bluuebunny/crossref_metadata_2025 huggingface dataset:
Obesity, Bariatric Surgery, and the Gut Microbiome
Authors: Ilhan Zehra
Published: June 2021

The long‐term success of Roux‐en‐Y gastric bypass (RYGB) surgery varies among patients; however, microbiota structure and how it affects success of the surgery in the long‐term are unknown. We hypothesize that the microbiome plays a role in successful and sustainable weight loss after RYGB surgery. We recruited post‐RYGB (> 13 months), normal‐weight, and morbidly obese subjects and categorized the RYGB subjects into successful (S‐RYGB) and unsuccessful (U‐RYGB) groups based on their initial weight loss and subsequent weight regain. We investigated gut microbiota's structure and function using16S rDNA sequencing and the metabolome using H‐NMR. Phylotype diversity (PD Whole Tree index), an indicator of the microbiome stability and function, was higher in the normal‐weight and S‐RYGB groups. High abundance of Enterobacteriales in RYGB groups showed that their abundance was not due to antibiotic treatment for surgery, but likely due to environmental changes imposed on the community due to the rearranged gut anatomy. Generally, fermentation products were higher in fecal samples of obese individuals and lower for the RYGB groups. More importantly, specific amino acids such as lysine and tryptophan were more abundant in the S‐RYGB group. Careful analysis of our wide range of genomic and metabolic data is helping us uncover possible mechanisms for the hypothesized role of the gut microbiome and successful weight loss after RYGB.
Reflex Control of Cutaneous Vasoconstriction during Whole‐body Cooling in Aged Humans
Authors: Greaney Jody , Stanhewicz Anna , Kenney W. , Alexander Lacy
Published: June 2021

Reflex cutaneous vasoconstriction (VC) is impaired in human aging; however, the relative causative contributions of altered skin sympathetic nervous system activity (SSNA), signal transduction, and end‐organ responsiveness are unclear. We hypothesized that 1) whole‐body cold stress would elicit blunted SSNA responses in healthy older (O) compared to young (Y) adults and 2) cutaneous adrenergic responsiveness would be reduced in O adults. 10 Y (24±1 yrs) and 11 O adults (57±2 yrs) participated in two protocols. In Protocol 1, reflex VC was induced by gradual whole‐body cooling (mean skin temperature = 30.5°) using a water‐perfused suit. SSNA (peroneal microneurography) and red cell flux (laser Doppler flowmetry; dorsum of foot) were measured continuously. SSNA was expressed as a percentage of baseline. In Protocol 2, an intradermal microdialysis fiber was placed in the skin of the lateral calf to measure red cell flux in response to graded intradermal infusions of norepinephrine (NE; 10‐12 to 10‐2 M). In each study, cutaneous vascular conductance (CVC=flux/mean arterial pressure) was expressed as a change from baseline. Reflex cutaneous VC was attenuated in O adults (‐0.034±0.01 Y v. ‐0.018±0.01 O ΔCVCbase; P<0.05). SSNA increased during cooling in Y (273±37%; P<0.05) but not O adults (143±10%; P>0.05). There was no age‐related difference in cutaneous adrenergic responsiveness to exogenous NE (dose‐response logEC50; ‐6.6±0.4 Y vs. ‐7.0±0.3 O; P=0.57). These data demonstrate that age‐related impairments in reflex cutaneous VC are mediated in part by blunted SSNA responses and not by reduced cutaneous adrenergic responsiveness, suggesting that presynaptic synthesis and/or SSNA‐mediated release of vesicular NE is decreased in aged skin.
Augmentation of Endothelium‐Dependent Vasodilatory Signaling Improves Functional Sympatholysis in Contracting Muscle of Older Adults
Authors: Hearon Christopher , Racine Matthew , Richards Jennifer , Luckasen Gary , Larson Dennis , Dinenno Frank
Published: June 2021

Sympathetic α‐adrenergic vasoconstriction is blunted within contracting skeletal muscle, and this 'functional sympatholysis' is impaired with age and may contribute to impaired blood flow during exercise in older adults. We have demonstrated that increasing endothelium‐dependent vasodilatory signaling during exercise in young individuals can augment sympatholysis. The purpose of this study was to determine if augmentation of endothelium‐dependent signaling in older adults can improve sympatholysis. In 10 older individuals, we measured forearm blood flow (Doppler ultrasound) and calculated vascular conductance (FVC) responses to local intra‐arterial infusion of phenylephrine (PE; α 1‐agonist) during 1) infusion of the endothelium‐dependent vasodilator acetylcholine (ACH), 2) mild (5% maximum voluntary contraction; MVC) or moderate (15% MVC) intensity handgrip exercise, and 3) mild or moderate exercise + ACH infusion. Vasoconstriction to PE during mild and moderate exercise was similar (ΔFVC: ‐28±3 and ‐26±4%) and was not blunted compared to that observed during ACH (ΔFVC: ‐28±3%). Augmentation of endothelium‐dependent signaling via ACH during mild exercise had no effect on PE mediated vasoconstriction (ΔFVC: ‐25±2%), whereas ACH infusion during moderate exercise significantly blunted vasoconstriction (ΔFVC: ‐13±1%; P<0.05 vs all conditions). These data suggest that augmenting endothelium‐dependent signaling in older individuals improves functional sympatholysis, and may be a strategy to promote tissue blood flow with age. Support: HL102720
Coronary Blood Flow Regulation is Impaired During Exercise in Patients with Peripheral Arterial Disease
Authors: Ross Amanda , Muller Matthew , Gao Zhaohui , Sinoway Lawrence
Published: June 2021

Peripheral arterial disease (PAD) is associated with an augmented blood pressure response while walking, impaired vascular function, and increased risk of myocardial infarction. We hypothesized that coronary exercise hyperemia is impaired in PAD. Seven PAD patients (67± 2 yrs) and 11 healthy controls (64 ± 2 yrs) performed dynamic plantar flexion exercise at progressive workloads (0.5 ‐ 7.0 kg) with their most symptomatic leg. Coronary blood flow velocity (CBV) in the left anterior descending artery was measured by transthoracic Doppler echocardiography and blood pressure and heart rate were monitored continuously. Rate Pressure Product (RPP) and the myocardial O2 supply/demand ratio (CBV/RPP *1000) were calculated. Since PAD patients exercised for a shorter duration, data were compared at the 2.0 kg workload, which all subjects performed with minimal pain. The change in RPP from rest to exercise at 2.0 kg was augmented in PAD patients vs. controls (2417 ± 489 vs. 1026 ± 143 mmHg*bpm, P = 0.01). The change in the myocardial O2 supply/demand ratio from rest to exercise was impaired in PAD patients vs. controls (2.94 ± 0.99 vs. 5.17 ± 1.35 au, P = 0.05). These data suggest that coronary hyperemia is inadequate for the large rise in myocardial metabolism during low intensity exercise in PAD, which may increase risk for adverse cardiovascular events.
Tetrahydrobiopterin Ameliorates the Exaggerated Exercise Pressor Response in Patients with Chronic Kidney Disease
Authors: Park Jeanie , Quyyumi Arshed
Published: June 2021

CKD patients have an exaggerated blood pressure (BP) response during rhythmic handgrip exercise (RHG 20%). Nitric Oxide (NO) levels increase substantially during exercise and help prevent excessive hypertension; therefore, reduced NO bioavailability may be one factor contributing to the exaggerated exercise pressor response, since CKD is characterized by decreased NO bioavailability. Tetrahydrobiopterin (BH4) is an essential cofactor for nitric oxide synthase that has been shown to increase NO bioavailability in experimental models of CKD. Therefore, we hypothesized that BH4 may ameliorate the exaggerated increase in BP during RHG 20%. In a randomized, double‐blinded, placebo‐controlled trial, we tested the effects of 12 weeks of oral BH4 treatment versus placebo on BP and muscle sympathetic nerve activity (MSNA) responses during RHG 20% in CKD. At baseline, CKD patients (N=32) had significantly higher BP responses, but equicovocal MSNA responses during RHG 20% compared to Controls without CKD (N=10). The CKD patients only were then randomized to BH4 versus placebo. In contrast to patients randomized to placebo (N=14), those randomized to BH4 (N=18) had a significant reduction in the BP response during RHG 20%, but no change in MSNA response. A subset of CKD patients randomized to placebo received intravenous nitroprusside (NTP) infusion during RHG 20% to lower BP responses to equal that of BH4‐treated patients; MSNA response during RHG20% was significantly lower after BH4 compared to after placebo when the BP responses were equalized with NTP. These findings suggest that BH4 ameliorates the exaggerated exercise pressor response in CKD via mechanisms both dependent and independent of sympathetic nerve response.
Overactivation of muscle mechanoreflex in human hypertension
Authors: Velasco Alejandro , Wang Zhongyun , Arbique Debbie , Smith Scott , Mitchell Jere , Vongpatanasin Wanpen
Published: June 2021

Our previous study in patients with mild essential hypertension demonstrated that moderate level rhythmic handgrip (RHG) at 30% maximal voluntary contraction (MVC), which typically had no effect on sympathetic nerve activity (SNA) in healthy normotensive subjects, evoked asympathoexcitatory response in hypertensive subjects. This finding indirectly suggested that mechanoreflex function was enhanced in hypertension. However, mechanoreflex function has not been directly assessed in hypertensive patients.

Accordingly, we measured SNA with intraneural microelectrodes in 5 subjects with untreated hypertension (HTN) and 6 age‐matched normotensive controls (NT) during passive arm cycling (PAC). PAC was used to preferentially stimulate the mechanoreflex. Surface electromyography was monitored during arm cycling to avoid inadvertent muscle contraction.

We found that SNA increased significantly in HTN compared to NT within the first minute of PAC, which was sustained at 3 minutes (27±10 vs. 2±6% total activity, p < 0.05). The increase in SNA was accompanied by a significant increase in mean arterial pressure (MAP) from 102±4 to 106±3 mmHg in the HTN group (p <0.05), while MAP remained unchanged in NT group (96±3 vs. 96±3 mmHg, p = NS). Rhythmic handgrip at 30% MVC also induced greater increases in SNA in the HTN than NT group (46±14 vs. ‐1±6% total activity, p <0.05).

Thus, our data represent the first direct evidence for enhanced mechanoreflex function in human hypertension.
Resting brachial artery shear rate is associated with exercise habituation in middle aged and older adults
Authors: Tanahashi Koichiro , Akazawa Nobuhiko , Choi Youngju , Kosaki Keisei , Sugawara Jun , Maeda Seiji
Published: June 2021

Hemodynamic shear stress, a frictional force of blood on the arterial wall, decreases with aging. The reduction in shear stress involved in development and progression of vascular endothelial dysfunction, a risk factor of cardiovascular disease. Habitual exercise is an effective strategy to improve vascular endothelial function. However, the effect of habitual exercise on the resting shear stress is unknown. The aim of this study was to determine whether brachial artery shear stress correlates with exercise habituation in middle aged and older adults.

A total of 112 healthy middle aged and older adults (50–76 years) participated in this study. We measured peak and mean brachial artery shear rates, as indices of shear stress, at rest. Daily step counts and maximum oxygen consumption (VO2max) were measured as an index of exercise habituation. Subjects were divided into the inactive group (< 7500 steps/day) and the active group (蠅 7500 steps/day).

VO2max was significantly higher in the active group than in the inactive group (P < 0.01). Peak shear rate and mean shear rate in the active group were significantly higher than in the inactive group (P < 0.01 and P < 0.05). VO2max correlated significantly with peak (r = 0.362, P < 0.01) and mean shear rates (r = 0.302, P < 0.05). These associations were remained significant even when adjusted for age.

These results suggest that habitual exercise may increase resting brachial artery shear stress in middle‐aged and older adults.
Assessing Kinetics of Functional Electrical Stimulation Rowing in Spinal Cord Injury Patients
Authors: Draghici Adina , Shefelbine Sandra , Taylor J Andrew , Picard Glen
Published: June 2021

‘Hybrid’ functional electrical stimulation (FES) ergometer rowing is a novel training therapy that enables the spinal cord injury (SCI) population to exercise the innervated upper body together with the electrically stimulated lower body muscles. This produces significantly greater aerobic power and peak oxygen consumption than either upper body or FES exercise alone. However, there is minimal information on the mechanical efficiency of FES‐rowing in the SCI population. A Concept 2 rowing ergometer was adapted to accommodate SCI patients and was instrumented to record upper body force and lower limbs forces. The objective of this work was to characterize efficiency during FES‐rowing by measuring the forces applied by the arms and the legs and the parameters observed during maximal aerobic capacity tests in SCI and able‐bodied rowers. The current setup allows correlating changes in oxygen consumption with changes in effective muscle forces collected at the feet and handle at three submaximal rowing intensities and during a submaximal bout of rowing to fatigue in SCI and able‐bodied rowers. The data suggests that while able‐bodied rowers increase legs and arms forces proportional with increased rowing intensity, the SCI rowers use primarily their arms to achieve a higher rowing wattage. FES‐rowing has positive effects on cardio‐respiratory fitness showing an increase in oxygen consumption; however, we hypothesize that this effect would be greatly enhanced by increasing the mechanical work done by the legs in SCI rowers.
Race Differences in Erythropoietin, 25‐hydroxyvitamin D, and Hemoglobin Before and After Weight Loss in Women
Authors: Carter Stephen , Fisher Gordon , Plaisance Eric , Fernandez Jose , Gower Barbara , Hunter Gary
Published: June 2021

Low hemoglobin (Hb) is a predictor of cardiovascular disease, thus, variables known to influence Hb are of clinical relevance. We examined the interrelationships of testosterone, erythropoietin (EPO), 25‐hydroxyvitamin D [25(OH)D] and Hb before and after weight loss. Overweight African American (AA) and European American (EA) women were provided a standardized 800 kcal/d diet for the purpose of reducing BMI < 25 kg/m2. Physiological measures and blood sampling were performed at baseline and upon reaching target BMI. Testosterone was similar between races before and after weight loss. Yet, Hb (AA, 11.6 ± 0.9 g/dL vs. EA, 12.5 ± 0.8 g/dL; P < 0.01) and 25(OH)D (AA, 14.2 ± 5.4 nmol/L vs. EA, 19.6 ± 5.9 nmol/L; P < 0.01) were lower while EPO was higher (AA, 14.3 ± 9.8 mIU/mL vs. EA, 7.9 ± 2.4 mIU/mL; P < 0.01) in AA women compared to EA women at baseline. Following weight loss, Hb was significantly decreased in both races (AA, ‐0.5 ± 0.7 g/dL vs. EA, ‐0.4 ± 0.6 g/dL; P < 0.01). Additionally, 25(OH)D (AA, +3.3 ± 5.4 nmol/L vs. EA, +4.5 ± 6.7 nmol/L; P < 0.05) and EPO (AA, +10.0 ± 23.8 mIU/mL vs. EA, +0.9 ± 4.5 mIU/mL, P < 0.01) were increased in both races. Changes in Hb from baseline to weight loss were positively associated with changes in 25(OH)D (r = 0.35; P < 0.01) and negatively associated with changes in EPO (r = ‐0.72; P < 0.01). Hb decreased as 25(OH)D and EPO increased with controlled weight loss among AA and EA women. Despite higher EPO, AAs had lower Hb that may have been mediated by lower 25(OH)D. Given the extent Hb was decreased, a large proportion of women particularly AA, were below the accepted threshold (< 12 g/dL) for anemia.
Effects of Aging and Treadmill Exercise on the Expression of Neurotrophin and Glutamate Receptors in the Hippocampus
Authors: Maejima Hiroshi , Kanemura Naohiko , Kokubun Takanori , Murata Kenji , Takayanagi Kiyomi
Published: June 2021

The objective of this study was to investigate the effects of aging and moderate exercise on the expression of neurotrophin and glutamate receptors in the hippocampus using senescence‐accelerated mouse P1 (SAMP1) and its age‐matched control mouse (SAMR1). The mice were assigned to four groups (SAMP1‐sedentary, SAMP1‐exercise, SAMR1‐sedentary and SAMR1‐exercise). The mice in the exercise groups performed moderate treadmill exercise (12 m/min, 60 min) five times a week for four weeks. The mRNA expression of brain‐derived neurotrophic factor (BDNF), the receptor of BDNF (TrkB), and NMDA receptor subunits (NR1 and NR2A) in the hippocampus were measured based on real time PCR. All protocols were approved by the ethics committee for animal research of Saitama Prefectural University. Exercise increased the expression of BDNF and NR1 only in SAMP1, whereas there was no significant effect of exercise on the expression of target genes in SAMR1. Though aging decreased the expression of TrkB, exercise increased the expression of TrkB only in SAMP1 as in BDNF and NR1. Taken together, SAMP1 mice were more sensitive to the exercise in the expression of neurotrophin and the receptors than SAMR1. This study elucidated the beneficial effects of the moderate exercise on the expression of NMDA receptor subunit, BDNF and the receptor of BDNF especially in the aged hippocampus, suggesting that moderate exercise has protective effects against degenerative diseases in the elderly. This work was supported by JSPS KAKENHI Grant 21500471
Respiratory and cardiovascular modulations in patients with spinal cord injury
Authors: Aslan Sevda , Ovechkin Alexander
Published: June 2021

Evaluation of autonomic cardiovascular deficits is clinically important to investigate the extent of impairment after spinal cord injury (SCI), and is based on recordings of blood pressure (BP) and heart rate (HR) in response to various conditions including orthostatic stress. Spectral power analyses of BP and HR oscillations during these tests can be used to evaluate sympathetic (0.04‐0.15Hz) and parasympathetic (0.15‐0.4Hz) regulations of cardiovascular function. These tests don't include the monitoring of respiration with the assumption that amplitude and frequency of these oscillations are regular, and located within the parasympathetic frequency range. However, respiratory insufficiency is common in SCI individuals due to paralysis, muscle weakness and/or spastic contractions of the muscles involved in respiration. We hypothesized that oscillatory respiratory patterns observed in SCI patients have a different autonomic effects compared to those in non‐injured. The aim was to investigate in what extent respiratory oscillatory patterns can affect autonomic cardiovascular responses in individuals with different neurological levels and severity of SCI. BP, HR and respiratory kinematics were recorded continuously at rest and in response to orthostatic stress in SCI and non‐injured subjects. SCI individuals demonstrated irregular breathing patterns that resulted in two main peak frequencies located both below and above 0.15 Hz. Magnitude of cross correlation between respiratory and both HR and BP significantly increased in frequencies below 0.15Hz and decreased above 0.15 Hz compared to non‐injured group. These results indicate that respiratory related oscillations in BP and HR can be augmented due to both pulmonary and autonomic nervous system dysfunction after SCI.
Clozapine, An Atypical Antipsychotic, Reduces The Contribution Of Brown Adipose Tissue (BAT) To Emotional Hyperthermia In Rats
Authors: Mohammed Mazher , Ootsuka Youichirou , Blessing William
Published: June 2021

Clozapine is an atypical antipsychotic drug used in patients with schizophrenia. Animal models of clozapine's actions are difficult to develop. BAT thermogenesis is increased by 5‐HT2A receptor activation and decreased by 5‐HT1A receptor activation in the CNS. Clozapine's interaction with these receptors predicts that the drug reduces BAT thermogenesis. We tested this in animal model in which BAT thermogenesis is initiated in a resident rat by introduction of an intruder rat confined to a small cage (Mohammed et al., 2012). ) Thermistor probes, connected to a headpiece, were placed in anterior mediastinum and interscapular BAT of anesthetized male Sprague‐Dawley rats (350‐450g. After 1 week the rat was maintained in a quiet, temperature controlled environment with ad libitum food and water. BAT and body temperatures were monitored via a swivel device. Clozapine was administered (0.03, 0.125, 0.5 and 2 mg/kg in 0.5 ml of acidified Ringer via subcutaneous catheter) and 30 min later the caged intruder was introduced for 30 min. At the lowest clozapine dose, the increase in BAT temperature (0.8±0.1C°) was greater (P<0.01) than the increase in body temperature (0.5±0.1C°). Clozapine, in a dose‐responsive manner, reduced the increase in BAT and body temperatures elicited during sudden confrontation with an intruder rat (log‐dose regression P<0001, R2 = 0.52, for BAT and P<0.01, R2 = 0.32 for body). Thus clozapine reduces BAT thermogenesis initiated by salient, threatening environmental events, thereby reducing emotional hyperthermia. BAT thermogenesis occurs in adult humans, possibly excessively in schizophrenics, so that our animal model may illuminate clozapine's therapeutic action and its contribute to obesity.

Supported by NHMRC
The Aging Brain
Authors: McCullough Louise
Published: June 2021

Aging is an important risk factor for the development of many chronic illnesses that increase functional disability and limit survival, including vascular disease, diabetes and dementia. These diseases are becoming increasingly prevalent in the US with the growth of our elderly population. One consistent finding in aging individuals and animals is the evidence of persistent low level elevations in circulating markers of inflammation, a phenomenon known as “inflammaging”. This pro‐inflammatory phenotype contributes to a global reduction in the capability of older individuals to cope with antigenic, toxic, physical and ischemic stressors. Elevated levels of inflammatory markers are strongly associated with increased risk for diabetes, coronary heart disease, frailty, stroke and mortality. Aging not only leads to higher baseline levels of systemic inflammatory markers, but also enhances baseline and stimulus‐induced pro‐inflammatory cytokine levels in the brain.

Advanced age increased T cells, dendritic cells (DCs) and myeloid cells (primarily neutrophils) at the site of injury, which contribute to the exacerbated behavioral deficits in the aged. Our work has shown that dramatic age‐related changes are present in the microbiome, contributing to breakdown of the intestinal barrier, loss of bacterial containment, and chronic activation of the immune system with aging. In addition, accumulation of adipose tissue, up‐regulation of vascular adhesion molecules, and thymic involution lead to defects in cellular immunity in aged mice. Age‐related changes that occur in the brain will be reviewed. New research from our laboratory and from that of others suggesting that this age‐associated damage can be reversed will be discussed.
The Ups and Downs of Aging in the Male Genitourinary Tract
Authors: Hannan Johanna
Published: June 2021

Lower urinary tract symptoms (LUTS), are a collection of filling, storage, voiding and postmicturition symptoms highly prevalent and negatively impacting the quality of life of aging men. These symptoms are commonly caused by benign prostatic hyperplasia (BPH), and additional risk factors include obesity, diabetes, hypercholesteremia and hypertension. In order to understand the pathological changes that occur in the lower male genitourinary (GU) tract, it is important to review the normal anatomy, physiology, vascular and neural control of the bladder, prostate and penis. Significant alterations in the male GU tract with aging manifest as impairments in physiological functions such as blood flow, neuropathy, fibrosis, and hypertrophy. Prostate enlargement (BPH) with bladder outlet obstruction due to dynamic and statics factors such as smooth muscle cell hyperplasia impair bladder emptying and promote dysfunction. Sexual dysfunction is highly prevalent and results from loss of compliance of the penile sinusoids associated with increased deposition of collagen, decreased elastic fibers, endothelial dysfunction, and neuropathy. Additionally, aging and cardiovascular disease can impair the structure and function of the internal pudendal arteries which supply blood to the penis during an erection. Understanding the changes in anatomy, the symptoms associated with impaired lower GU function and disease‐specific therapies for these conditions will no doubt improve the care and quality of life for our aging male population.
Low‐Fat Diets Differing in Protein and Carbohydrate Content on Cardiometabolic Risk Factors in Adults with Type 2 Diabetes
Authors: Watson Nerylee , Dyer Kathryn , Buckley Jonathon , Brinkworth Grant , Coates Alison , Parfitt Gaynor , Howe Peter , Noakes Manny , Murphy Karen
Published: June 2021

Objective

To compare the effects of a higher‐protein (HP) diet and a higher‐carbohydrate (HC) diet on cardiometabolic risk factors in type 2 diabetes (T2DM) in phases of weight loss and weight maintenance.

Methods

Overweight/obese adults (n = 61, BMI 33.5 ± 4.8kgm2, aged 37 – 67 years) with T2DM were randomized to a hypocaloric HP diet (38% carbohydrate, 30% protein, 29% fat) or an isocaloric HC diet (53%,21%,23%) for 12 weeks, after which energy was adjusted to maintain a stable weight for a further 12 weeks. Outcomes were measured at baseline and the end of each phase.

Results

Forty four participants completed the study (HP n=23, HC n=21). Following weight loss, there were significant (p<0.05) reductions in body mass (‐7.7 ± 4.0kg), waist circumference (‐7.6 ± 4.5cm), blood pressure (‐9.6/‐7.2 ± 9.7/6.1mmHg), HbA1c (‐1.4 ± 1.1%), fasting glucose (‐2.5 ± 2.8mmol/L), fasting insulin (‐8.5 ± 10mU/L) and triglycerides (‐0.6 ± 1.1mmol/L). In the weight maintenance phase there were small increases (p<0.05) in total cholesterol (0.2 ± 0.5mmol/L) and HDL (0.1 ± 0.2mmol/L); no other outcomes changed (p>0.05). There were no significant differences between diets in either phase.

Conclusion

Substantial improvements in cardiometabolic risk factors were achieved with weight loss in both diets and continued during weight maintenance.
Study was funded by a grant from the Pork Co‐operative Research Center.
Index‐based Dietary Patterns and All‐cause and Cause‐specific Mortality Stratified by Body Mass Index and Race/Ethnicity: NIH‐AARP Diet and Health Study
Authors: Schap T , Subar A , Anic G , George S , Krebs‐Smith S , Park Y , Reedy Jill
Published: June 2021

Objective

to examine how four diet quality indices– the Healthy Eating Index‐2010 (HEI‐2010), Alternative Healthy Eating Index (AHEI‐2010), alternate Mediterranean Diet Score (aMED), and Dietary Approaches to Stop Hypertension (DASH) Score – are associated with all‐cause, cardiovascular disease (CVD), and cancer mortality when stratified by body mass index (BMI: normal <25 kg/m2, overweight 25‐蠄30 kg/m2, obese 蠅 30kg/m2) and race/ethnicity (white, black) in the NIH‐AARP Diet and Health Study (n=492,823). Data from a 124‐item food frequency questionnaire were used to compute scores; adjusted hazard ratios (HR) and 95% CI were estimated using Cox proportional hazards regression. We documented 86419 deaths. For all BMI categories, higher diet quality index scores were associated with an 8‐30% reduced all‐cause and cancer mortality risk. For CVD mortality, normal and overweight individuals had a 16‐40% significantly reduced risk; reduced risk was not significant for obese individuals, with the exception of AHEI for men, HR = 0.84 (95% CI:0.75,0.92). For whites and blacks, higher scores were associated with an 11‐25% reduced risk for all‐cause mortality. For whites, high adherence for each index was protective for CVD and cancer mortality. For blacks, this relationship was not consistently significant across indices and cause‐specific outcomes. Only aMED (among women) and HEI (among men) were associated with reduced CVD and cancer mortality risk. Sample size may be a factor in non‐significant associations found among blacks. These findings suggest that adherence to healthy diets may lower the risk of mortality even for overweight and obese individuals.
Household‐level Analysis of Shared and Unique Predictors of Central Obesity in Chinese Children and Adults
Authors: Thompson Amanda , Houck Kelly , Adair Linda , Gordon‐Larsen Penny , Popkin Barry
Published: June 2021

Research into the impact of changing social and physical environments on obesity has been limited by methodological difficulties in distinguishing between the effects of individual developmental trajectories and macro‐level changes in diet, disease, and lifestyle. We examined the patterning of central obesity (waist‐to‐height ratio (WHtR) >0.5) in 1900 households participating in the China Health and Nutrition Survey. Adjusted multilevel regression models were used to identify shared and unique predictors of central obesity within households to assess how differences in developmental history and age shape risk. High WHtR was present in 10% of children, 45% of parents, and 74% of grandparents. Across the sample, urbanicity (OR: 1.57, 95%CI: 1.23‐2.01) was positively associated with high WHtR while higher quartiles of household sanitation (OR: 0.84, 95%CI: 0.75‐0.93) and physical activity (OR: 0.88, 95%CI: 0.8‐0.97) were negatively associated with high WHtR. Within households, the impact of socioeconomic status, diet, household sanitation, and physical activity on WHtR varied across family members with some factors, such as income quartile, associated with higher WHtR in children but lower WHtR in their grandmothers and mothers and others, such as household sanitation, only having a significant negative association with WHtR in older adults. These results suggest that developmental history may shape current vulnerability to central obesity even when accounting for shared environments and age.
Food Security among Households with Children in Indiana Improved Following a Supplemental Nutrition Assistance Program—Education Intervention
Authors: Rivera Rebecca , Maulding Melissa , Abbott Angela , Eicher‐Miller Heather
Published: June 2021

Objective

The effects of a Supplemental Nutrition Assistance Program‐Education (SNAP‐Ed) intervention on the food security of households with children in Indiana were determined.

Methods

A randomized, controlled, intervention study design using SNAP‐Ed as the intervention was implemented throughout Indiana from 8/2013 to 2/2014. Five hundred sixty SNAP‐Ed eligible participants 蠅18y were recruited and randomly allocated to receive 蠅4 SNAP‐Ed lessons or not during the 4 to 10 week study period, before and after which they also completed the 18‐item US Household Food Security Survey Module to assess food security status and a characteristics questionnaire. Analysis of covariance modeling, adjusted for participant and household characteristics, was used to determine changes in household food security status (p蠄0.05).

Results

The mean household food security improvement from before compared with after the study period was greater in the intervention (‐1.0, s=3.3) compared with the control group (‐0.4, s=2.7) in simple (p=0.04) and adjusted models (β= ‐0.7, p=0.03).

Conclusion

The SNAP‐Ed program is an effective intervention to improve food security in households with children in Indiana over a short‐term period.

Funding This project was supported with a grant from the University of Kentucky Center for Poverty Research through funding by the U.S. Department of Agriculture, Food and Nutrition Service, contract number AG‐3198‐S‐12‐0044.
Diet Influences the Oral Microbiota of Infants during the First Six Months of Life
Authors: Holscher Hannah , Mathai Rose , Kim Juhee , Swanson Kelly
Published: June 2021

Oral bacteria and fungi contribute to oral health and establishment of the distal gastrointestinal tract microbiota; however, the impact of diet on the oral microbiota of infants is under‐investigated. We aimed to characterize the influence of feeding method (exclusive human milk [HM], formula [FF], HM + FF [mixed], and solid foods) on oral bacterial and fungal communities in vaginally delivered infants during the first 6 mo of life. Infant (N=12) feeding records and tongue and cheek swabs were collected within 24 hr of birth, and at 2, 4, and 6 mo of age. DNA was extracted, sequenced on an Illumina MiSeq, and analyzed with QIIME 1.8 and SAS. Bacterial diversity was lowest in HM and highest in FF and solid food fed infants (p<0.01). Principal coordinates analysis (PCoA) of UniFrac distances between samples based on their 97% OTU composition and abundances indicated that bacterial communities were impacted by feeding method (p<0.005). Infants fed HM or mixed diets had reduced relative abundances of Bacteroidetes while solid foods increased Fusobacteria (p<0.05). Infants had greater proportions of Proteobacteria at birth compared to other time points (p<0.05). Among genera, Streptococcus predominated in all infants, with the highest proportions in HM or mixed diets. Compared to HM, the relative abundances of Prevotella were increased with FF (p=0.01) and solid foods (p=0.02). Fungal communities were not impacted by diet. Five infants had detectable levels of fungi within 24 hr of birth, 4 at 2 mo, 9 at 4 mo, and 10 at 6 mo. These novel findings demonstrate that the oral microbiota of infants differs depending on dietary composition during the first 6 mo of life. Funded by Hatch Project #ILLU‐971‐350.
Maternal Metformin Treatment During Obese Pregnancy Reduces Offspring Fatty Liver and Hepatic Inflammation
Authors: Thomas Hugh , Berlanga Alba , Byrne Christopher , Cagampang Felino
Published: June 2021

Obesity during pregnancy raises offspring risk of non‐alcoholic fatty liver disease (NAFLD) in adulthood. The anti‐diabetic drug metformin (MET) is prescribed for gestational diabetes treatment, yet long term effects of MET during obese pregnancy on offspring NAFLD risk are unknown. We investigated the impact of maternal MET treatment in obese pregnant mice on glucose tolerance (GT), insulin resistance (IR), body fat (BF%) and NAFLD severity in adult offspring.

Female C57/BL6J mice were fed control (C) or high fat (HF) diet 6 weeks prior to mating through pregnancy and lactation. Half the pregnant C and HF dams were given MET in drinking water (250mg/kg bodyweight/day) during pregnancy and lactation. Female offspring were weaned onto C or HF diet, giving 8 offspring groups (C/C, C/HF, HF/C, HF/HF and CMET/C, CMET/HF, HFMET/C and HFMET/HF). At 28 weeks GT tests were performed. Offspring were killed at 30 weeks, BF% assessed by μCT scan and livers collected. Expression of hepatic inflammatory genes was measured by RT‐PCR. IR was determined by HOMA‐IR. NAFLD severity was assessed by histological scoring. Data was analysed by mixed effects model.

Offspring of HF dam were fatter and had impaired GT and IR compared to offspring of C dam (p<0.05). Offspring of HF dams treated with MET had reduced body fat (mean effect size (ME) 0.8‐fold, p<0.05), improved GT and IR (ME 1.4‐ and 2.3‐fold respectively, both p<0.01), reduced NAFLD severity and lowered expression of inflammatory genes CCL2, TLR2, TLR4 and Osteopontin (p<0.05) vs offspring of untreated HF dams.

MET treatment in obese pregnant dams alleviates the developmental priming of metabolic disease in adult offspring.

Funded by Diabetes UK
Why Qualified Health Claims Do Not Work: A Content Analysis of Language Characteristics
Authors: Berhaupt‐Glickstein Amanda , Hallman William
Published: June 2021

The US Food and Drug Administration (FDA) regulates qualified health claims (QHCs) on food and dietary supplement labels. QHCs aim to communicate the quality and strength of scientific evidence behind the claim of a diet‐disease relationship. However, research shows that consumers understand QHCs as an indication of the overall healthfulness of a product. To understand the characteristics of QHCs and what may cause consumer confusion, a content analysis examined the language used to convey scientific evidence in 53, FDA‐enforced QHCs. The analysis revealed that 77% (n=41) of QHCs score above a 9th grade reading level. Most claims also describe the quality of evidence (n=51, 96%) (e.g. “very weak”), make reference to the consistency of evidence (n=41, 77%), while a quarter of claims (n=13) quantify the evidence (i.e. number of studies). Twenty‐five claims (47%) present the evidence before stating the diet‐disease relationship, while the remainder of QHCs present information in the reverse order (n=28, 53%). In the 53 QHCs studied, there are 36 ways in which evidence is presented, which likely contributes to consumer confusion. Regulators should consider whether reforming the language in QHCs would improve consumer understanding of these claims.
Comparability of Dietary Data Collection Programs for U.S. Adults, 2007‐2011
Authors: Conrad Zach , Chui Kenneth , Griffin Timothy , Peters Christian
Published: June 2021

National public health goals include increasing daily fruit and vegetable (F&V) consumption, and continuous surveillance is critical for assessing progress towards this goal. The National Health and Nutrition Examination Survey (NHANES), the Behavioral Risk Factor Surveillance Survey (BRFSS), and the USDA Food Availability Database (USDA FAD) are routinely used to monitor F&V consumption of adults at the national level, but the discrepancy between the data generated from these programs has not been investigated. The objectives of this study are to 1) estimate the daily per capita consumption of F&V from each of these programs, 2) compare estimates of consumption of individual F&V by processing form using statistical agreement tests, and 3) compare estimates of consumption of F&V groups using descriptive means comparison. Data were collected for 2007‐2011, and adjusted to reflect F&V consumption among individuals 蠅18 years of age, measured in mean daily per capita cup‐equivalents. The Bland‐Altman method and ordinary least products regression indicated proportional bias but not fixed bias. Descriptive means comparison revealed similar consumption estimates between some programs for certain F&V groups, but these similarities were not consistent, and overall variability was apparent. These results indicate that these dietary data collection programs do not yield similar results for daily per capita F&V consumption among adults in the U.S. Caution should be exercised when reporting progress toward achieving national public health nutrition goals related to F&V consumption. The authors report no source of funding for this study.
Associations Between Vegetable‐and‐Fruit Consumption and Food Deserts: Urban Adults 40+ years, NHANES 2003‐2010
Authors: Gahche Jaime , Sahyoun Nadine
Published: June 2021

Food deserts (FD) in urban areas are defined as areas where affordable and healthy food is difficult to obtain because of lack of available supermarkets or large grocery stores. Research has been inconsistent in regards to FD status and the association with fruit‐and‐vegetable (F/V) consumption. This study describes the linkage of data from the 2003‐2010 National Health and Nutrition Examination Survey (NHANES) and the United States Department of Agriculture's FD locator database in order to describe the relationship between FD status and income with F/V consumption. Analysis was restricted to those aged 40+ years, living in an urban area and characterized into 3 groups; low‐income living in a FD (low‐income FD), low‐income not living in a FD (low‐income non‐FD), and higher income not living in a FD (higher‐income non‐FD). Selected demographic, behavioral, nutritional, and health related outcomes were characterized. Linear regression models were constructed to examine the association between the 3 groups and F/V consumption. Mean cup equivalents of vegetables were: low‐income FD 1.2 (95% CI 1.1‐1.4), low‐income non‐FD 1.5 (95% CI 1.5‐1.6) and higher‐income non‐FD 1.7 (95% CI 1.7‐1.8). After adjusting for potential confounders, we found that the low‐income non‐FD group consumed 0.21 (95% CI ‐0.02, 0.04, P=0.0337) and the higher‐income non‐FD consumed 0.24 (95% CI 0.02, 0.45, P=0.0308) more cup equivalents of vegetables on any given day compared with the low‐income FD group. Consumption of fruit did not differ between the groups. These findings suggest that low‐income urban adults living in a FD did differ in their vegetable consumption, but not fruit consumption, compared to both low‐income and higher‐income non‐FD inhabitants.
Reported Barriers to Appropriate Early Breastfeeding Practices in Lebanon
Authors: Akik Chaza , Ghattas Hala , Filteau Suzanne , Knai Cecile
Published: June 2021

The World Health Organisation recommends exclusive breastfeeding (EBF) from within the first hour of life until 6 months of age. Breastfeeding practices in Lebanon fall short of these recommendations: while more than 90% of infants were ever breastfed, EBF rates are low and breastfeeding duration is inadequate. The Lebanese health system is likely to have a vital role in early breastfeeding practices since most deliveries are in institutions, many of which are private. This research aimed to identify stakeholders' perceptions of barriers to recommended early breastfeeding practices in the context of health services. Semi‐structured interviews were conducted with a purposeful sample of 59 stakeholders in early breastfeeding. The framework approach was used for data analysis. Findings revealed suboptimal antenatal preparedness to breastfeeding, hospital practices not conducive to EBF initiation during hospital stay, medicalisation of childbirth, health professionals' knowledge and attitudes towards breastfeeding and aggressive marketing by breast milk substitutes companies as contributing factors. The socio‐cultural context also appeared to support a belief system that is depreciative of breastfeeding. Future efforts should focus on sensitising women, empowering them and increasing their demand for appropriate breastfeeding practices and baby‐friendly practices within health services, improving health professionals' knowledge and skills for breastfeeding promotion, support and management, and limiting the aggressive marketing of breast milk substitutes companies.
The Effect of Early Life Methyl Donor Supplementation on Obesity Development
Authors: McKee Sarah , Reyes Teresa
Published: June 2021

Nearly 50% of women with a normal pre‐pregnancy body mass index gain more weight than recommended during their pregnancy. This excessive gestational weight gain (GWG) significantly increases the risk for the development of obesity in the offspring. Excessive GWG can be modeled in animals by feeding pregnant dams a high fat diet, leading to increased maternal weight gain and obesity‐promoting phenotypes in the offspring. Using a mouse model of excessive GWG, we have documented in the offspring an increased preference for sucrose and fat, increased expression of genes that underlie reward‐related behaviors, and both global and gene specific decreases in DNA methylation. These changes in reward‐related neural circuitry may contribute to the increased risk for the development of obesity in the offspring by altering the animal's response to highly palatable, energy dense foods. We have observed that supplementation during pregnancy can reverse some of the phenotypes that result from maternal high fat diet consumption. It is unknown whether postnatal (adolescent) methyl donor supplementation (MDS) can reverse these phenotypes. To determine this, offspring from dams fed either a high fat diet (HFD) or control diet during gestation were fed a methyl donor supplemented diet during adolescence. It has been determined that postnatal MDS significantly decreases body weight and abdominal fat pad weight in both male and female adult HFD offspring, and does not alter body weights of control diet offspring. Continued assessment of obesity development, preference for palatable foods, metabolic phenotypes, and expression changes of genes underlying homeostatic and hedonic feeding will elucidate whether early postnatal nutritional interventions can be utilized as a therapy to offset adult obesity risk.
Exploring Adolescent Involvement in Home Meal Preparation
Authors: Leak Tashara , Aasand Taylor , Vickers Zata , Reicks Marla
Published: June 2021

In low‐income households with multiple children, older siblings may assume adult roles including primary care provider for siblings. A qualitative study was conducted to explore if these adultified roles extended to meal preparation. At the conclusion of a randomized controlled trial involving families on food assistance, if an adolescent (13‐18 years) was present in the home, he or she was invited to participate in a semi‐structured interview. Interviews (n= 19) were analyzed using grounded theory methodology. Seventeen adolescents reported participating in meal preparation at one of three levels of involvement. Many described a low level of assistance, whereas a few described occasionally sharing cooking responsibilities (e.g., cooking for siblings monthly while parent is at work). A few also described themselves as independent food preparers, playing a major role in meal preparation, often more so than their parents. These adolescents were independent out of family obligation and indicated that the additional responsibilities produced stress, although they were confident in their ability to cook without the assistance of an adult. They served as surrogate parents in a utilitarian manner, as their primary goal was getting everyone fed, not necessarily preparing healthy meals. They were focused on preparing foods that siblings preferred which was consistent with parental expectations. Findings suggest that the level of adolescent involvement in meal preparation varies and additional research is needed to further explore the experience of independent adolescent food preparers and the impact on dietary intake of younger siblings. Funding: HFHL Institute, UMN. USDA‐AFRI 2012‐68001‐19631
Enriching the Diet In N‐3 Polyunsaturated Fatty Acids Reduces Adiposity and Adipocyte Size in a Broiler Chick Model for Childhood Obesity
Authors: Torchon T Emmanuelle , Das Suchita , Voy Brynn
Published: June 2021

Epidemiological studies suggest that enriching prenatal and perinatal diets in long‐chain omega‐3 polyunsaturated fatty acids (LC n‐3 PUFA) may be a tool with which to reduce adiposity, improve metabolic status and reduce the risk of childhood obesity. We used broiler chickens, which rapidly deposit adipose tissue post‐hatch and share a number of metabolic features with humans, to test the hypothesis that consumption of diets enriched in LC n‐3 PUFA during the early post‐hatch period of rapid adipose development reduces adiposity. From seven to 21 days of age,Cobb500 broiler chicks (n=10/group) were fed isocaloric diets formulated using either lard (primarily saturated), corn oil (primarily monounsaturated), flaxseed oil (PUFA, enriched in alpha linolenic acid (ALA, 18:3, n‐3)), or fish oil (PUFA, enriched in eicosapentaenoic acid (EPA, 20:5, n‐3) and docosahexaenoic acid (DHA, 22:6, n‐3)), each at 8% by weight. Abdominal fat pad weight, but not body weight, was significantly (p=0.0327) lower in birds fed the fish oil diet (21.3g±5.5) than those fed lard (26.7g±5.9), but did not differ in birds fed flax and corn‐oil based diets relative to lard. Fish oil also significantly reduced abdominal adipocyte size compared to all other diets (p<0.05). Subcutaneous adipocyte size was significantly smaller in corn, flax and fish oil groups relative to lard (p<0.05). Plasma non‐esterified fatty acid levels, as a reflection of lipolysis, increased in birds fed fish oil diets as compared to lard diets (p=0.0194). Collectively, our data suggest that altering the type of fatty acids consumed during childhood may attenuate adipose deposition and adipocyte size, which could have benefits in reducing childhood obesity.