Tufts University nutrition scientists provide updated MyPlate for older adults

The new MyPlate for Older Adults graphic from nutrition scientists at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston with support from AARP Foundation.
CREDIT
Tufts University

Nutrition scientists at the Jean Mayer U. S. Department of Agriculture Human Nutrition Research Center on Aging (USDA HNRCA) at Tufts University with support from AARP Foundation are introducing an updated MyPlate for Older Adults icon today. The updated icon emphasizes the nutritional needs of older adults in a framework of the 2015-2020 Dietary Guidelines for Americans from the U.S. Department of Health and Human Services and the U.S. Department of Agriculture. The icon and an accompanying website can be viewed at hnrca.tufts.edu/myplate.

"It is never too late to make smart changes in your diet. Shifting towards healthier food choices can improve symptoms or decrease risk for developing chronic diseases such as type 2 diabetes, hypertension and heart disease - all of which are more common in older than younger adults," said Alice H. Lichtenstein, D.Sc., senior scientist and director of the Cardiovascular Nutrition Laboratory at the USDA HNRCA. Lichtenstein served as vice chair on the 2015 Dietary Guidelines Advisory Committee.

The new MyPlate for Older Adults icon depicts a colorful plate with images to encourage older Americans to follow a healthy eating pattern bolstered by physical activity. The plate is composed of approximately:

• 50 percent fruits and vegetables;
• 25 percent grains, many of which are whole grains; and
• 25 percent protein-rich foods such as nuts, beans, fish, lean meat, poultry, and fat-free and low-fat dairy products such as milk, cheeses, and yogurts.

The new MyPlate for Older Adults icon also includes images of good sources of fluid, such as water, milk, tea, soup, and coffee; heart-healthy fats such as vegetable oils and soft margarines; and herbs and spices to be used in place of salt to lower sodium intake.

"We are so proud to collaborate with the USDA HNRCA at Tufts on the MyPlate for Older Adults icon to create practical nutritional guidance and awareness of the need for accessible meals," said Jim Lutzweiler, vice president, hunger impact area, AARP Foundation. "We believe at AARP Foundation in the importance of encouraging vulnerable and low-income older adults to develop healthy eating and physical activity patterns to maintain quality of life as they age."

The MyPlate for Older Adults icon also reminds older Americans to stay active by walking, riding a bicycle, swimming, or engaging in another activity. The Dietary Guidelines offers suggestions for older adults who are interested in improving their lifestyle and reducing their risk of disease and disability with regular exercise.

"Older adults who want to improve their overall health will benefit from using MyPlate for Older Adults. Many people are not aware of the key role that healthy eating patterns play in improving their bodily function such as that of brain, eye and the immune system," said Simin Nikbin Meydani, D.V.M., Ph.D., director of the Jean Mayer USDA HNRCA at Tufts University in Boston, and senior scientist and director of its Nutritional Immunology Laboratory. "Our collaboration with AARP Foundation will help us empower a larger group of older Americans to act on the Dietary Guidelines by making our new MyPlate for Older Adults icon more widely available."

The 2015 Dietary Guidelines recommend that Americans:

• Follow a healthy eating pattern across their lifespan;
• Focus on the variety and amount of nutrient-dense food they consume;
• Reduce their intake of added sugars, saturated fats and sodium to allowed limits;
• Shift toward healthier food and beverage choices; and,
• Support healthy eating patterns for all.

Lichtenstein advises older adults to begin by making small shifts in food and beverage choices to improve their overall eating pattern, and then continue to build on them. Making small changes, she says, and sticking with them is the best approach to long term improvements in eating habits. If someone plans on making major changes in their diet they are advised to talk with their primary healthcare provider.

The website that accompanies the updated MyPlate for Older Americans icon offers information about physical activity, using spices to reduce sodium, shopping tips, and recipes. Additionally, the MyPlate for Older Adults emphasizes all forms of food - fresh, frozen, dried and canned - to ensure the icon is relevant across personal preferences, availability, and cultural backgrounds. The website also offers helpful links to studies from researchers at the USDA HNRCA that are especially relevant for older adults. Both can be found online at hnrca.tufts.edu/myplate.

The updated MyPlate for Older Adults is the fourth such icon created by Lichtenstein and USDA HNRCA researchers specifically for older adults. AARP Foundation provided funding and creative input for the newest icon of MyPlate for Older Adults and the related website.

Peanuts, peanut butter may hold key to preventing obesity

Hispanic middle school children, at high risk for being overweight or obese, reduced their Body Mass Index (BMI) when they adhered to a nutrition intervention that included a snack of peanuts, compared to those children who did not.

The 12-week study was conducted by researchers at the University of Houston Department of Health and Human Performance (HHP), Baylor College of Medicine and Texas Woman's University. Their findings are published in the Journal of Applied Research on Children.
"Obesity is the most pressing health issue facing us today," said Craig Johnston, HHP assistant professor. "We'd like to think it's preventable, but from where I sit right now, there hasn't been a lot shown to be very effective on a large scale."

The study acknowledged that snacking is more common during the adolescent years and that the unhealthy eating habit can lead to an unhealthy weight. This is especially true if a student doesn't have access to other meals during the school day.

"We have a lot of kids skipping meals for a whole bunch of reasons," he said. "What we found is that kids get home from school around 4 p.m. There's less supervision by parents and less structure. Kids are sitting down at the TV and eating, eating, eating because they really didn't eat at school."

Instructors guided 257 Latino adolescents from three Houston-area charter schools through a program of physical activity and nutrition education. About half the students received a snack of peanuts or peanut butter three to four times a week, while the rest received the snack fewer than once a week. The snack was administered after school as students were boarding the school bus to go home. Peanuts were chosen because nuts are nutrient-dense snacks that promote a feeling of being full.

Following the 12-week intervention, students spent 12 more weeks maintaining the healthy snacking habit. At the end of the period, those students who received the snack more regularly experienced a decrease in their overall BMI (-.7kg/m2) compared to those who did not receive the regular peanut snack (-.3kg/m2). The researchers conclude that afterschool programs and schools can replace energy dense, unhealthy snacks with peanuts to provide a healthier alternative for children (researchers in the study ensured students did not suffer from nut allergies).

Johnston says the fight against obesity needs creative solutions that help people manage their weight, appetite and hunger by offering socially acceptable food choices.

"Schools are doing a great job of teaching kids, getting them workforce ready, and a whole bunch of other things. We've just got to make sure that our kids are going to live long, happy lives with that kind of education," he said.

Participants in the study were part of a larger longitudinal study on a school-based obesity intervention program. The Family Lifestyle Overweight (FLOW) Prevention Program is a school-based pediatric intervention for urban, low-income, minority students.

Dietary glycemic index linked to lung cancer risk in select populations

Consuming a diet with a high glycemic index, a classification of how rapidly carbohydrates elevate blood sugar levels, was independently associated with an increased risk of developing lung cancer in non-Hispanic whites, according to a new epidemiologic study from The University of Texas MD Anderson Cancer Center.

This research, published this week in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, represents the largest study to investigate potential links between glycemic index (GI) and lung cancer. The findings also unveil for the first time that GI was more significantly associated with lung cancer risk in particular subgroups, such as never-smokers and those diagnosed with the squamous cell carcinoma (SCC) subtype of lung cancer.

Nationally, lung cancer is the second most common cancer in both men and women, but is by far the leading cause of cancer mortality, with over 150,000 deaths from lung cancer expected in the U.S. in 2016, according to the American Cancer Society. While tobacco use is the leading cause of lung cancer, it fails to account for all cases, particularly in those who never smoked.

Accumulating evidence suggests that dietary factors may modulate lung cancer risk, explained Xifeng Wu, M.D., Ph.D, professor, Epidemiology and senior author of the study. Diets high in fruits and vegetables may decrease risk, while increased consumption of red meat, saturated fats and dairy products have been shown to increase lung cancer risk.

Glycemic index is a measure of the quality of dietary carbohydrates, defined by how quickly blood sugar levels are raised following a meal. Previous studies have investigated associations between GI and glycemic load (GL), a related measure of carbohydrate quantity, and risk of numerous other cancers.

"Diets high in glycemic index result in higher levels of blood glucose and insulin, which promote perturbations in the insulin-like growth factors (IGFs)," said Stephanie Melkonian, postdoctoral fellow with Wu's team and lead author of the study. "Previous research suggests increased levels of IGFs are associated with increased lung cancer risk. However, the association between glycemic index and lung cancer risk was unclear."

To clarify the associations between GI, GL and lung cancer risk, the researchers surveyed 1,905 MD Anderson patients newly diagnosed with lung cancer and 2,413 healthy individuals recruited from Kelsey-Seybold clinics. Participants self-reported past dietary habits and health histories. Dietary GI and GL was determined using published food GI values, and subjects were divided into five equal groups, based on their GI and GL values.

"We observed a 49 percent increased risk of lung cancer among subjects with the highest daily GI compared to those with the lowest daily GI," said Wu. "The associations were more pronounced among subjects who were never smokers, diagnosed with squamous cell carcinoma or had less than 12 years of education."

Interestingly, GL had no significant associations with lung cancer risk. "This suggests that it is the average quality, instead of quantity, of carbohydrates consumed that may modulate lung cancer risk," said Wu.

When investigating never smokers in the study, the researchers found that those in the highest GI group were more than twice as likely to develop lung cancer as those in the lowest group. Among smokers, the risk was only elevated by 31 percent between the two groups. The relatively mild effects of a risk factor such as GI are more evident in the absence of the dominant risk factor, explained Wu.

The researchers also noted stronger associations in those diagnosed with SCC and those with lower educational levels. Participants in the highest GI group were 92 percent more likely to develop the SCC subtype compared to the lowest GI group, possibly due to the influence of elevated IGFs on SCC development.

Among those with fewer than 12 years of education, subjects in the highest GI group were 77 percent more likely to develop lung cancer than those in the lowest GI group. This contrasts with an elevated risk of only 33 percent in subjects with more than 12 years of education.

The authors note that educational level is a proxy for socioeconomic status, which has been linked with diet quality and smoking behaviors. Thus, the associations between GI and education may reflect the joint impact of poor diet and smoking on lung cancer risk.

The authors note several limitations to the study, including being limited to non-Hispanic whites. Further, this was a retrospective study, subject to errors in recall of past dietary intake, and the study did not account for diabetes, hypertension or heart disease in their subjects.

In order to validate a causal relationship between GI and lung cancer, future work must incorporate prospective cohort studies in other ethnic groups. The researchers would also like to further investigate the underlying mechanisms by which GI may influence the risk of lung and other cancers.

While specific dietary recommendations cannot be made on the basis of these results, the authors suggest limiting foods and beverages with high GI, such as white bread or bagels, corn flakes and puffed rice, for a more balanced diet and to lower the risk for lung cancer and chronic diseases. Examples of low GI foods include whole-wheat or pumpernickel bread, rolled or steel-cut oatmeal and pasta.

"The results from this study suggest that, besides maintaining healthy lifestyles, such as avoiding tobacco, limiting alcohol consumption and being physically active, reducing the consumption of foods and beverages with high glycemic index may serve as a means to lower the risk of lung cancer," said Wu.

Anthocyanins in Strawberries Improve Insulin Resistance

A new study in Molecular Nutrition & Food Research found that anthocyanin-rich strawberries may improve insulin sensitivity.

Insulin resistance (IR) is a hallmark of metabolic syndrome and a risk factor for heart disease and type 2 diabetes. Typically, after a meal, the pancreas produces an appropriate amount of insulin to usher glucose from the bloodstream into the cells. People with IR have built up a tolerance to insulin, so the pancreas must churn out extra insulin to coax blood sugar into the cells. Over time, this process can lead to type 2 diabetes.

Researchers observed the effect of anthocyanins on the postprandial insulin response of 21 obese adults with insulin resistance. Subjects were served a typical ‘Western-style’ meal high in carbohydrates and fat plus a beverage that contained freeze-dried whole strawberry powder. The beverages were controlled for fiber, and the amount of strawberry powder ranged from 0 grams to 40 grams (equivalent to 3 cups of fresh strawberries). When subjects drank the most concentrated beverage, they didn’t produce as much insulin as when they drank the least concentrated versions. In other words, they didn’t need as much insulin to metabolize their meal after drinking the anthocyanin-rich strawberry shake.

While the exact mechanisms are unclear, strawberry anthocyanins may alter insulin signaling at a cellular level.

These results add to the collective evidence that consuming strawberries may help improve insulin action, says study author Britt Burton-Freeman, Ph.D.

Eunyoung Park, et al. A dose-response evaluation of freeze-dried strawberries independent of fiber content on metabolic indices in abdominally obese individuals with insulin-resistance in a randomized, single-blinded, diet-controlled crossover trial. Molecular Nutrition & Food Research, February 2016.

Low vitamin D predicts aggressive prostate cancer

A new study provides a major link between low levels of vitamin D and aggressive prostate cancer. Northwestern Medicine research showed deficient vitamin D blood levels in men can predict aggressive prostate cancer identified at the time of surgery.

The finding is important because it can offer guidance to men and their doctors who may be considering active surveillance, in which they monitor the cancer rather than remove the prostate.

"Vitamin D deficiency may predict aggressive prostate cancer as a biomarker," said lead investigator Dr. Adam Murphy, an assistant professor of urology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine urologist. "Men with dark skin, low vitamin D intake or low sun exposure should be tested for vitamin D deficiency when they are diagnosed with an elevated PSA or prostate cancer. Then a deficiency should be corrected with supplements."

Previous studies showing an association between vitamin D levels and aggressive prostate cancer were based on blood drawn well before treatment. The new Northwestern study provides a more direct correlation because it measured D levels within a couple of months before the tumor was visually identified as aggressive during surgery to remove the prostate (radical prostatectomy).

The relationship between vitamin D and prostate cancer may explain some disparities seen in prostate cancer, especially among African American men. Prior research by Murphy and colleagues showed African American men who live in low sunlight locations are up to 1½ times more likely to have vitamin D deficiency than Caucasian men.

But because vitamin D is a biomarker for bone health and aggressiveness of other diseases, all men should check their levels, Murphy said.

"All men should be replenishing their vitamin D to normal levels," Murphy said. "It's smart preventive health care."

Aggressive prostate cancer is defined by whether the cancer has migrated outside of the prostate and by a high Gleason score. A low Gleason score means the cancer tissue is similar to normal prostate tissue and less likely to spread; a high one means the cancer tissue is very different from normal and more likely to spread.

The study was published in the Journal of Clinical Oncology Feb. 22. Murphy collaborated on the study with Rick Kittles, associate director of cancer disparities at the University of Arizona Cancer Center.

The study was part of a larger ongoing study of 1,760 men in the Chicago area examining vitamin D and prostate cancer. The current study included 190 men, average age of 64, who underwent a radical prostatectomy to remove their prostate from 2009 to 2014.

Of that group, 87 men had aggressive prostate cancer. Those with aggressive cancer had a median level of 22.7 nanograms per milliliter of vitamin D, significantly below the normal level of more than 30 nanograms/milliliter. The average D level in Chicago during the winter is about 25 nanograms/milliliter, Murphy noted.

Most people in Chicago should be on D supplements, particularly during winter months, Murphy said.

"It's very hard to have normal levels when you work in an office every day and because of our long winter," he said. The Institute of Medicine recommends 600 international units of D per day, but Murphy recommends Chicago residents get 1,000 to 2,000 international units per day.

Link between sleep and social participation may be key to healthy aging

Sleep may be one of the most important factors for well-being; yet, according to the CDC, one in three adults does not get enough. Lack of sleep can lead to potential cognitive declines, chronic diseases and death. Now, research from the University of Missouri finds that older adults who have trouble sleeping, could benefit from participating in social activities, in particular attending religious events.

"Social connectedness is a key component for health and well-being for older adults," said Jen-Hao Chen, assistant professor of health sciences at the MU School of Health Professions and the Truman School of Public Affairs. "Close connections to, and participation in, social groups provides a sense of belonging and can be essential for healthy aging."

Yet despite past attention to the link between social participation and many different health outcomes, little research has been dedicated to linking social participation and another critical health outcome for older adults--sleep.

To study the relationship between sleep and social participation for older adults, Chen analyzed two waves of data collected over a five year period from the National Social Life, Health and Aging Project. He looked at three aspects of social participation; volunteering, attending religious services and being part of organized group activities. He then compared the data to sleep outcomes measured by actigraphy--wearable wrist sleep trackers. Results showed that older adults with greater levels of social participation were getting better sleep.

However, Chen says despite the strong associations between social participation and sleep, social participation does not necessarily lead to better sleep. The strong associations he found could also be due to those already sleeping well may feel well enough to be more active socially. His future research on sleep will continue to use innovative sleep measurements to understand the role various social relationships have on sleep behaviors and outcomes.

"When it comes to the discussion of healthy lifestyle, being socially connected and sleeping well are not often mentioned together," Chen said. "Yet sleep, just like physical activity and diet, can have significant impacts on our health outcomes, and is profoundly affected by our everyday social life. To promote sleep health we must consider a comprehensive approach that emphasizes the role of engaging in our communities, as well as getting enough and better sleep."

The study "Social Participation and Older Adults' Sleep" was published in the Journal of Social Science and Medicine.

Drinking more water associated with numerous dietary benefits

For people who want to control their weight or reduce their intakes of sugar, sodium and saturated fat, tap water may be what the doctor ordered.

A new study that examined the dietary habits of more than 18,300 U.S. adults found the majority of people who increased their consumption of plain water - tap water or from a cooler, drinking fountain or bottle - by 1 percent reduced their total daily calorie intake as well as their consumption of saturated fat, sugar, sodium and cholesterol.

People who increased their consumption of water by one, two or three cups daily decreased their total energy intake by 68 to 205 calories daily and their sodium intake by 78 to 235 grams, according to a paper by University of Illinois kinesiology and community health professor Ruopeng An. They also consumed 5 grams to nearly 18 grams less sugar and decreased their cholesterol consumption by 7 to 21 grams daily.

"The impact of plain water intake on diet was similar across race/ethnicity, education and income levels and body weight status," An said. "This finding indicates that it might be sufficient to design and deliver universal nutrition interventions and education campaigns that promote plain water consumption in replacement of beverages with calories in diverse population subgroups without profound concerns about message and strategy customization."

An examined data from four waves (2005-12) of the National Health and Nutrition Examination Survey, conducted by the National Center for Health Statistics. Participants were asked to recall everything they ate or drank over the course of two days that were three to 10 days apart.

An calculated the amount of plain water each person consumed as a percentage of their daily dietary water intake from food and beverages combined. Beverages such as unsweetened black tea, herbal tea and coffee were not counted as sources of plain water, but their water content was included in An's calculations of participants' total dietary water consumption.

On average, participants consumed about 4.2 cups of plain water on a daily basis, accounting for slightly more than 30 percent of their total dietary water intake. Participants' average calorie intake was 2,157 calories, including 125 calories from sugar-sweetened beverages and 432 calories from discretionary foods, which are low-nutrition, calorie-dense foods such as desserts, pastries and snack mixes that add variety to but are not necessary for a healthy diet.

A small but statistically significant 1 percent increase in participants' daily consumption of plain water was associated with an 8.6-calorie decrease in daily energy intake, as well as slight reductions in participants' intake of sugar-sweetened beverages and discretionary foods along with their consumption of fat, sugar, sodium and cholesterol.

While An found that the decreases were greater among men and among young and middle-aged adults, he suggested they could have been associated with these groups' higher daily calorie intakes.

The study was published in the Journal of Human Nutrition and Dietetics.