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Introduction

Obesity is one of the important challenges in public health worldwide. It may cause damage to the function of human organs and systems and ultimately lead to other chronic non-communicable diseases (NCDs) including cardiovascular disease, type 2 diabetes, dyslipidemia, chronic kidney disease, osteoarthritis, and cancer.18 Over the last decades, the global prevalence of obesity has increased rapidly, approximately 11% of men and 15% of women were obese in the world.9 In 2015, the prevalence of overweight and obesity among Chinese adults were 41.3% and 15.7%, respectively.10 Obesity-related NCDs brought a huge economic burden in China, and obesity and overweight accounted for 11.1% of deaths associated with NCDs in 2019.11

The root cause of obesity is that the bodys energy intake is greater than the bodys energy expenditure, resulting in excess energy being stored in the form of fat although lots of risk factors for obesity were explored and identified including genetics, diet, physical exercise, and psychological factors in previous studies.11 Thus, dietary factors still play a key role in the process of developing obesity even though some previous findings were controversial over countries or populations.12,13

The traditional nutritional epidemiology researches generally explore relationships between one or several foods or nutrients and health outcomes. Recently, dietary patterns of the overall diet were occupied to assess the comprehensive effects of food or nutrients on human health, and they showed more effectively and precisely than traditional those.14 However, different dietary patterns varied widely over countries, races, and research methods.15 Previous studies showed that western and junk food dietary patterns increased energy intake and risk of obesity,16 while Mediterranean dietary pattern was considered to reduce triglyceride levels.17 Also, an association between Chinese traditional dietary pattern and obesity was reported in one research.18 However, most of previous studies were cross-sectional studies between dietary patterns and obesity,1820 and it was rare to explore prospective associations between dietary patterns and obesity with community population cohorts in China.

There were huge differences in food culture and diet behaviors over different regions, even in China, due to the geographical features and ethnic diversity.21 Thus, based on a prospective community-based population cohort in Guizhou province, this study aimed to explore associations between dietary patterns and incident obesity in Southwest China.

Data for this study were from the Guizhou Population Health Cohort Study (GPHCS), a prospective community-based cohort in Guizhou province, China.22 The baseline survey was conducted between November 2010 and December 2012, and it was followed up between December 2016 and June 2020. The inclusion criteria for subjects in this study included followings: (1) aged 18 years or above; (2) lived in these communities and had no plan to move; (3) completed the questionnaire and blood sample collection; (4) signed written informed consent before data collection. A total of 9280 participants were recruited at the baseline. Those who had obesity at baseline (n = 644), who lost to follow-up (n = 1045), and who had missing data (n = 1634) or incomplete dietary survey (n = 215) were excluded. Finally, the remaining 5742 participants were eligible for the analysis (Figure 1). This study was approved by the Institutional Review Board of Guizhou Province Centre for Disease Control and Prevention (No. S2017-02).

Figure 1 Flow chart of participants in this cohort study.

A structured questionnaire was done through a face-to-face interview by local trained health professionals. The baseline and follow-up questionnaire included demographic characteristics (age, sex, ethnicity, educational level, marriage status, and occupation), lifestyle (smoking status, alcohol use, and physical activity), history of chronic diseases, and dietary factors. Current smokers referred to smoking tobacco products including manufactured or locally produced in a month.23 Alcohol drinkers referred to drinking alcohol more than once every month within the last 12 months.22 Physical activity was defined as meeting WHO recommendations on physical activity according to the global physical activity questionnaire (GPAQ).24

Dietary data including frequencies and quantities of 16 food items (fermented bean curd, bean paste, pickles, oil, legumes, meat, fruits, milk, eggs, fish, potatoes, grains, vegetables, beverages, desserts, and fried food) consumed during the recent 12 months before the study recruitment were collected by a simplified Food Frequency Questionnaire (FFQ). Anthropometric measurements including height, body weight, and blood pressure were measured. BMI was calculated as body weight in kilograms divided by height in meters squared (kg/m2). Obesity was defined as BMI 30kg/m2 based on the WHO BMI classification standard.25

In this study, factor analysis with eigenvalues >1 and varimax rotation was occupied to aggregate 16 food items into factors with food patterns. Four factors that explained most of the variances were determined based on scree plots and their loadings for the initial food items. The factor-loading matrix for the four dietary patterns and their food or food groups is shown in Table S1. Factor 1, named high-salt and high-oil pattern, was characterized by a high factor load of fermented bean curd, bean paste, pickles, and oil. Factor 2, named western pattern, was characterized by a high factor load of legumes, meat, fruits, milk, eggs, fish, and potatoes. Factor 3, named grain-vegetable pattern, was characterized by a high factor load of grains and vegetables. Factor 4, named junk food pattern, was characterized by a high factor load of beverages, desserts, and fried food. A summary score for each pattern was then derived and categorized into quartiles (Quartile 025th, Q1; 26th-50th, Q2; 51st-75th, Q3; 76th-100th, Q4) for further analysis.

The Students t-test and the Chi-square test were used for continuous variables and categorical variables, respectively. Person-years (PYs) of follow-up were calculated from the date of enrolling the cohort until the date of diagnosis of obesity, death, or follow-up, whichever came first. Because physical activity violated the proportional hazards assumption, the multivariable Cox proportional hazards regression models stratified by physical activity were employed to determine the association between dietary patterns and incident obesity and to estimate hazard risk (HR), adjusted HR (aHR), and their 95% confidence intervals (CIs). Several variables were adjusted and controlled in the multivariable models: age (1829, 3064, 65 years), sex (male/female), Han Chinese (no/yes), education years (9/<9), current smokers (no/yes), alcohol drinkers (no/yes), diabetes mellitus (no/yes), hypertension (no/yes). Tests for linear trends across increasing quartiles of dietary pattern were performed by assigning median value to each quartile of dietary pattern. The sensitivity analysis was conducted after exclusion of participants with overweight at baseline. All statistical tests were two-sided and P < 0.05 was considered statistically significant. All analyses were performed in R software (Version 4.1.0; R Foundation for Statistical Computing, Vienna, Austria).

The baseline characteristics of participants are presented in Table 1. Of all subjects, the average age was 45.06 15.21 years old and more than half were women. Most of them were Han Chinese and had 9 education years or longer. The prevalence of current smoking and alcohol drinking was around one-third, while the proportion of physical activity was more than four-fifths. There were significant differences in education level, physical activity, current smokers, alcohol drinkers, hypertension, and diabetes between men and women (detailed in Table 1).

Table 1 Baseline Characteristics of Participants

As shown in Table 2, four dietary patterns statistically varied over different age groups and physical activity groups. Men (53.6%) had higher grain-vegetable pattern scores than women (46.4%). Han Chinese had more chances to have western pattern and junk food pattern. Participants with less than 9 education years had lower proportions of high-salt and high-oil pattern, western pattern, and junk food pattern. Those subjects with hypertension or diabetes tended to have high-salt and high-oil pattern and junk food pattern. There were also significant differences in high-salt and high-oil patterns and western pattern among participants who were current smokers or alcohol drinkers.

Table 2 Participants Characteristics According to Quartiles of Four Dietary Patterns

During the follow-up of 40,524.15 PYs, 427 new obesity cases were identified and the incidence rate of obesity was 10.54/1000PYs overall. There were significant sex differences in the incidence rate (9.36/1000PYs for men vs 11.64/1000PYs for women, p = 0.004). The incidence rate increased with age and the age-specific incidence rates of obesity are displayed over sex in Figure 2. Similar sex differences were observed among those aged 30 to 64 years old (p = 0.010) or elders (p = 0.031). Also, the highest incidence rate of obesity reached 12.27/1000PYs and 9.8/1000PYs in both women and men aged 30 to 64 years, respectively.

Figure 2 Age-specific Incidence rates of obesity for Chinese adults over sex.

Abbreviation: PYs, person years of follow-up.

Note: **P < 0.01.

In the Cox regression model stratified by physical activity, associations between dietary patterns and incident obesity are presented in Table 3. Participants in the higher quartile of junk food pattern score were more likely to develop obese with the HR (95% CI) of 1.54 (1.162.02) and 1.44 (1.091.89) for the third and fourth quartiles, respectively. After the adjustment for covariates, both aHRs in the Q3 and Q4 group of junk food pattern increased slightly and were still significant. Also, the risk of incident obesity significantly increased with the score of junk food pattern (p for trend = 0.040). In addition, subjects in the Q3 group of western pattern had a significantly higher risk of incident obesity (aHR: 1.33, 95% CI: 1.011.75) compared to those in the Q1 group, and there was a marginally raised trend in the risk of incident obesity as western pattern scores (p for trend = 0.087). It was not found that there were any significant associations between high-salt and high oil pattern or grain-vegetable pattern and incident obesity. No significant interactions were observed between dietary pattern and main covariates, either. In the sensitivity analysis, the main results remained robust after exclusion of participants with overweight at baseline (seen in Figure S1).

Table 3 Associations Between Baseline Dietary Patterns and Incident Obesity

The prevalence of obesity has been increasing dramatically worldwide. As a leading risk factor for obesity, unhealthy dietary has been prevalent in China. During the follow-up of 40,524.15 PYs, the incidence rate of obesity was estimated at 10.54/1000PYs in this study population overall with a significant sex difference. Also, the highest incidence rate of obesity reached at 12.27/1000PYs and 9.80/1000PYs in both women and men aged 3064 years, respectively. Those findings indicated that there was a high risk of developing obesity in this study population, especially for women, which called the development and implementation of specific intervention for the prevention and control of obesity.

In the present study, four major dietary patterns were identified and then associations between four dietary patterns and incident obesity were explored among adult residents in Southwest China. The junk food pattern consisted of high consumption of beverages, desserts, and fried food. Likewise, the western pattern was characterized by high consumption of legumes, meat, fruits, milk, eggs, fish, and potatoes. We found that junk food pattern and western pattern were positively associated with the increased risk of developing obesity, while no significant associations between high-oil and high-salt pattern, grain-vegetable pattern and incident obesity were observed in this study. The results were consistent with the South Asian consensus on Nutritional Medical Treatment of Diabesity, which advocated for a hypocaloric diet and reducing intake of carbohydrates and saturated fats.26 Meanwhile, among Iranian women, it was reported that a low-carbohydrate diet was not associated with overweight and obesity.27

In China, the consumption of junk food such as desserts, beverages, and fried food is on the rise since the 1980s.11 In this study, the contribution of junk food dietary pattern to a higher risk of obesity was demonstrated, which was consistent with a Mediterranean prospective cohort design with a median 6-year follow-up.28 Previous studies revealed that during the frying process, excessive fat and calories tended to increase, and trans-fatty acids related to the risk of weight gain29 were also prone to be generated.30 Furthermore, the junk food pattern has a high intake of beverages and sweets, and the positive associations of sugar-sweetened beverages (SSBs) to obesity were confirmed by Framingham Heart Study.31 A recent meta-analysis revealed that the consumption of SSBs increased waist circumference in adult populations.32 Also, a cross-sectional study33 indicated that fruit drink intake was significantly linked with a higher risk of obesity among women. In addition, added sweet or sugar foods were positively associated with BMI in the women.34 Excess sugar intake among sweets and desserts was a significant contributor to the development of overweight or obesity.35,36

Over the past decades, the socioeconomic level has changed dramatically in China, especially in the southwest region. The transition from the traditional dietary pattern characterized by a high intake of vegetables, grains, and legumes to the Western model had occurred.37,38 It was observed that western dietary pattern had a higher incident risk of obesity and there was a marginally raised trend in the incident risk of obesity as western pattern levels in this study. Several studies have demonstrated that Chinese who had a western dietary pattern were more likely to suffer from obesity.39,40 Some similar findings were also reported among children and adolescents.12,41,42 One of possible reasons might be that meat and meat products are rich in cholesterol and saturated fatty acids,43,44 which could increase the risk of suffering from obesity to a certain degree.45 However, Daneshzad et al46 demonstrated that there was no significant association between total meat consumption and obesity based on a meta-analysis of observational studies. Therefore, more prospective studies are needed to clarify the association between red meat and total meat, and obesity.

Moreover, given the topographical characteristics of the Guizhou region, a wide range of potato products, boiled, fried, or mashed, were widely consumed in the local area. As a staple food in the western world, potatoes, an energy-dense food, played a significant role in the western diet pattern, and contributed greater amounts of carbohydrates to the diet.47 Foods containing more starches and refined carbohydrates were positively associated with weight gain.48 A meta-analysis confirmed that weight change was positively associated with the consumption of potatoes (boiled or mashed potatoes, potato chips, and French fries).49 Halkjaer et al50 also reported that total potato intake was associated with the increase in waist circumstances in women. However, the evidence for a link between potato intake and the risk of obesity remains controversial.51,52

Based on this 10-year community population-based cohort in Southwest China,53 this study extended the evidence on the association between dietary patterns and incident obesity. Also, this study collected data through FFQ rather than 24h dietary recall to get long-term usual intake more accurately.41,54 However, there were some main limitations in the study. First, the outcome of obesity was only assessed by BMI and did not include those measures of central obesity such as waistline in this study, which may underestimate the incidence of obesity. Second, over several years of follow-up, the daily diet measured on baseline may be time-varying to bias our findings but we did not collect detailed diet information in the follow-up of this study. Third, Cox proportional hazards regression models were employed with the strata by physical activity to meet Proportional Hazards Assumption. In addition, some possible confounding factors such as medications, family history of obesity or genetic variants related to obesity were not collected in this study, which may bias the findings from this study. Our findings in this southwest Chinese population need to be confirmed or clarified by more prospective studies over different populations. For future studies, associations between diets and obesity measured by waistline or body composition should be explored, and genediet interactions on developing obesity should be considered, too.

In summary, there was a high risk of incident obesity among this Chinese community population of Southwest China. Also, four dietary patterns were identified in this community population of Southwest China, and junk food and western pattern increased risks of incident obesity. The findings provided new evidence for obesity prevention and control from the dietary perspective, especially for the Chinese population. Urgent intervention is called to be developed to promote a healthy dietary pattern and prevent the becoming obesity.

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board (or Ethics Committee) of the center of disease control and prevention of Guizhou Province (No. S2017-02).

Written informed consent was obtained from all subjects before the data collection.

This work was supported by the Guizhou Province Science and Technology Support Program (Qiankehe [2018]2819).

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

The authors declare no conflicts of interest in this work.

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TOKYO -- Japanese YouTuber "GaaSyy," who was elected to Japan's House of Councillors on the ticket of the NHK Party, remains overseas and has not attended Diet sessions, with reports earlier this year that he was residing in Dubai. The head of the chamber's Committee on Rules and Administration has requested that he quickly return to Japan and appear in the Diet.

Many people may think that GaaSyy, whose real name is Yoshikazu Higashitani, should step down as a Diet member if he has no record of activities in his elected role. If he continues to remain absent it is possible that the upper house Committee on Discipline could discuss punishment including expelling him as a member of the chamber. But this is no simple matter.

Being voted in carries a great deal of significance for any candidate, not just GaaSyy. This is because it is the will of the people, which has the greatest value in a democracy. Diet members, in principle, have immunity from arrest during Diet sessions, though they can be arrested when caught in the act of a crime or when the house approves of it. This is stipulated in Articles 50 of Japan's Constitution, which states: "Except in cases provided by law, members of both Houses shall be exempt from apprehension while the Diet is in session, and any members apprehended before the opening of the session shall be freed during the term of the session upon demand of the House."

Article 51 of the supreme law further stipulates: "Members of both Houses shall not be held liable outside the House for speeches, debates or votes cast inside the House."

These constitutional stipulations are designed to protect the status of Diet members. It has been common throughout history and across the world -- not to mention in Russia -- for members of parliament to be arrested over words and actions that are unfavorable to the government. To ensure that such a thing never happens, Diet members in Japan are protected to a degree that may seem excessive at first glance.

Regarding the expulsion of Diet members, the second clause of Article 58 of the Constitution states: "Each House shall establish its rules pertaining to meetings, proceedings and internal discipline, and may punish members for disorderly conduct. However, in order to expel a member, a majority of two-thirds or more of those members present must pass a resolution thereon." A majority of two-thirds rather than a simple majority is a high hurdle, but still, there are deep-rooted views that this stipulation should be applied with caution.

The NHK Party says that GaaSyy is not returning to Japan because he will carry out his activities as a Diet member while living overseas. We cannot easily claim that his actions do not constitute political activities. There is a wide scope for determining what kind of activities are political. And if it turns out he is not doing his job satisfactorily, then the public has the option of voting him out in the next election.

Some people may say they cannot understand GaaSyy's approach, but if the principles protecting Diet members were loosened without caution, the move could return to haunt the country. While it is unthinkable for the current government to unfairly arrest lawmakers, we cannot rule out the possibility of a government that could do that surfacing in Japan in the future.

Parliamentary privileges stipulated in the Constitution act as a last line of defense to prevent the government's abuse of power.

(Mainichi political premier editorial division)

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Japan YouTuber Diet member's prolonged overseas absence opens can of legal worms - The Mainichi - The Mainichi

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Love CocaCola, but prefer to opt for a zero-calorie, sugar-free option? Then youve probably reached for Coke Zero or Diet Coke. Both are great alternatives to the original Coca-Cola, but what is the difference between the two?

If youre a Coca-Cola connoisseur, you may already know the answer to this question. Turns out, the difference between Coke Zero and Diet Coke really comes down to one thing: the taste.

The ingredients lists are similar for both products. They contain carbonated water, caramel color, phosphoric acid, and aspartame (among other things). But Coke Zero is formulated with the original taste of Coca-Cola in mind, while Diet Coke has a completely different blend of flavors, providing a lighter taste.

Sugar-free shouldnt have to mean having fewer options, Anna Wheeler, Health and Nutrition Manager at Coca-Cola Great Britain, wrote in an article answering this highly-debated question.

Diet Coke has a few ingredients that Coke Zero lacks (potassium citrate and acesulfame potassium), which contribute to its lighter taste. Coke Zero, on the other hand, contains citric acid, which Diet Coke does not, ultimately creating different flavors between the two.

So, while they sound similar and promise to accomplish the same thing: giving you a taste of Coca-Cola without the added sugar and calories, the blend of flavors is completely different. Can you taste the difference?

Are you wondering what the difference between Coke and Pepsi isnow? We got you covered there, too.

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Whats the Difference Between Coke Zero and Diet Coke? - LifeSavvy

A plant-based diet could be helpful if you want to lose weight, avoid diabetes, or reduce your risk of Alzheimers.

According to a recent commentary in the American Journal of Lifestyle Medicine, all doctors should be aware of the advantages of a plant-based diet for six different health conditions, including COVID-19, diabetes, cancer, cardiovascular disease, and weight loss.

The field of medicine, despite its prominent influence in society, has invested little to promote healthy lifestyle choices, says the commentary co-authored by Saray Stancic, MD, FACLM, director of medical education for the Physicians Committee for Responsible Medicine. The consequence of this is reflected in our ever-rising chronic disease statistics, most notably obesity and diabetes rates.

The authors claim that medical schools only provide a meager level of nutrition education throughout the course of four years and that this situation is not improved during postgraduate study. They point out that 90 percent of cardiologists who participated in a recent study of over 600 cardiologists said they had not obtained the necessary nutrition education during training.

The commentary accepts that not all doctors need to be nutrition specialists, but asserts that they should at the very least have a basic understanding of the advantages of a plant-based diet for these six conditions, for which they present detailed evidence, including the following:

It is time for all physicians across the globe to speak to the importance of diet and lifestyle in health, concludes the commentary, which recommends that physicians do this by counseling patients, assuring hospitals provide healthy menus, lecturing in the community, writing articles, using social media, and providing commentary to media.

Reference: Six Applications of Plant Based Diets for Health Promotion by Saray Stancic, MD, Josh Cullimore, MD and Neal Barnard, MD, 26 May 2022, American Journal of Lifestyle Medicine.DOI: 10.1177/15598276221104023

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6 Scientifically Proven Health Benefits of a Plant-Based Diet - SciTechDaily

Decoding the Indian DASH diet and its benefits

Jul 24, 2022, 07:15 am 2 min read

Indians are prone to developing high blood pressure by the time they hit 40. This could be due to stress, pollution, or even genetics. The Dietary Approaches to Stop Hypertension, or DASH, diet attempts to prevent hypertension and is followed all over the world. The Indian DASH diet uses the same principles but with an Indian twist, making it a more easy approach.

Hypertension or high blood pressure occurs when the force exerted by the blood while pushing against the walls of arteries is too high. It can damage the walls of arteries and increase the risk of heart and kidney diseases. The normal blood pressure is below 120/80 mm Hg. When systolic pressure is over 130 and diastolic is over 80, it's the first stage of hypertension.

Foods involved in Indian DASH diet

The Indian DASH diet encourages the intake of methi water, fruits and vegetables, dal paratha without oil, grilled paneer, moong sprouts, palak paneer, oats upma, green salad, curd, low-fat chapati, and brown rice. These are beneficial for reducing blood pressure levels and must be eaten in moderation. You can also add pork, beef, or bacon in controlled portions to your diet.

Remove these foods from your diet

Salt must be completely eliminated from your diet. Along with this, sugary snacks like cookies, pastries, and sodas should be avoided. Alcohol, caffeine, processed foods, and dairy products, along with some types of meats, should also be removed from your diet. Usage of oils must be minimal to none, as excessive oil can ruin the diet plan and affect your health.

Additional habits and precautions

It is vital to maintain regular physical exercise alongside the DASH diet. Forms of intoxication like smoking and alcohol consumption must be stopped entirely as they pose a threat to heart health and cause blood pressure levels to fluctuate. Reducing stress is essential to reducing hypertension, which can be done through hobbies, sports, or mindfulness and meditation.

Other benefits of DASH diet

There are many more benefits of the Indian DASH diet apart from maintaining blood pressure levels as this diet greatly promotes your overall health. This diet strengthens your bones, reduces uric acid levels in the body, prevents metabolic disorders, reduces bad cholesterol levels, and is also said to lower the risk of cancer. The DASH diet also promotes healthy weight loss.

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Decoding the Indian DASH diet and its benefits - NewsBytes

By The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)July 18, 2022

By the time they were 18 months old, infants who began receiving taster portions of the new Nordic diet were eating 46% more vegetables than those who were fed a conventional diet.

Introducing infants and toddlers to a lower-protein Nordic-style diet that places an emphasis on plant-based foods could allow them to obtain healthy eating habits

New research recently presented at the 54th Annual Meeting of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)suggests that the key to healthier eating habits may be to introduce babies and toddlers to a lower protein Nordic-style diet with a greater focus on plant-based foods.

By the time they were 18 months old, infants who began receiving taster portions of the new Nordic diet, which includes fruit, berries, roots, and vegetables, along with breast or formula milk, were eating nearly twice as many vegetables (a 46 percent increase) as those who were fed a conventional diet.

As part of the OTIS experiment, researchers from the University of Umein Sweden, the Stockholm County Council Centre for Epidemiology, and the University of California in the United States studied two groups of infants from 4-6 months to 18 months. 250 infants in total participated, and 82% of them completed the study.

A graphic explaining the benefits of a Nordic-style diet. Credit: The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)

The toddlers in the 2 groups had quite different eating patterns, according to the study. Those who followed the new Nordic diet, who received Nordic home-made baby food recipes, protein-reduced baby food products, and social media support from other parents, ate 4245% more fruit and vegetables at 1218 months of age than those who followed the traditional diet currently advised by the Swedish Food Agency.

Although in the traditional diet group, fruit consumption remained constant, but between 12 and 18 months, infants receiving the traditional diet consumed 36% fewer vegetables.

Babies on the Nordic diet had an average protein intake 17-29% lower than those on the conventional diet at 12-18 months of age. This was still within recommended protein intake levels and the overall calorie count between the two groups was the same. The protein reduction in the Nordic diet group was replaced by more carbohydrates from vegetables, not more cereals, together with some extra fat from rapeseed oil.

Lead researcher Dr. Ulrica Johansson, a Medicine Doctor in pediatrics and registered dietitian at the University of Ume, Sweden, said there did not appear to be any negative effects from having a lower protein intake.

Commenting on the findings, Dr. Johansson says: A Nordic diet with reduced protein introduced to infants naive to this model of eating, increased the intake of fruit, berries, vegetables, and roots, establishing a preferable eating pattern lasting over a 12-month period.

There were no negative effects on breastfeeding duration, iron status or growth.

A Nordic diet reduced in protein is safe, feasible, and may contribute to sustainable and healthy eating during infancy and early childhood, she added.

The novel research could pave the way to broadening the taste spectrum in infants and potentially provide an effective strategy for instilling healthier eating habits early in life.

The Nordic diet has a higher intake of regionally and seasonally produced fruit, berries, vegetables, herbs, mushrooms, tubers, and legumes, as well as whole grains, vegetable fats and oils, fish and eggs, and a lower intake of sweets, desserts and dairy, meat, and meat products.

Typical Nordic fruits include lingonberry, buckthorn berry, cranberry, raspberry, and blueberry, as well as fiber-rich vegetables such as turnip, beets, swede, root celery, carrots, parsnip, cabbage, broccoli, cauliflower, and kale.

Chair of the ESPGHAN Nutrition Committee, Professor Jiri Bronsky, stated: The authors have shown a significant effect of the diet in 12 and 18 months of age of the children. The Nordic diet group consumed more fruit and vegetables and less protein than the control group. The Nordic diet was well tolerated and did not negatively affect the growth of the child or breastfeeding duration. Importantly, this research demonstrates that this diet is safe, feasible and exposes infants to a variety of flavors which may influence long-lasting food preferences.

Meeting: 54th Annual Meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)

See more here:
Research Shows a Lower Protein Diet Could Be the Key to Healthier Eating Habits - SciTechDaily

This transcript has been edited for clarity.

Hello. I'm Dr David Johnson, professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia. Welcome back to another GI Common Concerns.

All of us routinely see diet recommendations on the Internet like TikTok or in new books. Every possible diet seems to receive this promotional push, although the evidence behind them is often lacking.

So what do we mean when we talk about a "healthy diet"?

Today, I'd like to spend a few minutes updating you on the current evidence and how I discuss it with my patients so that you can perhaps do the same in your own patient discussions.

The Western diet has really cannibalized the health of the United States and Western civilizations.

This diet is typically characterized by high intakes of processed and prepacked food items, red meat, dairy, and grains, consisting of high-fat, high-protein, and low-fiber components. These food items have become diets of convenience as opposed to diets potentially promoting health.

They've led to an associated increase in so-called "diseases of civilization," including cardiovascular disease, obesity, and a variety of metabolic diseases and cancers.

Western diets have been also associated with a variety of microbial and gut integrity changes, which in turn, are associated with an assortment of bad outcomes. Specifically, they're associated with decreases in microbial diversity in the gut; upregulation of proinflammatory mediators, cytokines, and chemokines; and several changes to gut integrity, immunity, and pathways that are derivatives toward diseases and even promoting translocation of gut bacteria.

In contradistinction, we have the Mediterranean diet, which is often proffered as the good or healthy diet for most patients. This comprises a diet that's high in fiber and low in animal protein and saturated fat, and is characterized by a higher ingestion of vegetables, fruits, and healthy fat and a lower intake of red meat and dairy. The Dietary Guidelines for Americans recommend a Mediterranean diet for promoting health and minimizing disease.

The high fiber content of Mediterranean diets is a key reason behind that recommendation. Fiber comes in soluble and insoluble forms. Soluble fiber gets digested, whereas insoluble fiber moves through the gastrointestinal tract, bringing components of water absorption and promoting gut motility, particularly in the colon.

Insoluble fiber has a variety of ascribed benefits, particularly related to the changes in the gut production of short-chain fatty acids, which are incredibly important for optimizing intestinal function.

We know that short-chain fatty acids increase secretion of immunoglobulins, induce regulatory T-cell tissue repair, promote antimicrobial peptides and mucus production, and basically optimize intestinal function and the intestinal barrier integrity. This is all critically important in promoting health.

There are also some data on short-chain fatty acid production as it relates to crossing the blood-brain barrier. This association with the brain-gut axis potentially changes gut-related derivatives, driving mood and behavioral activities in the brain. Therefore, we can say that the short-chain fatty acid derivative from the intestinal microbiome does have central nervous systemrelated effects.

There are also some very interesting data in this area related to the progression of COVID to severe disease or long-haul COVID, or even the development of COVID. Enhanced microbial diversity seems to be somewhat protective and, if infected with COVID, predictive of a rapid response and resolution. Short-chain fatty acids also serve as a marker, particularly when they're reduced. Branch-chain shorty acid called L-isoleucine has been shown to be predictive of longer-term consequences and more-severe COVID. So diet may have a significant role in even in the COVID world.

There are other elements in the diet that may contribute to disease.

Some things commonly added to diets have been shown in animal models to have a significant impact in changing gut integrity. In particular, this is observed in prepacked foods that are often found in the Western diet, which incorporate things such as emulsifiers and food additives with a goal toward enhanced aesthetics and taste.

Some that we see routinely in popular food items are carboxymethyl cellulose and polysorbate-80. These are derivatives in a variety of dairy products. Interestingly, they decelerate the melting of ice cream. That may be good for your kids eating an ice cream cone in the backseat in the summer, but not so good potentially for the intestine.

The same is true as it relates to maltodextrin, which is a very common thickener and sweetener, but again decreases the mucosal layer thickness and increases gut permeability.

Carrageenan, which is made from red seaweed, is added to increase texture, primarily in dairy products and sauces. It also decreases gut integrity and permeability changes and antigenic translocation.

Another common food additive is high-fructose corn syrup, something we're seeing more and more data about. Its use in sugary beverages was once implied to have, and now clearly is associated with, an increased risk for nonalcoholic fatty liver disease, early colon cancer, and a variety of other cancer pathways. Recent animal model data have shown mechanistically how it contributes to colon cancer. It was also most recently associated with liver cancer in postmenopausal women ingesting one sugary beverage a day.

Almost all sugary beverages have shifted from using cane sugar to high-fructose corn syrup because it's cheaper and sweeter. Interestingly, as data have become more onerous regarding its disease associations, in 2012 the corn industry went to the US Food and Drug Administration and petitioned to change the name from high-fructose corn syrup to corn sugar. That term sounds a lot easier and maybe even sweeter when it comes to possible health implications, but the FDA said no.

Since then, the widespread use of high-fructose corn syrup has been described as a food public health crisis. High-fructose corn syrup is something that is very easy to avoid when you talk about sugary beverages.

When it comes to artificial sweeteners, the top three that have been studied to date are aspartame, saccharin, and sucralose (Splenda). They are not absorbed but rather are fermentable sugars that get to the gut and change the gut microbiome. In animal models, they have been shown to promote obesity and diabetes, which is very much paradoxical to what their advertised intent is. Again, this has only been studied for these three agents, and we also don't have data in lower-threshold exposures.

I think it's common sense to minimize the use of these things and instead ask patients to use natural sugars, consume water, and incorporate other strategies; that's what I discuss with my own patients.

We can go the wrong way and make our patients too rigid about reading nutritional labels. I want to caution you about emerging food restrictive disorders that very much can become an eating disorder. So we don't want to go the opposite way.

I tell my patients to be a good, conscientious thinker, look at your food, minimize the processed foods, and build your meals. The Western diet needs to go. The more we can use the Mediterranean diet, the better off we are. You can still have your occasional cheeseburger and French fries but use common sense.

The Mediterranean diet really is simple. I routinely recommend this to my patients with inflammatory bowel disease, obesity, nonalcoholic fatty liver disease, along with other inflammatory disease conditions. But I do think we can make this a general recommendation across all patients in our attempt to promote health and thereby prevent disease.

I hope this has been helpful.

I'm Dr David Johnson. Thanks for listening.

David A. Johnson, MD, a regular contributor to Medscape, is professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia, and a past president of the American College of Gastroenterology. His primary focus is the clinical practice of gastroenterology. He has published extensively in the internal medicine/gastroenterology literature, with principal research interests in esophageal and colon disease, and more recently in sleep and microbiome effects on gastrointestinal health and disease.

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Forget Fad Diets, Here's the One You Need - Medscape

It is widely accepted in modern culture that people should divide their daily diet into three large meals breakfast, lunch, and dinner for optimal health. This belief primarily stems from culture and early epidemiological studies.

In recent years, however, experts have begun to change their perspective, suggesting that eating smaller, more frequent meals may be best for preventing chronic disease and weight loss. As a result, more people are changing their eating patterns in favor of eating several small meals throughout the day.

Those who advocate for eating small, frequent meals suggest that this eating pattern can:

While a few studies support these recommendations, others show no significant benefit. In fact, some research suggests it may be more beneficial to stick with three larger meals.

Here is what the research says.

Early epidemiological studies suggest that increased meal frequency can improve blood lipid (fats) levels and reduce the risk of heart disease. As a result, many experts advise against eating fewer, larger meals a day.

Over the years, some studies have supported these findings, suggesting that people who report eating small, frequent meals have better cholesterol levels than those who consume fewer than three meals per day.

In particular, one 2019 cross-sectional study that compared eating fewer than three meals per day or more than four meals per day found that consuming more than four meals increases HDL (high-density lipoprotein) cholesterol and lowers fasting triglycerides more effectively. Higher levels of HDL are associated with a reduced risk of heart disease.

This study observed no differences in total cholesterol or LDL (low-density lipoprotein) cholesterol. It is important to note, however, that this is an observational study, meaning it can only prove association, not causation.

Additionally, one review published in the American Heart Associations journal Circulation concluded that greater eating frequency is associated with a reduced risk for diabetes and cardiovascular disease, according to epidemiological studies.

There is a commonly held notion that more frequent meals can help influence weight loss. However, the research on this remains mixed.

For example, one study compared eating three meals per day or six smaller, more frequent meals on body fat and perceived hunger. Both groups received adequate calories to maintain their current body weight using the same macronutrient distribution: 30% of energy from fat, 55% carbohydrate, and 15% protein.

At the end of the study, researchers observed no difference in energy expenditure and body fat loss between the two groups. Interestingly, those who consumed six smaller meals throughout the day had increased hunger levels and desire to eat compared to those who ate three larger meals per day.

Although calorie intake was controlled in both groups, researchers hypothesized that those who consumed frequent meals would be more likely to consume more daily calories than those who ate less frequently.

Results of another large observational study suggest that healthy adults may prevent long-term weight gain by:

Moreover, according to the United States Department of Agriculture (USDA) Scientific Report of the 2020 Dietary Guidelines Advisory Committee, due to inconsistencies and limitations in the current body of evidence, there is insufficient evidence to determine the relationship between meal frequency and body composition and the risk of overweight and obesity.

Small, frequent meals are often touted as a cure-all for obesity. Many believe that eating every 2 to 3 hours can help boost metabolism.

Digestion of food does require energy. This is known as the thermic effect of food (TEF). However, it does not appear that meal frequency plays a role in boosting metabolism.

In fact, some studies suggest fewer, larger meals may increase TEF more than eating frequent meals.

Although evidence to support increased meal frequency in the general population remains mixed, several experts believe that eating small, frequent meals can benefit athletes.

According to the International Society of Sports Nutrition, athletes who follow a reduced-calorie diet may benefit from eating small frequent meals with adequate protein because it can help preserve lean muscle mass.

When prioritizing total daily calorie intake, limited evidence suggests that, in athletes, a higher meal frequency may increase performance, support fat loss, and improve body composition.

People who eat more frequently are more likely to have better diet quality. Specifically, those who consume at least three meals per day are more likely to have a greater intake of vegetables, greens, legumes, fruit, whole grains, and dairy.

These individuals are also more likely to consume less sodium and added sugars than those who consume two meals per day.

Similarly, another 2020 study published in the British Journal of Nutrition found that increased meal frequency approximately three meals per day is associated with higher diet quality.

Researchers found that snack frequency and diet quality varied depending on the definition of snacks.

Based on the presented studies, no substantial evidence supports one eating pattern over the other. Yet many of these studies also have limitations.

For example, there is no universally accepted definition of what a meal or snack consists of. This can have an impact on study outcomes.

With that said, both eating patterns can be beneficial as long the primary focus is on healthful eating habits.

A review published in Nutrition in Clinical Practiceshows that certain populations may benefit from six to 10 small, frequent meals. These include people who:

If your goal is to lose weight, it is important to be mindful of your portion sizes. Be sure to stay within your allotted daily calorie needs and divide them among the number of meals you consume.

For example, if you need 1,800 calories to maintain your weight and choose to eat six small meals daily, each meal should be around 300 calories.

Small, frequent meals often come in the form of ultra-processed foods and snacks that fall short in many vital nutrients your body needs. Thus, it is essential to focus on the quality of the foods you consume.

People who may benefit from three larger meals per day include:

Again, keeping diet quality in mind and prioritizing whole foods is essential. Fewer meals mean fewer opportunities to get in key nutrients the body needs.

While we do not have strong evidence to support the importance of meal frequency, substantial evidence supports the overall health benefits of following a well-balanced, nutrient-rich diet.

According to the Dietary Guidelines for Americans 20202025, a healthy diet should:

Evidence is mixed about the importance of food frequency. While there is no solid evidence to suggest that one eating style is superior to the other, both can offer health and wellness benefits if you follow a healthy eating pattern.

Thus, it ultimately comes down to personal preference and which approach works best for you. Additionally, if you have certain health conditions, one style may benefit you over the other.

As always, consult your healthcare provider before making any significant changes to your diet.

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Meal frequency and portion size: What to know - Medical News Today

After suffering from the severe summer heatwaves, we all look forward to enjoying the monsoon season. And now the season has finally arrived, we look for the reasons to indulge in our favourite snacks with a piping hot cup of 'kadak chai' while enjoying the beautiful weather. Apart from this, there's one thing which we should never take for granted and that is our health. Monsoon season can really take a toll on your health, especially hampering immunity. So, it is mandatory to consume food that can make your immune system strong. A strong immune system can protect you from many unwanted diseases. Having said that, here we bring you a list of fruits that you must add to your diet to cope up with monsoon effects. Take a look.

Also read:Monsoon Diet Tips: 7 Low-Cal Fruits And Vegetables For Monsoon Diet (Recipes Inside)

According to the USDA data, jamun consists of 1.41 mg iron, 15 mg of calcium and 18 mg of vitamin C. Besides, this seasonal delight is also rich in antioxidants that help boost immunity and formulate collagen resulting in glowing skin. For more benefits of jamun and healthy recipes, click here.

You must have heard the very popular saying ''an apple a day keeps the doctor away'. Well, that's true! Apples are rich in Vitamin C and flavonoids called quercetin that help in improving the immunity, keeping any ailment at bay. To know more benefits of apples, click here.

This fruit is known for its juicy pearls and extraordinary taste. Besides, it is loaded with antioxidants that help improve gut-health and immune system as well. These are some factors that can also help you in losing some extra kilos. According to Celebrity nutritionist and life coach Luke Coutinho, pomegranate might help you detox better than green tea. You can read the complete detailed study, click here.

Bananas are high in Vitamin B6 that helps in keeping the immune system function properly. You can use this fruit as a base to prepare delicious smoothies and shakes. For more banana benefits, click here.

Besides plenty of fibre and potassium, pears are rich in Vitamin C and also contain anti-inflammatory flavonoids in their peels-so make sure you consume the skin for the super nutrient boost. Click here.

So, what are you waiting for? Stock up these seasonal treats and add them to the diet now.

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Monsoon Diet: 5 Immunity-Boosting Fruits You Must Add To The Diet - NDTV Food

When it was announced earlier this month that Diet Coke queen, Kate Moss, would finally be taking her well-deserved place on the Coca-Cola throne as the UK creative director of the diet variety, fans of the supermodel rejoiced. Long has Moss been a champion of the beverage, and after the position sat empty for a decade following Marc Jacobs stint in the role, Moss seemed like the perfect replacement. As for what she would do as the creative director, that part was unclear. I'm looking forward to inspiring fans and celebrating the brand's 40th birthday in style, Moss said in the brands announcement, which also stated that Moss would continue to showcase the positive attitude of Diet Coke drinkers, throughout the summer.

On Wednesday, Moss duties as the queen of the no calorie Coke became clear(er) when the model hosted an event at London's 180 The Strand. It was there that Moss unveiled four newly-designed cans, each of which were inspired by some of Moss most iconic looks from throughout the years. Of course, one of those cans includes a leopard motif, referencing the models love for the animal print. Its fitting, then, that for the event, Moss opted to wear a leopard print blouse, which she paired with black tapered trousers, a large black belt, and some gold sandals. She finished off the look with a lip color which can only be described as Coke red.

David M. Benett/Getty Images Entertainment/Getty Images

Unfortunately, it seems like Moss creative director duties only reach across the UK, meaning American fans will likely have to travel abroad if they want to get their hands on a Moss-designed can. But thanks to the wonderful world wide web, we can still enjoy her reign from here, and sip on our non-Moss Cokes as a consolation.

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Kate Moss Takes Her Place as the New Queen of Diet Coke in Leopard - W Magazine

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