A diet low in manganese may increase the risk for anovulation, or failure of the ovary to release an egg during a menstrual cycle. Approximately every 28 days, the female body prepares for pregnancy. About halfway through the cycle, the ovary will release an egg in response to hormonal changes. Disruptions in this process can result in infertility.

The BioCycle Study, completed at the University at Buffalo, was initiated to better understand the impact of diet and lifestyle on reproductive hormones and menstrual cycle abnormalities, including anovulation. The study assessed 259 healthy, regularly menstruating women over the course of two menstrual cycles. Data collected provide insight on health history and physical activity. Blood samples collected from participants at eight specific phases of the menstrual cycle are used to measure hormone levels and detect irregularities in ovulation. In addition, the collection of dietary data promotes evaluation of nutrient intake and reproductive health outcomes.

Researchers at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) assessed the impact of dietary mineral intake on anovulation using data from the BioCycle Study. They found that a diet low in manganese, in reference to the recommended adequate intake (1.8mg/day for adult women), is associated with an increase in risk for anovulation.

How does this affect fertility?

Increasing intake of manganese is reasonable given that it is abundant in several readily available foods including teas, nuts, legumes, and whole grains But, before making dietary adjustments to improve fertility, the implications of these findings should be considered within the context of study design. In this case, anovulation was defined as sporadic, in that ovulation was only assessed over the course of two cycles and previous menstrual cycles occurred regularly. Consistent anovulation is a common cause of infertility, whereas intermittent anovulation is thought to have minimal impact on fertility, as menstrual cycles occurring before and after are believed to be healthy. However, a role for dietary manganese in fertility should not be ruled out as women with one sporadic anovulation have abnormal hormone profiles during preceding and future ovulatory cycles. This suggests ovarian dysfunction that may impact fertility.

Why does a diet low in manganese impair ovulation?

The exact function of manganese in human reproduction is not fully understood; however, studies rat studies indicate that the essential micronutrient may impact ovulation through its effects on the brain. Manganese accumulates in the hypothalamus, a region of the brain that regulates levels of reproductive hormones. Injection of manganese into the brain of prepubertal female rats increases levels of luteinizing hormone releasing hormone (LHRH), a reproductive hormone critical for ovulation.

Direct administration to the brain significantly differs from dietary intake of manganese; therefore further studies are required to determine the impact of manganese obtained from the diet. In addition, only a portion of manganese from the diet is absorbed, while the rest is excreted. Therefore, deficiency may be better reflected in manganese serum concentrations rather than dietary assessment. Furthermore, the body stores manganese in tissues including bone, liver, kidney, and pancreas. This suggests that a short-term dietary deficiency may not affect the overall balance of manganese in the body.

Nevertheless, observations on the association of dietary mineral intake and anovulation from the BioCycle Study are critical in stimulating further investigation into the impact of manganese on fertility.

What is Breakfast?

Breakfast is unique because it breaks a time of fasting (after a night of sleep). You are considered a breakfast eater if you eat your first meal of the day following your longest period of sleep, within 2 to 3 hours of waking and if your meal contains food or beverage from at least one food group. Your breakfast should provide at least 15% of your total daily caloric needs.

Should You Eat Breakfast?

Approximately one in five Americans are “breakfast skippers”. Skipping breakfast, as part of time-restricted eating patterns, such as intermittent fasting, has become increasingly popular as a weight management strategy. However, scientific evidence to support this is lacking. Many scientific studies have shown that breakfast skippers are at an increased risk for weight gain (e.g., increased hunger driving hormones, increased hunger throughout the day) and chronic disease.

A study comparing breakfast eaters to breakfast skippers found that those who ate breakfast had a decrease in appetite, improvement in healthy food choices and improved sleep quality. In addition, a study published in 2018 compared the effects of breakfast and dinner skipping in adult men and women. The study revealed that breakfast skipping, but not dinner skipping, negatively impacted the body’s ability to control blood sugar and insulin.

Research suggests that breakfast is important, but simply eating breakfast may only be half the battle. The true victory comes when you eat a high-quality breakfast packed full of protein and nutrients.

A Balanced Breakfast with Protein

Unfortunately, the majority of Americans who eat breakfast consume too little protein at their breakfast meal and instead, eat the majority of their daily protein at dinner. The higher amount of protein (greatly exceeding 30g of protein) typically consumed at dinner time cannot be stored for later use and is either used for energy or stored as fat.

Figure 1: Protein Distribution between Meals. Adapted from Paddon-Jones and Rasmussen, 2009

 

A high protein breakfast has been shown to benefit muscle health and to support weight loss by increasing muscle mass, energy expenditure (calories burned), satiety hormones, glucose regulation and by decreasing the desire to snack at night .

High protein breakfasts have also been shown to improve the body’s response to a high carbohydrate food up to 4-hours after the breakfast meal. A recent study looked at the effect of a high protein breakfast compared to a high fat or high carbohydrate breakfast on the body’s ability to control glucose and insulin following the consumption of white bread four hours after the breakfast meal. Participants consuming a high protein breakfast (30% protein) had improved blood sugar control and insulin levels after consuming the white bread.

Conclusion

Although breakfast may be the most frequently skipped meal in America, it continues to live up to its reputation as the most important meal of the day. So, when making your next breakfast choice, consider how much protein you have on your plate. Your first meal of the day can have long lasting effects throughout your day and on your long-term health!

References

  1. Nas A, Mirza N, Hagele F, Kahlhofer J, Keller J, Rising R, Kufer TA and Bosy-Westphal A. Impact of breakfast skipping compared with dinner skipping on regulation of energy balance and metabolic risk. Am J Clin Nutr. 2017; 105(6):1351-1361.
  2. Astbury NM, Taylor MA and Macdonald IA. Breakfast Consumption Affects Appetite, Energy Intake, and the Metabolic and Endocrine Responses to Foods Consumed Later in the Day in Male Habitual Breakfast Eaters. The Journal of Nutrition. 2011; 141(7).
  3. Pereira MA, Erickson E, McKee P, Schrankler K, Raatz SK, Lytle LA and Pellegrini AD. Breakfast frequency and quality may affect glycemia and appetite in adults and children. J Nutr. 2011; 141(1):163-168.
  4. Baum JI, Gray M and Binns A. Breakfasts higher in protein increase postprandial energy expenditure, increase fat oxidation, and reduce hunger in overweight children from 8 to 12 years of age. The Journal of nutrition. 2015; 145(10):2229-2235.
  5. Mamerow MM, Mettler JA, English KL, Casperson SL, Arentson-Lantz E, Sheffield-Moore M, Layman DK and Paddon-Jones D. Dietary protein distribution positively influences 24-h muscle protein synthesis in healthy adults. J Nutr. 2014; 144(6):876-880.
  6. Gwin JA and Leidy HJ. Breakfast Consumption Augments Appetite, Eating Behavior, and Exploratory Markers of Sleep Quality Compared with Skipping Breakfast in Healthy Young Adults. Current Developments in Nutrition. 2018; 2(11).
  7. Leidy HJ, Ortinau LC, Douglas SM and Hoertel HA. Beneficial effects of a higher-protein breakfast on the appetitive, hormonal, and neural signals controlling energy intake regulation in overweight/obese, “breakfast-skipping,” late-adolescent girls. Am J Clin Nutr. 2013; 97(4):677-688.
  8. Paddon-Jones D, Campbell WW, Jacques PF, Kritchevsky SB, Moore LL, Rodriguez NR and van Loon LJ. Protein and healthy aging. Am J Clin Nutr. 2015; 101(6):1339S-1345S.
  9. Chanet A, Verlaan S, Salles J, Giraudet C, Patrac V, Pidou V, Pouyet C, Hafnaoui N, Blot A, Cano N, Farigon N, Bongers A, Jourdan M, et al. Supplementing Breakfast with a Vitamin D and Leucine-Enriched Whey Protein Medical Nutrition Drink Enhances Postprandial Muscle Protein Synthesis and Muscle Mass in Healthy Older Men. J Nutr. 2017; 147(12):2262-2271.
  10. Megn H, Mathan NR, Ausman LM and Lichtenstein AH. Effect of prior meal macronutrient composition on postprandial glycemic responses and glycemic index and glycemic load value determinations. Am J Clin Nutr. 2017; 106:1246-1256.

 

The popularity of the essential polyunsaturated omega-3 fatty acids (O3FA) is on the rise. In 2017, O3FA achieved a spot on the top 20 foods and ingredients list that Americans are adding to their diets (The Hartman Group). In addition, the global fish oil market is expected to reach a whopping 4.08 billion dollars in the next four years!  The proposed health benefits are likely the driving force behind the increasing demand.

Despite their booming popularity, a large percentage of adults are not meeting the O3FA recommended intake. There are three primary O3FAs with distinct characteristics: alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Although commonly grouped under the umbrella term O3FAs, are all O3FAs created equal?

Unique Characteristics of O3FAs

Omega-3 fatty acids cannot be sufficiently produced in the body earning them the title of “essential fatty acids.” The plant-derived omega-3, ALA, is the parent precursor to EPA and DHA. Unfortunately, the conversion rate in our bodies is very low.  It is important to realize that in the process of metabolizing ALA to EPA and DHA, a series of anti-inflammatory markers are produced (leukotrienes, prostaglandins and thromboxane). As these anti-inflammatory metabolites are beneficial, direct EPA and DHA consumption is needed to meet bodily requirements.

Independent and Complementary Health Benefits

The majority of current research focuses on the health benefits of marine fatty acids.  DHA and EPA consumption portray an array of shared and complementary benefits related to the treatment of cardiovascular disease, depression diabetes, sleep disorders and more. DHA is more significantly associated with decreases in resting heart rate, blood pressure and with improvements in cellular membrane health due to its additional double bond and longer carbon chain. Increased cellular levels of EPA have been shown to benefit coronary heart disease, hypertension and to decrease inflammation. EPA and DHA are both associated with reduced gene expression related to fatty acid metabolism, reduced inflammation and oxidative stress.

Specific supplementation of ALA is not consistently associated with cardiovascular health. Although plant-derived ALA can be easily substituted in for excess omega-6 fatty acids (O6FAs). Research has shown that by reducing the O3FA:O6FA ratio, you can decrease bodily inflammation, increase anti-inflammatory markers and more efficiently utilize EPA and DHA.

An ALA, EPA and DHA-Rich Diet

The 2015-2020 Dietary Guidelines for Americans recommends that healthy adults consume at least 8 ounces of a variety of non-fried fatty seafood per week. For EPA and DHA requirements, the American Heart Association recommends fatty marine sources containing 500 mg or more of EPA and DHA per 3oz cooked serving (e.g., salmon and tuna).   ALA is the most commonly consumed O3FA in the Western diet as it is found in plant-based foods (e.g., dark green leafy vegetables, walnuts, canola oil, flax seed). Unlike EPA and DHA, an Adequate Intake (AI) level is established at 1.6 g/day and 1.1 g/day for men and women respectively.

The Final Verdict 

The wide range of benefits stemming from marine O3FAs indicates the importance of regular consumption of fatty seafood and EPA and DHA-containing products.  The incorporation of plant-derived ALA may serve more importantly as a substitute for omega-6 fatty acids to reduce bodily inflammation, decrease the high O3FA:O6FA ratio typically observed in the Western diet, and to help elevate EPA and DHA levels in the body. EPA and DHA may be featured as the health promoting “dynamic duo,” but ALA is still invited to the party!

 

References

1.         Yanni Papanikolaou JB, Carroll Reider and Victor L Fulgoni. U.S. adults are not meeting recommended levels for fish and omega-3 fatty acid intake: results of an analysis using observational data from NHANES 2003–2008. Nutrition Journal 2014.

2.         Harris WS, Mozaffarian D, Lefevre M, Toner CD, Colombo J, Cunnane SC, Holden JM, Klurfeld DM, Morris MC, Whelan J. Towards establishing dietary reference intakes for eicosapentaenoic and docosahexaenoic acids. J Nutr 2009;139(4):804S-19S. doi: 10.3945/jn.108.101329.

3.         Frits A. J. Muskiet MRF, Anne Schaafsma, E. Rudy Boersma and Michael A. Crawford. Is Docosahexaenoic Acid (DHA) Essential? Lessons from DHA Status Regulation, Our Ancient Diet, Epidemiology and Randomized Controlled Trials. Journal of nutrition 2004;134.

4.         Mozaffarian D, Wu JH. (n-3) fatty acids and cardiovascular health: are effects of EPA and DHA shared or complementary? J Nutr 2012;142(3):614S-25S. doi: 10.3945/jn.111.149633.

5.         Bork CS, Veno SK, Lundbye-Christensen S, Jakobsen MU, Tjonneland A, Schmidt EB, Overvad K. Dietary Intake of Alpha-Linolenic Acid Is Not Appreciably Associated with the Risk of Ischemic Stroke among Middle-Aged Danish Men and Women. J Nutr 2018. doi: 10.1093/jn/nxy056.

6.         Evangeline Mantzioris MJJ, Robert A Gibson and Leslie G Cleland Differences exist in the relationships between dietary linoleic and alpha-linolenic acids and their respective long-chain metabolites. Am J Clin Nutr 1995;61:320-4.

7.         Agriculture. USDoHaHSaUSDo. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015.

Dr. Stover graduated from Saint Joseph’s University with a B.S. degree in Chemistry and was awarded the Molloy Chemistry Award at graduation. He received a Ph.D. degree in Biochemistry and Molecular Biophysics from the Medical College of Virginia and performed his postdoctoral studies in Nutritional Sciences at the University of California at Berkeley. Patrick Stover was elected into the National Academy of Sciences in 2016. In 2014, he was elected as a Fellow of the American Association for the Advancement of Science. He also he received the SUNY Chancellor’s Award for Excellence in Scholarship and Creative Activities and the Osborne and Mendel Award for outstanding recent basic research accomplishments in nutrition from the American Society for Nutrition.

In 2012, he received a MERIT award from NIH’s National Institute of Diabetes and Digestive and Kidney Diseases and in 1999, he received the E.R.L. Stokstad Award in Nutritional Biochemistry from the American Society for Nutritional Sciences. In 1996, Patrick Stover received the Presidential Early Career Award for Scientists and Engineers from President Clinton, the highest honor bestowed by the U.S. government on outstanding scientists and engineers beginning their independent careers, and he has been selected as an Outstanding Educator four times by Cornell Merrill Presidential Scholars. He also serves as Editor for the Annual Review of Nutrition.

How did you first get involved in nutritional biochemistry and research? What made you interested in the field of nutrition science?

I caught the research bug through an undergraduate research experience at Saint Joseph’s University. Dr. Nelson’s research group was funded by the Naval Air Development Center and focused on the design, synthesis and function of synthetic prostaglandin oligomers as anti-ischemic agents. Studying the role and biological function of small nutrients became my passion and drove my interest in metabolism and biochemistry. I then studied enzymology and folate metabolism for my doctoral research under the mentorship of Dr. Verne Schirch at the Medical College of Virginia. This experience naturally led to an interest in nutrition and my migration to the University of California at Berkeley, when I studied folate nutrition and metabolism in the research group of Dr. Barry Shane.

When and why did you first join ASN? What value does ASN continue to provide you?

I joined ASN much later than I should have. I had regularly attended Experimental Biology and participated in ASN programming since graduate school but was most active in ASBMB. I joined ASN in1999 shortly after I was tenured as an associate professor, initially due to my interest in graduate education. I joined the Graduate Nutrition Education Committee and rose to rank of chair when we published what I believe is still a very important resource for all nutrition graduate programs: J Nutr.2002 Apr;132(4):779-84. ASN became my academic and professional home over the years—where I see old and meet new colleagues and collaborators, where my students present their research findings, where I developed leadership skills, and where I give time and treasure back to the nutrition community.

What aspects of ASN membership have you found most useful, professionally for you, your faculty and students? What other aspects of your membership do you find useful as your career has progressed?

All science is now a “social” science—collaboration is critical to address most important research questions. No one can succeed in a vacuum. Understanding how to forge meaningful and constructive partnerships through collaboration is essential to success, and ASN offers numerous opportunities to bring scientists together in an environment that promotes the exchange of ideas. Importantly, ASN also actively promotes mentoring opportunities for students and junior scientists, which has been invaluable for my students.

What aspects of your research do you foresee being most important for ASN members?

My bias is that nutrition, in all its dimensions, behaves as a complex dynamic system, and system approaches are needed to provide solutions to the problems we seek to solve. Hence, many of my current collaborators are those expert in systems biology and computer science.

Can you tell us more about your new position and what you hope to accomplish?

Perhaps the greatest challenge of our time is harmonizing agriculture, food systems, human health and environmental health. This is essential to address skyrocketing diet-related health care costs, environmental deterioration, and to ensure sustainability of our agriculture systems. Texas, as a national leader in agricultural production, coupled with its Healthy Texas A&M AgriLife Extension initiative, will be a model for aligning healthy and profitable agriculture with healthy people and healthy environments. As Vice Chancellor and Dean of Agriculture and Life Sciences at Texas A&M University and System, I have the privilege of working with the talented faculty, academic staff, students, state-wide agencies and stakeholders to be a national model for excellence in meeting the one-health challenge through research, teaching, Extension and service.

Is there anything else you’d like to tell ASN members, especially students and postdocs?

For the students and trainees, do what you love and you’ll love what you do! Strive to become a world-class expert in your field and enjoy as many colleagues as you can. Share your ideas with others, and they will share openly with you. Give back to the community that has given so much to you…perhaps through the ASN Foundation!

 

The Stover research group investigates the chemical, biochemical, genetic and epigenetic mechanisms that underlie the relationships between one-carbon metabolism and human pathologies including neural tube defects, cardiovascular disease and cancer. Specific interests include the regulation of folate-mediated one-carbon metabolism and genome expression and stability, the molecular basis of the fetal origins hypothesis, development of mouse models to elucidate mechanisms of folate-related pathologies, and translational control of gene expression.

 

March is National Nutrition Month. The campaign promotes healthy eating habits and nutrition education, and it celebrates the people who promote these healthy habits. In 2018, the theme is “Go Further with Food”, highlighting that food decisions make an impact on your overall health.

Members of the American Society for Nutrition (ASN) are diverse. We study nutrition as a science, reporting on the physiological and biological aspects of foods and nutrients. We are also the nutrition educators and practitioners who get the latest nutrition science into the hands of those who need it: policymakers, dietitians, medical doctors, nurses and allied health professionals, and consumers. To celebrate National Nutrition Month and ASN’s impact on enhancing the knowledge of nutrition and quality of life, we will be highlighting some of our programs and activities that ultimately influence public health and how we can “go further with food.”

NUTRITION 2018 – American Society for Nutrition’s Annual Meeting

Nutrition 2018 LogoThis year ASN kicks off a new annual meeting that will focus on the multidisciplinary field of nutrition science. The meeting will bring together basic, translational, clinical, and population scientists and practitioners. The meeting will be held in Boston June 9-12 and registration is open now!

Some hot nutrition topics at the meeting:

  • Role of Anti-inflammatory Nutrition Strategies
  • Pediatric Nutrition
  • Nutrition and the Environment
  • Precision Nutrition
  • Science of Breastfeeding
  • Food Allergies

These are only a few topics that are included in the 4-day nutrition meeting. Our NUTRITION 2018 schedule is now open so please refer to it for the latest sessions.

Stay tuned for more news and a special membership offer for dietitians and nutritionists during National Nutrition Month.

Richard Mattes, MPH, PhD, RD

Interview with Richard Mattes, Ph.D., Distinguished Professor of Nutrition Science at Purdue University, Adjunct Associate Professor of Medicine at the Indiana University School of Medicine, Affiliated Scientist at the Monell Chemical Senses Center, and Vice-President Elect for the American Society for Nutrition.

Dr. Mattes received his Ph.D. in Human Nutrition from Cornell University and conducted post-doctoral studies at the Memorial Sloan-Kettering Cancer Center and the Monell Chemical Senses Center. He remained at Monell for 13 years progressing to full member. At Purdue University, Dr. Mattes is the Director of the Ingestive Behavior Research Center, and the Director of Purdue’s Public Health Graduate Program. He also holds numerous external responsibilities including Associate Editor for The American Journal of Clinical Nutrition. He is also secretary of the Rose Marie Pangborn Sensory Science Scholarship Fund. Richard Mattes has been the principal investigator on National Institutes of Health grants continuously since 1984, and has authored of over 265 publications.

 

1. How did you first get involved in nutritional biochemistry and research? What made you interested in the field of nutrition science?

My original plan was to pursue a career in public health. I selected nutrition as a focus because while diet-related disorders were widespread, a large proportion appeared solvable. It was a field where one could make a difference. Following completion of my public health training, I realized I needed a deeper understanding of nutrition science to be in a position to address the issues that now seemed much more complicated. My pivot to nutrition and sensory science stemmed from my work under Shiriki Kumanyika who was interested in sodium intake and hypertension at the time as well as a recommendation by a friend to attend an illuminating course taught by Bruce Halpern, a sensory scientist in the Psychology Department at Cornell. Understanding the drivers of food choice, such as sensory function, seemed to be a critical control point for moderating diet-related chronic diseases.

2. When and why did you first join ASN? What convinced you to join the organization

I joined the American Institute of Nutrition (AIN) in 1986, immediately following completion of my post-doctoral training, when I thought I had completed a sufficient body of work to be eligible for membership. I considered it an honor to be a member of a professional association that included many of the scientists publishing work that guided my thinking. It was also an important resource for me since I was at an institution with a mission to understand the mechanisms and functions of the chemical senses, not address nutrition problems. So, while I had wonderful colleagues, few had similar training to me or similar interests and as a young scientist, I needed more feedback from people knowledgeable in nutrition. The AIN was an invaluable resource.

3. What aspects of ASN membership have you found most useful, professionally? What other aspects of your membership do you find useful as your career has progressed?

Membership benefits like access to all four ASN Journals have been, and continue to be the primary means for my keeping current with the advancing science.

4. What aspects of your research do you foresee being most important for ASN members?

My research has always been at the interface between nutrition, sensory, food and psychological sciences. I hope that it serves as a bridge to these other areas as they are integral to understanding food choice and how behavior influences physiology.

5. Can you tell us more about your current position and the research activities in which you are involved?

I currently have a split appointment. Sixty percent of my effort is devoted to building and administering a new public health graduate program. So, after over thirty years of basic and clinical research, I find myself back at my original professional aspiration. The other forty percent of my effort is as a traditional faculty member, though I do direct the Ingestive Behavior Research Center which provides a unique opportunity to train doctoral students in this area of specialization.

6. What do you feel are the biggest challenges facing nutrition researchers today? Are there any areas where you would like to see more research?

My biggest concern stems from the decreasing funding base for nutrition research. Of course, it directly limits what science can be pursued, but more insidiously, I think it drives scientists to take more advocacy roles for their area of work and this corrodes the scientific process. It also requires more time and energy being spent writing grants with the consequence being less time to engage in professional activities (e.g., reviewing manuscripts, serving on professional committees) which further hampers progress.

7. Is there anything else you’d like to tell students and postdocs within ASN?

 Invoke the word “no” as seldom as possible. Many will argue the best advice is to maintain a laser focus on one’s area of study. Not having tried this approach I can’t speak to is success. My experience is that every opportunity I’ve pursued in some way, at some time, has proven to be worthwhile.

 

Dr. Mattes’ research focuses on the areas of hunger and satiety, regulation of food intake in humans, food preferences, human cephalic phase responses and the mechanisms and functions of taste, with the objective of understanding the neural, genetic, metabolic, hormonal, cognitive, cultural and especially sensory influences on human ingestive behavior, nutrient utilization and energy balance in healthy and clinical populations.

 

As anyone in the nutrition field is aware, there are plenty of extreme dietary practices. Personally, I’ve heard about everything from the baby food diet to the Dukan diet to something about alkaline blood levels. Usually, these extreme dietary practices are met with an eye roll, knowing that these outrageous diets will last about as long as an avocado in it’s prime. But what if there was a dietary trend that promised long-term health benefits that focused not necessarily on what you eat, but when you eat?

Intermittent fasting is any period of voluntary food restriction. Protocols are varied and might include religious fasting, time restricted feeding (i.e. eating all calories within a short time window) or scheduled days of extreme caloric restriction (i.e. ≤ 25% of energy needs) followed by normal or high calorie days.

I am always skeptical of any diet or dietary pattern that claims to fix everything from obesity to cancer, but – bro-science aside – intermittent fasting is gaining a substantial amount of attention in research. A recent and thorough review in The Annual Review of Nutrition concluded that intermittent fasting might be a viable strategy to benefit overall human health, including improvements in biomarkers associated with chronic disease. Notably, however, most human research studies are limited by small sample sizes, lack of control groups, insufficient follow-up, and inclusion of normal weight or healthy individuals who are unlikely to respond to interventions.

The best diet for optimal health is one that is maintainable. A large (n=100) and long (1 year) study in metabolically healthy obese adults published last year found that drop-out was highest in the group randomized to alternate-day fasting. The long-term adherence to intermittent fasting and applicability to public health is therefore questionable.

Diet quantity and quality will always be paramount for the promotion of optimal health and healthy aging. For me, I couldn’t live without my morning matcha latte and eggs… but maybe breakfast isn’t the most important meal of the day, at least for habitual non-breakfast eaters.

The leading causes of death in the United States include heart disease, cancer, stroke, diabetes, and kidney disease (1). These conditions are strongly associated with poor diet, sedentary lifestyle, and excessive weight gain. Currently, 2 out of 3 Americans are either overweight or obese (2). As such, 75% of total healthcare costs are used for the treatment of these chronic conditions (3). Research continues to show that nutrition intervention can drastically improve one’s health and reduce the risk for many of these chronic diseases. Nutrition counseling by a registered dietitian nutritionist (RDN) can make a world of difference for chronic disease management, treatment, and prevention. Nutrition counseling that promotes lifestyle changes to include healthier diets and more physical activity have the potential to reduce incidence of type II diabetes by 34% (4), heart disease by 31%, and stroke by 20% (5). Utilizing these services can make a profound difference in the trajectory of health outcomes and healthcare costs for American’s. However, only 3% of all healthcare expenses are spent on preventive services (3). This is primarily due to a lack of coverage for these services by insurance companies. Medicare covers dietetic services only for patients who have diabetes or kidney disease. As such, patients who are prediabetic, obese, or have cardiovascular disease are not covered by Medicare to see a dietitian. Many people seek nutrition services and choose to pay out of pocket, recognizing the long term benefits these services provide. Yet, many individuals who need these services simply can’t afford to pay for them, costing around $118 an hour (6).

Under the Affordable Care Act (ACA), preventive services are covered more now than ever. The ACA mandated that insurance companies cover preventive services that were identified by the U.S. Preventive Services Task Force (USPSTF) (7). These services include “healthy diet and physical activity counseling” and “obesity screening and counseling (8).” Congress is currently proposing the American Health Care Act which threatens to discontinue the inclusion of these services. Such reform would be a step backwards in reducing the rates of chronic diseases and the rising healthcare costs. According to the Academy of Nutrition and Dietetics President Lucille Beseler, the American Healthcare Act will, “reverse advancements made in disease prevention and chronic care management (9).” With healthcare costs continuously on the rise, investing in prevention is a much-needed solution for our nation’s healthcare costs.

In addition to the inclusion of prevention services, the ACA also includes the Prevention and Public Health Fund. These funds are distributed to the states to be used for community specific programs, including prevention initiatives, surveillance, and research (10). Investing in these types of community programs can reduce healthcare costs. For every $1.00 spent, $6.60 in healthcare costs are saved over a five year period (3). The current healthcare reform proposal will repeal this fund, hurting the communities that have been benefiting from these public programs. The House of Representatives passed the American Health Care Act in May sending it to the Senate for deliberation. In June, the Senate released their revised version of the bill and titled it the Better Care Reconciliation Act. The Senate was unable to repeal the ACA by the September 30th deadline. In October, President Trump passed an Executive Order Promoting Healthcare Choices and Competition, which allows agencies to modify how they implement the ACA. As nutrition professionals, the implications of preventive services is extremely apparent, yet without proper support for these services we risk their exclusion from future healthcare reforms.

  1. FastStats. (2017). Available at: https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm. (Accessed: 15th December 2017)
  2. Overweight & Obesity Statistics | NIDDK. Available at: https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity. (Accessed: 15th December 2017)
  3. Prevention and Public Health Fund. Available at: https://www.apha.org/topics-and-issues/health-reform/prevention-and-public-health-fund. (Accessed: 15th December 2017)
  4. The data are in: Eat right, reduce your risk of diabetes – Harvard Health Blog – Harvard Health Publishing. Available at: https://www.health.harvard.edu/blog/the-data-are-in-eat-right-avoid-diabetes-2017010510936. (Accessed: 15th December 2017)
  5. Guide to Insurance and Reimbursement – Today’s Dietitian Magazine. Available at: https://www.todaysdietitian.com/newarchives/0217p40.shtml. (Accessed: 15th December 2017)
  6. Preventing Heart Disease | The Nutrition Source | Harvard T.H. Chan School of Public Health. Available at: https://www.hsph.harvard.edu/nutritionsource/disease-prevention/cardiovascular-disease/preventing-cvd/. (Accessed: 15th December 2017)
  7. Health Care Reform and Preventive Services. www.eatrightpro.org Available at: https://www.eatrightpro.org/resource/payment/nutrition-services/health-care-reform/healthcare-reform-and-preventive-services. (Accessed: 15th December 2017)
  8. USPSTF A and B Recommendations – US Preventive Services Task Force. Available at: https://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations/. (Accessed: 15th December 2017)
  9. Academy of Nutrition and Dietetics Announces Opposition to American Health Care Act. www.eatrightpro.org Available at: https://www.eatrightpro.org/resource/media/press-releases/public-policy/academy-announces-opposition-american-health-care-act. (Accessed: 15th December 2017)
  10. Prevention and Public Health Fund | HHS.gov. Available at: https://www.hhs.gov/open/prevention/index.html. (Accessed: 15th December 2017)

Interview with Sharon Donovan, Ph.D., R.D., Professor and Melissa M. Noel Endowed Chair in Nutrition and Health in the Division of Nutritional Sciences at the University of Illinois and Past President of the American Society for Nutrition.


Dr. Donovan received her Ph.D. in Nutrition from the University of California, Davis and completed a post-doctoral fellowship in Pediatric Endocrinology at Stanford University School of Medicine. She joined the University of Illinois, Urbana in 1991, where she became Professor in 2001 and in 2003 she was named the first recipient of the Melissa M. Noel Endowed Chair in Nutrition and Health. She served as Director of the Division of Nutritional Sciences Interdisciplinary Graduate Program from 1999-2009. Dr. Donovan served as President of the American Society for Nutrition for 2011-2012. She is also President-Elect of the International Society for Research on Human Milk and Lactation (ISRHML) and she continues to provide leadership and guidance in several committees and special initiatives for ASN. In October 2017, she was elected to National Academy of Medicine.

How did you first get involved in nutrition research? What made you interested in the field of nutrition science?

I was an undergraduate student at U.C. Davis majoring in Zoology, with the intention of going to veterinary school. In my junior year, I took a physiological chemistry course (basically nutritional biochemistry) taught by Richard Freedland—and I loved the course! Afterward, I took a nutrition course in the Department of Nutrition, where Bo Lönnerdal was a guest lecturer on the topic of pediatric nutrition—and I was hooked! I switched my major to nutrition science and started doing research in his laboratory and eventually was accepted into his laboratory for my doctoral degree.

When and why did you first join ASN? What convinced you to join the organization?

I joined the former AIN in 1984 as a graduate student in nutrition at U.C. Davis and attended my first FASEB meeting in 1985. I became a Full Member in 1989. I joined because the American Society for Nutrition is the top nutrition society for basic, translational and applied research in nutrition.

What aspects of ASN membership have you found most useful, professionally? What other aspects of your membership do you find useful as your career has progressed?

ASN membership has been instrumental throughout my career. Early on, ASN provided a framework for disseminating my research through annual meetings and publications. Likewise, through ASN I was able to build a broad professional network of colleagues at other institutions in the U.S. and around the world. ASN also provided numerous leadership opportunities through the RIS groups, on the Executive Board as Councilor and Secretary and, eventually, as President of the Society. All of these activities have been very professionally fulfilling for me.

What aspects of your research do you foresee being most important for ASN members?

My laboratory conducts basic and translational research in the area of pediatric nutrition. During this phase of life, proper nutrition is of key importance for growth, development and long-term functional outcomes, such as cognition and immune response. A large focus in my lab is how early life events influence the composition and functional capacity of the gut microbiome. As we learn more about the microbiome and its relationship with many of the same diseases that have long been associated with dietary intake, it is clear that nutrition researchers should know more about this newly appreciated “organ”.

Can you tell us more about your current position and the research activities in which you are involved?

I am a Professor in the Department of Food Science and Human Nutrition and am affiliated with the Division of Nutritional Sciences and the Department of Pediatrics. Currently, my collaborators and I are investigating dietary approaches to improve the structural and functional development of the intestine and the brain, and the development of gut microbiome and the gut-brain-microbiome axis. In addition, I enjoy engaging with researchers in other fields to conduct transdisciplinary research focused on ways to prevent childhood obesity and picky eating behaviors and to reduce the severity of symptoms in children with autism.

What do you feel are the biggest challenges facing nutrition researchers today? Are there any areas where you would like to see more research?

Obviously, research funding continues to be a challenge for researchers in all areas. However, given the importance of nutrition in health and chronic disease prevention, I believe that there are many opportunities for nutrition researchers for interdisciplinary collaborations, which can be very attractive for funding agencies. In my opinion, more research is needed in understanding the contribution of the individual to interactions with diet and other environmental factors. For example, what role are host genetics and epigenetics genetics playing in responses to diet? This has been a hot area of research for a decade, but has not been fully translated to clinical medicine. Similarly, we need to know a lot more about the host aspect of host-microbe interactions, if we are going to tease out the role that the microbiome plays in health and disease.

Is there anything else you’d like to tell ASN members, especially students and postdocs?

I encourage everyone to take the opportunity to get involved in ASN. There are opportunities to “dip your toe” in the water and see how you like it! The RIS’s and other membership engagement groups, such as the Student Interest Group and the Postdoc/Early Career Nutrition Interest Group are great places to get involved. Networking is critical, particularly at earlier stages of your career, and professional contacts made through networking can help open doors that lead to opportunities, including internships, postdocs and jobs. Later in your career, being known by your colleagues can help with getting letters of P&T or learning about new positions in industry.

Omega-3 fatty acids have been long touted for their cardiovascular benefits. But many research studies strongly suggest that these fatty acids exert improvements well beyond those related to heart health.

 

Omega-3 fatty acids and/or fish oil supplements (the latter being a rich source of omega-3s) have been administered to those with cancer, heart disease, rheumatoid arthritis, and psychiatric disorders (i.e. schizophrenia and major depressive disorder) with resultant improvements in disease-specific outcomes and body composition (read: more and/or better quality of muscle) (1, 2). The supplement also has essentially no side effects, aside from the occasional lingering fishy after-taste. It’s thought that these beneficial effects are due to omega-3’s inhibition of numerous pro-inflammatory pathways.

So is there a place for these supplements in healthy populations? Say, exercising older adults? This is exactly what Mariasole Da Boit and a group of colleagues investigated in a randomized, double-blind placebo controlled trial published in the American Journal of Clinical Nutrition earlier this year (3). Fifty men and women (age 70.6 ± 4.5) participated in a resistance exercise training program for lower limbs twice weekly for 18 weeks. All were randomized to 3g fish oil/day or placebo (3g safflower oil/day). In women, maximal isometric torque (static contraction) and muscle quality defined by torque per unit of muscle cross-sectional area improved more in the fish oil group, independent of muscle mass changes; no differences were observed in men. Plasma triglycerides decreased in both sexes, while maximal isokinetic torque (moving contraction), 4-minute walk test, chair-rise time, muscle size, and muscle fat did not differ. The authors speculate that omega-3 improves neuromuscular function and/or enhances the contractile properties of type II (fast-twitch) muscle fibers. Some findings suggest that older women do not increase muscle strength to the same degree as older men; thus women could undergo a more profound response to resistance training since there is a greater capacity for muscular improvement.

While this is only one study and the mechanisms behind the results are somewhat speculative, the results are promising. With forthcoming research, omega-3 fatty acid supplements might become an evidence-based recommendation for healthy community-dwelling older adults and many clinical populations.

  1. Lee S, Gura KM, Kim S, Arsenault DA, Bistrian BR, Puder M. Current clinical application of omega-6 and omega-3 fatty acids. Nutrition in Clinical Practice 2006; 21(4):323-41
  2. Murphy RA, Mourtzakis M, Chu QS, Baracos VE, Reiman T, Mazurak VC. Nutritional intervention with fish oil provides a benefit over standard of care for weight and skeletal muscle mass in patients with nonsmall cell lung cancer receiving chemotherapy. Cancer 2011;117(8):1775-82.
  3. Da Boit , Sibson R, Sivasubramaniam S, Meakin JR, Greig CA, Aspden RM, et al. Sex differences in the effect of fish-oil supplementation on the adaptiveresponse to resistance exercise training in older people: a randomized controlled trial. American Journal of Clinical Nutrition 2017; 105:151-8