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Preterm birth (defined as delivery before 37 weeks of gestation) is associated with significant short and long-term adverse-health outcomes including death. Infants born preterm are more likely than infants born full term to die during the neonatal period (first 28 days) and infancy (first year), and mortality rates increase proportionally with decreasing gestational age or birth weight.

Previous research has shown a positive correlation between the maternal diet, preterm birth, infant birth weight and healthy infants. A new study has found that eating habits before conception may also play a role in preterm birth and healthy infants.

The results of a new study published in the Journal of Nutrition has shown that women who consistently eat a diet rich in lean protein, fruit, vegetables and some whole grains before and during pregnancy have a decreased risk of preterm birth.

The study, conducted by researchers from the University of Adelaide, investigated the dietary habits of over 300 Australian women, at least 18 years in age, before pregnancy and followed them through the birth of their infant. This small cohort was part of a larger prospective study that assessed the effects of asthma during pregnancy.

Dietary patterns were assessed and categorized into three groups: high-protein/fruit, high-fat/high-sugar/fast food, and vegetarian. Women with higher scores on the high-protein/fruit pattern were less likely to have babies born preterm, while the women with higher scores for the high-fat/high-sugar/fast food diet were more at risk to deliver babies preterm.

These findings suggest that preterm delivery might actually be modified by maternal diet. Eating a healthy diet that includes lean protein, fruits, vegetables and whole grains before pregnancy is important for a pregnant1 and the long-term health of the child.

Grieger JA et al; J Nutr. 2014 Jul;144(7):1075-80. doi: 10.3945/jn.114.190686.

Low-GIMagnesium (Mg) is an essential mineral that has many important roles in the body and is required by over 300 enzymes. Inadequate dietary intake of Mg has been related to many chronic inflammatory or metabolic diseases such as hypertension, metabolic syndrome, type 2 diabetes, osteoporosis, cardiovascular diseases, and even some cancers.

Magnesium is found most abundantly in healthy foods such as whole grains, green leafy vegetables, nuts and legumes. It is estimated that 75% of the U.S. population gets less than the minimum recommended level (RDA) in the diet.

In a new study published in the European Journal of Clinical Nutrition, researchers investigated the potential association between dietary Mg intake and serum C-reactive protein (CRP), a marker of inflammation. Nearly 33,000 adult participants from seven cross-sectional studies were included in the meta-analysis. Magnesium intake in the intervention studies varied from 50-450 mg/day and for relatively short durations up to 4 months.

Evidence from the intervention studies showed a potential beneficial effect of Mg intake on serum CRP levels. In the observational studies included in the review, having a CRP level greater than or equal to 3 mg/L (indicating the presence of inflammation) was 49% more likely in the group with the lowest Mg intake when compared to the group with the highest Mg intake.

This meta-analysis and review supports the connection between low Mg intake and increased markers of inflammation. The researchers suggest that the potential beneficial effect of Mg intake on chronic disease may be at least partly explained by reducing inflammation.

DT Dibaba, P Xun and K He. European Journal of Clinical Nutrition (2014) 68(4):510–516.

PreschoolA new Cochrane Review suggests that zinc supplementation might reduce the overall risk of death in children 6 months to 12 years-old.

Zinc is a trace mineral that is needed for many important functions in the body. Deficiency may cause problems with growth, diarrhea, and immune function. Mild zinc deficiency may be overlooked, since symptoms are not always obvious and may include loss of hair, appetite, weight, and the senses of taste and smell. Severe zinc deficiency contributes to numerous child deaths per year due to diarrhea, pneumonia, and malaria.

In a newly published Cochrane Review, researchers conducted a comprehensive literature search for data on the effects of zinc in children 6 months to 12 years-old. Eighty well-designed clinical trials with a total of 205,401 participants were ultimately identified for inclusion.

The Cochrane review found that giving children zinc supplement might reduce their risk of death in general, particularly their risk of death due to diarrhea. Children given zinc experience less diarrhea than children not given zinc. The review noted that zinc supplements may be associated with increased risk of vomiting.

The author concluded that the benefits of preventive zinc supplementation outweigh the harms in areas where the risk of zinc deficiency is relatively high. Further research should determine optimal intervention characteristics such as supplement dose.

Mayo-Wilson et al. Cochrane Database Syst Rev. 2014 May 15;5:CD009384. doi: 10.1002/14651858.CD009384.pub2

weight lossA low glycemic index (GI), low calorie diet with moderate amounts of carbohydrates is more effective for controlling hunger, and improving weight loss and insulin sensitivity than a low-fat, high GI diet.

Obesity is one of the most significant health concerns worldwide and is related to health issues such as hypertension, type 2 diabetes, cardiovascular disease, and some cancers. Low-glycemic index (GI) diets have shown to have beneficial effects in many chronic conditions such as these, but their impact on weight loss, satiety and inflammation are still somewhat inconclusive.

In a new study published online in the American Journal of Clinical Nutrition, researchers compared the effects of 3 diets on weight loss, satiety, inflammation and other metabolic markers. The randomized controlled study included 122 overweight or obese men and women aged 30 to 60 years. During the study period of 6 months, participants were randomly assigned to one of 3 isocaloric, energy-restricted diets: 1) a moderate carbohydrate and high-GI diet (HGI), 2) a moderate-carbohydrate and low-GI-Low Fat diet (LGI), 3) a low-fat and high-GI diet (LF) patterned after the American Heart Association Diet.

Reductions in BMI were greater in the Low GI group than the LF by week 16 and at the completion of the study. Measurements of insulin sensitivity, fasting insulin and beta-cell function were all significantly better in the LGI group than the LF group. Although the differences in the 3 groups didn’t reach statistical significance, there was a tendency for a greater improvement with a low-GI diet with respect to hunger, satiety, lipid profiles and other inflammatory and metabolic markers.

The results of this study showed that a low-calorie low-GI diet with moderate amounts of carbohydrates is more effective than a high-GI low-fat diet at decreasing body weight and improving markers of insulin metabolism.

Martí Juanola-Falgarona et al. Am J Clin Nutr June 2014. doi:10.3945/ajcn.113.081216.

LungRespiratory infectious conditions place a substantial health and economic burden on society. The economic impact of colds has been estimated to be $40 billion dollars in the USA annually. Recent systematic reviews have reported a positive, although modest, effect of probiotics in terms of preventing common cold symptoms. The recent systematic review further evaluated the effect of probiotics, specifically Lactobacillus and Bifidobacterium strains, on the duration of acute respiratory infections in otherwise healthy children and adults.

In the latest review, twenty randomised controlled trials (RCT) were included, of which twelve were considered to have a low risk of bias. The duration of probiotic treatment ranged from 3 weeks to 7 months, although the majority of trials were carried out for approximately 3 months over the winter months.

The meta-analysis revealed significantly fewer numbers of days of illness per person, shorter illness episodes by almost a day, and fewer numbers of days absent from day care/school/work in participants who received a probiotic intervention than in those who had taken a placebo.

In conclusion, this systematic review provides evidence from good-quality RCT that adding probiotics to diet helps reduce the duration of respiratory illness episodes in otherwise healthy children and adults and offers a viable cost-saving option in improving quality of life.

Sarah King et al; Br J Nutr. 2014 Apr 29:1-14

An analysis of 70 trials reveals that omega-3 supplementation may be as effective at reducing blood pressure as other lifestyle intervention.

Nearly 4 out of 10 Australian adults have elevated blood pressure, which is linked to an increased risk of strokes, coronary heart disease, and total mortality.  A recent metaanalysis published in the American Journal of Hypertension analyzed 70 RCT trials to determine the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on blood pressure.

Weighted differences were used to separate individuals into an EPA+DHA group and a placebo group. All of the studies combined resulted in a 1.52 mm Hg reduction in systolic blood pressure and a 0.99 mm Hg reduction in diastolic blood pressure for the EPA+DHA group over the placebo group.

Additional data was used to further separate these into subgroups for additional analysis. This revealed even stronger effects of EPA+DHA, where a 4.51 mm Hg reduction in systolic blood pressure and a 3.05 mm Hg reduction in diastolic blood pressure were observed among untreated hypertensive subjects. In this subgroup, EPA+DHA treatment was as effective, or more effective, at lowering blood pressure than other lifestyle-intervention including increasing physical activity and restricting alcohol and sodium.

These results continue to build on prior evidence showing that omega-3 fatty acids may play a role in helping individuals control their blood pressure. One of the authors, Dominik Alexander, PhD, noted that “when measuring blood pressure, even small reductions can have a significant clinical impact.” A 2 mm Hg reduction in blood pressure reduces stroke mortality by 6%, coronary heart disease mortality by 4%, and total mortality by 3%.

Overall, available evidence from randomised controlled trials (RCT) indicates that provision of EPA+DHA reduces systolic blood pressure, while provision of ≥2 grams reduces diastolic blood pressure.

Miller, P.E. et al. Am J Hypertens. 2014 Mar 6. [Epub ahead of print] PMID:24610882


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LemonResults from a new meta-analysis indicate an association between improved survival among women with breast cancer who have a higher intake of vitamin C from supplements or food.

The association between dietary vitamin C intake and breast cancer survival is inconsistent and few studies have specifically examined vitamin C supplement use among women with breast cancer. In a new study published online in the European Journal of Cancer, Swedish researchers summarized results from prospective studies to determine whether there is an association between vitamin C intakes and the risk of breast cancer mortality.

The current meta-analysis identified ten studies that included 17,696 women who were diagnosed with breast cancer. The studies examined the effect of dietary vitamin C intake or supplementing with vitamin C following breast cancer diagnosis.

When the studies that reported the effects of vitamin C supplements were evaluated, their use was associated with a 19% lower risk of total mortality and a 15% lower risk of dying from breast cancer in comparison with no use. When analyzing vitamin C intake from foods, researchers observed that for every 100mg per day increase in dietary vitamin C there was 27% decrease in total mortality and 22% decrease in breast cancer-specific mortality.

Results from this meta-analysis indicate that vitamin C supplement use after breast cancer diagnosis is associated with a reduction in total mortality and breast cancer-specific mortality. More studies on post diagnosis supplementation should be conducted to confirm these results and further our understanding of how their use during radiation or chemotherapy may influence breast cancer outcomes.

Holly R. Harris et al (May 2014), European Journal of Cancer, Vol.50 (7):1223–1231

SunshineA new meta-analysis reveals that higher Vitamin D levels are associated with significantly reduced mortality in patients with colorectal and breast cancer.

Breast cancer (BC) and colorectal cancer (CRC) are two of the most common causes of cancer death worldwide. These cancers share many of the same risk factors which include smoking, physical inactivity, poor diet, excessive alcohol consumption and obesity. The results of several studies have suggested that low vitamin D levels may be a potential risk factor for many cancers, including BC and CRC.

In a recent study published in the European Journal of Cancer, researchers summarized the evidence regarding a potential protective role of high Vitamin D levels with cancer mortality, and specifically among breast cancer and colorectal cancer patients.

The comprehensive literature search included studies which analyzed the association of vitamin D with suvival in breast cancer and colorectal cancer patients. The review included five studies of colorectal cancer patients (n=2,330), and five studies of breast cancer patients (n=4,413). The studies all compared mortality across two to five categories of vitamin D levels.

Among colorectal cancer patients, when compared to the category of lowest vitamin D, the group with the highest vitamin D levels had a 29% decreased risk of overall cancer mortality, and a 35% decreased mortality risk of CRC specifically. Comparing high to low vitamin D levels among breast cancer patients revealed a 38% and 42% reduction of overall cancer and BC mortality respectively.

These results showed that higher Vitamin D levels (>75nmol/L or 30 ng/dl) were associated with significantly reduced mortality in patients with colorectal and breast cancer. Randomised controlled trials are needed to evaluate whether vitamin D supplementation can improve survival in colorectal and breast cancer patients with low vitamin D status (25(OH)D<50nmol/L) at diagnosis and before treatment

Maalmi H. et al. Eur J Cancer. 2014 Feb 27. pii: S0959-8049(14)00124-5.

Research on omega-3 fatty acid levels in women during late pregnancy reveals a connection between low omega-3 intake during pregnancy and higher risk of postpartum depression.

Postpartum depression is a relatively common disorder that can lead to unhealthy early mother-infant interaction and potentially poor early childhood development. It is estimated that the disorder may affect as many as 10-15% of women in the first three months after birth. Several previous studies have looked at the possible connection between seafood intake and the incidence of postpartum depression.

In a study published online in PLos One, researchers sought to determine whether a low maternal omega-3 index in late pregnancy was associated with higher levels of postpartum depressive symptoms. The omega-3 index is a measurement of the omega-3 fats EPA and DHA in red blood cells, expressed as a percentage of total fatty acids.

The study group included 72 Norwegian women who were pregnant between November 2009 and June 2011. At 28 weeks of pregnancy, blood samples were taken from the mothers to determine the fatty acids status. At the well-baby check-up 3 months postpartum, a regional version of the Edinburgh Postnatal Depression Scale (EPDS) was used to determine the level of depressive symptoms in the mothers.

The women with a lower omega-3 index had a higher level of depressive symptoms three months after pregnancy. When analyzing percentage of DHA alone, the association was even more significant. In addition to the omega-3 index and DHA content, other measures such as the omega-3/omega-6 ratio were also inversely correlated to higher depressive symptoms. The reported dietary and supplemental intake of fish was highly correlated to the measured omega-3 index.

Since a low omega-3 index during pregnancy may be associated with a higher rate of depression symptoms after childbirth, increasing seafood or omega-3 supplement intake during and after pregnancy should be encouraged, especially in those that eat little to no seafood.

The researchers also suggest that larger and more powerful intervention studies should be completed, since there are currently no established reference values for fatty acid status in pregnant or lactating women.

Markhus MW et al. (2013). PLoS ONE 8(7): e67617.


salmonThe results of a new meta-analysis shows that long-term supplementation with omega-3s reduce blood markers of inflammation and may reduce the risk of chronic inflammatory-related diseases.

Inflammation is known to play a role in numerous chronic diseases such as diabetes, cardiovascular disease (CVD), obesity-related diseases, rheumatoid arthritis and other autoimmune diseases.  Omega-3 fatty acids have often been linked to providing benefits regarding these conditions, likely due to their anti-inflammatory function.

In a recent meta-analysis published in the online journal PLoS One, scientists reviewed the literature to determine the effect of marine-derived omega-3s on blood levels of several markers of inflammation.

The meta-analysis included 4,601 participants from 68 randomized, controlled trials of healthy subjects, subjects with chronic autoimmune diseases, and subjects with chronic non-autoimmune diseases (ie. cardiovascular disease). Fasting blood levels of the inflammatory markers TNF-a (tumor necrosis factor-alpha), IL-6 (interleukin-6) and CRP (C-reactive protein) were compiled and analyzed. Researchers also separated studies using omega-3s from supplementation as active treatment with those using omega-3s from dietary intake (fish) and included them into different meta-analyses.

A combined analysis of all study subjects revealed a significant link between omega-3 supplementation and decreased blood levels of CRP and IL-6. Among the subjects with chronic non-autoimmune disease, a longer duration of supplementation related to an even greater reduction in blood levels of IL-6 and TNF-a.  A similar finding was observed for IL-6 levels among healthy subjects. Higher dietary intake of omega-3s did result in lower IL-6 levels, but fish intake alone (without supplementation) did not appear to lower CRP or TNF-a.  The benefits of omega-3 supplementation were also more significant in non-obese subjects (BMI <30), particularly in the chronic non-autoimmune disease group.

The results of this study confirm that long-term supplementation of omega-3s from fish oil can effectively lower inflammatory markers and may help reduce the risk of chronic inflammation.

Li K, Huang et al.  PLoS ONE (2014); 9(2): e88103.

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