Download Nutrition and Health 2016 – Nutrients v Food

Dr Cameron Mitchell
Liggins Institute
University of Auckland
16:30 - 16:50 Nutrition and Health 2016 – Nutrients v Food
Nutrition and Health 2016 – Nutrients v Food
Cameron Mitchell PhD
Rotorua GP CME meeting
Friday, 10 June, 2016
Disclosure
• I have received research funding from: Fonterra, Dairy Farmers of Canada,
Nestle
• I have acted as a consultant for: Goodman Fielder
• I have received speaking honoraria from: National Fitness Products
(Canada)
Nutrients vs Food
Vitamin Deficiencies
Ricketts
Scurvy
Vitamins vs. Fruit and vegetables
Vitamins all cause mortality
Macpherson et al. Am J Clin Nutr 2012;97:437-444
Fruit and vegetables all cause mortality
Wang X et al. BMJ 2014; 349 :g4490
What is so good about produce?
• Phytochemicals
• Satiety
• Fibre
• Very difficult to over dose
Fibre
10% Risk reduction
for each 10g increase
in daily fibre intake
Yang Yang et al. Am. J. Epidemiol. 2015;181:83-91
Fibre supplement
All cause mortality is not related to 10 year average fibre supplement use once
adjusted for potential confounders
Pocobelli et al. Am J Clin Nutr. 2010;91(6):1791-800
Why if Fibre good for you?
• Lowers energy density of food
• Helps to manage blood glucose
• Improves bowel health
Fish consumption
Zhao et al. Eur J Clin Nutr. 2016;70(2):155-61
Omega-3 consumption
Rizos et al. JAMA. 2012;308(10):1024-1033
Fish oil in NZ
PRACTICE CHANGER
Stop recommending omega-3 fatty
acid supplements for cardiovascular
protection. They have no significant
impact on all-cause mortality, acute
myocardial infarction, sudden death,
or stroke.1
STRENGTH OF
RECOMMENDATION
A: Based on a meta-analysis of
randomized controlled trials (RCTs).
Rizos E, Ntzani E, Bika E, et al.
Association between omega-3 fatty
acid supplementation and risk of
major cardiovascular disease events:
a systematic review and metaanalysis. JAMA. 2012;308:10241033.
Fam Pract. 2013 Aug; 62(8):
422–424.
Albert et al. Sci Rep. 2015;70:7928
Nuts and mortality
Mayhew et al. Br J Nurtr. 2016;115(2):212-25
Trans fat
de Souza et al. BMJ. 2015;351:h3978
Nutrient density
• More: protein, fibre, vitamins and
minerals
• Less: saturated fat, sugar and
sodium
• 15% reduction in all cause
mortality
Streppel et al. Eur J Clin Nutr. 2014;68(6):741-7
Food processing
Anthony Fardet et al. Adv Nutr 2015;6:629-638
Modern Food
The future of food?
Take home points
• Recommend foods rather than nutrients
• Whole foods are best
• Be weary of supplements
• “Nutraceuticals” may be coming but not it is not time to
abandon food yet