The American journal of clinical nutrition
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Dietary supplement use is increasingly common in the United States. Multivitamin formulations with or without minerals are typically the most common type of dietary supplement reported in surveys and studies that collect data relating to dietary supplement use. In the National Health and Nutrition Examination Survey (NHANES) 1999-2000, 52% of adults reported taking a dietary supplement in the past month, and 35% reported regular use of a multivitamin-multimineral (MVMM) product. ⋯ Individuals who use dietary supplements (including MVMM formulations) generally report higher dietary nutrient intakes and healthier diets in studies in which dietary data were also collected. Among adults with a history of breast or prostate cancer, usage rates for dietary supplements in general and MVMMs are considerably higher (eg, 56-57% for MVMMs), and these subgroups are more likely to also report use of single vitamin and mineral supplements. Thus, MVMM use contributes a considerable proportion of nutrient intakes in the United States and may contribute to risk of excessive intakes.
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Consumption of sugar-sweetened beverages (SSBs), particularly carbonated soft drinks, may be a key contributor to the epidemic of overweight and obesity, by virtue of these beverages' high added sugar content, low satiety, and incomplete compensation for total energy. Whether an association exists between SSB intake and weight gain is unclear. We searched English-language MEDLINE publications from 1966 through May 2005 for cross-sectional, prospective cohort, and experimental studies of the relation between SSBs and the risk of weight gain (ie, overweight, obesity, or both). ⋯ A school-based intervention found significantly less soft-drink consumption and prevalence of obese and overweight children in the intervention group than in control subjects after 12 mo, and a recent 25-week randomized controlled trial in adolescents found further evidence linking SSB intake to body weight. The weight of epidemiologic and experimental evidence indicates that a greater consumption of SSBs is associated with weight gain and obesity. Although more research is needed, sufficient evidence exists for public health strategies to discourage consumption of sugary drinks as part of a healthy lifestyle.
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Recent discoveries, notably of the hormones leptin and adiponectin, have revised the notion that adipocytes are simply a storage depot for body energy. Instead, adipocytes are also endocrine organs, with multiple metabolic roles in regulating whole-body physiology. ⋯ Importantly, the adipocyte hormones leptin and adiponectin also activate AMPK; remarkably, the same pathway is activated by certain antidiabetic agents such as thiazolidinediones. Increasingly, our understanding of the adipocyte as an endocrine organ is leading to new insights into obesity and health.
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Thirty years have been added to the average life expectancy of Americans over the past century. It is a reasonable expectation that Americans will achieve an average life span of > or =100 y within this century. The most dramatic decreases in early-life and midlife mortality coincided with advances in medicine; curative medicine has played a lesser role. ⋯ The influence of nutrition on health status and morbidity supports primary, secondary, and tertiary prevention of disease and intervention strategies at each point in the process. The objective of such a prevention-oriented model is to enable people to live well for longer, while minimizing chronic disability. Starting down the right path with appropriate nutrition and staying on it by eating well are important components of healthy aging.
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Highest rates of obesity and diabetes in the United States are found among the lower-income groups. The observed links between obesity and socioeconomic position may be related to dietary energy density and energy cost. Refined grains, added sugars, and added fats are among the lowest-cost sources of dietary energy. ⋯ Limiting access to inexpensive foods through taxes on frowned upon fats and sweets is a regressive measure. The broader problem may lie with growing disparities in incomes and wealth, declining value of the minimum wage, food imports, tariffs, and trade. Evidence is emerging that obesity in America is a largely economic issue.