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Sujatha Rajaram, PhD
Associate Professor, School of Public Health
School of Public Health
Publications    Scholarly Journals--Published
  • Wien M, Rajaram S, Oda K, Sabaté J. Decreasing the linoleic acid to alpha-linolenic acid diet ratio increases eicosapentaenoic acid in erythrocytes in adults. Lipids. 2010 Aug;45(8):683-92.  ( 0/2010 )
  • Burns-Whitmore BL, Haddad EH, Sabaté J, Jaceldo-Siegl K, Tanzman J, Rajaram S. Effect of n-3 fatty acid enriched eggs and organic eggs on serum lutein in free-living lacto-ovo vegetarians. Eur J Clin Nutr. 2010 Nov;64(11):1332-7. ( 0/2010 )
  • Rajaram S, Hasso Haddad E, Mejia A, Sabaté J. Walnuts and fatty fish influence different serum lipid fractions in normal to mildly hyperlipidemic individuals: a randomized controlled study. Am J Clin Nutr 2009;89:1657S-1663S. ( 5/2009 )
    Background: Increased consumption of n-3 fatty acids reduces the incidence of coronary heart disease (CHD). Objective: To determine if walnuts (plant n-3 fatty acid) and fatty fish (marine n-3 fatty acid) have similar effects on serum lipid markers at intakes recommended for primary prevention of CHD. Design: In a randomized crossover feeding trial, 25 normal to mildly hyperlipidemic adults consumed 3 isoenergetic diets (~30% total fat, <10% saturated fat) for 4 wk each: control (no nuts or fish); walnut (42.5 g walnuts/10.1 MJ) and fish (113 g salmon, twice/wk). Fasting blood was drawn at baseline and end of each diet period and analyzed for serum lipids. Results: Serum total and LDL cholesterol following the walnut diet (4.87 ± 0.18 mmol/L, 2.77 ± 0.15 mmol/L) was lower than the control (5.14 ± 0.18 mmol/L, 3.06 ± 0.15 mmol/L) and fish (5.33 ± 0.18 mmol/L, 3.2 ± 0.15 mmol/L; P<0.0001) diets. Fish diet reduced serum triglyceride, and increased HDL cholesterol (1.0 ± 0.11 mmol/L, 1.23 ± 0.05 mmol/L) compared to control (1.12 ± 0.11 mmol/L, 1.19 ± 0.05 mmol/L) and walnut (1.11 ± 0.11 mmol/L; P<0.05, 1.18 ± 0.05 mmol/L; P<0.001) diets. The ratios of total: HDL cholesterol, LDL: HDL cholesterol and apo B: A-1 were lower (P<0.05) after walnut compared to the other two diets. Conclusions: Including walnuts and fatty fish to a healthy diet lowered serum cholesterol and triglyceride, respectively, affecting CHD risk favorably.
  • Torabian S, Haddad E, Rajaram S, Banta J, Sabaté J. Acute effect of nut consumption on plasma total polyphenols, antioxidant capacity and lipid peroxidation in healthy volunteers. J Hum Nutr Diet, 2009;22:64-71. ( 0/2009 )
    Background: Nuts have been shown to have beneficial effects on human health due to the healthy fat content; however, the effect of antioxidants (i.e. polyphenols) in nuts have not been fully investigated. The present study aimed to assess the immediate effect of a polyphenol-rich meal (75% of energy from nuts: walnuts or almonds) and a polyphenol-free meal on plasma polyphenol content, antioxidant capacity and lipid peroxidation in healthy volunteers. Methods: Thirteen subjects participated in a randomized, crossover, intervention study. After an overnight fast, walnuts, almonds or a control meal in the form of smoothies were consumed by study subjects. Each subject participated on three occasions, 1 week apart, consuming one of the smoothies each time. Blood samples were obtained at fasting and then at intervals up to 3.5 h after consumption of the smoothies. Results: There was a significant increase in plasma polyphenol concentration following both nut meals, with peak concentrations being achieved at 90 min, and with a walnut meal having a more sustained higher concentration than an almond meal. The plasma total antioxidant capacity reached its highest point at 150 min postconsumption of the nut meals, and was higher after the almond compared to walnut meal. A gradual significant (P < 0.05) reduction in the susceptibility of plasma to lipid peroxidation was observed 90 min after ingestion of the nut meals. No changes were observed following consumption of control meal. Conclusions: Consumption of both nuts increased plasma polyphenol concentrations, increased the total antioxidant capacity and reduced plasma lipid peroxidation.
  • Thorpe DL, Knutsen SF, Beeson WL, Rajaram S, Fraser GE. Effects of meat consumption and vegetarian diet on risk of wrist fracture over 25 years in a cohort of peri- and postmenopausal women. Publ Health Nutr, 2008;11:564-72. ( 0/2008 )
    Background: Evidence suggesting that a diet high in fruits and vegetables may be beneficial to bone health has sparked interest in the potential benefit of a vegetarian diet. However, other studies have raised a question regarding the adequacy of protein in such a diet. Objective: The aim of the present study was to take a whole foods approach in examining the effects of foods high in protein on the risk of wrist fracture (WF) in a cohort with a significant proportion consuming a meat-free diet. Design: A cohort study of women who completed two lifestyle surveys 25 years apart. Subjects: One thousand eight hundred and sixty-five peri- and postmenopausal women at the time of the first survey. Results: There was a significant interaction between meat consumption and foods high in vegetable protein. Among vegetarians, those who consumed the least vegetable protein intake were at highest risk for fracture. However, increasing levels of plant-based high-protein foods decreased WF risk, with a 68% reduction in risk (hazard ratio (HR)50.32, 95% confidence interval (CI) 0.13–0.79) in the highest intake group. Among those with lowest vegetable protein consumption, increasing meat intake decreased the risk of WF, with the highest consumption decreasing risk by 80% (HR50.20, 95% CI 0.06–0.66). Conclusions: The finding that higher consumption frequencies of foods rich in protein were associated with reduced WF supports the importance of adequate protein for bone health. The similarity in risk reduction by vegetable protein foods compared with meat intake suggests that adequate protein intake is attainable in a vegetarian diet.
  • Rajaram S, Sabaté J. Nuts, body weight and insulin resistance. Br J Nutr, 2006, 96:S79-S86. ( 0/2006 )
  • Jambazian P, Haddad E, Rajaram S, Tanzman J, Sabaté J. Almonds in the diet simultaneously improve plasma alpha-tocopherol concentrations and reduce plasma lipids.  J Am Diet Assoc, 2005;105:449-454. ( 0/2005 )
  • Dyett P A, Sabate J, Haddad E, Rajaram S, & Shavlik D. (2013). Vegan lifestyle behaviors An exploration of congruence with health-related beliefs and assessed health indices. Appetite, 67, 119-124. ( 8/2013 - Present ) Link...
    This study aimed to investigate health belief as a major motive for diet and lifestyle behaviors of 100 vegans in the United States; and to determine congruence with selected health and nutrition outcomes. Response data from an administered questionnaire was analyzed. Statistical analyses determined the most common factors influencing diet choice; the number of vegans practicing particular lifestyle behaviors; body mass index; and prevalence of self-reported chronic disease diagnoses. Nutrient intakes were analyzed and assessed against Dietary Reference Intakes. Health was the most reported reason for diet choice (47%). In the health belief, animal welfare, and religious/other motive categories, low percentages of chronic disease diagnoses were reported: 27%, 11%, and 15%, respectively. There were no significant differences in health behaviors and indices among vegan motive categories, except for product fat content choices. Within the entire study population, health-related vegan motive coincided with regular exercise; 71% normal BMI (mean = 22.6); minimal alcohol and smoking practices; frequently consumed vegetables, nuts, and grains; healthy choices in meal types, cooking methods, and low-fat product consumption; and adequate intakes for most protective nutrients when compared to reference values. But incongruence was found with 0% intake adequacy for vitamin D; and observation of excessive sodium use. (C) 2013 Elsevier Ltd. All rights reserved.
  • Uppala P T, Dissmore T, Lau B H S, Andacht T, & Rajaram S. (2013). Selective Inhibition of Cell Proliferation by Lycopene in MCF-7 Breast Cancer Cells In vitro: A Proteomic Analysis. Phytotherapy Research, 27(4), 595-601. ( 4/2013 - Present ) Link...
    Lycopene, a red pigmented carotenoid present in many fruits and vegetables such as tomatoes, has been associated with the reduced risk of breast cancer. This study sought to identify proteins modulated by lycopene during cell proliferation of the breast cancer cell line MCF-7 to gain an understanding into its mechanism of action. MCF-7 breast cancer cells and MCF-10 normal breast cells were treated with 0, 2, 4, 6, 8, and 10M of lycopene for 72h. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) tetrazolium reduction assay was used to measure cell proliferation and two-dimensional fluorescence difference gel electrophoresis to assess the changes in protein expression, which were identified using MALDI-ToF/ToF (matrix-assisted laser desorption ionization tandem time-of-flight) and Mascot database search. MTT and cell proliferation assays showed that lycopene selectively inhibited the growth of MCF-7 but not MCF-10 cells. Difference gel electrophoresis analysis revealed that proteins in the MCF-7 cells respond differently to lycopene compared with the MCF-10 cells. Lycopene altered the expression levels of proteins such as Cytokeratin 8/18 (CK8/18), CK19 and their post translational status. We have shown that lycopene inhibits cell proliferation in MCF-7 human breast cancer cells but not in the MCF-10 mammary epithelial cells. Lycopene was shown to modulate cell cycle proteins such as beta tubulin, CK8/18, CK19 and heat shock proteins. Copyright (c) 2012 John Wiley & Sons, Ltd.
  • Creske M, Modeste N, Hopp J, Rajaram S, & Cort D. (2013). How do diet and body mass index impact dental caries in Hispanic elementary school children?. J Dent Hyg, 87(1), 38-46. ( 2/2013 - Present ) Link...
    PURPOSE: The purpose of this observational study was to examine the association between body mass index and dental caries in Hispanic children. The research evaluated the influences of obesity, diet, parent education level, family acculturation, tooth brushing habits and gender as predictors of childhood caries. METHODS: One examiner visually screened 177 third grade students from 3 elementary schools located in southern California's Coachella Valley. The children were screened for number of decayed, missing and filled teeth (DMFT). Height, weight, age and gender determined their body mass index. Primary caregivers completed a 30-point questionnaire for each participant. Multivariate analyses accessed the association between childhood dental caries and weight status and the influences of the measured variables. RESULTS: Results indicate that those in the obese category had a statistically significant lower rate of DMFT than did children in the healthy weight category. Overweight children showed a higher DMFT than healthy weight children but the results were not statistically significant. Covariates that significantly influenced this association were diet and socioeconomic status. CONCLUSION: Results from this study provide oral health professionals with baseline data and literature to support development of preventive programs for this population that concurrently address both obesity and oral health issues in scope and design.
  • Chiang Y L, Haddad E, Rajaram S, Shavlik D, & Sabate J. (2012). The effect of dietary walnuts compared to fatty fish on eicosanoids, cytokines, soluble endothelial adhesion molecules and lymphocyte subsets: a randomized, controlled crossover trial. Prostaglandins Leukotrienes and Essential Fatty Acids, 87(4-5), 111-117. ( 10/2012 - Present ) Link...
    We tested the hypothesis that walnut consumption can exert effects on markers of inflammation and endothelial activation similar to those produced by fish consumption. In a crossover dietary intervention trial, 25 normal to mildly hyperlipidemic men and women were randomly assigned to one of three isoenergetic diets: a walnut diet incorporating 42.5 g of walnuts per 10.1 mj 6 times per week (1.8% of energy n-3 fat); a fish diet providing 113 g of fatty fish per 10.1 mj 2 times per week (0.8% of energy n-3 fat), or a control diet (no nuts or fish, 0.4% of energy n-3 fat) for 4 weeks on each diet. Both the walnut and fish diets inhibited circulating concentrations of prostaglandin E metabolite (PGEM) and 11-dehydro thromboxane B2, but demonstrated no effect on blood interleukin-1 beta (1L-1 beta), interleukin-6 (IL-6), tumor necrosis factor-(alpha) over bar (INF-(alpha) over bar), and C-reactive protein (CRP) or the number of circulating lymphocyte subsets. On the walnut diet the proportion of plasma phospholipid (alpha) over bar -linolenic acid (ALA) increased 140% and arachidonic acid (AA) decreased 7% compared to both the control and fish diets. The proportion of plasma phospholipid eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) increased about 200% and 900% respectively on the fish diet relative to either the control or walnut diet. The walnut diet inhibited E-selectin by 12.7% relative to the fish diet, and the fish diet inhibited secretory intercellular adhesion molecule-1 (s-ICAM-1) by 4.5% relative to the control diet. Both walnuts and fish in commonly consumed amounts may have modest albeit distinct effects on circulating adhesion molecules. (C) 2012 Elsevier Ltd. All rights reserved.
  • Burns-Whitmore B L, Haddad E H, Sabate J, Jaceldo-Siegl K, Tanzman J, & Rajaram S. (2010). Effect of n-3 fatty acid enriched eggs and organic eggs on serum lutein in free-living lacto-ovo vegetarians. European Journal of Clinical Nutrition, 64(11), 1332-1337. ( 11/2010 - Present ) Link...
    Background/Objective: Lutein is a xanthophyll found in the chloroplasts of dark green leafy vegetables, chromoplasts of fruits, and egg yolk. Dietary, serum and macular lutein are inversely related to the risk of age-related macular degeneration. Although the lutein from egg is known to be more bioavailable than that from spinach, not much is known about lutein bioavailability from n-3 fatty acid enriched eggs and organic eggs, both of which are increasingly available to consumers. Subjects/Methods: We determined the effects of feeding n-3 fatty acid-enriched eggs and organic eggs on serum lutein, zeaxanthin and beta-carotene in 20 healthy lacto-ovo-vegetarian (LOV) adults using a single-blind, randomized, crossover study design with a 4-week washout between treatments: six organic eggs or six n-3 fatty acid enriched eggs per week or no egg control for 8weeks each. Results: Serum lutein was significantly higher in both egg treatments (P<0.009) compared with the control, but was not different between the two egg treatments. Serum beta-carotene was also higher in the egg groups compared with control but only approached significance (P = 0.066). Serum zeaxanthin increased in both egg treatments compared with control but did not reach statistical significance (P = 0.139). Conclusion: n-3 fatty acid enriched eggs and organic eggs may both significantly increase serum lutein in healthy LOV consuming a predominately plant-based diet. European Journal of Clinical Nutrition (2010) 64, 1332-1337; doi: 10.1038/ejcn.2010.140; published online 28 July 2010
  • Wien M, Rajaram S, Oda K, & Sabate J. (2010). Decreasing the Linoleic Acid to alpha-Linolenic Acid Diet Ratio Increases Eicosapentaenoic Acid in Erythrocytes in Adults. Lipids, 45(8), 683-692. ( 8/2010 - Present ) Link...
    The n-6/n-3 fatty acid (FA) ratio has increased in the Western-style diet to similar to 10-15:1 during the last century, which may have contributed to the rise in cardiovascular disease (CVD). Prior studies have evaluated the effects on CVD risk factors of manipulating the levels of n-6 and n-3 FA using food and supplements or investigated the metabolic fate of linoleic acid (LNA) and alpha-linolenic acid (ALA) by varying the n-6/n-3 ratios. However, no previous studies have investigated the potential interaction between diet ratios and supplementation with eicosapentaenoic acid (EPA, 20:5n-3) and docosahexaenoic acid (DHA, 22:6n-3). We used a factorial design approach with adults (n = 24) in a controlled feeding trial to compare the accretion of EPA and DHA into red blood cell membranes (RBC) by adding a direct source (algal oil supplement) of EPA and DHA in a diet with a 10:1 versus 2:1 ratio of n-6/n-3 FA. Subjects were randomized into 8-week crossover diet sequences and each subject consumed three of four diets [10:1, 10:1 plus supplement (10:1 + S), 2:1 and 2:1 + S]. LNA and ALA intakes were 9.4 and 7.7%, and 1.0 and 3.0% during the low and high ALA diets, respectively. Compared to the Western-style 10:1 diet, the 2:1 diet increased EPA by 60% (P < 0.0001) in RBC membranes without the direct EPA source and a 34% increase (P = 0.027) was observed with the 10:1 + S diet; however, DHA levels increased in both diet ratios only with a direct DHA source. Shifting towards a 2:1 diet is a valid alternative to taking EPA-containing supplements.
  • Rajaram S, Connell K M, & Sabate J. (2010). Effect of almond-enriched high-monounsaturated fat diet on selected markers of inflammation: a randomised, controlled, crossover study. British Journal of Nutrition, 103(6), 907-912. ( 3/2010 - Present ) Link...
    Frequent consumption of nuts lowers the risk of CHD. While lowering blood lipids is one of the mechanisms for cardioprotection, the present study sought to determine whether monounsaturated fat-rich almonds also influence other CHD risk factors such as inflammation and haemostasis. This was a randomised, controlled, crossover feeding study with twenty-five healthy adults (eleven men; fourteen women), age 22-53 years. Following a 2 week run-in phase (34 % energy from fat), subjects were assigned in random order to three diets for 4 weeks each: a heart-healthy control diet with no nuts (<30% energy from fat), low-almond diet and high-almond diet (10% or 20% isoenergetic replacement of control diet with almonds, respectively). Serum E-selectin was significantly lower on the high-almond diet compared with the control diet. E-selectin decreased as the percentage of energy from almonds increased (P<0.0001). C-reactive protein (CRP) was lower in both the almond diets compared with the control diet. A clear dose response was not observed for either E-selectin or CRP. There was no effect of diet on IL-6 or fibrinogen. Tissue plasminogen activator antigen was significantly lower on the control and high-almond diets compared with the low-almond diet, although the values were within normal range. In conclusion, consumption of almonds influenced a few but not all of the markers of inflammation and haemostasis. A clear dose response was not observed for any of the markers studied.
  • Rajaram S, Haddad E H, Mejia A, & Sabate J. (2009). Walnuts and fatty fish influence different serum lipid fractions in normal to mildly hyperlipidemic individuals: a randomized controlled study. American Journal of Clinical Nutrition, 89(5), S1657-S1663. ( 5/2009 - Present ) Link...
    Background: Increased consumption of n-3 (omega-3) fatty acids decreases the incidence of coronary heart disease (CHD). Objective: The objective was to determine whether walnuts (plant n-3 fatty acid) and fatty fish (marine n-3 fatty acid) have similar effects on serum lipid markers at intakes recommended for primary prevention of CHD. Design: In a randomized crossover feeding trial, 25 normal to mildly hyperlipidemic adults consumed 3 isoenergetic diets (approximate to 30% total fat and <10% saturated fat) for 4 wk each: a control diet (no nuts or fish), a walnut diet (42.5 g walnuts/10.1 mJ), or a fish diet (113 g salmon, twice/wk). Fasting blood was drawn at baseline and at the end of each diet period and analyzed for serum lipids. Results: Serum total cholesterol and LDL cholesterol concentrations in adults who followed the walnut diet (4.87 +/- 0.18 and 2.77 +/- 0.15 mmol/L, respectively) were lower than in those who followed the control diet (5.14 +/- 0.18 and 3.06 +/- 0.15 mmol/L, respectively) and those who followed the fish diet (5.33 +/- 0.18 and 3.2 +/- 0.15 mmol/L, respectively; P < 0.0001). The fish diet resulted in decreased serum triglyceride and increased HDL-cholesterol concentrations (1.0 +/- 0.11 and 1.23 +/- 0.05 mmol/L, respectively) compared with the control diet (1.12 +/- 0.11 and 1.19 +/- 0.05 mmol/L, respectively) and the walnut diet (1.11 +/- 0.11 mmol/L, P < 0.05, and 1.18 +/- 0.05 mmol/L, P < 0.001, respectively). The ratios of total cholesterol: HDL cholesterol, LDL cholesterol: HDL cholesterol, and apolipoprotein B: apolipoprotein A-I were lower (P < 0.05) in those who followed the walnut diet compared with those who followed the control and fish diets. Conclusion: Including walnuts and fatty fish in a healthy diet lowered serum cholesterol and triglyceride concentrations, respectively, which affects CHD risk favorably. Am J Clin Nutr 2009; 89(suppl): 1657S-63S.
  • Rajaram S, & Sabate J. (2009). Fifth International Congress on Vegetarian Preface. American Journal of Clinical Nutrition, 89(5), S1541-S1542. ( 5/2009 - Present ) Link...
  • Torabian S, Haddad E, Rajaram S, Banta J, & Sabate J. (2009). Acute effect of nut consumption on plasma total polyphenols, antioxidant capacity and lipid peroxidation. Journal of Human Nutrition and Dietetics, 22(1), 64-71. ( 2/2009 - Present ) Link...
    Nuts have been shown to have beneficial effects on human health due to the healthy fat content; however, the effect of antioxidants (i.e. polyphenols) in nuts have not been fully investigated. The present study aimed to assess the immediate effect of a polyphenol-rich meal (75% of energy from nuts: walnuts or almonds) and a polyphenol-free meal on plasma polyphenol content, antioxidant capacity and lipid peroxidation in healthy volunteers. Thirteen subjects participated in a randomized, crossover, intervention study. After an overnight fast, walnuts, almonds or a control meal in the form of smoothies were consumed by study subjects. Each subject participated on three occasions, 1 week apart, consuming one of the smoothies each time. Blood samples were obtained at fasting and then at intervals up to 3.5 h after consumption of the smoothies. There was a significant increase in plasma polyphenol concentration following both nut meals, with peak concentrations being achieved at 90 min, and with a walnut meal having a more sustained higher concentration than an almond meal. The plasma total antioxidant capacity reached its highest point at 150 min postconsumption of the nut meals, and was higher after the almond compared to walnut meal. A gradual significant (P < 0.05) reduction in the susceptibility of plasma to lipid peroxidation was observed 90 min after ingestion of the nut meals. No changes were observed following consumption of control meal. Consumption of both nuts increased plasma polyphenol concentrations, increased the total antioxidant capacity and reduced plasma lipid peroxidation.
  Scholarly Journals--Accepted
  • Rajaram S, Connell KM, Sabaté J. Effect of almond-enriched high monounsaturated fat diet on selected markers of inflammation: a randomized, controlled, crossover study. Br J Nutr 2009 (in press). ( 0/2009 )
    Frequent consumption of nuts lowers the risk of coronary heart disease (CHD). While lowering blood lipids is one of the mechanisms for cardio-protection, this study sought to determine if monounsaturated fat rich almonds also influences other CHD risk factors such as inflammation and hemostasis. This was a randomized, controlled, crossover feeding study with 25 healthy adults (11 men; 14 women), age 22-53 y. Following a 2 week run-in phase (34% energy from fat), subjects were assigned in random order to 3 diets for 4 weeks each: a heart healthy control diet with no nuts (<30% energy from fat), low almond diet and high almond diet (10% or 20% isoenergetic replacement of control diet with almonds respectively).  Serum E-selectin was significantly lower on the high almond diet compared to the control diet. E-selectin decreased as the percentage of energy from almonds increased (P <0.0001). C-reactive protein (CRP) was lower in both the almond diets compared to the control diet. A clear dose response was not observed for either E-selectin or CRP. There was no effect of diet on interleukin-6 or fibrinogen. Tissue plasminogen activator antigen was significantly lower on the control and high almond diets compared to the low almond diet, although the values were within normal range. In conclusion, consumption of almonds influenced a few but not all of the markers of inflammation and hemostasis. A clear dose response was not observed for any of the markers studied.
  Books and Chapters
  • Rajaram S, Sabaté J. Nuts, Body Weight and Insulin Resistance. In Frutos Secos, Salud y Culturas Mediterraneás (Tree Nuts, Health, and Mediterranean Culture). Edited by Salas J, Ros E, Sabaté J. Editorial Glosa, Barcelona, Spain, 2005, pg. 277-296. ( 0/2005 )
  • Rajaram S, Dyett PA, Sabaté J. Nutrition and Vegetarianism. In Nutritional Concerns of Women. Edited by Klimis-Azcas, D, Wolinsky, I. CRC Press, Boca Raton, 2004, pg. 419-456. ( 0/2004 )
  Abstract
  • Rajaram S, Sabate J, & Mohan S. (2012). Effect of n-3 polyunsaturated fatty acids on peroxisome proliferator-activated receptor gamma (PPAR gamma) expression in adults. Faseb Journal, 26, . ( 4/2012 - Present )
  • Shih Y, Wang W, Oda K, Jaceldo-Seigl K, Sabate J, . . . Burns-Whitmore B. (2011). Feeding eggs improves plasma markers of choline status. Faseb Journal, 25, . ( 4/2011 - Present )