Dietary intake and the development of the metabolic syndrome: the Atherosclerosis Risk in Communities study

System biology approach intersecting diet and cell metabolism with pathogenesis of brain disorders

The surge in meals high in calories has prompted an epidemic of metabolic disorders around the world such that the elevated incidence of obese and diabetic individuals is alarming. New research indicates that metabolic disorders pose a risk for neurological and psychiatric conditions including stroke, Alzheimer's disease, Huntington's disease, and depression, all of which have a metabolic component. These relationships are rooted to a dysfunctional interaction between molecular processes that regulate energy metabolism and synaptic plasticity. The strong adaptive force of dietary factors on shaping the brain during evolution can be manipulated to transform the interaction between cell bioenergetics and epigenome with the aptitude to promote long-lasting brain healthiness. A thorough understanding of the association between the broad action of nutrients and brain fitness requires high level data processing empowered with the capacity to integrate information from a multitude of molecular entities and pathways. Nutritional systems biology is emerging as a viable approach to elucidate the multiple molecular layers involved in information processing in cells, tissues, and organ systems in response to diet. Information about the wide range of cellular and molecular interactions elicited by foods on the brain and cognitive plasticity is crucial for the design of public health initiatives for curtailing the epidemic of metabolic and brain disorders.

Pathways and mechanisms linking dietary components to cardiometabolic disease: thinking beyond calories

Calories from any food have the potential to increase risk for obesity and cardiometabolic disease because all calories can directly contribute to positive energy balance and fat gain. However, various dietary components or patterns may promote obesity and cardiometabolic disease by additional mechanisms that are not mediated solely by caloric content. Researchers explored this topic at the 2017 CrossFit Foundation Academic Conference 'Diet and Cardiometabolic Health - Beyond Calories', and this paper summarizes the presentations and follow-up discussions. Regarding the health effects of dietary fat, sugar and non-nutritive sweeteners, it is concluded that food-specific saturated fatty acids and sugar-sweetened beverages promote cardiometabolic diseases by mechanisms that are additional to their contribution of calories to positive energy balance and that aspartame does not promote weight gain. The challenges involved in conducting and interpreting clinical nutritional research, which preclude more extensive conclusions, are detailed. Emerging research is presented exploring the possibility that responses to certain dietary components/patterns are influenced by the metabolic status, developmental period or genotype of the individual; by the responsiveness of brain regions associated with reward to food cues; or by the microbiome. More research regarding these potential 'beyond calories' mechanisms may lead to new strategies for attenuating the obesity crisis.

Effects of saccharin supplementation on body weight, sweet receptor mRNA expression and appetite signals regulation in post-weanling rats

Non-nutritive sweeteners have been considered to promote diet healthfulness by delivering a pleasant sweet taste without calories. We investigated the effects of long term supplementation with drinks containing saccharin on body weight and possible mechanisms of the effects in post-weanling rats. Our results showed that saccharin solution intake increased food intake and energy intake in male rats. In males, saccharin solution intake increased TIR3 mRNA expression in the taste buds and ghrelin receptor mRNA expression both in the taste buds and hypothalamus, whereas no effects were observed in females. These results suggest the effects of saccharin solution exposure on food intake and body weight gain may be different in developmental males and females. In males, peripheral sweet taste receptors and both peripheral and central ghrelin receptors may be involved in the effect of saccharin solution intake to promote food intake and weight gain.

Twenty-four-year trends and determinants of change in compliance with Swiss dietary guidelines

BACKGROUND AND AIMS

A healthy diet is the cornerstone of disease prevention, and dietary guidelines have been issued in most countries. We aimed to assess trends in compliance with dietary guidelines in the population of Geneva, Switzerland.

METHODS

Multiple cross-sectional, population-based surveys conducted between 1993 and 2016 in the canton of Geneva, Switzerland [20,310 participants (52.3% women, mean age 51.9 ± 10.7 years)]. Trends in compliance with the Swiss dietary guidelines regarding food intake were assessed using logistic regression (a) for each guideline and (b) for at least three guidelines. Compliance before and after the first and second issuing of the guidelines was assessed.

RESULTS

After multivariable adjustment, compliance with fruits increased overall [odds ratio and (95% confidence interval) for 1-year increase: 1.007 (1.003-1.012), p < 0.001], in men, participants aged over 45 and with low educational level. Compliance with vegetables increased overall [1.015 (1.008-1.022), p < 0.001], in both genders, age groups [45-54 and 55-64] and participants with low educational level. Compliance with meat increased in women [1.007 (1.001-1.013), p = 0.021] and participants with a university degree. Compliance with fresh fish increased in age group [55-64] [1.009 (1.000-1.018), p = 0.041]. Compliance with dairy products decreased overall [0.979 (0.972-0.986), p < 0.001] and in all groups studied, except for age group [65-74]. Compliance with at least three guidelines increased in age group [55-64] only [1.013 (1.002-1.024), p = 0.019]. No effect of the issuing of the guidelines was found.

CONCLUSION

In the Geneva adult population, compliance with the Swiss dietary guidelines improved little. Issuing of dietary guidelines did not impact trends.

The relation of Dietary diversity score and food insecurity to metabolic syndrome features and glucose level among pre-diabetes subjects

INTRODUCTION

Prediabetes is considered as an increased risk factor for cardiovascular disease and overt diabetes and is the precursor stage of diabetes. Dietary Diversity Score (DDS) is recognized as an essential factor of a high-quality diet. However, diets with more varieties of food items might increase calorie intake and body weight. Therefore, this study was carried out to determine the association of DDS with metabolic syndrome features in adults with prediabetes.

METHODS

Three hundred subjects were randomly selected from participants who were undergone diabetes test screening program. Dietary intake was assessed by using a validated semi-quantitative food frequency questionnaire. DDS was calculated by scoring food intake as nine food groups. The 18-items USDA household food securities and International Physical Activity (IPAQ) were also measured. The metabolic syndrome was defined according to the Adult Treatment Panel III.

RESULTS

DDS mean for cases and controls were 4.43 and 4.9, respectively (p<0.005). The prevalence of food insecurity was 67/3% in cases and 55/4% in controls group. The decrease in metabolic syndrome probability was compatible with quartiles of DDS (the quartiles odds ratios: 0.6, 0.5, 0.4, 0.19, P=0.05). A higher DDS was associated with lower level of fasting blood glucose, HDL-cholesterol, TG and Waist circumference.

CONCLUSION

Lower DDS was associated with high probability of metabolic syndrome and with some features of it, like high fasting blood glucose. Therefore, it seems that increase in dietary diversity scores could prevent the pre diabetes development to overt diabetes.

Dietary Flavonoids, Copper Intake, and Risk of Metabolic Syndrome in Chinese Adults

The effects of flavonoids and copper (Cu) on metabolic syndrome (MetS) have been investigated separately, but no information exists about the joint associations between flavonoids and Cu on the risk of MetS in population studies. In this cross-sectional study, a total of 9108 people aged 20⁻75 years from the Harbin Cohort Study on Diet, Nutrition, and Chronic Non-Communicable Diseases (HDNNCDS) were included. Flavonoid intakes were calculated based on the flavonoid database created in our laboratory. Cu and other nutrient intakes were estimated using the Chinese Food Composition Table. Among all study subjects, a total of 2635 subjects (28.9%) met the diagnostic criteria for inclusion in the MetS group. Total flavonoids (fourth vs. first quartile, odds ratio (OR): 0.77, 95% confidence interval (CI) 0.66⁻0.90, P_trend = 0.002) and Cu (OR 0.81, 90% CI: 0.70⁻0.94, P_trend = 0.020) were inversely associated with the risk of MetS after adjusting for potential confounders. Higher flavonoid intake was more strongly associated with a lower risk of MetS with high levels of Cu intake (P_interaction = 0.008). Dose⁻response effects showed an L-shaped curve between the total intake of five flavonoids and the risk of MetS. These results suggest that higher flavonoid intake is associated with a lower risk of MetS, especially under high levels of Cu intake.

Dietary Patterns and Metabolic Syndrome among Type 2 Diabetes Patients in Gaza Strip, Palestine

Background

The prevalence of metabolic syndrome is raising worldwide; however, the role of diet in the origin of metabolic syndrome is not understood well. This study identifies major dietary patterns among type 2 diabetes mellitus patients with and without metabolic syndrome; and its association with metabolic syndrome components in Gaza Strip, Palestine.

Methods

This cross sectional study was conducted among 1200 previously diagnosed type 2 diabetes mellitus (both genders, aged 20 – 64 years) patients receiving care in primary healthcare centers in Gaza Strip, Palestine. Metabolic syndrome was defined based on the International Diabetes Federation criteria; dietary patterns were evaluated using a validated semi-quantitative food frequency questionnaire. Statistical analysis was performed using SPSS version 20.

Results

Two major dietary patterns were identified by factor analysis: Asian-like pattern and sweet-soft drinks-snacks pattern. After adjustment for confounding variables, patients in the highest tertile of the Asian-like pattern characterized by a high intake of whole grains, potatoes, beans, legumes, vegetables, tomatoes and fruithad a lower odds for (Metabolic syndrome, central obesity, high triglycerides, low HDL cholesterol and high blood pressure), (OR 0.766 CI 95% (.642–.914)), (OR 0.797 CI 95% (.652–.974)), (OR 0.791 CI 95% (.687–.911)), (OR 0.853 CI 95% (.743–.978)) and (OR 0.815 CI 95% (.682–.973)) respectively, (P value < 0.05 for all). No significant association was found between the sweet-soft drinks-snacks pattern with metabolic syndrome and its components.

Conclusion

The Asian-like pattern may be associated with a lower prevalence of metabolic syndrome and its components among type 2 diabetes patients.

Comparative Metabolomics Elucidates Postprandial Metabolic Modifications in Plasma of Obese Individuals with Metabolic Syndrome

Although higher intakes of dairy milk are associated with a lower risk of metabolic syndrome (MetS), the underlying protective mechanism remains unclear. This study investigated the dynamic metabolic profile shift following the ingestion of low-fat milk or an isocaloric volume of rice milk in obese individuals with metabolic syndrome (MetS). In a randomized, double-blind, crossover study, postprandial plasma samples ( n = 266) were collected from 19 MetS participants. Plasma samples were analyzed by a targeted metabolomics platform which specifically detects 117 metabolites from 25 metabolic pathways. The comprehensive time-course metabolic profiling in MetS participants indicated that the postprandial metabolic profiles distinguish low-fat milk and rice milk consumption in a time-dependent manner. Metabolic biomarkers, such as orotate, leucine/isoleucine and adenine, showed significantly different trends in the two test beverages. Bayesian statistics identified 12 metabolites associated with clinical characteristics of postprandial vascular endothelial function, such as flow-mediated dilation (FMD), postprandial plasma markers of oxidative stress and NO status. Furthermore, metabolic pathway analysis based on these metabolite data indicated the potential utility of metabolomics to provide mechanistic insights of dietary interventions to regulate postprandial metabolic excursions.

Risk of Metabolic Syndrome among Middle-Aged Koreans from Rural and Urban Areas

Metabolic syndrome (MetS) is a common global health problem. This study aims to assess nutrient intake and risk of MetS in middle-aged Koreans based in residential areas. Participants were 161,326 (142,137 in urban and 19,189 in rural) subjects enrolled in the Korea Genome and Epidemiology Study. The prevalence of MetS was much higher in rural (39.8%) than that in urban (22.5%) subjects (p < 0.001). The rural residents showed significantly higher blood pressure (p < 0.001), serum triglyceride levels (p < 0.001), and LDL (Low density lipoprotein)-cholesterol level (p < 0.001), as well as the odds ratio (OR) for MetS (OR = 1.65, 95% CI: 1.59⁻1.71), compared to urban residents. The rural subjects showed a higher consumption of carbohydrate and sodium compared to the urban subjects (p < 0.001). After adjusting for potential confounders, subjects in the highest quartile of carbohydrate intake had higher OR for MetS (OR = 1.23, 95% CI: 1.15⁻1.32) and those in the highest quartile of sodium intake had a higher chance of having MetS (OR = 1.11, 95% CI: 1.07⁻1.16) than did those in the lowest quartiles. Our results suggested that the higher consumption of carbohydrate and sodium in rural residents might be associated with the increased risk of MetS in this population.

Nut consumption and risk of metabolic syndrome and overweight/obesity: a meta-analysis of prospective cohort studies and randomized trials

Background

Nut consumption has been shown to reduce the risk of cardiovascular disease. However, its role in the prevention of metabolic disorders, such as metabolic syndrome (Mets) and overweight/obesity, remains controversial. We therefore conducted a meta-analysis to determine the association of nut consumption with Mets and overweight/obesity.

Methods

Eligible studies were identified by searching the PubMed and Embase databases and by reviewing the references of relevant literatures. We used random effect models to pool the studies-specific risk ratio (RR) and weighted mean difference (WMD).

Results

This meta-analysis included six prospective cohort studies with 420,890 subjects and 62 randomized feeding trials with 7184 participants. Among the cohort studies, the summary RR for every 1-serving/week increase in nut intake was 0.96 (95% confidence interval [CI]: 0.92 to 0.99; n = 3) for Mets, 0.97 (95% CI: 0.95 to 0.98; n = 2) for overweight/obesity, and 0.95 (95% CI: 0.89 to 1.02; n = 2) for obesity. Pooling of randomized trials indicated that nut consumption was related to a significant reduction in body weight (WMD: - 0.22 Kg, 95% CI: -0.40 to - 0.04), body mass index (WMD: - 0.16 Kg/m², 95% CI: -0.31 to - 0.01), and waist circumference (WMD: - 0.51 cm, 95% CI: -0.95 to - 0.07). These findings remained stable in the sensitivity analysis, and no publication bias was detected.

Conclusion

Nut consumption may be beneficial in the prevention of Mets and overweight/obesity. Additional prospective studies are needed to enhance these findings and to explore the metabolic benefits for specific subclasses of nut.

Metabolic syndrome prevalence and its risk factors among adults in China: A nationally representative cross-sectional study

OBJECTIVES

The aim of this study was to examine sex disparity in metabolic syndrome prevalence and its risk factors among Chinese adults.

METHODS

Using the 2010-2012 China National Nutrition and Health Survey (CNNHS), a nationally representative cross-sectional study on nutrition and non-communicable chronic diseases, a total of 98,042 participants aged 18 years and older were included in the analysis. Dietary information was collected with a food frequency questionnaire (FFQ). Metabolic syndrome was defined according to the updated NCEP ATP III criteria. A multivariable logistic regression model was performed to examine the associations between sociodemographic and dietary factors with metabolic syndrome prevalence, and the results are presented using odd ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

The overall standardized prevalence of metabolic syndrome was 24.2% (24.6% in men and 23.8% in women). The metabolic syndrome prevalence was positively associated with age in men and women. The prevalence of metabolic syndrome was negatively associated with the physical activity level among men and inversely associated with the education level among women (P for trend < 0.01). Frequent consumption of fungi and algae was an underlying risk factor for metabolic syndrome in men, whereas frequent consumption of nuts and pork was associated with a decreased prevalence of metabolic syndrome in women.

CONCLUSIONS

The prevalence of metabolic syndrome in men was not different from that in women. There are sex-specific associations between multiple risk factors and metabolic syndrome.

Association between Nitrogen Stable Isotope Ratios in Human Hair and Serum Levels of Leptin

Stable isotope ratios have been reported to be potential biomarkers of dietary intake and nutritional status. High serum levels of leptin, a hormone which regulates energy metabolism and food intake, are associated with insulin resistance and metabolic syndrome. However, little is known about the association between stable isotope ratios and the metabolic risk in humans. We investigated whether the carbon and nitrogen stable isotope ratios in hair are associated with serum leptin levels. Hair samples were collected from 399 healthy adults (233 men and 166 women) aged 40 to 70 years of a community-based cohort in Korea and the bulk stable isotope ratios of carbon (δ¹³C) and nitrogen (δ¹⁵N) were measured for all hair samples. Serum leptin levels were analyzed by radioimmunoassay. δ¹⁵N showed positive correlations with serum leptin levels. In multivariate models, increasing δ¹⁵N were associated with elevated serum leptin levels (defined as ≥ the median values), whereas δ¹³C were not significantly associated with serum leptin levels. The odds ratio (95% confidence interval) per 1‰ increase in δ¹⁵N for an elevated serum leptin level was 1.58 (1.11-2.26). In participants with high body mass index, δ¹⁵N showed positive associations with serum leptin levels, whereas these associations were not seen in participants with low body mass index. The nitrogen stable isotopic ratio in hair is positively associated with serum leptin levels. The hair δ¹⁵N could be used as a clinical marker to estimate metabolic risk.

Dairy food consumption is associated with a lower risk of the metabolic syndrome and its components: a systematic review and meta-analysis

A systematic review and a meta-analysis of observational studies were performed to assess the dose–response relationship between specific types of dairy foods and the risk of the metabolic syndrome (MetS) and its components. Studies of dairy foods and the risk of the MetS and its components published up to June 2016 were searched using PubMed, EMBASE and a reference search. Random-effects models were used to estimate the pooled relative risks (RR) with 95 % CI. Finally, ten cross-sectional studies, two nested case–control studies and twenty-nine cohort studies were included for the analysis. In a dose–response analysis of cohort studies and cross-sectional studies, the pooled RR of the MetS for a one-serving/d increment of total dairy food (nine studies) and milk (six studies) consumption (200 g/d) were 0·91 (95 % CI 0·85, 0·96) and 0·87 (95 % CI 0·79, 0·95), respectively. The pooled RR of the MetS for yogurt (three studies) consumption (100 g/d) was 0·82 (95 % CI 0·73, 0·91). Total dairy food consumption was associated with lower risk of MetS components, such as hyperglycaemia, elevated blood pressure, hypertriacylglycerolaemia and low HDL- cholesterol. A one-serving/d increment of milk was related to a 12 % lower risk of abdominal obesity, and a one-serving/d increment of yogurt was associated with a 16 % lower risk of hyperglycaemia. These associations were not significantly different by study design, study location or adjustment factors. This meta-analysis showed that specific types of dairy food consumption such as milk and yogurt as well as total dairy food consumption were inversely related to risk of the MetS and its components.

Sugar sweetened beverages and cardiometabolic health

PURPOSE OF REVIEW

It is widely accepted that sugar sweetened beverages (SSB) are implicated in weight gain and adverse cardiometabolic heath. To make informed recommendations about SSB, new evidence needs to be considered against existing literature. The present review will provide an update on the epidemiological and trial evidence linking intake of SSB to cardiometabolic outcomes.

RECENT FINDINGS

The weight of the evidence from prospective cohort studies supports a strong positive association between intake of SSB and weight gain and risk type 2 diabetes (T2D) and coronary heart disease (CHD) that is independent of adiposity. Associations with stroke are less clear and suggestive of greater risk in women than men. Findings from short-term trials of SSB and markers of cardiometabolic risk including lipids, glucose, blood pressure, and inflammatory cytokines provide mechanistic support for associations with T2D and CHD. Putative underlying mechanisms include adverse glycemic effects and increased hepatic metabolism of fructose.

SUMMARY

Conclusive evidence from epidemiological studies and trials on markers of cardiometabolic risk support an etiologic role of SSB in relation to weight gain and risk of T2D and CHD that is independent of weight. Continued efforts to reduce intake of SSB should be encouraged to improve the cardiometabolic health of individuals and populations.

Modified Healthy Eating Index and Incidence of Metabolic Syndrome in Children and Adolescents: Tehran Lipid and Glucose Study

OBJECTIVE

To assess the relationship between modified healthy eating index (mHEI) with the development of metabolic syndrome (MetS) among children and adolescents.

STUDY DESIGN

Dietary data were collected using a food frequency questionnaire among 424 healthy subjects, aged 6-18 years. The components of mHEI were grains, vegetables and fruits, dairy, red to white meat ratio, butter, sweet snacks, sweetened beverages, salty snacks, and fast food. Multivariable logistic regression models were used to estimate the incidence of MetS after 3.6 years of follow-up in each quartile of the mHEI score, adjusted for baseline age, sex, total energy intake, physical activity, and body mass index.

RESULTS

The mean ± SD age and mHEI scores of participants were 13.6 ± 3.7 years and 55.9 ± 10.0, respectively, at baseline. MetS developed in 11% of the participants at the end of follow-up. After adjustment for confounders, the occurrences of MetS decreased in the highest quartile compared with the lowest quartile of the mHEI score (OR = 0.35, 95% CI 0.13-0.98, P for trend = .025). In addition, higher scores of mHEI components including fruits, salty snacks, and fast food were associated with lower risk of MetS.

CONCLUSIONS

Higher scores of mHEI as an indicator of diet quality may hinder the development of MetS among children and adolescents.

Associations of vegetable and fruit consumption with metabolic syndrome. A meta-analysis of observational studies

OBJECTIVE

To examine the associations of vegetable and/or fruit consumption with metabolic syndrome (MetS).

DESIGN

Meta-analysis of observational studies.

SETTING

The electronic databases of PubMed, Web of Science and EMBASE were searched up to September 2017 for observational studies concerning the associations of vegetable and/or fruit consumption with MetS. The pooled relative risk (RR) of MetS for the highest v. the lowest category of vegetable and/or fruit consumption, as well as their corresponding 95 % CI, were calculated.

RESULTS

A total of twenty-six observational studies (twenty cross-sectional, one case-control and five cohort studies) were included in the meta-analysis. Specifically, sixteen studies were related to vegetable consumption and the overall multivariable-adjusted RR evidenced a negative association between vegetable consumption and MetS (RR=0·89, 95 % CI 0·85, 0·93; P<0·001). For fruit consumption, sixteen studies were included and the overall multivariable-adjusted RR demonstrated that fruit consumption was inversely associated with MetS (RR=0·81, 95 % CI 0·75, 0·88; P<0·001). For vegetable and fruit consumption, eight studies were included; the overall multivariable-adjusted RR showed that vegetable and fruit consumption was also negatively associated with MetS (RR=0·75, 95 % CI 0·63, 0·90; P=0·002).

CONCLUSIONS

The existing evidence suggests that vegetable and/or fruit consumption is negatively associated with MetS. More well-designed prospective cohort studies are needed to elaborate the concerned issues further.

Diet Pattern and Respiratory Morbidity in the Atherosclerosis Risk in Communities Study

RATIONALE

Dietary intake is a potential risk factor for respiratory morbidity in adult populations. Few studies capture the effect of dietary patterns, representative of the combination of nutrients consumed, on self-reported respiratory morbidity in combination with objective measures of lung function.

OBJECTIVES

To evaluate patterns of dietary intake in relation to respiratory morbidity and objective measures of lung function in a U.S.

POPULATION

METHODS

The ARIC (Atherosclerosis Risk in Communities) study investigators enrolled 15,792 participants from four U.S. communities between 1987 and 1989 and collected data using a validated food frequency questionnaire to assess diet. Principal component analysis was applied, and patterns representative of "Western" and "Prudent" diets emerged. We investigated cross-sectional associations between dietary patterns and pulmonary assessments that included asthma and chronic obstructive pulmonary disease (COPD) diagnosis, respiratory symptoms, and lung function. Multivariable Poisson regression models included quintiles of dietary patterns and potential confounders. Interaction of dietary patterns with obesity, sex, and smoking status was assessed in relation to all outcomes.

RESULTS

Higher scores in the "Western" dietary pattern (quintile 5 vs. quintile 1) were associated with higher prevalence of COPD (prevalence ratio [PR], 1.62; 95% confidence ratio [CI], 1.33-1.97), wheeze (PR, 1.37; 95% CI, 1.11-1.69), cough (PR, 1.32; 95% CI, 1.32-1.59), and phlegm (PR, 1.27; 95% CI, 1.05-1.54) and lower percent predicted forced expiratory volume in 1 second (FEV1), percent predicted forced vital capacity (FVC), and FEV1/FVC ratio. Higher scores in the "Prudent" dietary pattern (quintile 5 vs. quintile 1) were associated with lower prevalence of COPD (PR, 0.82; 95% CI, 0.70-0.95) and cough (PR, 0.77; 95% CI, 0.67-0.89) and higher percent predicted FEV1 and FEV1/FVC ratio. The prevalence of asthma was not related to dietary intake.

CONCLUSIONS

A "Western" dietary pattern was associated with respiratory symptoms, lower lung function, and COPD in ARIC participants.

Nut consumption in relation to all-cause and cause-specific mortality: a meta-analysis 18 prospective studies

Several previous meta-analyses show a consistent inverse association between nut consumption and all-cause mortality, but the associations with cause-specific mortality remain uncertain. A recent meta-analysis on nut consumption and multiple health outcomes combined incidence and mortality outcomes across most of the analyses, which may have introduced heterogeneity across studies. We conducted an updated meta-analysis to evaluate the nut-mortality association. We searched PubMed and EMBASE and we contacted authors for additional data. The final analyses included 18 prospective studies. The random-effects summary RRs for high compared with low nut consumption were 0.81 (95% CI: 0.78-0.84) for all-cause mortality (18 studies with 81 034 deaths), 0.75 (95% CI: 0.71-0.79) for CVD mortality (17 studies with 20 381 deaths), 0.73 (95% CI: 0.67-0.80) for CHD mortality (14 studies with 10 438 deaths), 0.82 (95% CI: 0.73-0.91) for stroke mortality (13 studies with 4850 deaths) and 0.87 (95% CI: 0.80-0.93) for cancer mortality (11 studies 21 353 deaths). These results were broadly consistent within subgroups according to various study and population characteristics and within sensitivity analyses that took into account potential confounders. Peanut (5 studies) and tree nut (3 studies) consumption were similarly associated with mortality risks. Dose-response analyses suggested evidence for nonlinear associations between nut consumption and mortality (P-nonlinearity <0.001 for all outcomes except cancer mortality), with mortality risk levelling off at the consumption of about 3 servings per week (12 g d^-1). Our findings suggest that nut consumption is associated with reduced all-cause and cause-specific mortality, with the strongest reduction for CHD mortality. Both tree nuts and peanuts may lower mortality and most of the survival benefits may be achieved at a relative low level of nut consumption.

Effect of Dietary Sugar Intake on Biomarkers of Subclinical Inflammation: A Systematic Review and Meta-Analysis of Intervention Studies

It has been postulated that dietary sugar consumption contributes to increased inflammatory processes in humans, and that this may be specific to fructose (alone, in sucrose or in high-fructose corn syrup (HFCS)). Therefore, we conducted a meta-analysis and systematic literature review to evaluate the relevance of fructose, sucrose, HFCS, and glucose consumption for systemic levels of biomarkers of subclinical inflammation. MEDLINE, EMBASE, and Cochrane libraries were searched for controlled intervention studies that report the effects of dietary sugar intake on (hs)CRP, IL-6, IL-18, IL-1RA, TNF-&alpha;, MCP-1, sICAM-1, sE-selectin, or adiponectin. Included studies were conducted on adults or adolescents with &ge;20 participants and &ge;2 weeks duration. Thirteen studies investigating 1141 participants were included in the meta-analysis. Sufficient studies (&ge;3) to pool were only available for (hs)CRP. Using a random effects model, pooled effects of the interventions (investigated as mean difference (MD)) revealed no differences in (hs)CRP between fructose intervention and glucose control groups (MD: &minus;0.03 mg/L (95% CI: &minus;0.52, 0.46), I² = 44%). Similarly, no differences were observed between HFCS and sucrose interventions (MD: 0.21 mg/L (&minus;0.11, 0.53), I² = 0%). The quality of evidence was evaluated using Nutrigrade, and was rated low for these two comparisons. The limited evidence available to date does not support the hypothesis that dietary fructose, as found alone or in HFCS, contributes more to subclinical inflammation than other dietary sugars.

[Dietary patterns and metabolic syndrome components in women with excess weight 18 to 45 years old]

OBJECTIVE

To analyze the association between dietary patterns and metabolic syndrome (MS) components in adult women with excess weight.

MATERIAL AND METHODS

Cross-sectional study with anthropometric, dietary, biochemical and blood pressure data. Dietary patterns were identified by factor analysis and multiple logistic regression models were used to analyze associations.

RESULTS

The prevalence of altered glucose was 14.6%, of hypertriglyceridemia 40.4%, of altered concentration of high density lipoprotein cholesterol(HDLc) 45.0%, hypertension 4.6% and MS 30%. The pattern with high consumption of corn tortillas, meats and legumes, was associated with less possibility of hyperglycemia (OR= 0.62; 95%CI 0.39-0.98). The pattern with high consumption of sweet and salty snacks, milk, rice, soaps and pasta, was inversely associated with the possibility of low HDLc concentration (OR= 0.76; 95%CI 0.60-0.97).

CONCLUSIONS

A dietary pattern with greater consumption of legumes, meats and corn tortillas was associated with less possibility of having hyperglycemia.

Age and gender-specific distribution of metabolic syndrome components in East China: role of hypertriglyceridemia in the SPECT-China study

BACKGROUND

Chinese population are experiencing remarkably changes of economic and cultural environments. The present study was to examine the prevalence of metabolic syndrome (MetS) by age between genders and to investigate the current characteristics of MetS and its components in China.

METHODS

SPECT-China is a population-based cross-sectional survey on Chinese adults aged ≥18 years in East China. A total of 10,441 Chinese residents participated in anthropometric and laboratory measurements. Of these, 9969 subjects (females, 5868) were eligible for the data analysis reported here. Estimates of the prevalence of MetS and its components were calculated. Presence of MetS was defined based on the IDF/AHA harmonized criteria. MetS z-score was calculated to evaluate the degree of total metabolic disorder.

RESULTS

The age-standardized prevalence of the metabolic syndrome was 22.0% (21.9% in men and 22.0% in women). Unlike the continuous MetS rise with age in females, the MetS prevalence in males remained stable among 46-55, 56-65 and > 65 yrs. age groups (31.2%, 31.4%, 32.5%, p = 0.538). In the five components of MetS, contrary to the elevated BP and BG disorders, the frequency of TG disorders decreased with age in males (46.6%(46-55 yrs), 37.2% (56-65 yrs), 27.7%(> 65 yrs), p < 0.001). Multivariable logistic regression showed that in males, more TG disorders were associated with higher BMI, higher educational level and current nonsmoker. In the MetS subjects, the 3-factor combinations which included TG disorders decreased with age in both genders. The whole metabolic profile became better in older male MetS subjects, which was opposite to the female.

CONCLUSION

Our results showed a distinct age-related prevalence of MetS between genders in dramatically changed China, in which the TG disorders played an important role. More targeted measures need to be taken to meet the serious challenges of metabolic diseases.

TRIAL REGISTRATION

ChiCTR-ECS- 14005052 , Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China).

Dietary diversity score is associated with cardiovascular risk factors and serum adiponectin concentrations in patients with metabolic syndrome

Background

Metabolic syndrome is associated with cardio-metabolic risk factors and lipid abnormalities. Previous studies evaluated the dietary habits and nutrient intakes among patients with metabolic syndrome; however the association between metabolic risk factors and adiponectin with dietary diversity score (DDS) in patients with metabolic syndrome has not been evaluated yet. Therefore the aim of the current study was to evaluate these relationships among patients with metabolic syndrome.

Methods

One hundred sixty patients with metabolic syndrome were recruited in the study. The anthropometric parameters including weight, height, waist circumference and hip circumference were measured. Serum adiponectin concentration was measured by enzyme- linked immunosorbent assay method (ELISA). Lipid profile and fasting serum glucose concentrations (FSG) were also measured with enzymatic colorimetric methods. Blood pressure was also measured and DDS was calculated using the data obtained from food frequency questionnaire (FFQ).

Results

Subjects in lower DDS categorizes had significantly lower energy and fiber intake; whereas mean protein intake of subjects in the highest quartile was significantly higher than second quartile. Higher prevalence of obesity was also observed in the top quartiles (P < 0.001). Subjects in the lower quartiles had higher serum triglyceride concentrations and systolic blood pressure (SBP) values and lower serum adiponectin concentrations compared with subjects in higher DDS categorizes (P < 0.05). The prevalence of metabolic syndrome components among patients in lower DDS quartiles was significantly higher (P < 0.05).

Conclusion

Our study found a lower serum triglyceride and SBP and higher serum adiponectin concentrations in top quartiles of DDS. The findings clarify the possible preventive role of higher dietary diversity score against metabolic syndrome. However, for further confirming the findings, more studies are warranted.

Nonnutritive Sweeteners in Weight Management and Chronic Disease: A Review

OBJECTIVE

The objective of this review was to critically review findings from recent studies evaluating the effects of nonnutritive sweeteners (NNSs) on metabolism, weight, and obesity-related chronic diseases. Biologic mechanisms that may explain NNS effects will also be addressed.

METHODS

A comprehensive review of the relevant scientific literature was conducted.

RESULTS

Most cross-sectional and prospective cohort studies report positive associations between NNS consumption, body weight, and health conditions, including type 2 diabetes, cardiovascular disease, and nonalcoholic fatty liver disease. Although findings in cellular and rodent models suggest that NNSs have harmful effects on metabolic health, most randomized controlled trials in humans demonstrate marginal benefits of NNS use on body weight, with little data available on other metabolic outcomes.

CONCLUSIONS

NNS consumption is associated with higher body weight and metabolic disease in observational studies. In contrast, randomized controlled trials demonstrate that NNSs may support weight loss, particularly when used alongside behavioral weight loss support. Additional long-term, well-controlled intervention studies in humans are needed to determine the effects of NNSs on weight, adiposity, and chronic disease under free-living conditions.

Longitudinal association of metabolic syndrome and dietary patterns: A 13-year prospective population-based cohort study

BACKGROUND AND AIMS

Diet is a potential factor contributing to the development of the Metabolic Syndrome (MetS). This longitudinal study with repeated measurements of dietary intake was thus conducted to examine the longitudinal association between major dietary patterns and risk of MetS.

METHODS AND RESULTS

The study was conducted within the framework of the Isfahan Cohort Study (ICS), in which 1387 participants were followed from 2001 to 2013. Validated food frequency questionnaire, anthropometric measurements, blood pressure, fasting serum lipids and blood sugars were evaluated in three phases of the study. Mixed effect Logistic and Cumulative Logit regressions were applied to evaluate the longitudinal associations between dietary patterns change and MetS and number of MetS components. Three dietary patterns were identified: Healthy, Iranian and Western dietary patterns. After adjustment for potential confounders, the higher scores of Healthy diet were inversely associated with the risk of MetS and number of MetS components (OR: 0.50, 95% CI: 0.36-0.70, OR: 0.52, 95% CI: 0.39-0.70, respectively). The greater adherence to the Iranian diet was positively associated with the risk of MetS and number of MetS components (OR: 1.28, 95% CI: 1.01-1.65, OR: 1.45, 95% CI: 1.16-1.81, respectively). The Western dietary pattern did not show any significant associations.

CONCLUSION

Adherence to a Healthy diet was associated with lower risk of MetS even in a developing country setting. However, the Iranian diet was positively associated with the risk of MetS. These results may guide the development of improved preventive nutrition interventions in this adult population.

Reduction of the Oxidative Stress Status Using Steviol Glycosides in a Fish Model (Cyprinus carpio)

Steviol glycosides are sweetening compounds from the Stevia rebaudiana Bertoni plant. This product is considered safe for human consumption and was approved as a food additive by the Food and Drugs Administration (FDA) and European Food Safety Authority (EFSA). Its effects on the ecosystem have not been studied in depth; therefore, it is necessary to carry out ecotoxicological studies in organisms such as Cyprinus carpio. The present study aimed to evaluate the antioxidant activity by SGs on diverse tissues in C. carpio using oxidative stress (OS) biomarkers. To test the antioxidant activity, carps were exposed to four systems: (1) SGs free control, (2) CCl₄ 0.5 mL/kg, (3) SGs 1 g/L, and (4) CCl₄ 0.5 mL/kg + SGs 1 g/L at 96 h. The following biomarkers were analyzed: lipoperoxidation (LPX), hydroperoxide content (HPC), and protein carbonyl content (PCC), as well as antioxidant activity of superoxide dismutase (SOD) and catalase (CAT). It was found that both (3 and 4) systems' exposure decreases LPX, CHP, PCC, SOD, and CAT with respect to the CCl₄ system. The results of this study demonstrate that the concentrations of SGs used are not capable of generating oxidative stress and, on the contrary, would appear to induce an antioxidant effect.

Associations Between Nonnutritive Sweetener Intake and Metabolic Syndrome in Adults

OBJECTIVE

Individuals looking to improve their health or weight status often use nonnutritive sweeteners (NNS), yet NNS consumption has been associated with increased risk factors for metabolic syndrome (MetS). Most studies examining NNS only assess total intake using diet soda as a proxy for NNS consumption, without distinguishing potential risks associated with individual sweeteners. The objective of this cross-sectional investigation was to identify whether there were associations between NNS consumption (total or individual) and risk factors for MetS in adults (n = 125) from Southwest Virginia.

METHODS

Participants provided three 24-hour dietary recalls and blood pressure, waist circumference, fasting glucose, triglycerides, and high-density lipoprotein cholesterol were assessed. Linear regression models, adjusted for age, sex, caloric intake, dietary quality, and physical activity, examined associations between total and individual types of NNS with MetS and MetS risk factors.

RESULTS

Sixty-three participants were classified as NNS consumers and eighteen met the criteria for MetS. While no significant associations between MetS and NNS consumption were found, waist circumference was positively associated with total NNS, saccharin, sucralose, and acesulfame potassium, and both fasting glucose and triglyceride values were positively associated with total NNS and aspartame consumption.

CONCLUSION

While these cross-sectional data are consistent with previous work implicating NNS in development of MetS, additional research using randomized controlled trials is needed to clarify whether and how NNS in general or specific NNS might contribute to risk factors for MetS. This trial was registered at clinicaltrials.gov (NCT03364452).

A Healthy Beverage Consumption Pattern Is Inversely Associated with the Risk of Obesity and Metabolic Abnormalities in Korean Adults

As the use of beverages in diets is increasing, several studies have examined the effect of beverage consumption in human health. Thus, we aimed at identifying specific beverage patterns and determining their associations with obesity and metabolic syndrome (MetS) risk factors in Korean adults. Based on the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2012 data, 19,800 Korean adults (≥20 years) with a single 24-h dietary recall and health examination data were investigated. All beverage items consumed by participants were categorized into 15 beverage groups based on the KNHANES coding system. Three major beverage consumption patterns were identified according to factor analysis: (1) the "healthy beverage" (high intake of dairy products, 100% fruit/vegetable juices and low intake of alcoholic beverages); (2) the "sugar-sweetened beverage" (high intake of soda, sweetened coffee/tea, and fruit drink); and (3) the "unsweetened beverage" (high intake of unsweetened coffee) patterns. Multivariable logistic regression analyses were conducted to determine the odds of obesity (body mass index ≥25 kg/m²) and MetS (defined by National Cholesterol Education Program III [NCEP III]) for each beverage pattern after controlling for covariates. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for associations of the "healthy beverage" pattern with risks of obesity, abdominal obesity, and elevated triglycerides, fasting blood glucose (FBG), and blood pressure (BP) were 0.88 (0.79-0.98), 0.83 (0.74-0.92), 0.88 (0.78-0.99), 0.85 (0.79-0.98), and 0.81 (0.72-0.92), respectively. AORs (95% CIs) of associations of the "sugar-sweetened beverage" pattern with risks of abdominal obesity, elevated FBG and BP were 1.15 (1.03-1.30), 1.14 (1.01-1.29), and 1.18 (1.04-1.33), respectively. However, no associations were found between the "unsweetened beverage" pattern and any parameters examined. Intake of healthy beverages should be encouraged to reduce risks of obesity and metabolic abnormalities; however, individuals who consume sugar-sweetened beverages should be advised on the adverse effects of those beverages on the risk of obesity and MetS.

Current evidence on the association of the metabolic syndrome and dietary patterns in a global perspective

The metabolic syndrome (MetS) is a key indicator of two main causes of death worldwide: CVD and diabetes. The present paper aimed to perform a review of the population-based research on the association of dietary patterns and the MetS in terms of methodology and findings. For the purpose of the present study, a scoping literature review was conducted using MEDLINE and EMBASE databases and hand searching in Google Scholar. Thirty-nine population-based studies were selected. Most of these studies used the factor analysis method and the a priori dietary approach, which had been initially extracted via a posteriori methods such as using the Mediterranean dietary pattern. The main finding was that following the Mediterranean or similar 'healthy' pattern reduced risk of the MetS, while following a 'Western' pattern increased risk of the MetS. The methodological approach in determining the dietary pattern of a population, whether a priori or a posteriori, should be chosen based on the purpose of the research. Overall, evidence suggests a diet based on the components of the Mediterranean diet and the avoidance of the 'Western' diet can aid in preventing the MetS.

Meat Consumption and Risk of Metabolic Syndrome: Results from the Korean Population and a Meta-Analysis of Observational Studies

Many studies have reported harmful effects of red meat or processed meat on chronic diseases including cancer and diabetes, but epidemiological evidence for metabolic syndrome is limited and remains controversial. Therefore, we performed a meta-analysis of observational studies to assess the association between various meat consumption and risk of metabolic syndrome. The PubMed and ISI Web of Science databases were searched through June 2017, and further included unpublished results from Korea National Health and Nutrition Examination Survey 2012–2015, including 8387 Korean adults. Sixteen studies were suitable for meta-analysis, which included 19,579 cases among 76,111 participants. We used a random-effects model to calculate the pooled relative risks (RR) and 95% confidence intervals (CI). The pooled RR for metabolic syndrome of the highest versus lowest category of meat intake was 1.14 (95% CI: 1.05, 1.23) for total meat, 1.33 (95% CI: 1.01, 1.74) for red meat, 1.35 (95% CI: 1.18, 1.54) for processed meat, and 0.86 (95% CI: 0.76, 0.97) for white meat. All of these associations did not differ significantly by study design and adjustment factors. Our findings indicated that total, red, and processed meat intake is positively associated with metabolic syndrome, and white meat intake is inversely associated with metabolic syndrome.

A posteriori dietary patterns and metabolic syndrome in adults: a systematic review and meta-analysis of observational studies

OBJECTIVE

Observational studies reported potential associations between different dietary patterns and the risk of metabolic syndrome (MetS); however, a consistent perspective has not been established to date. The current systematic review and meta-analysis aimed to evaluate the relationship between a posteriori dietary patterns and MetS by pooling available data.

DESIGN

MEDLINE and EMBASE databases were searched for relevant articles published up to July 2015 with no time restriction and with English language restriction. Two independent reviewers completed study selection and data extraction. Random-effects models (DerSimonian-Laird method) were used to pool effect sizes of eligible studies. The potential sources of heterogeneity were assessed using the I2 statistic.

RESULTS

Nineteen papers that identified dietary patterns using an a posteriori method were selected and included in the meta-analysis. The 'Healthy/Prudent' dietary pattern was inversely associated with risk of MetS (OR=0·89; 95 % CI 0·84, 0·94, P=0·002). In contrast, the 'Unhealthy/Western' dietary pattern had a significant positive association with risk of MetS (OR=1·16; 95 % CI 1·11, 1·22, P<0·001).

CONCLUSIONS

Our findings provide evidence that greater adherence to a healthy/prudent dietary pattern is associated with a lower risk of MetS, while an unhealthy/Western dietary pattern is associated with increased risk of MetS. These data suggest that a diet based on healthy food choices is also beneficial for prevention of MetS.

Saccharin Increases Fasting Blood Glucose but Not Liver Insulin Resistance in Comparison to a High Fructose-Fed Rat Model

Recent data indicate that artificial sweeteners (AS) may have deleterious effects on glucose metabolism. The purpose of this study was to compare the effects of AS and the effects of a high fructose diet (HFrD) on glucose metabolism and insulin resistance (IR) in Sprague-Dawley (SD) rats. SD rats were fed either regular chow, chow with saccharin (Sac) (0.1 mg/mL) placed in their water, or HFrD for seven weeks. Glucose, insulin, and triglycerides (Tg) levels were measured upon completion. A homeostatic model assessment (HOMA)-IR index was used to determine insulin resistance. The liver was stained to detect signs of a fatty liver. Hepatic mRNA expression of glucose metabolism regulation genes, Srepb-1c (sterol regulatory element binding protein) and ChREB (α & β) (carbohydrate response element binding protein), as well as other glycolytic and lipogenic genes including glucose-6-phosphatase (G6pc), were considered IR markers. Both HFrD and Sac significantly increased fasting blood glucose levels compare to the control (140 ± 5 and 137 ± 6 vs. 118 ± 3 mg/dL, respectively, p < 0.05). However, only HFrD increased insulin secretion (0.99 ± 0.12 vs. 0.7 ± 0.1 and 0.6 ± 0.1 ug/L), Tg levels (420 ± 43 vs. 152 ± 20 and 127 ± 13 mg/dL), and the HOMA-IR index (3.4 ± 0.4 vs. 2.3 ± 0.36 and 2.13 ± 0.3) (HFrD vs. control and sac, p < 0.05). Fatty liver changes were only observed in HFrD fed rats. The expression of ChREB β, Srepb-1c, and G6pc mRNA were only significantly elevated (between 2-10 times folds, p < 0.05) in HFrD fed rats. Sac may increase fasting blood glucose but has no effect on liver insulin resistance.

Non-Nutritive Sweeteners in the Packaged Food Supply-An Assessment across 4 Countries

Increased interest among consumers in the reduction of dietary sugar intake has led to the wider availability of food products containing non-nutritive sweeteners (NNS). However, the extent to which NNS are currently being used by manufacturers to sweeten processed food and beverage products, and how NNS may be displacing added sugars as a sweetener is unknown. The current study utilized branded food composition databases from Australia, Mexico, New Zealand and the US to determine the percentage of processed food and beverage products for which there are nutrition data containing NNS and to compare total sugar density (g per 100 mL for beverages and g per 100 g for foods) between products with and without NNS. Ordinary least squares regression at the country-product level was performed to examine associations between presence of NNS and total sugar. Across all countries, 5% of products contained at least one NNS, with the highest prevalence among beverages (22%). Mexico had the highest percentage of products with NNS (11%), as compared to the United States (US) (4%), New Zealand (1%), and Australia (<1%). The presence of NNS was associated with lower mean total sugar density among beverages (range across countries: 7.5 to 8.7 g per 100 mL) and among foods (23.2 to 25.5 g per 100 g). Products with both added sugar ingredients and NNS had a lower overall mean total sugar density when compared to products containing only added sugar ingredients. Due to paucity of data on sales and market shares across these countries, our results do not reflect the extent to which consumers purchase NNS containing products. Continued monitoring of NNS in the food supply, extension of work from these data, and inclusion of market shares of products will be important as more countries introduce policies to reduce sugar.

Mindfulness Is Associated with the Metabolic Syndrome among Individuals with a Depressive Symptomatology

The Metabolic Syndrome (MetS) is a major public health burden. Dispositional mindfulness has recently been associated with eating disorders, being overweight, and could therefore be associated with the MetS. We aimed to examine in a cross-sectional design the relationship between mindfulness, the MetS, and its risk factors in a large sample of the adult general population and the influence of depressive symptomatology on this association. Adults participating in the NutriNet-Santé study who had completed the Five Facets Mindfulness Questionnaire and attended a clinical and biological examination were available for inclusion. Multivariable logistic regression models adjusted for socio-demographic and lifestyle factors were performed. A total of 17,490 individuals were included. Among individuals with a depressive symptomatology, those with higher mindfulness were less likely to have a MetS (OR: 0.73, 95% CI: 0.57–0.93), a high waist circumference, a low HDL-cholesterol level and an elevated fasting blood glucose level (all p <0.05). In those without depressive symptomatology, individuals with higher mindfulness were less likely to have a high waist circumference (p <0.01). In conclusion, higher mindfulness was associated with lower odds of developing a MetS only among individuals with a depressive symptomatology.

Do Coffee Polyphenols Have a Preventive Action on Metabolic Syndrome Associated Endothelial Dysfunctions? An Assessment of the Current Evidence

Epidemiologic studies from several countries have found that mortality rates associated with the metabolic syndrome are inversely associated with coffee consumption. Metabolic syndrome can lead to arteriosclerosis by endothelial dysfunction, and increases the risk for myocardial and cerebral infarction. Accordingly, it is important to understand the possible protective effects of coffee against components of the metabolic syndrome, including vascular endothelial function impairment, obesity and diabetes. Coffee contains many components, including caffeine, chlorogenic acid, diterpenes and trigonelline. Studies have found that coffee polyphenols, such as chlorogenic acids, have many health-promoting properties, such as antioxidant, anti-inflammatory, anti-cancer, anti-diabetes, and antihypertensive properties. Chlorogenic acids may exert protective effects against metabolic syndrome risk through their antioxidant properties, in particular toward vascular endothelial cells, in which nitric oxide production may be enhanced, by promoting endothelial nitric oxide synthase expression. These effects indicate that coffee components may support the maintenance of normal endothelial function and play an important role in the prevention of metabolic syndrome. However, results related to coffee consumption and the metabolic syndrome are heterogeneous among studies, and the mechanisms of its functions and corresponding molecular targets remain largely elusive. This review describes the results of studies exploring the putative effects of coffee components, especially in protecting vascular endothelial function and preventing metabolic syndrome.

Coffee Intake Decreases Risk of Postmenopausal Breast Cancer: A Dose-Response Meta-Analysis on Prospective Cohort Studies

Aim: A dose-response meta-analysis was conducted in order to summarize the evidence from prospective cohort studies regarding the association between coffee intake and breast cancer risk. Methods: A systematic search was performed in electronic databases up to March 2017 to identify relevant studies; risk estimates were retrieved from the studies and linear and non-linear dose-response analysis modelled by restricted cubic splines was conducted. A stratified and subgroup analysis by menopausal and estrogen/progesterone receptor (ER/PR) status, smoking status and body mass index (BMI) were performed in order to detect potential confounders. Results: A total of 21 prospective studies were selected either for dose-response, the highest versus lowest category of consumption or subgroup analysis. The dose-response analysis of 13 prospective studies showed no significant association between coffee consumption and breast cancer risk in the non-linear model. However, an inverse relationship has been found when the analysis was restricted to post-menopausal women. Consumption of four cups of coffee per day was associated with a 10% reduction in postmenopausal cancer risk (relative risk, RR 0.90; 95% confidence interval, CI 0.82 to 0.99). Subgroup analyses showed consistent results for all potential confounding factors examined. Conclusions: Findings from this meta-analysis may support the hypothesis that coffee consumption is associated with decreased risk of postmenopausal breast cancer.

Coffee Intake Decreases Risk of Postmenopausal Breast Cancer: A Dose-Response Meta-Analysis on Prospective Cohort Studies

Aim: A dose-response meta-analysis was conducted in order to summarize the evidence from prospective cohort studies regarding the association between coffee intake and breast cancer risk. Methods: A systematic search was performed in electronic databases up to March 2017 to identify relevant studies; risk estimates were retrieved from the studies and linear and non-linear dose-response analysis modelled by restricted cubic splines was conducted. A stratified and subgroup analysis by menopausal and estrogen/progesterone receptor (ER/PR) status, smoking status and body mass index (BMI) were performed in order to detect potential confounders. Results: A total of 21 prospective studies were selected either for dose-response, the highest versus lowest category of consumption or subgroup analysis. The dose-response analysis of 13 prospective studies showed no significant association between coffee consumption and breast cancer risk in the non-linear model. However, an inverse relationship has been found when the analysis was restricted to post-menopausal women. Consumption of four cups of coffee per day was associated with a 10% reduction in postmenopausal cancer risk (relative risk, RR 0.90; 95% confidence interval, CI 0.82 to 0.99). Subgroup analyses showed consistent results for all potential confounding factors examined. Conclusions: Findings from this meta-analysis may support the hypothesis that coffee consumption is associated with decreased risk of postmenopausal breast cancer.

Health Implications Associated with Aspartame Consumption: A Substantial Review

Aspartame, an artificial sweetening agent belongs to dipeptide chemical category with a very strong sweetening potential. Although research findings in humans and non-human primates have demonstrated numerous negative effects of aspartame (biochemical, histological, neurological, behavioral, genetic etc)., the status of aspartame is still debatable. Present manuscript is a critical review of the substantial research findings related to aspartame intake on different research models. Purpose of this review was to spread the awareness about adverse effect of aspartame intake to outline the occurrence of health issues among the population. The process of uptake, storage, compartmentalization and distribution of aspartame within the body is associated with metabolic disorders and various clinical conditions. Available research literature indicates that higher amount of aspartame ingestion should be monitored carefully to avoid health implication within society.

Soda Intake Is Directly Associated with Serum C-Reactive Protein Concentration in Mexican Women

Background

Soda intake is associated with an increased risk of cardiovascular disease. Consumption of diet sodas, often considered healthy alternatives to sodas, could also increase the likelihood of cardiovascular outcomes.

Objective

This study aims to evaluate the relation between soda and diet soda and biomarkers of cardiovascular risk.

Methods

We conducted a cross-sectional analysis among 825 Mexican women free of diabetes, cardiovascular disease, and cancer, and for whom serum concentrations of C-reactive protein (CRP), C-peptide, adiponectin, and leptin were available. Mean ± SD age was 45.9 ± 6.6 y, the majority of women were premenopausal (60.4%), and the prevalence of obesity was 35%. We estimated the adjusted percentage differences in biomarkers and 95% CIs by performing multiple linear regression models comparing categories of consumption for soda and diet soda adjusting for age, family history of heart disease, menopause, menopausal hormone therapy, socioeconomic status, region, smoking, physical activity, alcohol intake, and dietary patterns.

Results

In the entire study sample we observed a 50% higher serum CRP concentration in women in the highest soda intake quartile (median intake: 202.9 mL/d, IQR: 101.4, 304.3 mL/d) compared to those in the lowest (median intake: 11.8 mL/d, IQR: 0.0, 152.1 mL/d). After stratification by menopausal status, results remained significant only for premenopausal women. Premenopausal women in the highest quartile of soda intake had 56% higher CRP concentration relative to women in the lowest quartile. We observed no significant association with the other biomarkers. After further adjustment for body mass index, a potential mediator, results remained significant only for CRP. Diet soda consumption was not associated with any of the biomarkers.

Conclusions

Consumption of soda was associated with adverse levels in a biomarker of inflammation and cardiovascular risk, serum CRP, in Mexican women. These results add to the accumulating evidence on soda and cardiovascular risk. More research is necessary to understand the potential impact of artificially sweetened sodas.

Association of dietary patterns with continuous metabolic syndrome in children and adolescents; a nationwide propensity score-matched analysis: the CASPIAN-V study

OBJECTIVE

This study aims to determine the association of dietary patterns with metabolic syndrome (MetS) and its components in children and adolescents.

METHODS

This nationwide study was conducted in 2015 among 4200 students aged 7-18 years, who lived in 30 provinces in Iran. The analysis was conducted based on the propensity score using a matched case-control study design. Three dietary patterns were obtained conducting a principal component analysis with a varimax rotation on 16 dietary groups. Continuous MetS score was computed by standardizing the residuals (z-scores) of MetS components by regressing them according to age and sex. The gold standard diagnosis of MetS was considered based on the International Diabetes Federation criteria. Moreover, for the purpose of data analysis, matched logistics analysis was used.

RESULTS

The study participants consisted of 3843 children and adolescents (response rate 91.5%) with mean (SD) age of 12.45 (3.04) years. Totally 49.4% of students were girls and 71.4% lived in urban areas. Three dietary patterns were obtained: Healthy, Western, and Sweet. Prevalence of MetS was 5% (boy 5.5 and girl 4.5%). Results of multivariate analysis show that students with Sweet dietary patterns were at higher risk for abdominal obesity (OR 1.29; 95% CI 1.01-1.66), elevated blood pressure (OR 1.35; 95% CI 1.01-1.81) and MetS (OR 1.33; 95% CI 1.02-1.74). The two other dietary patterns were not associated with MetS and its components.

CONCLUSION

Sweet dietary pattern increase the risk of MetS and some its components in Iranian children and adolescents. This finding provides valuable information for effective preventive strategies of MetS based on diet rather than medication to maintain healthy lifestyle habits.

Dietary factors influence the association of cyclin D2 polymorphism rs11063069 with the risk of metabolic syndrome

The relationship of CCND2 gene variation, rs11063069 with metabolic syndrome (MetS) modulates by dietary factors but enough data are not available on this issue. So, the hypothesis, which assumes that dietary factors modulate the relationship of CCND2 polymorphisms with the risk of MetS was investigated in our study. Subjects of this nested case-control study were selected from participants of the Tehran Lipid and Glucose Study. Each case (n=974) was pair-matched individually with a control by age, sex and the follow-up duration. Dietary patterns were determined using factor analysis. CCND2 rs11063069 was genotyped by the ARMS-polymerase chain reaction analysis. Two dietary patterns were extracted: the healthy dietary pattern (HDP) and the Western dietary pattern; among G allele carriers, being in the highest quartiles of HDP score decreased risk of MetS (OR, Q1:3.01 [1.95-6.15], Q4:0.88 [0.39-1.78], P trend=.001), compared with those in the lowest quartile. In addition, the consumption of some vegetables, red-yellow vegetable (tomatoes, squash and carrots) and fruits by G allele carriers could decrease the risk of high fasting plasma glucose (P interaction=.003), low HDL-C (P interaction=.03) and high blood pressure (P interaction=.01) respectively. No significant interaction was observed in this study between nutrients (macronutrients, zinc, magnesium and iron) and CCND2 rs11063069 in relation to MetS or its components in this study. Our findings showed that by promoting adherence to HDP and increasing intake of some vegetables and fruits, the risk of MetS or its components reduced in G allele carriers; these associations were not observed in the AA genotype group.

Effect of dietary habits on the risk of metabolic syndrome: Yazd Healthy Heart Project

Objective

Metabolic syndrome (MetS) refers to a group of risk factors that increase the risk of cardiovascular mortality and morbidity. Dietary habits are among the most important risk factors for MetS. The current study aimed at assessing the effect of dietary habits on the risk of MetS in a 10-year follow-up study in central Iran.

Design

Cohort study.

Setting

Yazd, Iran.

Subjects

Participants aged 20–74 years without any history of MetS, who were originally recruited for Yazd Healthy Heart Project (YHHP) during 2005–2006, were revisited during 2015–2016. At phase I of YHHP, demographic data, anthropometric measurements, five components of MetS, biochemical tests and dietary habits were evaluated; and the same data were collected in phase II.

Results

A total of 1092 participants were eligible to be included in the present study. After follow-up, the 10-year cumulative incidence of MetS was 56·1 %. After adjustment for potential confounders, increased risk of MetS (hazard ratio; 95 % CI) was found in those who did not try to control their body weight (1·57; 1·06, 2·35), did not usually eat salad (1·91; 1·22, 3·00) and added salt to their food (1·57, 1·06, 2·33). These associations were stronger in men than in the total population after subgroup analysis, but were not present in women.

Conclusions

Dietary habits affect the risk of MetS in the Iranian population. Lifestyle interventions are needed to improve dietary habits to reduce the risk of MetS. Future studies are highly recommended to confirm our results in other populations.

Fasting Plasma Glucose, Self-Appraised Diet Quality and Depressive Symptoms: A US-Representative Cross-Sectional Study

Depression and type 2 diabetes (T2D) contribute significantly to global burden of disease and often co-occur. Underpinning type 2 diabetes is poor glycaemic control and glucose is also an obligatory substrate for brain metabolism, with potential implications for cognition, motivation and mood. This research aimed to examine the relationships between fasting plasma glucose and depressive symptoms in a large, population representative sample of US adults, controlling for other demographic and lifestyle behavioural risk factors. Using the 2013–2014 National Health and Nutrition Examination Survey (NHANES) data, this study first investigated the relationship between fasting plasma glucose and mental disorders at a population-level, accounting for demographic, health behavioural and weight-related factors known to co-occur with both type 2 diabetes and mental disorders. Depressive symptoms were derived from the 9-item Patient Health Questionnaire. Fasting plasma glucose was obtained through medical examination and demographic (age, household income, sex) and health characteristics (perceived diet quality, daily time sedentary) were self-reported. Body mass index was calculated from objectively measured height and weight. In the univariate model, higher fasting plasma glucose was associated with greater depressive symptoms among females (b = 0.24, 95% CI = 0.05, 0.43, p < 0.05), but not males. In the final fully adjusted model, the relationship between fasting plasma glucose and depressive symptoms was non-significant for both males and females. Of all independent variables, self-appraised diet quality was strongly and significantly associated with depressive symptoms and this remained significant when individuals with diabetes were excluded. Although diet quality was self-reported based on individuals’ perceptions, these findings are consistent with a role for poor diet in the relationship between fasting plasma glucose and depressive symptoms.

From Neighborhood to Genome: Three Decades of Nutrition-Related Research from the Atherosclerosis Risk in Communities Study

For 30 years, the Atherosclerosis Risk in Communities (ARIC) cohort study has examined the etiology and progression of atherosclerosis and atherosclerotic diseases.1 This research has evaluated variation in cardiovascular disease (CVD) risk in relation to age, race, gender, location and lifestyle factors, including diet. In this commentary, we describe ARIC research that illustrates an expanded view of the relationship between diet and health and suggest ways that future cohort studies may influence the direction of nutrition and dietetics practice.

Is there an association between artificial sweetener consumption and assisted reproduction outcomes?

Previous studies have suggested an association between high intake of sweetened beverages and a number of adverse health outcomes. In this cross-sectional study, we investigated the association between daily consumption of sweetened soft drinks or coffee and the outcome of intracytoplasmic sperm injection (ICSI) treatment. Patients (n = 524) were interviewed by a nutritionist before ICSI treatment, using a food frequency questionnaire. Regression analysis showed that consumption of ≥3 servings of regular soft drinks or any amount of diet soft drinks was associated with oocyte dysmorphism, diminished embryo quality on days 2 and 3 of culture, and a mild effect on blastocyst formation, implantation and pregnancy rate. Consumption of artificially sweetened coffee was negatively associated with embryo quality on days 2 and 3. However, consumption of coffee or soft drinks was not associated with the odds of live birth. Even so, patients should be advised about the potential negative effects of sugar and artificial sweeteners before attempting infertility treatment. This study is limited by the use of a non-validated food frequency questionnaire, lack of information on quantity of sweeteners consumed, and lack of data on glucose levels in blood serum or follicular fluid. Further investigation is warranted.