By Teresa Johnson, MSPH, RD

Robert Waterland, PhD, an associate professor at Baylor College of Medicine, described nutritional influences on human developmental epigenetics. Waterland defined epigenetics as “mitotically heritable stable alterations in gene expression potential that are not caused by changes in DNA sequence.” Multiple factors likely contribute to epigenetic changes, including cytosine methylation, histone modification, auto-regulatory transcription factors, and non-coding RNAs, Waterland pointed out, and they tend to work in a synergistic fashion to influence gene transcription. Waterland said he is particularly interested in DNA methylation because methylation requires dietary donors and cofactors, which is influenced by nutritional factors. He presented data demonstrating that periconceptual maternal nutrition status predicts hypomethylation in a mother’s infant. These changes are stable and maintained over a lifetime, Waterland said, and may point to evidence of metabolic imprinting as an adaptive response to early nutrition.

“We live in a microbial world,” said Dingding An, PhD, a researcher at Boston Children’s Hospital. An elaborated on the role of early life gut microflora in immune system development, and explained that microbial exposure begins at birth and influences our risk for chronic diseases such as inflammatory bowel disease, asthma, arthritis, and autism later in life. Many early-life factors impact the makeup of the gut microbial population in particular, such as nutrition, hygiene, and antibiotic use. An presented data indicating that some gut microbes enhance immune cell maturation and immune response. But the timing of microbial exposure is critical, An added, because later exposure diminishes the response, indicating that key windows of regulation have been missed.

Deborah Sloboda, PhD, an associate professor at McMaster University, provided insights into the impacts of fructose consumption during pregnancy. Fructose is a monosaccharide present in honey, maple syrup, and fruit sugar, and is widely available in processed foods. Fructose consumption differs by sex and age, Sloboda said, with highest consumption reported among lower socioeconomic status females during their reproductive years. This is important, Sloboda said, because “the early-life environment plays a very big role in determining health and disease risk later in life.” Her data from animal models indicate that high fructose intake during pregnancy induces changes in the offspring’s metabolic response. Taurine supplementation reversed fructose-induced adverse metabolic programming, Sloboda said, but not in the presence of a high fat diet, emphasizing the importance of correctly identifying the population in need of intervention.

Growing up in the now well-studied Swedish village Överkalix strongly influenced the research of Lars Bygren, MD, PhD, a professor at University of Umea. Bygren, who addressed the topic of transgenerational outcomes associated with paternal nutrition, explained that human responses to early-life exposures, especially in males, have the potential to impact development for multiple generations. In particular, exposure to high food availability during slow-growth periods negatively affects the health of subsequent generations, and could explain the present day prevalence of many chronic diseases. Byrgen said data from other studies, including the Taiwan betel nut study and the ALSCAP study, lend support to these conclusions.

By Meghan Anderson Thomas, MS

I constantly hear:

Omnivores: “Vegetarians just don’t look healthy.”
Vegetarians: “ Meat just isn’t good for you.” Or “I feel so much better when I’m not eating it”

So who has it right? Can they both be right and wrong at the same time? I think the answer lies in the motivations behind the eater. The omnivore may have a point because vegetarianism, like all other diets, has the capacity to be unhealthy.

Essentially, vegetarianism, pescetarianism, veganism, etc. are elimination diets. Like any elimination diet, they have the potential to lack vital nutrients including certain vitamins that are predominately found in animal products. According to Sabate, vegetarian diets when compared to meat-based diets are more likely to be deficient in vital nutrients(1). Similarly, when omnivores (typical American diet) obtain the abundance of their calories from meat and dairy they have less room for the fruit and vegetables that provide them with the other nutrients vegetarians so easily acquire. Moreover, studies show that the increased risk of cancer and heart disease in meat-based diets may be related to a deficiency in the phytochemicals and other compounds found in plant-based foods, not just the intake of saturated fats and excess calories(2).

Again, the problem lies in the motivation. Vegetarians and omnivores alike that eat for health are much more likely to eat properly. The choice of becoming a vegetarian for health reasons alone may lead the vegetarian in question to a more healthful diet in which they are cognizant of variety and balance. That being said, there are plenty of vegetarians that may be doing it for the wrong reasons or are, like most, uneducated in making the proper nutritional decisions.

The observation that vegetarians are unhealthy may actually be evident. Most will argue that they have been deficient in iron, zinc, calcium and B vitamins since they have eliminated animal products, leading to anemia(2). Not to mention that most vegetarians are women who are prone to anemia due to menstruation. The fatigue that follows leads to the snowball effect of fatigue, decreased exercise and depression. The point is, diet has a strong influence on health and well-being and it is dangerously easy to eat incorrectly, even if one’s intentions may be pure. This is seen in all “types” of eaters alike.

It is important to remember that as a vegetarian, the elimination of a steak may reduce your risk for heart disease, hypertension, atherosclerosis, hyperlipidemia, etc., but it is not a free pass to eat all the junk food you can to make up for it. The elimination of meat alone is not the ticket to health. Instead, it seems to be a correlation: the vegetarians motivated by health are also more likely to be cognizant enough to eat right all of the time. Furthermore, Sabate illustrates that the vegetarian diet is viewed as improving health and limiting disease when compared to the meat-based diet(1).

References
1. Sabate, J. (2003). The contribution of vegetarian diets to health and disease: a paradigm shift? The American Journal of Clinical Nutrition, 78 (3), 502S-507S.
2. Nieman, D. C. (1999). Physical fitness and vegetarian diets: is there a relation? The American Journal of Clinical Nutrition, 70 (3), 570S-575S.

By Stefano Vendrame

Here we go again. I’m reading the billionth newspaper article referring to the “French paradox,” with the author explaining that “in spite of their high saturated fat intake, the French die less of coronary heart disease thanks to their higher consumption of red wine.”

It’s an old story that keeps coming back. I’ve heard it time and again from TV shows, newspapers, books and magazines, even university professors. It has been told so many times that in the back of their minds a lot of people still believe the concept that drinking red wine can prevent cardiovascular disease. It all dates back to the early nineties, when Serge Renaud and Michel De Lorgeril published a paper in Lancet entitled “Wine, alcohol, platelets, and the French paradox for coronary heart disease” (1).

Presenting epidemiological data, the authors observed that French people had a high consumption of saturated fat, and yet their mortality for coronary heart disease (CHD) was low. In the US and the UK, where consumption of saturated fat was substantially equivalent to France, mortality for CHD was much higher. They called this the “French paradox.” There was, however, a difference; in France, they would also drink more red wine. Since alcohol does have some fibrinolitic and atheroprotective effects, and red wine contains some protective polyphenols, such as resveratrols that come straight from red grapes, they hypothesized that higher red wine consumption could explain the apparent paradox. To further support this hypothesis, there were some striking data from three different cities within France itself. CHD mortality per 100,000 men was much lower in Toulouse compared to Strasbourg and Lille (78 vs 102 and 105, respectively), in spite of cheese consumption being higher (51 g/day vs 34 and 42 g/day, respectively). However, wine consumption in Toulouse was also significantly higher compared to the other two cities (383 g/day vs. 286 and 267 g/day, respectively). Again, wine consumption appeared to “counteract the untoward effects of saturated fats,” to use the words of the authors.

In the 1990s, wine sales in Europe were inexorably declining, with many young people in traditionally wine-drinking countries steadily switching to beer, considering wine drinking an old-fashioned habit. The wine industry jumped on the “French paradox” story, promoting an epic marketing campaign which instilled in a lot of people the idea that drinking red wine is good for your heart. It was so effective that I know people who didn’t drink alcohol at all, and started drinking a glass of red with their meals for fear that not doing so would increase their risk of dropping dead from a heart attack.

Not surprisingly, a great deal of research ensued. Indeed, when polyphenols are extracted from red grapes or red wine they exert beneficial effects, but the amount of wine needed to get enough resveratrols to produce a significant effect would be incompatible with the toxic effects of alcohol (2,3). And while a moderate consumption of alcohol is associated with a slightly reduced death rate from heart attack, it is also associated with a slightly increased death rate from cancer, liver cirrhosis and car accidents (4,5). Tough choice.

Anyone who has visited France will notice they enjoy their cheeses and sauces and foie gras, they always eat them with plenty of vegetables and grains, and a visit to any morning market in France will strike for the abundance of colors coming from all sorts of fruits, vegetables and herbs, and for the customers eagerly filling their baskets with them. So, was it really wine that was the key to explain the French paradox? A mere look at the rest of the Toulouse-Strasbourg-Lille table published in that very Lancet article would have provided good clues that wine was not necessarily part of the answer, and even if it was, it was certainly not all of it!

Granted, in Toulouse they drank more red wine than in Strasbourg and Lille, while eating slightly more cheese, but they also ate a lot more vegetables (306 g/day vs. 217 and 212 g/day, respectively), a lot more fruit (238 g/day vs. 149 and 160 g/day), half the butter (13 g/day vs. 22 and 20 g/day), more vegetable fat (20 g/day vs. 16 and 15 g/day) and more bread (225 g/day vs. 164 and 152 g/day). In other words, they were eating more fruits and vegetables and they ingested more dietary fiber, less saturated fat, more polyunsaturated fat and more grains. Still surprised that their deaths were less often attributed to cardiovascular disease?

The popular narrative of the French paradox gets the premise and the conclusion wrong. It is wrong to assume that saturated fat is all that matters to predict cardiovascular risk, since we know very well that it is just one of the many dietary factors involved. And it is dead wrong to suggest that drinking a few glasses of red wine is all you need to make it better. If anything, the whole story proves once more the concept that the balance of diet in general is more important than any single component in preventing disease and ensuring good health. You can eat a little bit more cheese, but if you eat a lot more fruits and vegetables, you are still doing fine. I propose a toast to this basic rule of nutrition, and I’ll be happy to toast with a glass of good French red wine, as they do in Toulouse. But just like them, I’ll get plenty of fruits and veggies afterwards to prevent CHD. Cheers!

References
1. Renaud S, de Lorgeril M. Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet. 1992; 339:1523-6.

2. Bianchini F, Vainio H. Wine and resveratrol: mechanisms of cancer prevention? Eur J Cancer Prev. 2003; 12:417-25.

3. Goldberg DM, Yan J, Soleas GJ. Absorption of three wine-related polyphenols in three different matrices by healthy subjects. Clinical Biochemistry. 2003; 36:79-87.

4. Norström T, Ramstedt M. Mortality and population drinking: a review of the literature. Drug Alcohol Rev. 2005; 24:537-47.

5. Klatsky AL. Alcohol and cardiovascular diseases. Expert Rev Cardiovasc Ther. 2009; 7:499-506.