The Truth About Fat Burning Foods

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Determining the role of omega3 fatty acids and other polyunsaturated fatty acids in weight control

The positive effects of omega-3 PUFAs were observed early on among Greenland Inuits, who, despite high fat intake, displayed low mortality from coronary heart disease (Dyerberg et al., 1975). Other epidemiological studies have reported lower prevalence of obesity, type 2 diabetes and cardiovascular diseases in populations consuming large amounts of omega-3 PUFAs from fatty fish (Mouratoff et al., 1969 Kromann and Green, 1980). Subsequent studies have demonstrated that dietary supplementation of omega-3 PUFAs exerts positive effects in several metabolic diseases including coronary heart disease, hypertension, arteriosclerosis, diabetes and inflammatory diseases (Terry et al., 2003 Din et al., 2004 Calder, 2004 Ruxton et al., 2004). The PUFAs are fatty acids containing two or more double bonds. These fatty acids are essential since they cannot be produced in the human body and must therefore be provided in the diet. There are two main types of PUFA, the omega-3 and the omega-6 fatty...

Types and sources of polyunsaturated fatty acids

The therapeutic significance of omega-3 PUFAs has been clearly indicated in clinical trials and epidemiological studies (Bucher et al., 2002 Hu et al., 2002). Fatty fish or fish oils are the richest sources of long-chain omega-3 PUFAs, but as already discussed, the dietary intake of fish has decreased. However, fish stocks are also declining and there have been reports indicating the accumulation of heavy metals and pollutants in some fish (Hites et al., 2004). There is thus an urgent need for alternative sources of long-chain omega-3 PUFAs and there is considerable interest in developing new techniques for this purpose. The primary producers of various omega-3 PUFAs in nature are bacteria, algae, fungi, insects and some invertebrates. Other PUFAs are extracted from oily plant seeds (Table 13.2).

Production and purification of omega3 polyunsaturated fatty acids

The long-chain PUFAs arachidonic acid, EPA and DHA (Fig. 13.1) are of nutritional importance and also play important roles in the prevention of various diseases. Fish oil is the conventional source of EPA and DHA. However, fish oils contain a crude mixture of several different fatty acids and the omega-3 PUFAs need to be extracted and purified before they can be used for dietary supplementation in pharmacological applications. It should be noted that fish cannot produce the long-chain omega-3 PUFAs by themselves and the fatty acids that can be extracted from fish fat derive originally from marine microalgae. Many methods have been used to purify EPA and DHA from fish oil including, for example, chromatographic methods, distillation, enzymatic splitting and crystallisation. However, these processes are expensive and new methods and sources need to be identified. Microalgae produce omega-3 PUFAs and several studies have been performed to develop a commercially feasible technology to...

Omega3 and other polyunsaturated fatty acids in functional food products

Functional foods are food products that have beneficial effects on physiology and or have the ability to reduce the risk of a disease. Functional foods may be conventional food or foods that have been enriched with functional components to provide greater health benefits, but they do not include purified substances provided in pills or capsules. Since omega-3 PUFAs have been shown to have beneficial effects in several health conditions they are considered to be a functional food. The positive effects of omega-3 PUFAs in different diseases have been established and these fatty acids have been particularly interesting in coronary heart disease but also in several other conditions such as arteriosclerosis, type 2 diabetes, cancer, depression and asthma (de Lorgeril et al., 1994 Simopoulos, 1999 Ruxton et al., 2004 Nettleton and Katz, 2005). The beneficial effects of omega-3 PUFAs on health have resulted in the production of dietary supplements becoming a large industry. There is also a...

Polyunsaturated fatty acids on energy metabolism and other factors connected to weight control

The mechanism behind the benefits of omega-3 PUFAs on energy metabolism is at present not completely understood. There are, however, many possibilities since these fatty acids have many different roles in a cell. For example, apart from being an energy source, fatty acids build up the cellular membranes, regulate gene expression and function as signalling molecules and as precursors for complex biologically active molecules such as, for example, eicosanoids (Simopoulos, 1999, Ruxton et al., 2004). Since omega-3 PUFAs exert positive effects in many different diseases there have been implications for a common pathway for the effects. One mechanism that has been presented is the ability of omega-3 PUFAs to affect the biochemical composition of biological membranes (Ma et al., 2004). Indeed, the cellular fatty acids composition is a mirror of the ingested types of fatty acids. Incorporation of PUFAs into lipid membranes results in altered interaction between the lipids and the membrane...

Trans Fatty Acids

Most trans fatty acids are formed during partial hydrogenation of vegetable oils to produce margarine and certain baked foods including biscuits and pastries. Trans fatty acids have a similar impact on lipid levels as saturated fat, decreasing HDL and increasing LDL (48). Specific information relating to people with diabetes is lacking but there are some large studies that show the evidence is not conclusive regarding coronary risk and trans fatty acid intake. The Nurses Health Study (49) shows that high intakes of foods that are a significant source of trans fat may be associated with a risk of coronary heart disease. The EURAMIC study (50) however found no significant effect.

Macronutrient Composition Of The Diet

A combination of carbohydrate and cis-monounsaturated fatty acids should provide 60-70 total daily energy intake. Total fat intake should be restricted to 35 total energy. Ci's-monounsaturated fatty acids should provide between 10 and 20 total energy. Saturated and trans-fatty acids should provide under 10 total energy. Polyunsaturated fatty acids should not exceed 10 total energy. Protein intake should range between 10 and 20 total energy. Protein intake should not go below 0.6 g kg normal body weight day but should be at the lower end of the range (0.8 g kg body weight day) in cases of nephropathy or where abnormal microalbuminuria has been identified. Protein (10-20 ) Carbohydrate (45-60 ) Cis-monounsaturated fat (10-20 ) Polyunsaturated fat (< 10 ) Saturated trans fat (< 10 )

Protective Dietary Changes For Cardiovascular Disease Patients

To date, the most effective dietary intervention for people who already have cardiovascular disease is omega-3-rich fish oil. Evidence for this comes from a high-quality systematic review of randomised controlled trials.14 Advice to increase intakes of long chain omega-3 fats for people with some cardiovascular disease (compared with no such advice) appears to reduce the risk of fatal myocardial infarction (relative risk 0.7, 95 CI 0.6 to 0.8), sudden death (relative risk 0.7, 95 CI 0.6 to 0.9), and overall death (relative risk 0.8, 95 CI 0.7 to 0.9), but not nonfatal myocardial infarction (relative risk 0.8, 95 CI 0.5 to 1.2). The effects of these cardioprotective doses of omega-3 fats appear consistent whether the advice is dietary (eating more oily fish, usually 2 to 3 large portions weekly) or supplemental (taking the equivalent of 0.5 to 1.0 g of a mixture of eicosapentanoic acid (EPA) and docosahexanoic acid (DHA) fatty acids daily). A further systematic review examined the...

Step I and step II diets

Step I diet limits calories derived from saturated fats to 8 to 10 percent of total calories and cholesterol to less than 300 mg day. 3. Step II diet further restricts calories from saturated fats to less than 7 percent of total calories and restricts cholesterol intake to less than 200 mg day.

Evidence Linking Diet To Cancer

Epidemiological studies in the U.S. have defined certain specific dietary factors as having highest impact on reduction of cancer risk. The most consistent relationship is an inverse relationship between cancer risk and intake of vegetables and fruits. Additional dietary factors with evidence for decreased cancer risk include whole grains, dietary fiber, certain micronutrients (e.g., selenium, vitamin E, vitamin D, and calcium), and certain types of fat (e.g., n-3 fatty acids, particularly n-3 n-6 ratios), as well as physical activity. Other diet-related factors that increase risk include high intakes of total fat and other types of fat (e.g., saturated fat), alcohol, certain food preparation methods such as smoking, salting, and pickling foods, and high-temperature cooking of meats, as well as obesity (high body mass index).4 Results from these studies have led to organizations such as

Physician as Catalyst

Another example of a patient trapped in the Magic Pill delusion involved a high-ranking military officer. It was obvious that he was struggling with being overweight. One day he asked me for the fat burning pill. With all due respect, I told him control is more about the person than the pill. At that point he changed the discussion because he was not able or willing to change his lifestyle. Using the change behavior model, patients in the Magic Pill category are in the contemplation stage, but unfortunately they are contemplating in the wrong way by thinking the power for change is in the pill. Many patients who present to the clinic for weight loss have a collection of weight loss books on their shelves at home. They are looking for the special diet, like a fat-burning suit they can climb into for a period of time that will melt away the fat. These patients gain no insight into how their daily habits cause their obesity. And certainly they have no knowledge, process, or program to...

Perioperative nutritional support

Accurate measures of nutritional outcome. Thus, some authors argue that a lack of clear-cut benefits exists in groups other than selected groups 120 . This has prompted investigators to carefully select the most beneficial candidates, including patients with major trauma, severely malnourished patients undergoing elective surgery, and well-nourished minimally stressed patients unable to eat for 7 to 10 days postoperatively. Most comparative studies show enteral nutrition to be equal to parenteral nutrition. In a prospective study of well-nourished patients with a gastrointestinal malignancy undergoing elective surgery, Gianotti showed a decreased length of stay with 7 days of preoperative oral supplementation consisting of omega-3 fatty acids, arginine, and nucleotides 121 .

Immuneenhancing enteral feeds

Feeds specifically supplemented with some of the nutrients described above have been formulated with the aim of improving immune function and so reducing the risk of infection in patients known to have impaired host resistance, i.e. the critically ill and after major surgery or trauma. Most clinical trials have been small and some have failed to provide equal energy and total protein to the new feed and the control feed patients. Multiple subgroup analysis complicates assessment of principle endpoints. The best studied feed is Impact (Sandoz Nutrition, Minneapolis, MN) which is supplemented with arginine, nucleotides, and omega-3 fatty acids. Other products include Immune-Aid (McGaw Inc., Irvine, CA), which is also supplemented with glutamine and branched-chain amino acids, and Replete (Clintec Nutrition, Deerfield, IL) with only glutamine and omega-3 fatty acid supplements. The effect of these feeds remains controversial and they are expensive compared with standard enteral feeds....

Negative Side To Some Natural Foods

While it may offend some people's sensitivities to even suggest that foods such as corn or potatoes can effectively be bad for your health, you should consider what happens in your body every time you eat these foods. The surges of glucose into the bloodstream that result from eating these foods not only promote fat formation, they also sap immune strength. Further, these foods definitely promote and maintain weight gain, which ultimately has its own associated negative health effects. Remember that cattle are fed large amounts of corn so that they will get fat more quickly and produce the tastier fat-marbled cuts of meat. Animals (and people) are not fattened up by eating fat-containing foods. Sugar (glucose) overdose, NOT the eating of fat, produces fat in your body. All fatty foods and protein foods produce relatively minor changes in the blood glucose level after a meal. However, all foods can result in weight gain if you already have chronically elevated insulin levels, as...

Potential Dietary Interventions

A role for omega-3 fatty acids in modulating enzyme activity is provided by Leeson et al. (98), in which there is a significant positive relationship between the number of Asp alleles and flow-mediated dilation and omega-3 fatty acids levels. Benefit of vitamin E supplementation is suggested by Hingorani et al. (104). The authors state that the altered production of NO mediated by the Glu298Asp polymorphism might explain the unexpectedly large benefit of -tocopherol in preventing MI in the CHAOS study (105). The authors

Acute respiratory disease syndrome

Nutritional metabolic treatment in patients with acute respiratory disease syndrome should be by the enteral route as soon as possible. This approach will reduce the supply of omega-6 polyunsaturated fatty acids and improve the supply of omega-3 polyunsaturated fatty acids. If parenteral feeding is necessary, procedures that increase oxygen consumption, CO2 production, ventilation, and ventilation-perfusion maldistribution, impair body temperature control, or favor inflammatory reaction

Prevention Of Coronary Heart Disease As The Goal

Terol, saturated fatty acids, and trans fatty acids and increased exercise and stress management. In fact, a recent study employing intensive lifestyle changes in patients with coronary heart disease achieved a 37 lowering of LDL (low-density lipoprotein) cholesterol, a 91 decline in anginal episodes, and a decline in coronary artery stenosis within a year all without drugs. A prescription for lifestyle changes should accompany the one for a hypocholesterolemic drug.

Clinical Utility of Testing

MCAD deficiency is a disease that can be treated if promptly diagnosed in the early postnatal period. Precautions, such as avoidance of fasting and saturated fats and ingestion of carbohydrates prior to bedtime, can eliminate the symptoms and related complications of the disease. Although prenatal diagnosis on chorionic villus sampling or cultured amniocytes using biochemical or molecular genetic testing, or both, is possible, with the inherent risks of the procedures, it may offer no advantage to postnatal testing of acylcarnitines and other metabolites character

Aromatic plants prevent the oxidation of dietary fats

Some foods naturally contain antioxidant compounds that protect them from turning rancid, such as the tocopherols (vitamin E) found in virgin olive oil and the ascorbic acid (vitamin C) of lemon. To extend the shelf life of their products, food processing companies began using these natural compounds more than twenty years ago while seeking ways to synthesize substances with greater antioxidant action. However, consumers feared the unknown toxicity of synthesized products, causing research to be confined to natural compounds.

Current Dietary Guidelines

A number of national or professional health organizations have recommended guidelines for healthy diets, either for general health or focused on specific aims such as controlling obesity or diabetes, or preventing heart disease. Most current guidelines emphasize limitation of caloric consumption from fats. For example, the Chinese Ministry of Health guidelines for prevention and control of overweight and obesity in adults included moderate caloric restriction plus physical activity with an emphasis on diets with low fat content, complex carbohydrates (including cereals), and fresh fruits and vegetables 2 . In the setting of dyslipidemia, they also recommend limitation of saturated fat and cholesterol. The American Diabetes Association published a technical review of dietary guidelines for people with or at high risk of developing diabetes 3 . Recommendations for people with either type-1 or type-2 diabetes were to include carbohydrates from whole grains, fruit, vegetables, and low-fat...

Dietary Effects on Mortality

Despite the abundance of dietary guidelines, it is hard to find evidence that dietary composition has major effects on longevity. In the Malmo Diet and Cancer Study, all-cause mortality rates were not significantly related to the fat content of the diet in either men or women 7 . The rate of death attributable to cardiovascular disease, however, was significantly inversely related to dietary fat intake in men, but not in women. The EPIC study evaluated dietary intake as a predictor of mortality among over 70,000 people at least 60 years of age in 10 European countries 8 . Instead of evaluating simple dietary composition (i.e. percent of calories from fat, carbohydrate, protein, and alcohol), they constructed a 'Mediterranean diet score' reflecting the dietary composition previously shown in Greece to be associated with longevity. The score was derived from points for answering dietary questions on consumption of various types of foods. Higher scores, indicating dietary composition...

Classical anorexia nervosa postpubertal

A food intake history is obtained by asking the patient to recall what she has eaten on the previous day, commencing with breakfast which is often missed. An avoidance of carbohydrate and fat-containing foods is the rule. It is likely that pastry, puddings, biscuits, and confectionery are entirely omitted, as are fried foods, butter, and full-cream milk. When asked to explain her restricted choice of food, the patient is likely to defend it on the grounds that she wishes to follow a 'healthy' diet. What remains is an often stereotyped selection of vegetables and fruit. 'Diet' drinks and unsweetened fruit juice are preferred, although some patients are partial to black coffee. It is the mother who will indicate that her daughter finds ways of avoiding meals, preferring to prepare her own food and withdrawing into her bedroom to eat it.

Effects of Pglucans on lipid metabolism

More data on the effect of dietary fibre on cardiovascular diseases have been gained from intervention trials. Over 50 studies have investigated the effect of P-glucans on blood cholesterol levels. Some investigators have also addressed the task to make overall evaluations on the relation between oat P-glucan intake and its cholesterol-lowering effects. A large meta-analysis of oat products and their lowering effects on plasma cholesterol was made by Ripsin et a .51 The included studies presented differences in study designs, oat products, doses of oats and control products, and subjects with different initial cholesterol levels, gender and age the influence of these parameters was assessed in the meta-analysis. To be included in the meta-analysis, studies had to be controlled and randomized and the control product had to have a low soluble fibre content. Moreover, the trial should also have included a dietary assessment and measurement of body weight. Twelve trials were included in...

Inpatient treatment

It is not only the patient who tends to underestimate the food requirements to restore her weight to normal. Metabolic studies have demonstrated that for each kilogram of weight gain a surplus calorie balance of 7500 cal is needed. (133) It is prudent to begin with a modest calorie intake of 1200 to 1500 cal daily during the first 7 days in order to avoid the rare but dangerous complication of acute gastric dilatation. Thereafter the caloric intake is gradually increased and may rise to 4000 cal daily. The best diet is that consisting of a wide range of foods avoiding any preferences for 'safe' foods and including carbohydrate and fat-containing foods. Concentrated foods (e.g. Build-up, Complan, Carnation Breakfast Food) added to milk may be used to achieve a high caloric intake. The aim is to achieve a positive energy balance of 1500 to 2250 cal daily, leading to a daily weight gain of 200 to 300 g.

Hcholf Diets And Cholesterol Metabolism

The mechanisms behind these modifications of cholesterol metabolism and the differences between the effects of complex and simple CHOs are unclear and may differ between control and hypercholesterolemic subjects. Moreover, it is difficult to differentiate the specific effects of raised CHO intake and reduced fat, particularly saturated fat intake. Stacpoole et al.12 found a decrease in cholesterol synthesis in hypercholesterolemic subjects fed high-CHO diets. Vidon et al.11 found on the contrary that cholesterol synthesis increased when control subjects were shifted from high-fat to high-CHO diets. HMG-CoA reductase messenger ribonucleic acid (mRNA) concentrations in circulating mononuclear cells were increased by the high-CHO diet. Both studies suggested an increased clearance rate of LDL cholesterol. This could be explained by the decreased intake of saturated fatty acid (SFA) during ingestion of high-CHO diets since SFA decreases LDL receptor expression and LDL receptor-mediated...

Radiographic and Other Studies

More common with intrahepatic cholestasis than extrahepatic disease. Severe hyperlipidemia in Alagille disease is associated with atherosclerosis and renal lipi-dosis. Treat with bile-acid binding resins such as cholestyramine or ursodeoxycholic acid. No significant effect is seen with dietary saturated fat or cholesterol restriction, or with cholesterol-lowering agents.

Evidence Of Cardioprotection By Mediterranean Diets

Typical traditional diets in Mediterranean countries (Table 12.1) are characterized by large intakes of cereals, vegetables, and vegetable-derived foods rich in complex carbohydrates and fiber, fresh fruit rich in natural antioxidants, and marine foods rich in polyunsaturated omega-3 fatty acids moderate wine consumption very small intakes of meat, dairy foods, eggs and sweets and high consumption of olive oil rich in omega-9 monounsaturated fatty acid oleate and antioxidant polyphenols as the main source of fat.6-7

Fat And Insulin Sensitivity

Himsworth first made the association between increased dietary fat and insulin resistance in the 1930s and since then much has been published on these effects. In a recently published review on the subject by Storlien et al. (22), the premise was developed that the type of fatty acids eaten may be as important as the quantity of fat in the diet. High-fat diets, particularly high saturated fat, are associated with the development of Type 2 diabetes and glucose intolerance, while the intake of long-chain fatty acids, in particular n-3 fatty acids, seems protective. In addition the San Luis Valley Diabetes Study found that high saturated fat and low starch and fibre intakes were associated with hyperinsulinaemia in a non-diabetic population (23).

Fish And Omega3 Fatty Acids

The cardioprotective benefits of the 'Mediterranean' diet and its reduction of mortality are strikingly evident in the results of studies such as the DART study (32) and the Lyon Diet Heart Study (33). The results of these studies are not solely due to the regular inclusion of oily fish, but this did have a key role. Oily fish such as mackerel, herring, sardines, trout and salmon are a rich source of the n-3 polyunsaturates. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the long-chain omega-3 PUFAs, are thought to be beneficial due to their anti-thrombolytic and anti-inflammatory action as well as their triglyceride-lowering effects. The UK Department of Health has recommended to the general population that they consume two portions of fish (100 g or 3-4 oz portion) a week, one of which should be oily (34). People with diabetes should be encouraged to include oily fish in the diet, ideally two to three times a week (35). Fish oils are increasingly available in capsule or...

Soya Protein Flavonoids And Phytooestrogens

The efficacy of soya and soya derivatives in lowering total cholesterol and LDL-cholesterol was recently supported by the US Food and Drug Administration (FDA) approving a health claim about the role of soya protein in reducing the risk of CHD. In 1999 the FDA finalised a rule that authorises the use on food labels and in food packages under FDA jurisdiction of the health claims concerning the association between soya protein and reduced risk of CHD '25g of soya protein a day, as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease' (37). Serum total cholesterol and LDL-cholesterol concentrations can be lowered by about 13 , plasma TG by 10 and HDL-cholesterol goes up by about 2 (38), and these beneficial effects are also seen in people with Type 2 diabetes (39). It is unclear if the benefits come from the main phyto-oestrogens found in soya, diadzein and genistein or from the soy protein itself. Epidemiological evidence suggests high intakes of...

Treating Obese Adolescents

Like adults, some adolescents would like a fat-burning pill to take each day that would obviate the need to make health behavior changes like reducing calories and increasing physical activity. However, there is no magic pill, and the treatment options are more restrictive for an adolescent than for an adult. Though sibutramine plus behavioral therapy was more effective than behavioral therapy alone 51 , and orlistat received Federal Drug Commission approval for use with patients aged 12 to 16 52 , the long-term positive and negative impact of such therapy is not known. Therefore, pharmacotherapy should be used with great caution. Finally, bariatric surgery is an option in rare situations (see Chapter 7). It is recommended that such candidates be severely obese (BMI > 40), have attained their skeletal maturity (> 13 for girls > 15 for boys), and have comorbidities related to the obesity that will be improved with weight loss 53 .

Agricultural Applications Crops And Cows

Cotton and corn have become resistant to herbicides and insects. Soybeans have herbicide resistance and lower saturated fat content. Having herbicidal-resistant plants is important because many crop plants suffer stress when treated with herbicides. Resistant crops are not stressed by the chemicals that are used to control weeds.

Types Of Dietary Fat And Their Sources

Fatty acids are long, straight-chain molecules of 4 to 24 carbon atoms that can be categorized as saturated, monounsaturated, or polyunsaturated. The differences between these are based on the chemistry of the molecule. Saturated fats contain only single bonds between all carbon atoms single bonds leave the maximum number of bonding sites open, which are then filled by hydrogen atoms. As a result, these compounds are said to be fully saturated with hydrogen. In contrast, mono-unsaturated fatty acids contain one double bond, and polyunsaturated fatty acids contain more than one double bond. The primary dietary source of saturated fats is animal fats, the primary source of monounsaturated fats is olive oil, and that of polyunsaturated fats is vegetable oils like corn oil. Among other things, the number of double bonds predicts how solid the fatty acid will be at room temperature saturated fat, with no double bonds, is solid. The number also predicts how susceptible the fatty acid is to...

Historical Perspectives On Carbohydrate

Since 1980, dietary recommendations for people with diabetes have unanimously emphasised reducing saturated fat intake. However, if saturated fat intake is reduced, the energy has to be replaced by some other nutrient. Because there are concerns about potential adverse effects of high-protein diets on renal and bone health, the choice is either more carbohydrate or more unsaturated fat. And here lies the controversy. Since carbohydrate is the main glycaemic element in the diet (being the main precursor of blood glucose), an increase in dietary carbohydrate might be expected to result in greater postprandial glycaemia and compromise diabetes control. An increase in fat, on the other hand, might promote weight gain and decrease insulin sensitivity.

Stimulation Of Cancer Progression By Saturated And Omega6 Fatty Acids

OMEGA-3 mated that the risk of death at any time in breast cancer patients increases 1.4-fold for each kilogram increase in monthly fat intake.16,17 In a five-year study of 384 men treated for prostate cancer, patients with the highest saturated-fat intake had a threefold higher risk of dying than patients with the lowest saturated-fat intake.18 not be as clear as previously thought, at least not for breast, colon, and prostate cancer.6, 7 8 For example, a pooled analysis of cohort studies suggests that fat intake is not a risk factor for development of breast cancer.9 Other recent studies have reported that a lower total fat intake (from about 33 percent to about 20 percent of calories) is not associated with decreased breast cancer risk.3 Still other meta-analysis studies have reported conflicting results.10 Importantly, some studies reported that a high omega-6 to omega-3 ratio in fat tissue, rather than total fat consumption, might be associated with increased breast cancer...

Current Recommendations For Carbohydrate Intake

For the past 20 years, most diabetes associations around the world have recommended high-carbohydrate diets that are low in fat and high in fibre for people with diabetes (15,16). The British Diabetic Association's recommendations state that carbohydrate should provide 50-55 of the total energy content of the diet while fat should contribute 30-35 of energy intake, of which < 10 should be saturated fat, < 10 polyunsaturated fat (PUFA) and

What Is The Scientific Basis For Recommending High Carbohydrate Intake

There is no doubt that the goal of increasing carbohydrate intake was actually to reduce fat consumption, especially saturated fat. People with diabetes were no longer dying of diabetic ketoacidosis but coronary heart disease. In fact, some experts suspected that the prescribed high-fat (and high saturated fat) diabetic diets might actually be partly responsible for the heightened risk of cardiovascular disease among people with diabetes. Several well-designed intervention studies in diabetic subjects were undertaken and showed that high-carbohydrate diets (55-70 energy) could result in lower blood cholesterol and TG levels with no deterioration in glycaemic control compared to traditional 'diabetic' diets containing less carbohydrate and more saturated fat (12-14, 21-25). Indeed, much to their surprise, HbA1c, glucose tolerance and fasting glucose were often improved following treatment with a high-carbohydrate diet. This implied that insulin sensitivity was improved on a higher...

Inhibition Of Cancer By Omega3 Fatty Acids

We have seen that intake of saturated and omega-6 fatty acids may promote tumor progression through a variety of mechanisms. Now we turn to the potential of omega-3 fatty acids, primarily EPA and DHA as found in fish oil, to inhibit tumor development and metastasis. Many of the successful animal studies used high doses of EPA or fish oil, which produced anticancer effects through a prooxidant mechanism. Although these results are not very relevant to our interests the doses are excessive and we do not advocate a prooxidant strat-egy a smaller number of studies have suggested that moderate doses, which do not act by prooxidant means, may still be beneficial. Also, negative effects were reported in a few high-dose animal studies these could likely be reduced or eliminated by using lower doses of fish oil, which would not cause prooxidant effects and would be less likely to cause immunosuppression.

Summary of Research and Conclusions

A relatively large number of in-vitro and animal studies have been published regarding the ability of omega-3 fatty acids, and specifically EPA, DHA, or fish oil, to inhibit cancer proliferation and progression. At least 57 in-vitro studies have been published, and of these, 47 reported that omega-3 fatty acids could inhibit proliferation or invasion, or induce differentiation of cancer cells.35,65-68 Eleven studies directly correlated the antiproliferative effect with increased lipid peroxidation.69-73 In addition to these, at least 11 reported that omega-3 fatty acids could increase the effectiveness of chemotherapy or radiotherapy against cancer cells.74-78 This effect is likely due to increased lipid peroxidation and drug uptake. Of the 66 animal studies on omega-3 fatty acids Thirty-eight reported that omega-3 fatty acids could inhibit tumor growth and metastasis in rodents.79-83 Five other studies were negative or reported increased metastasis.84-88 Eleven studies focused on the...

Which Diet Is Best For Improving Insulin Sensitivity

The degree of insulin sensitivity is also affected by the energy content and macronutrient composition of the diet. Epidemiological and dietary intervention studies in humans indicate that a high-fat, energy-dense diet promotes weight gain and the development of obesity (47), impairs insulin sensitivity and increases the risk of developing Type 2 diabetes (48). Relatively high intakes of saturated fat appear to worsen insulin resistance and are also associated with higher blood levels of LDL-cholesterol and a greater risk of atherosclerosis (49,50). Indirect evidence suggests that the fibre content and GI of the diet may influence insulin sensitivity, weight gain and the risk of developing Type 2 diabetes. In the CARDIA study of young adults, low fibre consumption predicted 10-year weight gain and fasting insulin levels (a measure of insulin resistance) more strongly than did total or saturated fat consumption (54). Fibre but not amount and type of fat was associated with 2-h insulin...

Clinical Use of Fish

The two primary commercial sources of omega-3 fatty acids are fish oil and flaxseed oil. Although most anticancer studies have been conducted with fish oil, or its components EPA and DHA, flaxseed oil presents a tempting alternative. It is far less expensive and contains a greater percentage of omega-3 fatty acids its content of alpha-linolenic acid is approximately 58 per One important factor in the clinical use of EPA is the amount and type of other fatty acids in the diet, since the presence of saturated and omega-6 fatty acids may affect uptake and metabolism of EPA.35 For example, omega-6 fatty acids compete with EPA for cellular uptake.173, 174,175 To be effective, then, EPA is best combined with a diet low in omega-6 fatty acids and saturated fats. As discussed previously, an ideal omega-3 to omega-6 ratio may be in the range of 1 1 to 1 2. These low ratios may be difficult to achieve, but ratios just above this range should be attainable. For example, a 1 3 ratio could be...

Evidence For Sucrose Restriction In Diabetic Diets

Many randomised, controlled trials have shown that the isocaloric substitution of moderate amounts of refined sucrose for starch in diabetic diets has no adverse effects on blood glucose or lipid levels in people with diabetes (69-71). In fact, several studies show improved glycaemic control, especially in children with Type 1 diabetes (72). This makes sense when we consider that most foods containing sugar have a GI less than 60, while that of most modern starchy foods is over 70 (37,73). Many diabetes associations now officially recognise that sucrose restriction is not necessary in diabetic diets, although some put an upper limit of 30 g per day (the average intake in the non-diabetic population is about 60 g per day). Unfortunately, the dietary dogma of sucrose avoidance in diabetic diets is so well entrenched in the mind of the public and most health professionals that little change has occurred in practice. Intense sweeteners and low-joule soft drinks are almost universally...

A word about reducedcalorie foods

Macronutrient alternatives such as intense and bulk sweeteners, bulking agents and fat replacers, and the foods into which they are formulated, can be considered as weight loss ingredients in their own right, but they are only validated as such if they actually help consumers to lose weight. The role of reduced-calorie foods in weight management has been the subject of thorough debate since intense sweeteners gathered momentum in the 1960s and particularly since the 'low-fat' trend of the 1990s failed to reverse the trend towards obesity, particularly in the USA and Europe. A recent review of the subject (Stowell, 2006) led to the following conclusion.

Calorierestricted Diets

(TG) and high-density lipoprotein (HDL) cholesterol concentrations fell with weight loss, irrespective of macronutrient content, but the decrement in TG concentration was greater, and the fall in HDL cholesterol attenuated, in response to calorie-restricted diets relatively high in MUFA and low in CHO. Low-density lipoprotein (LDL) cholesterol concentration decreased when either MUFA or CHO replaced saturated fat (SF) in the diet, but the improvement in LDL cholesterol concentration did not take place if dietary intake of SF was not decreased. Finally, improvement in all of these variables in response to a diet relatively high in MUFA and lower in CHO persisted several weeks after a period of weight maintenance with the test diets.

Dietary Components Implicated in Carcinogenesis

Procarcinogenic factors in the diet include sedentary lifestyle, excess energy intake and specific dietary substances. Energy intake is positively correlated with cancer risk and mortality 9 . Interestingly, elevated BMI, an indicator of obesity and therefore a surrogate for excess energy intake, does not seem to influence cancer risk, whereas actual energy expenditure and energy intake significantly influence risk 10 . Epidemiologic studies indicate that cancers of the gastrointestinal tract are amongst the most susceptible to modification by dietary factors 11 . The mechanisms of dietary carcinogenesis fall into several categories direct DNA damage (e.g., nitrites), cytochrome activation or inhibition (e.g., alcohol), carcinogen activation (e.g., pickled salted foods), direct cytotoxicity (e.g., mycotoxins), oxidative damage (e.g., saturated fats), alterations in physiology (e.g., rice, dietary fiber) and hormonal effects (e.g., phytoestrogens).

Variations In Glycaemic Index

Perhaps the best example of the ability of differences in glycaemic index of CHO-enriched diets to modify glycaemic control and lipoprotein metabolism in patients with Type 2 diabetes is the report by Jarvi and colleagues (38). These investigators compared the metabolic effects of two diets, each containing 55 of total calories as CHO, in 20 patients, consuming each of the test diets for 24 days. The glycaemic indices were calculated to vary from 57 to 83 as compared to white wheat bread. The two test diets were compared to each other, as well as to baseline values obtained on an uncontrolled diet. Of considerable interest was the observation that fasting plasma glucose, TG, and LDL cholesterol concentrations fell on both diets, supporting the general belief that essentially any prescribed diet is better than no diet plan. On the other hand, the degree of improvement in all of these variables was the same, irrespective of the difference in glycaemic index of the diet. Furthermore, the...

Efficacy of Risk Reduction Diet

Early data showed that an increase in the polyunsaturated fatty acid concentration in membranes stimulated the oxidation of precarcinogens to reactive intermediates.11 The largest study to date, however, a pooled analysis on roughly 350,000 women, found no association between replacing monounsat-urated, polyunsaturated fats with carbohydrates on the incidence of breast cancer.12 In this same study, a weak positive association was identified between replacing saturated fats with carbohydrates on breast cancer incidence. There is little evidence linking dietary fat to the incidence of colorectal cancer. A single large randomized trial, however, showed no effect of a diet low in fat and high in fiber, fruit, and vegetables on the recurrence of colorectal adenomas.13

Effectiveness of Physician Counseling Poor Diet

There is inconclusive evidence that physician counseling can lead to dietary changes.55-59 In one such study, physicians gave patients a self-help booklet and a brief motivational message, which led to significant changes in the intake of fat and fiber, compared with a usual care comparison group.56 Most studies, however, have included several hours of physician education and training on diet counseling, as other studies have shown that physicians receive little training on diet and may often not be aware of the effect of dietary modifications.60-63 Similar studies have observed that brief training of physicians can lead to changes in blood cholesterol,64 saturated fat intake,65 and fruit and vegetable intake.55 Some studies, however, have found no effect of physician counseling, and many primary care-based studies have also employed office systems, computer-tailored print messages, and counseling by nutritionists and nurses, which make it difficult to understand the independent...

Effectiveness of Physician Counseling Overweight and Obesity

There is inconclusive evidence about the effects of physician counseling to help patients lose weight.65,81-85 In one such study, physicians counseled patients and incorporated meal replacements and nurse visits, which led to losses of approximately 4 of body weight, equal to the effects of two nutritionist-led intervention conditions.81 There have been few studies, however, and many studies that showed an effect on weight loss were actually designed to improve dietary patterns, such as decreasing saturated fat intake.64,65,86 A significant barrier to physician counseling for overweight and obesity is the apparent complexity of counting calories, which is the basis of all weight loss recommendations.87 Training programs have been developed and user-friendly reminder cards have been developed, but many barriers remain and conclusions based on the available evidence are difficult to make.87,88

Recommendations of Professional Groups Poor Diet

Professional groups differ on some of the specifics of diet, but generally recommend that patients limit the intake of high-fat (especially saturated and trans-unsaturated fat) and high-sugar foods and eat a sufficient amount of fruits and vegetables (e.g., five or more servings) and whole grains. There are differences, however, in the specifics. For example, the United States Department of Agriculture's 2000 Dietary Guidelines for Americans suggests eating no more than 30 of calories from fat, while the American Heart Association suggests eating between 25 and 35 of calories from fat.94,95 The American Cancer Society guidelines, released in 2002, are less specific but generally recommend the same above changes as other groups.96

Evidence From Epidemiological Studies

Research Fund came to a scientific consensus that evidence for an association between the intake of saturated fat and or animal fat and colon cancer risk is very strong.5 Continuing population studies reveal that mortality data for colorectal cancer in 22 European countries, the U.S., and Canada correlate with the consumption of animal fat.6 Eating a diet rich in n-3 PUFAs, as present fish and fish oils, may decrease the risk of colorectal cancer. Caygill et al.7 reported an inverse correlation between fish and fish oil consumption and colorectal cancer. This inverse relationship was significant for both male and female patients with colorectal cancer, whether the intakes were in the current period or 10 years or 23 years before cancer mortality.7 It is noteworthy that these effects were only observed in countries with a high (> 85 g day) animal fat intake. Also, the Mediterranean diet, which is rich in olive oil and fish, is associated with a low risk of colorectal cancer.8 The...

Evidence From Preclinical Efficacy Studies

Ample and consistent experimental evidence from preclinical efficacy studies conducted earlier have provided convincing evidence that not only the amounts but also types of dietary fat differing in fatty acid composition are important factors in determining the modulatory effect of fatty acids in colon tumor devel-opment.27-30 Studies conducted in our laboratory and those of others have consistently demonstrated that the diets high in beef tallow and lard, which are high in saturated fats and corn oil (high in n-6 PUFAs 20 to 23 in the diet), significantly increased chemically induced colon carcinogenesis in F344 and Sprague-Dawley rats as compared to diets low (5 ) in these fats.1027-32 Deschner et al.33 demonstrated that dietary n-3 PUFA (fish oil), inhibits methylazoxymeth-anol (metabolite of azoxymethane)-induced focal areas of dysplasia and colon tumors, whereas n-6 PUFAs (corn oil) enhance colon tumorigenesis in rats. In a recent study, Chang et al.10 reported that high dietary...

Summary And Conclusions

In conclusion, both epidemiological and preclinical studies provide evidence for the beneficial effects of diets rich in n-3 PUFA in the prevention of colorectal cancer. Preclinical studies have provided convincing evidence that the colon tumor-promoting effect of dietary fat depends on its fatty acid composition. Preclinical studies also demonstrate that a Western-style diet rich in mixed lipids including saturated fats of animal origin as well as n-6 PUFAs has a greater potential to promote colon tumorigenesis compared to diets containing equivalent amounts of fat but rich in n-3 PUFAs. Although the mechanisms by which diets high in saturated fats (such as those in Western diets) and n-6 PUFAs promote colon carcinogenesis are not fully known, the studies conducted thus far indicate that increased levels of colonic luminal secondary bile acids, modulation of ras-p21 activity, eicosanoid production via the influence on COX activity, and the expression of apoptosis by the types of...

Transport And Metabolism

The third component of the endogenous lipid transport system involves non-lipoprotein-associated movement of free FA through the circulation. These FA, largely products of cellular TG hydrolysis, are secreted by adipose tissue into plasma, where they bind with albumin. Recent evidence suggests that saturated fatty acids (SAFA) and C18 1n-9 are more slowly mobilized than PUFA, at a rate that is independent of their relative proportion in adipose tissue ( 40, 41). Albumin-bound FA are removed in a concentration gradient-dependent manner by metabolically active tissues and used largely as energy sources. Dietary factors profoundly influence lipoprotein levels and metabolism, which in turn alter an individual's susceptibility to atherosclerosis. Dietary fat, CH, fiber, protein, alcohol consumption, and energy balance all have major impact. Classic studies originally revealed that consumption of saturated fats elevated circulating total and LDL CH levels in humans (45). Plasma...

Dietary recommendations and therapeutic use

The most important effect of omega-3 PUFAs, and in particular EPA and DHA, is the triglyceride-lowering effect observed in humans (Connor et al., 1993). Lowering circulating triglycerides has been proven to protect against coronary heart disease and the use of fish oil or increased consumption of fish after myocardial infarction reduced reinfarc-tion and mortality (Calder, 2004). The American Heart Association have presented guidelines for dietary fish intake, proposing that patients without documented coronary heart disease should eat a variety of fish, preferably oily fish, twice a week (Kris-Etherton et al., 2002). Patients with documented coronary heart disease should consume dietary supplementation of at least 1 g EPA and DHA per day. Long-chain omega-3 PUFAs derived from fish and fish oils have beneficial effects in people with pre-existing cardiovascular heart disease. One serving of fish per week may decrease the risk of mortality in heart failure by...

Estimated Therapeutic and Loael Doses of Flaxseed Lignans

A 60-gram flaxseed dose would contain about 12 grams per day of alpha-linolenic acid, which could be of some concern (see Chapter 17). Although alpha-linolenic acid is an omega-3 fatty acid, it is not reliably converted to EPA in vivo and may not be as effective as EPA. If the two fatty acids were administered together, alpha-linolenic acid might compete for cellular uptake and reduce the effectiveness of EPA. Therefore, if high doses of flaxseed are used, it may be prudent to use a defatted form. Alternatively, a semi-purified SECO or SD extract could be used.

TABLE 1011 continued Foods for Specific Needs

The market for vitamin, herbal supplements, energy bars, beverages, and powders is growing very rapidly.134 Fortified and functional foods have been very successful in the United States in the last two decades. Sales of energy beverages, functional foods, and the self-care products are rising rapidly, with high-nutrient commodities having a special place (high DHA content, vitamin E, and omega-3s, among others). Some markets are more active, with soft drinks, dairy, confectionery, bakery, and breakfast cereals accounting for the majority of all new products.717132 It is clear that the organic, natural, and functional food marketplace is one of the strongest and most sustainable health-driven markets in the world, setting a trend for decades to come. In this trend, soya products play a special role.135 Fortification with probiotics will become commonplace in the eating habits of the near future. Another aspect in the development of healthful foods is enrichment with omega-3s long...

Dyslipidaemia And Other Cardiovascular Risk Factors

Patients are undernourished and advice to reduce saturated fat should not be at the expense of reducing total protein or energy intake. Current recommendations are that 35 of energy should be derived from fat (41), with emphasis placed on reducing the saturated to polyunsaturated fat ratios.

The Mode of Action of PLA2 Snake Presynaptic Neurotoxins

The SPANs PLA2 activity is not fatty acid specific. Eicosopentanoic acid and arachidonic acid were recently found to promote exocytosis as deduced from increased membrane capacitance in PC-12 cells (Ong et al. 2006). Moreover, arachidonic acid, and some detergents, were found to stimulate the release of munc18 from syntaxin, thus allowing formation of SNARE complexes, a passage which is expected to increase exocytosis (Rickman and Davletov 2005). Moreover, omega-3 and omega-6 polyunsaturated fatty acids were found to stimulate membrane expansion at the nerve growth cone by a mechanism requiring syntaxin 3 (Darios and Davletov 2006). Accordingly, it is possible that these fatty acids contribute to the increased neuroexocytosis triggered in phase 2, but their role may be limited in vivo as the lysophospholipid was found to be much more effective than the fatty acid in the induction of paralysis (Caccin et al. 2006 Rigoni et al. 2005).

Nutritional constraints

Are considered to have more adverse effects on health than saturated fats (SFA). However, it is not desirable that the elimination of TFA results in final fat compositions with levels of saturated fats that are substantially higher than the original combined levels of TFA and SFA. It should also be mentioned that consumer understanding about TFA is limited and that therefore the discrimination between partially hydrogenated fats, high-trans and fully hydrogenated fats, and virtually zero trans, is blurred. An illustration of this is readily available via an Internet search on 'trans fatty acids' status in spring 2005.

Implementation of transfree fats in manufacturing and the supply chain

The nature of the successful replacement of partially hydrogenated fats, as outlined above, yields a number of specific solutions to specific product applications. The identification of the respective best set of solutions for a manufacturer is more complicated. On implementing a technical solution, the balance between utilization of a special fat composition, re-design of the manufacturing process and complexity of the supply chain - more raw materials on-site - has to be found. All three factors are related to additional costs. Consequently, they should all be subject to optimization after initial trans-free solutions are established. The complexity of a new transfree raw material portfolio could be a 'show stopper' in cases where layout and tank capacity of a manufacturing site do not allow implementation. Either investment in hardware or preferentially harmonization of raw materials can overcome this impasse. This harmonization of trans-free raw materials needs to involve process...

Prevention of Type2 Diabetes

During the last few years well-conducted, randomized studies have unequivocally shown that type-2 diabetes mellitus can be effectively prevented or delayed by lifestyle modification programs in people at risk of developing it 2-4 . The ADA, the DNSG of the EASD and Diabetes UK have incorporated diabetes prevention guidelines in their nutritional recommendations. The ADA gives emphasis to the fact that structured programs that focus on lifestyle changes, including education, reduced fat and energy intake, regular physical activity and regular participant contact, can reduce the risk of developing diabetes. The DNSG of the EASD state that weight reduction and maintenance of weight loss in overweight individuals is a critical component of the lifestyle modification program, which may be expected to reduce the risk of developing type-2 diabetes. The appropriate macronutrient composition of the diet is a total fat < 30 of energy intake, saturated fat < 10 and fiber intake > 15g...

Malnutrition syndromes of childhood

Saturated unsaturated fatty acid ratio tal feature of CF. Inflammatory markers such as soluble IL-2 receptor and eosinophilic cationic protein are often increased. Infections are worsened by diminished immune responsiveness, possibly related to abnormal zinc turnover, reduced thymulin activity, and reduced IL-2 and NK activity. Both copper and zinc are reduced in CF 105, 106 . Nutritional therapy includes dietary supplements, increased fat and protein absorption with oral pancreatic enzymes, supplemental fat-soluble vitamins (vitamin K), and omega-3 long-chain polyunsaturated fatty acids, such as docosahexaenoic acid. Evaluation of growth requires a specialized approach 107 .

The Cost Benefit Analysis of Polymorphisms within Lipoprotein Metabolism

Mthfr C677t Gene Polymorphism

APO-E4 is not the only thrifty allele to influence cholesterol levels. Ancestral diets rich in fiber, vegetable protein, plant sterols, etc., were clearly low in trans-fatty acids and the other substrates of cholesterol biosynthesis (Figure 2.10). It has been suggested that, as a result, a range of cholesterol raising polymorphisms exist that have been conserved by evolution (61). These include the B2B2 genotype of the cholesteryl ester transfer protein-TaqlB, which favors cholesterol transfer to the liver for bile acid synthesis (62), and the T54 GA AA genotypes of the intestinal fatty acid binding protein gene which favors fatty acid absorption for cholesterol synthesis (63). Clearly, a partial return to our ancestral diet of vegetables, fruit, and nuts would be an effective measure to reduce aberrant blood lipid profiles. Figure 2.10 shows how plant sterols like -sitosterol are structurally similar to cholesterol and hence may competitively reduce cholesterol absorption.

Human Encephalisation May Be Linked To An Evolutionary Reduction In Gut Mass

A large brain mass comes at a cost the metabolic price for cerebral maintenance being nine-fold higher than that for the body as a whole (97). To sustain a large brain, an evolutionary adaptation may have been made. It is believed that a surplus in cerebral mass and energy need is closely counterbalanced by a reduction in the mass and associated energy needs of the gastrointestinal tract (97). Indeed, the relationship between body size and gut size are clearly linked via diet herbivores, which eat bulky, macronutrient poor foods have large complex guts, whereas carnivores that eat a less bulky nutrient-dense diet have smaller, simple stomachs with a long intestine but smaller colon. The trend among primates is toward a high-quality diet, small gut, and large brain, with humans having an extremely high encephalization quotient of 4.6 based on the Martin equation (91,97). This encephalization quotient has probably been achieved by a move toward a meat-based diet rich in unsaturated...

Alpf Vat Does It Mean

Proglycogen Macroglycogen

Chain (12 carbon atoms or more) carboxylic acids with an even number of carbon atoms. They may contain no double bonds, in which case they are referred to as saturated fatty acids, one double bond (mono-unsaturated fatty acids), or several double bonds - the polyunsaturated fatty acids. Many individual fatty acids are named, like monosaccharides, according to the source from which they were first isolated. Thus, lauric acid (C12, saturated) comes from the laurel tree, myristic acid (C14, saturated) from the Myristica or nutmeg genus, palmitic acid (C16, saturated) from palm oil, and stearic acid (C18, saturated) from suet (Greek steatos). Oleic acid (C18, mono-unsaturated) comes from the olive (from Latin olea, olive, or oleum, oil). Linoleic acid, C18 with two double bonds, is a polyunsaturated acid common in certain vegetable oils it is obtained from linseed (from the Latin linum for flax and oleum for oil). It will be seen from Figs 1.4 and 1.9 that saturated fatty acids, such as...

Effecs Of Irr On Wound Healing

ATP, but they are also readily stored in adipocyte TAGs. One reason for this is that LC-SFAs require carnitine acyltransferase for transport into the mitochondria for oxidation,25 so they are, therefore, more readily incorporated into TAGs. Some saturated fatty acids, like stearic acid (18 0), will be stored in TAGs or will be desaturated and converted to monounsaturated fatty acids (MuFAs), such as oleic acid (18 1 ra-9), before storage or P-oxidation.26 Medium-chain fatty acids (8 to 14 carbon) are preferentially P-oxidized in liver mitochondria, because they do not require enzyme transport into the mitochondria. The MuFA are readily utilized for energy by P-oxidation in mitochondria but may also be stored in adipocyte TAGs.27 The long-chain rn-3 and m-6 PuFAs (> 18 carbon) (Figure 3.4) are a significant component of cellular phospholipids but may also occur, to some degree, in TAGs. This lipid class is considered essential, because mammals do not have the enzymatic ability to...

Lactic Acid and Insulin

Some natural compounds have also been reported to inhibit the cancer-promoting effects of insulin. For example, genistein inhibited insulin-induced proliferation of human breast cancer cells in vitro.132 This likely occurred via inhibition of PTK activity. In addition, some natural compounds may be able to reduce insulin production by reducing insulin resistance. Insulin resistance occurs when cells are no longer sensitive to insulin and thus more is produced in an effort to reduce blood glucose levels. Insulin resistance has been implicated as a risk factor for breast cancer.133,134,135 Diets high in omega-6 fatty acids promote insulin resistance, possibly via chronic activation of PKC.136,137,138 Natural compounds that can reduce insulin resistance include omega-3 fatty acids and other PKC inhibitors.139-142 Omega-3 fatty acids have been reported to effectively reduce both lactic acid and insulin production in vivo. For example, in a randomized, double-blind, placebo-controlled...

Mode Of Action Of Types Of Dietary Fats Against Colon Cancer

Metabolic epidemiological studies demonstrated that populations who are on a typical Western diet and at high risk for colon cancer excrete high levels of secondary bile acids.4647 Several preclinical studies indicate that diets high in saturated fatty acids (beef tallow and lard) and n-6 PUFAs (corn oil or safflower oil) increase the concentration of colonic luminal secondary bile acids including deoxycholic acid and lithocholic acid, whereas dietary fish oil had no such enhancing effect.31 Secondary bile acids have been shown to stimulate protein kinase C (PKC) in a manner similar to phorbol esters, to induce cell proliferation, to increase ornithine decarboxylase activity, a rate-limiting enzyme in polyamine biosynthesis, and to act as promoters in colon carcinogenesis.48-53 Collectively, these observations suggest that secondary bile acids that are modulated by types of dietary fat may be important for inducing cellular response in relation to colon tumor promotion. It is known...

Endothelial Activation As Main Target For Antiatherogenic Properties Of Olive Oil Components

The detection and quantitation of increased adhesion molecule expression and the subsequent monocyte adhesion after stimulation of cultured endothelial cells with cytokines allows the establishment of an in vitro system suitable to study the molecular machinery involved in endothelial activation. This system allows an assessment of how external interventions modulate the response to a given constant amount of stimulation, having therefore the potential of identifying new triggers and detecting and comparing external interventions. This has proven useful to identify the inhibitory action of nitric oxide,42 n-3 polyunsaturated fatty acids,43 and some antioxidants44 in early atherogenesis. We devised a series of experiments to investigate whether oleate and natural antioxidants obtained from extra-virgin olive oil influence the endothelial responses to pro-inflammatory stimuli triggering endothelial activation.

Diet And Prevention Of Plaque Inflammation And Rupture

The oxidized LDL theory is not inconsistent with the well established lipid-lowering treatment of CHD. There is a positive correlation between plasma levels of LDL and markers of lipid peroxidation7277 and low absolute LDL level results in reduced amounts of LDL available for oxidative modification. LDL levels can be lowered by drugs or by reducing saturated fats in the diet. Reduction of the oxidative susceptibility of LDL was reported after replacing dietary fat with carbohydrates. Pharmacological quantitative (lowering of cholesterol) and nutritional qualitative (high antioxidant intake) approaches to prevent CHD are additive and complementary, not mutually exclusive. An alternative way to reduce LDL concentrations is to replace saturated fats with polyunsaturated fats in the diet. However, diets high in polyunsaturated fatty acids increase the polyunsaturated fatty acid content of LDL particles and render them more susceptible to oxidation, which would argue against use of such...

Low Carbohydrate Versus Low Fat Diets

A low-fat diet is promoted by the American Heart Association 2 and by the federal government's previous Food Guide Pyramid, which places carbohydrates at the base of the pyramid, with 8 to 11 daily servings recommended 3 . The conventional low-calorie, low-fat dietary recommendation is to maximize complex carbohydrates and limit total fat to 30 , of which 10 can be saturated fat. The problem is that America has followed this dietary recommendation for decades and now is in the midst of an obesity epidemic. If the nation is following a low-fat diet, then why are most Americans overweight or obese Is there scientific evidence that this diet is effective for weight loss What should a physician tell patients who want to follow a low-fat diet By 1994, grain products and sweeteners together accounted for 78 of all carbohydrates consumed. Protein intake decreased from 16.5 to 15.5 in men and from 16.9 to 15.1 in women. The percentage of total calories from fat decreased from 36.9 to 32.8 for...

Pariza 2001 Birds Behaviour

Formation, contents, and estimation of daily intake of conjugated linoleic acid isomers and trans-fatty acids in foods. In Yurawecz, MP, Mossoba MM, Kramer JKG, Pariza MW, Nelson GJ, eds. Advances in Conjugated Linoleic Acid Research. Vol. 1. Champaign, IL AOCS Press 1999 378-396.

Key Aspects Of Energy Expenditure

Changes in body energy content occur through changes in the balance between daily intake and energy expenditure. Energy intake is episodic, derived primarily from the carbohydrates, proteins, and fats in foods consumed. Total daily energy expenditure for theoretical and analytic purposes can be divided into several components

Eicosanoids lipid metabolites

Specific fatty acids derived from dietary lipids are incorporated into the structure of the phospholipid cell membranes. These phospholipids represent a reservoir of potential metabolic mediators, the nature of which depends on the fatty acids ingested (or infused). Under enzymatic action, the phospholipid membranes release fatty acid molecules which are converted to a number of eicosanoids. The intake of omega-6 fatty acids causes the release of arachidonic acid which produces thromboxane A2 and prostaglandin E2 via the cyclo-oxygenase pathway. The former is a potent vasoconstrictor while the latter is an immunosuppressant. The substitution of omega-3 for omega-6 fatty acids in the diet ultimately results in the production of eicosapentanoic acid, thromboxane A 3, and the 3 series prostanoids. Thromboxane A3 is a less potent vasoconstrictor than A2, and the 3 series prostanoids are less immunosuppressant than the 2 series.

Effects of structured lipids related to weight control

Human studies have been conducted with a variety of structured lipids as demonstrated in Table 14.3. Matsuo et al. (2001) examined the effects of a liquid diet supplement containing structured lipid composed of 10 MCFA and 90 LCFA as compared with a liquid formula containing LCT in 13 healthy male volunteers. Although body weight increased non-significantly in both groups, the rates of variation in body fat percentage were lower in the structured lipid group than in the LCT group throughout the 12-week study. Despite this, in another 12-week study comparing LCT with a diet supplemented with 14 g of structured fat containing only 1.7 g MCFA, results showed decreases in body weight, including subcutaneous and visceral fat as measured by air displacement methods (Kasai et al., 2003). Similarly, Takeuchi et al. (2002) examined the effects of 20 g of structured lipid containing MCFA and LCFA versus the same quantity of soybean oil for 3 weeks in 6 young men. The rate of variation in body...

Protein and amino acid metabolism

Due to the possible role of NO in the pathogenesis of septic shock syndrome and the role of NO in mediating the hypotensive effect of TNF 170 , there has been concern that arginine supplementation might not be indicated in critically ill patients 171 . A study of the metabolic effects of supplementing enterally fed critically ill patients with arginine indicated that arginine is mainly metabolized into ornithine by the arginase enzyme rather than into NO 172,173 . In a study of 50 burn patients Saffle et al. 173 reported no differences in mortality in patients randomized to receive an immune-enhancing enteral formula containing arginine as compared with patients received a standard high-protein formula. However, in a review of immunonutrition in critically ill patients, there was increased mortality with immunonutrition, especially in patients with sepsis 174 . In a randomized multicenter clinical trial, mortality was 44 in patients with severe sepsis receiving enteral nutrition...

Eicosanoids Prostanoids and Leukotrienes

Eicosanoids were introduced in Chapter 7. There we focused on how prostanoids and leukotrienes are produced from fatty acids, namely via the cyclooxygenase and lipoxygenase pathways, respectively. We also looked at how different fatty acids in the membrane produce different series of prostanoids and leukotrienes, then noted that eicosanoids derived from omega-6 fatty acids facilitate cancer progression and eicosanoids from omega-3 fatty acids inhibit it. We focus here on the role eicosanoids play in angiogenesis and other aspects of cancer progression, as well as on natural compound's ability to inhibit the production of detrimental eico-sanoids or increase that of beneficial ones. Natural compounds that inhibit the production of eico-sanoids derived from omega-6 fatty acids (detrimental eicosanoids) or increase the production of eicosanoids derived from omega-3 fatty acids (beneficial eico-sanoids) are listed in Table 8.2. Although most studies on these compounds were conducted in...

Perioperative Feeding Considerations

Multiple studies have investigated the impact of immunonutrition (EN supplemented with micro- or macronutrients) intended to preserve or improve immune function and thereby improve outcomes in GI cancer patients. Immune enhancing nutrients that have been explored in gastrointestinal cancer patients include omega-3 fatty acids (n3), glutamine (GLN), arginine (ARG), nucleic acids and combinations of these nutrients (Table 7.6). Meta-analyses have demonstrated improved outcomes (reductions in morbidity and mortality) with the use of immunonutrition perioperatively in patients undergoing major GI cancer resections 111, 112 . Arginine, RNA and omega-3 fatty acids Daly 66 1992 EN vs. isEN Omega-3 fatty acids Fearon 116 2001

The impact of different food components on satiety

The results of a number of studies suggest that the order of satiating efficiency of macronutrients is protein > carbohydrate > fat > alcohol, although this conclusion was not confirmed in one study (Raben et al., 2003). The weak effect of fat on satiety is well documented. In many studies that covertly manipulated the fat content of foods, subjects did not respond to higher fat levels in preloads with subsequent lower hunger ratings and or lower food and energy intakes. This is a consistent finding across studies with various foods (e.g. foods with fat replacers, regular foods with high low fat levels) (de Graaf et al., 1996) and with different groups of subjects (Rolls et al., 1994).

Contemporary Dietary Patterns that Work The Mediterranean Diet

One of the best-known aspects of the Mediterranean diet is the potentially protective role that moderate consumption of red wine confers. In the late 1970s it was noted that avid drinkers of red wine in France had less heart disease than other Western populations, even though they consumed more saturated fat in their diet. This became known as the French Paradox. We now recognize that the presence of high concentrations of antioxidant polyphenolic bioflavonoids in red grape skins can help prevent vascular disease. In the West, our current intake of DHA and EPA is of concern. Over the past century, our diet has changed dramatically. Most notably we have increased our intake of saturated fats, trans-fatty acids, and linoleic acid (LLA). This has been at the expense of a reduced intake of the n-3 fatty acids, which includes a-linolenic acid (ALA) and a range of n-3 long-chain polyunsaturated fatty acids, particularly DHA and EPA (187).

Low carbohydrate diets are they safe

Health care professionals continue to be concerned with the potential negative side effects of high dietary protein intake associated with low carbohydrate diets. Concerns include dehydration, fatigue, increased calcium excretion, colon cancer and increased renal burden 21 . Additionally, high saturated fat intake and increased risk of heart disease are associated with low carbohydrate, high protein diets 22 . Diabetics are one population in whom the use of low carbohydrate diets needs to be carefully monitored given the high incidence of renal disease 23 . Some research has demonstrated a decrease in microalbuminuria with improvement in glycemic control 24 with no increase in serum creatinine concentrations 19 however, few studies have directly addressed more sensitive markers of renal function such as the glomular filtration rate (GFR). Although the data suggests that at 6 months there is an improvement of co-morbid conditions among low-carbohydrate dieters, the potential for...

Beef pork lamb and vealTotal fat grams

Carnitine is a compound synthesized in the body from glutamate and methionine. Carnitine (or L-carnitine) has been advertised as a fat burner that will improve cardiovascular function and muscle strength, and delay the onset of fatigue. Their claim is that carnitine increases fat utilization during exercise. No research supports increased use of fatty acids after carnitine ingestion, and no increase in performance has been demonstrated after its use.

Increased Plasma Membrane Fluidity

A In plasma, the omega-6 to omega-3 ratio changed from 0.9 to 0.41. To give an idea of plasma concentrations, the total omega-3 fatty acid concentration changed from 390 to 1,200 jM. EPA plasma concentrations changed from 34 to 690jM and DHA plasma concentrations changed from 330 to 530 jM. While increased membrane fluidity can assist cancer cells in some respects and omega-3 fatty acids can increase membrane fluidity, the latter do not generally promote tumor progression. They do increase drug transport across the cell wall, however. For example, EPA increased the uptake of the chemotherapy drug mitomycin in colon cancer cells but not in normal cells.142 Similar effects were seen in other cancer cell lines.143 Furthermore, omega-3 fatty acids do not increase tumor cell's ability to deform and squeeze through passages. For example, in one study on leukemia cells, the higher the DHA content, the less the leu-kemic cells were able to deform.144 Lastly, omega-3 fatty acids can alter...

Disorders of lipid metabolism

Intervention studies have shown that cholesterol reduction using diet, drugs, or surgery reduces the risk of developing or worsening coronary disease. In general, a 1 per cent reduction in low-density lipoprotein-cholesterol has been associated with roughly a 2 per cent reduction in disease end-points. (59 General agreement exists that eating less saturated fat and cholesterol, and adopting a diet and exercise habits to reduce obesity will benefit the health of most people. Exercise has a much greater effect in reducing triglyceride levels than in reducing low-density lipoprotein-cholesterol concentrations. Triglyceride levels are reduced after even a single exercise session. The efficacy of regular aerobic exercise in mild-to-moderate hypertriglyceridaemia has been repeatedly demonstrated. Diet and exercise programmes for patients with disorders of lipid metabolism are more successful than for patients with obesity, because positive reinforcement is immediate (namely, lower...

Soy and Other Phytoestrogens

It is believed that the lower risk of breast cancer, cardiovascular disease, and osteoporosis in Asian women is partly due to their high soy diet, since these benefits are lost when they adopt Western dietary habits. Flaxseed, from flax (Linum usitatissimum), is the source of another type of phytoestrogen, lignan, as well as linolenic acid and omega-3 fatty acids. Red clover (Trifolium pratense) contains isoflavones as well as coumarin and produces effects somewhat similar to those of diethylstilbestrol. The negative effect of red clover on sheep fertility threatened the economy in New Zealand at one time.

Natural Compounds That Stimulate Andor Support The Immune System

In addition to stimulating the immune system, we must also inhibit immune evasion. One primary way cancer cells evade immune attack is by producing excessive amounts of immunosuppressive substances like PGE2 and immunosuppressive cytokines, such as transforming growth factor-beta and IL-10. Natural compounds that reduce production of TGF-beta and or IL-10 include PSK and other polysaccharides, proanthocyanidins, omega-3 fatty acids, monoterpenes, and vitamin E 3-11 In addition, protein kinase inhibitors like genistein can reduce the signaling effects of IL-10.12 Natural compounds that inhibit PGE2 production include omega-3 fatty acids and other compounds discussed in Chapter 8 (see Table 8.2). Lastly, compounds that reduce vascular endothelial growth factor production (see Chapter 8)

Environmental Factors And Neurodegeneration

Among environmental factors associated, over the years, with an increased risk for AD several studies have been conducted to explore the role of heavy metals on brain development and dementia. Association between aluminum in drinking water and AD was observed, however results are still inconclusive, including positive and negative findings (37,38) conflicting results have been obtained also concerning occupational or environmental exposures to aluminum (29). The homeostasis of zinc, copper, and iron are altered in the brain of AD individuals, and under mildly acidic conditions, such as those believed to occur in AD brain, iron and zinc ions have been observed to induce Ap aggregation, so that their possible implication in the formation of Ap aggregates in the AD brain has been postulated (39). Elevated levels of iron, zinc, and selenium in the brain have been associated with AD (40). The role of copper in Ap aggregation is still controversial APP has copper-binding domains, and there...

Audit And Evaluation

Although the nutritional recommendations for people with Type 1 and Type 2 diabetes are in essence the same, there may be a difference in emphasis. Cardiovascular disease is the main cause of mortality in both Type 1 and Type 2 diabetes, so restriction of saturated fat is a prime aim for all people with diabetes. However, there should be greater emphasis on modification of fat intake for people with Type 2 diabetes where lipid abnormalities are more common.

Blood Pressure

Increased intakes of both potassium44,45 and calcium46,47 appear to help reduce blood pressure reductions in weight48 and sodium intake49-56 are also helpful. Salt restriction leads to reductions of 4 to 5 mmHg systolic and 2 to 3 mmHg diastolic in people with high blood pressure. Omega-3 fats do not appear to make much difference to blood pressure (although their effects on mortality are strong and important).57 58 The combined beneficial effect of a diet high in fruits, vegetables, and low fat dairy foods including whole grains, poultry, fish, and nuts and containing smaller amounts of red meat, salt, and sweets (the DASH diet, with smaller amounts of total and saturated fat, sodium, and cholesterol and larger amounts of potassium, calcium, magnesium, dietary fiber, and protein) than the typical U.S. diet was investigated in a high-quality randomised controlled trial.59 Participants were adults with systolic blood pressures of 120 to 159 mmHg and diastolic pressures of 80 to 95 mmHg...

Summary

Dietary advice for people with cardiovascular disease should include advice to increase long-chain omega-3 fats first and foremost. Other useful advice is to replace saturated fats with unsaturated fats and to adopt a Mediterranean-style diet. These steps represent the most important dietary advice known to reduce illness and mortality and should be given before patients receive additional advice to alter specific risk factors in their diets.

Omega3 fatty acids

Inflammatory mediators including prostaglandins, leukotrienes, and platelet activating factor are products of omega-6 fatty acids such as linoleic acid and its product, arachidonic acid. Most standard enteral formulas contain omega-6 fatty acids as the principle fat source. Fish oils with omega-3 fatty acids have anti-inflammatory effects in animal models, probably because production of arachidonic acid metabolites is reduced. In human volunteers dietary supplements of omega-3 fatty acids reduce monocyte production of interleukin 1a, interleukin 1b, and tumor necrosis factor. Experimental studies show varying effects of omega-3 fatty acids on outcome in animal models of sepsis. A preliminary study shows a trend to reduced infection in patients given fish oil as their fat source after abdominal surgery.

Abstract

Concentrations of glucose and lipids in the blood have important health implications and are influenced by dietary intake. Dietary intake and energy expenditure regulate body weight, which is also an important determinant of health. Thus it would be important to determine the optimal diet for affecting blood glucose and lipids and body weight. Many professional health organizations in different countries have made dietary recommendations that include caloric restriction when needed to prevent or reverse overweight or obesity, limitation of saturated and trans fat, and emphasis on fruits and vegetables. These professional groups have not recommended extremely low carbohydrate or extremely low fat diets, despite much popular interest and recent research in these approaches. In several clinical trials, diet and exercise interventions prevented or delayed the development of type-2 diabetes. These trials showed the value of diet interventions, but did not attempt to determine which dietary...

Aetiology

The cause of this disease is largely unknown. Smoking accounts for about 30 of the risk. Diets high in saturated fats may be important, but not the previously controversial factors such as alcohol and caffeine intake. Sporadic chronic pancreatitis is associated with a 5 lifetime risk. In hereditary pancreatitis there is an elevated 40-70-fold risk of pancreatic cancer. There is also increased risk in various familial cancer syndromes, for example

Heart Attack

Oping atherosclerosis and to dissolve any plaque that has already formed. Omega-3 fats, found in fatty deep cold-water fish and in some vegetable sources, the highest concentrations being in walnuts, flaxseed, rapeseed (source of canola oil), and purslane, a green leafy vegetable, inhibit blood clotting, encourage activity of the parasym-pathetic nervous system, increase blood flow, protect against heart arrythmias, dissolve clots, lower blood triglycerides, raise HDL cholesterol, and have anti-inflammatory properties. Antioxi-dants and other compounds found in fruits and vegetables prevent plaque from building up on the arterial walls, reduce blood pressure, and strengthen heart muscles. Excellent blood thin-ners that prevent clotting are the omega-3 fatty acids, vitamin E, and garlic, onions, and cayenne. Exercise is vitally important in maintaining the integrity of the arteries and heart muscles as well as facilitating the circulation of oxygenated blood.

Lipids

Tained from vegetable oils, and arachidonic acid, obtained directly from animal fats and indirectly through conversion of linoleic acid in vivo (see Figure 7.4). The omega-3 fatty acids of interest are primarily EPA (ei-cosapentaenoic acid) and DHA (docosahexaenoic acid), obtained from fish oil. The 3 and 6 designations refer to how many carbon atoms the location of the first double carbon bond is from the omega end, or tail, of the fatty acid chain. The locations of the omega-6 and omega-3 double carbon bonds for arachidonic acid, EPA, and DHA are readily apparent in Figures A.22 through A.24 of Appendix A. Note in the table that in contrast to other oils, olive oil is a very rich source of omega-9 fatty acids. Therefore, discussions on omega-6 and omega-3 fatty acids in this chapter do not pertain to olive oil. Although data are still being gathered, it appears that omega-9 fatty acids are neutral in their effects on cancer, as compared to either omega-6 or omega-3 fatty acids.1

Discussion

A large number of animal studies have reported that omega-3 fatty acids, especially EPA found in fish oil, produce an antitumor effect.29,30,91,121 126 For example, EPA, or fish oil containing EPA, inhibited development and growth of colon, prostate, and pancreatic cancers and the growth and metastasis of breast cancer in rodents. The doses used in most studies were high about 10 to 20 percent of diet, or the human equivalent of about 120 to 240 grams per day. At this excessive dose, the primary mechanism of tumor inhibition apparently was increased lipid peroxidation.89,90,91 Not surprisingly then, the effect could be inhibited by vitamin E treatment. A prooxidant mechanism is also responsible for many of the cytotoxic results seen in vitro.127 Both omega-3 and omega-6 fatty acids are cytotoxic to human breast, lung, and prostate cancer cells in vitro but not to normal

EPA and Eicosanoids

A number of investigators have reported that omega-3 supplementation can inhibit production of 2-series prostanoids and 4-series leukotrienes by normal cells and cancer cells. These eicosanoids can assist angio-genesis and cancer progression (see Chapters 7 and 8). Even moderate doses of omega-3 fatty acids can change tissue fatty acid profiles and PGE2 production. For example, a 3-gram dose of fish oil (containing 540 milligrams of EPA and 360 milligrams of DHA) increased the ratio of omega-3 to omega-6 fatty acids in breast tissue and plasma in patients with breast cancer, and an 11-gram dose (2.1 grams of EPA and 1.9 grams of DHA) reduced production of PGE2 by intestinal cells in healthy subjects.133,134, a The ability of omega-3 fatty acids to inhibit eicosanoid production is dependent on the dietary omega-3 to omega-6 ratio. Ideal dietary ratios of total omega-3 to total omega-6 fatty acids for eicosanoid inhibition, health promotion, and disease treatment may be about 1 1 to 1...

Dyslipidaemia

There is abundant evidence in non-diabetic individuals that replacing SF with either unsaturated fat or CHO will lower LDL cholesterol concentrations to a similar degree (27,28), and this appears to be the case in patients with Type 2 diabetes (15,17-20). Given the evidence that pharmacological lowering of LDL cholesterol decreases CHD risk in patients with Type 2 diabetes (25,26), the intake of SF should be limited to less than 10 of total calories in these individuals. The decision to replace SF with either unsaturated fat or CHO will have an enormous impact on the circulating concentration of TG-rich lipoproteins. There is substantial evidence in patients with Type 2 diabetes that diets low in SF and high in CHO will increase fasting plasma TG concentration as compared to substitution of SF with MUFA PUFA (15,17-20). Evidence has recently been published that fasting RLP concentrations are also increased in patients with Type 2 diabetes (29), and the postprandial accumulation of...

Legumes

Legumes are peas, lentils, peanuts, carob, and beans, including soybean products like soy milk, tofu, and tempeh. They grow in pods on vines peanuts grow underground. Legumes are high in protein, 25 to 38 , which is more than eggs and many meats, have no cholesterol or saturated fat, and contain numerous vitamins and minerals including calcium, iron, zinc, potassium, and the B vitamins. Soybeans are a complete protein and when the other legumes are combined with grains, they also constitute a complete protein. Legumes contain omega-3 fatty acids, complex carbohydrates which have a low glycemic index, and fiber. They contain phytochemicals that have anticancer activity and that reduce serum cholesterol. They are beneficial for the heart, liver, kidneys, pancreas, lungs, and intestinal tract. Some

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