With the global increase in the epidemic of obesity and type 2 diabetes with a concomitant increase in atherosclerotic disease, an investigation into the effects of various macronutrients and food products has become necessary. Such investigation will allow us to better understand the relationship between the intake of various macronutrients and the pathogenesis of mechanisms underlying the regulation of insulin sensitivity and resistance, oxidative stress and inflammation, the regulation of hunger and satiety and atherogenesis. This review covers the first decade of work in this area relating the intake of usual foods and diets to their immediate and long term outcomes. The review also covers the exciting novel area of anti-inflammatory effects of certain foods. Hopefully, a comprehensive understanding of these actions of macronutrients and their long term effects will allow us to formulate food combinations which will lead to healthy eating habits and improvement in our overall health status.

Objectives: The time-dependent study of comorbidities provides insight into disease progression and trajectory. We hypothesize that understanding longitudinal disease characteristics can lead to more timely intervention and improve clinical outcomes. As a first step, we developed an efficient and easy-to-install toolkit, the Time-based Elixhauser Comorbidity Index (TECI), which pre-calculates time-based Elixhauser comorbidities and can be extended to common data models (CDMs). Methods: A Structured Query Language (SQL)-based toolkit, TECI, was built to pre-calculate time-specific Elixhauser comorbidity indices using data from a clinical data repository (CDR). Then it was extended to the Informatics for Integrating Biology and the Bedside (I2B2) and Observational Medical Outcomes Partnership (OMOP) CDMs. Results: At the University of Arkansas for Medical Sciences (UAMS), the TECI toolkit was successfully installed to compute the indices from CDR data, and the scores were integrated into the I2B2 and OMOP CDMs. Comorbidity scores calculated by TECI were validated against: scores available in the 2015 quarter 1–3 Nationwide Readmissions Database (NRD) and scores calculated using the comorbidities using a previously validated algorithm on the 2015 quarter 4 NRD. Furthermore, TECI identified 18,846 UAMS patients that had changes in comorbidity scores over time (year 2013 to 2019). Comorbidities for a random sample of patients were independently reviewed, and in all cases, the results were found to be 100% accurate. Conclusions TECI facilitates the study of comorbidities within a time-dependent context, allowing better understanding of disease associations and trajectories, which has the potential to improve clinical outcomes.