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This may be most important breakthrough in nutrition knowledge I have seen since vitamin C and E. Please see the book The China Study, published in 2004, for the whole-food, plant-based diet for optimal health

AJCN Apr, 2006

[Vit D prevents heart disease] Vitamin D in congestive heart failure Am J Clin Nutr 2006 83: 731-732 " Congestive heart failure (CHF) is a disease in which the heart can no longer meet the demands the body. CHF can be caused by hypertension, myopathy, diabetes, coronary artery disease, or defective heart valves (1)...In the current issue of the Journal, Schleithoff et al (3) report on a clinical trial conducted in men with CHF (mean age: 55 y) who were randomly assigned to receive a placebo or vitamin D (50 µg/d; 2000 IU/d). The authors found no effect of vitamin D on either left ventricular function or 15-mo survival rates. However, serum concentrations of tumor necrosis factor , an inflammatory cytokine, decreased with vitamin D treatment; in contrast, concentrations of interleukin 10, an antiinflammatory cytokine, increased. These changes suggest that vitamin D has protective effects on the heart itself and on the atherosclerosis that may precipitate CHF (4, 5).

The article by Schleithoff et al is important because it offers 2 insights about vitamin D. First, the article confirms previous evidence that vitamin D supplementation affects immune-modulating cytokines in desirable ways. Second, it points to a higher dose requirement for achieving this. The study by Witte and Clark (2) used vitamin D at 10 µg/d (400 IU/d), and this dose did not affect cytokine concentrations. Another study by Mahon et al (6) produced modest responses with 25 µg vitamin D/d (1000 IU/d). With the use of 50 µg vitamin D/d (2000 IU/d), Schleithoff et al produced more substantial effects on inflammatory cytokine concentrations. A pattern is emerging: higher doses of vitamin D have greater effects on regulatory molecules of the immune system..."

[fish oil slows macular degeneration] Diet and age-related macular degeneration: expanding our view Am J Clin Nutr 2006 83: 733-734 "...Because there is no cure and limited treatments for the end-stage condition of AMD, it is the leading cause of blindness in persons older than 50 y ...The results of several previous epidemiologic studies and clinical trials suggest that diets high in antioxidant nutrients (vitamins C and E, carotenoids such as lutein and zeaxanthin, fruit and vegetables that contain these nutrients, and nonnutritive antioxidants) or zinc are associated with a decreased occurrence of early or late AMD (3). A high dietary intake of fat was associated with a higher prevalence or incidence of early or late AMD in numerous studies (4), whereas higher intakes of fish or n–3 fatty acids were associated with lower rates of AMD (4)..."

[Inflammation and cachexia and cytokines] Cachexia: pathophysiology and clinical relevance Am J Clin Nutr 2006 83: 735-743 "Cachexia causes weight loss and increased mortality. It affects more than 5 million persons in the United States. Other causes of weight loss include anorexia, sarcopenia, and dehydration... Both nutritional support and orexigenic agents play a role in the management of cachexia."

[vit D reduces inflammation] Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial Am J Clin Nutr 2006 83: 754-759 "...Conclusions:Vitamin D3 reduces the inflammatory milieu in CHF patients and might serve as a new antiinflammatory agent for the future treatment of the disease. Our data provide evidence for the involvement of an impaired vitamin D–parathyroid hormone axis in the progression of CHF."

[fiber reduces inflammation] Association between dietary fiber and serum C-reactive protein Am J Clin Nutr 2006 83: 760-766 "Conclusions:Our results suggest that dietary fiber is protective against high CRP, which supports current recommendations for a diet high in fiber."

[low-fat diet reduces inflammation] Responses of inflammatory markers to a low-fat, high-carbohydrate diet: effects of energy intake
Am J Clin Nutr 2006 83: 774-779 "Conclusion: During the eucaloric [constant caloric intake] phase, the low-fat, high-carbohydrate diet exerted unfavorable effects on the inflammatory markers. In contrast, the ad libitum low-fat, high-carbohydrate intake caused weight loss and affected inflammatory markers favorably. Thus, the energy content of a low-fat, high-carbohydrate diet determines changes in inflammatory markers."

[Protein better than carbs] Partial substitution of carbohydrate intake with protein intake from lean red meat lowers blood pressure in hypertensive persons
Am J Clin Nutr 2006 83: 780-787 "Conclusion: Within the context of other studies, these results suggest that modest substitution of carbohydrate-rich foods with protein-rich foods may lower blood pressure in hypertensive persons."

[How exercise controls weight] Carbohydrate balance predicts weight and fat gain in adults Am J Clin Nutr 2006 83: 803-808 "If a long-term relations does exist between glycogen stores and Energy Intake, this may partly explain why continuance of physical activity promotes weight maintenance."

[People with HIV/AIDS need vitamin C]Vitamins C and E in adolescents and young adults with HIV infection Am J Clin Nutr 2006 83: 870-879 "Conclusions: Low plasma ascorbate concentrations in HIV-positive subjects suggest that vitamin C requirements are significantly higher in those with HIV infection. Plasma tocopherol concentrations were not depressed by HIV infection and may be maintained by compensatory mechanisms such as the activity of -tocopherol transfer protein."

[high glucose foods like soda cause macular degeneration] Dietary glycemic index and carbohydrate in relation to early age-related macular degeneration[ARM]
Am J Clin Nutr 2006 83: 880-886 " Objective: The purpose of the present study was to examine the relation between dietary carbohydrate quality, as measured by dietary glycemic index (GI) or total carbohydrate intake, and ARM... Conclusion: Our results suggest that dietary GI may be an independent risk factor for ARM."

[unsat'd fat reduces cholesterol] Serum fatty acids as biomarkers of fat intake predict serum cholesterol concentrations in a population-based survey of New Zealand adolescents and adults Am J Clin Nutr 2006 83: 887-894 "Conclusion: Saturated and polyunsaturated fat intakes, measured by using fatty acid biomarkers, are important predictors of serum cholesterol concentrations in New Zealand."

[how doctors could learn about nutrition in med school] Supplement: An Evidence-Based Approach to Medical Nutrition Education

Comprehensive integration of nutrition into medical training "1) nutrition content must be broad in nature and be vertically integrated across the preclinical and clinical years and continued through postgraduate training, and 2) active adult learning (eg, "learning by doing") should be practiced whenever possible...Students must be routinely exposed to physicians practicing nutrition for nutrition to become part of standard patient care. "

How can nutrition education contribute to competency-based resident evaluation? "This article illustrates one way that the NAA curriculum objectives can be translated into specific competencies to demonstrate medical knowledge, patient care, practice-based learning, interpersonal and communication skills, professionalism, and systems-based practice."

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