Eur J Clin Nutr. 61(5): pdfs

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Hi All, A new issue of the European Journal of Clinical Nutrition is received for Volume 61, Issue 5. Citations and most abstracts can be viewed from: http://www.nature.com/ejcn/journal/v61/n5/index.html There was one free full-text paper that relates to diet selection that attracted attention. It concluded: "In conclusion, we have found evidence that dietary patterns that indiscriminate focus on low intake of carbohydrates in general and high intake of proteins in general, and reflect diets that have been frequently recommended for weight reduction, may be associated with increased total mortality if they are pursued for extended periods". It was: Trichopoulou A, Psaltopoulou T, Orfanos P, Hsieh CC,

Trichopoulos D.Low-carbohydrate-high-protein diet and long-term survival in a general population cohort.Eur J Clin Nutr. 2007 May;61(5):575-81. Epub 2006 Nov 29. PMID: 17136037http://www.nature.com/ejcn/journal/v61/n5/full/1602557a.htmlhttp://www.nature.com/ejcn/journal/v61/n5/pdf/1602557a.pdf Objective: We have evaluated the effects on mortality of habitual low carbohydrate-high-protein diets that are thought to contribute to weight control. Design: Cohort investigation. Setting: Adult Greek population. Subjects methods: Follow-up was performed from 1993 to 2003 in the context of the Greek component of the European Prospective Investigation into Cancer and nutrition. Participants were

22 944 healthy adults, whose diet was assessed through a validated questionnaire. Participants were distributed by increasing deciles according to protein intake or carbohydrate intake, as well as by an additive score generated by increasing decile intake of protein and decreasing decile intake of carbohydrates. Proportional hazards regression was used to assess the relation between high protein, high carbohydrate and the low carbohydrate-high protein score on the one hand and mortality on the other. Results: During 113 230 persons years of follow-up, there were 455 deaths. In models with energy adjustment, higher intake of carbohydrates was associated with significant reduction of total mortality, whereas higher intake of protein was associated with nonsignificant increase of total mortality (per decile, mortality ratios 0.94 with 95% CI 0.89 -0.99, and 1.02 with 95% CI 0.98 -1.07 respectively). Even more predictive of higher mortality were

high values of the additive low carbohydrate-high protein score (per 5 units, mortality ratio 1.22 with 95% CI 1.09 -to 1.36). Positive associations of this score were noted with respect to both cardiovascular and cancer mortality. Conclusion: Prolonged consumption of diets low in carbohydrates and high in protein is associated with an increase in total mortality. A similar pdf-availed more-high-profile journal paper with the same final author as a co-author was: Lagiou P, Sandin S, Weiderpass E, Lagiou A, Mucci L, Trichopoulos D, Adami HO.Low carbohydrate-high protein diet and mortality in a cohort of Swedish women.J Intern Med. 2007 Apr;261(4):366-74. PMID: 17391111 OBJECTIVE: The long-term health consequences of diets used for weight control are not established. We have evaluated the association of the frequently

recommended low carbohydrate diets - usually characterized by concomitant increase in protein intake - with long-term mortality. DESIGN: The Women's Lifestyle and Health cohort study initiated in Sweden during 1991-1992, with a 12-year almost complete follow up. SETTING: The Uppsala Health Care Region. SUBJECTS: 42,237 women, 30-49 years old at baseline, volunteers from a random sample, who completed an extensive questionnaire and were traced through linkages to national registries until 2003. MAIN OUTCOME MEASURES: We evaluated the association of mortality with: decreasing carbohydrate intake (in deciles); increasing protein intake (in deciles) and an additive combination of these variables (low carbohydrate-high protein score from 2 to 20), in models controlling for energy intake, saturated fat intake and several nondietary covariates. RESULTS:

Decreasing carbohydrate or increasing protein intake by one decile were associated with increase in total mortality by 6% (95% CI: 0-12%) and 2% (95% CI: -1 to 5%), respectively. For cardiovascular mortality, amongst women 40-49 years old at enrolment, the corresponding increases were, respectively, 13% (95% CI: -4 to 32%) and 16% (95% CI: 5-29%), with the additive score being even more predictive. CONCLUSIONS: A diet characterized by low carbohydrate and high protein intake was associated with increased total and particularly cardiovascular mortality amongst women. Vigilance with respect to long-term adherence to such weight control regimes is advisable. A second paper that is pdf-availed from this issue was: Backhouse SH, C, son E, Nute M.Effects of the glycemic index of breakfast on metabolic responses to brisk walking in females.Eur J Clin Nutr.

2007 May;61(5):590-6. Epub 2006 Nov 29. PMID: 17136034 Objective: The aim of this study was to examine the metabolic responses during 1 h of brisk walking, 3 h after ingesting high glycemic index (HGI) and moderate glycemic index (MGI) breakfasts. Design and subjects: Six females completed three treadmill walking trials ( approximately 50% \[Vdot]O(2) max), separated by at least 1 month. Three hours before walking, they ingested either water or a HGI or MGI breakfast. The MGI breakfast consisted of a mixture of an HGI breakfast cereal and low GI carbohydrate (CHO) foods. The GI values of the HGI and MGI meals were 77 and 51, respectively. Setting: The study took place in the School of Sport and Exercise Sciences at Loughborough University, Loughborough, UK. Results: In the HGI and MGI trials, plasma glucose and serum insulin concentrations peaked

15 min into the postprandial period. At the onset of exercise, plasma insulin concentrations were twofold higher in the HGI (31.5+/-7.7 mul U l(-1)) than in the MGI trial (15.2+/-1.9 mul U l(-1)) (P<0.05). However, there were no differences in substrate utilization between the two CHO trials. Conclusion: These results suggest that although the addition of LGI CHO foods to an HGI breakfast cereal reduces the overall GI of the meal, the metabolic response to exercise is similar to that following a breakfast comprised entirely of HGI foods. ... Plasma glucose and serum insulinPlasma glucose concentrations remained stable throughout the FAST trial (Figure 1), but rose rapidly after ingestion of the test meals, reaching a peak at 15 min in the HGI and MGI trials (6.6±0.6 and 6.2±0.2 mmol/l, respectively). Plasma glucose concentrations in the fed trials then declined during the remainder of the postprandial

period. The incremental area under the curve (IAUC) during the postprandial period was not different between the HGI and MGI trial, but greater in the fed trials compared to the FAST trial (P<0.05) (HGI: 85±30 vs MGI: 74±26 vs FAST 8±4 mmol/l x 180 min) during the postprandial period. At 15 min during exercise, plasma glucose concentrations decreased markedly in the HGI trial, reaching a nadir (4.0±0.2 mmol//l) that was significantly lower (condition time effect; P<0.05) than in the MGI and FAST trials. This difference persisted for 30 min into exercise (P<0.05). Thereafter, plasma glucose concentrations returned to pre-exercise values and at the end of exercise values were similar in all three trials (HGI: 4.7±0.1mmol/l vs MGI: 4.8±0.1mmol/l vs FAST: 4.9±0.2mmol/l). Serum insulin concentrations (Figure 2) remained stable throughout the FAST trial. However, following the HGI and MGI

breakfasts, serum insulin concentrations increased rapidly and peaked at 15 min during the postprandial period (HGI: 90.1±14.0 l U/l vs MGI: 67.1±12.2 l U/l). This resulted in a significant (P<0.01) increase from the pre-meal baseline values of 9.4±1.4 lU/l and 11.7±0.8 l U/l for the HGI and MGI trials, respectively. Serum insulin concentrations then declined throughout the remainder of the postprandial period. The incremental area under the serum insulin response curve (IAUC) during the postprandial period was not different between the HGI and MGI trial, but greater in the fed trials compared to the FAST trial (P<0.05) (HGI: 8369±1595 vs MGI: 5142±707 vs FAST: 42±42 l U/ml 180 min). Immediately before exercise, serum insulin concentrations were twofold higher in the HGI trial (31.5±7.7 l U/l) compared to the MGI trial (15.2±1.9 l U/l) (P<0.05). Thereafter, values were similar in each of the three trials (Figure 2). Plasma free

fatty acidsFollowing ingestion of the breakfasts, plasma FFA concentrations were reduced to below fasting values (P<0.01) in both fed trials and remained lower throughout the postprandial period (Figure 3). During exercise, FFA concentrations were higher in the FAST (P<0.01), compared to the HGI and MGI trials. In the HGI and MGI trials, FFA concentrations increased with time, but there was no difference between trials. Plasma lactateFollowing the ingestion of HGI and MGI breakfasts, plasma lactate concentrations increased significantly (P<0.05), peaking at 30 and 60 min during the postprandial period in the HGI and MGI trials, respectively. Plasma lactate concentrations were higher during the first 2 h of the postprandial period in the MGI (2.36±0.22mmol/l) than in the HGI (1.57±0.12mmol/l) and FAST (1.00±0.12mmol/l; P<0.05) trials. However, at the start of exercise, plasma lactate concentrations had returned to resting

concentrations in the HGI and MGI trials. No differences were observed between trials throughout the 1 h walk. Estimated carbohydrate and fat oxidation ratesDuring the 1 h of brisk walking, the total carbohydrate oxidation (HGI: 1.2±0.1. vs MGI: 1.3±0.1 vs FAST: 0.9±0.1 g/min) was higher (Figure 4) and total fat oxidation (HGI; 0.3±0.01 vs MGI: 0.3±0.1 vs FAST: 0.4±0.1 g/min) was lower (Figure 5), in both the fed trials, when compared to the FAST trial (P<0.05). No differences were observed between the HGI and MGI trials. -- Al Pater, alpater@...

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