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Urine pH is an indicator of dietary acid-base load, fruit and vegetables and meat intakes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population study. Welch AA, Mulligan A, Bingham SA, Khaw KT. Br J Nutr. 2008 Jun;99(6):1335-43. Epub 2007 Nov 28. PMID: 18042305 In conclusion, a more alkaline diet, higher fruit and vegetable and lower meat intake were related to more alkaline urine with a magnitude similar to intervention studies. As urine pH relates to dietary acid-base load its use to monitor change in consumption of fruit and vegetables, in individuals, warrants further investigation.

A positive association of lumbar spine bone mineral density with dietary protein is suppressed by a negative association with protein sulfur. Thorpe M, Mojtahedi MC, Chapman-Novakofski K, McAuley E, Evans EM. J Nutr. 2008 Jan;138(1):80-5. PMID: 18156408 Results suggest that protein intake is positively associated with aBMD, but benefit at the LS is offset by a negative impact of the protein sulfur acid load. If validated experimentally, these findings harmonize conflicting theories on the role of dietary protein in bone health.

Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. Stanhope KL, Schwarz JM, Keim NL, Griffen SC, Bremer AA, Graham JL, Hatcher B, Cox CL, Dyachenko A, Zhang W, McGahan JP, Seibert A, Krauss RM, Chiu S, Schaefer EJ, Ai M, Otokozawa S, Nakajima K, Nakano T, Beysen C, Hellerstein MK, Berglund L, Havel PJ. J Clin Invest. 2009 May;119(5):1322-34. Epub 2009 Apr 20. PMID: 19381015 doi: 10.1172/JCI37385. Studies in animals have documented that, compared with glucose, dietary fructose induces dyslipidemia and insulin resistance. To assess the relative effects of these dietary sugars during sustained consumption in humans, overweight and obese subjects consumed glucose- or fructose-sweetened beverages providing 25% of energy requirements for 10 weeks. Although both groups exhibited similar weight gain during the intervention, visceral adipose volume was significantly increased only in subjects consuming fructose. Fasting plasma triglyceride concentrations increased by approximately 10% during 10 weeks of glucose consumption but not after fructose consumption. In contrast, hepatic de novo lipogenesis (DNL) and the 23-hour postprandial triglyceride AUC were increased specifically during fructose consumption. Similarly, markers of altered lipid metabolism and lipoprotein remodeling, including fasting apoB, LDL, small dense LDL, oxidized LDL, and postprandial concentrations of remnant-like particle-triglyceride and -cholesterol significantly increased during fructose but not glucose consumption. In addition, fasting plasma glucose and insulin levels increased and insulin sensitivity decreased in subjects consuming fructose but not in those consuming glucose. These data suggest that dietary fructose specifically increases DNL, promotes dyslipidemia, decreases insulin sensitivity, and increases visceral adiposity in overweight/obese adults.

A comparison of egg consumption with other modifiable coronary heart disease lifestyle risk factors: a relative risk apportionment study. Barraj L, Tran N, Mink P. Risk Anal. 2009 Mar;29(3):401-15. Epub 2008 Nov 4. PMID: 19000074 DOI: 10.1111/j.1539-6924.2008.01149.x Guidelines from the American Heart Association (AHA) recommend that healthy adults limit their intake of dietary cholesterol to less than 300 mg per day. Since a large egg contains about 71% of that amount, the AHA recommends restricting egg consumption unless dietary cholesterol intakes from other sources are limited. We applied a risk apportionment approach to estimate the contribution of egg consumption and other modifiable lifestyle risk factors (e.g., smoking, poor diet, minimal exercise, and alcohol intake) to coronary heart disease (CHD) risk at the population level. Specifically, we categorized the U.S. adult population ages 25+ into distinct risk groups based on the prevalence of modifiable lifestyle risk factors and applied an apportionment model, typically used to assess risk contribution at the individual level, to estimate the contribution of egg intake to CHD risk. Our analysis shows that the combination of modifiable lifestyle risk factors accounts for less than 40% of the population CHD mortality. For the majority of U.S. adults age 25+, consuming one egg a day accounts for <1% of CHD risk. Hence, focusing on decreasing egg intake as an approach to modify CHD risk would be expected to yield minimal results relative to changing other behaviors such as smoking and other dietary habits.

A review of scientific research and recommendations regarding eggs. Kritchevsky SB. J Am Coll Nutr. 2004 Dec;23(6 Suppl):596S-600S. Review. PMID: 15640512 For much of the past 40 years, the public has been warned away from eggs because of a concern over coronary heart disease risk. This concern is based on three observations: 1. eggs are a rich source of dietary cholesterol; 2. when fed experimentally, dietary cholesterol increases serum cholesterol and; 3. high serum cholesterol predicts the onset of coronary heart disease. However, data from free-living populations show that egg consumption is not associated with higher cholesterol levels. Furthermore, as a whole, the epidemiologic literature does not support the idea that egg consumption is a risk factor for coronary disease. Within the nutritional community there is a growing appreciation that health derives from an overall pattern of diet rather than from the avoidance of particular foods, and there has been a shift in the tone in recent dietary recommendations away from "avoidance" messages to ones that promote healthy eating patterns. The most recent American Heart Association guidelines no longer include a recommendation to limit egg consumption, but recommend the adoption of eating practices associated with good health. Based on the epidemiologic evidence, there is no reason to think that such a healthy eating pattern could not include eggs.

Eggs distinctly modulate plasma carotenoid and lipoprotein subclasses in adult men following a carbohydrate-restricted diet. Mutungi G, Waters D, Ratliff J, Puglisi M, Clark RM, Volek JS, Fernandez ML. J Nutr Biochem. 2009 Apr 13. [Epub ahead of print] PMID: 19369056 We previously reported that carbohydrate restriction (CR) (10-15% en) during a weight loss intervention lowered plasma triglycerides (TG) by 45% in male subjects (P<.05). However, only those subjects from the EGG group presented higher concentrations of these two carotenoids in plasma, which were correlated with the higher concentra

Single food focus dietary guidance: lessons learned from an economic analysis of egg consumption. Schmier JK, Barraj LM, Tran NL. Cost Eff Resour Alloc. 2009 Apr 14;7:7. PMID: 19366457 Methods A risk apportionment model estimated the increased risk for coronary heart disease (CHD) attributable to egg cholesterol content, the decreased risk for other conditions (age-related macular degeneration (AMD), cataract, neural tube defects, and sarcopenia) associated with egg consumption, and a literature search identified the cost of illness of each condition. The base 795 case scenario calculated the costs or savings of each condition attributable to egg cholesterol or nutrient content. Results Given the costs associated with CHD and the benefits associated with the other conditions, the most likely scenario associated with eating an egg a day is savings of $2.82 billion annually with uncertainty ranging from a net cost of $756 million to net savings up to $8.50 billion. Conclusion This study evaluating the economic impact of egg consumption suggests that public health campaigns promoting limiting egg consumption as a means to reduce CHD risk would not be cost-effective from a societal perspective when other benefits are considered. Public health intervention that focuses on a single dietary constituent, and foods that are high in that constituent, may lead to unintended consequences of removing other beneficial constituents and the net effect may not be in its totality a desirable public health outcome. As newer data become available, the model should be updated.

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ScienceDaily (Feb. 25, 2009) - Researchers at Purdue University have precisely measured the impact of a high-fat diet on the spread of cancer, finding that excessive dietary fat caused a 300 percent increase in metastasizing tumor cells in laboratory animals.

Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. Hyppönen E, Power C. Am J Clin Nutr. 2007 Mar;85(3):860-8. PMID: 17344510 Conclusion: Prevalence of hypovitaminosis D in the general population was alarmingly high during the winter and spring, which warrants action at a population level rather than at a risk group level. Data from the 1958 birth cohort suggest that, at different cutoffs for hypovitaminosis D, a substantial public health problem exists in British whites. Obese participants and those living in Scotland were at the highest risk of hypovitaminosis D. However, the prevalence in the general population was very high during the winter and spring, which suggests that, to improve the situation, action is required at a population level rather than at a risk-group level. In the United States, calls have gone out for an increase in vitamin D fortification of foods (11), and the data from the current study suggest that such action is also warranted in the United Kingdom. Vitamin D is currently available without prescription as a dietary supplement only as part of cod liver oil or multivitamin products; hence, a need clearly exists to consider increased availability of over-the-counter supplements. Hypovitaminosis D has been implicated in the development of serious conditions, including diabetes, various types of cancer, and cardiovascular diseases, in addition to its essential role in maintaining bone health (1, 2). The high rates of hypovitaminosis D reported in this study suggest that immediate action is needed to improve the vitamin D status of the British population.

Using these functional indicators, several studies have more accurately defined vitamin D deficiency as circulating levels of 25(OH)D ≤ 80 nmol or 32 µg/L. Recent studies reveal that current dietary recommendations for adults are not sufficient to maintain circulating 25(OH)D levels at or above this level, especially in pregnancy and lactation. Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. Hollis BW. J Nutr. 2005 Feb;135(2):317-22. Review. PMID: 15671234 [

Lutein and zeaxanthin concentrations in plasma after dietary supplementation with egg yolk. Handelman GJ, Nightingale ZD, Lichtenstein AH, Schaefer EJ, Blumberg JB. Am J Clin Nutr. 1999 Aug;70(2):247-51. PMID: 10426702 CONCLUSIONS: Egg yolk is a highly bioavailable source of lutein and zeaxanthin. The benefit of introducing these carotenoids into the diet with egg yolk is counterbalanced by potential LDL-cholesterol elevation from the added dietary cholesterol.

Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? New SA, Robins SP, Campbell MK, Martin JC, Garton MJ, Bolton-Smith C, Grubb DA, Lee SJ, Reid DM. Am J Clin Nutr. 2000 Jan;71(1):142-51. PMID: 10617959 Conclusion: The BMD results confirm our previous work (but at peripheral bone mass sites), and our findings associating bone resorption with dietary factors provide further evidence of a positive link between fruit and vegetable consumption and bone health.

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Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico. [No authors listed] Lancet. 1999 Aug 7;354(9177):447-55. Erratum in: Lancet 2001 Feb 24;357(9256):642. Lancet. 2007 Jan 13;369(9556):106. PMID: 10465168 Interpretation Dietary supplementation with n-3 PUFA led to a clinically important and satistically significant benefit. Vitamin E had no benefit. Its effects on fatal cardiovascular events require further exploration

Cholesterol, coconuts, and diet on Polynesian atolls: a natural experiment: the Pukapuka and Tokelau island studies. Prior IA, Davidson F, Salmond CE, Czochanska Z. Am J Clin Nutr. 1981 Aug;34(8):1552-61. PMID: 7270479 Two populations of Polynesians living on atolls near the equator provide an opportunity to investigate the relative effects of saturated fat and dietary cholesterol in determining serum cholesterol levels. The habitual diets of the toll dwellers from both Pukapuka and Tokelau are high in saturated fat but low in dietary cholesterol and sucrose. Coconut is the chief source of energy for both groups. Tokelauans obtain a much higher percentage of energy from coconut than the Pukapukans, 63% compared with 34%, so their intake of saturated fat is higher. The serum cholesterol levels are 35 to 40 mg higher in Tokelauans than in Pukapukans. These major differences in serum cholesterol levels are considered to be due to the higher saturated fat intake of the Tokelauans. Analysis of a variety of food samples, and human fat biopsies show a high lauric (12:0) and myristic (14:0) content. Vascular disease is uncommon in both populations and there is no evidence of the high saturated fat intake having a harmful effect in these populations.

Relationship of dietary linoleic acid to blood pressure. The International Study of Macro-Micronutrients and Blood Pressure Study [corrected] Miura K, Stamler J, Nakagawa H, Elliott P, Ueshima H, Chan Q, Brown IJ, Tzoulaki I, Saitoh S, Dyer AR, Daviglus ML, Kesteloot H, Okayama A, Curb JD, Rodriguez BL, Elmer PJ, Steffen LM, Robertson C, Zhao L; International Study of Macro-Micronutrients and Blood Pressure Research Group. Hypertension. 2008 Aug;52(2):408-14. Epub 2008 Jul 7. Erratum in: Hypertension. 2008 Sep;52(3):e29. PMID: 18606902 doi: 10.1161/HYPERTENSIONAHA.108.112383 Dietary linoleic acid intake may contribute to prevention and control of adverse blood pressure levels in general populations

Dietary cod protein improves insulin sensitivity in insulin-resistant men and women: a randomized controlled trial. Ouellet V, Marois J, Weisnagel SJ, Jacques H. Diabetes Care. 2007 Nov;30(11):2816-21. Epub 2007 Aug 6. PMID: 17682120 CONCLUSIONS - Dietary cod protein improves insulin sensitivity in insulin-resistant individuals and thus could contribute to prevention of type 2 diabetes by reducing the metabolic complications related to insulin resistance.