Nutrition Updates


Soenen S, Westerterp-Plantenga MS. No differences in satiety or energy intake after high-fructose corn syrup, sucrose, or milk preloads. Am J Clin Nutr 2007;86:1586–1594.  It is hypothesized that increases in overweight may be related to increased consumption of soft drinks, specifically those containing high-fructose corn syrup (HFCS). HFCS is comprised of a mixture of fructose and glucose and may differ from sucrose in its gastrointestinal and absorption effects, which may affect satiety and subsequent energy intake. In addition to the direct effects of dietary sugars, it has also been observed that intake of caloric beverages does not seem to produce compensatory decreases in caloric intake at subsequent meals. In the present study, Soenen and Westerterp-Plantenga evaluate the satiating effects of iso-caloric beverages sweetened with sucrose or with HFCS.

To examine the differences between sugar- and non-sugar-based drinks, satiety was also determined following intake of milk or of a minimally caloric diet beverage. Participants were tested according to a repeated-measures design, and all participants received all beverage conditions. Peak satiety following intake of milk, sucrose, or HFCS beverages was approximately 50 minutes. In study 2, a test meal was given at this time point, and meal size was measured after preloads with the four different types of beverages. Overall, meal size and energy intake was lower following preload of milk, sucrose, or HFCS beverages relative to the minimally caloric diet beverage. However, total caloric intake (preload + meal) was higher with the energy-containing beverages in comparison with the minimally caloric beverages, suggesting that compensation for the energy intake from these beverages is only partial. These data suggest that despite differences in the nutritional composition of HFCS, sucrose, or milk beverages, they do not differ in their effects on subsequent satiety or energy intake.

Comment: In his accompanying editorial, Dr. Anderson asserts that based on the evidence described here and elsewhere, there is little reason to claim that sucrose in beverages would confer significant benefits over HFCS. Moreover, he argues that the posited role of HFCS in the development of the obesity problem is not supported by the effects of such beverages on satiety, short-term food intake, or biological factors.

Editorial Comment: Anderson GH. Much ado about high-fructose corn syrup in beverages: the meat of the matter. Am J Clin Nutr 2007;86:1577–1578.


Schwarz S, Obermüller-Jevic UC, Hellmis E, Koch W, Jacobi G, Biesalski H-K. Lycopene inhibits disease progression in patients with benign prostate hyperplasia. J Nutr 2008;138:49–53.  Lycopene has received considerable attention as a possible protectant in the development of prostate cancer. Epidemiological studies have shown that high intake and blood levels of lycopene are associated with a reduced risk of developing prostate cancer. Schwarz et al. report on a randomized clinical study intended to evaluate the efficacy of lycopene supplementation on disease progression in patients with benign prostate hyperplasia (BPH), a population at risk for developing prostate cancer.

Forty men with BPH were randomized into the trial, and half were given 15 mg/d supplementation and the other half were given placebo. Participants took the capsules daily with a meal for 6 months. The primary outcome measure was decreased PSA levels in the blood. Following 6 months of supplementation with lycopene, men with BPH had greater decreases in total serum PSA and smaller increases in prostate weight and volume in comparison with those taking placebo. The authors propose that supplementation with lycopene may inhibit the progression of prostate disease through apoptosis in BPH tissue, the inhibition of cell tissue proliferation in benign prostate tissue, and/or through antioxidant effects on oxidative stress-mediated cell proliferation and remodeling. This was a relatively small clinical trial, but the effects support further investigation into the role of lycopene in prostate health.


Baker WL, Gutierrez-Williams G, White CM, Kluger J, Coleman CI. Effect of cinnamon on glucose control and lipid parameters. Diabetes Care 2008;31:41–43.  The insulin-mimetic properties of cinnamon have come under focus as a possible means of regulating glucose control in diabetics. In addition to enhancing glucose uptake, cinnamon may also reduce lipid levels in animal models of type 2 diabetes. To better assess the effects of cinnamon on glucose control and plasma lipids, Baker et al. conducted a meta-analysis of existing randomized controlled trials of cinnamon supplementation in people with diabetes.

Five clinical trials with a total combined number of 282 participants were included in the meta-analysis. Participants were given 1–6 g/d cinnamon cassia for an average of 12 weeks. Four studies were conducted on participants with type 2 diabetes, and one on adolescents with type 1 diabetes. Outcome measures included changes in fasting blood glucose, total cholesterol, triglycerides, HDL and LDL cholesterol, and glycated hemoglobin (A1C). Upon analysis, there were no differences between cinnamon intake and fasting blood glucose, lipid profiles, or A1C. The authors acknowledge the limitations of meta-analysis and suggest that significantly larger sample sizes would be needed to demonstrate statistically significant differences in the various study endpoints. The authors conclude that based on current evidence there is no support for the role of cinnamon in the management of diabetes, but that the efficacy of cinnamon in pre-diabetics and other at-risk populations is not known.


Mitrou PN, Kipnis V, Thiébaut ACM, Reedy J, Subar AF, Wirfält E, Flood A, Mouw T, Hollenbeck AR, Leitzmann MF, Schatzkin A. Mediterranean dietary pattern and prediction of all-cause mortality in a US population. Arch Int Med 2007;167:2461–2468.  Eating a Mediterranean-style diet – a diet rich in fruits and vegetables, olive oil, nuts, and plant proteins – is associated with lower levels of cardiovascular disease, cancer, and dementia. Mitrou et al. extend these observations with a prospective analysis of Mediterranean dietary patterns and mortality in the US. They proposed that adhering to a Mediterranean-style of eating would be associated with reductions in mortality.

Participants were recruited from the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study. Participants were enrolled into the NIH-AARP Diet and Health Study between 1995 and 1996, and a cohort of 380,296 people (∼43% female) was used. Participants were followed up through December 2005, and mortality from all causes, cardiovascular disease (CVD), and cancer were ascertained. Dietary patterns were assessed using food-frequency questionnaires (FFQ), and conformity to a Mediterranean style diet was determined using a Mediterranean diet score (0 = low conformity; 9 = high conformity). Participants were categorized into low (0–3), moderate (4–5) or high (6–9) conformity. Higher conformity to a Mediterranean dietary pattern was associated with reduced risk for all-cause mortality, cancer mortality, and CVD mortality. Conformity with a Mediterranean diet pattern tended to be higher among people with a BMI between 18.5 and 30, higher education, higher physical activity, non-smokers, and – for women – with use of menopausal hormone therapy, all indicating a generally healthy lifestyle. The benefits of a Mediterranean diet was more pronounced in smokers within the normal range of BMI, and the authors suggest that following such a dietary pattern could be particularly important for smokers. It is proposed that Mediterranean dietary patterns harness the combined effects of dietary antioxidants, as well as contributing dietary fiber and a low omega-6:omega-3 fatty acid ratio. This is the first study to prospectively analyze Mediterranean dietary patterns and mortality risk in an older population in the United States.


Rogers PJ, Appleton KM, Kessler D, Peters TJ, Gunnell D, Hayward RC, Heatherley SV, Christian LM, McNaughton SA, Ness AR. No effect of n-3 long-chain polyunsaturated fatty acid (EPA and DHA) supplementation on depressed mood and cognitive function: a randomised controlled trial. B J Nutr 2008;99:421–431.  Lower levels of n-3 fatty acids, and lower n-3:n-6 fatty acid ratios are associated with severity of depressive symptoms in depressed people in comparison with non-depressed people. Lower dietary intake of n-3 fatty acids or fatty fish is associated with increased prevalence of depression. Supplementation with n-3 fatty acids, typically eicosapentaenoic acid (EPA) and/or docosahexaenoic acid (DHA), has become an attractive option to both practitioners and the general populace as an alternative to conventional medications for depression. In the present study Rogers et al. examined the effects of n-3 fatty acid supplementation (EPA + DHA) on mood in mild to moderately depressed people.

Participants were randomly assigned to receive 1.5 g EPA + DHA supplementation or placebo for 12 weeks. n-3 fatty acid supplementation contributed 630 mg EPA and 850 mg DHA to the diet; the placebo consisted of 2,360 mg olive oil. Both types of capsule contained orange oil to improve palatability and blinding. Mood was assessed using the short form of the Depression, Anxiety and Stress Scales (DASS), and participants who had a mild-to-low severity score (10–24) on the DASS were used (n = 218). Cognitive tasks assessed a variety of cognitive facets, including working memory, impulsivity, reaction time, and speed of information processing. Mood, cognitive function, and fasting plasma fatty acids were measured at baseline, and after 4 and 12 weeks of supplementation. Plasma concentrations of EPA and DHA were not associated with DASS scores at baseline. Over the course of the study, plasma levels of EPA and DHA increased in the supplemented group but not in the placebo group. Supplementation with EPA + DHA did not affect mood or cognitive scores in individuals with mild to moderate depression scores over the 12 weeks of the study. The intention of the study was to have relevance to the general population rather than modification of major depressive symptoms in a clinical setting, and the study represents the largest trial examining n-3 fatty acid supplementation on mood in the general populace.

Comment: Dr. Richardson observes that the study by Rogers et al. used a high-DHA formulation for the intervention, and that DHA-rich formulations are less efficacious in modulating mood than EPA-rich formulations. Research contributing to the American Psychiatric Association's recommendations of increasing n-3 fatty acid intake suggests that treatment with EPA appears to be the most effective. It is possible, therefore, that in the present study the composition of the EPA + DHA supplement was not suitable to produce changes in mood.

Editorial Comment: Richardson AJ. n-3 fatty acids and mood: the devil is in the detail. Br J Nutr 2008;99:221–223.

KE D'Anci