Dairy food intake is positively associated with cardiovascular health: findings from Observation of Cardiovascular Risk Factors in Luxembourg study

Conflicting findings have been reported about dairy food consumption and risk for cardiovascular disease. Furthermore, few studies have examined dairy food intake in relation to cardiovascular health and the incorporation of lifestyle factors such as diet and physical activity. This study examined whether dairy food consumption was associated with cardiovascular health, recently defined by the American Heart Association. Data were analyzed from 1352 participants from the Observation of Cardiovascular Risk Factors in Luxembourg survey. A validated food frequency questionnaire was used to measure intakes of milk, yogurt, cheese, dairy desserts, ice cream, and butter. Seven cardiovascular health metrics were assessed: smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and fasting plasma glucose. A total cardiovascular health score (CHS) was determined by summing the total number of health metrics at ideal levels. It was hypothesized that greater dairy food consumption (both low fat and whole fat) would be associated with better global cardiovascular health, as indicated by a higher CHS. Total dairy food intake was positively associated with the CHS. Higher intakes of whole fat milk, yogurt, and cheese were associated with better cardiovascular health. Even when controlling for demographic and dietary variables, those who consumed at least 5 servings per week of these dairy products had a significantly higher CHS than those who consumed these products less frequently. Higher total whole fat dairy food intake was also associated with other positive health behaviors, including being a nonsmoker, consuming the suggested dietary intakes of recommended foods, and having a normal body mass index. Increased dairy food consumption was associated with better cardiovascular health.     

Dietary patterns in a high-risk population for glucose intolerance. Japanese-Brazilian Diabetes Study Group

We evaluated dietary habits as risk factor for glucose intolerance in a high risk population of Japanese-Brazilians enrolled in a study on the prevalence of diabetes (DM). Based on oral glucose tolerance test and WHO criteria, 331 had normal tolerance (NGT), 88 impaired tolerance (IGT) and 83 had type 2 DM (51 self-reported, 32 newly diagnosed diabetics). Clinical, laboratory and dietary data, assessed by food frequency questionnaire (FFQ), were compared between the NGT group and another composed of IGT and newly diagnosed DM (disturbed glucose tolerance or DGT group). Associations of total energy intake and nutrient intakes with glucose intolerance were analyzed by logistic regression. Also, subjects with NGT and DGT entered into separate models of multiple linear regression including BMI as the dependent variable, and total energy intake or each nutrient as independent variables. DGT group showed higher waist-to-hip ratio, blood pressure, plasma glucose and insulin levels and worse lipid profile. Total energy intake, macronutrients, fibers, alcohol and saturated fat intakes did not differ between groups; DGT was not associated with any nutrient intake in multivariate analyses. BMI of the subjects with DGT but not with NGT was associated with protein and cholesterol intakes in linear regression analysis. Our findings did not support an association between nutritional factors and glucose intolerance even in subjects who are unaware of their DGT, using FFQ to reflect current habits. However, we suggest that protein and cholesterol intakes may be markers of increased BMI. Despite assuming that obesity and insulin resistance precedes DM, FFQ may not be useful in the assessment of unfavorable dietary patterns among subjects at risk for glucose intolerance, such as Japanese-Brazilians with elevated BMI.     

The effects of race, household income, and parental education on nutrient intakes of 9- and 10-year-old girls NHLBI growth and health study

Nutrient intakes of 2149 black and white, 9- and 10-year-old girls varied by race, household income, and parental education. Of the three variables, higher education was most consistently associated with more desirable levels of nutrient intakes, that is, lower percentage of dietary fat and higher levels of vitamin C, calcium, and potassium. Higher income was related to higher intakes of vitamin C, but lower intakes of calcium and iron. Higher income was associated with lower percentage of dietary fat. After adjustment for income and education, race was associated with intakes of calcium, vitamin C, and to a lesser extent, percentages of kilocalories from total fat and polyunsaturated fat, and potassium. Black girls had a significantly lower intake of calcium (720 versus 889 mg) and a higher intake of vitamin C (91 versus 83 mg).Proportions of the cohort with inadequate or excessive intakes of micronutrients and macronutrients were also estimated. A high proportion of girls exceeded the recommended intake level of 30% of kilocalories from total fat (90% of black girls; 84% of white girls) and 10% of kilocalories from saturated fat (92 and 93%, respectively). Low intakes of calcium (40% of black girls and 20% of white girls) and zinc (36 and 38%, respectively) commonly were found for girls of both races.     

Dietary fat intake and risk of type 2 diabetes in women

BACKGROUND: The long-term relations between specific types of dietary fat and risk of type 2 diabetes remain unclear. OBJECTIVE: Our objective was to examine the relations between dietary fat intakes and the risk of type 2 diabetes. DESIGN: We prospectively followed 84204 women aged 34-59 y with no diabetes, cardiovascular disease, or cancer in 1980. Detailed dietary information was assessed at baseline and updated in 1984, 1986, and 1990 by using validated questionnaires. Relative risks of type 2 diabetes were obtained from pooled logistic models adjusted for nondietary and dietary covariates. RESULTS: During 14 y of follow-up, 2507 incident cases of type 2 diabetes were documented. Total fat intake, compared with equivalent energy intake from carbohydrates, was not associated with risk of type 2 diabetes; for a 5% increase in total energy from fat, the relative risk (RR) was 0.98 (95% CI: 0.94, 1.02). Intakes of saturated or monounsaturated fatty acids were also not significantly associated with the risk of diabetes. However, for a 5% increase in energy from polyunsaturated fat, the RR was 0.63 (0.53, 0.76; P < 0.0001) and for a 2% increase in energy from trans fatty acids the RR was 1.39 (1.15, 1.67; P = 0.0006). We estimated that replacing 2% of energy from trans fatty acids isoenergetically with polyunsaturated fat would lead to a 40% lower risk (RR: 0.60; 95% CI: 0.48, 0.75). CONCLUSIONS: These data suggest that total fat and saturated and monounsaturated fatty acid intakes are not associated with risk of type 2 diabetes in women, but that trans fatty acids increase and polyunsaturated fatty acids reduce risk. Substituting nonhydrogenated polyunsaturated fatty acids for trans fatty acids would likely reduce the risk of type 2 diabetes substantially.     

高脂饲料对OLETF大鼠糖代谢及血清磷脂脂肪酸组成的影响

目的:观察高脂饲料对自发性2型糖尿病模型OLETF大鼠糖代谢及血清磷脂脂肪酸组成的影响。方法:将20只14w雄性OLETF大鼠随机分为两组,分别以高脂及标准饲料喂饲10w,两种饲料中饱和脂肪酸、单不饱和脂肪酸、多不饱和脂肪酸占总脂肪酸的百分含量相似。大鼠第24w龄时进行口服糖耐量试验,同时测定大鼠的胰岛素水平和血清磷脂脂肪酸组成。结果:实验期间两组大鼠总进食量无统计学差异,但高脂饲料组大鼠体重明显高于标准饲料组(P<0.01);口服糖耐量试验和胰岛素水平测定结果表明,两组大鼠的糖代谢状态无统计学差异;血清磷脂脂肪酸组成中,除总n-6PUFA和18:3(n-3)的百分含量无统计学差异外,其他各脂肪酸组分在两组间的差异均具有统计学意义(P<0.01)。结论:在饲料脂肪酸组成保持可比的情况下,饲料脂肪量的增加可使OLETF大鼠的体重明显增加,而对糖代谢的影响不明显,同时对OLETF大鼠血清磷脂脂肪酸组成产生明显影响。     

Higher glycemic load diet is associated with poorer nutrient intake in women with gestational diabetes mellitus

Changes in the quality and quantity of carbohydrate foods may compromise nutrient intake in women with gestational diabetes mellitus (GDM). We hypothesized that glycemic index, glycemic load (GL), carbohydrate intake, grains, and cereal product consumption would be associated with nutrient adequacy. Eighty-two women with GDM (61% of Asian background, 34% whites) completed a 3-day food record following their routine group nutrition education session. Nutrient intakes were compared to Nutrient Reference Values (NRV) for Australia and New Zealand. Nutrient intake across energy-adjusted tertiles of glycemic index, GL, carbohydrate intake, and intake of grains and cereal products were assessed. The majority of women (66%-99%) did not meet the NRV for fiber, folate, vitamin D, iodine, and iron, and exceeded NRV for saturated fat and sodium. Higher dietary GL was associated with lower intakes of total, monounsaturated, and polyunsaturated fat; vitamin E; and potassium (all P < .001). Higher grain intake was not significantly associated with intake of any micronutrients. In Australian women with GDM, high dietary GL predicts greater risk of poor nutrition.     

Vitamin supplement intake is related to dietary intake and physical activity: The Child and Adolescent Trial for Cardiovascular Health (CATCH)

OBJECTIVE: To explore the relationship of multiple-vitamin supplement use with selected food groups, physical activity, lifestyle behaviors, and weight status. SUBJECTS AND METHODS: Two thousand seven hundred sixty-one adolescents in the 12th grade who participated in the fourth Child and Adolescent Trial for Cardiovascular Health study had height and weight measured and completed health behavior survey and food frequency questionnaires. Logistic regression models were used to determine the likelihood of supplement use with health and activity behaviors and dietary intake. RESULTS: Prevalence of multiple-vitamin supplement use among adolescents was 25% and varied by sex and race/ethnicity. Supplement users had higher mean daily intakes of most food groups, but lower intakes of total fat and saturated fat than nonusers. Higher food index scores were positively associated with the likelihood of using multiple-vitamin supplements. Supplement users were more likely to be physically active, participate in team and organized sports, and less likely to be overweight and to watch more than an hour of television per day. CONCLUSIONS: Adolescents who use multiple vitamin supplements have more healthful dietary and lifestyle behaviors than nonusers. Further study on supplement use by adolescents, including other types of supplements used and reasons for use, is warranted.     

Studies of consistency of dietary intake during the first four years of life in a prospective analysis: Bogalusa Heart Study.

The consistency of intake levels for several dietary components over a 5-year period (age 6 months to 4 years) in a biracial infant-early childhood cohort has been demonstrated. Young children with high intakes of selected dietary components associated with risk of cardiovascular disease (e.g., total fat, saturated fat, dietary cholesterol) continue to have higher intakes as they mature than do their peers. Spearman rank correlation coefficients at a significant level are noted between ages 2 and 4 for the following nutrients: total protein (r = 0.65), animal protein (r = 0.46), total sugar (r = 0.39), sucrose (r = 0.37), starch (r = 0.33), total fat (r = 0.53), saturated fatty acid (SFA, r = 0.48), polyunsaturated fatty acid (PUFA, r = 0.43), and cholesterol (r = 0.49). At 2 years of age, some 47-65% of those in the upper tertile for total fat, SFA, and cholesterol intake remain in the upper tertile at age 4. Persistence of eating behaviors appears to begin as early as age 2, in part because of parental control over food patterns. These observations have implications for reduction of early cardiovascular risk factors in children and adoption of a more prudent dietary intake through consumer education.     

Studies of consistency of dietary intake during the first four years of life in a prospective analysis: Bogalusa Heart Study

The consistency of intake levels for several dietary components over a 5-year period (age 6 months to 4 years) in a biracial infant-early childhood cohort has been demonstrated. Young children with high intakes of selected dietary components associated with risk of cardiovascular disease (e.g., total fat, saturated fat, dietary cholesterol) continue to have higher intakes as they mature than do their peers. Spearman rank correlation coefficients at a significant level are noted between ages 2 and 4 for the following nutrients: total protein (r = 0.65), animal protein (r = 0.46), total sugar (r = 0.39), sucrose (r = 0.37), starch (r = 0.33), total fat (r = 0.53), saturated fatty acid (SFA, r = 0.48), polyunsaturated fatty acid (PUFA, r = 0.43), and cholesterol (r = 0.49). At 2 years of age, some 47-65% of those in the upper tertile for total fat, SFA, and cholesterol intake remain in the upper tertile at age 4. Persistence of eating behaviors appears to begin as early as age 2, in part because of parental control over food patterns. These observations have implications for reduction of early cardiovascular risk factors in children and adoption of a more prudent dietary intake through consumer education.     

Effects of Dietary Fiber,Fats, and Meat Intakes on the Risk of Barrett's Esophagus

Animal and human models suggest associations between fat intake, fiber intake, and the risk of esophageal adenocarcinoma. We evaluated whether these factors may act early in the carcinogenic pathway as a risk factor for Barrett's esophagus, a potentially premalignant precursor to esophageal adenocarcinoma using a case-control design within the Kaiser Permanente, Northern California population. Incident Barrett's esophagus cases (n = 296) were matched to persons with gastroesophageal reflux disease (GERD) (n = 308) and to population controls (n = 309). Higher intakes of omega-3-fatty-acids [cases vs. population controls; OR = 0.46, 95% CI = 0.22–0.97, 4th vs. 1st quartiles of intake], polyunsaturated fat, total fiber (OR = 0.34, 95% CI = 0.15–0.76), and fiber from fruits and vegetables (OR = 0.47 95% CI = 0.25–0.88) were associated with a lower risk of Barrett's esophagus. Higher meat intakes were associated with a lower risk of long-segment Barrett's esophagus (OR = 0.25, 95% CI = 0.09–0.72). In contrast, higher trans-fat intakes were associated with increased risk (OR = 1.11; 95% CI = 1.03–1.21 per g/day). Total fat intake, barbecued foods, and fiber intake from sources other than fruits and vegetables were not associated with Barrett's esophagus. Future studies to evaluate whether dietary interventions might influence the risk of Barrett's esophagus or esophageal adenocarcinoma in high risk persons are needed.     

Dietary adherence and associated glycemic control in families of young children with type 1 diabetes

OBJECTIVE: This study examined the dietary intake, dietary adherence, and associated daily glycemic control of young children (mean age 5.6+/-1.6 years) with type 1 diabetes in 33 families. DESIGN: This was a one-sample cross-sectional study. Children's nutrient and energy intakes were measured using 3-day diet diaries. Children's mean daily blood glucose levels were assessed prospectively for 2 weeks using the FreeStyle (TheraSense, Inc, Alameda, CA) home blood glucose meter. STATISTICAL ANALYSIS: Means, standard deviations, and frequencies described the sample. Associations between dietary adherence and glycemic control were examined by one-tailed Pearson correlations. RESULTS: Mean nutrient intakes were less than the Dietary Reference Intake for children's intake of vitamin B-12 and calcium. Children's dietary deviations revealed better-than-predicted adherence to the number and timing of feedings per day and number of carbohydrate units consumed per meal. In contrast, children's daily carbohydrate intake was approximately 80%+/-21% of the recommended levels based on their weight and age. In addition, children's energy intake was only 78%+/-18% of the recommended levels based on age. Correlations revealed a positive association between poor dietary adherence and higher blood glucose levels. CONCLUSIONS: Young children with type 1 diabetes are likely to have adequate dietary intake of most micronutrients. However, their adherence to specific carbohydrate and energy intake recommendations may be lower. Because the preschool years represent a period of rapid growth, diet plans for preschoolers with diabetes need to be revised often for optimal management of type 1 diabetes. Close adherence to dietary recommendations is one behavior that may improve blood glucose control in young children with diabetes.     

An index of diet and eating patterns is a valid measure of diet quality in an Australian population

Diet indices represent an integrated approach to assessing eating patterns and behaviors. The aim of this study was to develop a comprehensive food-based dietary index to reflect adherence to healthy eating recommendations, evaluate the construct validity of the index using nutrient intakes, and evaluate this index in relation to sociodemographic factors, health behaviors, risk factors, and self-assessed health status. Data were analyzed from adult participants of the Australian National Nutrition Survey who completed a 108-item FFQ and a food habits questionnaire (n = 8220). The dietary guideline index (DGI) consisted of 15 items reflecting the dietary guidelines, including dietary indicators of vegetables and legumes, fruit, total cereals, meat and alternatives, total dairy, beverages, sodium, saturated fat, alcoholic beverages, and added sugars. Diet quality was incorporated using indicators relating to whole-grain cereals, lean meat, reduced/low fat dairy, and dietary variety. We investigated associations between the DGI score, sociodemographic factors, health behaviors, chronic disease risk factors, and nutrient intakes. We found associations between the DGI scores and sex, age, income, area-level socioeconomic disadvantage, smoking, physical activity, waist:hip ratio, systolic blood pressure (males only), and self-assessed health status (females only) (all P < 0.05). Higher DGI scores were associated with lower intakes of energy, total fat, and saturated fat and higher intakes of fiber, beta-carotene, vitamin C, folate, calcium, and iron (P < 0.05). This food-based dietary index is able to discriminate across a variety of sociodemographic factors, health behaviors, and self-assessed health and reflects intakes of key nutrients.     

Association of Dietary Proportions of Macronutrients with Visceral Adiposity Index: Non-Substitution and Iso-Energetic Substitution Models in a Prospective Study

We aimed to investigate associations between dietary macronutrient proportions and prospective visceral adiposity index changes (ΔVAI). The study included 1254 adults (18–74 years), from the Tehran Lipid and Glucose Study (TLGS), who were followed for three years. Dietary intakes were assessed twice using food frequency questionnaires. Associations of dietary macronutrient with ΔVAI and risk of visceral adiposity dysfunction (VAD) after three years were investigated. The percentage of energy intake from protein in the total population, and from fat in women, were associated with higher increases in VAI. A 5% higher energy intake from protein substituted for carbohydrate, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) was associated with higher ΔVAI. Higher energy intake from animal protein substituted for PUFAs was positively associated with ΔVAI. Substituting protein and PUFAs with MUFAs were related to higher ΔVAI. The associations were similar in men and women, but reached significance mostly among women. Risk of VAD was increased when 1% of energy from protein was replaced with MUFAs. Substituting protein for carbohydrate and fat, and fat for carbohydrate, resulted in increased risk of VAD in women. Higher dietary proportions of protein and animal-derived MUFA may be positively associated with ΔVAI and risk of VAD.     

Dietary Intake in Early Pregnancy and Glycemia in Late Pregnancy among Women with Obesity

Women with obesity have increased risk for hyperglycemia during pregnancy, with negative health consequences for mother and child. We aimed to investigate adherence to nutritional recommendations in early pregnancy and to examine associations between early pregnancy dietary intake and late pregnancy glycemia among women with obesity. We included 120 women with pre-pregnancy body mass index (BMI) ≥30 kg/m² who participated in one of two randomized controlled trials. The participants completed a food frequency questionnaire in early pregnancy (gestational weeks 12–22). Fasting and 120 min glucose tolerance after ingestion of 75 g glucose were assessed in late pregnancy (gestational weeks 32–37). About 90% of the participants reported early pregnancy diary intake within the recommendations. Average intakes of vitamin D, iron, and folate were below recommended levels. High intakes of dairy products and protein in early pregnancy were associated with lower fasting glucose in late pregnancy, whereas high intake of bread was associated with lower 120 min glucose. There were no clear associations between single dietary variables and gestational diabetes mellitus (GDM) diagnosis in late pregnancy. In conclusion, some early pregnancy dietary variables were associated with late pregnancy glycemia. Potential causality of these findings should be investigated in future studies.     

Effect of dietary factors on incidence of type 2 diabetes: a systematic review of cohort studies

We systematically reviewed cohort studies on the effect of nutrient and food intake (except for alcohol) on the incidence of type 2 diabetes, which had been published in English as of May 2004. Using the MEDLINE (PubMed) database as well as reference lists of searched papers, 15 individual cohort studies (a total of 31 papers) were identified. The number of subjects (n= 895-85,060), follow-up length (5.9-23 y), the number of diabetes cases (n= 74-4,085), dietary assessment method used (simple food questionnaire, food frequency questionnaire, food frequency interview, diet history interview, and 24-h recall), and method of case ascertainment (questionnaire, oral glucose tolerance test, fasting glucose level, death certificate, and nationwide registry) varied among studies. For nutrients, intakes of vegetable fat, polyunsaturated fatty acid, dietary fiber (particularly cereal fiber), magnesium, and caffeine were significantly inversely correlated and intakes of trans fatty acid and heme-iron, glycemic index, and glycemic load were significantly positively correlated with the incidence of type 2 diabetes in several papers. For foods and food groups, several papers showed significantly decreased risk for type 2 diabetes with the higher consumption of grain (particularly whole grain) and coffee, and significantly increased risk with processed meat consumption. Because all the studies were carried out in Western countries, however, research in non-Western countries including Japan is needed.     

Food preference questionnaire as a screening tool for assessing dietary risk of cardiovascular disease within health risk appraisals

OBJECTIVE: Nutrition components of health risk appraisals (HRAs) aim to rapidly and accurately assess dietary behaviors that increase disease risk. Because cognitive research suggests that recalling food likes/dislikes may be simpler and more accurate than recalling intake, we tested whether a preference measure was predictive of cardiovascular disease risk factors within an HRA. METHODS: HRA participants (422 primarily non-Hispanic white men, mean age 46+/-10 years) from a manufacturing company completed surveys to assess fat and sweet food/beverage preference; frequency of consuming fat and sweet foods/beverages, alcoholic beverages, fiber-rich foods (whole grains, fruits, and vegetables); and physical activity. Per measured risk factors, 34% had central obesity (waist circumference>or=102 cm), 32% had hypertension (>or=140 and/or>or=90 mm Hg), 52% had prehypertension (>or=120 to 139 and/or>or=80 to 89 mm Hg), and 52% had an elevated total cholesterol level (>or=200 mg/dL [5.2 mmol/L]). STATISTICAL ANALYSES: Multiple linear regression models explaining variability in waist circumference, blood pressure, and serum lipids were tested. RESULTS: Although preference and intake pairs for fat and sweets were significantly correlated, intake of fat and sweets failed to associate significantly with any risk factor. Significant variance in waist circumference was explained by age, fat preference, fiber intake, and physical activity. Those with greater circumferences liked fat more, consumed less fiber, and exercised less. Waist circumference in turn contributed significantly to models predicting serum lipid levels and blood pressure. Alcohol intake explained variability in serum lipid levels-higher intakes were associated with higher high-density lipoprotein cholesterol levels. The models predicting risk were generally more explanatory in younger (<50 years) than in older men. CONCLUSIONS: Including a preference measure within an HRA appears to enhance cardiovascular disease risk factor assessment. Fat preference, intake of fiber-rich foods, and alcohol proved the best dietary determinants of cardiovascular disease risk factors.     

Dietary factors and development of impaired glucose tolerance and diabetes in a general Japanese population: the hisayama study

BACKGROUND: There have been few prospective studies on diet and glucose abnormalities as determined by oral glucose tolerance test. METHODS: To investigate the impact of dietary factors on the development of glucose intolerance including diabetes and impaired glucose tolerance, we performed a follow-up survey of 1,075 subjects aged 40-74 years of normal glucose tolerance from 1988 through 1993/1994 by repeated 75 g oral glucose tolerance test and dietary survey. Information on habitual food consumption was obtained using a semiquantitative food frequency method. RESULTS: Of the total subjects studied, 119 (11.1%) developed impaired glucose tolerance and 24 (2.2%) developed diabetes during the follow-up. At baseline, the age-adjusted amount of alcohol intake was significantly higher in males who developed glucose intolerance than in those who did not (26.7 g vs. 15.7 g, p < 0.05), while the polyunsaturated/saturated fatty acids (P/S) ratio was significantly higher in females with future glucose intolerance (1.42 vs. 1.31, p < 0.05). Among the female subjects who developed glucose intolerance, the intake of animal fat less decreased during the follow-up period compared with normal subjects, resulting in a significant decrease in the P/S ratio (-0.09 vs. 0.05, p < 0.05). In a multiple logistic regression analysis, alcohol intake at baseline for males and decreased P/S ratio during the follow-up for females remained a significant risk factor for glucose intolerance independent of other dietary and non-dietary factors as well. CONCLUSIONS: These results suggest that a high intake of alcohol and a decreased P/S ratio contribute to the risk of glucose intolerance in contemporary Japanese.     

Diet during early pregnancy and development of gestational diabetes

Diet composition may be a modifiable predictor of risk for abnormal glucose tolerance during pregnancy. Prior studies suggest that diets high in total fat, saturated fat, red and processed meats, and with high glycaemic load increase the risk of developing gestational diabetes mellitus (GDM), while polyunsaturated fats, carbohydrates and fibre are protective. The aim of this study was to investigate associations of these and other nutrients and foods, including n-3 fatty acids, trans fats, whole grains and dietary patterns, with risk of GDM. We studied 1733 women with singleton pregnancies enrolled in Project Viva, a prospective pregnancy and birth cohort study in eastern MA. Using multinomial logistic regression, we examined associations of first trimester diet, assessed by validated food frequency questionnaire, with results of glucose tolerance testing at 26-28 weeks of gestation. A total of 91 women developed GDM and 206 women had impaired glucose tolerance (IGT). Pre-pregnancy body mass index (BMI) was a strong predictor for GDM risk (OR 3.44 [95% CI 1.88, 6.31] for pre-pregnancy BMI > or =30 vs. <25 kg/m(2)). After adjustment for confounders, the OR [95% CI] for risk of GDM for total dietary fat was 1.00 [0.96, 1.05], for saturated fat 0.98 [0.88, 1.08], for polyunsaturated fat 1.09 [0.94, 1.26], for trans fat 0.87 [0.51, 1.49], and for carbohydrates 1.00 [0.96, 1.03] per each 1% of total energy. The adjusted OR [95% CI] for risk of GDM for a one standard deviation increase in energy-adjusted glycaemic load (32 units, about two soft drinks) was 0.96 [0.76, 1.22] and for each daily serving of whole grains was 0.90 [0.73, 1.13]. Dietary patterns and intake of red and processed meats were not predictive of glucose tolerance outcome. Estimates for IGT were similar to those for GDM. Intake of n-3 fatty acids was associated with increased GDM risk (OR 1.11 [95% CI 1.02, 1.22] per each 300 mg/day), but not with IGT risk. Except for this finding, perhaps due to chance, these data do not show that nutrient or food intake in early pregnancy is linked to risk of GDM. Nutritional status entering pregnancy, as reflected by pre-pregnancy BMI, is probably more important than pregnancy diet in development of GDM.     

Dietary fat intake and risk of coronary heart disease in women: 20 years of follow-up of the nurses' health study

The authors examined the associations of dietary fat and specific types of fat with risk of coronary heart disease (CHD) among 78,778 US women initially free of cardiovascular disease and diabetes in 1980. They documented 1,766 incident CHD cases (including 1,241 nonfatal myocardial infarctions and 525 CHD deaths) during 20 years of follow-up. Polyunsaturated fat intake was inversely associated with CHD risk (multivariate relative risk (RR) for the highest vs. the lowest quintile = 0.75, 95% confidence interval (CI): 0.60, 0.92; p(trend) = 0.004), whereas trans-fat intake was associated with an elevated risk of CHD (RR = 1.33, 95% CI: 1.07, 1.66; p(trend) = 0.01). The associations between intakes of polyunsaturated fat and trans-fat with CHD risk were most evident among women younger than age 65 years (for polyunsaturated fat, RR = 0.66, 95% CI: 0.50, 0.85; p(trend) = 0.002 and for trans-fat, RR = 1.50, 95% CI: 1.13, 2.00; p(trend) = 0.01). The inverse association between polyunsaturated fat intake and CHD risk was strongest among women whose body mass index was >or=25 kg/m(2). Findings continue to support an inverse relation between polyunsaturated fat intake and CHD risk, particularly among younger or overweight women. In addition, trans-fat intake was associated with increased risk of CHD, particularly for younger women.     

Diet and nutrient intakes and risk of non-Hodgkin's lymphoma in Connecticut women

A population-based case-control study (601 cases and 717 controls) was conducted in 1995-2001 among Connecticut women to evaluate the relation between diet and nutrient intakes and the risk of non-Hodgkin's lymphoma (NHL). When the highest quartile of intake was compared with the lowest, the authors found an increased risk of NHL associated with animal protein (odds ratio = 1.7, 95% confidence interval: 1.2, 2.4) and saturated fat (odds ratio = 1.9, 95% confidence interval: 1.1, 2.3) but a reduced risk for polyunsaturated fat (odds ratio = 0.6, 95% confidence interval: 0.4, 0.9) and no relation for vegetable protein and monounsaturated fat. An increased risk was also observed for higher intakes of retinol, eggs, and dairy products. On the other hand, a reduced risk was found for higher intakes of dietary fiber and for several fruit and vegetable items. Risk of NHL associated with diet and nutrient intakes appeared to vary based on NHL subtype. An association between dietary intake and NHL risk is biologically plausible because diets high in protein and fat may lead to altered immunocompetence, resulting in an increased risk of NHL. The antioxidant or inhibiting nitrosation reaction properties of vegetables and fruits may result in a reduced risk. Further investigation of the role of dietary intakes on the risk of NHL is warranted.