Category: Diet and Nutrition

How Processing Depletes the Nutrients in Milk Substitutes

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A University of Copenhagen study of plant-based drinks reveals a common issue: they are lacking in proteins and essential amino acids compared to cow’s milk. The explanation lies in their extensive processing, causing chemical reactions that degrade protein quality in the product and, in some cases, produce new substances of concern.

Over the last decade, the global market for plant-based beverages has seen remarkable growth, with oat, almond, soy and rice drinks emerging as popular alternatives to cow’s milk in coffee and oatmeal during this time.

One of the likely reasons for millions of litres of plant-based drinks ending up in the shopping baskets of consumers is that their climate footprint is often lower than that of cow’s milk. But consumers would be mistaken if they considered plant-based beverages healthier than cow’s milk. This is highlighted in a new study conducted by the University of Copenhagen in collaboration with the University of Brescia, Italy.

In the study, published in Food Research International, researchers examined how chemical reactions during processing affect the nutritional quality of ten different plant-based drinks, comparing them with cow’s milk. The overall picture is clear:

“We definitely need to consume more plant-based foods. But if you’re looking for proper nutrition and believe that plant-based drinks can replace cow’s milk, you’d be mistaken,” says Department of Food Science professor Marianne Nissen Lund, the study’s lead author.

Long shelf life at the expense of nutrition

While milk is essentially a finished product when it comes out of a cow, oats, rice, and almonds require extensive processing during their conversion to a drinkable beverage. Moreover, each of the plant-based drinks tested underwent Ultra High Temperature (UHT) treatment, a process that is widely used for long-life milks around the world. In Denmark, milk is typically found only in the refrigerated sections of supermarkets and is low-pasteurized, meaning that it receives a much gentler heat treatment. 

“Despite increased plant-based drink sales, cow milk sales remain higher. Consequently, plant-based drinks undergo more intense heat treatments than the milk typically sold in Denmark, in order to extend their shelf life. But such treatment comes at a cost,” says Marianne Nissen Lund.

UHT treatment triggers a so-called “Maillard reaction”, a chemical reaction between protein and sugar that occurs when food is fried or roasted at high temperatures. Among other things, this reaction impacts the nutritional quality of the proteins in a given product.

“Most plant-based drinks already have significantly less protein than cow’s milk. And the protein, which is present in low content, is then additionally modified when heat treated. This leads to the loss of some essential amino acids, which are incredibly important for us. While the nutritional contents of plant-based drinks vary greatly, most of them have relatively low nutritional quality,” explains the professor.

For comparison, the UHT-treated cow’s milk used in the study contains 3.4 grams of protein per liter, whereas 8 of the 10 plant-based drinks analyzed contained between 0.4 and 1.1 grams of protein. The levels of essential amino acids were lower in all plant-based drinks. Furthermore, 7 out of 10 plant-based drinks contained more sugar than cow’s milk.

Heat treatment may produce carcinogens

Besides reducing nutritional value, heat treatment also generates new compounds in plant-based drinks. One such compound measured by the researchers in four of the plant-based drinks made from almonds and oats is acrylamide, a carcinogen that is also found in bread, cookies, coffee beans and fried potatoes, including French fries.

“We were surprised to find acrylamide because it isn’t typically found in liquid food. One likely source is the roasted almonds used in one of the products. The compound was measured at levels so low that it poses no danger. But, if you consume small amounts of this substance from various sources, it could add up to a level that does pose a health risk,” says Marianne Nissen Lund.

Additionally, the researchers detected α-dicarbonyl compounds and hydroxymethylfurfural (HMF) in several of the plant-based drinks. Both are reactive substances that could potentially be harmful to human health when present in high concentrations, although this is not the case here.

While professor of nutrition Lars Ove Dragsted is not particularly concerned about the findings either, he believes that the study highlights how little we know about the compounds formed during food processing:

“The chemical compounds that result from Maillard reactions are generally undesirable because they can increase inflammation in the body. Some of these compounds are also linked to a higher risk of diabetes and cardiovascular diseases. Although our gut bacteria break down some of them, there are many that we either do not know of or have yet to study,” says Lars Ove Dragsted of the Department of Nutrition, Execercise and Sports.

Professor Dragsted adds: “This study emphasizes why more attention should be paid to the consequences of Maillard reactions when developing plant-based foods and processed foods in general. The compounds identified in this study represent only a small fraction of those we know can arise from Maillard reactions.”

Make Your Own Food

According to Professor Marianne Nissen Lund, the study highlights broader issues with ultra-processed foods: 

“Ideally, a green transition in the food sector shouldn’t be characterized by taking plant ingredients, ultra-process them, and then assuming a healthy outcome. Even though these products are neither dangerous nor explicitly unhealthy, they are often not particularly nutritious for us either.”

Her advice to consumers is to: “generally opt for the least processed foods and beverages, and to try to prepare as much of your own food as possible. If you eat healthy to begin with, you can definitely include plant-based drinks in your diet – just make sure that you’re getting your nutrients from other foods.”

At the same time, Professor Lund hopes that the industry will do more to address these issues:
“This is a call to manufacturers to further develop their products and reconsider the extent of processing. Perhaps they could rethink whether UHT treatment is necessary or whether shorter shelf lives for their products would be acceptable.”

Source: University of Copenhagen

Five Years of Vitamin D Supplements Fails to Prevent Diabetes

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Using significantly higher doses of vitamin D than recommended for five years did not affect the incidence of type 2 diabetes in elderly men and women, according to a new study from the University of Eastern Finland which appears in Diabetologia.

In population studies, low levels of vitamin D in the body have been associated with a higher risk of type 2 diabetes, but such observational studies cannot directly prove a causative link. Experimental studies have shown that the use of significantly higher doses of vitamin D than recommended slightly reduces the risk of developing type 2 diabetes in individuals with impaired glucose metabolism, ie, those with prediabetes. In contrast, no effects have been observed in individuals without prediabetes. However, the studies with non-prediabetic subjects have used relatively small doses of vitamin D or have been short-term. Until now, there has been no research data on the effects of long-term use of high doses of vitamin D on the risk of type 2 diabetes in individuals without glucose metabolism disorders.

In the Finnish Vitamin D Trial (FIND) conducted at the University of Eastern Finland from 2012 to 2018, 2 495 men aged 60 and older and women aged 65 and older were randomised for five years into either a placebo group or groups receiving either 40 or 80 micrograms of vitamin D3 per day. In the statistical analyses of the now-published sub-study, 224 participants who were already using diabetes medications at the start of the study were excluded. Comprehensive information was collected from the participants on lifestyle, nutrition, diseases, and their risk factors. Data was also obtained from national health registers. About one-fifth were randomly selected for more detailed examinations, and blood samples were taken from them.

During the five years, 105 participants developed type 2 diabetes: 38 in the placebo group, 31 in the group receiving 40 micrograms of vitamin D3 per day, and 36 in the group receiving 80 micrograms of vitamin D3 per day. There was no statistically significant difference in the number of cases between the groups.

In the more closely studied group of 505 participants, the blood calcidiol level, which describes the body’s vitamin D status, was on average 75nmol/L at the start, and only 9% had a low level, ie, below 50nmol/L. After one year, the calcidiol level was on average 100nmol/L in the group that used 40 micrograms of vitamin D per day and 120nmol/L in the group that used 80 micrograms of vitamin D per day. There was no significant change in the placebo group. The effects of vitamin D on blood glucose and insulin levels, body mass index, and waist circumference were examined during the first two years of the study, but no differences were observed between the groups.

The findings of the FIND study reinforce the view that the use of higher doses of vitamin D than recommended does not significantly affect the risk of developing type 2 diabetes in individuals without prediabetes and who already have a good vitamin D status. So far, there is no research data on whether high doses of vitamin D can be beneficial in preventing type 2 diabetes in individuals without prediabetes but with vitamin D deficiency.

Source: University of Eastern Finland

Drinking Plenty of Water may Actually be Good for You

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Public health recommendations generally suggest drinking eight cups of water a day. And many people just assume it’s healthy to drink plenty of water.

Now researchers at UC San Francisco have taken a systematic look at the available evidence, analysed 18 randomised controlled trials. In their review, published in JAMA Network Open, they concluded that drinking enough water can help with weight loss and prevent kidney stones, as well as migraines, urinary tract infections and low blood pressure.

“For such a ubiquitous and simple intervention, the evidence hasn’t been clear, and the benefits were not well established, so we wanted to take a closer look,” said Benjamin Breyer, MD, MAS, professor and chair of the UCSF Department of Urology.

“The amount of rigorous research turned out to be limited, but in some specific areas, there was a statistically significant benefit,” said Breyer, the senior author of the study. “To our knowledge, this is the first study assessing the benefits of water consumption on clinical outcomes broadly.”

Strong evidence suggested that drinking eight cups of water a day significantly decreased the likelihood of getting another kidney stone. Several studies found that drinking about six cups of water a day helped adults lose weight. But a study that included adolescents found that drinking a little more than eight cups of water a day had no effect.

Still, the authors said that encouraging people to drink water before meals would be a simple and cheap intervention that could have huge benefits, given the increased prevalence of obesity.

Other studies indicated that water can help prevent migraines, control diabetes and low blood pressure, and prevent urinary tract infections. Adults with recurrent headaches felt better after three months of drinking more water. Drinking about four more cups of water a day helped diabetic patients whose blood glucose levels were elevated.

Drinking an additional six cups a day of water also helped women with recurrent urinary tract infections. It reduced the number of infections and increased the amount of time between them. Drinking more water also helped young adults with low blood pressure.

“We know that dehydration is detrimental, particularly in someone with a history of kidney stones or urinary infections,” Breyer said. “On the other hand, someone who suffers from frequent urination at times may benefit from drinking less. There isn’t a one size fits all approach for water consumption.”

Source: University of California – San Francisco

Many not Getting Enough Nutrients in Their Pregnancy, Study Finds

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It’s generally estimated that around 10% of pregnant people struggle to meet their nutritional needs – but the real number could be far higher, according to new research in The Journal of Nutrition.

Over 90% of pregnant individuals are potentially failing to get enough iron, vitamin D, or vitamin E from the food they eat, while over one-third could be short of calcium, vitamin C, and vitamin A. Troublingly, almost two-thirds of pregnant people were also found to be getting insufficient dietary folate – a critical nutrient that helps prevent birth defects in the baby’s brain and spine.

“It’s important to remember that many pregnant people take prenatal vitamin supplements, which might help prevent nutritional deficiencies,” says lead author Dr Samantha Kleinberg, professor at Stevens Institute of Technology. “Nonetheless, this is a startling finding that suggests we need to be looking much more closely at whether pregnant individuals are getting the nutrients they need.”

Where most previous studies of nutrition during pregnancy relied on a few days of food diaries, or on simply asking people what they remembered eating, the Stevens team asked pregnant people to take before-and-after photos of everything they ate over two 14-day periods. Experts then reviewed the photos to assess the amount of food actually eaten and determine the nutrients consumed during each meal.

That’s a far more accurate approach, because people are notoriously bad at estimating portion size or accurately reporting what they’ve eaten, Dr Kleinberg explains. A photo-based approach is also much less laborious for pregnant people, making it easy to collect data over a period of weeks instead of just a few days.

“Most surveys only track diet over a day or two – but if you feel off one day and don’t eat much, or have a big celebratory meal over the weekend, that can skew the data,” Dr Kleinberg says. “By looking at a longer time period, and using photos to track diet and nutrition, we’re able to get a much richer and more precise picture of what people actually ate.”

The study found significant dietary variations between individuals, but also among the same individuals from one day to the next, suggesting that shorter studies and population-based reports might be failing to spot important nutritional deficits. “Some people eat really well, and others don’t – so if you just take an average, it looks like everything’s fine,” Dr Kleinberg explains. “This study suggests that in reality, an alarming number of pregnant people may not be getting the nutrients they need from their food.”

Using food photos also recorded the exact timing of meals and snacks, and to explore the way that patterns of eating behaviour correlated with total energy and nutrient intake. When pregnant people ate later in the day, the data shows, they were likely to consume significantly more total calories – potentially an important finding as researchers explore connections between eating behaviours and health problems such as gestational diabetes.

The current research didn’t directly study health outcomes, so it’s too early to say whether insufficient nutrition or excessive energy consumption is adversely impacting pregnant individuals or their babies. “We’ll be digging into that in future studies, and looking at possible connections with eating patterns and changes in glucose tolerance,” Dr Kleinberg says.

Source: Stevens Institute of Technology

Genetically Tailored Diets for IBS may Soon be Possible

Irritable bowel syndrome. Credit: Scientific Animations CC4.0

An international study has found that genetic variations in human carbohydrate-active enzymes may affect how people with irritable bowel syndrome (IBS) respond to a carbohydrate-reduced diet.

The research, which is published in Clinical Gastroenterology & Hepatologyshows that IBS patients with genetic defects in carbohydrate digestion had a better response to certain dietary interventions. This could lead to tailored treatments for IBS, using genetic markers to predict which patients benefit from specific diets.

Irritable bowel syndrome (IBS) is a digestive disorder affecting up to 10% of the global population. It is characterised by abdominal pain, bloating, diarrhoea, or constipation. Despite its prevalence, treating IBS remains a challenge as symptoms and responses to dietary or pharmacological interventions vary significantly.

Patients often connect their symptoms to eating certain foods, especially carbohydrates, and dietary elimination or reduction has emerged as an effective treatment option, though not all patients experience the same benefits.

Nutrigenetics (the science investigating the combined action of our genes and nutrition on human health) has highlighted how changes in the DNA can affect the way we process food. A well-known example is lactose intolerance, where the loss of function in the lactase enzyme hinders the digestion of dairy products.

Now, this pioneering new study suggests that genetic variations in human carbohydrate-active enzymes (hCAZymes) may similarly affect how IBS patients respond to a carbohydrate-reduced (low-FODMAP) diet.

The team have now revealed that individuals with hypomorphic (defective) variants in hCAZyme genes are more likely to benefit from a carbohydrate-reduced diet.

The study, involving 250 IBS patients, compared two treatments: a diet low in fermentable carbohydrates (FODMAPs) and the antispasmodic medication otilonium bromide. Strikingly, of the 196 patients on the diet, those carrying defective hCAZyme genes showed marked improvement compared to non-carriers, and the effect was particularly pronounced in patients with diarrhoea-predominant IBS (IBS-D), who were six times more likely to respond to the diet. In contrast, this difference was not observed in patients receiving medication, underscoring the specificity of genetic predisposition in dietary treatment efficacy.

These findings suggest that genetic variations in hCAZyme enzymes, which play a key role in digesting carbohydrates, could become critical markers for designing personalised dietary treatments for IBS. The ability to predict which patients respond best to a carbohydrate-reduced diet has the potential to strongly impact IBS management, leading to better adherence and improved outcomes.

Study leader Dr D’Amato, Gastrointestinal Genetics Research group at CIC bioGUNE and the Department of Medicine and Surgery at LUM University in in Italy.

In the future, incorporating knowledge of hCAZyme genotype into clinical practice could enable clinicians to identify in advance which patients are most likely to benefit from specific dietary interventions. This would not only avoid unnecessary restrictive diets for those unlikely to benefit but also open the door to personalised medicine in IBS.

Source: University of Nottingham

Raising Happy Eaters: Unlocking the Secrets of Childhood Appetite

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The foundation for healthy eating behaviour starts in infancy. Young children learn to regulate their appetite through a combination of biological, psychological, and sociological factors. In a new paper published in Social Science & Medicine, researchers at the University of Illinois Urbana-Champaign propose a model that explores these factors and their interactions, providing guidelines for better understanding childhood appetite self-regulation.

“When we talk about obesity, the common advice is often to just eat less and exercise more. That’s a simplistic recommendation, which almost makes it seem like an individual’s willpower solely determines their approach to food,” said lead author Sehyun Ju, a doctoral student in the Department of Human Development and Family Studies, part of the College of Agricultural, Consumer and Environmental Sciences at Illinois. 

Appetite self-regulation is related to general self-regulation, but it specifically concerns an individual’s ability to regulate food intake, which affects healthy development and obesity risk. Children are born with a capacity to regulate appetite based on hunger and satiety signals, but with increased exposure to environmental factors, their eating is increasingly guided by psychological reasoning and motivations. Therefore, it is important to take a developmental perspective to trace changes in eating behaviours over time, Ju stated.

Ju and her colleagues provide a comprehensive framework based on the biopsychosocial pathways model, which outlines three interacting categories: Biological factors, including sensory experience, physiological hunger and satiety signals, brain-gut interaction, and the influence of the gut microbiome; psychological factors, including emotional self-regulation, cognitive control, stress regulation, and reward processing; and social factors, such as parental behaviour and feeding practices, culture, geographic location, and food insecurity.

The researchers combine this framework with temperamental theory to explore how the pathways are modified by individual temperament.

Children react differently to stimuli based on their psychological and emotional make up, Ju explained. For example, openness to novelty and positive anticipation can affect whether a child is willing to try new foods. If a parent pressures their child to eat, it could be counter-productive for a child with heightened sensitivity to negative affect, causing the child to consume less.

The model also takes children’s developmental stages into account. Infants have basic appetite regulation based on physiological cues. They gradually become more susceptible to external influences and by age 3-5, children begin to exhibit greater self-control and emotional regulation.

“By analysing the pathways outlined in our model, we can better understand the combined influences of multiple factors on children’s appetite self-regulation and their motivations to approach food,” Ju said. “For example, the presence of palatable food may not generate similar responses in everyone. Children could approach food as a reward, for pleasure-seeking, or to regulate emotions. The underlying motivations can be diverse, and they are influenced by external factors as well as temperamental characteristics.”

Socio-environmental influences include parent-child interactions around food, as well as non-food-related caregiver practices that can impact the child’s emotional regulation. The household food environment, cultural value of food intake, and food availability are also important factors, the researchers stated.

“If we understand the differential susceptibility to various factors, we can identify and modify the environmental influences that are particularly obesogenic based on children’s temperamental characteristics. Then we will be able to provide more refined approaches to support children’s healthy eating behaviour,” Ju explained.

Source: University of Illinois College of Agricultural, Consumer and Environmental Sciences

Avo at Breakfast for Women, Oats for Men, Study Suggests

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New research from the University of Waterloo suggests that men and women should have different kinds of food for breakfast in order to help lose weight.

The study, which employed a mathematical model of men’s and women’s metabolisms, showed that men’s metabolisms respond better on average to a meal laden with high carbohydrates like oats and grains after fasting for several hours, while women are better served by a meal with a higher percentage of fat, such as omelettes and avocados. The findings are out now in Computers in Biology and Medicine.

“Lifestyle is a big factor in our overall health,” said Stéphanie Abo, an Applied Mathematics PhD candidate and the lead author of the study. “We live busy lives, so it’s important to understand how seemingly inconsequential decisions, such as what to have for breakfast, can affect our health and energy levels. Whether attempting to lose weight, maintain weight, or just keep up your energy, understanding your diet’s impact on your metabolism is important.”

The study builds on an existing gap in research on sex differences in how men and women process fat. “We often have less research data on women’s bodies than on men’s bodies,” said Anita Layton, a professor of Applied Mathematics and Canada 150 Research Chair in Mathematical Biology and Medicine.

“By building mathematical models based on the data we do have, we can test lots of hypotheses quickly and tweak experiments in ways that would be impractical with human subjects.”

“Since women have more body fat on average than men, you would think that they would burn less fat for energy, but they don’t,” said Layton. “The results of the model suggest that women store more fat immediately after a meal but also burn more fat during a fast.”

Going forward, the researchers hope to build more complex versions of their metabolism models and extend beyond the consideration of biological sex by incorporating an individual’s weight, age, or stage in the menstrual cycle.

Source: University of Waterloo

More Protein and Fibre While Dropping Calories is Key for Weight Loss

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Participants on a self-directed dietary education program who had the greatest success at losing weight across a 25-month period consumed greater amounts of protein and fibre, found a study published in Obesity Science and Practice. Personalisation and flexibility also were key in creating plans that dieters could adhere to over time. 

At the one-year mark, successful dieters (41% of participants) had lost 12.9% of their body weight, compared with the remainder of the study sample, who lost slightly more than 2% of their starting weight. 

The dieters were participants in the Individualised Diet Improvement Program, which uses data visualisation tools and intensive dietary education sessions to increase dieters’ knowledge of key nutrients, enabling them to create a personalised, safe and effective weight-loss plan, said Manabu T. Nakamura, a professor of nutrition at the University of Illinois Urbana-Champaign and the leader of the research.

“Flexibility and personalisation are key in creating programs that optimise dieters’ success at losing weight and keeping it off,” Nakamura said. “Sustainable dietary change, which varies from person to person, must be achieved to maintain a healthy weight. The iDip approach allows participants to experiment with various dietary iterations, and the knowledge and skills they develop while losing weight serve as the foundation for sustainable maintenance.”

The pillars of iDip are increasing protein and fibre consumption along with consuming 1500 calories or less daily. 

Based on the dietary guidelines issued by the Institutes of Medicine, the iDip team created a one-of-a-kind, two-dimensional quantitative data visualisation tool that plots foods’ protein and fibre densities per calorie and provides a target range for each meal. Starting with foods they habitually ate, the dieters created an individualised plan, increasing their protein intake to about 80g and their fibre intake to about 20g daily.

In tracking the participants’ eating habits and their weights with Wi-Fi enabled scales, the team found strong inverse correlations between the percentages of fibre and protein eaten and dieters’ weight loss.    

“The research strongly suggests that increasing protein and fibre intake while simultaneously reducing calories is required to optimise the safety and efficacy of weight loss diets,” said first author and U. of I. alumna Mindy H. Lee, a then-graduate student and registered dietitian-nutritionist for the iDip program. 

Nakamura said the preservation of lean mass is very important while losing weight, especially when using weight-loss drugs.

 “Recently, the popularity of injectable weight loss medications has been increasing,” Nakamura said. “However, using these medications when food intake is strongly limited will cause serious side effects of muscle and bone loss unless protein intake is increased during weight loss.”

A total of 22 people who enrolled in the program completed it, including nine men and 13 women. Most of the dieters were between the ages of 30–64. Participants reported they had made two or more prior attempts to lose weight. They also had a variety of comorbidities – 54% had high cholesterol, 50% had skeletal problems and 36% had hypertension and/or sleep apnoea. Additionally, the dieters reported diagnoses of diabetes, nonalcoholic fatty liver disease, cancer and depression, according to the study.

The seven dieters who reported they had been diagnosed with depression lost significantly less weight: about 2.4% of their starting weight compared with those without depression, who lost 8.39% of their initial weight. The team found that weight loss did not differ significantly among participants with other comorbidities, or between younger and older participants or between men and women.

Body composition analysis indicated that dieters maintained their lean body mass, losing an average of 7.1kg of fat mass and minimal muscle mass at the six-month interval. Among those who lost greater than 5% of their starting weight, 78% of the weight they lost was fat, according to the study.

Overall, the participants reduced their fat mass from an average of 42.6kg at the beginning of the program to 35.7kg at the 15-month mark. Likewise, the dieters reduced their waists by about 7cm at six months and by a total of 9cm at 15 months, the team found. 

In tracking dieters’ protein and fibre intake, the team found a strong correlation between protein and fibre consumption and weight loss at three months and 12 months.

“The strong correlation suggests that participants who were able to develop sustainable dietary changes within the first three months kept losing weight in the subsequent months, whereas those who had difficulty implementing sustainable dietary patterns early on rarely succeeded in changing their diet in the later months,” Nakamura said.

The team hypothesised that this correlation could also have been associated with some dieters’ early weight loss success, which may have bolstered their motivation and adherence to their program.

Source: University of Illinois at Urbana-Champaign

Study Reveals Diet is the Main Risk Factor for Colon Cancer in Younger Adults

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A new Cleveland Clinic study has identified diet-derived molecules called metabolites as main drivers of young-onset colorectal cancer risk, especially those associated with red and processed meat. The NPJ Precision Oncology report, which analysed metabolite and microbiome datasets, highlighted that one of the best ways a younger ( < 60 years) adult can prevent colorectal cancer is to discuss their diet with their doctor.

Increased monitoring and screening for colorectal cancer is an extremely helpful tool. Despite the success of these methods, these data indicate physicians can take a different approach with their younger patients, says senior author and gastrointestinal oncologist Suneel Kamath,MD.

“At the end of the day, it’s impractical to apply our care models for those over 60 to younger adults simply because we cannot give everyone in the system yearly colonoscopies,” he explains. “What is much more feasible is to give everyone in the system a simple test to measure a biomarker that determines their colorectal cancer risk. Then we can give the most at-risk individuals appropriate screening.”

Former clinical fellow Thejus Jayakrishnan, MD, and Naseer Sangwan, PhD, director of the Microbial Sequencing & Analytics Resource Core co-led the work. Researchers in Cleveland Clinic’s Center for Young-Onset Colorectal Cancer provided large-scale analyses of patient data from individuals who received care for either young- or average-onset colorectal cancer at Cleveland Clinic.

One previous study from this team identified differences in the metabolites (diet-derived molecules) of young – versus average-onset colorectal cancer, while another identified differences in gut microbiome between younger and older adults with colorectal cancer. These studies provided many potential directions for studying young-onset CRC. However, when more factors are involved in cancer risk, it becomes more complicated to understand what’s going on and plan future research, Dr Sangwan says. Interactions between these factors, like when our gut bacteria consume our metabolites and produce their own, make it even more complex.

Dr Sangwan and his team then developed an AI algorithm to combine and analyse the existing studies’ datasets and clarify what factors are most relevant for future study. Surprisingly, Dr Sangwan’s analysis revealed that differences in diet (identified through analysing metabolites) accounted for a significant proportion of the differences observed between the young-onset and older-onset patients.

“Researchers – ourselves included – have begun to focus on the gut microbiome as a primary contributor to colon cancer risk. But our data clearly shows that the main driver is diet,” Dr Sangwan says. “We already know the main metabolites associated with young-onset risk, so we can now move our research forward in the correct direction.”

The team was excited to see diet play such a large role in cancer risk, because it is much easier to identify at-risk patients by counting the metabolites in their blood than it is to sequence the bacterial DNA in their stool for different microbes.

“It can actually be very complicated and difficult to change your microbiome,” explains Dr Kamath. “While it’s not always easy, it is much simpler to change your diet to prevent colon cancer.”

Addressing factors in our diet to prevent colon cancer

Younger colon cancer patients had higher levels of metabolites associated with the production and metabolism of an amino acid called arginine, and with the urea cycle compared to their older peers. These differences may be tied to long-term consumption of red meat and processed meat. The team is now analyzing national datasets to validate their Cleveland Clinic-specific findings in patients across the country.

After they show that arginine and urea cycle metabolites (and, by proxy, red and processed meat overconsumption) are elevated across younger adults with colon cancer nationwide, they plan to test whether certain diets or commercially available drugs that regulate arginine production and the urea cycle can help prevent or even treat young-onset colorectal cancer.

Dr Kamath says that even though more research is needed to understand exactly how dietary factors cause colon cancer, his current findings have already changed the way he delivers patient care.

“Even though I knew before this study that diet is an important factor in colon cancer risk, I didn’t always discuss it with my patients during their first visit. There is so much going on, it can already be so overwhelming,” says Dr Kamath. “Now, I always make sure to bring it up to my patients, and to any healthy friends or family members they may come in with, to try and equip them with the tools they need to make informed choices about their lifestyle.”

Source: Cleveland Clinic

Sugar Intake Decreasing but Still Too High

Further action needed, according to a University of Bonn study on child and adolescent nutrition

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University of Bonn researchers have analysed data on sugar intake among children and adolescents in a long-term study, finding that intake has been declining steadily since 2010 – but is still above the level recommended by the World Health Organization (WHO). The results, to be published in the European Journal of Nutrition, are already available online.

“Our study concerns the intake of free sugars,” explains Dr Ines Perrar, who is a research associate at the University of Bonn Institute of Nutritional and Food Science (IEL) and lead author of the study. “There is debate on whether sugar, like salt and fats, is linked to the development of chronic diseases.” The WHO defines “free” sugar as any form of sugar, including honey, syrup and fruit juice concentrates, added by a manufacturer or when preparing food and beverages at home. Free sugar also includes sugar naturally occurring in juices.

For their project, IEL researchers analysed data from the “Dortmund Nutritional and Anthropometric Longitudinally Designed” cohort study (DONALD). The DONALD study has been ongoing since 1985, gathering detailed data on nutrition, metabolism, growth and health of children and adolescents. “Study participants weigh and document everything they eat and drink on three consecutive days every year,” relates Dr Ute Nöthlings, Professor of Nutritional Epidemiology at the IEL. “Referring to our Institute’s in-house nutrient database, we are able to estimate intake of certain nutrients, including free sugars.”

Sugar intake too high among adolescents in particular

The authors evaluated 4218 sets of three-day weighing dietary records by 751 children and adolescents between ages three and 18 in the years 2010–2023. “Our finding is that free sugar intake continues to decline,” Dr Perrar notes, “but average daily intake still exceeds the level recommended by the WHO and the German Nutrition Society (Deutsche Gesellschaft für Ernährung, DGE) of a maximum 10% of total daily energy intake.”

An analysis of DONALD back in 2019 already indicated that free sugar intake has been declining since 2005, then in 2016 a median value of approximately 16% of daily energy intake was determined. That value has subsequently declined further to 11.7%. The researchers surmise this trend may be explained by increased awareness of the health consequences of excessive consumption of sugar-sweetened beverages and certain other sugary foods.

While the decline definitely represents good progress, there are noteworthy age group differences, as Professor Nöthlings points out, who is director of the DONALD study, spokesperson for the Transdisciplinary Research Area (TRA) Sustainable Futures and a member of the Life and Health TRA at the University of Bonn: “During the observation period, we saw a relatively high intake of free sugars around 15 percent of the daily energy intake in some cases, particularly among adolescents aged six to 14. The intake then declines significantly with increasing age.”

Actual sugar intake likely higher

The researchers point out that the actual sugar intake is likely higher than the study data suggests, due in part to potential under-reporting by the study participants self-reporting on what they eat. In addition, the study is not broadly representative of society, as the design of this large study favours participation by families of a rather higher socioeconomic status who are generally more aware regarding nutrition and health issues.

Source: University of Bonn