebo on blood pressure, finding that 100% fruit juice intake showed a reduction of both systolic and diastolic blood pressure�about 3 points for systolic blood pressure and 2 points for diastolic blood pressure.

No body weight change, cholesterol scores, glucose metabolism, or risk of stroke occurred between 100% fruit juice and placebo.

Low-moderate 100% fruit juice consumption is not associated with increased risk of cardiovascular disease and is associated with apparent benefit against the development of  cardiovascilsr disease.

Eating fruit rather than drinking its juice is more beneficial to health, and the increase in  intake of fruit juice is likely to develop diabetes and drinking fruit juice on a daily basis has been linked to higher central blood pressures.

On average, Americans get more than 200 calories a day from sugary drinks, about four times what we consumed in 1965.

Brownies, cakes, cookies, doughnuts, ice cream, pastries, pies, puddings, and sweet rolls are just some of the processed foods widely understood to contain substantial amounts of added sugar.

Sugars naturally present in honey and syrups, including maple syrup, are also considered added sugars.

Condiments are spices, or sauces, that you add to food to enhance its flavor.

Tomato ketchup, relish, barbecue sauce, salad dressings, and salsa are condiments, and they can contain considerable amounts of sugar per serving.

Many prepared foods contain additional sweeteners.

Breakfast cereals contain added sugar, but so do ready-to-eat meals, breads, soups, tomato sauces, snacks, and cured meats.

Sugar-sweetened yogurts are processed with added sugar, and can can double or triple the total amount of sugar of Plain unsweetened yogurt.

Dairy products account for about 10% of total fats in the average US diet.

Lowest risk for mortality individuals who eat the least added sugar, but consumed a moderate amount of added sugar between 3.5 and 9.1% of their total daily caloric intake (Shah N).

It is recommended that discretionary calories, including added sugars and solid fats, be limited between 5-10% of daily caloric intake.

NHS and Health Professional Follow-up Study involving 127,536 individuals indicated a strong positive association between the intake of food rich in refined starches and added sugars with 10% relative risk increase of coronary heart disease.

It is recommended that ten percent of total energy should be derived from added sugars.

Children and adolescents get 16% of their daily calories from added sugars, and adults approximately 13%.

Men aged 20-39 get the highest percentage of the calories from added sugars, 14%, and men 60 years or older get the lowest at about 11%.

Women have similar pattern and similar percentages of added sugars.

As income increases the amount of calories from added sugars decreases.

Large pooled analysis of five studies in Europe and North America found that higher levels of fish consumption were linked to slower rates of global cognitive and memory decline.

There is a dose-dependent in inverse relationship between fish consumption and mortality from coronary artery disease (Zutphen).

Consuming even a comparatively small amount of fish�at least one 4-ounce serving of fish per week, on average�can affect your risk of stroke as well as other heart-related health conditions.

The study EPIC-NL (European Prospective Investigation into Cancer and Nutrition – Netherlands).

The authors found that those who ate fish of any kind were slightly less,  (only 7% less likely to experience a stroke than those who didn’t eat any fish at all. 

Comparing those who didn’t eat fish at all with those who ate some fish made no statistically significant difference for the risk of heart disease, heart attack, or death from any heart-related cause.

 People who consumed at least 1 portion of lean fish per week were 30% less likely to experience an ischemic stroke than those who ate no fish at all.

Those who consumed only fatty fish were 14% less likely to experience a stroke of any kind, were nearly 50% less likely to have a heart attack and were just over 60% less likely to die of a heart-related cause.

Consuming even a comparatively small amount of fish�at least one 4-ounce serving of fish per week, on average�can affect your risk of stroke as well as other heart-related health conditions. 

Approximately two thirds of added calories are from foods and about one third are from beverages.

Children require more dietary energy relative to their body size that than at any other time in life, equaling 1000 kcal/day in the first year of life and additional 100 cal kilocalories/D for each year of age after that until puberty.

Metabolic regulatory networks that control fuel and energy metabolism include the adenosine monophosphate activated protein kinase-alpha, mammalian target of rapamycin, and hexosamine pathways.

US recommended dietary allowance for protein is 0.8 g per kilogram per day based on short term nitrogen balance studies.

 

The current recommended dietary allowance (RDA) for protein for adults is 0.8 g/kg/day, which averages to ~50 g/d (56 g/d for men; 46 g/d for women) for average weight sedentary adults.

 

Recommendations for older adults suggest an average protein intake of 1-1.2 g per kilogram per day and even higher for those with acute or chronic diseases. 

There are opposite effects of animal and vegetable protein on the outcomes of type two diabetes, cardiovascular disease, all-cause and cardiovascular mortality, with beneficial effects of vegetable protein and detrimental effects of animal proteins.

Evidence is growing yet the beneficial effects of higher intakes of dietary total proteins on muscle mass and strength, physical functioning, hip fracture, and frailty.

Higher total fruit, vegetable, and legume intake is inversely associated with major cardiovascular disease, myocardial infarction, cardiovascular mortality, non-cardiovascular mortality, and total mortality

During normoglycemia glucose is converted to pyruvate, which leads to the reduction of nicotinamide adenine dinucleotide to nicotinamide dinucleotide hydrate and the generation of adenosine triphosphate via the mitochondrial oxidative phosphorylase and pathway.

Enteral nutritional support results in a significant reduction in the risk of developing infectious complications and reduces hospital stay in patients with critical illness.

Fruit and vegetable consumption is not associated with breast cancer risk.

Recent studies reveal no relation between fruit and vegetable consumption and overall cancer incidence.

Fruit and vegetable consumption is associated with a lower incidence of colorectal and lung cancers, as well as several other common cancers.

Dietary components from vegetables interact with intestinal immune receptors and regulate the organogenesis of lymphoid follicles, intestinal immunity and the microbiota

Artificial feeding is indicated in patients with pre-existing malnutrition or for those whose oral intake is anticipated to be inadequate for 7 days or longer.

Intake of green leafy vegetables and vitamin C-rich fruits and vegetables inversely related to risk for coronary artery disease.

 

Fewer than 1 in 10 adults and adolescents eat enough fruits and vegetables, and 9 in 10 Americans aged 2 years or older consume more than the recommended amount of sodium.

Higher intake of folate and vitamin B6 associated with lower risk for coronary heart disease.

An inverse relation between coronary artery disease and the consumption of fruits, vegetable and other foods containing vitamins, particularly vitamin E.

Children who eat fish at least once a week sleep better and have IQ scores that are 4 points higher, on average, than those who consume fish less frequently or not at all.

(Jianghong Liu)

Arinine supplemented diets reduce infections and length of stay of hospital patients undergoing in elective surgical procedures.

Glutamine supplemented parenteral nutrition reduces infection and mortality in critically ill patients.

Antioxidant supplementation is associated with reduced mortality among critically ill patients with systemic inflammation.

Persons who consume more than 100 IU of vitamin E a day for more than two years have lower rates of coronary events and lower rates of progression of coronary artery lesions.

Adherence of a traditional Mediterranean diet is associated with a significant reduction in total mortality.

Numerous studies indicate a Mediterranean diet as an approach to stop hypertension and whole-food plant-based dietary patterns have a favorable impact on cardiovascular outcomes.

In hospitalized patients nutritional support increases calori c and protein intake and body weight but has little effect on clinical outcomes. except for nonelective readmissions (Bally MR et al).

Skipping meals increases abdominal fat.

There is a protective association between seafood consumption and dementia.

Seafood is high in long chain n-3 fatty acid docosahexaenoic acid which promotes normal neuronal function.

Prudent dietary pattern-higher intake of fruits, vegetables, fish, poultry, whole grains, and legumes associated with a lower risk of coronary artery disease.

Less than 25% of adults eat 5 or more servings of fruits and vegetables per day.

Americans eat 3.75 servings of fruit and vegetables per day.

For men who consume less than 2 servings of vegetables per day are 162% more likely to develop diabetes than those who consume 2 or more servings per day. 

Eating whole fruits particularly apples, blueberries, and grapes are significantly associated with a lower risk of type two diabetes by 23%.

The Nurse Health Study revealed the women who consume blueberries or strawberries twice a week at a substantial reduction in cognitive decline compared to women who did not consume berries.

In the Copenhagen heart study the risk of dementia in wine drinkers was reduced by about 50% in both genders.

Consumption of fruit juices linked to higher risk of type two diabetes, increasing risk by 21%.

Overall, the proportion of carbohydrate in a diet is not linked to the risk of onset of Type 2 diabetes, although there is some evidence that a diet containing certain high-carbohydrate items, such as sugar-sweetened drinks, white rice  is associated with an increased risk.

‘Western pattern’-higher intake of red and processed meat, high-fat dairy products, sweets, and desserts associated with a higher risk of coronary artery disease.

It is encouraged to avoid processed meat and limit red meat consumption to twice a week because of links to heart disease, diabetes, and colon cancer.

To replace these meats it recommends consuming fish, poultry, beans or nuts.

Meta-analyses show that redmeat and processed meat are associated with an increased risk of diabetes.

It is recommend eating at least 8 oz (227 grams) of fish each week.

Each additional 100 g serving of fish per week is associated with a 5% reduce risk of acute coronary syndrome.

Dairy products have a well-balanced macro and micro nutrient composition, and provide several functional peptides derive from casein and whey proteins.

There is evidence that dairy consumption is inversely associated with incident hypertension may only among middle ages subjects, but its affects among hypertensive patients remains unclear.

Consumption of low fat dairy product is associated with lower diastolic blood pressure and better blood pressure control among adults with hypertension.

Conversely, consumption of high-fat dairy products is associated with higher blood pressure.

Western diets are risk factors for certain diseases, especially inflammatory bowel disease.

Processed foods may promote obesity and chronic illness with its high energy density, large portions size, low content of fiber micronutrients and phytochemicals, poor quality of dietary fat, high glycemic load and high-intensity flavoring.

PURE study suggests an increased intake of poor quality carbohydrates was linked to an increased risk of major cardiovascular events and death in patients from 20 different countries.

Diets high in poor quality carbohydrates was linked to a greater risk of heart attack, stroke, and death.

PURE study analysis that included more than 135,000 participants from 5 continents suggests a diet with a high glycemic index was associated with a 21% increase in risk of a major cardiovascular event or death among those with no history of cardiovascular disease and this risk became greater among those with preexisting cardiovascular disease.

PURE study, investigators obtained data related to a cohort of 137,851 participants between the ages of 35-70 years from 20 countries on 5 continents. 

The study had a median follow-up of 9.5 years and data from country-specific food-frequency questionnaires. 

8780 deaths and 8252 major cardiovascular events occurred within the study cohort.

Those with a high glycemic index were at an increased risk of a major cardiovascular event or death: increased in risk was present among those with preexisting cardiovascular disease 

and among those without preexisting cardiovascular disease .

Investigators noted similar associations were seen when examining individual aspects of the composite endpoint.

Not all carbohydrates foods are the same: Diets high in poor quality carbohydrates are associated with reduced longevity, while diets rich in high quality carbohydrates such as fruit, vegetables and legumes have beneficial effects.

Processed foods frequently have removal of water promoting shelf life, decreasing transportation costs but with an increase in calories.

Processed products have an increased concentration of calories, but are deficient in fiber micronutrients, phytochemicals, which are plant substances that may have protective effects of vegetables and fruits against , heart disease and malignancies.

Dietary fat of processed foods have a poor quality, relying on transfat and saturated fat for product stability.

The traditional target is to restrict the intake of saturated fatty acids to less than 10% of daily energy intake and less than 7% for high-risk groups.

High animal proteins intake is associated with cardiovascular mortality and high plant protein intake is inversely associated with all cause and cardiovascular mortality,, especially among individuals with at least one lifestyle risk factor.

Substitution of protein for carbohydrate favors weight management, decreases blood pressure, improves cardio metabolic biomarkers, including blood lipid and lipoprotein profiles and glycemic regulation.

Diet fat in processed foods increase the risk of heart disease, while protective polyunsaturated fats are removed or destroyed the manufacturing process.

Ultra processed foods are high in sugar, salt and fat, having high-intensity flavoring which overrides endogenous satiety mechanism to produce obesity.

Only about 5% of sodium intake comes from salt added at the table or during home cooking and nearly 80% comes from sources of which consumers have a little control, including processed and restaurant foods with the added sodium.

About 15% of sodium comes from the foods that naturally contains sodium.

Ultra processed foods have high glycemic index levels.

Minimally processed foods include high cereal fiber, folate, and longchain omega-three polyunsaturated fats .

5-10% of elderly outpatients have malnutrition.

30-60% of hospitalized elderly patients have malnutrition.

It is recommended to limit consumption of added sugars to less than 10% of calories per day.

High vegetable diets protects against ulcerative colitis.

A diet rich in fats, polyunsaturated fatty acids increase risk of Crohn’s disease and ulcerative colitis.

Glucose and amino acids are building blocks for the generation of high energy molecules.

Glucose and amino acids have a role in signaling molecules that affect a number of different cell-signaling pathways.

These pathways function as a metabolic regulatory network that control fuel and energy metabolism.

Three nutrient sensing pathway that comprise the network that controls fuel and energy metabolism include adenosine monophosphate activated protein kinase alpha, mammalian target of rapamycin (m-TOR), and hexosamine pathways.

Dietary approach to prevent cardiovascular diseases includes: replacing saturated and trans-fatty acids with mono-unsaturated and polyunsaturated fats, increasing the consumption of fish or plants sources of omega-3 fats, and eating a diet rich in nuts, vegetables, fruits, and whole grains while avoiding foods with high glycemic content.

Eating at least one fish meal per week associated with a reduced relative risk of sudden cardiac death in a retrospective analysis of the Physician’s Health Study.

Replacing saturated fat with monounsaturated fat would decrease cardiovascular risk by 30%.

Diets rich in monosaturated fats typically lower triglycerides and raise HDL cholesterol.

Among US adults, the higher the consumption of dietary cholesterol or eggs is significantly associated with a higher risk of incident CVD and all-cause mortality in a dose response manner (Zhong V).

Eggs, especially the yolk, are a major source of dietary cholesterol: a large egg contains approximately 186 mg of cholesterol.

For most people, dietary cholesterol has only a modest effect on the amount of cholesterol in the bloodstream.

Guidelines for Americans eliminated an earlier recommendation to limit dietary cholesterol to 300 milligrams (mg) per day.

Saturated fat in the diet clearly does raise LDL by a significant amount and should still be consumed in limited quantities.

Foods high in fiber, low in saturated fat can lower cholesterol.

The best diet to lower cholesterol is rich in fruits, vegetables, fish, and whole grains.

 

Consuming more whole grains has been linked in multiple studies with a reduced risk of cardiovascular disease.

The Dietary Guidelines recommend that at least half of all grains consumed be whole grains. 

Americans consume a little more than 6 ounces of grains per day on average, the amount of whole grains they consume is just under 1 ounce per day.

From the meta-analyses, it is concluded that each serving of whole grains consumed is associated with a reduction in the study participants’ overall cardiovascular risk by 4%. 

Increasing intake of whole grains to half of their consumption, it is calculated that the reduction in CV risk would increase to 9%.

The more of these healthful foods eaten, the less one consumes foods that are high in saturated fat and highly refined carbohydrates, which both damage the cardiovascular system.

High-fiber foods help reduce cholesterol level by making unhealthy dietary fats harder to absorb from the gut.

Meat consumption is not a risk for cardiovascular disease, but it is the high levels of saturated fat found in most modern domesticated animals.

Red meat consumption is associated with increased risk of total, cardiovascular disease and cancer mortality (Pan An et al).

Diets high in fat and meat content increase fecal bile acids and colon cancer risk.

In the above study substitution of fish, poultry, nuts, legumes, and low-fat dairy products, and whole grains for red meat was associated with significantly lower risk of cardiovascular disease.

Red meat intake is associated with significant elevated risk of total, cardiovascular disease and cancer mortality for unprocessed and processed red meat with a relatively greater risk for processed meat.

Red meat consumption associated with increased risk of developing colorectal cancer.

Meta- analyses indicate consumption of red meat leads to a 1.43 increased risk of developing colorectal cancer.

Consumption of red meat and processed meats increases the risk of developing colorectal cancer, and meta-analyses show consumptions leads to a 1.43 increased risk of colorectal cancer per times per week consumed and 1.29 per 100 g/day.

Processed meat consumption associated with colorectal cancer with a 1.21 increased risk per 50 g per day.

A low-fat diet accounting for 20% of energy intake reduces the risk of colorectal cancer.

Evidence exists that red meat, especially processed meat is linked to increased risk of colorectal cancer.

Foods containing dietary fiber linked to decrease risk.

Leafy vegetables are low in carbohydrates.

Decreased risk probably related for garlic, milk and calcium intake.

In the Harvard Health Professionals Study of more than 37,000 men and a study of more than 83,000 women from the Harvard Nurses Health Study followed up for almost 3,000,000 person years found that consumption of both processed and unprocessed red meat was associated with an increased risk of premature mortality from all causes as well as from cardiovascular disease and cancer.

Red meat consumption is associated with an increased risk of type II DM (Pan A et al).

Red meat and processed meat when cooked at high temperatures contain heterocyclic amines.

Heterocyclic amines are carcinogenic.

Heme in red meat forms N-nitroso compounds in the G.I. tract, and many are carcinogenic.

Dietary heme iron has a 10 fold higher content in red meat than in white meat, may be pro carcinogenic.

Heme iron can alter DNA, catalyzes the peroxidation of fat in foods and induce colon cytotoxicity.

Nitritesfrom cured meats react with amines generating N-nitroso compounds which may be carcinogenic.

Nitrates or nitrites may be addedv to meat for preservation, that also could increase exogenous exposure to nitrosamines which are carcinogenic.

Substituting red meat with poultry low-fat dairy products, fish, nuts, legumes, whole grains is associated with a lower mortality.

Men and women in the highest quartile and the lowest quartile overrated and processed meat intake have modest elevations in risks for overall mortality, as well as for cancer and cardiovascular disease.

Recommendations by the American Institute for Cancer Research Fund is to reduce red and processed meat intake to decrease cancer incidence.

There are major nutritional benefits to consuming some red meat and some white meat, but no such reason to consume most processed meats.

Clinical trials show a low-fat, low fat and high complex carbohydrate diet, or high protein-low carbohydrate diet are equallyhealthy.

There has been a marked increase in the proportion of global consumption of animal foods.

The total gross consumption of meat and dairy products is higher in higher income countries compared to lower income countries doubling and tripling the daily intake, respectively.

For the prevention of cancer and heart disease is generally recommended to limit the intake of saturated fats 7%-10% of total dailycalories.

The production of any animal source foods requires more feed stock than the production of grain, fruit and vegetables, and legumes.

15%-23% of the world’s water goes to livestock.

Water use is 2 to 5 greater for animal source foods than the four basic crops.

Agriculture provides between 25 and 35% of all carbon emissions, users between 1/2 to 2/3 of all nitrogen and chemical pesticides

Livestock production accounts for 55% of soil erosion, 37% pesticides applied, 50% of antibiotics consumed and a third of nitrogen and phosphorus discharged to surface water.

Livestock are responsible for 18% of greenhouse gas emissions, far greater than that used by transportation services.

Lean animal protein can improve lipid levels if visible fat is trimmed and meats are allowed to drain their fat when cooking.

Animal protein improves satiety and insulin sensitivity and can facilitate weight loss.

A meta-analysis indicated the relative risk estimates for animal fat intake and colorectal cancer was insignificant (Alexander DD et al.).

A prospective study that suggested vegetarians and vegans were more likely to have a stroke than those who ate land animal protein.

Nutrition-cooking red meat at high temperature causes charring which results in high levels of heterocyclic amines , implicated in gastrointestinal and prostate neoplasms.

Cooking meats at high temperature or on an open inflamed produces heterocyclic amines and polycyclic aromatic hydrocarbons which are carcinogens in animal studies.

Well done meet in epidemiologic studies confirms a positive association with colorectal cancer.

Long-term meat consumption may increase the risk of cancer of the distal colon.

High dietary intakes of fat, especially of trans fats, and red meat or independently associated with insulin resistance and increased risk of mellitus.

Woman’s Health Initiative Dietary Modification trial indicated a low fat dietary intervention did not reduce the risk of colorectal cancer in postmenopausal women during 8.1 years of follow-up.

Women’s Intervention Nutrition Study found that a diet in low fat improved relapsed free survival among women with early breast cancer.

Increased fruits and vegetable intake decrease risk of stroke.

Total dietary consumption of fresh fruit and particularly citrus fruit is associated with a modestly lower risk of developing prostate cancer.

Diet composed of more than 5 servings daily of fruits and vegetables associated with a 26% lower risk of stoke than a diet of fewer than 3 servings of fruits or vegetables daily, and a diet of 3-5 servings of fruits and vegetables provided a 9% lowered risk.

Iron and folic acid supplementation in areas with high rates of malaria and other infections increased the risk of severe illness and death in preschool children, indicating that guidelines for universal supplementation with iron and folic acid should be revised.

The nutritional impact of frying depends on the type of fat or oil used as the frying medium, as well as what is being fried and for how long. 

Fried foods usually have higher in calorie density than if it is not deep fried. 

About 650,000 veterans had completed the MVP lifestyle survey of consumption of  fried food, with over 150,000 (90% of whom were men), were included in the final analysis, 

Compared to those who consumed fried food of any kind less than once per week, those who consumed fried food daily were 14% more likely to be diagnosed with coronary artery disease.

Those who ate fried food at least 1 time per week were 7% more likely to be diagnosed with coronary artery disease.

The risk of death from heart attack or stroke were statistically the same: 14% greater risk of death for those eating fried food daily or 7% greater risk of death for those eating fried food just once per week.

 

Meta-Analysis Provides Insight on Fried Food and its Impact on Heart Health

A meta-analysis of nearly 20 studies  on the effects of consuming fried foods on cardiovascular health.

There is a direct link between consumption of fried food and increased risk of cardiovascular disease and all-cause mortality.

A meta-analysis suggests that for jevery additional serving of fried food per week is  linked to a 3% increase in risk of major adverse cardiovascular events, a 2% increase in risk of coronary heart disease, and a 12% increase in risk of heart failure.

Limiting fried-food consumption reduces the amount of total fat intake and industrially produced trans-fatty acid intake for a healthy diet. 

Meta analysis related to 562,445 individuals and 36,727 major cardiovascular events evaluating fried food consumption: When comparing those with the highest levels of fried food intake to those with the lowest: increased intake was associated with a 28% increase in risk of major cardiovascular events, a 22% increase in risk of coronary heart disease a 37% increase in risk of stroke, and a 37% increase in risk of heart failure, a 2% increase in risk of cardiovascular mortality and a 3% increase in risk for all-cause mortality.

In a randomized, double blind controlled trial in Norway-Western Norway B Vitamin Intervention Trial (WENBIT,) with 3096 adult patients undergoing coronary angiography randomized to assess the effect of treatment with vitamin B6, folic acid, vitamin B12, or placebo: no effect of treatment with B6, B12 or folic acid was noted on mortality or cardiovascular events during a median follow-up of 38 months (Ebbing).

A trial of selenium and vitamin E (SELECT study) taken alone or together in 35,000 men did not reduce the risk of prostate cancer.

Women’s health initiative found that multivitamin use did not reduce the risk of cancer, including colorectal cancer (Newhouser ML et al).

Multivitamins are the most common dietary supplement.

Multivitamins are taken regularly by at least one third of US adults.

The traditional role of daily multivitamin therapy is to prevent nutritional deficiency.

The combination of multivitamins and minerals, contained in multivitamin preparations, may mirror healthy dietary patterns such as fruit and vegetable intake, which is been modestly and inversely associated with cancer risk in some studies.

In general trials of high dose individual vitamins and minerals for cancer has had lack of effect.

For a health population there is no evidence in support of the recommendation for the use of multivitamin/mineral supplements the primary prevention of chronic disease.

The self reported use of 15 vitamins and minerals supplements in relation to 38,772 women in the Iowa Women’s Health Study was associated with higher risk of total mortality, and supplemental iron was strongly and dose dependently associated with increased risk of mortality while supplemental calcium was associated with a decreased risk.

Multivitamin use during and after adjuvant chemotherapy for colorectal cancer in patients with stage IIIa disease was not associated with improved outcomes (Ng K et al).

In a randomized double blind controlled trial of high-dose versus standard dose multivitamin supplementation for 24 months and 3418 patients with HIV initiating HAART therapy: there was no decrease in HIV disease progression or death, but they may have been an increase in ALT levels (Isanaka

S et al).

No beneficial effect was seen with supplementation with relatively low doses of B vitamins and/or omega 3 fatty acids on cancer outcomes in individuals with prior cardiovascular disease(Andreeva AA et al).

In a study in northern China of an undernourished population of 3318 individuals age 40-69 years with a previous cytologic diagnosis of esophageal squamous dysphasia and who were follow for 20 additional years: There was no effect on total or cause specific mortality, demmonstrating little benefit of multivitamin supplementation on mortality in either well or poorly nourished populations (Wang J-B et al).

Eating vegetables and protein before carbohydrate intake leads to lower levels of postmeal glucose and insulin in obese patients with type two diabetes.

 

A diet of higher saturated fat and refined grains is linked to a greater risk of adult acne.

 

Adults who eat three slices of white bread daily have a significantly increased risk for dying from cardiovascular causes.

The NutriNet-Sante study was a survey of health and demographic information administered to over 170,000 initial participants. 

This study is focused on adult acne, not adolescent acne.

Individuals who followed the healthy pattern diet were 12% less likely to report current acne, while those following the fatty and sugary pattern were 12% more likely to have acne.

In those in the animal products and refined cereals group were just 3% more likely to have current acne.

The greater intake of meats, fish, vegetables, or fruits were associated with a slight-to-moderately lower risk of acne.

Drinking milk or sugary beverages as well as consuming fatty and sugary products were more significantly associated with greater risk of adult acne.

A metaanalysis reveals that an avocado rich diet significantly decrease TC, LDL-C, and TG levels (Peou S et al).

Magnesium-rich foods including avocado, banana, dark leafy vegetables, dried fruits, lentils, soybeans, nuts, whole grains, fish, yogurt and dark chocolate.

Vegetable Total carbohydrates Fiber Net carbs Calories Fat Protein

alfalfa sprouts 2.1 g 1.9 g 0.2 g 23 0.69 g 3.99 g

celery 3.0 g 1.6 g 1.4 g 16 0.2 g 0.7 g

iceberg lettuce 3.0 g 1.2 g 1.8 g 14 0.1 g 0.9 g

zucchini 3.11 g 1.0 g 2.11 g 17 .32 g 1.21 g

white mushrooms 3.3 g 1.0 g 2.3 g 22 0.3 g 3.1 g

radishes 3.4 g 1.6 g 1.8 g 16 0.10 g 0.68 g

spinach 3.6 g 2.2 g 1.4 g 23 0.4 g 2.9 g

cucumber 3.6 g 0.5 g 3.1 g 16 0.1 g 0.7 g

arugula 3.65 g 1.6 g 2.05 g 25 0.66 g 2.58 g

Swiss chard 3.7 g 1.6 g 2.1 g 19 0.2 g 1.8 g

asparagus 3.88 g 2.1 g 1.78 g 20 0.12 g 2.20 g

tomatoes 3.89 g 1.2 g 1.69 g 18 0.2 g 0.88 g

radicchio 4.48 g 0.9 g 3.58 g 23 0.25 g 0.25 g

bell peppers 4.71 g 1.2 g 3.51 g 18 0.0 g 1.18 g

cauliflower 4.97 g 2.0 g 2.97 g 25 0.28 g 1.92 g

broccoli 6.64 g 2.6 g 4.04 g 34 0.4 g 2.8 g

Meatless burgers may help people reduce their consumption of red meat, but they are a highly processed food: Compared with burgers made with beef, they are about equal in saturated fat and calories, and higher in sodium and carbohydrates.