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Yang SL, Wu L, Huang HL, Zhang LL, Chen YX, Zhou S, Chen XX, Wang JF, Zhang CB, Bao ZJ. Diet and lifestyle behaviours simultaneously act on frailty: it is time to move the threshold of frailty prevention and control forward. BMC Public Health 2024; 24:1097. [PMID: 38643079 PMCID: PMC11032589 DOI: 10.1186/s12889-024-18639-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/17/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND To analyse the association among the simultaneous effects of dietary intake, daily life behavioural factors, and frailty outcomes in older Chinese women, we predicted the probability of maintaining physical robustness under a combination of different variables. METHODS The Fried frailty criterion was used to determine the three groups of "frailty", "pre-frailty", and "robust", and a national epidemiological survey was performed. The three-classification decision tree model was fitted, and the comprehensive performance of the model was evaluated to predict the probability of occurrence of different outcomes. RESULTS Among the 1,044 participants, 15.9% were frailty and 50.29% were pre-frailty; the overall prevalence first increased and then decreased with age, reaching a peak at 70-74 years of age. Through univariate analysis, filtering, and embedded screening, eight significant variables were identified: staple food, spices, exercise (frequency, intensity, and time), work frequency, self-feeling, and family emotions. In the three-classification decision tree, the values of each evaluation index of Model 3 were relatively average; the accuracy, recall, specificity, precision, and F1 score range were between 75% and 84%, and the AUC was also greater than 0.800, indicating excellent performance and the best interpretability of the results. Model 3 takes exercise time as the root node and contains 6 variables and 10 types, suggesting the impact of the comprehensive effect of these variables on robust and non-robust populations (the predicted probability range is 6.67-93.33%). CONCLUSION The combined effect of these factors (no exercise or less than 0.5 h of exercise per day, occasional exercise, exercise at low intensity, feeling more tired at work, and eating too many staple foods (> 450 g per day) are more detrimental to maintaining robustness.
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Affiliation(s)
- Shan-Lan Yang
- Department of Gerontology, Shanghai Key Laboratory of Clinical Geriatric Medicine, Research Center on Aging and Medicine, Huadong Hospital Affiliated to Fudan University, Fudan University, 200040, Shanghai, P. R. China
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, 200040, Shanghai, P. R. China
| | - Lei Wu
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 330006, Nanchang, P. R. China
| | - He-Lang Huang
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 330006, Nanchang, P. R. China
| | - Lang-Lang Zhang
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, 330006, Nanchang, P. R. China
| | - Yi-Xin Chen
- Department of Gerontology, Shanghai Key Laboratory of Clinical Geriatric Medicine, Research Center on Aging and Medicine, Huadong Hospital Affiliated to Fudan University, Fudan University, 200040, Shanghai, P. R. China
| | - Sheng Zhou
- Department of Gerontology, Shanghai Key Laboratory of Clinical Geriatric Medicine, Research Center on Aging and Medicine, Huadong Hospital Affiliated to Fudan University, Fudan University, 200040, Shanghai, P. R. China
| | - Xiu-Xiu Chen
- Department of Gerontology, Shanghai Key Laboratory of Clinical Geriatric Medicine, Research Center on Aging and Medicine, Huadong Hospital Affiliated to Fudan University, Fudan University, 200040, Shanghai, P. R. China
| | - Jiao-Feng Wang
- Department of Gerontology, Shanghai Key Laboratory of Clinical Geriatric Medicine, Research Center on Aging and Medicine, Huadong Hospital Affiliated to Fudan University, Fudan University, 200040, Shanghai, P. R. China
| | - Chao-Bao Zhang
- Department of Gerontology, Shanghai Key Laboratory of Clinical Geriatric Medicine, Research Center on Aging and Medicine, Huadong Hospital Affiliated to Fudan University, Fudan University, 200040, Shanghai, P. R. China.
| | - Zhi-Jun Bao
- Department of Gerontology, Shanghai Key Laboratory of Clinical Geriatric Medicine, Research Center on Aging and Medicine, Huadong Hospital Affiliated to Fudan University, Fudan University, 200040, Shanghai, P. R. China.
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, 200040, Shanghai, P. R. China.
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Park J, Kim OY. Macronutrients modified dietary intervention in the management of overweight/obese children and adolescents: a systematic review. Clin Exp Pediatr 2024; 67:191-200. [PMID: 37448128 PMCID: PMC10990656 DOI: 10.3345/cep.2023.00262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/02/2023] [Accepted: 07/10/2023] [Indexed: 07/15/2023] Open
Abstract
The prevalence of obesity in adults and children is rapidly increasing worldwide. Obesity is among the main causes of chronic diseases and various problems, including economic consequences and they can also be affected by genetic, environmental, psychological, and socioeconomic factors. Dietary modification is a well-known and important factor in weight control, in particular, dietary macronutrient composition, food selection, dietary patterns, and energy restriction can affect weight reduction. Therefore, this systematic review aims to provide basic evidence for identifying the optimal macronutrient composition for managing obesity in Korean children and adolescents. We searched literature through an international database, studies were selected using our eligibility criteria and quality was assessed via a risk of bias tool. In our results, several studies have demonstrated that dietary macronutrient modifications affect body composition and metabolic markers in children and adolescents. In contrast, hypocaloric diets, regardless of macronutrient composition, are reportedly effective for weight loss in obese children. However, these findings were based on intervention studies that examined the association between dietary macronutrient composition and obesity in non-Korean children and adolescents. Therefore, in the future, more intervention studies are needed to elucidate this relationship and evidence between macronutrients and obesity in Korean children and adolescents.
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Affiliation(s)
- Jihyun Park
- Clinical Nutrition Major, Department of Health Science, Graduate School of Dong-A University, Busan, Korea
| | - Oh Yoen Kim
- Clinical Nutrition Major, Department of Health Science, Graduate School of Dong-A University, Busan, Korea
- Department of Food Science and Nutrition, Dong-A University, Busan, Korea
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Li DX, Yin LP, Song YQ, Shao NN, Zhu H, He CS, Sun JJ. KCNQ1 rs2237895 gene polymorphism increases susceptibility to type 2 diabetes mellitus in Asian populations. World J Diabetes 2024; 15:552-564. [PMID: 38591089 PMCID: PMC10999049 DOI: 10.4239/wjd.v15.i3.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/13/2023] [Accepted: 02/02/2024] [Indexed: 03/15/2024] Open
Abstract
BACKGROUND The association of single nucleotide polymorphism of KCNQ1 gene rs2237895 with type 2 diabetes mellitus (T2DM) is currently controversial. It is unknown whether this association can be gene realized across different populations. AIM To determine the association of KCNQ1 rs2237895 with T2DM and provide reliable evidence for genetic susceptibility to T2DM. METHODS We searched PubMed, Embase, Web of Science, Cochrane Library, Medline, Baidu Academic, China National Knowledge Infrastructure, China Biomedical Liter-ature Database, and Wanfang to investigate the association between KCNQ1 gene rs2237895 and the risk of T2DM up to January 12, 2022. Review Manager 5.4 was used to analyze the association of the KCNQ1 gene rs2237895 polymorphism with T2DM and to evaluate the publication bias of the selected literature. RESULTS Twelve case-control studies (including 11273 cases and 11654 controls) met our inclusion criteria. In the full population, allelic model [odds ratio (OR): 1.19; 95% confidence interval (95%CI): 1.09-1.29; P < 0.0001], recessive model (OR: 1.20; 95%CI: 1.11-1.29; P < 0.0001), dominant model (OR: 1.27. 95%CI: 1.14-1.42; P < 0.0001), and codominant model (OR: 1.36; 95%CI: 1.15-1.60; P = 0.0003) (OR: 1.22; 95%CI: 1.10-1.36; P = 0.0002) indicated that the KCNQ1 gene rs2237895 polymorphism was significantly correlated with susceptibility to T2DM. In stratified analysis, this association was confirmed in Asian populations: allelic model (OR: 1.25; 95%CI: 1.13-1.37; P < 0.0001), recessive model (OR: 1.29; 95%CI: 1.11-1.49; P = 0.0007), dominant model (OR: 1.35; 95%CI: 1.20-1.52; P < 0.0001), codominant model (OR: 1.49; 95%CI: 1.22-1.81; P < 0.0001) (OR: 1.26; 95%CI: 1.16-1.36; P < 0.0001). In non-Asian populations, this association was not significant: Allelic model (OR: 1.06, 95%CI: 0.98-1.14; P = 0.12), recessive model (OR: 1.04; 95%CI: 0.75-1.42; P = 0.83), dominant model (OR: 1.06; 95%CI: 0.98-1.15; P = 0.15), codominant model (OR: 1.08; 95%CI: 0.82-1.42; P = 0.60. OR: 1.15; 95%CI: 0.95-1.39; P = 0.14). CONCLUSION KCNQ1 gene rs2237895 was significantly associated with susceptibility to T2DM in an Asian population. Carriers of the C allele had a higher risk of T2DM. This association was not significant in non-Asian populations.
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Affiliation(s)
- Dong-Xu Li
- First Clinical Medical College, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Li-Ping Yin
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Yu-Qi Song
- First Clinical Medical College, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Nan-Nan Shao
- School of Clinical Medicine, Anhui Medical University, Hefei 230031, Anhui Province, China
| | - Huan Zhu
- First Clinical Medical College, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Chen-Sen He
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Jiang-Jie Sun
- School of Health Care Management, Anhui Medical University, Hefei 230032, Anhui Province, China
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Pan Y, Su J, Qian S, Xu G. Impact of habitual intake of glucosamine, fresh fruit, and tea on the risk of urolithiasis: A two-sample Mendelian randomization study. Medicine (Baltimore) 2024; 103:e37254. [PMID: 38428885 PMCID: PMC10906626 DOI: 10.1097/md.0000000000037254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/23/2024] [Indexed: 03/03/2024] Open
Abstract
Dietary patterns have a significant impact on the occurrence of urolithiasis. This study aimed to investigate the causal relationships between the consumption of glucosamine, fresh fruits, and tea, and the predisposition to urinary stones using a Mendelian randomization (MR) approach. Genetic proxies for these dietary factors were obtained from the UK Biobank, while the summary data for urolithiasis genome-wide association analyses were sourced from the FinnGen consortium. Five MR methodologies, namely inverse variance weighted (IVW), MR-Egger regression, weighted median, weighted mode, and simple mode, were employed in the analysis. To validate the findings, sensitivity evaluations such as the MR-PRESSO disruption test and Cochran Q test for heterogeneity were performed. The IVW method showed that glucosamine consumption had a strong inverse association with urolithiasis risk (Odds Ratio [OR] = 0.006, 95% Confidence Interval [CI] 0.0001-0.287, P = .009), surpassing the associations of fresh fruits (OR = 0.464, 95% CI 0.219-0.983, P = .045) and tea (OR = 0.550, 95% CI 0.345-0.878, P = .012). These findings were consistent when verified using alternative MR techniques, and the sensitivity analyses further supported their credibility. The results of this MR analysis demonstrate that regular consumption of glucosamine, fresh fruits, and tea is inversely correlated with the risk of developing urolithiasis.
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Affiliation(s)
- Yongdong Pan
- Department of Pediatric Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jingyi Su
- Department of Pediatric Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Subo Qian
- Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Guofeng Xu
- Department of Pediatric Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Xiong J, Sun C, Wen X, Hou Y, Liang M, Liu J, Wei Q, Yuan F, Peng C, Chen Y, Chang Y, Wang C, Zhang J. miR-548ag promotes DPP4 expression in hepatocytes through activation of TLR(7/8)/NF-κB pathway. Int J Obes (Lond) 2024:10.1038/s41366-024-01504-8. [PMID: 38424257 DOI: 10.1038/s41366-024-01504-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 02/02/2024] [Accepted: 02/19/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE In our previous study, we identified a notable increase in miR-548ag content after obesity, which contributes to the progression of Type 2 diabetes Mellitus(T2DM) through the up-regulation of Dipeptidyl Peptidase-4(DPP4) expression within the liver. However, the precise molecular mechanisms underlying the upregulation of DPP4 by miR-548ag remain elusive. Mature miRNAs rich in GU sequences can activate the TLR(7/8)/NF-κB signalling pathway, which transcriptionally activates DPP4 expression. Notably, the proportion of GU sequences in hsa-miR-548ag was found to be 47.6%. The study proposes a hypothesis suggesting that miR-548ag could potentially increase DPP4 expression in hepatocytes by activating the TLR(7/8)/NF-κB signalling pathway. METHODS Male C57BL/6J mice were fed normal chow diet (NCD, n = 16) or high-fat diet (HFD, n = 16) for 12 weeks. For a duration of 6 weeks, NCD mice received intraperitoneal injections of a miR-548ag mimic, while HFD mice and db/db mice (n = 16) were administered intraperitoneal injections of a miR-548ag inhibitor. qRT-PCR and Western Blot were used to detect the expression level of miR-548ag, DPP4 and the activation of TLR(7/8)/NF-κB signalling pathway. HepG2 and L02 cells were transfected with miR-548ag mimic, miR-548ag inhibitor, TLR7/8 interfering fragment, and overexpression of miR-548ag while inhibiting TLR7/8, respectively. RESULTS (1) We observed elevated levels of miR-548ag in the serum, adipose tissue, and liver of obese mice, accompanied by an upregulation of TLR7/8, pivotal protein in the NF-κB pathway, and DPP4 expression in the liver. (2) miR-548ag promotes DPP4 expression in hepatocytes via the TLR(7/8)/NF-κB signalling pathway, resulting in a reduction in the glucose consumption capacity of hepatocytes. (3) The administration of a miR-548ag inhibitor enhanced glucose tolerance and insulin sensitivity in db/db mice. CONCLUSIONS MiR-548ag promotes the expression of DPP4 in hepatocytes by activating the TLR(7/8)/NF-κB signalling pathway. MiR-548ag may be a potential target for the treatment of T2DM.
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Affiliation(s)
- Jianyu Xiong
- Medical College of Shihezi University, Bei-Er-Lu, Shihezi, 832000, Xinjiang, China
| | - Chaoyue Sun
- Medical College of Shihezi University, Bei-Er-Lu, Shihezi, 832000, Xinjiang, China
- Laboratory of Xinjiang Endemic and Ethic Diseases, Shihezi University, Shihezi, 832000, Xinjiang, China
| | - Xin Wen
- Medical College of Shihezi University, Bei-Er-Lu, Shihezi, 832000, Xinjiang, China
- Laboratory of Xinjiang Endemic and Ethic Diseases, Shihezi University, Shihezi, 832000, Xinjiang, China
| | - Yanting Hou
- Medical College of Shihezi University, Bei-Er-Lu, Shihezi, 832000, Xinjiang, China
- Laboratory of Xinjiang Endemic and Ethic Diseases, Shihezi University, Shihezi, 832000, Xinjiang, China
| | - Maodi Liang
- Medical College of Shihezi University, Bei-Er-Lu, Shihezi, 832000, Xinjiang, China
- Laboratory of Xinjiang Endemic and Ethic Diseases, Shihezi University, Shihezi, 832000, Xinjiang, China
| | - Jie Liu
- Medical College of Shihezi University, Bei-Er-Lu, Shihezi, 832000, Xinjiang, China
- Laboratory of Xinjiang Endemic and Ethic Diseases, Shihezi University, Shihezi, 832000, Xinjiang, China
| | - Qianqian Wei
- Medical College of Shihezi University, Bei-Er-Lu, Shihezi, 832000, Xinjiang, China
- Laboratory of Xinjiang Endemic and Ethic Diseases, Shihezi University, Shihezi, 832000, Xinjiang, China
| | - Fangyuan Yuan
- Medical College of Shihezi University, Bei-Er-Lu, Shihezi, 832000, Xinjiang, China
- Laboratory of Xinjiang Endemic and Ethic Diseases, Shihezi University, Shihezi, 832000, Xinjiang, China
| | - Chaoling Peng
- Medical College of Shihezi University, Bei-Er-Lu, Shihezi, 832000, Xinjiang, China
- Laboratory of Xinjiang Endemic and Ethic Diseases, Shihezi University, Shihezi, 832000, Xinjiang, China
| | - Yao Chen
- Medical College of Shihezi University, Bei-Er-Lu, Shihezi, 832000, Xinjiang, China
- Laboratory of Xinjiang Endemic and Ethic Diseases, Shihezi University, Shihezi, 832000, Xinjiang, China
| | - Yongsheng Chang
- Medical College of Shihezi University, Bei-Er-Lu, Shihezi, 832000, Xinjiang, China.
- Department of Physiology and Pathophysiology, Tianjin Medical University, Tianjin, 300000, China.
| | - Cuizhe Wang
- Medical College of Shihezi University, Bei-Er-Lu, Shihezi, 832000, Xinjiang, China.
- Laboratory of Xinjiang Endemic and Ethic Diseases, Shihezi University, Shihezi, 832000, Xinjiang, China.
| | - Jun Zhang
- Medical College of Shihezi University, Bei-Er-Lu, Shihezi, 832000, Xinjiang, China.
- Laboratory of Xinjiang Endemic and Ethic Diseases, Shihezi University, Shihezi, 832000, Xinjiang, China.
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Greenwood H, Barnes K, Ball L, Glasziou P. Comparing dietary strategies to manage cardiovascular risk in primary care: a narrative review of systematic reviews. Br J Gen Pract 2024:BJGP.2022.0564. [PMID: 38373850 PMCID: PMC10904132 DOI: 10.3399/bjgp.2022.0564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 09/19/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Nutrition care in general practice is crucial for cardiovascular disease (CVD) prevention and management, although comparison between dietary strategies is lacking. AIM To compare the best available (most recent, relevant, and high-quality) evidence for six dietary strategies that are effective for primary prevention/absolute risk reduction of CVD. DESIGN AND SETTING A pragmatic narrative review of systematic reviews of randomised trials focused on primary prevention of cardiovascular events. METHOD Studies about: 1) adults without a history of cardiovascular events; 2) target dietary strategies postulated to reduce CVD risk; and 3) direct cardiovascular or all-cause mortality outcomes were included. Six dietary strategies were examined: energy deficit, Mediterranean-like diet, sodium reduction (salt reduction and substitution), the Dietary Approaches to Stop Hypertension (DASH) diet, alcohol reduction, and fish/fish oil consumption. Reviews were selected based on quality, recency, and relevance. Quality and certainty of evidence was assessed using GRADE. RESULTS Twenty-five reviews met inclusion criteria; eight were selected as the highest quality, recent, and relevant. Three dietary strategies showed modest, significant reductions in cardiovascular events: energy deficit (relative risk reduction [RRR] 30%, 95% confidence interval [CI] = 13 to 43), Mediterranean-like diet (RRR 40%, 95% CI = 20 to 55), and salt substitution (RRR 30%, 95% CI = 7 to 48). Still, some caveats remain on the effectiveness of these dietary strategies. Salt reduction, DASH diet, and alcohol reduction showed small, significant reductions in blood pressure, but no reduction in cardiovascular events. Fish/fish oil consumption showed little or no effect; supplementation of fish oil alone showed small reductions in CVD events. CONCLUSION For primary prevention, energy deficit, Mediterranean-like diets, and sodium substitution have modest evidence for risk reduction of CVD events. Strategies incorporated into clinical nutrition care should ensure guidance is person centred and tailored to clinical circumstances.
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Affiliation(s)
- Hannah Greenwood
- Institute for Evidence-Based Healthcare, Faculty of Health Science & Medicine, Bond University, Gold Coast
| | - Katelyn Barnes
- Centre for Community Health and Wellbeing, University of Queensland, Brisbane; senior research officer, Academic Unit of General Practice, ACT Health Directorate; School of Medicine and Psychology, The Australian National University, Canberra
| | - Lauren Ball
- Centre for Community Health and Wellbeing, University of Queensland, Brisbane
| | - Paul Glasziou
- Institute for Evidence-Based Healthcare, Faculty of Health Science & Medicine, Bond University, Gold Coast
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Liu Z, Huang H, Xie J, Hou L, Xu C. Different dietary carbohydrate component intakes and long-term outcomes in patients with NAFLD: results of longitudinal analysis from the UK Biobank. Nutr J 2023; 22:67. [PMID: 38062487 PMCID: PMC10704713 DOI: 10.1186/s12937-023-00897-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND This study aimed to investigate the association between the intake of different dietary carbohydrate components and the long-term outcomes of non-alcoholic fatty liver disease (NAFLD). METHODS We used prospective data from 26,729 NAFLD participants from the UK Biobank cohort study. Dietary information was recorded by online 24-hour questionnaires (Oxford WebQ). Consumption of different carbohydrate components was calculated by the UK Nutrient Databank Food Composition Table. Cox proportional hazards models were used to estimate the adjusted hazard ratio (HR) and 95% confidence interval (CI). A substitution model was used to estimate the associations of hypothetical substitution for free sugars. RESULTS During a median of 10.5 (IQR: 10.2-11.2) years and a total of 280,135 person-years of follow-up, 310 incident end-stage liver disease (ESLD) and 1750 deaths were recorded. Compared with the lowest quartile, the multi-adjusted HRs (95% CI) of incident ESLD in the highest quartile were 1.65 (1.14-2.39) for free sugars, 0.51 (0.35-0.74) for non-free sugars, and 0.55 (0.36-0.83) for fiber. For overall mortality, the multi-adjusted HRs (95% CI) in the highest quartile were 1.21 (1.04-1.39) for free sugars, 0.79 (0.68-0.92) for non-free sugars, and 0.79 (0.67-0.94) for fiber. Substituting free sugars with equal amounts of non-free sugars, starch or fiber was associated with a lower risk of incident ESLD and overall mortality. CONCLUSIONS A lower intake of free sugars and a higher intake of fiber are associated with a lower incidence of ESLD and overall mortality in NAFLD patients. These findings support the important role of the quality of dietary carbohydrates in preventing ESLD and overall mortality in NAFLD patients.
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Affiliation(s)
- Zhening Liu
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China
| | - Hangkai Huang
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China
| | - Jiarong Xie
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China
- Department of Gastroenterology, Ningbo First Hospital, Ningbo, 315010, China
- Zhejiang Provincial Clinical Research Center for Digestive Diseases, Hangzhou, 310003, China
| | - Linxiao Hou
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China
| | - Chengfu Xu
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, 310003, China.
- Zhejiang Provincial Clinical Research Center for Digestive Diseases, Hangzhou, 310003, China.
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Roba AA, Assefa N, Roba KT, Dessie Y, Hamler E, Fawzi W. Association between dietary protein intake, diet quality and diversity, and obesity among women of reproductive age in Kersa, Ethiopia. Front Public Health 2023; 11:1258515. [PMID: 38035304 PMCID: PMC10682820 DOI: 10.3389/fpubh.2023.1258515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/25/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction In Ethiopia, there is limited evidence on the effect of dietary protein intake on women's body mass index. Therefore, this study investigated the association between dietary protein intake, diet quality, and overweight and obesity. Methods A cross-sectional study was conducted among 897 women of reproductive age. Food frequency questionnaires were used to assess 7-day dietary intake. It was converted into protein and other macro-nutrient intakes, Minimum Dietary Diversity for Women, and Global Dietary Quality Score. Body Mass Index (BMI) of overweight & obese women were defined as ≥25 kg/m2. An adjusted odds ratio with a 95% confidence interval (in a multivariate logistic regression model) was used to determine the strength of the association between BMI and dietary protein intake, adjusting for potential confounders. Results The median dietary protein intake was 41.3 (32.9, 52.6) grams/day or 0.8 (0.6, 1.0) grams/kilogram of body weight/day. The prevalence of overweight and obesity was 7.5% (n = 67). Only 220 (24.5%) women could meet the recommended minimum dietary diversity of five or more food groups out of 10 per day. Furthermore, only 255 (28.4%) women were found to have a low risk for nutrient adequacy. Interestingly, women who consumed moderate dietary protein had a significantly lower likelihood of being overweight or obese, with AOR of 0.21 (95% CI 0.10-0.48). Similarly, those who consumed a high amount of protein had even lower odds, with AOR of 0.03 (95% CI 0.01-0.14), compared to those who consumed a low amount of dietary protein. Age of 40-49 years (AOR = 3.33, 95% CI 1.24-8.95) compared to 18-29 years, non-farmers (AOR = 3.21, 95% CI 1.55-6.62), higher consumption of food from unhealthy groups (AOR = 1.30, 95% CI 1.05-1.61), and high fat intake (AOR = 1.06, 95% CI 1.04-1.09) were associated with overweight and obesity. Conclusions and recommendations The study indicated an inverse relationship between BMI and dietary protein intake. It also revealed that women who consumed foods from unhealthy or unhealthy when consumed in excessive amounts were more likely to be overweight or obese. Increasing dietary protein consumption can help reproductive-age women reduce the odds of obesity and overweight. Furthermore, community-based educational programs, policy changes, and healthcare services can support this effort.
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Affiliation(s)
- Aklilu Abrham Roba
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
- Faculty of Health Science, Erciyes University, Kayseri, Türkiye
| | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Kedir Teji Roba
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Yadeta Dessie
- College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Elena Hamler
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Wafaie Fawzi
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Reynolds AN, Kahleova H, Uusitupa M, Hermansen K, Aas AM, Schwab U, Lean MEJ, Pfeiffer A, Salas-Salvadó J, Mann JI. Not all very-low-carbohydrate diets are created equal. Reply to Conte C, Camajani E, Lai A, Caprio M [letter]. Diabetologia 2023; 66:1754-1755. [PMID: 37407870 DOI: 10.1007/s00125-023-05963-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/15/2023] [Indexed: 07/07/2023]
Affiliation(s)
- Andrew N Reynolds
- Department of Medicine, University of Otago, Dunedin, New Zealand.
- Edgar Diabetes and Obesity Research Centre, University of Otago, Dunedin, New Zealand.
| | - Hana Kahleova
- Physicians Committee for Responsible Medicine, Washington, DC, USA
- Institute for Clinical and Experimental Medicine, Diabetes Centre, Praha, Czech Republic
| | - Matti Uusitupa
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Kjeld Hermansen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Anne-Marie Aas
- Division of Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ursula Schwab
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Human Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Michael E J Lean
- Department of Human Nutrition, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Andreas Pfeiffer
- Department of Endocrinology Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jordi Salas-Salvadó
- Departament de Bioquímica i Biotecnologia, Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain
| | - Jim I Mann
- Department of Medicine, University of Otago, Dunedin, New Zealand
- Edgar Diabetes and Obesity Research Centre, University of Otago, Dunedin, New Zealand
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Aas AM, Axelsen M, Churuangsuk C, Hermansen K, Kendall CWC, Kahleova H, Khan T, Lean MEJ, Mann JI, Pedersen E, Pfeiffer A, Rahelić D, Reynolds AN, Risérus U, Rivellese AA, Salas-Salvadó J, Schwab U, Sievenpiper JL, Thanopoulou A, Uusitupa EM. Evidence-based European recommendations for the dietary management of diabetes. Diabetologia 2023; 66:965-985. [PMID: 37069434 DOI: 10.1007/s00125-023-05894-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Diabetes management relies on effective evidence-based advice that informs and empowers individuals to manage their health. Alongside other cornerstones of diabetes management, dietary advice has the potential to improve glycaemic levels, reduce risk of diabetes complications and improve health-related quality of life. We have updated the 2004 recommendations for the nutritional management of diabetes to provide health professionals with evidence-based guidelines to inform discussions with patients on diabetes management, including type 2 diabetes prevention and remission. To provide this update we commissioned new systematic reviews and meta-analyses on key topics, and drew on the broader evidence available. We have strengthened and expanded on the previous recommendations to include advice relating to dietary patterns, environmental sustainability, food processing, patient support and remission of type 2 diabetes. We have used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to determine the certainty of evidence for each recommendation based on findings from the commissioned and identified systematic reviews. Our findings indicate that a range of foods and dietary patterns are suitable for diabetes management, with key recommendations for people with diabetes being largely similar for those for the general population. Important messages are to consume minimally processed plant foods, such as whole grains, vegetables, whole fruit, legumes, nuts, seeds and non-hydrogenated non-tropical vegetable oils, while minimising the consumption of red and processed meats, sodium, sugar-sweetened beverages and refined grains. The updated recommendations reflect the current evidence base and, if adhered to, will improve patient outcomes.
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Miksza U, Adamska-Patruno E, Bauer W, Fiedorczuk J, Czajkowski P, Moroz M, Drygalski K, Ustymowicz A, Tomkiewicz E, Gorska M, Kretowski A. Obesity-related parameters in carriers of some BDNF genetic variants may depend on daily dietary macronutrients intake. Sci Rep 2023; 13:6585. [PMID: 37085692 PMCID: PMC10121660 DOI: 10.1038/s41598-023-33842-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/19/2023] [Indexed: 04/23/2023] Open
Abstract
Some common single-nucleotide polymorphisms of the brain-derived neurotrophic factor (BDNF) gene have been associated not only with the neurodegenerative diseases but also with some eating disorders. The aim of this study was to assess the possible differences in the obesity-related and glucose metabolism parameters between some BDNF genotypes', that may depend on the daily energy and macronutrients intake. In 484 adult participants we performed the anthropometric measurements, body composition analysis, and body fat distribution. The daily dietary intake was assessed using the 3-day food intake diaries. Blood glucose and insulin concentrations were measured at fasting and during oral glucose tolerance tests. Moreover, the visceral adipose tissue/subcutaneous adipose tissue (VAT/SAT) ratio and homeostatic model assessment of insulin resistance were calculated. We noted that participants carrying the GG genotype had lower skeletal muscle mass and fat free mass (FFM) when carbohydrate intake was > 48%, whereas they presented higher fat-free mass (FFM), and surprisingly higher total cholesterol and LDL-C concentrations when daily fiber intake was > 18 g. Moreover, in these subjects we noted higher waist circumference, BMI, and fasting glucose and insulin concentrations, when > 18% of total daily energy intake was delivered from proteins, and higher VAT content and HDL-C concentrations when > 30% of energy intake was derived from dietary fat. Our results suggest that glucose homeostasis and obesity-related parameters in carriers of some common variants of BDNF gene, especially in the GG (rs10835211) genotype carriers, may differ dependently on daily energy, dietary macronutrients and fiber intake.
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Affiliation(s)
- Urszula Miksza
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland.
- Clinical Research Support Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland.
| | - Edyta Adamska-Patruno
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland.
- Clinical Research Support Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland.
| | - Witold Bauer
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Joanna Fiedorczuk
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Przemyslaw Czajkowski
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Monika Moroz
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Krzysztof Drygalski
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Andrzej Ustymowicz
- Department of Radiology, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Elwira Tomkiewicz
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Maria Gorska
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
| | - Adam Kretowski
- Department of Nutriomics, Clinical Research Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
- Clinical Research Support Centre, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, Marii Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland
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12
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Lewandowski S, Neale E, D'Arcy E, Hodge AM, Schoenaker DAJM. Quality of low-carbohydrate diets among Australian post-partum women: Cross-sectional analysis of a national population-based cohort study. MATERNAL & CHILD NUTRITION 2023:e13502. [PMID: 36938942 DOI: 10.1111/mcn.13502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/17/2023] [Accepted: 03/01/2023] [Indexed: 03/21/2023]
Abstract
Low-carbohydrate diets (LCDs) are popular among people attempting weight loss and recommended for pregnant women with gestational diabetes (GDM), but they may increase health risks if nutritionally inadequate. We aimed to describe the dietary intake of post-partum women according to their relative carbohydrate intake, overall, and among women attempting weight loss or diagnosed with GDM in their recent pregnancy. This cross-sectional population-based cohort study included 2093 post-partum women aged 25-36 years who participated in the Australian Longitudinal Study on Women's Health. Dietary intake was assessed using a validated food frequency questionnaire. Relative carbohydrate intake was determined using a previously developed LCD score. Data were weighted to account for oversampling of women from rural/remote areas. More than half of women (n[weighted] = 1362, 66.3%) were trying to lose weight, and 4.6% (n[weighted]=88) had GDM in their recent pregnancy. Women with the lowest relative carbohydrate intake (LCD score quartile 4) consumed 36.8% of total energy intake from carbohydrates, and had a lower intake of refined grains, whole grains, fruit and fruit juice, and a higher intake of red and processed meat, compared with women with the highest relative carbohydrate intake (quartile 1). Different food groups, both healthy and unhealthy, were restricted depending on whether women were attempting weight loss and had recent GDM. These findings may reflect a lack of knowledge among post-partum women on carbohydrates and dietary guidelines. Health professionals may have an important role in providing advice and support for post-partum women who wish to restrict their carbohydrate intake, to ensure optimal diet quality.
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Affiliation(s)
- Sophie Lewandowski
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Elizabeth Neale
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Ellie D'Arcy
- Integrated Care, Western New South Wales Local Health District, New South Wales, Dubbo, Australia
| | - Allison M Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Danielle A J M Schoenaker
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia.,School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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13
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The Impact of High Protein Diets on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Nutrients 2023; 15:nu15061372. [PMID: 36986102 PMCID: PMC10058321 DOI: 10.3390/nu15061372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/14/2023] Open
Abstract
High protein diets have gained increased popularity as a means of losing weight, increasing muscle mass and strength, and improving cardiometabolic parameters. Only a few meta-analyses have addressed their impact on cardiovascular morbidity and mortality and failed to show any significant associations without applying strict values to define high protein intake. Due to the conflicting research background, we conducted a meta-analysis to assess the impact of high protein diets compared to normal protein consumption on cardiovascular outcomes in adults without established cardiovascular disease. Fourteen prospective cohort studies were included. A total of 6 studies, including 221,583 participants, reported data about cardiovascular death, without showing a statistically significant difference in the random effect model (odds ratio: 0.94; confidence interval: 0.60–1.46; I2 = 98%; p = 0.77). Analysis of three studies, which included 90,231 participants showed that a high protein diet was not associated with a lower risk of stroke (odds ratio: 1.02; confidence interval: 0.94–1.10; I2 = 0%; p = 0.66). Regarding the secondary outcome of non-fatal myocardial infarction, stroke, or cardiovascular death, 13 studies that included 521,155 participants showed no statistically significant difference (odds ratio; 0.87; confidence interval: 0.70–1.07; I2 = 97%; p = 0.19). In conclusion, according to our study results, high protein consumption does not affect cardiovascular prognosis.
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