PURPOSE: Walnut is known to have unique favorable fatty acids, phytochemicals, and other nutrient profiles. As a result, there has been growing interest in evaluation of its health benefit related to cardiovascular disease (CVD). Although inverse associations of nut consumption and risk factors of cardiovascular disease have been reported in many epidemiological studies and qualitative reviews, few meta-analysis studies have been reported. This meta-analysis was conducted in order to evaluate the effect of a walnut-enhanced diet on CVD risk factors. METHODS: We searched Pubmed, Cochrane, Science Direct, and KISS (Korean studies Information Service System) through July 2014. A random-effects meta-analysis was conducted on 17 trials reporting total cholesterol (TC), 14 trials reporting LDL cholesterol (LDL-C), 15 trials reporting HDL cholesterol (HDL-C), 17 trials reporting triglyceride (TG), and four trials reporting flow-mediated dilation (FMD). RESULTS: In meta-analysis, intake of a walnut-enhanced diet resulted in significantly lowered TC, LDL-C, and TG by -0.124 mmol/l (95% CI, -0.209, -0.039; p = 0.004), -0.085 mmol/lL (95% CI, -0.167, -0.004; p = l0.039), and -0.080 mmol/l (95% CI, -0.155, -0.004; p = 0.039), respectively. The overall pooled estimate of the effect on FMD was +1.313% (95% CI, 0.744, 1.882, p = 0.000). HDL-C was not affected by walnut intake. No statistical heterogeneity was observed for any analysis. Results of funnel plots and Egger's regression suggested a low likelihood of publication bias in all biomarkers (p > 0.05). CONCLUSION: Findings of this meta-analysis provide consistent evidence that walnut-enhanced diet intake reduces the CVD risk factors.
Biomarkers ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Diet ; Fatty Acids ; Information Services ; Insurance Benefits ; Juglans* ; Nuts ; Phytochemicals ; Population Characteristics ; Publication Bias ; Risk Factors ; Triglycerides

PURPOSE: This review describes the historical changes in nutrition philosophy from a reductionist to a holistic approach during the 20th century. Also, the role and efficient use of a holistic approach to precision nutrition are discussed. RESULTS: Over the past century, significant progress has been made in human nutrition research, unraveling fundamental mechanisms of single nutrients on single targets or pathways. This kind of a reductionist approach has helped to save populations from nutrient deficiency diseases and improve associated health outcomes in large parts of the world. However, a new set of nutrition problems, like obesity and diet-related chronic diseases, are growing each year worldwide, increasing the financial burden on the health care system. A linear cause-effect association between single nutrients and a single physiologic effect, is insufficient to solve the complex nutrition-health relationships. Research that involves a more holistic rather than reductionist approach is needed to tackle a new set of nutrition problems. Recent advances in technology, informatics, and statistical methods are enabling an understanding of the diversity of individuals and the complex interactions between foods and human bodies, leading to the concept of “precision nutrition.” CONCLUSION: The emerging goal of precision nutrition is to provide tailored dietary advice for maintaining health and preventing obesity and diet-related chronic diseases. The parts are already being installed. To grab the complexity, reductionism and holism must be used interdependently.
Chronic Disease ; Deficiency Diseases ; Delivery of Health Care ; Human Body ; Humans ; Informatics ; Obesity ; Philosophy

PURPOSE: This study was conducted in order to investigate the protective effects of ethanolic extract of Acanthopanax koreanum Nakai (AE) against carbon tetrachloride (CCl4)-induced liver injury in rats. METHODS: Male Sprague-Dawley rats were randomly divided into four groups in order to receive the following experimental diets with intraperitoneal injection of CCl4 (2.0 mL/kg body weight, 20% solution 0.65 mL) for eight weeks (n = 8 per group): CCl4 control (CON), CCl4 + AE 1% (AE1), CCl4 + AE 3% (AE3), or CCl4 + acanthoic acid 0.037%, which is equivalent to AE 3% (AA). RESULTS: Highest serum ALT activity and albumin level were observed in the CCL4 control group, but showed a significant decrease by either AE or AA supplementation in a dose-dependent manner (p = 0.0063 and 0.0076, respectively). Both hemotoxylin and eosin staining and Masson's staining indicated remarkable prevention of CCl4-induced liver damage in the AE3 group. TNFalpha and IL-6 production were significantly lowered in the AE treated groups, but not in the AA group (p = 0.0016 and p = 0.0002, respectively). The effects of AE3 were greater than those of AA for inflammation and liver toxicity biomarkers. CONCLUSION: Taken together, the results suggested that ethanolic extract of Acanthopanax koreanum Nakai provided hepa-toprotective effects, leading to the reduction of inflammatory response. In addition, the effect of AE was superior to that of single compound AA.
Eleutherococcus* ; Animals ; Biomarkers ; Body Weight ; Carbon Tetrachloride ; Carbon* ; Diet ; Eosine Yellowish-(YS) ; Ethanol ; Hematoxylin ; Humans ; Inflammation ; Injections, Intraperitoneal ; Interleukin-6 ; Liver* ; Male ; Rats ; Rats, Sprague-Dawley* ; Tumor Necrosis Factor-alpha

The prevalence of atherothrombotic disease continues to rise, presenting an increasing number of challenges to modern society and creating interest in functional foods. Platelet activation, adhesion, and aggregation at vascular endothelial disruption sites are key events in atherothrombotic disease. Physiological challenges such as hyperlipidemia, obesity, and cigarette smoking are associated with vascular changes underlying platelet aggregation and inflammatory processes. However, it is difficult to determine the beneficial response of functional foods in healthy subjects. To address this problem, challenge models and high-risk models related to smokers, obesity, and dyslipidemia are proposed as sensitive measures to evaluate the effects of functional foods in healthy subjects. In this review, we construct a model to evaluate the effects of functional food such as natural products on blood flow based on a human intervention study.
Atherosclerosis ; Biological Products ; Blood Circulation ; Blood Vessels ; Dyslipidemias ; Functional Food* ; Healthy Volunteers ; Humans* ; Hyperlipidemias ; Obesity ; Platelet Activation ; Platelet Aggregation ; Prevalence ; Smoking

Purpose: DNA damage and repair responses are induced by metabolic diseases and environmental stress. The balance of DNA repair response and the antioxidant system play a role in modulating the entire body’s health. This study uses a high-fat and high-calorie (HFC) drink to examine the new roles of a plant-based multivitamin/mineral supplement with phytonutrients (PMP) for regulating the antioxidant system and cellular DNA repair signaling in the body resulting from metabolic stress. Methods: In a double-blind, randomized, parallel-arm, and placebo-controlled trial, healthy adults received a capsule containing either a PMP supplement (n = 12) or a placebo control (n = 12) for 8 weeks. Fasting blood samples were collected at 0, 1, and 3 hours after consuming a HFC drink (900 kcal). The blood samples were analyzed for the following oxidative stress makers: areas under the curve reactive oxygen species (ROS) levels, plasma malondialdehyde (MDA), erythrocytes MDA, urinary MDA, oxidized low-density lipoprotein, and the glutathione:oxidized glutathione ratio at the time points. We further examined the related protein levels of DNA repair signaling (pCHK1 (Serine 345), p-P53 (Serine 15), and γH2AX expression) in the plasma of subjects to evaluate the time-dependent effects of a HFC drink. Results: In a previous study, we showed that PMP supplementation for eight weeks reduces the ROS and endogenous DNA damage in human blood plasma. Results of the current study further show that PMP supplementation is significantly correlated with antioxidant defense. Compared to the placebo samples, the blood plasma obtained after PMP supplementation showed enhanced DNA damage response genes such as pCHK1(Serine 345) (a transducer of DNA response) and γH2AX (a hallmark of DNA damage) during the 8 weeks trial on metabolic challenges. Conclusion Our results indicate that PMP supplementation for 8 weeks enhances the antioxidant system against oxidative stress and prevents DNA damage signaling in humans.

BACKGROUND/OBJECTIVES: In a healthy person, from 35 years of age, there is an annual loss of muscle mass at the rate of 1–2% and is associated with a decline in the quality of life. This study aimed to identify the particular dietary patterns associated with the risk of lower lean muscle mass in Korean postmenopausal women. SUBJECTS/METHODS: The Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based, continuous cross-sectional annual survey. The participants of the KNHANES IV (2008–2009) and V (2010–2011) were considered for this study. The study sample consisted of 1548 postmenopausal women, aged 45–86 years. Lower lean muscle mass was defined as having appendicular skeletal muscle mass corrected for body weight less than 1 standard deviation of the young reference group aged 20 to 39 years in KNHANES IV and V. To identify the dietary pattern using factor analysis, 24-h recall data was used. RESULTS: The prevalence of lower lean muscle mass was 31.3% in this study population. Four dietary patterns were identified by factor analysis; ‘Diverse’, ‘Western’, ‘Traditional’, and ‘Snacks and beverages’. The ‘Western’ pattern, highest factor loadings for flour and bread, potatoes, red meat, processed meat, eggs, and cheese, was significantly associated with a high (60%) risk of lower lean muscle mass (odds ratio [95% confidence interval] = 1.60 [1.07–2.39], P for trend = 0.01) after adjustments for potential covariates. The other 3 dietary patterns were not associated with lower lean muscle mass. CONCLUSIONS The study findings suggest that the ‘Western’ dietary pattern that includes flour and bread, potatoes, red meat, processed meat, eggs, and cheese, may be associated with a higher risk of lower lean muscle mass in Korean postmenopausal women.

BACKGROUND/OBJECTIVES: In a healthy person, from 35 years of age, there is an annual loss of muscle mass at the rate of 1–2% and is associated with a decline in the quality of life. This study aimed to identify the particular dietary patterns associated with the risk of lower lean muscle mass in Korean postmenopausal women. SUBJECTS/METHODS: The Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based, continuous cross-sectional annual survey. The participants of the KNHANES IV (2008–2009) and V (2010–2011) were considered for this study. The study sample consisted of 1548 postmenopausal women, aged 45–86 years. Lower lean muscle mass was defined as having appendicular skeletal muscle mass corrected for body weight less than 1 standard deviation of the young reference group aged 20 to 39 years in KNHANES IV and V. To identify the dietary pattern using factor analysis, 24-h recall data was used. RESULTS: The prevalence of lower lean muscle mass was 31.3% in this study population. Four dietary patterns were identified by factor analysis; ‘Diverse’, ‘Western’, ‘Traditional’, and ‘Snacks and beverages’. The ‘Western’ pattern, highest factor loadings for flour and bread, potatoes, red meat, processed meat, eggs, and cheese, was significantly associated with a high (60%) risk of lower lean muscle mass (odds ratio [95% confidence interval] = 1.60 [1.07–2.39], P for trend = 0.01) after adjustments for potential covariates. The other 3 dietary patterns were not associated with lower lean muscle mass. CONCLUSIONS The study findings suggest that the ‘Western’ dietary pattern that includes flour and bread, potatoes, red meat, processed meat, eggs, and cheese, may be associated with a higher risk of lower lean muscle mass in Korean postmenopausal women.

In this study, we investigated that consumers could differentiate between levels of claims and clarify how a visual aid influences consumer understanding of the different claim levels. We interviewed 2,000 consumers in 13 shopping malls on their perception of and confidence in different levels of health claims using seven point scales. The average confidence scores given by participants were 4.17 for the probable level and 4.07 for the possible level; the score for the probable level was significantly higher than that for the possible level (P < 0.05). Scores for confidence in claims after reading labels with and without a visual aid were 5.27 and 4.43, respectively; the score for labeling with a visual aid was significantly higher than for labeling without a visual aid (P < 0.01). Our results provide compelling evidence that providing health claims with qualifying language differentiating levels of scientific evidence can help consumers understand the strength of scientific evidence behind those claims. Moreover, when a visual aid was included, consumers perceived the scientific levels more clearly and had greater confidence in their meanings than when a visual aid was not included. Although this result suggests that consumers react differently to different claim levels, it is not yet clear whether consumers understand the variations in the degree of scientific support.
Audiovisual Aids ; Weights and Measures

BACKGROUND/OBJECTIVES: By the year 2050, thirty-eight percent of the Korean population will be over the age of 65. Health care costs for Koreans over age 65 reached 15.4 trillion Korean won in 2011, accounting for a third of the total health care costs for the population. Chronic degenerative diseases, including coronary heart disease (CHD), drive long-term health care costs at an alarming annual rate. In the elderly population, loss of independence is one of the main reasons for this increase in health care costs. Korean heath policies place a high priority on the prevention of CHD because it is a major cause of morbidity and mortality. SUBJECTS/METHODS: This evidence-based study aims to the estimate potential health care cost savings resulting from the daily intake of omega-3 fatty acid supplementation. Potential cost savings associated with a reduced risk of CHD and the medical costs potentially avoided through risk reduction, including hospitalizations and physician services, were estimated using a Congressional Budget Office cost accounting methodology. RESULTS: The estimate of the seven-year (2005-2011) net savings in medical costs resulting from a reduction in the incidence of CHD among the elderly population through the daily use of omega-3 fatty acids was approximately 210 billion Korean won. Approximately 92,997 hospitalizations due to CHD could be avoided over the seven years. CONCLUSIONS: Our findings suggest that omega-3 supplementation in older individuals may yield substantial cost-savings by reducing the risk of CHD. It should be noted that additional health and cost benefits need to be revisited and re-evaluated as more is known about possible data sources or as new data become available.
Aged* ; Budgets ; Coronary Disease ; Cost Savings ; Cost-Benefit Analysis ; Surveys and Questionnaires ; Fatty Acids, Omega-3 ; Functional Food ; Health Care Costs* ; Hospitalization ; Humans ; Incidence ; Income* ; Korea ; Mortality ; Risk Reduction Behavior

We investigated whether the combination of phytochemicals and acetic acid in the form of fruit vinegar provides an additive effect on changes of mRNA levels related to fatty acid oxidation in human hepatocyte (HepG2). Among the seven fruit vinegars (Rubuscoreanus, Opuntia, blueberry, cherry, red ginseng, mulberry, and pomegranate) studied, treatment of HepG2 with pomegranate vinegar (PV) at concentrations containing 1 mM acetic acid showed the highest in vitro potentiating effect on the mRNA expression levels of peroxisome proliferator-activated receptor alpha, carnitinepalmitoyl transferase-1, and acyl-CoA oxidase compared to the control group (P < 0.05). Reversed-phase liquid chromatography in combination with quadrupole time-of-flight mass spectrometry analysis revealed four potential compounds (punicalagin B, ellagic acid, and two unidentified compounds) responsible for altered gene expression in HepG2 cells treated with PV as compared with the others. Further investigations are warranted to determine if drinking PV beverages may help to maintain a healthy body weight in overweight subjects.
Acetic Acid ; Acyl-CoA Oxidase ; Beverages ; Blueberry Plant ; Body Weight ; Chromatography, Reverse-Phase ; Drinking ; Ellagic Acid ; Fruit ; Gene Expression ; Hep G2 Cells ; Hepatocytes ; Humans ; Mass Spectrometry ; Morus ; Opuntia ; Overweight ; Panax ; PPAR alpha ; Prunus ; Punicaceae ; RNA, Messenger