Diet
#13956 - 07/14/03 01:58 PM
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Heather
Reged: 12/09/02
Posts: 7799
Loc: Seattle, WA
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All articles related to diet and digestive health research should be posted here.
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Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!
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Journal of the National Cancer Institute, Vol. 95, No. 12, 914-916, June 18, 2003
© 2003 Oxford University Press
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BRIEF COMMUNICATION
Glycemic Load, Carbohydrate Intake, and Risk of Colorectal Cancer in Women: A Prospective Cohort Study
Paul D. Terry, Meera Jain, Anthony B. Miller, Geoffrey R. Howe, Thomas E. Rohan
Affiliations of authors: P. D. Terry, T. E. Rohan, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY; M. Jain, Integrated Policy and Planning Division, Ontario Ministry of Health and Long-Term Care, and Department of Public Health Sciences, University of Toronto, Toronto, Canada; A. B. Miller, Department of Public Health Sciences, University of Toronto, and Division of Clinical Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany; G. R. Howe, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
Correspondence to: Paul D. Terry, Ph.D., M.P.H., National Institute of Environmental Health Sciences, Epidemiology Branch, P.O. Box 12233 MD A3–05, Research Triangle Park, NC 27709–2233 (e-mail: terry2@niehs.nih.gov).
ABSTRACT
Mounting evidence suggests that high circulating levels of insulin might be associated with increased colorectal cancer risk. The glycemic effects of diets high in refined starch may increase colorectal cancer risk by affecting insulin and/or insulin-like growth factor-I levels. We examined the association between dietary intake and colorectal cancer risk in a cohort of 49 124 women participating in a randomized, controlled trial of screening for breast cancer in Canada. Linkages to Canadian mortality and cancer databases yielded data on mortality and cancer incidence up to December 31, 2000. During an average 16.5 years of follow-up, we observed 616 incident cases of colorectal cancer (436 colon cancers, 180 rectal cancers). Rate ratios for colorectal cancer for the highest versus the lowest quintile level were 1.05 (95% confidence interval [CI] = 0.73 to 1.53; Ptrend = .94) for glycemic load, 1.01 (95% CI = 0.68 to 1.51; Ptrend = .66) for total carbohydrates, and 1.03 (95% CI = 0.73 to 1.44; Ptrend = .71) for total sugar. Our data do not support the hypothesis that diets high in glycemic load, carbohydrates, or sugar increase colorectal cancer risk.
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Eating Food Too Fast Speeds Heartburn - Slow Eating Cuts Acid Reflux Risks
By Jennifer Warner
WebMD Medical News
May 23, 2003 - Fast eating, not just fast food, can increase the risk of acid reflux after meals, according to a new study. Researchers say people who eat their food quickly are more likely to suffer from gastroesophageal reflux disease (GERD).
GERD occurs when stomach acids wash up into the esophagus and cause symptoms such as chest pain and heartburn. If left untreated, the condition can lead to more serious problems, such as narrowing of the esophagus, bleeding, or a precancerous condition known as Barrett's esophagus.
Several lifestyle factors are known to affect the risk of GERD, such as a person's weight and the type of foods they eat. But in this study, researchers looked at whether the speed alone with which a person eats a meal may contribute to the risk of acid reflux and GERD.
Researchers asked 10 healthy volunteers to eat a normal, 690-calorie meal in either five or 30 minutes on alternate days and then monitored them for two hours after the meals for signs of acid reflux and GERD.
The study showed that the speedy meals induced a total of 15 GERD episodes compared to 11.5 GERD episodes triggered by the more leisurely meal. Acid reflux episodes were reported a total of 12.5 times after the five-minute meal versus 8.5 times after the 30-minute meal.
The results were presented this week at Digestive Disease Week in Orlando, Fla.
"Since rapid food intake produces more [GERD], eating slowly may represent another life-style modification aimed at reducing [GERD]," write Stephan M. Wildi of the Medical University of South Carolina in Charleston, and colleagues. "In other words, 'Your mother was right.'"
SOURCES: Abstract, Digestive Disease Week, May 17-23, Orlando, Fla.
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CardioSource 3 May 2003, Volume 361, Issue 9368 Pages 1496-1501
Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study
Sheila A Bingham a, Nicholas E Day b, Robert Luben b, Pietro Ferrari c, Nadia Slimani c, Teresa Norat c, Françoise Clavel-Chapelon d, Emmanuelle Kesse d, Alexandra Nieters e, Heiner Boeing f, Anne Tjønneland g, Kim Overvad h,i, Carmen Martinez j, Miren Dorronsoro k, Carlos A Gonzalez l, Timothy J Key m, Antonia Trichopoulou n, Androniki Naska n, Paolo Vineis o, Rosario Tumino p, Vittorio Krogh q, H Bas Bueno-de-Mesquita r, Petra HM Peeters s, Göran Berglund t, Göran Hallmans u, Eiliv Lund v, Guri Skeie v, Rudolf Kaaks c and Elio Riboli c *
Abstract
Background Dietary fibre is thought to protect against colorectal cancer but this view has been challenged by recent prospective and intervention studies that showed no protective effect.
Methods
We prospectively examined the association between dietary fibre intake and incidence of colorectal cancer in 519978 individuals aged 25–70 years taking part in the EPIC study, recruited from ten European countries. Participants completed a dietary questionnaire in 1992–98 and were followed up for cancer incidence. Relative risk estimates were obtained from fibre intake, categorised by sex-specific, cohort-wide quintiles, and from linear models relating the hazard ratio to fibre intake expressed as a continuous variable.
Findings
Follow-up consisted of 1939011 person-years, and data for 1065 reported cases of colorectal cancer were included in the analysis. Dietary fibre in foods was inversely related to incidence of large bowel cancer (adjusted relative risk 0·75 [95% CI 0·59–0·95] for the highest versus lowest quintile of intake), the protective effect being greatest for the left side of the colon, and least for the rectum. After calibration with more detailed dietary data, the adjusted relative risk for the highest versus lowest quintile of fibre from food intake was 0·58 (0·41–0·85). No food source of fibre was significantly more protective than others, and non-food supplement sources of fibre were not investigated.
Interpretation
In populations with low average intake of dietary fibre, an approximate doubling of total fibre intake from foods could reduce the risk of colorectal cancer by 40%.
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Affiliations
a MRC Dunn Human Nutrition Unit, Cambridge, UK.
b Strangeways Research Laboratory, University of Cambridge, Cambridge, UK.
c International Agency for Research on Cancer (IARC-WHO), Lyon, France.
d INSERM, U 521, Institut Gustave Roussy, Villejuif, France.
e German Cancer Research Centre, Heidelberg, Germany.
f German Institute of Human Nutrition, Potsdam-Rehbücke, Germany.
g Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark.
h Department of Clinical Epidemiology, Aalborg Hospital and Aarhus University Hospital, Denmark.
i Department of Epidemiology and Social Medicine, University of Aarhus, Denmark.
j Andalusian School of Public Health, Granada, Spain.
k Department of Public Health of Guipuzkoa, San Sebastian, Spain.
l Catalan Institute of Oncology, Barcelona, Spain.
m Cancer Research UK, Radcliffe Infirmary, Oxford, UK.
n University of Athens Medical School, Greece.
o University of Torino and CPO-Piemonte, Torino, Italy.
p Ragusa Cancer Registry, Sicily, Italy.
q Department of Epidemiology, National Cancer Institute, Milan, Italy.
r National Institute of Public Health and the Environment, Bilthoven, Netherlands.
s Julius Centre for Health Sciences and Primary Care, University Medical Center, Netherlands.
t Malmö Diet and Cancer Study, Lund University, Malmö, Sweden.
u Department of Nutritional Research, University of Umeå, Sweden.
v Institute of Community Medicine, University of Tromsø, Norway.
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* Correspondence to: Dr Elio Riboli, Unit of Nutrition and Cancer, International Agency for Research on Cancer (IARC-WHO), 150 Cours Albert-Thomas, 69372 Lyon cedex 08, France
Source
Elsevier Science Inc.
© 2003 Elsevier Science Ltd
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Dig Dis Sci. 2002 Aug;47(8):1697-704.
High-fiber diet supplementation in patients with irritable bowel syndrome (IBS): a multicenter, randomized, open trial comparison between wheat bran diet and partially hydrolyzed guar gum (PHGG).
Parisi GC, Zilli M, Miani MP, Carrara M, Bottona E, Verdianelli G, Battaglia G, Desideri S, Faedo A, Marzolino C, Tonon A, Ermani M, Leandro G.
Servizio di Gastroenterologia, Casa di Cura Abano Terme USL 16, Padova, Italy.
High-fiber diet supplementation is commonly used in IBS, although it poses several management problems. Partially hydrolyzed guar gum (PHGG) has shown beneficial effects in animal and human studies, but its potential role in IBS symptom relief has not been evaluated yet. We investigated PHGG in IBS patients and compared it to a wheat bran diet. Abdominal pain, bowel habits, and subjective overall rating were longitudinally evaluated in 188 adult IBS patients (139 women and 49 men) for 12 weeks. Patients were classified as having diarrhea-predominant, constipation-predominant, or changeable bowel habits and were randomly assigned to groups receiving fiber (30 g/day of wheat bran) or PHGG (5 g/day). After four weeks, patients were allowed to switch group, depending on their subjective evaluation of their symptoms. Significantly more patients switched from fiber to PHGG (49.9%) than from PHGG to fiber (10.9%) at four weeks. Per protocol analysis showed that both fiber and PHGG were effective in improving pain and bowel habits, but no difference was found between the two groups. Conversely, intention-to-treat analysis showed a significantly greater success in the PHGG group (60%) than in the fiber group (40%). Moreover, significantly more patients in the PHGG group reported a greater subjective improvement than those in the Fiber group. In conclusion, improvements in core IBS symptoms (abdominal pain and bowel habits) were observed with both bran and PHGG, but the latter was better tolerated and preferred by patients, revealing a higher probability of success than bran and a lower probability of patients abandoning the prescribed regimen, suggesting that it can increase the benefits deriving from fiber intake in IBS, making it a valid option to consider for high-fiber diet supplementation.
Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial
PMID: 12184518 [PubMed - indexed for MEDLINE]
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Nutrition. 1998 May;14(5):470-1. Related Articles, Links
Bran: may irritate irritable bowel.
Lewis MJ, Whorwell PJ.
The irritable gut is known to be hypersensitive, and it is reasonable to suspect that patients with the disorder might be hyperreactive to agents that stimulate or irritate it. This appears to be a possible explanation for the adverse effects of bran on hospital patients with this disorder, but we do not yet know how this product affects community IBS sufferers. We cannot ignore the fact that fiber and bran have major beneficial effects in other areas, not least in the reduction of colonic carcinoma. In conclusion, it is probably best to recommend that patients with IBS be left to judge for themselves whether bran helps or exacerbates their symptoms, but there is enough evidence to suggest that the current dogma of routinely treating all IBS sufferers with bran should be challenged. Proprietary sources of fiber, such as ispaghula, may be more appropriate for those IBS subjects (for example, constipated) for whom fiber supplementation is believed justified.
PMID: 9614316 [PubMed - indexed for MEDLINE]
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Lancet. 1994 Jul 2;344(8914):39-40.
Bran and irritable bowel syndrome: time for reappraisal.
Francis CY, Whorwell PJ.
Department of Medicine, University Hospital of South Manchester, UK.
Whilst following up large numbers of patients with irritable bowel syndrome we got the impression that wholemeal wheat and bran products made people with the condition worse rather than better. One hundred consecutive new referrals, all of whom had tried bran, were questioned to resolve this issue. 55% of patients were made worse by bran whereas only 10% had found it helpful. With the exception of fruit, other forms of dietary fibre were not as detrimental and proprietary supplements were found to be beneficial. All symptoms of irritable bowel syndrome were exacerbated by bran, with bowel disturbance most often adversely affected, followed by abdominal distension and pain. The results of this study suggest that the use of bran in irritable bowel syndrome should be reconsidered. The study also raises the possibility that excessive consumption of bran in the community may actually be creating patients with irritable bowel syndrome by exacerbating mild, non-complaining cases.
PMID: 7912305 [PubMed - indexed for MEDLINE]
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Gastroenterol Clin North Am. 1991 Jun;20(2):313-24.
Diet and the irritable bowel syndrome.
Friedman G.
Department of Medicine, Mt. Sinai School of Medicine, New York, New York.
Food intake plays a key role in triggering or perpetuating symptoms in patients with IBS. Evaluation of the impact of diet in the individual patient requires a precise dietary history and a 7-day prospective dietary analysis, which should include the quality and quantity of food consumed, chronologic sequence and nature of symptoms, and the frequency and consistency of bowel movements. The caloric density of the meal, total fat intake, the quantity and quality of lactose-containing foods, sorbitol, fructose, and the nature and quantity of soluble and insoluble fiber intake must be noted. Patients with reflux esophageal symptoms should eliminate foods that decrease LES pressure, such as chocolate, peppermint, alcohol, and coffee. Direct esophageal mucosal irritants such as tomatoes, citrus juices, sharp condiments, and alcohol should be limited. Gastric emptying is slowed with the ingestion of fats and soluble fiber. Small bowel motility is slowed by soluble fiber and fatty foods. Gaseous syndromes may be reduced by avoidance of smoking, chewing gum, excessive liquid intake, and carbonated drinks. The reduced intake of large amounts of lactose-containing foods, sorbitol, and fructose may limit postprandial bloating. Flatus production can be lowered by reducing fermentable carbohydrates such as beans, cabbage, lentils, brussel sprouts, and legumes. Soluble and insoluble fiber ingestion will reduce sigmoidal intraluminal pressures and overcome spastic constipation when given in progressive graded doses. Effective dietary manipulations remain a key factor in reducing symptoms in IBS.
Publication Types:
Review
Review, Tutorial
PMID: 2066155 [PubMed - indexed for MEDLINE]
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High-Protein Diets Can Hurt Kidneys - Damage Stems From Proteins Found in Meat
By Sid Kirchheimer
WebMD Medical News
March 17, 2003 -- High-protein diets like that of the popular Atkins diet may accelerate the loss of kidney function in people with early problems. However, these controversial diets do not seem to affect people with normal kidneys, suggests new research.
The problem is, as many as 20 million Americans are at risk for reduced kidney function but don't know it. Therefore, people on high-protein diets may be unknowingly damaging their kidneys.
"There are no symptoms attributable to this early kidney disease, but it's very prevalent," says Eric Knight, MD, MPH, lead researcher of the study and a doctor at Brigham and Women's Hospital in Boston. Those at highest risk are people with high blood pressure, diabetes, or are older than age 65, he says.
Even in his study, about one in four of the 1,624 women studied had mildly reduced kidney function that produced no obvious symptoms.
Knight's findings on high-protein diets are published in the March 18 edition of Annals of Internal Medicine. It's the latest chapter in the ongoing Nurses Health Study, which has already documented that frequent meat consumption may increase risk of colon cancer.
The women studied were questioned about their consumption of meat and other foods, and other health risks were also evaluated. They were tracked for 11 years, and researchers found that those with mild kidney problems who ate a high-protein diet --- especially protein from meat -- had a faster loss in function. No such association was noted among women with these kidney problems who got most of their protein from dairy foods. However, high meat consumption didn't seem to exacerbate problems in those with healthy kidneys.
"We saw a significantly measurable association in those consuming about 1.3 grams of animal protein for each kilo of body weight," Knight tells WebMD. "That level is not as high as the protein you get from animal sources in the Atkins diet. So clearly a person who is undertaking a high-protein diet such as Atkins should have a kidney function test and carefully be monitored while following this diet."
Are high-protein diets safe for those with normal kidney function?
"If the Atkins diet was the only way of losing weight, perhaps the benefits would outweigh the risks," he says. "Obviously, extreme obesity is a risk factor of kidney disease. But there are other health risks associated with high consumption of meat products, such as too much animal fats and saturated fats that increase the risk of heart disease. I think the message of our study is that people with mild reduced kidney function should be careful to moderate their intake of meat overall and very carefully consider the risk and benefits before starting an Atkins-type diet."
When beginning the Atkins plan, dieters typically eat about 2 grams of animal protein for each gram of body weight, says Colette Heimowitz, director of education and research for Atkins Nutritionals. That means a woman weighing 150 pounds would consume about 135 grams of protein each day -- nearly 40% more than what was typically consumed by those in Knight's study. In later stages of the high-protein diet, the amount of protein is reduced to levels consumed by those in Knight's study.
"We tell people they shouldn't do this program without first getting a physical and be monitored by their doctors, and those with mild renal insufficiency need to be under a doctor's supervision because they can't take in as much protein as the program offers in the induction phase," Heimowitz tells WebMD. "And we already say that in our books and on our web site. They can still follow an Atkins-type weight-loss plan by choosing healthy fats and healthy carbohydrates but will lose weight at a slower pace."
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SOURCES: Annals of Internal Medicine, March 18, 2003. Eric Knight, MD, MPH, doctor, Brigham and Women's Hospital; research fellow, Harvard Medical School, Boston. Colette Heimowitz, director of education and research, Atkins Nutritionals, New York.
© 2003 WebMD Inc. All rights reserved.
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Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!
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European Journal of Nutrition
Publisher: Steinkopff Verlag
ISSN: 1436-6207
DOI: 10.1007/s00394-002-0380-4
Issue: Volume 41, Number 6/December 2002
Pages: 244 - 248
Relationship between lifestyle factors and defecation in a Japanese population
Shigeyuki Nakaji A1, Shoji Tokunaga A2, Juichi Sakamoto A3, Masahiro Todate A3, Tadashi Shimoyama A1, Takashi Umeda A1, Kazuo Sugawara A1
A1 Department of Hygiene, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562 Japan. nakaji@cc.hirosaki-u.ac.jp
A2 Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
A3 First Department of Internal Medicine, Hirosaki University School of Medicine, Hirosaki, Japan
Abstract:
Summary. Background: There is a paucity of accurate data regarding any association in the general population between defecation and lifestyle factors such as diet, exercise, physique, and childbirth.
Aims of the study: To evaluate the effects of such lifestyle factors on defecation among regional residents of Japan.
Methods: Residents (n = 1,699) of northern Japan, aged over 40 years, were surveyed in 1995 using a questionnaire to assess their lifestyle factors (diet, beverage consumption, exercise, physique, and childbirth), and examining their defecation status. We evaluated the relationship between these lifestyle factors and defecation using logistic regression analysis. The authors used four measures (defecation frequency, subjective defecation state, subjective fecal properties, and fecal consistency) and assigned the subjects to a group defined by their defecatory status: constipation, diarrhea, or normal, depending on the responses of the subjects to all four criteria.
Results: The tendency for constipation correlated positively with age in males (p = 0.130), although this trend was not observed in females (p = 0.641). Of the dietary factors examined, only rice, which accounts for the largest proportion of daily dietary fiber intake in Japan, demonstrated a preventive effect on constipation in both sexes (p = 0.050 in males and 0.003 in females). Walking was a preventive factor for constipation among males (p = 0.049), and alcohol also inhibited constipation among males (p = 0.007).
Conclusions: These results suggest that exercise, such as walking, and a high intake of dietary fiber, such as rice, were useful in the maintenance of defecation.
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