Research Digest

ERD Examine.com Research Digest Issue 7 ◆ May 2015 1 Table of Contents 05 Going nuts over infant peanut exposure Randomized trial of peanut consumption in infants at risk for peanut allergy 13 How the Food Industry Spins Science to Fit Its Agenda By Andy Bellatti, MS, RD 16 Non-celiac gluten sensitivity: much ado about something? Small Amounts of Gluten in Subjects with Suspected Nonceliac Gluten Sensitivity: a Randomized, Double-Blind, Placebo-Controlled, Cross-Over Trial 23 Baby probiotics for prevention of ADHD and Asperger’s A possible link between early probiotic intervention and the risk of neuropsychiatric disorders later in childhood: a randomized trial 31 Putting the “D” in Death A reverse J-shaped association between serum 25- hydroxyvitamin D and cardiovascular disease mortality – the CopD-study 40 Eggcellent Eggs: Is it safe for people with diabetes to eat a lot of eggs? The effect of a high-egg diet on cardiovascular risk factors in people with type 2 diabetes: the Diabetes and Egg (DIABEGG) study—a 3-mo randomized controlled trial 46 Do BCAAs and arginine prevent central fatigue during exercise? Branched-chain amino acids and arginine improve performance in two consecutive days of simulated handball games in male and female athletes: a randomized trial 52 HMB-elly be gone β-Hydroxy-β-methylbutyrate (HMB) supplementation and resistance exercise sig- nificantly reduce abdominal adiposity in healthy elderly men 58 Spicing up your workout Curcumin supplementation likely attenuates delayed onset muscle soreness (DOMS) 65 INTERVIEW: Shawn Wells, MPH, RD 71 Ask the Researcher: James Heathers, Ph.D. 2 From the Editor Does “natural” matter in food and nutrition? inform what you eat. You MOST CERTAINLY don’t have to be anyone’s definition of “paleo”. Humans can eat a vari- I don’t think natural versus processed is just a fluff issue. ety of foods and thrive. Different people have astoundingly Many people use heuristics to guide how they eat, whether different reactions to food, due to their gut microbiomes, they know it or not. It’s hard for most people (Soylent aficio- disease states, and many other factors. nados excepted) to envision a mostly processed/powdered diet being healthier than a diet composed mostly of less Why does this matter for ERD and nutrition research in processed plants and animals. general? Well, it’s very easy to get caught up in research details and miss the big picture of health. Yes, heating toma- For ERD, we occasionally point out that certain nutrients toes increases lycopene absorption. Yes, piperine increases and supplements don’t need to come in pill form, and can absorption of curcumin. But so many people obsess over be ingested through food. But constantly telling people how details while missing the truly high impact habits, like cir- to eat sounds preachy from most anybody, and we are pretty cadian rhythm entrainment and stress reduction. Avoiding much evidence-conveyors rather than gurus. That doesn’t yo-yo dieting and enjoying wholesome meals is a good pre- mean we don’t have opinions on an individual level though. requisite to supplementation in general. And my personal opinion is that natural does probably matter. And while evidence is our bread and butter, know the lim- I don’t mean the literal definitions of natural and processed, itations of evidence. Just because research suggests that which gets into annoying semantics and downward spirals artificial sweeteners may be fairly safe, don’t take that as of argumentation. Yes, cutting a carrot is processing it. Yes, an excuse to drink two Diet Cokes every day for thirty applying heat can be considered processing. I’m not talking years. From reading ERD, you should be well aware that about gray areas though. This is about a smoothie versus a study findings don’t equal truth. Although evidence is Diet Coke. Pastured beef versus a zero carb protein bar with mixed, we’re just starting to find that artificial sweeteners thirty ingredients. may adversely impact the gut microbiome. While nutrition research is complex, nature is magnitudes of order more Don’t get me wrong: artificial foods can be magically deli- complex. It’s probably a good idea to consider both when cious. If you have enough self-control, Cheetos can be making decisions for your own health. worth every flourescent orange dusted finger that needs washing before using your laptop. A little bit, or even a moderate amount every once in a while, isn’t likely to be terrible for you. But that’s a guess. There will be no randomized trials on Cheetos (I think). What there is though, is history. Many thousands of years of humans eating food that can help Kamal Patel, Editor-in-Chief 3 Contributors Researchers Trevor Kashey Alex Leaf Courtney Silverthorn Zach Bohannan Anders Nedergaard Jeff Rothschild Ph.D(c) M.S(c) Ph.D. M.S. Ph.D. M.Sc., RD Editors Gregory Lopez Pablo Sanchez Soria Kamal Patel Pharm.D. Ph.D. M.B.A., M.P.H., Ph.D(c) Reviewers Arya Sharma Natalie Muth Stephan Guyenet Sarah Ballantyne Katherine Rizzone Spencer Nadolsky Ph.D., M.D. M.D., M.P.H., RD Ph.D. Ph.D. M.D. D.O. Mark Kern Gillian Mandich Ph.D., RD Ph.D(c) 4 Going nuts over infant peanut exposure Randomized trial of peanut consumption in infants at risk for peanut allergy Introduction Peanut allergies are becoming more widespread across the globe. In the United States, up to 1.4% of the population, or as many as 4.4 million people have a peanut allergy. Peanut exposure is one of the leading causes of allergy-related deaths due to anaphylax- is, a set of symptoms that can include facial and oral swelling, difficulty breathing, a dangerous drop in blood pressure, and cardiac arrest. Other less severe symptoms include itchy skin and mouth, hives, and gastrointestinal distress. Unlike some other food allergies, like milk, soy, and egg, a peanut allergy rarely lessens with age. While there has been a lot research into possible therapies, there is currently no treatment other than complete avoidance, which requires hypervigilance in case of cross-contamination of other foods, leading to trace amounts of peanut in foods that would otherwise be assumed as safe. Many current research efforts focus instead on ways to prevent the development of severe allergies like this one. Researchers discovered that dietary antigens (foreign substanc- es that trigger the immune system to respond) for allergenic foods can pass through the placenta to the fetus, as well as pass through breast milk to an infant. Based on this finding, they hypothesized that preventing this early exposure would reduce the incidence of food allergies. 5 For most of the first decade of the 21st century, women Figure 1 - Peanuts: from snack darling were advised to avoid possible allergy triggers like peanuts, to object of constant vigilance dairy, and egg during their pregnancies, as well as to avoid feeding them to their infants. In spite of these efforts, epide- miological data show that the incidence of allergies actually increased. In fact, a meta-analysis of studies following children whose mothers had avoided dietary allergens found that those children developed allergies at approximately the same rate as children whose mothers did not adhere to the dietary recommendations. As a result, the recommendation to avoid dietary allergens during pregnancy was later aban- doned. Figure 1 notes some milestones from the past few decades with regards to peanut allergy. The increase in allergy rates in response to avoiding certain foods raises the question of whether deliberate exposure to potentially allergenic foods could reduce the incidence of allergies. This study was designed to investigate this question in the context of peanut allergies in infants. The number of people with a peanut allergy is increasing worldwide, which can result in a serious and sometimes life-threatening allergic reaction. Previous recommendations for mothers to avoid allergens during pregnancy and breastfeeding did not prevent the rise in allergies in children. The purpose of this study was to see if consumption of peanuts at an early age might help prevent development of peanut allergies in children. Who and what was studied? Infants from four to 11 months who had already been diag- nosed with severe eczema and/or egg allergy were included in this study. Because the study was on infants, and because of the possibility of serious allergic reactions, the trial was conducted as an ‘open-label’ study, rather than a blind or double-blind study. Both the researchers and the parents knew whether or not their child would receive the peanut snack. The infants were divided into two groups on the basis of a Source: Sicherer et al., J Allergy Clin Immunol. 2010 skin prick test (SPT) with peanut allergens. About 15% of 6 the infants in the study were assigned to one group after an Parents were provided with the peanut snacks to feed to initial positive SPT, defined as a skin wheal, or localized their child, with the option of substituting an equivalent region of redness and swelling, between one to four milli- amount of peanut butter instead. The researchers conducted meters. The 80% of the infants with a negative initial SPT in-person follow-up appointments at 12, 30, and 60 months were assigned to a second group. Infants with wheals larg- into the study. At each appointment, children were tested er than four millimeters were excluded from the study for for reactions to the peanut protein SPT. Researchers also safety reasons, as they would be expected to already have measured the levels of peanut-specific antibodies.

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