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Nutrients, Volume 5, Issue 10 (October 2013), Pages 3779-4268

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Research

Jump to: Review, Other

Open AccessArticle An Instrument to Measure Adherence to Weight Loss Programs: The Compliance Praxis Survey-Diet (COMPASS-Diet)
Nutrients 2013, 5(10), 3828-3838; doi:10.3390/nu5103828
Received: 6 May 2013 / Revised: 26 July 2013 / Accepted: 12 September 2013 / Published: 26 September 2013
Cited by 2 | PDF Full-text (204 KB) | HTML Full-text | XML Full-text
Abstract
Adherence to behavioral weight loss strategies is important for weight loss success. We aimed to examine the reliability and validity of a newly developed compliance praxis-diet (COMPASS-diet) survey with participants in a 10-week dietary intervention program. During the third of five sessions, [...] Read more.
Adherence to behavioral weight loss strategies is important for weight loss success. We aimed to examine the reliability and validity of a newly developed compliance praxis-diet (COMPASS-diet) survey with participants in a 10-week dietary intervention program. During the third of five sessions, participants of the “slim-without-diet” weight loss program (n = 253) completed the COMPASS-diet survey and provided data on demographic and clinical characteristics, and general self-efficacy. Group facilitators completed the COMPASS-diet-other scale estimating participants’ likely adherence from their perspective. We calculated internal consistency, convergent validity, and predictive value for objectively measured weight loss. Mean COMPASS-diet-self score was 82.4 (SD 14.2) and COMPASS-diet-other score 80.9 (SD 13.6) (possible range 12–108), with lowest scores in the normative behavior subscale. Cronbach alpha scores of the COMPASS-diet-self and -other scale were good (0.82 and 0.78, respectively). COMPASS-diet-self scores (r = 0.31) correlated more highly with general self-efficacy compared to COMPASS-diet-other scores (r = 0.04) providing evidence for validity. In multivariable analysis adjusted for age and gender, both the COMPASS-diet-self (F = 10.8, p < 0.001, r2 = 0.23) and other (F = 5.5, p < 0.001, r2 = 0.19) scales were significantly associated with weight loss achieved at program conclusion. COMPASS-diet surveys will allow group facilitators or trainers to identify patients who need additional support for optimal weight loss. Full article
Open AccessArticle The Role of Vitamin D Level and Related Single Nucleotide Polymorphisms in Crohn’s Disease
Nutrients 2013, 5(10), 3898-3909; doi:10.3390/nu5103898
Received: 24 June 2013 / Revised: 19 August 2013 / Accepted: 12 September 2013 / Published: 27 September 2013
Cited by 4 | PDF Full-text (217 KB) | HTML Full-text | XML Full-text
Abstract
New Zealand has one of the highest rates of Crohn’s Disease (CD) in the world, and there is much speculation as to why this might be. A high risk of CD has been associated with deficient or insufficient levels of Vitamin D [...] Read more.
New Zealand has one of the highest rates of Crohn’s Disease (CD) in the world, and there is much speculation as to why this might be. A high risk of CD has been associated with deficient or insufficient levels of Vitamin D (Vit D), lifestyle as well as various genetic polymorphisms. In this study we sought to analyse the relevance of serum Vit D levels, lifestyle and genotype to CD status. Serum samples were analysed for 25-OH-Vitamin D levels. DNA was isolated from blood and cheek-swabs, and Sequenom and ImmunoChip techniques were used for genotyping. Serum Vit D levels were significantly lower in CD patients (mean = 49.5 mg/L) than those found in controls (mean = 58.9 mg/L, p = 4.74 × 10−6). A total of seven single nucleotide polymorphisms were examined for effects on serum Vit D levels, with adjustment for confounding variables. Two variants: rs731236[A] (VDR) and rs732594[A] (SCUBE3) showed a significant association with serum Vit D levels in CD patients. Four variants: rs7975232[A] (VDR), rs732594[A] (SCUBE3), and rs2980[T] and rs2981[A] (PHF-11) showed a significant association with serum Vit D levels in the control group. This study demonstrates a significant interaction between Vit D levels and CD susceptibility, as well as a significant association between Vit D levels and genotype. Full article
Open AccessArticle Dietary Magnesium Intake Improves Insulin Resistance among Non-Diabetic Individuals with Metabolic Syndrome Participating in a Dietary Trial
Nutrients 2013, 5(10), 3910-3919; doi:10.3390/nu5103910
Received: 1 August 2013 / Revised: 4 September 2013 / Accepted: 10 September 2013 / Published: 27 September 2013
Cited by 6 | PDF Full-text (218 KB) | HTML Full-text | XML Full-text
Abstract
Many cross-sectional studies show an inverse association between dietary magnesium and insulin resistance, but few longitudinal studies examine the ability to meet the Recommended Dietary Allowance (RDA) for magnesium intake through food and its effect on insulin resistance among participants with metabolic [...] Read more.
Many cross-sectional studies show an inverse association between dietary magnesium and insulin resistance, but few longitudinal studies examine the ability to meet the Recommended Dietary Allowance (RDA) for magnesium intake through food and its effect on insulin resistance among participants with metabolic syndrome (MetS). The dietary intervention study examined this question in 234 individuals with MetS. Magnesium intake was assessed using 24-h dietary recalls at baseline, 6, and 12 months. Fasting glucose and insulin levels were collected at each time point; and insulin resistance was estimated by the homeostasis model assessment (HOMA-IR). The relation between magnesium intake and HOMA-IR was assessed using linear mixed models adjusted for covariates. Baseline magnesium intake was 287 ± 93 mg/day (mean ± standard deviation), and HOMA-IR, fasting glucose and fasting insulin were 3.7 ± 3.5, 99 ± 13 mg/dL, and 15 ± 13 μU/mL, respectively. At baseline, 6-, and 12-months, 23.5%, 30.4%, and 27.7% met the RDA for magnesium. After multivariate adjustment, magnesium intake was inversely associated with metabolic biomarkers of insulin resistance (P < 0.01). Further, the likelihood of elevated HOMA-IR (>3.6) over time was 71% lower [odds ratio (OR): 0.29; 95% confidence interval (CI): 0.12, 0.72] in participants in the highest quartile of magnesium intake than those in the lowest quartile. For individuals meeting the RDA for magnesium, the multivariate-adjusted OR for high HOMA-IR over time was 0.37 (95% CI: 0.18, 0.77). These findings indicate that dietary magnesium intake is inadequate among non-diabetic individuals with MetS and suggest that increasing dietary magnesium to meet the RDA has a protective effect on insulin resistance. Full article
Open AccessArticle Vitamin and Mineral Deficiencies Are Highly Prevalent in Newly Diagnosed Celiac Disease Patients
Nutrients 2013, 5(10), 3975-3992; doi:10.3390/nu5103975
Received: 19 July 2013 / Revised: 13 September 2013 / Accepted: 13 September 2013 / Published: 30 September 2013
Cited by 33 | PDF Full-text (232 KB) | HTML Full-text | XML Full-text
Abstract
Malabsorption, weight loss and vitamin/mineral-deficiencies characterize classical celiac disease (CD). This study aimed to assess the nutritional and vitamin/mineral status of current “early diagnosed” untreated adult CD-patients in the Netherlands. Newly diagnosed adult CD-patients were included (n = 80, 42.8 ± [...] Read more.
Malabsorption, weight loss and vitamin/mineral-deficiencies characterize classical celiac disease (CD). This study aimed to assess the nutritional and vitamin/mineral status of current “early diagnosed” untreated adult CD-patients in the Netherlands. Newly diagnosed adult CD-patients were included (n = 80, 42.8 ± 15.1 years) and a comparable sample of 24 healthy Dutch subjects was added to compare vitamin concentrations. Nutritional status and serum concentrations of folic acid, vitamin A, B6, B12, and (25-hydroxy) D, zinc, haemoglobin (Hb) and ferritin were determined (before prescribing gluten free diet). Almost all CD-patients (87%) had at least one value below the lower limit of reference. Specifically, for vitamin A, 7.5% of patients showed deficient levels, for vitamin B6 14.5%, folic acid 20%, and vitamin B12 19%. Likewise, zinc deficiency was observed in 67% of the CD-patients, 46% had decreased iron storage, and 32% had anaemia. Overall, 17% were malnourished (>10% undesired weight loss), 22% of the women were underweight (Body Mass Index (BMI) < 18.5), and 29% of the patients were overweight (BMI > 25). Vitamin deficiencies were barely seen in healthy controls, with the exception of vitamin B12. Vitamin/mineral deficiencies were counter-intuitively not associated with a (higher) grade of histological intestinal damage or (impaired) nutritional status. In conclusion, vitamin/mineral deficiencies are still common in newly “early diagnosed” CD-patients, even though the prevalence of obesity at initial diagnosis is rising. Extensive nutritional assessments seem warranted to guide nutritional advices and follow-up in CD treatment. Full article
(This article belongs to the Special Issue Nutrition and Celiac Disease) Print Edition available
Open AccessArticle Food Predictors of Plasma Carotenoids
Nutrients 2013, 5(10), 4051-4066; doi:10.3390/nu5104051
Received: 1 August 2013 / Revised: 10 September 2013 / Accepted: 13 September 2013 / Published: 11 October 2013
Cited by 8 | PDF Full-text (250 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Empirical prediction models that weight food frequency questionnaire (FFQ) food items by their relation to nutrient biomarker concentrations may estimate nutrient exposure better than nutrient intakes derived from food composition databases. Carotenoids may especially benefit because contributing foods vary in bioavailability and [...] Read more.
Empirical prediction models that weight food frequency questionnaire (FFQ) food items by their relation to nutrient biomarker concentrations may estimate nutrient exposure better than nutrient intakes derived from food composition databases. Carotenoids may especially benefit because contributing foods vary in bioavailability and assessment validity. Our objective was to develop empirical prediction models for the major plasma carotenoids and total carotenoids and evaluate their validity compared with dietary intakes calculated from standard food composition tables. 4180 nonsmoking women in the Nurses’ Health Study (NHS) blood subcohort with previously measured plasma carotenoids were randomly divided into training (n = 2787) and testing (n = 1393) subsets. Empirical prediction models were developed in the training subset by stepwise selection from foods contributing ≥0.5% to intake of the relevant carotenoid. Spearman correlations between predicted and measured plasma concentrations were compared to Spearman correlations between dietary intake and measured plasma concentrations for each carotenoid. Three to 12 foods were selected for the α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin, lycopene, and total carotenoids prediction models. In the testing subset, Spearman correlations with measured plasma concentrations for the calculated dietary intakes and predicted plasma concentrations, respectively, were 0.31 and 0.37 for α-carotene, 0.29 and 0.31 for β-carotene, 0.36 and 0.41 for β-cryptoxanthin, 0.28 and 0.31 for lutein/zeaxanthin, 0.22 and 0.23 for lycopene, and 0.22 and 0.27 for total carotenoids. Empirical prediction models may modestly improve assessment of some carotenoids, particularly α-carotene and β-cryptoxanthin. Full article
(This article belongs to the Special Issue Vitamin A and Carotenoids)
Open AccessArticle The Importance of Dose, Frequency and Duration of Vitamin D Supplementation for Plasma 25-Hydroxyvitamin D
Nutrients 2013, 5(10), 4067-4078; doi:10.3390/nu5104067
Received: 23 May 2013 / Revised: 22 September 2013 / Accepted: 26 September 2013 / Published: 11 October 2013
Cited by 7 | PDF Full-text (466 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The importance of dose, frequency and duration of vitamin D supplementation for plasma 25(OH)D levels is not well described and rarely reported for supplementation that exceeds 2000 IU per day. The objective is to examine dose, frequency and duration of supplementation in [...] Read more.
The importance of dose, frequency and duration of vitamin D supplementation for plasma 25(OH)D levels is not well described and rarely reported for supplementation that exceeds 2000 IU per day. The objective is to examine dose, frequency and duration of supplementation in relation to plasma 25(OH)D in a large population-based sample. We accessed data on 2714 volunteers that contributed to 4224 visits and applied multilevel regression. Compared to not using supplements, a minimum regimen of 1000–2000 IU once or twice per week for one month was not effective in raising 25(OH)D. Compared to this minimum regimen, higher doses of 2000–3000, 3000–4000, and 5000 IU or more were associated with a 7.49, 13.19 and 30.22 nmol/L 25(OH)D increase, respectively; frequencies of three to four, five to six and seven times/week were associated with a 5.44, 16.52 and 30.69 nmol/L increase, respectively; and supplementation of five months or longer was associated with an increase of 6.68 nmol/L (p < 0.01 for all). Age, body weight, physical activity, smoking, and self-rated health were significantly associated with 25(OH)D. Whereas dose, frequency and duration of supplementation are important to healthy subjects committed to optimizing their nutritional status, to the design of clinical trials, individual characteristics and lifestyle contribute substantially to 25(OH)D. Full article
(This article belongs to the Special Issue Vitamin D and Human Health) Print Edition available
Open AccessArticle Impact of Multi-Micronutrient Supplementation on Growth and Morbidity of HIV-Infected South African Children
Nutrients 2013, 5(10), 4079-4092; doi:10.3390/nu5104079
Received: 12 July 2013 / Revised: 13 September 2013 / Accepted: 16 September 2013 / Published: 11 October 2013
Cited by 2 | PDF Full-text (402 KB) | HTML Full-text | XML Full-text
Abstract
Poor growth, micronutrient deficiencies and episodes of diarrhea and respiratory infections occur frequently in HIV-infected children. We investigated whether multi-micronutrient supplementation would improve the growth performance and reduce the number of episodes of diarrhea and/or of respiratory symptoms in HIV-infected children. In [...] Read more.
Poor growth, micronutrient deficiencies and episodes of diarrhea and respiratory infections occur frequently in HIV-infected children. We investigated whether multi-micronutrient supplementation would improve the growth performance and reduce the number of episodes of diarrhea and/or of respiratory symptoms in HIV-infected children. In a double-blind randomized trial, HIV-infected South African children aged 4–24 months (n = 201) were assigned to receive multi-micronutrient supplements or placebo daily for six months. The children were assessed for respiratory symptoms or diarrhea bi-weekly; weights and heights were measured monthly. In total, 121 children completed the six month follow up study period (60%). A total of 43 children died; 27 of them had received supplements. This difference in mortality was not statistically significant (p = 0.12). Weight-for-height Z-scores improved significantly (p < 0.05) among children given supplements compared with those given placebo (0.40 (0.09–0.71)) versus −0.04 (−0.39–0.31) (mean (95% CI)). Height-for-age Z-scores did not improve in both treatment groups. The number of monthly episodes of diarrhea in the placebo group (0.36 (0.26–0.46)) was higher (p = 0.09) than in the supplement group (0.25 (0.17–0.33)) and the number of monthly episodes of respiratory symptoms was significantly higher (p < 0.05) among children on placebos (1.01 (0.83–1.79)) than those on supplements (0.66 (0.52–0.80)). Multi-micronutrient supplements significantly improved wasting and reduced the number of episodes of diarrhea and respiratory symptoms. Full article
(This article belongs to the Special Issue Nutrients and Immune Function)
Open AccessArticle The Blood Lactate Increase in High Intensity Exercise Is Depressed by Acanthopanax sieboldianus
Nutrients 2013, 5(10), 4134-4144; doi:10.3390/nu5104134
Received: 1 July 2013 / Revised: 9 September 2013 / Accepted: 23 September 2013 / Published: 16 October 2013
Cited by 4 | PDF Full-text (318 KB) | HTML Full-text | XML Full-text
Abstract
This study investigates the anti-fatigue effects of Acanthopanax sieboldianus (A. sieboldianus) at various exercise intensities. Two experiments were conducted in 18 Sprague-Dawley rats. In Experiment 1, a three-stage increment test (15 m/min for 5 min, and 20 m/min for 5 [...] Read more.
This study investigates the anti-fatigue effects of Acanthopanax sieboldianus (A. sieboldianus) at various exercise intensities. Two experiments were conducted in 18 Sprague-Dawley rats. In Experiment 1, a three-stage increment test (15 m/min for 5 min, and 20 m/min for 5 min and 25 m/min for 10 min) was performed using a treadmill. In Experiment 2, a 10-min swimming test was conducted. Blood samples were extracted from each rat before, during and after the exercises and the blood concentrations of lactate and glucose measured. In both experiments, water (control) or A. sieboldianus solution (ASS) was administered orally using a zonde 30 min before the exercise. In the swimming test, ASS administration significantly decreased the blood lactate level measured at the end of the exercise and 5 min post-exercise relative to the water group, although the two groups did not differ significantly in the treadmill test. Our study demonstrates that a single oral administration of A. sieboldianus prior to high-intensity exercise significantly decreases the blood lactate concentration suggesting that A. sieboldianus has an intrinsic anti-fatigue effect. Full article
Open AccessArticle Antioxidant and Anticlastogenic Capacity of Prickly Pear Juice
Nutrients 2013, 5(10), 4145-4158; doi:10.3390/nu5104145
Received: 21 June 2013 / Revised: 18 September 2013 / Accepted: 18 September 2013 / Published: 18 October 2013
Cited by 6 | PDF Full-text (156 KB) | HTML Full-text | XML Full-text
Abstract
Plants belonging to the genus Opuntia spp. are the most abundant of the Cactaceae family, grown throughout America and the Mediterranean central area. Its fruit, known as cactus pear or prickly pear, is an oval berry grouped in different colors. Some studies [...] Read more.
Plants belonging to the genus Opuntia spp. are the most abundant of the Cactaceae family, grown throughout America and the Mediterranean central area. Its fruit, known as cactus pear or prickly pear, is an oval berry grouped in different colors. Some studies have shown its antioxidant activities which may help in preventing chronic pathologies such as diabetes. The purpose of the study was to evaluate the antioxidant capacity of three varieties of prickly pear juice (red-purple, white-green and yellow-orange) in five different concentrations (100, 250, 500, 750, and 1000 mg/mL) by DPPH (1,1-diphenyl-2-picrylhydrazyl radical) colorimetric method, selecting the best variety to determine its anticlastogenic potential against methyl methanesulfonate (MMS). The results indicate that the highest antioxidant was found in the juice of the prickly pear red-purple variety (PPRP), in all concentrations. Its anticlastogenic potential was therefore evaluated with a micronucleus assay. The experiment was run over two weeks. A negative control was included along with a positive control with MMS (40 mg/kg), a group of mice treated with PPRP (25 mL/kg), and three groups with PPRP (in doses of 25, 16.5 and 8.3 mL/kg) plus the mutagen. The PPRP was administered daily by oral gavage and the MMS was injected intraperitoneally five days prior to the end of the experiment. Blood samples were obtained at 0, 24, 48, 72 and 96 h in order to determine the frequency of micronucleated polychromatic erythrocytes (MNPE). The results indicated that PPRP is not a genotoxic agent, on the contrary, it may reduce the number of MNPE. In this regard, the PPRP showed an anticlastogenic effect directly proportional to its concentrations. Thus, the highest protection was obtained with a concentration of 25 mL/kg after 48 h of treatment. Full article
(This article belongs to the Special Issue Nutritional Toxicology)
Open AccessArticle Manifestations of Fasting-Induced Fatty Liver and Rapid Recovery from Steatosis in Voles Fed Lard or Flaxseed Oil Lipids
Nutrients 2013, 5(10), 4211-4230; doi:10.3390/nu5104211
Received: 5 August 2013 / Revised: 10 September 2013 / Accepted: 27 September 2013 / Published: 22 October 2013
Cited by 4 | PDF Full-text (1036 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Long-chain n-3 polyunsaturated fatty acids (PUFA) can have beneficial effects against fat deposition, cardiovascular diseases, and liver steatosis. We investigated how diets based on lard (predominantly saturated and monounsaturated fatty acids) or flaxseed oil (rich in 18:3n-3) affect liver [...] Read more.
Long-chain n-3 polyunsaturated fatty acids (PUFA) can have beneficial effects against fat deposition, cardiovascular diseases, and liver steatosis. We investigated how diets based on lard (predominantly saturated and monounsaturated fatty acids) or flaxseed oil (rich in 18:3n-3) affect liver fat-% and fatty acid profiles of tundra voles (Microtus oeconomus). We also studied potential participation of hyaluronan (HA) in the pathology of fatty liver and whether the development and recovery of fasting-induced steatosis are influenced by n-3 PUFA. The dietary fatty acid composition was manifested in the liver fatty acid signatures. Fasting for 18 h induced macrovesicular steatosis and the liver fat-% increased to 22% independent of the preceding diet. Fasting-induced steatosis did not involve inflammation or connective tissue activation indicated by the absence of both leukocyte accumulation and increased HA. Food deprivation modified the liver fatty acid signatures to resemble more closely the diets. Fasting reduced the proportions of long-chain n-3 PUFA in both dietary regimes and n-3/n-6 PUFA ratios in the lard-fed voles. Decreases in long-chain n-3 PUFA may promote lipid accumulation by modulating the expression of lipid-metabolizing genes. Dietary 18:3n-3 did not prevent the development or attenuate the manifestation of steatosis in the fasted voles or promote the recovery. Full article

Review

Jump to: Research, Other

Open AccessReview Polyphenols: Benefits to the Cardiovascular System in Health and in Aging
Nutrients 2013, 5(10), 3779-3827; doi:10.3390/nu5103779
Received: 15 April 2013 / Revised: 25 July 2013 / Accepted: 4 August 2013 / Published: 26 September 2013
Cited by 64 | PDF Full-text (415 KB) | HTML Full-text | XML Full-text
Abstract
Numerous studies have demonstrated the importance of naturally occurring dietary polyphenols in promoting cardiovascular health and emphasized the significant role these compounds play in limiting the effects of cellular aging. Polyphenols such as resveratrol, epigallocatechin gallate (EGCG), and curcumin have been acknowledged [...] Read more.
Numerous studies have demonstrated the importance of naturally occurring dietary polyphenols in promoting cardiovascular health and emphasized the significant role these compounds play in limiting the effects of cellular aging. Polyphenols such as resveratrol, epigallocatechin gallate (EGCG), and curcumin have been acknowledged for having beneficial effects on cardiovascular health, while some have also been shown to be protective in aging. This review highlights the literature surrounding this topic on the prominently studied and documented polyphenols as pertaining to cardiovascular health and aging. Full article
(This article belongs to the Special Issue Polyphenols and Human Health)
Open AccessReview Non-Celiac Gluten Sensitivity: The New Frontier of Gluten Related Disorders
Nutrients 2013, 5(10), 3839-3853; doi:10.3390/nu5103839
Received: 20 August 2013 / Revised: 17 September 2013 / Accepted: 18 September 2013 / Published: 26 September 2013
Cited by 117 | PDF Full-text (212 KB) | HTML Full-text | XML Full-text
Abstract
Non Celiac Gluten sensitivity (NCGS) was originally described in the 1980s and recently a “re-discovered” disorder characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected with either celiac disease (CD) or wheat [...] Read more.
Non Celiac Gluten sensitivity (NCGS) was originally described in the 1980s and recently a “re-discovered” disorder characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected with either celiac disease (CD) or wheat allergy (WA). Although NCGS frequency is still unclear, epidemiological data have been generated that can help establishing the magnitude of the problem. Clinical studies further defined the identity of NCGS and its implications in human disease. An overlap between the irritable bowel syndrome (IBS) and NCGS has been detected, requiring even more stringent diagnostic criteria. Several studies suggested a relationship between NCGS and neuropsychiatric disorders, particularly autism and schizophrenia. The first case reports of NCGS in children have been described. Lack of biomarkers is still a major limitation of clinical studies, making it difficult to differentiate NCGS from other gluten related disorders. Recent studies raised the possibility that, beside gluten, wheat amylase-trypsin inhibitors and low-fermentable, poorly-absorbed, short-chain carbohydrates can contribute to symptoms (at least those related to IBS) experienced by NCGS patients. In this paper we report the major advances and current trends on NCGS. Full article
(This article belongs to the Special Issue Nutrition and Celiac Disease) Print Edition available
Open AccessReview Cocoa and Heart Health: A Historical Review of the Science
Nutrients 2013, 5(10), 3854-3870; doi:10.3390/nu5103854
Received: 15 July 2013 / Revised: 10 September 2013 / Accepted: 11 September 2013 / Published: 26 September 2013
Cited by 2 | PDF Full-text (263 KB) | HTML Full-text | XML Full-text
Abstract
The medicinal use of cocoa has a long history dating back almost five hundred years when Hernán Cortés’s first experienced the drink in Mesoamerica. Doctors in Europe recommended the beverage to patients in the 1700s, and later American physicians followed suit and [...] Read more.
The medicinal use of cocoa has a long history dating back almost five hundred years when Hernán Cortés’s first experienced the drink in Mesoamerica. Doctors in Europe recommended the beverage to patients in the 1700s, and later American physicians followed suit and prescribed the drink in early America—ca. 1800s. This article delineates the historic trajectory of cocoa consumption, the linkage between cocoa’s bioactive-mechanistic properties, paying special attention to nitric oxides role in vasodilation of the arteries, to the current indicators purporting the benefits of cocoa and cardiovascular health. Full article
(This article belongs to the Special Issue Chocolate and Cocoa in Human Health)
Open AccessReview Dietary Factors and Type 2 Diabetes in the Middle East: What Is the Evidence for an Association?––A Systematic Review
Nutrients 2013, 5(10), 3871-3897; doi:10.3390/nu5103871
Received: 28 April 2013 / Revised: 8 August 2013 / Accepted: 9 September 2013 / Published: 26 September 2013
Cited by 7 | PDF Full-text (277 KB) | HTML Full-text | XML Full-text
Abstract
This review aims to search and summarise the available evidence on the association between dietary factors and type 2 diabetes mellitus (T2DM) in Middle Eastern populations, where diabetes prevalence is among the highest in the world. Electronic databases were searched; authors, libraries, [...] Read more.
This review aims to search and summarise the available evidence on the association between dietary factors and type 2 diabetes mellitus (T2DM) in Middle Eastern populations, where diabetes prevalence is among the highest in the world. Electronic databases were searched; authors, libraries, and research centres in the Middle East were contacted for further studies and unpublished literature. Included studies assessed potential dietary factors for T2DM in Middle Eastern adults. Two reviewers assessed studies independently. Extensive searching yielded 17 studies which met the inclusion criteria for this review. The findings showed that whole-grain intake reduces the risk of T2DM, and potato consumption was positively correlated with T2DM. Vegetables and vegetable oil may play a protective role against T2DM. Dietary patterns that are associated with diabetes were identified, such as Fast Food and Refined Grains patterns. Two studies demonstrated that lifestyle interventions decreased the risk of T2DM. In summary, the identified studies support an association between some dietary factors and T2DM; however, many of the included studies were of poor methodological quality so the findings should be interpreted with caution. The review draws attention to major gaps in current evidence and the need for well-designed studies in this area. Full article
(This article belongs to the Special Issue Nutrition and Diabetes)
Open AccessReview Nutrient Intake Values for Folate during Pregnancy and Lactation Vary Widely around the World
Nutrients 2013, 5(10), 3920-3947; doi:10.3390/nu5103920
Received: 25 July 2013 / Revised: 3 September 2013 / Accepted: 3 September 2013 / Published: 30 September 2013
Cited by 8 | PDF Full-text (310 KB) | HTML Full-text | XML Full-text
Abstract
Folate is a B-vitamin with particular importance during reproduction due to its role in the synthesis and maintenance of DNA. Folate is well known for its role in preventing neural tube defects (NTDs) during the periconceptional period. There is also an increased [...] Read more.
Folate is a B-vitamin with particular importance during reproduction due to its role in the synthesis and maintenance of DNA. Folate is well known for its role in preventing neural tube defects (NTDs) during the periconceptional period. There is also an increased need for folate throughout pregnancy to support optimal growth and development of the fetus and blood volume expansion and tissue growth of the mother. During lactation, women are at risk of folate deficiency due to increased demands to accommodate milk folate levels. Nutrient Intake Values (NIVs) for folate have been calculated to take into account additional needs during pregnancy and lactation. However, these values vary widely between countries. For example, the folate requirement that is set to meet the needs of almost all healthy women during pregnancy varies from 300 µg/day in the United Kingdom to 750 µg/day in Mexico. Currently, there is no accepted standardized terminology or framework for establishing NIVs. This article reviews country-specific NIVs for folate during pregnancy and lactation and the basis for setting these reference values. Full article
Open AccessReview Risk of High Dietary Calcium for Arterial Calcification in Older Adults
Nutrients 2013, 5(10), 3964-3974; doi:10.3390/nu5103964
Received: 2 July 2013 / Revised: 23 August 2013 / Accepted: 10 September 2013 / Published: 30 September 2013
Cited by 3 | PDF Full-text (176 KB) | HTML Full-text | XML Full-text
Abstract
Concern has recently arisen about the potential adverse effects of excessive calcium intakes, i.e., calcium loading from supplements, on arterial calcification and risks of cardiovascular diseases (CVD) in older adults. Published reports that high calcium intakes in free-living adults have relatively [...] Read more.
Concern has recently arisen about the potential adverse effects of excessive calcium intakes, i.e., calcium loading from supplements, on arterial calcification and risks of cardiovascular diseases (CVD) in older adults. Published reports that high calcium intakes in free-living adults have relatively little or no beneficial impact on bone mineral density (BMD) and fracture rates suggest that current recommendations of calcium for adults may be set too high. Because even healthy kidneys have limited capability of eliminating excessive calcium in the diet, the likelihood of soft-tissue calcification may increase in older adults who take calcium supplements, particularly in those with age or disease-related reduction in renal function. The maintenance of BMD and bone health continues to be an important goal of adequate dietary calcium consumption, but eliminating potential risks of CVDs from excessive calcium intakes needs to be factored into policy recommendations for calcium by adults. Full article
(This article belongs to the Special Issue Calcium Needs of Older Adults)
Open AccessReview Molecular Link between Vitamin D and Cancer Prevention
Nutrients 2013, 5(10), 3993-4021; doi:10.3390/nu5103993
Received: 7 August 2013 / Revised: 11 September 2013 / Accepted: 18 September 2013 / Published: 30 September 2013
Cited by 38 | PDF Full-text (312 KB) | HTML Full-text | XML Full-text
Abstract
The metabolite of vitamin D, 1α,25-dihydroxyvitamin D3 (also known as calcitriol), is a biologically active molecule required to maintain the physiological functions of several target tissues in the human body from conception to adulthood. Its molecular mode of action ranges from [...] Read more.
The metabolite of vitamin D, 1α,25-dihydroxyvitamin D3 (also known as calcitriol), is a biologically active molecule required to maintain the physiological functions of several target tissues in the human body from conception to adulthood. Its molecular mode of action ranges from immediate nongenomic responses to longer term mechanisms that exert persistent genomic effects. The genomic mechanisms of vitamin D action rely on cross talk between 1α,25-dihydroxyvitamin D3 signaling pathways and that of other growth factors or hormones that collectively regulate cell proliferation, differentiation and cell survival. In vitro and in vivo studies demonstrate a role for vitamin D (calcitriol) in modulating cellular growth and development. Vitamin D (calcitriol) acts as an antiproliferative agent in many tissues and significantly slows malignant cellular growth. Moreover, epidemiological studies have suggested that ultraviolet-B exposure can help reduce cancer risk and prevalence, indicating a potential role for vitamin D as a feasible agent to prevent cancer incidence and recurrence. With the preventive potential of this biologically active agent, we suggest that countries where cancer is on the rise—yet where sunlight and, hence, vitamin D may be easily acquired—adopt awareness, education and implementation strategies to increase supplementation with vitamin D in all age groups as a preventive measure to reduce cancer risk and prevalence. Full article
(This article belongs to the Special Issue Vitamin D and Human Health) Print Edition available
Open AccessReview Mobilization of Stored Iron in Mammals: A Review
Nutrients 2013, 5(10), 4022-4050; doi:10.3390/nu5104022
Received: 1 August 2013 / Revised: 4 September 2013 / Accepted: 12 September 2013 / Published: 10 October 2013
Cited by 24 | PDF Full-text (434 KB) | HTML Full-text | XML Full-text
Abstract
From the nutritional standpoint, several aspects of the biochemistry and physiology of iron are unique. In stark contrast to most other elements, most of the iron in mammals is in the blood attached to red blood cell hemoglobin and transporting oxygen to [...] Read more.
From the nutritional standpoint, several aspects of the biochemistry and physiology of iron are unique. In stark contrast to most other elements, most of the iron in mammals is in the blood attached to red blood cell hemoglobin and transporting oxygen to cells for oxidative phosphorylation and other purposes. Controlled and uncontrolled blood loss thus has a major impact on iron availability. Also, in contrast to most other nutrients, iron is poorly absorbed and poorly excreted. Moreover, amounts absorbed (~1 mg/day in adults) are much less than the total iron (~20 mg/day) cycling into and out of hemoglobin, involving bone marrow erythropoiesis and reticuloendothelial cell degradation of aged red cells. In the face of uncertainties in iron bioavailability, the mammalian organism has evolved a complex system to retain and store iron not immediately in use, and to make that iron available when and where it is needed. Iron is stored innocuously in the large hollow protein, ferritin, particularly in cells of the liver, spleen and bone marrow. Our current understanding of the molecular, cellular and physiological mechanisms by which this stored iron in ferritin is mobilized and distributed—within the cell or to other organs—is the subject of this review. Full article
(This article belongs to the Special Issue Dietary Iron and Human Health)
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Open AccessReview Nutritional Management of Insulin Resistance in Nonalcoholic Fatty Liver Disease (NAFLD)
Nutrients 2013, 5(10), 4093-4114; doi:10.3390/nu5104093
Received: 18 May 2013 / Revised: 14 August 2013 / Accepted: 19 September 2013 / Published: 11 October 2013
Cited by 19 | PDF Full-text (323 KB) | HTML Full-text | XML Full-text
Abstract
Nonalcoholic fatty liver disease (NAFLD) is an emerging global health concern. It is the most common form of chronic liver disease in Western countries, affecting both adults and children. NAFLD encompasses a broad spectrum of fatty liver disease, ranging from simple steatosis [...] Read more.
Nonalcoholic fatty liver disease (NAFLD) is an emerging global health concern. It is the most common form of chronic liver disease in Western countries, affecting both adults and children. NAFLD encompasses a broad spectrum of fatty liver disease, ranging from simple steatosis (NAFL) to nonalcoholic steatohepatitis (NASH), and is strongly associated with obesity, insulin resistance, and dyslipidemia. First-line therapy for NAFLD includes weight loss achieved through diet and physical activity. However, there is a lack of evidenced-based dietary recommendations. The American Diabetes Association’s (ADA) recommendations that aim to reduce the risk of diabetes and cardiovascular disease may also be applicable to the NAFLD population. The objectives of this review are to: (1) provide an overview of NAFLD in the context of insulin resistance, and (2) provide a rationale for applying relevant aspects of the ADA recommendations to the nutritional management of NAFLD. Full article
(This article belongs to the Special Issue Nutrition and Diabetes)
Open AccessReview Adiponectin: An Attractive Marker for Metabolic Disorders in Chronic Obstructive Pulmonary Disease (COPD)
Nutrients 2013, 5(10), 4115-4125; doi:10.3390/nu5104115
Received: 3 June 2013 / Revised: 18 September 2013 / Accepted: 23 September 2013 / Published: 14 October 2013
Cited by 12 | PDF Full-text (209 KB) | HTML Full-text | XML Full-text
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease which may be complicated by development of co-morbidities including metabolic disorders. Metabolic disorders commonly associated with this disease contribute to lung function impairment and mortality. Systemic inflammation appears to be a [...] Read more.
Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease which may be complicated by development of co-morbidities including metabolic disorders. Metabolic disorders commonly associated with this disease contribute to lung function impairment and mortality. Systemic inflammation appears to be a major factor linking COPD to metabolic alterations. Adipose tissue seems to interfere with systemic inflammation in COPD patients by producing a large number of proteins, known as “adipokines”, involved in various processes such as metabolism, immunity and inflammation. There is evidence that adiponectin is an important modulator of inflammatory processes implicated in airway pathophysiology. Increased serum levels of adiponectin and expression of its receptors on lung tissues of COPD patients have recently highlighted the importance of the adiponectin pathway in this disease. Further, in vitro studies have demonstrated an anti-inflammatory activity for this adipokine at the level of lung epithelium. This review focuses on mechanisms by which adiponectin is implicated in linking COPD with metabolic disorders. Full article
(This article belongs to the Special Issue Nutrition and Respiratory Disease)
Open AccessReview Anorexia of Aging: A Modifiable Risk Factor for Frailty
Nutrients 2013, 5(10), 4126-4133; doi:10.3390/nu5104126
Received: 3 July 2013 / Revised: 16 August 2013 / Accepted: 17 September 2013 / Published: 14 October 2013
Cited by 20 | PDF Full-text (1231 KB) | HTML Full-text | XML Full-text
Abstract
Anorexia of aging, defined as a loss of appetite and/or reduced food intake, affects a significant number of elderly people and is far more prevalent among frail individuals. Anorexia recognizes a multifactorial origin characterized by various combinations of medical, environmental and social [...] Read more.
Anorexia of aging, defined as a loss of appetite and/or reduced food intake, affects a significant number of elderly people and is far more prevalent among frail individuals. Anorexia recognizes a multifactorial origin characterized by various combinations of medical, environmental and social factors. Given the interconnection between weight loss, sarcopenia and frailty, anorexia is a powerful, independent predictor of poor quality of life, morbidity and mortality in older persons. One of the most important goals in the management of older, frail people is to optimize their nutritional status. To achieve this objective it is important to identify subjects at risk of anorexia and to provide multi-stimulus interventions that ensure an adequate amount of food to limit and/or reverse weight loss and functional decline. Here, we provide a brief overview on the relevance of anorexia in the context of sarcopenia and frailty. Major pathways supposedly involved in the pathogenesis of anorexia are also illustrated. Finally, the importance of treating anorexia to achieve health benefits in frail elders is highlighted. Full article
(This article belongs to the Special Issue Nutritional Influences on Age-Related Frailty)
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Open AccessReview Health Benefits of Methylxanthines in Cacao and Chocolate
Nutrients 2013, 5(10), 4159-4173; doi:10.3390/nu5104159
Received: 23 July 2013 / Revised: 9 September 2013 / Accepted: 23 September 2013 / Published: 18 October 2013
Cited by 13 | PDF Full-text (300 KB) | HTML Full-text | XML Full-text
Abstract
One may wonder why methylxanthines are so abundant in beverages used by humans for centuries, or in cola-drinks that have been heavily consumed since their appearance. It is likely that humans have stuck to any brew containing compounds with psychoactive properties, resulting [...] Read more.
One may wonder why methylxanthines are so abundant in beverages used by humans for centuries, or in cola-drinks that have been heavily consumed since their appearance. It is likely that humans have stuck to any brew containing compounds with psychoactive properties, resulting in a better daily life, i.e., more efficient thinking, exploring, hunting, etc., however, without the serious side effects of drugs of abuse. The physiological effects of methylxanthines have been known for a long time and they are mainly mediated by the so-called adenosine receptors. Caffeine and theobromine are the most abundant methylxanthines in cacao and their physiological effects are notable. Their health-promoting benefits are so remarkable that chocolate is explored as a functional food. The consequences of adenosine receptor blockade by natural compounds present in cacao/chocolate are here reviewed. Palatability and health benefits of methylxanthines, in general, and theobromine, in particular, have further contributed to sustain one of the most innocuous and pleasant habits: chocolate consumption. Full article
(This article belongs to the Special Issue Chocolate and Cocoa in Human Health)
Open AccessReview Maize Prolamins Could Induce a Gluten-Like Cellular Immune Response in Some Celiac Disease Patients
Nutrients 2013, 5(10), 4174-4183; doi:10.3390/nu5104174
Received: 1 August 2013 / Revised: 2 October 2013 / Accepted: 10 October 2013 / Published: 21 October 2013
Cited by 2 | PDF Full-text (191 KB) | HTML Full-text | XML Full-text
Abstract
Celiac disease (CD) is an autoimmune-mediated enteropathy triggered by dietary gluten in genetically prone individuals. The current treatment for CD is a strict lifelong gluten-free diet. However, in some CD patients following a strict gluten-free diet, the symptoms do not remit. These [...] Read more.
Celiac disease (CD) is an autoimmune-mediated enteropathy triggered by dietary gluten in genetically prone individuals. The current treatment for CD is a strict lifelong gluten-free diet. However, in some CD patients following a strict gluten-free diet, the symptoms do not remit. These cases may be refractory CD or due to gluten contamination; however, the lack of response could be related to other dietary ingredients, such as maize, which is one of the most common alternatives to wheat used in the gluten-free diet. In some CD patients, as a rare event, peptides from maize prolamins could induce a celiac-like immune response by similar or alternative pathogenic mechanisms to those used by wheat gluten peptides. This is supported by several shared features between wheat and maize prolamins and by some experimental results. Given that gluten peptides induce an immune response of the intestinal mucosa both in vivo and in vitro, peptides from maize prolamins could also be tested to determine whether they also induce a cellular immune response. Hypothetically, maize prolamins could be harmful for a very limited subgroup of CD patients, especially those that are non-responsive, and if it is confirmed, they should follow, in addition to a gluten-free, a maize-free diet. Full article
(This article belongs to the Special Issue Nutrition and Celiac Disease) Print Edition available
Open AccessReview IGF-1, the Cross Road of the Nutritional, Inflammatory and Hormonal Pathways to Frailty
Nutrients 2013, 5(10), 4184-4205; doi:10.3390/nu5104184
Received: 3 July 2013 / Revised: 1 October 2013 / Accepted: 1 October 2013 / Published: 21 October 2013
Cited by 10 | PDF Full-text (408 KB) | HTML Full-text | XML Full-text
Abstract
The decline in functional capacity is a heterogeneous phenomenon in the elderly. An accelerated ageing determines a frail status. It results in an increased vulnerability to stressors for decreased physiological reserves. The early identification of a frail status is essential for preventing [...] Read more.
The decline in functional capacity is a heterogeneous phenomenon in the elderly. An accelerated ageing determines a frail status. It results in an increased vulnerability to stressors for decreased physiological reserves. The early identification of a frail status is essential for preventing loss of functional capacity, and its clinical consequences. Frailty and mobility limitation result from an interplay of different pathways including multiple anabolic deficiency, inflammation, oxidative stress, and a poor nutritional status. However, the age-related decline in insulin-like growth factor 1 (IGF-1) bioactivity deserves special attention as it could represent the ideal crossroad of endocrine, inflammatory, and nutritional pathways to frailty. Several minerals, namely magnesium, selenium, and zinc, appear to be important determinants of IGF-1 bioactivity. This review aims to provide an overview of the potential usefulness of nutrients modulating IGF-1 as potential therapeutic targets in the prevention of mobility limitation occurring in frail older subjects. Full article
(This article belongs to the Special Issue Nutritional Influences on Age-Related Frailty)
Open AccessReview Iron, Human Growth, and the Global Epidemic of Obesity
Nutrients 2013, 5(10), 4231-4249; doi:10.3390/nu5104231
Received: 30 August 2013 / Revised: 27 September 2013 / Accepted: 12 October 2013 / Published: 22 October 2013
Cited by 2 | PDF Full-text (246 KB) | HTML Full-text | XML Full-text
Abstract
Iron is an essential nutrient utilized in almost every aspect of cell function and its availability has previously limited life. Those same properties which allow iron to function as a catalyst in the reactions of life also present a threat via generation [...] Read more.
Iron is an essential nutrient utilized in almost every aspect of cell function and its availability has previously limited life. Those same properties which allow iron to function as a catalyst in the reactions of life also present a threat via generation of oxygen-based free radicals. Accordingly; life exists at the interface of iron-deficiency and iron-sufficiency. We propose that: (1) human life is no longer positioned at the limits of iron availability following several decades of fortification and supplementation and there is now an overabundance of the metal among individuals of many societies; (2) this increased iron availability exerts a positive effect on growth by targeting molecules critical in regulating the progression of the cell cycle; there is increased growth in humans provided greater amounts of this metal; and indices of obesity can positively correlate with body stores of iron; and (3) diseases of obesity reflect this over-abundance of iron. Testing potential associations between iron availability and both obesity and obesity-related diseases in populations will be difficult since fortification and supplementation is so extensively practiced. Full article
(This article belongs to the Special Issue Dietary Iron and Human Health)
Open AccessReview The Gluten-Free Diet: Testing Alternative Cereals Tolerated by Celiac Patients
Nutrients 2013, 5(10), 4250-4268; doi:10.3390/nu5104250
Received: 29 August 2013 / Revised: 7 October 2013 / Accepted: 15 October 2013 / Published: 23 October 2013
Cited by 8 | PDF Full-text (718 KB) | HTML Full-text | XML Full-text
Abstract
A strict gluten-free diet (GFD) is the only currently available therapeutic treatment for patients with celiac disease, an autoimmune disorder of the small intestine associated with a permanent intolerance to gluten proteins. The complete elimination of gluten proteins contained in cereals from [...] Read more.
A strict gluten-free diet (GFD) is the only currently available therapeutic treatment for patients with celiac disease, an autoimmune disorder of the small intestine associated with a permanent intolerance to gluten proteins. The complete elimination of gluten proteins contained in cereals from the diet is the key to celiac disease management. However, this generates numerous social and economic repercussions due to the ubiquity of gluten in foods. The research presented in this review focuses on the current status of alternative cereals and pseudocereals and their derivatives obtained by natural selection, breeding programs and transgenic or enzymatic technology, potential tolerated by celiac people. Finally, we describe several strategies for detoxification of dietary gluten. These included enzymatic cleavage of gliadin fragment by Prolyl endopeptidases (PEPs) from different organisms, degradation of toxic peptides by germinating cereal enzymes and transamidation of cereal flours. This information can be used to search for and develop cereals with the baking and nutritional qualities of toxic cereals, but which do not exacerbate this condition. Full article
(This article belongs to the Special Issue Nutrition and Celiac Disease) Print Edition available

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Open AccessProject Report Investigation of Effect of Nutritional Drink on Chemotherapy-Induced Mucosal Injury and Tumor Growth in an Established Animal Model
Nutrients 2013, 5(10), 3948-3963; doi:10.3390/nu5103948
Received: 8 August 2013 / Revised: 17 September 2013 / Accepted: 22 September 2013 / Published: 30 September 2013
Cited by 2 | PDF Full-text (1317 KB) | HTML Full-text | XML Full-text
Abstract
Chemotherapy-induced mucositis represents a significant burden to quality of life and healthcare costs, and may be improved through enhanced nutritional status. We first determined the safety of two nutritional drinks (plus placebo), and then potential gut protection in tumor-bearing rats in a [...] Read more.
Chemotherapy-induced mucositis represents a significant burden to quality of life and healthcare costs, and may be improved through enhanced nutritional status. We first determined the safety of two nutritional drinks (plus placebo), and then potential gut protection in tumor-bearing rats in a model of methotrexate-induced mucositis. In study 1, animals were fed one of two test diets (or placebo or control chow pellets) for a total of 60 days and were monitored daily. All diets were found to be safe to administer. In study 2, after seven days of receiving diets, a Dark Agouti Mammary Adenocarcinoma (DAMA) was transplanted subcutaneously. Ten days after starting diets, animals had 2 mg/kg intramuscular methotrexate administered on two consecutive days; after this time, all animals were given soaked chow. Animals were monitored daily for changes in bodyweight, tumor burden and general health. Animals were killed 10, 12 and 16 days after initially starting diets, and tissues were collected at necropsy. In study 1, animals receiving diets had gained 0.8% and 10.8% of their starting bodyweight after 60 days, placebo animals 4.4%, and animals fed on standard chow had gained 15.1%. In study 2, there was no significant influence of test diet on bodyweight, organ weight, tumor burden or biochemical parameters. Only animals treated with MTX exhibited diarrhea, although animals receiving Diet A and Diet C showed a non-significant increase in incidence of diarrhea. Administration of these nutritional drinks did not improve symptoms of mucositis. Full article
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Open AccessCommentary Eating and Obesity—The New World Disorder
Nutrients 2013, 5(10), 4206-4210; doi:10.3390/nu5104206
Received: 21 August 2013 / Revised: 17 September 2013 / Accepted: 18 September 2013 / Published: 21 October 2013
Cited by 3 | PDF Full-text (146 KB) | HTML Full-text | XML Full-text
Abstract
Obesity is not a new phenomenon. Paleolithic artefacts, some almost 35,000 years old, depict obesity in its classical gynoid form, suggesting that early hunter-gathers were not entirely safeguarded by the assumed Stone Age diet [1]. Nevertheless it has been convincingly argued by [...] Read more.
Obesity is not a new phenomenon. Paleolithic artefacts, some almost 35,000 years old, depict obesity in its classical gynoid form, suggesting that early hunter-gathers were not entirely safeguarded by the assumed Stone Age diet [1]. Nevertheless it has been convincingly argued by Boyd Eaton and others that the 21st century epidemic of non-communicable diseases (NCDs), including obesity, is attributable to mankind no longer enjoying the diet of our ancestors for which we remain genetically and metabolically programmed [2]. Even if our forebears seemed to revere obesity sufficiently to carve out stone “venuses”, it is still unclear if they were documenting a commonplace feature, although the frequency with which these venuses appear across thousands of years and even thousands of miles apart might suggest that obesity, in women at least, was not a complete rarity [3]. Full article
(This article belongs to the Special Issue Eating Disorder and Obesity)

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