Diet

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Would taxing sugar-sweetened beverages improve population health and save money? Is this the “nudging society” gone too far?

Taxing sugar-sweetened beverages in Germany would improve population health and save money

A tiered tax system that incentivizes companies to reduce sugar content has greatest impact

Researchers model the taxation of sugar-sweetened beverages with population health and overall healthcare costs in Germany. CREDIT Leiada Krozjhen, Unsplash (CC0, https://creativecommons.org/publicdomain/zero/1.0/deed.en)

In Germany, taxing sugar-sweetened beverages could prevent or postpone cases of type 2 diabetes, extend healthy lifespans and save up to €16.0 billion in societal costs over the next 20 years, according to a new study led by Karl Emmert-Fees of the Technical University of Munich, published November 21st in the open access journal PLOS Medicine.

The World Health Organization has recommended that governments worldwide lessen the social and economic burden of cardiometabolic disease by taxing sugar-sweetened beverages. These taxes either reduce consumption by increasing the price, such as the one peso per liter tax in Mexico, or incentivize companies to reformulate their drinks with a lower sugar content, such as the tiered tax structure in the United Kingdom. Germany has not yet implemented a tax on sugar-sweetened beverages, so researchers estimated the health and economic impacts of these two possible taxation scenarios.

Through modeling, the researchers predicted the effects of a 20% tax on sugar-sweetened beverages and a tiered tax similar to the one used in the United Kingdom. For each scenario, they estimated changes in sugar consumption, weight, associated medical and societal costs, and the risk of type 2 diabetes, heart disease and stroke, from 2023 to 2043.

The researchers discovered that during the next 20 years, a tax on sugar-sweetened beverages could reduce sugar intake in the German adult population on average by 1 gram per day, prevent or postpone more than 132,000 cases of type 2 diabetes and save €9.6 billion by encouraging consumers to change their behavior. A tiered structure, however, would reduce sugar consumption on average by 2.34 grams per day, prevent or postpone more than 244,000 cases of type 2 diabetes and save €16.0 billion by incentivizing companies to sell drinks with less sugar.

While both tax systems would help reduce the health burden and societal costs of cardiometabolic disease, the researchers conclude that a tiered tax would likely have the largest impact. The researchers conclude that taxing sugar-sweetened beverages would be a viable policy option for German decision makers that would improve the health of the German population.

Emmert-Fees adds, “Overall, we found that the taxation of sugar-sweetened beverages could have a substantial impact on population health in Germany. Particularly people who consume a lot of these beverages would benefit from the highest reduction in sugar intake.”

Posted on Diet

Research shows swapping out pulses for common proteins and grains improves our diet

Benefits of Swapping Grains for Pulses

Substituting ½ cup of pulses daily in place of one ounce of refined grains while keeping calories constant increases fibre, magnesium, copper, and potassium, a nutrient of concern, by more than 10% Coalition to Advance Pulses

  A recently published study[i] in Nutrients, an open-access peer-reviewed scientific journal, demonstrates that exchanging pulses for small amounts of typical protein sources and refined grains significantly improves the nutritional profile of the American diet.  This new research adds to the extensive established body of evidence showcasing the multiple benefits of including pulses in a healthy diet. 

Researchers modelled the nutritional impact of substituting servings of protein foods and/or refined grains with servings of pulses (e.g., dry peas, lentils, chickpeas, dry beans) while keeping calories consistent in the Healthy U.S.-Style Dietary Pattern identified in the 2020-2025 Dietary Guidelines for Americans.  Results showed an improved nutritional profile of the diet.  Specifically, the addition of about ¼ cup of pulses per day in place of one ounce per day of common protein foods increases fibre, a nutrient of concern, and decreases cholesterol, each by more than 10%.  Additionally, they found that substituting ½ cup of pulses daily instead of one ounce of refined grains while keeping calories constant increases fibre, magnesium, copper, and potassium, a nutrient of concern, by more than 10%. 

“Our results suggest that encouraging increased pulse consumption may be an effective strategy for improving nutrient intake and achieving a healthier dietary pattern,” author Victor Fulgoni III, PhD, of Nutrition Impact, LLC.  “Pulses (dry peas, lentils, chickpeas, beans) are excellent sources of fibre, folate and potassium and good plant protein sources.”  The study was funded by the Coalition for the Advancement of Pulses.

The findings are consistent with the body of existing peer-reviewed studies that show the inclusion of pulses as part of a plant-forward dietary strategy imparts cardiovascular, metabolic, and gut protective effects; improves weight outcomes, and low-grade inflammation, and may play a role in immune-related disease risk management.[ii]  The American Heart Association and other public health organizations recommend adding more plant-based and less animal protein to reduce the risk of heart disease, high blood pressure and high cholesterol.[iii]

“This research underscores the fact that pulses are a nutritional powerhouse,” said Tim McGreevy, CEO, USA Dry Pea and Lentil Council and American Pulses Association.  “They are high in fiber, plant protein and several important macronutrients.  We know this and are working with our partners to increase awareness about the nutritional benefits of regular pulse consumption.”

Pulses are so nutritious that dietary guidelines globally include them in both the vegetable and/or protein food groups or as a separate food group all together. i, [iv],[v],[vi] The Dietary Guidelines for Americans 2020 – 2025 and the USDA’s Choose My Plate indicate that beans, peas, and lentils can be considered as part of the vegetable or protein groups.

Posted on Cognitive dysfunction, Diet

Following a Mediterranean diet reduces the risk of cognitive decline in older people

Can Mediterranean diet help people with MS preserve thinking skills?
Can Mediterranean diet help people with MS preserve thinking skills?

According to a study published in the journal Molecular Nutrition and Food Research, old people who follow a Mediterranean diet are at a lower risk of cognitive decline. The study provides new evidence for a better understanding of the biological mechanisms related to the impact of the diet on cognitive health in the ageing population.

The study is led by Mireia Urpí-Sardá, adjunct lecturer and member of the Biomarkers and Nutritional & Food Metabolomics research group of the Faculty of Pharmacy and Food Sciences, the Institute for Nutrition and Food Safety (INSA-UB), the Food and Nutrition Torribera Campus of the University of Barcelona, and the CIBER on Frailty and Healthy Ageing (CIBERFES).

This European study, part of the Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL) was carried out over twelve years and it involved 840 people over 65 years of age (65% of whom were women) in the Bourdeaux and Dijon regions of France.

Healthy diet and cognitive performance

According to Cristina Andrés-Lacueva, UB professor and head of the CIBERFES group, “within the framework of the study, a dietary metabolomic index has been designed —based on biomarkers obtained from the participants’ serum— on the food groups that form part of the Mediterranean diet. Once this index is known, its association with cognitive impairment is evaluated”.

in the study, baseline levels of saturated and unsaturated fatty acids, gut microbiota-derived polyphenol metabolites and other phytochemicals in serum that reflect individual bioavailability were chosen as biomarkers. Some of these indicators have not only been recognized as marks of exposure to the main food groups of the Mediterranean diet but have also been held responsible for the health benefits of the Mediterranean dietary pattern.

The metabolome or set of metabolites — related to food and derived from gut microbiota activity — was studied through a large-scale quantitative metabolomic analysis from the serum of the participants without dementia, from the beginning of the study. Cognitive impairment was assessed by five neuropsychological tests over twelve years.

As a result, the study reveals a protective association between the score of the Mediterranean diet based on serum biomarkers and cognitive decline in older people.

Biomarkers to study the benefits of the diet

According to Mercè Pallàs, professor at the UB Neurosciences Institute (UBneuro), “the use of dietary pattern indices based on food-intake biomarkers is a step forward towards the use of more accurate and objective dietary assessment methodologies that take into account important factors such as bioavailability”.

Expert Alba Tor-Roca, first author of the study and CIBERFES researcher at the UB, explains that “we found that adherence to Mediterranean diet assessed by a panel of dietary biomarkers is inversely associated with long-term cognitive decline in older people. These results support the use of these indicators in long-term follow-up assessments to observe the health benefits associated with the Mediterranean diet or other dietary patterns and therefore, guide personalized counselling at older ages”.

Posted on Diet, Multiple Sclerosis

Low-fat diet reduces fatigue in patients with multiple sclerosis

The results may lead to a new form of treatment for overeating.

New research from Oregon Health & Science University suggests that people with multiple sclerosis, or MS, could benefit from a low-fat diet to improve the fatigue that’s a debilitating, and often-underappreciated, symptom of the condition.

The study, published online Wednesday in the Multiple Sclerosis Journal, is the latest in a line of OHSU research dating back a decade testing the principle that diet matters, especially for people with MS.

“Fatigue is very disabling for these patients,” said principal investigator and senior author Vijayshree Yadav, M.D., professor of neurology in the OHSU School of Medicine and director of the OHSU Multiple Sclerosis Center. “There is no FDA-approved drug for fatigue, but we know that fatigue greatly affects their quality of life.”

In the new study, researchers conducted a randomized controlled trial in which 39 people with MS who experienced fatigue were divided into two groups: 19 people were placed in the control group and received diet training at the completion of the study after 16 weeks. The other 20 received nutrition counseling from dieticians and then adhered to a low-fat diet, which was confirmed through routine blood sampling revealing clear signals of reduced caloric intake.

“You cannot really fudge the biomarkers,” Yadav said.

In contrast to a 2016 study that tested a purely plant-based diet, the new study was modified to include meat while still remaining low-fat. Exercise was not part of the program, meaning the study solely focused on diet as an intervention.

Compared with the control group, the active group of participants revealed significant improvement in fatigue, which was gauged through the Modified Fatigue Impact Scale. Every four weeks, participants answered standardized questions measuring aspects such as their ability to pay attention, concentrate and to carry out routine physical activities.

“The results reinforced what we had seen before,” Yadav said. “A low-fat diet can truly make a difference in a patient’s fatigue level, even without going so far as to make it a vegan diet.”

Posted on Diet

Is red meat intake linked to inflammation?

Inflammation is a risk factor for many chronic diseases, including cardiovascular disease (CVD), and the impact of diet on inflammation is an area of growing scientific interest. In particular, recommendations to limit red meat consumption are often based, in part, on old studies suggesting that red meat negatively affects inflammation – yet more recent studies have not supported this.

“The role of diet, including red meat, on inflammation and disease risk has not been adequately studied, which can lead to public health recommendations that are not based on strong evidence,” said Dr. Alexis Wood, associate professor of pediatrics – nutrition at the USDA/ARS Children’s Nutrition Research Center at Baylor College of Medicine and Texas Children’s Hospital. “Our team sought to take a closer look by using metabolite data in the blood, which can provide a more direct link between diet and health.”

Wood and her team analyzed cross-sectional data captured from approximately 4,000 older adults participating in the Multi-Ethnic Study of Atherosclerosis (MESA), and recently published their findings in The American Journal of Clinical Nutrition. Cross-sectional data is a useful source of evidence on how diet affects health; it uses data that is observed with free-living people, without attempting to influence their usual lifestyle. In this way, it may be easier to take results from such studies and apply them to non-research settings. In addition to assessing participants’ self-reported food intake and several biomarkers, researchers also measured an array of dietary intake metabolites in blood. Plasma metabolites can help capture the effects of dietary intake as food is processed, digested and absorbed. 

Researchers found that when adjusted for body mass index (BMI), intake of unprocessed and processed red meat (beef, pork or lamb) was not directly associated with any markers of inflammation, suggesting that body weight, not red meat, may be the driver of increased systemic inflammation. Of particular interest was the lack of a link between red meat intake and C-reactive protein (CRP), the major inflammatory risk marker of chronic disease.

“Our analysis adds to the growing body of evidence that indicates the importance of measuring plasma markers, such as metabolites, to track diet and disease risk associations, versus relying on self-reported dietary intake alone,” Wood said. “Our analysis does not support previous observational research associations linking red meat intake and inflammation.”

Because observational studies cannot indicate cause and effect, randomized controlled trials (RCTs) where individuals are randomly assigned to consume a dietary factor of interest or not consume it, are needed as an additional line of evidence to adequately understand if red meat does not alter inflammation. Several RCTs have demonstrated that lean unprocessed beef can be enjoyed in heart-healthy dietary patterns.

“We have reached a stage where more studies are needed before we can make recommendations to limit red meat consumption for reducing inflammation if we want to base dietary recommendations on the most up-to-date evidence,” Wood said. “Red meat is popular, accessible and palatable – and its place in our diet has deep cultural roots. Given this, recommendations about reducing consumption should be supported by strong scientific evidence, which doesn’t yet exist.”