Nutrition reviews
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Nutrition is now becoming once more of intense interest to biological and medical scientists working on the control of development and human health. It is also now of ever greater public health interest. Few scientists, however, recognize that the same interest for those involved in fundamental science and public health developed a century ago focusing on the way in which nutrition and specific micronutrients, as well as general energy and protein intakes, were crucial to infant growth and appropriate development. ⋯ New evidence on epigenetics and the structural changes in the fetus in response to inappropriate maternal diets provides mechanisms to explain this. Unfortunately, a vicious intergenerational cycle of maternal and fetal epigenetic change seems to herald markedly increased future burdens of disease. The nutrition field is therefore challenged not only in terms of science, but also in new dimensions of public health of immense economic significance.
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The increasing global health problems of overweight and obesity are associated with coronary heart disease, hypertension, diabetes, osteoarthritis, and certain cancers, among other health concerns. Vegetarian diets are associated with reduced body weight, lower incidence of certain chronic disease, and lower medical costs compared with non-vegetarian diets. We reviewed the literature to ascertain the extent to which and by what mechanism(s) a plant-based diet may mediate body weight.
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Four mechanisms were reviewed to explain the possible association between sweetened beverages and increased overweight or obesity: excess caloric intake, glycemic index and glycemic load, lack of effect of liquid calories on satiety, and displacement of milk. The findings were inconsistent across studies. The strongest support was for the excess caloric intake hypothesis, but the findings were not conclusive. Assigning possible links between sweetened beverage consumption and adiposity requires research that compares and contrasts specific mechanisms, especially in populations at risk for obesity, while controlling for likely confounding variables.
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While there is a significant amount of data showing health benefits of increased fish consumption, there are conflicting reports about the cardiovascular risks of mercury in seafood. A recent long-term study attempted to resolve this controversy, providing an opportunity to balance recommendations from the US Environmental Protection Agency for mercury with those from the American Heart Association for fish consumption.
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The role of the food industry in the response to the epidemic of obesity is guided by many factors, including the current state of knowledge of the problem. There have been efforts among food and beverage companies to help increase our knowledge about the factors contributing to overweight and to investigate product and marketing changes that may help reduce the risk of weight gain. The value of their future contributions is dependent on corporate resolve, but also on interactive guidance from government and health institutions on the best strategies to take and the best research to support. This is especially clear given the complex nature of the causes of obesity and approaches for treatment.