Health
Reducing sugar intake has a small but significant effect on body weight in adults, finds a paper published on www.bmj.com .
Although the effect is relatively small (an average reduction of 0.8 kg), the findings provide some support for international guidelines to cut sugar intake to less than 10 percent of total energy to help reduce the global obesity epidemic.
Excessive sugar in the diet has been linked to obesity, and a higher risk of chronic diseases. The most consistent association has been between a high intake of sugar sweetened beverages and the development of obesity, but not all studies have reported a statistically significant link.
The World Health Organization has suggested that intake of “free sugars” should be less than 10% of total energy intake, but no upper safe limit has been agreed.
So a team of researchers at the University of Otago and the Riddet Institute in New Zealand analyzed the results of 71 studies (30 randomized controlled trials and 41 cohort studies) of sugar intake and body fatness to summarize evidence on the association between intake of dietary sugars and body weight in both adults and children.
Free sugars were defined as sugars that are added to foods by the manufacturer, cook, or consumer; plus those naturally present in honey, syrups, and fruit juices. Differences in study design and quality were taken into account to minimize bias.
They found that advice to reduce free sugars was associated with an average 0.8 kg reduction in weight (in studies that ran for up to 8 months), while advice to increase intake was associated with a corresponding 0.75 kg increase.
This parallel effect, they suggest, seems be due to an altered energy intake, since replacing sugars with other carbohydrates did not result in any change in body weight.
The evidence was also less consistent in children, mainly due to poor compliance to dietary advice. However, for sugar sweetened beverages, the risk of being overweight or obese increased among children with the highest intake compared with those with the lowest intake.
The authors say that, given the many causes of obesity, it is unsurprising that the effect of reducing intake is relatively small, and they point out that some other unmeasured (confounding) factors may explain some or all of this effect. But they add “the overall consistency of the findings, regardless of study type, is reassuring.”
They also acknowledge that the extent to which population based advice to reduce sugars might reduce risk of obesity “cannot be extrapolated from the present findings, because few data from the studies lasted longer than ten weeks.”
But conclude that “when considering the rapid weight gain that occurs after an increased intake of sugars, it seems reasonable to conclude that advice relating to sugars intake is a relevant component of a strategy to reduce the high risk of overweight and obesity in most countries.”
In an accompanying editorial, US experts say the association between sugar and poor health has remained contentious over the past few decades, but that accumulating evidence “points towards a role for sugar and other refined carbohydrates in the development of overweight.”
They say reducing the intake of sugar sweetened drinks “is a high priority” and point to policies such as taxes on sugar laden drinks, restrictions on advertising to children, and limits on serving sizes.
They also call for action at many levels, including educational programs, improvements in foods and drinks in schools and worksites, and nutrition programs for people with low incomes.
Finally, a feature comments on the 40th anniversary of the publication of the popular book – Pure, White and Deadly – written by the British physiologist John Yudkin, which claimed that high sugar consumption was associated with heart disease.
It considers new evidence linking fructose (found in nearly all added sugars) with insulin resistance – a pre-cursor of heart disease – and suggests that Yudkin’s warnings are finally being recognized, despite ongoing opposition from the sugar industry.
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Eating three or more servings of blueberries and strawberries per week may help women reduce their risk of a heart attack by as much as one-third, researchers reported in Circulation: Journal of the American Heart Association.
Blueberries and strawberries contain high levels of naturally occurring compounds called dietary flavonoids, also found in grapes and wine, blackberries, eggplant, and other fruits and vegetables.
A specific sub-class of flavonoids, called anthocyanins, may help dilate arteries, counter the buildup of plaque and provide other cardiovascular benefits, according to the study.
“Blueberries and strawberries can easily be incorporated into what women eat every week,” said Eric Rimm D.Sc., senior author and Associate Professor of Nutrition and Epidemiology at the Harvard School of Public Health in Boston, Mass. “This simple dietary change could have a significant impact on prevention efforts.”
Blueberries and strawberries were part of this analysis simply because they are the most-eaten berries in the United States. Thus, it’s possible that other foods could produce the same results, researchers said.
Scientists from the Harvard School of Public Health in the United States and the University of East Anglia, United Kingdom conducted a prospective study among 93,600 women ages 25 to 42 who were registered with the Nurses’ Health Study II. The women completed questionnaires about their diet every four years for 18 years.
During the study, 405 heart attacks occurred. Women who ate the most blueberries and strawberries had a 32-percent reduction in their risk of heart attack compared to women who ate the berries once a month or less – even in women who otherwise ate a diet rich in other fruits and vegetables.
“We have shown that even at an early age, eating more of these fruits may reduce risk of a heart attack later in life,” said Aedín Cassidy, Ph.D., lead author and head of the Department of Nutrition at Norwich Medical School of the University of East Anglia in Norwich, United Kingdom.
The findings were independent of other risk factors, such as age, high blood pressure, family history of heart attack, body mass, exercise, smoking, caffeine or alcohol intake.
The American Heart Association supports eating berries as part of an overall balanced diet that also includes other fruits, vegetables and whole-grain products. Eating a variety of foods is the best way to get the right amounts of nutrients.
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Some children who are accurately diagnosed in early childhood with autism lose the symptoms and the diagnosis as they grow older, a study supported by the National Institutes of Health has confirmed.
The research team made the finding by carefully documenting a prior diagnosis of autism in a small group of school-age children and young adults with no current symptoms of the disorder.
The report is the first of a series that will probe more deeply into the nature of the change in these children’s status.
Having been diagnosed at one time with an autism spectrum disorder (ASD), these young people now appear to be on par with typically developing peers.
The study team is continuing to analyze data on changes in brain function in these children and whether they have subtle residual social deficits.
The team also is reviewing records on the types of interventions the children received, and to what extent they may have played a role in the transition.
“Although the diagnosis of autism is not usually lost over time, the findings suggest that there is a very wide range of possible outcomes,” said NIMH Director Thomas R. Insel, M.D. “For an individual child, the outcome may be knowable only with time and after some years of intervention. Subsequent reports from this study should tell us more about the nature of autism and the role of therapy and other factors in the long term outcome for these children.”
The study, led by Deborah Fein, Ph.D., at the University of Connecticut, Storrs, recruited 34 optimal outcome children, who had received a diagnosis of autism in early life and were now reportedly functioning no differently than their mainstream peers.
For comparison, the 34 children were matched by age, sex, and nonverbal IQ with 44 children with high-functioning autism, and 34 typically developing peers. Participants ranged in age from 8 to 21 years old.
Prior studies had examined the possibility of a loss of diagnosis, but questions remained regarding the accuracy of the initial diagnosis, and whether children who ultimately appeared similar to their mainstream peers initially had a relatively mild form of autism.
In this study, early diagnostic reports by clinicians with expertise in autism diagnosis were reviewed by the investigators.
As a second step to ensure accuracy, a diagnostic expert, without knowledge of the child’s current status, reviewed reports in which the earlier diagnosis had been deleted.
The results suggested that children in the optimal outcome group had milder social deficits than the high functioning autism group in early childhood, but had other symptoms, related to communication and repetitive behavior, that were as severe as in the latter group.
The investigators evaluated the current status of the children using standard cognitive and observational tests and parent questionnaires. The optimal outcome children had to be in regular education classrooms with no special education services aimed at autism. They now showed no signs of problems with language, face recognition, communication, and social interaction.
This study cannot provide information on what percentage of children diagnosed with ASD might eventually lose the symptoms.
Study investigators have collected a variety of information on the children, including structural and functional brain imaging data, psychiatric outcomes, and information on the therapies that the children received.
Analysis of those data, which will be reported in subsequent papers, may shed light on questions such as whether the changes in diagnosis resulted from a normalizing of brain function, or if these children’s brains were able to compensate for autism-related difficulties.
The verbal IQs of the optimal outcome children were slightly higher than those with high functioning autism. Additional study may reveal whether IQ may have been a factor in the transition they made.
“All children with ASD are capable of making progress with intensive therapy, but with our current state of knowledge most do not achieve the kind of optimal outcome that we are studying,” said Dr. Fein. “Our hope is that further research will help us better understand the mechanisms of change so that each child can have the best possible life.”
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UKIAH, Calif. – Recent nursing school graduates began an 18-week residency at Ukiah Valley Medical Center today.
This team of nine nurses from Mendocino and Lake counties will spend two days per week in clinical practice and one day in education, led by preceptors, mentors, debriefers, subject matter experts and other UVMC leaders throughout the residency.
Upon completion, the nurses will be well trained, equipped and eager to put their skills to work in providing destination healthc are to patients at UVMC.
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