Showing papers by "Frank M. Sacks published in 2015"

MIND diet associated with reduced incidence of Alzheimer's disease

Abstract: Introduction In a previous study, higher concordance to the MIND diet, a hybrid Mediterranean-Dietary Approaches to Stop Hypertension diet, was associated with slower cognitive decline. In this study we related these three dietary patterns to incident Alzheimer's disease (AD). Methods We investigated the diet-AD relations in a prospective study of 923 participants, ages 58 to 98 years, followed on average 4.5 years. Diet was assessed by a semiquantitative food frequency questionnaire. Results In adjusted proportional hazards models, the second (hazards ratio or HR = 0.65, 95% confidence interval or CI 0.44, 0.98) and highest tertiles (HR = 0.47, 95% CI 0.26, 0.76) of MIND diet scores had lower rates of AD versus tertile 1, whereas only the third tertiles of the DASH (HR = 0.61, 95% CI 0.38, 0.97) and Mediterranean (HR = 0.46, 95% CI 0.26, 0.79) diets were associated with lower AD rates. Discussion High adherence to all three diets may reduce AD risk. Moderate adherence to the MIND diet may also decrease AD risk.

MIND diet slows cognitive decline with aging

Abstract: Introduction The Mediterranean and dash diets have been shown to slow cognitive decline; however, neither diet is specific to the nutrition literature on dementia prevention. Methods We devised the Mediterranean-Dietary Approach to Systolic Hypertension (DASH) diet intervention for neurodegenerative delay (MIND) diet score that specifically captures dietary components shown to be neuroprotective and related it to change in cognition over an average 4.7 years among 960 participants of the Memory and Aging Project. Results In adjusted mixed models, the MIND score was positively associated with slower decline in global cognitive score (β = 0.0092; P Discussion The study findings suggest that the MIND diet substantially slows cognitive decline with age. Replication of these findings in a dietary intervention trial would be required to verify its relevance to brain health.

The crucial roles of apolipoproteins E and C-III in apoB lipoprotein metabolism in normolipidemia and hypertriglyceridemia.

Abstract: Purpose of reviewTo describe the roles of apolipoprotein C-III (apoC-III) and apoE in VLDL and LDL metabolismRecent findingsApoC-III can block clearance from the circulation of apolipoprotein B (apoB) lipoproteins, whereas apoE mediates their clearance Normolipidemia is sustained by hepatic secreti

Sex Differences in the Effects of Weight Loss Diets on Bone Mineral Density and Body Composition: POUNDS LOST Trial

Abstract: Context: Weight loss is associated with reduction in bone mineral density (BMD). Objective: The objective was to address the role of changes in fat mass (FM) and lean mass (LM) in BMD decline in both sexes. Design: A 2-year randomized controlled trial, the Preventing Overweight Using Novel Dietary Strategies (POUNDS-LOST). Setting: The setting was the general community. Patients or Other Participants: Enrolled were 424 overweight and obese participants (mean age, 52 ± 9 y; 57% females). Intervention: Intervention included weight loss diets differing in fat, protein, and carbohydrates. Main Outcome Measures: Main outcome measures were change in spine, total hip (TH), and femoral neck (FN) BMD and sex differences after dietary intervention. Results: At baseline, a stronger correlation between BMD and body composition measurements was observed in women, primarily with LM (r = 0.419, 0.507, and 0.523 for spine, FN, and TH, respectively; all P < .001). In men, only LM correlated with hip BMD (r = 0.298; P < .0...

PCSK7 genotype modifies effect of a weight-loss diet on 2-year changes of insulin resistance: The pounds lost trial

Abstract: OBJECTIVE A common variant rs236918 in the PCSK7 gene has the strongest association with iron homeostasis and is related to insulin resistance. Dietary carbohydrate (CHO) modulates the genetic effect on insulin resistance. We examined whether 2-year weight-loss diets modify the effect of PCSK7 genetic variants on changes in fasting insulin levels and insulin resistance in a randomized, controlled trial. RESEARCH DESIGN AND METHODS Data were analyzed in the Preventing Overweight Using Novel Dietary Strategies (POUNDS LOST) trial, which is a randomized, controlled 2-year weight-loss trial using diets that differed in macronutrient proportions. PCSK7 rs236918 was genotyped in 730 overweight or obese adults (80% whites) in this trial. We assessed the progression in fasting insulin and glucose levels, and insulin resistance by genotypes. RESULTS During the 6-month weight-loss phase, the PCSK7 rs236918 G allele was significantly associated with greater decreases in fasting insulin levels in the high–dietary CHO group ( P for interaction = 0.04), while the interaction for changes in HOMA-insulin resistance (HOMA-IR) ( P for interaction = 0.06) did not reach significant levels in white subjects. The G allele was significantly associated with a greater decrease in fasting insulin levels and HOMA-IR in response to high dietary CHO levels ( P = 0.02 and P = 0.03, respectively). From 6 months to 2 years (weight-regain phase), the interactions became attenuated due to the regaining of weight ( P for interactions = 0.08 and 0.06, respectively). In addition, we observed similar and even stronger results in the whole-study samples from the trial. CONCLUSIONS Our data suggest that PCSK7 genotypes may interact with dietary CHO intake on changes in insulin sensitivity in the white Americans.

Dietary Fat Modifies the Effects of FTO Genotype on Changes in Insulin Sensitivity

Abstract: Background: The common variants in the fat mass and obesity–associated (FTO) gene have been associated with obesity and insulin resistance. Recently, studies also linked FTO variants with macronutrient intakes. Objective: We aimed to investigate whether diet interventions varying in macronutrients modified the effects of FTO genotypes on changes in insulin resistance. Methods: We genotyped FTO variants rs1558902 and rs9939609 and measured insulin resistance in fasting plasma samples at baseline and at 6-mo and 2-y visits in 743 overweight or obese adults (aged 30–70 y, 60% women) from a randomized weight-loss dietary interventional trial, the Preventing Overweight Using Novel Dietary Strategies (POUNDS LOST) trial. We assessed interactions between FTO variants and intakes of dietary fat and protein in relation to change in body weight and insulin resistance using generalized estimating equation models. Results: We found significant interactions between rs1558902 and dietary fat on changes in homeostasis model assessment of insulin resistance (HOMA-IR) and insulin (P = 0.003 and 0.004, respectively). Each risk allele (A) of rs1558902 showed a trend to be related to a 0.05-unit less reduction in both log(insulin) and log(HOMA-IR) among the participants assigned to low-fat diets (both P = 0.06), but this was not significantly related to reduction in those assigned to high-fat diets (both P > 0.1) during the 2-y period of intervention. Our data showed that the association between rs9939609 and changes in insulin resistance was not modified by diet macronutrient intakes. Conclusions: Our results show that carriers of the risk alleles of rs1558902 benefit differently in improving insulin sensitivity by consuming high-fat weight-loss diets rather than low-fat diets. Still, given our data, we acknowledge it is difficult to determine whether fat or carbohydrate contributed to the observed associations. This trial was registered at clinicaltrials.gov as {"type":"clinical-trial","attrs":{"text":"NCT00072995","term_id":"NCT00072995"}}NCT00072995.

Dietary Fat Intake Modifies the Effect of a Common Variant in the LIPC Gene on Changes in Serum Lipid Concentrations during a Long-Term Weight-Loss Intervention Trial.

Abstract: Background: Hepatic lipase (HL) plays a pivotal role in the metabolism of HDL and LDL. Recent genome-wide association studies have identified common variants in the HL gene (LIPC) associated with HDL cholesterol. Objective: We tested the effect of a common variant in LIPC on changes in blood lipids in response to weight-loss diets in the Preventing Overweight Using Novel Dietary Strategies Trial. Methods: We genotyped LIPC rs2070895 in 743 overweight or obese adults aged 30–70 y (61% women) who were assigned to high-fat (40% energy) or low-fat (20% energy) diets for 2 y. We measured serum concentrations of total cholesterol (TC), triglycerides, LDL cholesterol, and HDL cholesterol at baseline and 2 y of intervention. Results: At 2 y of intervention, dietary fat modified effects of the variant on changes in serum TC, LDL cholesterol, and HDL cholesterol (P-interaction: 0.0008, 0.004, and 0.03, respectively). In the low-fat group, as compared to the G allele, the A allele tended to be related to the decrease in TC and LDL cholesterol concentrations [TC (β ± SE): −5.5 ± 3.0, P = 0.07; LDL cholesterol: −4.8 ± 2.5, P = 0.06] and a lower increase in HDL cholesterol concentrations (β ± SE: −1.37 ± 0.69, P = 0.048), whereas an opposite effect in the high-fat diet group was evident [TC (β ± SE): 7.3 ± 2.7, P = 0.008; LDL cholesterol: 4.1 ± 2.3, P = 0.07], and there was no genetic effect on changes in HDL cholesterol concentrations (P = 0.54). Conclusion: Dietary fat intake modifies the effect of a common variant in LIPC on changes in serum lipids during a long-term weight-loss intervention in overweight or obese adults. This trial was registered at clinicaltrials.gov as {"type":"clinical-trial","attrs":{"text":"NCT00072995","term_id":"NCT00072995"}}NCT00072995.

Effects of Lowering Glycemic Index of Dietary Carbohydrate on Plasma Uric Acid Levels: The OmniCarb Randomized Clinical Trial.

Abstract: Objective The effects of carbohydrates on plasma uric acid levels are a subject of controversy. We determined the individual and combined effects of carbohydrate quality (the glycemic index) and quantity (the proportion of total daily energy [percentage of carbohydrates]) on uric acid levels. Methods We conducted a randomized, crossover trial of 4 different diets in overweight or obese adults without cardiovascular disease (n = 163). Participants consumed each of 4 diets over a 5-week period, each of which was separated by a 2-week washout period. Body weight was kept constant. The 4 diets were high glycemic index (≥65) with high percentage of carbohydrates (58% kcal), low glycemic index (≤45) with low percentage of carbohydrates (40% kcal), low glycemic index with high percentage of carbohydrates, and high glycemic index with low percentage of carbohydrates. Plasma uric acid levels were measured at baseline and after completion of each 5-week period for comparison between the 4 diets. Results Of the 163 study participants, 52% were women and 50% were non-Hispanic African American subjects; their mean age was 52.6 years, and their mean ± SD uric acid level was 4.7 ± 1.2 mg/dl. Reducing the glycemic index lowered uric acid levels when the percentage of carbohydrates was low (−0.24 mg/dl; P < 0.001) or high (−0.17 mg/dl; P < 0.001). Reducing the percentage of carbohydrates marginally increased the uric acid level only when the glycemic index was high (P = 0.05). The combined effect of lowering the glycemic index and increasing the percentage of carbohydrates was −0.27 mg/dl (P < 0.001). This effect was observed even after adjustment for concurrent changes in kidney function, insulin sensitivity, and products of glycolysis. Conclusion Reducing the glycemic index lowers uric acid levels. Future studies should examine whether reducing the glycemic index can prevent gout onset or flares.

Vitamin D metabolism-related genetic variants, dietary protein intake and improvement of insulin resistance in a 2 year weight-loss trial: POUNDS Lost.

Abstract: Aims/hypothesis Vitamin D and related genetic variants are associated with obesity and insulin resistance. We aimed to examine whether vitamin D metabolism-related variants affect changes in body weight and insulin resistance in response to weight-loss diets varying in macronutrient content.

Abstract P150: Weight-Loss Diets and 2-Year Change of Circulating Amino Acids in Two Randomized Intervention Trials

Abstract: Background: Emerging evidence has related circulating amino acids to diabetes and cardiovascular risk. Little is known about how diet modifications affect circulating amino acids. The present study aimed to examine the effects of weight-loss diets on long-term changes in plasma amino acids, and their relations with weight loss and metabolic outcomes. Methods and Results: We repeatedly measured plasma amino acid profiles over 2 years among overweight or obese participants from two randomized dietary interventional weight-loss trials: 774 from the Preventing Overweight Using Novel Dietary Strategies trial (POUNDS LOST) and 318 from Dietary Intervention Randomized Controlled Trial (DIRECT). The plasma levels of most amino acids decreased from baseline during follow-up in both trials. In the POUNDS LOST trial, compared to the high-protein diets, the average-protein weight-loss diets showed a greater effect on decreasing plasma levels of a diabetes-associated branched-chain amino acid (BCAA) valine and another amino acid methyl-histidine at 6 months, independent of weight change (p<0.002). Furthermore, the changes of plasma BCAA leucine/isoleucine, aromatic amino acid tyrosine and phenylalanine, and four other amino acids (alanine, sarcosine, hydroxyproline, and methionine) were positively related to concurrent weight loss, consistently in both trials (5-13g weight loss per 1 unit decease in log[amino acid in μmol/L], p<0.002). Moreover, the changes in tyrosine and alanine were positively related to changes in insulin resistance, independent of weight change, in both trials (p<0.05). Conclusion: Our findings underscore the potential importance of weight-loss dietary interventions in improvement of amino acid profiles and related cardiometabolic risk.

Low vs high glycemic index diet--reply.

Abstract: account for the discrepancy? Among eligible patients at our medical center, both options are presented as clinically equivalent; despite this, in 2013 we observed that 41% opted for conventional WBI and 59% chose hypofractionation,5 thereby generating considerable excess cost. This suggests that patient preference may play a significant role in the observed international differences. It is encouraging that rates of hypofractionated WBI approximately tripled over the study period. In an era of patientdriven medical decision making, still wider adoption is likely to require either clear evidence of superiority or economic incentives that favor the less costly of the 2 medically equivalent therapies.

Compositions and methods for assessing cardiovascular disease

Abstract: Some aspects of this disclosure relate to the characterization of lipoproteins (e.g., vLDL, LDL, and/or HDL) based on their content of lipoprotein-associated proteins (e.g., apolipoproteins) for the determination of cardiovascular disease risk. Some aspects of this disclosure relate to methods for the diagnosis, early detection, risk estimation and monitoring of the course of diseases, in which one or more lipoprotein-associated protein is detected in a lipoprotein. The characterization of the levels of lipoproteins with different lipoprotein-associated protein content provide an index for assessing the risk of a disease, for example, a cardiovascular disease.