The American journal of clinical nutrition, Jan 4, 2015
Carbohydrate quality may be an important determinant of type 2 diabetes (T2D); however, relations... more Carbohydrate quality may be an important determinant of type 2 diabetes (T2D); however, relations between various carbohydrate quality metrics and T2D risk have not been systematically investigated. The purpose of this study was to prospectively examine the association between carbohydrates, starch, fibers, and different combinations of these nutrients and risk of T2D in women. We prospectively followed 70,025 women free of cardiovascular disease, cancer, and diabetes at baseline from the Nurses' Health Study (1984-2008). Diet information was collected with the use of a validated questionnaire every 4 y. Cox regression was used to evaluate associations with incident T2D. During 1,484,213 person-years of follow-up, we ascertained 6934 incident T2D cases. In multivariable analyses, when extreme quintiles were compared, higher carbohydrate intake was not associated with T2D (RR = 0.98; 95% CI: 0.89, 1.08; P-trend = 0.84), whereas starch was associated with a higher risk (RR = 1.23;...
We tested whether nutrient intakes estimated from 4-d diet records were associated with plasma li... more We tested whether nutrient intakes estimated from 4-d diet records were associated with plasma lipoprotein subclasses in 103 men who were randomly assigned to a low-fat (24% fat) and a high-fat (46% fat) diet for 6 wk each in a crossover design. Postheparin plasma lipoprotein lipase (LPL) and hepatic lipase (HL) activities were also determined in a subset of 43 men. Changes in intake (ie, high fat minus low fat) of total saturated fatty acids, as well as myristic (14:0) and palmitic (16:0) acids, were positively correlated (P < 0.01) with increases in mass of large LDL particles [measured by analytic ultracentrifugation as mass of lipoproteins of flotation rate (S f o ) 7-12] and with LDL peak particle diameter and flotation rate, but not with changes in LDL-cholesterol concentration. Changes in total saturated fatty acids as well as myristic and palmitic acids were also inversely associated with changes in HL activity (P < 0.05). With the high-fat diet only, variation in dietary total saturated fatty acid intake was inversely correlated (P < 0.01) with concentrations of small, dense LDL of S f o 0-5. This correlation was significant specifically for myristic acid (P < 0.001). Stearic acid (18:0), monounsaturates, and polyunsaturates showed no significant associations with lipoprotein concentrations. These data indicate that a high saturated fat intake (especially 14:0 and 16:0) is associated with increased concentrations of larger, cholesterol-enriched LDL and this occurs in association with decreased HL activity.
The metabolism in plasma of apo(a) and apoB100, the major pro- tein components of lipoprotein(a) ... more The metabolism in plasma of apo(a) and apoB100, the major pro- tein components of lipoprotein(a) (Lp(a)), and the mechanism by which estrogen lowers Lp(a) concentration are both not well under- stood. Estrogen or placebo were administered to 12 postmenopausal women in a double-blind cross-over design; and after each treatment, apo(a) and apoB100 in Lp(a) were endogenously labeled by iv trideu-
Androgens are known to lower plasma triglycerides, an in- dependent risk factor for coronary hear... more Androgens are known to lower plasma triglycerides, an in- dependent risk factor for coronary heart disease (CHD). Tri- glycerides are carried in plasma on very low density (VLDL) and low density (LDL) lipoprotein particles. Apolipoprotein CIII (apoCIII), a strong predictor of CHD, impairs the metab- olism of VLDL and LDL, contributing to increased triglycer- ides. The objective of this study
-Circulating very-long chain saturated fatty acids (VLCSFAs) may play an active role in the etiol... more -Circulating very-long chain saturated fatty acids (VLCSFAs) may play an active role in the etiology of cardiometabolic diseases. -We measured three VLCSFAs (C20:0, C22:0, and C24:0) in plasma and erythrocytes using gas-liquid chromatography among 794 incident coronary heart disease (CHD) cases who were prospectively identified and confirmed among women in Nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; Health Study (NHS; 1990-2006) and among men in Health Professionals Follow-up Study (HPFS; 1994-2008). A total of 1233 CHD-free controls were randomly selected and matched to cases in these two cohorts. Conditional logistic regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI). Plasma VLCSFAs were correlated with favorable profiles of blood lipids, C-reactive protein, and adiponectin in the NHS and HPFS, as well as with fasting insulin and C-peptide levels in a nationally-representative U.S. comparison population. After multivariate adjustment for lifestyle factors, body mass index (BMI), diet, and long-chain n-3 and trans fatty acids, total VLCSFAs in plasma was associated with a 52% decreased risk of CHD [pooled HR (95% CI); 0.48 (0.32, 0.72), comparing extreme quintiles; Ptrend&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001]. For VLCSFAs in erythrocytes, a non-significant inverse trend with CHD risk was observed [pooled HR (95% CI); 0.66 (0.41, 1.06), comparing extreme quintiles; Ptrend=0.16]. -In U.S. men and women, plasma VLCSFAs were independently associated with favorable profiles of blood lipids and other CVD risk markers and a lower risk of CHD. Erythrocyte VLCSFAs were associated with non-significant trends of lower CHD risk. Future studies are warranted to elucidate underlying biological mechanisms.
International journal of food sciences and nutrition, Jan 28, 2015
India has the second largest number of people with diabetes in the world following China. Evidenc... more India has the second largest number of people with diabetes in the world following China. Evidence indicates that consumption of whole grains can reduce the risk of type 2 diabetes. This article describes the study design and methods of a trial in progress evaluating the effects of substituting whole grain brown rice for polished (refined) white rice on biomarkers of diabetes risk (glucose metabolism, dyslipidemia, inflammation). This is a randomized controlled clinical trial with a crossover design conducted in Chennai, India among overweight but otherwise healthy volunteers aged 25-65 y with a body mass index ≥23 kg/m(2) and habitual rice consumption ≥200 g/day. The feasibility and cultural appropriateness of this type of intervention in the local environment will also be examined. If the intervention is efficacious, the findings can be incorporated into national-level policies which could include the provision of brown rice as an option or replacement for white rice in government...
Previous observational studies of self-reported dairy product consumption and stroke risk have re... more Previous observational studies of self-reported dairy product consumption and stroke risk have reported mixed findings. Few studies have used circulating biomarkers that provide objective measures of dairy fat intake. We tested the hypothesis that the circulating biomarkers of dairy fat, pentadecanoic acid (15:0), heptadecanoic acid (17:0), and trans palmitoleate (trans 16:1n-7), were associated with lower incidence of stroke, especially ischemic stroke. Secondarily, we evaluated 14:0, which is obtained from dairy products and beef, and also endogenously synthesized. In participants from 2 large US cohorts (the Health Professionals Follow-Up Study: 51,529 men; the Nurses' Health Study: 121,700 women) with stored blood samples in 1993-1994 (n = 18,225) and 1989-1990 (n = 32,826), respectively, we prospectively identified 594 incident stroke cases (median follow-up: 8.3 y) and matched them 1:1 to risk-set-sampled control subjects by age, sex, race, and smoking. Total plasma and re...
Evidence regarding the relationship of n-3 fatty acids (FA) to type 2 diabetes and metabolic synd... more Evidence regarding the relationship of n-3 fatty acids (FA) to type 2 diabetes and metabolic syndrome components (MetS) is inconsistent. To examine associations of adipose tissue n-3 FA with MetS. We studied 1611 participants without prior history of diabetes or heart disease who were participants in a population-based case-control study of diet and heart disease (The Costa Rica Heart Study). We calculated prevalence ratios (PR) and 95% confidence intervals (CI) for MetS by quartile of n-3 FA in adipose tissue derived mainly from plants (α-Linolenic acid (ALA)), fish (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) or metabolism (docosapentaenoic acid (DPA), as well as the EPA:ALA ratio, a surrogate marker of delta-6 desaturase activity). N-3 FA levels in adipose tissue were associated with MetS prevalence in opposite directions. The PR (95% CI) for the highest compared with the lowest quartile adjusted for age, sex, body mass index (BMI), residence, lifestyle, diet and ...
Breastfeeding accounts for a sizable proportion of infant HIV infections. Some fatty acids (FAs) ... more Breastfeeding accounts for a sizable proportion of infant HIV infections. Some fatty acids (FAs) are potent immunomodulators with virucidal activity, and their primary source in breastfed children is breast milk. The aims of the study were to examine whether the percentage weight concentration of FAs in breast milk was associated with the risk of mother-to-child transmission (MTCT) of HIV by breastfeeding and with shedding of cell-free virus (CFV) or cell-associated virus (CAV) in breast milk. We conducted a case-control study nested within a cohort of HIV-infected Tanzanian women and children. We matched 59 incident breastfeeding MTCT cases to 59 nontransmitting controls based on the child's age at sample collection. We quantified FAs, CFV, and CAV in a breast milk sample collected before the infant's first positive HIV test. After adjustment for indicators of maternal HIV disease stage, the risk of MTCT was inversely related to 11c,14c-eicosadienoic acid [odds ratio (OR) f...
Apolipoprotein (apo) E and apoC-III concentrations in VLDL and LDL are associated with coronary h... more Apolipoprotein (apo) E and apoC-III concentrations in VLDL and LDL are associated with coronary heart disease. We studied the relationship between apoE and apoC-III and the abnormal concentrations and distribution of apoB lipoproteins in 10 hypercholesterolemic and 13 hypertriglyceridemic patients compared with 12 normolipidemic subjects (mean age, 45 years). Sixteen distinct types of apoB lipoprotein particles were separated by first using anti-apoE and anti-apoC-III immunoaffinity chromatography in sequence and then ultracentrifugation [light VLDL, dense VLDL, IDL, and LDL, with apoE with or without apoC-III (E(+)C-III(+), E(+)C-III(-)) or without apoE with or without apoC-III (E(-)C-III(+), E(-)C-III(-))]. The concentrations of VLDL particles with apoC-III (E(+)C-III(+), E(-)C-III(+)) were increased in the hypertriglyceridemic group compared with the hypercholesterolemic and normolipidemic groups. These particles were the most triglyceride rich of the particle types, and their tr...
Plasma was screened for the presence of lipoprotein[a] using 2-16% nondenaturing, polyacrylamide ... more Plasma was screened for the presence of lipoprotein[a] using 2-16% nondenaturing, polyacrylamide gradient gel electrophoresis. Gels were scanned with a densitometer after staining with Sudan black B. Bands that migrated above low density lipoprotein bands were identified as lipoprotein[a] by immunoblotting with polyclonal and monoclonal antibodies to apolipoprotein[a]. Lipoprotein[a] was measured by gradient gel electrophoresis and by radioimmunoassay in 115 male patients with premature coronary artery disease and 132 control subjects. Lipoprotein[a] bands were detected in 96.7% of subjects with lipoprotein[a] values above 40 mg/dl; in 31.3% with values between 21 and 40 mg/dl, and in 6.5% with values below 20 mg/dl. This gel methodology is a simple and effective procedure for detecting elevated plasma lipoprotein[a] levels and for investigating size heterogeneity, but does not replace immunoassay for quantitation.
Long-chain n-3 fatty acid intake in Colombia is low because fish consumption is limited. Vegetabl... more Long-chain n-3 fatty acid intake in Colombia is low because fish consumption is limited. Vegetable oils with high n-3 fatty acid content are recommended, but their concentrations of trans fats were high in previous studies. Thus, regular monitoring of the fatty acid composition of vegetable oils is required. Our objective was to quantify the fatty acid composition in commercially available oils in Bogota, Colombia and determine if composition changed from 2008 to 2013. Cross-sectional study. We obtained samples of all commercially available oils reported in a survey of low- and middle-income families with a child participating in the Bogota School Children Cohort. Bogota, Colombia. Not applicable. Sunflower oil had the highest trans-fatty acid content (2·18 %). Canola oil had the lowest proportion of trans-fatty acids (0·40 %) and the highest n-3 fatty acid content (9·37 %). In terms of percentage reduction from 2008 to 2013 in 18:1 and 18:2 trans-fatty acids, canola oil had 89 % and 65 % reduction, mixed oils had 44 % and 48 % reduction, and sunflower oil had 25 % and 51 % reduction, respectively. Soyabean oil became widely available in 2013. The content of trans-fatty acids decreased in all oils from 2008 to 2013, suggesting a voluntary reduction by industry. We believe that regular monitoring of the fatty acid composition of oils is warranted.
To examine whether total physical activity or activity patterns are associated with metabolic syn... more To examine whether total physical activity or activity patterns are associated with metabolic syndrome and its components. Participants include 1994 controls from a case-control study of non-fatal myocardial infarction in Costa Rica (1994-2004). Physical activity was assessed via self-administered questionnaire and patterns were identified using principal components analysis. Metabolic syndrome was assessed via blood samples and anthropometry measurements from in-home study visits. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated using log binomial regression. Adjusted least squares means of metabolic syndrome components were calculated by quintile of total activity and pattern scores. Four activity patterns were identified: rest/sleep, agricultural, light indoor activity, and manual labor. Total activity was not associated with metabolic syndrome. Metabolic syndrome prevalence was 20% lower in participants with the highest scores on the agricultural job pattern compared to those with the lowest (PR: 0.80, 95% CI: 0.68-0.94). Higher total activity was associated with lower triglycerides and lower HDL cholesterol. Higher scores on each pattern were inversely associated with metabolic syndrome components, particularly waist circumference and fasting blood glucose. Patterns or types of physical activity may be more strongly associated with metabolic syndrome and its components than total activity levels.
The results of studies assessing relationships between vitamin E intake and status and lung funct... more The results of studies assessing relationships between vitamin E intake and status and lung function are conflicting. This study aimed to evaluate the effect of vitamin E intake and serum levels of tocopherol isoforms on lung function in a cross-sectional sample of 580 men from the Normative Aging Study, a longitudinal aging study. Regression models were used to look at associations of serum tocopherol isoform levels and vitamin E intake with lung function parameters after adjustment for confounders. Vitamin E intake was measured using a food frequency questionnaire and serum levels of γ, α, and δ-tocopherol levels were measured using high-performance liquid chromatography. After adjustment for potential confounders, serum γ-tocopherol had a significant inverse association with forced vital capacity (β = -0.10, p = 0.05). Alpha and δ-tocopherol were not associated with any lung function parameter. After classifying COPD status according to Global Initiative for Obstructive Lung Disease (GOLD) stage criteria, serum levels of δ-tocopherol were lower in participants with more severe COPD (p = 0.01). Serum levels of δ-tocopherol were also lower in participants with greater levels of smoking (p = 0.02). Both vitamin E intake (β = 0.03, p = 0.02; β = 0.03, p = 0.01) and use of vitamin E supplements (β = 0.05, p = 0.03; β = 0.06. p = 0.02) were positively associated with FEV1 and FVC, after adjusting for confounders. Subjects who took vitamin E supplements had significantly higher α-tocopherol levels (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and lower γ-tocopherol levels (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) than non-users. In this study, there is a positive association between dietary vitamin E intake and lung function, and evidence of an inverse relationship between serum levels of γ-tocopherol and lung function.
Objective The objectives of the present study were to determine the prevalence of potentially pat... more Objective The objectives of the present study were to determine the prevalence of potentially pathogenic microorganisms that indicate the hygienic and sanitary conditions of human milk samples collected at a Human Milk Bank. Methods Three hundred and thirty eight (338) samples of human milk collected from a milk
Background and aims-To examine whether the association between the -514C/T polymorphism of the he... more Background and aims-To examine whether the association between the -514C/T polymorphism of the hepatic lipase gene and myocardial infarction (MI) is modified by history of hypercholesterolemia and increased waist circumference.
Little is known about the distinct perceptions towards rice and beans that may shape the consumpt... more Little is known about the distinct perceptions towards rice and beans that may shape the consumption of these main staple foods among Costa Ricans. We aimed to identify barriers and motivators that could change the current staple into a healthier one, and assess the sensory perceptions of these foods in this population. Focus group discussions and sensory tastings of 8 traditional white or brown rice and beans preparations were conducted in 98 Costa Ricans, aged 40-65 years. Traditional habits and family support emerged as the two main drivers for current consumption. Consuming similar amounts of rice and beans, as well as unfamiliarity with brown rice, are habits engrained in the Costa Rican culture, and are reinforced in the family and community environment. Suggested strategies for consuming more brown rice and more beans included introducing them during childhood, disseminating information of their health benefits that take into account the importance of tradition, lowering the cost, increasing availability, engaging women as agents of change and for brown rice masking the perceived unpleasant sensory characteristics by incorporating them into mixed dishes. Plain brown rice received the lowest mean hedonic liking scores. The preparations rated highest for pleasant were the beans: rice 1:1 ratio regardless of the type of rice. This study identified novel strategies to motivate Costa Rican adults to adapt their food choices into healthier ones within their cultural and sensory acceptability.
The American journal of clinical nutrition, Jan 4, 2015
Carbohydrate quality may be an important determinant of type 2 diabetes (T2D); however, relations... more Carbohydrate quality may be an important determinant of type 2 diabetes (T2D); however, relations between various carbohydrate quality metrics and T2D risk have not been systematically investigated. The purpose of this study was to prospectively examine the association between carbohydrates, starch, fibers, and different combinations of these nutrients and risk of T2D in women. We prospectively followed 70,025 women free of cardiovascular disease, cancer, and diabetes at baseline from the Nurses' Health Study (1984-2008). Diet information was collected with the use of a validated questionnaire every 4 y. Cox regression was used to evaluate associations with incident T2D. During 1,484,213 person-years of follow-up, we ascertained 6934 incident T2D cases. In multivariable analyses, when extreme quintiles were compared, higher carbohydrate intake was not associated with T2D (RR = 0.98; 95% CI: 0.89, 1.08; P-trend = 0.84), whereas starch was associated with a higher risk (RR = 1.23;...
We tested whether nutrient intakes estimated from 4-d diet records were associated with plasma li... more We tested whether nutrient intakes estimated from 4-d diet records were associated with plasma lipoprotein subclasses in 103 men who were randomly assigned to a low-fat (24% fat) and a high-fat (46% fat) diet for 6 wk each in a crossover design. Postheparin plasma lipoprotein lipase (LPL) and hepatic lipase (HL) activities were also determined in a subset of 43 men. Changes in intake (ie, high fat minus low fat) of total saturated fatty acids, as well as myristic (14:0) and palmitic (16:0) acids, were positively correlated (P < 0.01) with increases in mass of large LDL particles [measured by analytic ultracentrifugation as mass of lipoproteins of flotation rate (S f o ) 7-12] and with LDL peak particle diameter and flotation rate, but not with changes in LDL-cholesterol concentration. Changes in total saturated fatty acids as well as myristic and palmitic acids were also inversely associated with changes in HL activity (P < 0.05). With the high-fat diet only, variation in dietary total saturated fatty acid intake was inversely correlated (P < 0.01) with concentrations of small, dense LDL of S f o 0-5. This correlation was significant specifically for myristic acid (P < 0.001). Stearic acid (18:0), monounsaturates, and polyunsaturates showed no significant associations with lipoprotein concentrations. These data indicate that a high saturated fat intake (especially 14:0 and 16:0) is associated with increased concentrations of larger, cholesterol-enriched LDL and this occurs in association with decreased HL activity.
The metabolism in plasma of apo(a) and apoB100, the major pro- tein components of lipoprotein(a) ... more The metabolism in plasma of apo(a) and apoB100, the major pro- tein components of lipoprotein(a) (Lp(a)), and the mechanism by which estrogen lowers Lp(a) concentration are both not well under- stood. Estrogen or placebo were administered to 12 postmenopausal women in a double-blind cross-over design; and after each treatment, apo(a) and apoB100 in Lp(a) were endogenously labeled by iv trideu-
Androgens are known to lower plasma triglycerides, an in- dependent risk factor for coronary hear... more Androgens are known to lower plasma triglycerides, an in- dependent risk factor for coronary heart disease (CHD). Tri- glycerides are carried in plasma on very low density (VLDL) and low density (LDL) lipoprotein particles. Apolipoprotein CIII (apoCIII), a strong predictor of CHD, impairs the metab- olism of VLDL and LDL, contributing to increased triglycer- ides. The objective of this study
-Circulating very-long chain saturated fatty acids (VLCSFAs) may play an active role in the etiol... more -Circulating very-long chain saturated fatty acids (VLCSFAs) may play an active role in the etiology of cardiometabolic diseases. -We measured three VLCSFAs (C20:0, C22:0, and C24:0) in plasma and erythrocytes using gas-liquid chromatography among 794 incident coronary heart disease (CHD) cases who were prospectively identified and confirmed among women in Nurses&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; Health Study (NHS; 1990-2006) and among men in Health Professionals Follow-up Study (HPFS; 1994-2008). A total of 1233 CHD-free controls were randomly selected and matched to cases in these two cohorts. Conditional logistic regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI). Plasma VLCSFAs were correlated with favorable profiles of blood lipids, C-reactive protein, and adiponectin in the NHS and HPFS, as well as with fasting insulin and C-peptide levels in a nationally-representative U.S. comparison population. After multivariate adjustment for lifestyle factors, body mass index (BMI), diet, and long-chain n-3 and trans fatty acids, total VLCSFAs in plasma was associated with a 52% decreased risk of CHD [pooled HR (95% CI); 0.48 (0.32, 0.72), comparing extreme quintiles; Ptrend&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001]. For VLCSFAs in erythrocytes, a non-significant inverse trend with CHD risk was observed [pooled HR (95% CI); 0.66 (0.41, 1.06), comparing extreme quintiles; Ptrend=0.16]. -In U.S. men and women, plasma VLCSFAs were independently associated with favorable profiles of blood lipids and other CVD risk markers and a lower risk of CHD. Erythrocyte VLCSFAs were associated with non-significant trends of lower CHD risk. Future studies are warranted to elucidate underlying biological mechanisms.
International journal of food sciences and nutrition, Jan 28, 2015
India has the second largest number of people with diabetes in the world following China. Evidenc... more India has the second largest number of people with diabetes in the world following China. Evidence indicates that consumption of whole grains can reduce the risk of type 2 diabetes. This article describes the study design and methods of a trial in progress evaluating the effects of substituting whole grain brown rice for polished (refined) white rice on biomarkers of diabetes risk (glucose metabolism, dyslipidemia, inflammation). This is a randomized controlled clinical trial with a crossover design conducted in Chennai, India among overweight but otherwise healthy volunteers aged 25-65 y with a body mass index ≥23 kg/m(2) and habitual rice consumption ≥200 g/day. The feasibility and cultural appropriateness of this type of intervention in the local environment will also be examined. If the intervention is efficacious, the findings can be incorporated into national-level policies which could include the provision of brown rice as an option or replacement for white rice in government...
Previous observational studies of self-reported dairy product consumption and stroke risk have re... more Previous observational studies of self-reported dairy product consumption and stroke risk have reported mixed findings. Few studies have used circulating biomarkers that provide objective measures of dairy fat intake. We tested the hypothesis that the circulating biomarkers of dairy fat, pentadecanoic acid (15:0), heptadecanoic acid (17:0), and trans palmitoleate (trans 16:1n-7), were associated with lower incidence of stroke, especially ischemic stroke. Secondarily, we evaluated 14:0, which is obtained from dairy products and beef, and also endogenously synthesized. In participants from 2 large US cohorts (the Health Professionals Follow-Up Study: 51,529 men; the Nurses' Health Study: 121,700 women) with stored blood samples in 1993-1994 (n = 18,225) and 1989-1990 (n = 32,826), respectively, we prospectively identified 594 incident stroke cases (median follow-up: 8.3 y) and matched them 1:1 to risk-set-sampled control subjects by age, sex, race, and smoking. Total plasma and re...
Evidence regarding the relationship of n-3 fatty acids (FA) to type 2 diabetes and metabolic synd... more Evidence regarding the relationship of n-3 fatty acids (FA) to type 2 diabetes and metabolic syndrome components (MetS) is inconsistent. To examine associations of adipose tissue n-3 FA with MetS. We studied 1611 participants without prior history of diabetes or heart disease who were participants in a population-based case-control study of diet and heart disease (The Costa Rica Heart Study). We calculated prevalence ratios (PR) and 95% confidence intervals (CI) for MetS by quartile of n-3 FA in adipose tissue derived mainly from plants (α-Linolenic acid (ALA)), fish (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) or metabolism (docosapentaenoic acid (DPA), as well as the EPA:ALA ratio, a surrogate marker of delta-6 desaturase activity). N-3 FA levels in adipose tissue were associated with MetS prevalence in opposite directions. The PR (95% CI) for the highest compared with the lowest quartile adjusted for age, sex, body mass index (BMI), residence, lifestyle, diet and ...
Breastfeeding accounts for a sizable proportion of infant HIV infections. Some fatty acids (FAs) ... more Breastfeeding accounts for a sizable proportion of infant HIV infections. Some fatty acids (FAs) are potent immunomodulators with virucidal activity, and their primary source in breastfed children is breast milk. The aims of the study were to examine whether the percentage weight concentration of FAs in breast milk was associated with the risk of mother-to-child transmission (MTCT) of HIV by breastfeeding and with shedding of cell-free virus (CFV) or cell-associated virus (CAV) in breast milk. We conducted a case-control study nested within a cohort of HIV-infected Tanzanian women and children. We matched 59 incident breastfeeding MTCT cases to 59 nontransmitting controls based on the child's age at sample collection. We quantified FAs, CFV, and CAV in a breast milk sample collected before the infant's first positive HIV test. After adjustment for indicators of maternal HIV disease stage, the risk of MTCT was inversely related to 11c,14c-eicosadienoic acid [odds ratio (OR) f...
Apolipoprotein (apo) E and apoC-III concentrations in VLDL and LDL are associated with coronary h... more Apolipoprotein (apo) E and apoC-III concentrations in VLDL and LDL are associated with coronary heart disease. We studied the relationship between apoE and apoC-III and the abnormal concentrations and distribution of apoB lipoproteins in 10 hypercholesterolemic and 13 hypertriglyceridemic patients compared with 12 normolipidemic subjects (mean age, 45 years). Sixteen distinct types of apoB lipoprotein particles were separated by first using anti-apoE and anti-apoC-III immunoaffinity chromatography in sequence and then ultracentrifugation [light VLDL, dense VLDL, IDL, and LDL, with apoE with or without apoC-III (E(+)C-III(+), E(+)C-III(-)) or without apoE with or without apoC-III (E(-)C-III(+), E(-)C-III(-))]. The concentrations of VLDL particles with apoC-III (E(+)C-III(+), E(-)C-III(+)) were increased in the hypertriglyceridemic group compared with the hypercholesterolemic and normolipidemic groups. These particles were the most triglyceride rich of the particle types, and their tr...
Plasma was screened for the presence of lipoprotein[a] using 2-16% nondenaturing, polyacrylamide ... more Plasma was screened for the presence of lipoprotein[a] using 2-16% nondenaturing, polyacrylamide gradient gel electrophoresis. Gels were scanned with a densitometer after staining with Sudan black B. Bands that migrated above low density lipoprotein bands were identified as lipoprotein[a] by immunoblotting with polyclonal and monoclonal antibodies to apolipoprotein[a]. Lipoprotein[a] was measured by gradient gel electrophoresis and by radioimmunoassay in 115 male patients with premature coronary artery disease and 132 control subjects. Lipoprotein[a] bands were detected in 96.7% of subjects with lipoprotein[a] values above 40 mg/dl; in 31.3% with values between 21 and 40 mg/dl, and in 6.5% with values below 20 mg/dl. This gel methodology is a simple and effective procedure for detecting elevated plasma lipoprotein[a] levels and for investigating size heterogeneity, but does not replace immunoassay for quantitation.
Long-chain n-3 fatty acid intake in Colombia is low because fish consumption is limited. Vegetabl... more Long-chain n-3 fatty acid intake in Colombia is low because fish consumption is limited. Vegetable oils with high n-3 fatty acid content are recommended, but their concentrations of trans fats were high in previous studies. Thus, regular monitoring of the fatty acid composition of vegetable oils is required. Our objective was to quantify the fatty acid composition in commercially available oils in Bogota, Colombia and determine if composition changed from 2008 to 2013. Cross-sectional study. We obtained samples of all commercially available oils reported in a survey of low- and middle-income families with a child participating in the Bogota School Children Cohort. Bogota, Colombia. Not applicable. Sunflower oil had the highest trans-fatty acid content (2·18 %). Canola oil had the lowest proportion of trans-fatty acids (0·40 %) and the highest n-3 fatty acid content (9·37 %). In terms of percentage reduction from 2008 to 2013 in 18:1 and 18:2 trans-fatty acids, canola oil had 89 % and 65 % reduction, mixed oils had 44 % and 48 % reduction, and sunflower oil had 25 % and 51 % reduction, respectively. Soyabean oil became widely available in 2013. The content of trans-fatty acids decreased in all oils from 2008 to 2013, suggesting a voluntary reduction by industry. We believe that regular monitoring of the fatty acid composition of oils is warranted.
To examine whether total physical activity or activity patterns are associated with metabolic syn... more To examine whether total physical activity or activity patterns are associated with metabolic syndrome and its components. Participants include 1994 controls from a case-control study of non-fatal myocardial infarction in Costa Rica (1994-2004). Physical activity was assessed via self-administered questionnaire and patterns were identified using principal components analysis. Metabolic syndrome was assessed via blood samples and anthropometry measurements from in-home study visits. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated using log binomial regression. Adjusted least squares means of metabolic syndrome components were calculated by quintile of total activity and pattern scores. Four activity patterns were identified: rest/sleep, agricultural, light indoor activity, and manual labor. Total activity was not associated with metabolic syndrome. Metabolic syndrome prevalence was 20% lower in participants with the highest scores on the agricultural job pattern compared to those with the lowest (PR: 0.80, 95% CI: 0.68-0.94). Higher total activity was associated with lower triglycerides and lower HDL cholesterol. Higher scores on each pattern were inversely associated with metabolic syndrome components, particularly waist circumference and fasting blood glucose. Patterns or types of physical activity may be more strongly associated with metabolic syndrome and its components than total activity levels.
The results of studies assessing relationships between vitamin E intake and status and lung funct... more The results of studies assessing relationships between vitamin E intake and status and lung function are conflicting. This study aimed to evaluate the effect of vitamin E intake and serum levels of tocopherol isoforms on lung function in a cross-sectional sample of 580 men from the Normative Aging Study, a longitudinal aging study. Regression models were used to look at associations of serum tocopherol isoform levels and vitamin E intake with lung function parameters after adjustment for confounders. Vitamin E intake was measured using a food frequency questionnaire and serum levels of γ, α, and δ-tocopherol levels were measured using high-performance liquid chromatography. After adjustment for potential confounders, serum γ-tocopherol had a significant inverse association with forced vital capacity (β = -0.10, p = 0.05). Alpha and δ-tocopherol were not associated with any lung function parameter. After classifying COPD status according to Global Initiative for Obstructive Lung Disease (GOLD) stage criteria, serum levels of δ-tocopherol were lower in participants with more severe COPD (p = 0.01). Serum levels of δ-tocopherol were also lower in participants with greater levels of smoking (p = 0.02). Both vitamin E intake (β = 0.03, p = 0.02; β = 0.03, p = 0.01) and use of vitamin E supplements (β = 0.05, p = 0.03; β = 0.06. p = 0.02) were positively associated with FEV1 and FVC, after adjusting for confounders. Subjects who took vitamin E supplements had significantly higher α-tocopherol levels (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and lower γ-tocopherol levels (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) than non-users. In this study, there is a positive association between dietary vitamin E intake and lung function, and evidence of an inverse relationship between serum levels of γ-tocopherol and lung function.
Objective The objectives of the present study were to determine the prevalence of potentially pat... more Objective The objectives of the present study were to determine the prevalence of potentially pathogenic microorganisms that indicate the hygienic and sanitary conditions of human milk samples collected at a Human Milk Bank. Methods Three hundred and thirty eight (338) samples of human milk collected from a milk
Background and aims-To examine whether the association between the -514C/T polymorphism of the he... more Background and aims-To examine whether the association between the -514C/T polymorphism of the hepatic lipase gene and myocardial infarction (MI) is modified by history of hypercholesterolemia and increased waist circumference.
Little is known about the distinct perceptions towards rice and beans that may shape the consumpt... more Little is known about the distinct perceptions towards rice and beans that may shape the consumption of these main staple foods among Costa Ricans. We aimed to identify barriers and motivators that could change the current staple into a healthier one, and assess the sensory perceptions of these foods in this population. Focus group discussions and sensory tastings of 8 traditional white or brown rice and beans preparations were conducted in 98 Costa Ricans, aged 40-65 years. Traditional habits and family support emerged as the two main drivers for current consumption. Consuming similar amounts of rice and beans, as well as unfamiliarity with brown rice, are habits engrained in the Costa Rican culture, and are reinforced in the family and community environment. Suggested strategies for consuming more brown rice and more beans included introducing them during childhood, disseminating information of their health benefits that take into account the importance of tradition, lowering the cost, increasing availability, engaging women as agents of change and for brown rice masking the perceived unpleasant sensory characteristics by incorporating them into mixed dishes. Plain brown rice received the lowest mean hedonic liking scores. The preparations rated highest for pleasant were the beans: rice 1:1 ratio regardless of the type of rice. This study identified novel strategies to motivate Costa Rican adults to adapt their food choices into healthier ones within their cultural and sensory acceptability.
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