LAB NAME: Nutritional Epidemiology 1. Using an epidemiologic approach, investigate the role of foods and food components such as carbohydrates sources (e.g., whole grains, sugar sweetened beverages), selected nutrients (e.g., folate, vitamin B12, magnesium), other bioactive food components (e.g., flavonoids, carotenoids), healthy dietary patterns (Dietary Guidelines for Americans, Mediterranean Diet) and gene-diet interactions in preventing age-related conditions such as weight gain, inflammation, insulin resistance and type 2 diabetes mellitus, cardiovascular disease, cancer, cognitive decline, musculoskeletal disorders, vision disorders and kidney disease. 1.A. Determine if higher sugar consumption is associated with cardiometabolic risk factors such as abdominal obesity, ectopic fat accumulation in liver and visceral depots, and inflammation and insulin resistance. 1.B. Determine the role that vitamin B6 plays in chronic inflammation and if modulation of vitamin B6 status can influence risk of inflammation. 1.C. Determine if inadequate vitamin B12 status is associated with reduced muscle power in older adults. 1.D. Determine if consumption of diets consistent with the 2010 Dietary Guidelines for Americans recommendations is associated with maintenance of healthy weight, normal metabolic function, and reduced risk of age-related chronic diseases. 1.E. Determine if lower dietary choline intake is related to accelerated brain aging and increased risk for dementia, and whether omega-3 fatty acids modifies these relationships. 1.F. Determine if specific flavonoids may reduce the risk of age-related chronic disease, including CVD, type 2 diabetes, and dementia. 1.G. Determine if dairy foods or components of dairy foods may help to prevent the development of age-related chronic disease. 2. Using an epidemiologic approach, examine the health effects of high folic acid intakes and the interaction between high folic acid intake and vitamin B12 status to investigate safe upper limits for intake of folic acid in older individuals (in collaboration with the HNRCA Vitamin and Metabolism Laboratory). 3. Using an experimental approach, conduct separate food-based intervention studies to examine the impact of dietary modification with individual foods (including whole grain, dietary fiber, added sugar, and fermented dairy) on weight change and ectopic fat depots (in collaboration with the HNRCA Energy Metabolism Laboratory), microbiota or intermediate metabolic markers of disease risk.
LAB NAME: Nutritional Epidemiology Many age-related conditions that result in disability and premature death, such as weight gain, type 2 diabetes, cardiovascular disease, cancer, cognitive decline, and musculoskeletal disorders, appear to have strong nutritional connections. However, the development of nutritional recommendations and public health interventions requires a greater understanding of the presumptive role that nutrition plays in healthy aging. Our project objectives will be achieved through the application of observational epidemiologic methods in community-based aging population samples to identify dietary patterns, foods and food components associated with age-related health outcomes and testing of these candidate foods and food components in intervention trials of intermediate markers of age-related disease risk.
Our research relating nutrition to age-related chronic disease risk (Objective 1) demonstrated progress on projects related to cardiovascular, musculoskeletal, renal and liver health, and longevity. We made significant progress on multiple projects examining diet and cardiometabolic health. As part of our research program on the relationship between added sugars and cardiometabolic health (Objective 1.a), we completed three projects demonstrating that greater sugar-sweetened beverage (SSB) consumption among middle-aged and older adults was associated with a higher risk of fatty liver disease, greater increases in visceral adipose tissue with aging, and increased preclinical Alzheimer’s disease. A fourth project on SSB, insulin resistance and prediabetes is ongoing. Results from another project that is examining the possible genetic modification by Carbohydrate Responsive Element Binding Protein of the cardiometabolic consequence of added sugar consumption were presented at the 2015 American Diabetes Association meeting. These findings were also used as preliminary data for a funded American Heart Association grant and a National Institutes of Health (NIH) grant. A manuscript describing these results is currently in preparation for submission. Our research programs on the health benefits of dietary flavonoids (Objective 1.f) resulted in two published paper on flavonoid intake and inflammation and cardiovascular disease (CVD) incidence and analyses are nearing completion on a paper examining the relationship between flavonoid intake and risk of pre-diabetes. Our ongoing research on dairy food consumption and cardiometabolic health (Objective 1.g) resulted in a paper demonstrating that higher consumption of skim/low-fat milk and yogurt could delay the development of hypertension with aging. As part of this project, we also examined the trends in dairy consumption from 1999 to 2008 among a representative sample of Americans using data from the National Health and Nutrition Examination Survey (NHANES). As part of our long-standing research program on whole grain and fiber intake, we observed that higher dietary fiber intake may reduce incidence of knee osteoarthritis and knee pain worsening with age and that any effect of fiber may be partially mediated through reduced body weight. We also established a publically available comprehensive dietary fiber evidence map linking dietary fiber and health (http://ilsina.org/our-work/research-tools-open-data/dietary-fiber-database/). Our group has one paper in press in PLOS One which describes this database, one paper in preparation that focused on the evidence from intervention studies on dietary fiber and the gut microbiota, and has resulted in three poster presentations at Experimental Biology. In additional work on the relationship between diet and age-related disorders, we observed that better adherence to the Dietary Guidelines for Americans was associated with better vascular health, particularly in younger adults (Objective 1.d). We did not observe any relationship between vitamin B12 status and muscle power in older adults (Objective 1.c). We initiated a project examining the relationship between protein intake in middle age and healthy aging, as characterized by maintenance metabolic health and physical performance and prevention of physical disability. We also initiated the feasibility phase of a study, the Adhering to Dietary Approaches for Personal Taste (ADAPT) Research Initiative, designed to identify consumers of popular diets including Paleo, low-carb, vegetarian, vegan, raw, Mediterranean, gluten-free, low-fat, and others to examine how nutrient intakes differ between diets, determine what factors affect adherence to these different diets and compare the relative metabolic impacts of the various diets. Our focus on popular dietary patterns is unique and unexplored in other similar cohort studies to date. Nearly 14,000 individuals responded to the initial ADAPT Recruitment and Feasibility Survey.
1. Sugar-sweetened beverage consumption increases risk of fatty liver disease. Nonalcoholic fatty liver disease affects ~30% of U.S. adults and is associated with a greater risk of type 2 diabetes and cardiovascular disease, yet the role of excess intake of sugar-sweetened beverages (SSB) remains unknown. Tufts University researchers at USDA in Boston, Massachusetts, in collaboration with researchers from the National, Heart, Lung, and Blood Institute (NHLBI) Framingham Heart Study examined the cross-sectional association between SSB intake and fatty liver disease in members of the Framingham Offspring and the Third Generation cohorts. Liver fat was measured using computed tomography in 2634 participants. The risk of fatty liver disease was 60% higher in those consuming >/=1 serving/day of SSB compare to those who consumed <1 serving/week. This association was strongest in those who were overweight and obese. These findings provide further evidence of harmful effects of regular SSB consumption and suggest another route by which SSB consumption may affect type 2 diabetes and CVD risk.
2. Sugar-sweetened beverage consumption is associated with increased visceral adipose tissue. Excessive fat deposited around the abdomen, and particularly fat that is stored around a number of important internal organs such as the liver, pancreas and intestines within the abdominal cavity, called visceral adipose tissue (VAT), is strongly linked to the development of diabetes and cardiovascular diseases. Emerging evidence suggests that greater intake of sugar-sweetened beverages (SSB) may be associated with abnormal fat accumulation in VAT. Tufts University researchers at USDA in Boston, Massachusetts, in collaboration with researchers from the National, Heart, Lung, and Blood Institute (NHLBI) Framingham Heart Study examined the prospective association of habitual SSB and diet soda intakes and change in quantity (volume) and quality (attenuation) of VAT measured using computed tomography in 1003 participants (mean age 45.3 years, 45.0% women) the Framingham Heart Study Third Generation cohort. Higher SSB intake was significantly associated with greater increase in VAT volume and with greater decline of VAT attenuation. Regular SSB intake was associated with adverse change in both VAT quality and quantity, whereas we observed no such association for diet soda.
3. Dairy consumption slows the age-related increase in blood pressure. In spite of the fact that dairy is a good source of a number of nutrients believed to help limit increases in blood pressure (BP), such as calcium, potassium and magnesium, evidence is limited on the long-term association between consumption of various dairy products and the changes in BP or the risk of hypertension. Tufts University researchers at USDA in Boston, Massachusetts, examined this relationship in 2,636 Framingham Heart Study Offspring Cohort members over a 13 year follow-up period who were free of hypertension. Greater intakes of total dairy, total low fat/fat free dairy, low fat/skim milk, and yogurt were associated with smaller annualized increments in systolic BP blood pressure and a lower risk of hypertension incidence with age. However, these inverse associations between total low fat/fat free dairy and low fat/skim milk and hypertension risk were attenuated as the follow-up time increased, suggesting a delay in development of hypertension. These findings suggest that for many Americans, the addition of more dairy products, particularly yogurt, to their diets may prevent or delay the development of hypertension.
Jacques, P.F., Cassidy, A., Rogers, G., Peterson, J.J., Dwyer, J.T. 2015. Dietary flavonoid intakes and cardiovascular disease incidence in the Framingham Offspring Cohort. British Journal of Nutrition. 114:1496-1503. doi: 10.1017/S0007114515003141.
Peterson, J.J., Dwyer, J.T., Jacques, P.F., Mccullough, M.L. 2015. Improving the estimation of flavonoid intake for study of health outcomes. Nutrition Reviews. 73(8):553-576. doi: 10.1093/nutrit/nuv008.
Wang, H., Fox, C.A., Troy, L.M., Mckeown, N.M., Jacques, P.F. 2015. Longitudinal association of dairy consumption with the changes in blood pressure and the risk of incident hypertension: the Framingham Heart Study. British Journal of Nutrition. 114(11):1887-1899. doi: 10.1017/S0007114515003578.
Ma, J., Karlsen, M.C., Chung, M., Jacques, P.F., Saltzman, E., Smith, C.E., Fox, C.S., Mckeown, N.M. 2015. Potential link between excess added sugar intake and ectopic fat: a systematic review of randomized controlled trials. Nutrition Reviews. 74(1):18-32. doi: 10.1093/nutri/nuv047.
Karlsen, M.C., Ellmore, G.S., Mckeown, N.M. 2016. Seeds - health benefits, barriers to incorporation, and strategies for practitioners in supporting consumption among consumers. Food and Nutrition Sciences. 51(1):50-59.