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Bile acids play an active role in fat metabolism and, in high-fat diets, elevated concentrations of fecal bile acids may be related to an increased risk of colorectal cancer. This study investigated concentrations of fecal and serum bile acids in 36 vegans and 36 omnivores. The reduced rank regression was used to identify dietary patterns associated with fecal bile acids. Dietary patterns were derived with secondary and conjugated fecal bile acids as response variables and 53 food groups as predictors. Vegans had higher fiber (p < 0.01) and lower fat (p = 0.0024) intake than omnivores. In serum, primary and glycine-conjugated bile acids were higher in vegans than in omnivores (p ≤ 0.01). All fecal bile acids were significantly lower in vegans compared to omnivores (p < 0.01). Processed meat, fried potatoes, fish, margarine, and coffee contributed most positively, whereas muesli most negatively to a dietary pattern that was directly associated with all fecal bile acids. According to the pattern, fat intake was positively and fiber intake was inversely correlated with bile acids. The findings contribute to the evidence that, in particular, animal products and fat may play a part in higher levels of fecal bile acids.

Background/Objectives: Growing evidence emerged about the role of diet in heart failure (HF) development, but data are sparse and inconclusive. We examined the association between a Mediterranean-style diet, its components and HF risk. Subjects/Methods: Analyses were carried out in 24 008 middle-aged participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam (Germany), including 209 incident HF cases within 8.2 years. The traditional Greek Mediterranean diet score (tMED) was used to assess dietary adherence. Cox’s proportional hazards regression was applied to estimate the relationship between the adherence to the Mediterranean-style diet, its components and HF risk. Results: After adjustment for age, sex and energy intake, a 2-unit increment in the tMED was associated with 26% lower risk of HF (HR (95% confidence interval (CI)): 0.76 (0.60–0.97)). After multivariable adjustment, this association was slightly attenuated and lost significance [HR (95%CI): 0.82 (0.64–1.05)]. Interestingly, we observed a significant association in multivariable adjusted models when milk products were excluded from the score (HR (95% CI): 0.75 (0.59–0.96)). Three score components were significantly associated with HF risk: alcohol (HR (95%CI): 0.73 (0.55–0.97) for moderate versus low/high intakes), meat: 2.04 (1.17–3.55) and fish: 0.59 (0.36–0.95), both for the highest versus the lowest quintile. Conclusions: The tMED was not significantly associated with HF risk, but low meat, high fish and moderate alcohol intake were inversely associated with HF risk in our non-Mediterranean population. Minor dietary changes could be valuable primary prevention measures, particularly the increase of fish consumption while reducing the intake of meat.

Background/objective: Blood proportions of fatty acids (FAs) and FA-ratios reflecting desaturase activity are associated with the risk of chronic diseases like type 2 diabetes mellitus or cardiovascular diseases. Biomarkers of dyslipidemia are considered as potential mediators of this association. We evaluated associations of erythrocyte membrane proportions of individual disease-related polyunsaturated fatty acids (PUFAs), trans -FAs, dairy-derived saturated FAs (SFAs) (15:0, 17:0) and FA-ratios with biomarkers of dyslipidemia (high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, non-HDL-cholesterol, triglycerides). Subjects/methods: We conducted a cross-sectional analysis of a subsample ( n =1759) of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study. Associations of individual FAs and FA-ratios with plasma biomarkers of dyslipidemia were evaluated by linear multivariable regression. Results: Most notably, FA-ratios reflecting activity of Δ6-desaturase (D6D) and stearoyl-coenzyme A-desaturase (SCD) were positively associated with triglyceride and LDL-cholesterol concentrations (adjusted means (95% confidence interval (CI)) of triglycerides (mg/dl) across D6D tertiles: men—102 (94.7–110), 111 (104–120), 144 (134–156) and women—73.5 (70.0–77.2), 82.9 (79.0–86.9), 94.2 (89.7–98.9)); across SCD tertiles: men—99.0 (91.8–107), 115 (107–124), 144 (134–156) and women—72.4 (69.0–76.0), 81.5 (77.8–85.5), 97.2 (92.6–102)), whereas inverse associations with triglycerides were observed for the estimated Δ5-desaturase (D5D) activity (adjusted means (95% CI) of triglycerides (mg/dl) across D5D tertiles: men—128 (119–138), 121 (113–131), 106 (97.9–114) and women—92.0 (87.6–96.6), 82.8 (78.9–86.9), 75.3 (71.6–79.1), P -values for trend at least 0.0006). Furthermore, we observed generally weaker and less consistent associations of dairy-derived SFAs (mainly 17:0) with triglycerides and HDL-cholesterol. Individual PUFAs and trans -FAs were, if at all, only weakly associated with dyslipidemia markers. Conclusions: Our findings suggest that triglyceride and LDL-cholesterol concentrations may be mediators that link intake and metabolism of FAs to metabolic risk.

Bile acids (BAs) are increasingly recognised as metabolic regulators, potentially improving insulin sensitivity following bariatric surgery. However, physiological relevance of such observations remains unknown. Hence, we analysed serum BA composition and associated gut-derived hormone levels following lifestyle-induced weight loss in individuals with metabolic syndrome (MetS). 74 non-smoking men (45–55 yr) with MetS were randomised to a lifestyle-induced weight loss program (supervision via telemonitoring) or to a control arm. Before and after a 6 months intervention period clinical and laboratory parameters, body composition, serum BA profile, FGF-19 and GLP-1 concentrations were determined in fasting blood samples. 30 participants in the control and 33 participants in the treatment arm completed the study and were included in the data analysis. In participants of the treatment arm lifestyle-induced weight loss resulted in markedly improved insulin sensitivity. Serum levels of BA species and total GLP-1 decreased, while FGF-19 remained stable. Serum BA composition changed towards an increased 12α-hydroxylated/non-12α-hydroxylated ratio. None of these parameters changed in participants of the control arm. Our results demonstrate that improved metabolic control by lifestyle modifications lowers serum levels of BAs and GLP-1 and changes serum BA composition towards an increased 12α/non-12α ratio (ICTRP Trial Number: U1111-1158-3672).

Background/Objectives: Nuts have beneficial effects on coronary heart disease and many cardiovascular risk factors. However, their effect on stroke is less established, and no studies on the topic are available in Northern and Central European populations. Therefore, we aimed at investigating the association between nut consumption and the risk of stroke in a German population. Subjects/Methods: We used data from a prospective cohort of 26 285 participants of the European Prospective Investigation into the Cancer and Nutrition Potsdam Study. During a median follow-up time of 8.3 years (interquartile range: 7.5–9.2), 288 incident cases of stroke occurred. Nut consumption (standard portion size of 50 g) was assessed at baseline with a semiquantitative food-frequency questionnaire. Results: The median nut intake was 0.82 g per day, interquartile range: 0.41–4.11. In the multivariable model, an increased risk of stroke was observed among participants who never consumed nuts (hazard ratio (HR): 1.56, 95% confidence interval: 1.17–2.08), compared with those consuming <½ portion/week. However, there was no evidence of a dose–response relationship between nut consumption and stroke. Compared with those who consumed <½ portion/week, the multivariable HR for total stroke was 1.06 (0.75–1.52) among those who consumed ½ to 1 portion/week and 1.37 (0.92–2.05) for those who consumed >1 portion/week. Similar nonsignificant associations were observed in stratified analysis for gender, or for fatal and nonfatal stroke. Conclusions: We could not observe an association between nut consumption and the risk of developing stroke (fatal/nonfatal) in a population with low habitual nut consumption.

Objectives: This paper describes the dietary intake of total fat, saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA) and cholesterol of participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) in 27 centres across 10 countries. Methods: Between 1995 and 2000, a stratified random sample of 36 034 participants (age range 35–74 years) completed a standardized 24-h dietary recall, assessed by means of the computer software EPIC-SOFT. Lipid intake data were calculated using a standardized nutrient database. Results: On average, the contribution of fat to total energy intake was >or= 34% of energy intake (%en) in women and >or= 36%en in men for most EPIC centres, except for the British, Dutch and most Italian cohorts. Total fat (>40%en) and MUFA intakes (21%en, mainly from olive oil) were highest in Greece. Except for the Greek, Spanish and Italian centres, the average MUFA intake ranged between 10 and 13%en, with a high proportion derived from animal sources. SFA intake in women and men was lowest in the Greek, Spanish, Italian and UK cohorts with an average of

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