Body Mass Index Associated with Risk of All-cause Mortality

In white adults, being overweight or obese (and possibly underweight) is associated with increased all-cause mortality. All-cause mortality is generally lowest with a BMI of 20.0 to 24.9.

A high body-mass index (BMI) is associated with increased mortality from cardiovascular disease and certain cancers, but the precise relationship between BMI and all-cause mortality remains uncertain.

A large analysis reported in the December 2, 2010 issue of the New England Journal of Medicine confirms the relationship between being overweight or obese and a greater risk of dying from all causes.

An international team of researchers pooled data from 19 prospective studies totaling 1,462,958 white male and female participants between the ages of 19 and 84. Body mass index (BMI), calculated by dividing a person’s weight in kilograms by the square of their height in meters, was determined for all subjects. The participants were followed for periods that ranged from a maximum of 7 to 28 years, during which 160,087 deaths occurred.

Upon enrollment, the average BMI was 26.2. Compared with women whose body mass index was between 22.5 and 24.9, having a BMI of 25 to 29.9 was associated with a 13 percent greater risk of death over the period of follow-up. This risk rose with increasing body mass index categories, with women whose BMI was 40 to 49.9 having 2.5 times the risk of death from all causes than those with a BMI of 22.5 to 24.9. Risks among men were similar. Although a small risk of death was also observed for those whose BMI was below 20, the authors suggest that the finding was in part caused by preexisting disease.

In white adults, overweight and obesity (and possibly underweight) are associated with increased all-cause mortality. All-cause mortality is generally lowest with a BMI of 20.0 to 24.9.

de Gonzalez AB, Phil D, et al. Body-Mass Index and Mortality among 1.46 Million White Adults. 2010. N Engl J Med 363:2211-9.

To learn more and calculate your BMI, see the following link: http://www.nhlbisupport.com/bmi

Supplemental Vitamins During Breast Cancer Treatment May Reduce Mortality Risk

In a large population-based study of Chinese women with breast cancer, multivitamin use reduced the risk of mortality and the risk of cancer recurrence.

Nutritional supplement use during cancer treatment is currently controversial. Antioxidants may protect normal cells from oxidative damage that occurs during radiotherapy and certain chemotherapy regimens. However, the same mechanism could protect tumor cells and potentially reduce effectiveness of some cancer treatments. Recently, researchers evaluated vitamin supplement use during cancer treatment and in the first six months after breast cancer diagnosis, looking for correlations with total mortality and cancer recurrence.

A population-based prospective cohort study of 4,877 women diagnosed with invasive breast cancer was conducted between March of 2002 and April of 2006 in Shanghai, China. The women (aged 20-75) were interviewed approximately six months after diagnosis, then followed-up with later via in-person interviews.


During an average follow-up of 4.1 years, 444 deaths and 532 recurrences occurred. Vitamin use shortly after breast cancer diagnosis was associated with reduced risk of mortality and recurrence. Women who used nutritional supplements (vitamin E, vitamin C, multivitamins) had an 18% reduction in risk of mortality and a 22% reduced recurrence risk. The inverse association was found regardless of whether vitamin use was concurrent or non-concurrent with chemotherapy, but was only present among patients who did not receive radiotherapy.

Vitamin supplement use in the first six months after breast cancer diagnosis may be associated with reduced risk of mortality and recurrence. The results of this study do not support the current recommendation that all breast cancer patients should avoid use of vitamin supplements.

Nechuta S, et al. Vitamin supplement use during breast cancer treatment and survival: a prospective cohort study. Cancer Epidemiol Biomarkers Prev, 21 Dec 2010.

Healthy Eating Patterns Increase Survival Rates in Older Adults

A newly published study supports the idea that a relatively low-fat, plant-based diet increases quality of life and survival in older adults.

A report published in the January 2011 issue of the Journal of the American Dietetic Association concluded that eating healthy food really does increase survival in older adults.

Researchers analyzed data from 2,582 participants in The Health, Aging and Body Composition Study. Participants were American adults aged 70 to 79 upon enrollment. Dietary questionnaires completed during the second year after enrollment were used to identify 6 predominant dietary patterns: high-fat dairy products, meat, fried foods and alcohol, breakfast cereal, refined grains, sweets and desserts, and healthy foods. The healthy foods diet was characterized by a higher intake of low-fat dairy products, fruit, whole grains, poultry, fish and vegetables, and reduced consumption of meat, fried foods, sweets, high-calorie drinks and added fat.

During the follow-up period of up to 10 years, 739 deaths occurred in the study group. Those whose diets consisted of healthy food had a significantly lower risk of dying than those whose diets were dominated by high-fat dairy products (ice cream, cheese, whole milk), meat, fried foods and alcohol, sweets, and other desserts. Researchers found a 40 percent greater risk of dying among those who consumed relatively higher amounts of high-fat dairy products, and a 37 percent greater risk for those whose diets were characterized by a lot of sweets.

This study's findings are consistent with current guidelines to consume relatively high amounts of vegetables, fruit, whole grains, poultry, fish, and low-fat dairy products. Diets that follow this pattern appear to be associated with superior nutritional status, improved quality of life, and higher rates of survival in older adults.

Anderson AL, et al. Dietary Patterns and Survival of Older Adults. 2011. Journal of the American Dietetic Association 11(1):84-91.

Multivitamin Supplementation May Have Positive Effects on Body Weight

New research suggests that obese individuals who use a multivitamin and mineral supplement may experience both a decrease in body weight and improved serum lipid profiles.

Obese individuals are more likely to have lower blood concentrations of most vitamins and minerals. Unfortunately, there is currently limited information on the effects of nutritional supplementation on body weight control and energy metabolism in obese adults.

In new research published in the International Journal of Obesity, scientists evaluated the effects of multivitamin/mineral supplementation on body fat, energy expenditure, and lipid profiles in obese Chinese women.

Ninety-six obese Chinese women between the ages of 18 and 55 participated in a 26-week randomized, double-blind, placebo-controlled intervention study. Subjects were divided into three groups, receiving either a multivitamin/mineral supplement (MMS), 162mg of calcium, or placebo daily. Body weight, BMI, waist circumference, fat mass, lean tissue, resting energy expenditure, blood pressure, fasting plasma glucose and serum insulin, total cholesterol, LDL and HDL cholesterol, and triglycerides were measured at the beginning and end of the study period.

After 26 weeks, the multivitamin/mineral group had significantly lower body weight, BMI, fat mass, total and LDL cholesterol, significantly higher resting energy expenditure and HDL cholesterol than individuals in the placebo group. They were also more likely to have a reduced waist circumference. The calcium group also had significantly higher HDL cholesterol and lower LDL cholesterol levels compared with the placebo group.

The results suggest that multivitamin/mineral supplementation could reduce body weight and fatness and improve serum lipid profiles in obese women, possibly through increased energy expenditure and fat oxidation.

Li Y, Wang C, Zhu K, Feng RN, and Sun CH. Effects of multivitamin and mineral supplementation on adiposity, energy expenditure and lipid profiles in obese Chinese women. 2010. Int J Obes (Lond) 34(6):1070-7.

Compound From Olive Fruit Shows Heart Health Potential

New research shows portion-controlled meal replacement diets as more effective than standard diets at both initial weight loss and long-term weight maintenance in type 2 diabetics.
In a recent study, supplementing with hydroxytyrosol – a polyphenolic compound extracted from olives – correlated with higher activity levels of the enzyme arylesterase, an antioxidant biomarker, and lower levels of oxidized LDL cholesterol. Oxidized LDL is believed to be a major player in promoting atherosclerosis (the build-up of fatty plaques in arteries) and general cardiovascular disease.

Hydroxytyrosol is thought to be the main antioxidant compound in olive fruit, and it is believed to play a significant role in many of the health benefits attributed to olive oil. Previous research has linked the compound to cardiovascular benefits, typically reductions in LDL or “bad” cholesterol. Data has also suggested the compound may boost eye health and reduce the risk of macular degeneration.

Spanish researchers reported these most recent results in the British Journal of Nutrition. Twenty-two healthy volunteers between 20 and 45 years of age and with a BMI between 18 and 33 kg/m2 were recruited. Volunteers were randomly assigned to receive 10 to 15 grams per day of hydroxytyrosol-enriched sunflower oil or non-enriched sunflower oil for three weeks. The former provided a daily hydroxytyrosol dose of between 45 and 50 mg. After the initial three week period, volunteers had two weeks of no intervention before crossing over to receive the other intervention.

Results showed no changes in total, LDL, or HDL-cholesterol between the groups. However, consumption of the hydroxytyrosol-enriched sunflower oil produced significant reductions in oxidized LDL from 79.8 units per liter at the start of the study to 64.1 U/l after three weeks, compared to an increase from 72.7 to 86.4 U/l during the control phase. Furthermore, the activity of arylesterase increased from 235.2 to 448.9 U/l during the hydroxytyrosol phase, compared with an increase from 204.1 to 310.3 U/l during the control phase.

The researchers reported that although hydroxytyrosol-enriched sunflower oil did not significantly reduce LDL-cholesterol or increase HDL-cholesterol, it acted as a functional food by increasing arylesterase activity and reducing oxidized LDL. Based on these results, dietary sources of hydroxytyrosol appear to be capable of reducing certain risk factors associated with coronary artery disease.

Vazquez-Velasco M, et al. Effects of hydroxytyrosol-enriched sunflower oil consumption on CVD risk factors. 2010. Br J Nutr, ePub ahead of print. doi: 10.1017/S0007114510005015

Meal Replacements Better Than Standard Diets for Weight Loss in Diabetics

New research shows portion-controlled meal replacement diets as more effective than standard diets at both initial weight loss and long-term weight maintenance in type 2 diabetics.

A recent study published in Diabetes Education compared the efficacy of a portion-controlled meal replacement diet (PCD) to a standard diet (SD) based on American Diabetes Association recommendations in achieving and maintaining weight loss.

Participants included 119 overweight men and women with type 2 diabetes and a body mass index (BMI) between 25 and 40. Subjects were randomly assigned to one of two diets (PCD or SD) that contained 75% of predicted energy needs. The diets were then followed by a maintenance phase of one year.

Weight loss at 34 weeks and weight maintenance at 86 weeks was significantly better on PCD versus SD. Approximately 40% of the PCD participants lost at least 5% of their initial weight compared with only 12% of those on the standard diet. Significant improvements in biochemical and metabolic measures were observed at 34 weeks in both groups. The ease and self-reported adherence to the diet were greater in the PCD group throughout the study.

In this study, a diet using portion-controlled meal replacements resulted in significantly greater initial weight loss and less regain after one year of maintenance than a standard, self-selected, food-based diet. As PCDs may help obese patients with type 2 diabetes adhere to a weight control program, diabetes educators should consider recommending them as part of a comprehensive approach to weight control.

Recommended healthy diet USANA RESET

Cheskin LJ, et al. Efficacy of meal replacements versus a standard food-based diet for weight loss in type 2 diabetes: a controlled clinical trial. 2008. Diabetes Educ 34(1):118-27

High Glycemic Load Diets Increase Risk of Age-Related Hearing Loss

In a recent study of adults over 50 years old, those with a high glycemic load diet had a significantly increased risk of age-related hearing loss.

Age-related hearing loss is a common disability in older adults, and nutrition may play a role in the development of this condition. Carbohydrate nutrition is thought to possibly relate to age-related hearing loss.

In a recent issue of the Journal of Nutrition, researchers sought to determine the association between glycemic index (GI) and glycemic load (GL) and age-related hearing loss.

Hearing loss was measured in 2956 participants aged 50 years or older enrolled in the Blue Mountains Hearing Study. Food frequency questionnaires were used to document intakes of carbohydrates, sugar, starch, cereal and total fiber. Australian GI values were used to calculate average GI and GL values of the diets.

A higher average dietary GI was associated with a 59% increased prevalence of any hearing loss. Participants in the highest 25% of average dietary GL intake compared with those in the lowest 25% had a 76% greater risk of developing hearing loss. Higher carbohydrate and sugar intakes were also associated with occurrence of hearing loss.

In this study group, a high-GL diet was a predictor of hearing loss, as was higher intake of total carbohydrates. It is possible that prolonged high blood glucose levels after a meal may be an underlying biological mechanism in the development of age-related hearing loss.

Gopinath B, et al. Dietary Glycemic Load Is a Predictor of Age-Related Hearing Loss in Older Adults. 2010. J Nutr 140(12):2207-12.