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Yuan K, Xie X, Huang W, Li D, Zhao Y, Yang H, Wang X. Elucidating causal relationships of diet-derived circulating antioxidants and the risk of osteoporosis: A Mendelian randomization study. Front Genet 2024; 15:1346367. [PMID: 38911297 PMCID: PMC11190308 DOI: 10.3389/fgene.2024.1346367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 05/24/2024] [Indexed: 06/25/2024] Open
Abstract
Background Osteoporosis (OP) is typically diagnosed by evaluating bone mineral density (BMD), and it frequently results in fractures. Here, we investigated the causal relationships between diet-derived circulating antioxidants and the risk of OP using Mendelian randomization (MR). Methods Published studies were used to identify instrumental variables related to absolute levels of circulating antioxidants like lycopene, retinol, ascorbate, and β-carotene, as well as antioxidant metabolites such as ascorbate, retinol, α-tocopherol, and γ-tocopherol. Outcome variables included BMD (in femoral neck, lumbar spine, forearm, heel, total body, total body (age over 60), total body (age 45-60), total body (age 30-45), total body (age 15-30), and total body (age 0-15)), fractures (in arm, spine, leg, heel, and osteoporotic fractures), and OP. Inverse variance weighted or Wald ratio was chosen as the main method for MR analysis based on the number of single nucleotide polymorphisms (SNPs). Furthermore, we performed sensitivity analyses to confirm the reliability of the findings. Results We found a causal relationship between absolute retinol levels and heel BMD (p = 7.6E-05). The results of fixed effects IVW showed a protective effect of absolute retinol levels against heel BMD, with per 0.1 ln-transformed retinol being associated with a 28% increase in heel BMD (OR: 1.28, 95% CI: 1.13-1.44). In addition, a sex-specific effect of the absolute circulating retinol levels on the heel BMD has been observed in men. No other significant causal relationship was found. Conclusion There is a positive causal relationship between absolute retinol levels and heel BMD. The implications of our results should be taken into account in future studies and in the creation of public health policies and OP prevention tactics.
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Affiliation(s)
- Kexin Yuan
- Gansu University of Chinese Medicine, Lanzhou, China
| | - Xingwen Xie
- Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China
| | - Weiwei Huang
- Gansu University of Chinese Medicine, Lanzhou, China
| | - Dingpeng Li
- The Second People’s Hospital of Gansu Province, Lanzhou, China
| | - Yongli Zhao
- Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China
| | - Haodong Yang
- Gansu University of Chinese Medicine, Lanzhou, China
| | - Xuetao Wang
- Gansu University of Chinese Medicine, Lanzhou, China
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Webster J, Dalla Via J, Langley C, Smith C, Sale C, Sim M. Nutritional strategies to optimise musculoskeletal health for fall and fracture prevention: Looking beyond calcium, vitamin D and protein. Bone Rep 2023; 19:101684. [PMID: 38163013 PMCID: PMC10757289 DOI: 10.1016/j.bonr.2023.101684] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/20/2023] [Accepted: 05/04/2023] [Indexed: 01/03/2024] Open
Abstract
Falls and osteoporotic fractures are a major public health problem, particularly among older adults. A third of individuals aged 65 years and over fall at least once each year, with up to 20 % of these resulting in serious injury, including fracture. In conjunction with regular exercise, the importance of diet for musculoskeletal health has largely focused upon calcium, vitamin D, and protein, particularly in the context of preventing falls and fractures. Whilst there is evidence for the benefits of these nutrients for musculoskeletal health, other aspects of the diet remain largely underexplored. For example, vegetables are rich sources of macro- and micronutrients that are essential for muscle function and bone health, which are key factors in the prevention of falls and fractures. Recent work has highlighted the importance of nutrients such as vegetable-derived nitrate and vitamin K1 in optimising muscle strength, physical function, and bone quality. In the context of dietary patterns, vegan/plant-based diets have recently gained popularity due to perceived health benefits, animal welfare, or to tackle climate change. The elimination and/or substitution of animal-based products for plant foods (without careful planning and/or expert dietary guidance) could, however, have long-term negative musculoskeletal consequences; a trend uncovered by recent evidence. Within the overarching theme of nutrition for fall and fracture prevention in older populations, the aim of this review is to (i) summarise the current evidence for calcium, vitamin D and protein; (ii) describe the importance of vegetables and selected nutrients, such as nitrate and vitamin K1, for muscle function and bone structural integrity; and (iii) highlight current evidence around different dietary patterns (e.g., plant-based, diet quality, data driven approaches) and their impact on musculoskeletal health.
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Affiliation(s)
- James Webster
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Jack Dalla Via
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Christina Langley
- Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
| | - Cassandra Smith
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Craig Sale
- Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
| | - Marc Sim
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
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3
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Li H, Chen L, Yuan C, Yang H, Ma Z, Zuo J. Diet-derived antioxidants and osteoporosis: A Mendelian randomization study. PLoS One 2023; 18:e0293145. [PMID: 38019728 PMCID: PMC10686434 DOI: 10.1371/journal.pone.0293145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Antioxidants can prevent osteoporosis, but the association between serum antioxidants and the cause of osteoporosis remains unknown. We aimed to utilize Mendelian randomization (MR) to determine whether genetically predicted serum levels of diet-derived antioxidants can affect the risk of osteoporosis, to determine the effect of dietary supplementation of antioxidants. METHODS Genetic variants associated with diet-derived antioxidants were selected from the genome-wide association studies. A total of 12,946 osteoporosis cases and 506,624 healthy controls were obtained from UK Biobank (UKB) and Genetic Factors of Osteoporosis (GEFOS) consortia. We implemented a two-sample MR design and performed several sensitivity analyses to evaluate the causal relationship. RESULTS In UKB, the genetically predicted higher β-carotene (OR = 0.863, p = 7.37 × 10-6, power = 100%) and γ-tocopherol (OR = 0.701, p = 0.021, power = 5%) had an inverse relationship with osteoporosis. However, only the association of serum β-carotene passed FDR correction. In GEFOS, there were no significant diet-derived antioxidants. The direction of the association of β-carotene with osteoporosis (OR = 0.844, p = 0.106, power = 87%) was consistent with that in the UKB dataset. A fixed-effects meta-analysis confirmed that β-carotene (OR = 0.862, p = 2.21 × 10-6) and γ-tocopherol (OR = 0.701, p = 2.31 × 10-2) could decrease the risk of osteoporosis. To reduce exclusion limit bias, we used total body bone mineral density, lumbar spine bone mineral density and femoral neck bone mineral density as surrogates and found that the genetically elevated circulating β-carotene level could increase total body BMD (beta = 0.043, p-value = 8.26 x 10-5, power = 100%), lumbar spine BMD (beta = 0.226, p-value = 0.001, power = 100%) and femoral neck BMD(beta = 0.118, p-value = 0.016, power = 100%). CONCLUSIONS We observed that genetically predicted serum β-carotene could elevate BMD and prevent osteoporosis.
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Affiliation(s)
- Haitao Li
- Department of Orthopeadics, The China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Lanlan Chen
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Affiliated Hospital of Jilin University, Changchun, Jilin, China
| | - Chaofeng Yuan
- Department of Gastrointestinal Colorectal Surgery, The China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Hongqun Yang
- Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Affiliated Hospital of Jilin University, Changchun, Jilin, China
| | - Zhuangzhuang Ma
- Department of Orthopeadics, The China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Jianlin Zuo
- Department of Orthopeadics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
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4
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Ukegbu PO, Ortutu B, Chinaza UP, Ojwang A. Socio-demographic characteristics and dietary pattern of community-dwelling adults in Abia State, Nigeria. Ghana Med J 2023; 57:241-249. [PMID: 38957668 PMCID: PMC11216734 DOI: 10.4314/gmj.v57i3.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024] Open
Abstract
Objective Identification of dietary patterns and their association with socio-demographic factors. Design Community-based cross-sectional study design. Setting Urban and rural communities in Abia State, Nigeria. Participants Eight hundred and sixty-eight (868) male and female adults aged 20 to 59 years. Methods Identification of Dietary patterns (DP) by Principal Component Analysis (PCA) based on the consumption of 10 food groups, assessed using a 7-day qualitative food frequency questionnaire. Bivariate and multivariate logistic regression analyses evaluated the association between identified patterns and socio-economic factors. Results Two dietary patterns 'traditional and convenience DPs were identified, explaining 52% of the total variance. The traditional DP was loaded with starchy staples, vegetable soups/sauces, and animal proteins. The convenience DP was characterised by high factor loading of processed cereals, carbonated drinks and alcoholic beverages. Larger households (>3) had lower odds of adhering to high traditional DP [AOR =0.633; 95% CI (0.429-0.934); p = 0.021]. Females [AOR =1.586; 95% CI (1.104-2.279); p = 0.013] and middle-aged adults (AOR = 1.750; 95% CI (1.075-2.848);p = 0.024] were more likely to adhere to the convenience DP, whereas, the odds of adhering to the convenience pattern was lower among adults residing in rural areas [AOR =0.3161.586; 95% CI (0.219-0.456); p = 0.001]. Conclusion Socio-economic variables (age, gender, household size and place of residence) were associated with dietary patterns among community dwellers in Nigeria. Funding None declared.
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Affiliation(s)
- Patricia O Ukegbu
- Department of Human Nutrition and Dietetics, Michael Okpara University of Agriculture, Umudike, Abia State, PMB 7267, Umuahia, Nigeria
| | - Beulah Ortutu
- Department of Human Nutrition and Dietetics, Michael Okpara University of Agriculture, Umudike, Abia State, PMB 7267, Umuahia, Nigeria
| | - Uche P Chinaza
- Department of Human Nutrition and Dietetics, Michael Okpara University of Agriculture, Umudike, Abia State, PMB 7267, Umuahia, Nigeria
| | - Alice Ojwang
- Department of Human Nutrition and Dietetics, The Technical University of Kenya, Nairobi, Kenya
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Abstract
➤ Oxidative stress has been implicated as a causative factor in many disease states, possibly including the diminished bone mineral density in osteoporosis. ➤ Understanding the effects of oxidative stress on the development of osteoporosis may lead to further research improving preventative and therapeutic measures that can combat this important contributor to morbidity and mortality worldwide. ➤ A diet rich in whole plant foods with high antioxidant content along with antioxidant-preserving lifestyle changes may improve bone mineral density and reduce the risk of fragility-related fractures. While it is not explicitly clear if antioxidant activity is the effector of this change, the current evidence supports this possibility. ➤ Supplementation with isolated antioxidants may also provide some osteoprotective benefits, but whole plant food-derived antioxidants potentially have more overall benefits. Larger-scale clinical trials are needed to give credence to definitive clinical recommendations.
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Affiliation(s)
- Jeff S Kimball
- Loma Linda University Medical Center, Loma Linda, California
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6
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Ludvigsson JF, Appelros P, Askling J, Byberg L, Carrero JJ, Ekström AM, Ekström M, Smedby KE, Hagström H, James S, Järvholm B, Michaelsson K, Pedersen NL, Sundelin H, Sundquist K, Sundström J. Adaptation of the Charlson Comorbidity Index for Register-Based Research in Sweden. Clin Epidemiol 2021; 13:21-41. [PMID: 33469380 PMCID: PMC7812935 DOI: 10.2147/clep.s282475] [Citation(s) in RCA: 124] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/02/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose Comorbidity indices are often used to measure comorbidities in register-based research. We aimed to adapt the Charlson comorbidity index (CCI) to a Swedish setting. Methods Four versions of the CCI were compared and evaluated by disease-specific experts. Results We created a cohesive coding system for CCI to 1) harmonize the content between different international classification of disease codes (ICD-7,8,9,10), 2) delete incorrect codes, 3) enhance the distinction between mild, moderate or severe disease (and between diabetes with and without end-organ damage), 4) minimize duplication of codes, and 5) briefly explain the meaning of individual codes in writing. Conclusion This work may provide an integrated and efficient coding algorithm for CCI to be used in medical register-based research in Sweden.
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Affiliation(s)
- Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Pediatrics, Orebro University Hospital, Orebro, Sweden.,Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.,Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Peter Appelros
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro SE-701 82, Sweden
| | - Johan Askling
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Rheumatology, Theme Inflammation and Infection, Karolinska University Hospital, Stockholm, Sweden
| | - Liisa Byberg
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Juan-Jesus Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna Mia Ekström
- Global & Sexual Health Research Group (GloSH), Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Magnus Ekström
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Ekström Smedby
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Hannes Hagström
- Division of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden.,Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine, Karolinska Huddinge, Institutet, Stockholm, Sweden
| | - Stefan James
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.,Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Bengt Järvholm
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Karl Michaelsson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Helene Sundelin
- Neuropediatric Unit, Department of Women's and Children's Health, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.,Division of Children's and Women's Health, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Johan Sundström
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,The George Institute for Global Health, University of New South Wales, Sydney, Australia.,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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7
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Warensjö Lemming E, Byberg L. Is a Healthy Diet Also Suitable for the Prevention of Fragility Fractures? Nutrients 2020; 12:nu12092642. [PMID: 32872582 PMCID: PMC7551566 DOI: 10.3390/nu12092642] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/20/2022] Open
Abstract
Osteoporosis and sarcopenia contribute to the risk of fracture in the population. These conditions share common features, and it is known that a healthy diet may have beneficial effects on both, theoretically resulting in fewer fractures. The present narrative review gives an overview of recent epidemiological research related to the association between healthy diets/dietary patterns, bone health and fragility fractures. The review also gives a brief overview on general dietary recommendations and advice as the cornerstone of public health nutrition. Although muscle health and sarcopenia contribute to the risk of fractures, these endpoints were not the focus of this review. Healthy diets are nutrient dense and contain bioactive components that are needed for the constant remodeling of the skeleton and to slow the rate of bone loss and muscle wasting, thus contributing to the prevention of fragility fractures. Compliance with healthy dietary patterns were predominantly found to be inversely associated with bone outcomes, although this was not entirely consistent across all studies. Different a priori diet scores, such as the Mediterranean diet score and the Dietary Inflammatory Index, as well as a posteriori data driven dietary patterns, such as the prudent or healthy dietary pattern, were inversely associated with fragility fractures in different populations. In conclusion, different healthy dietary patterns may contribute to bone health and less fractures. Following current dietary guidelines is thus advisable for the prevention of fragility fractures.
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Warensjö Lemming E, Byberg L, Stattin K, Ahmad S, Lind L, Elmståhl S, Larsson SC, Wolk A, Michaëlsson K. Dietary Pattern Specific Protein Biomarkers for Cardiovascular Disease: A Cross-Sectional Study in 2 Independent Cohorts. J Am Heart Assoc 2019; 8:e011860. [PMID: 31433701 PMCID: PMC6585372 DOI: 10.1161/jaha.118.011860] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 04/23/2019] [Indexed: 12/11/2022]
Abstract
Background Mechanisms related to the influence of diet on the development of cardiovascular disease are not entirely understood, and protein biomarkers may help to understand these pathways. Studies of biomarkers identified with multiplex proteomic methods and dietary patterns are largely lacking. Methods and Results Dietary patterns were generated through principal component analysis in 2 population-based Swedish cohorts, the EpiHealth (EpiHealth study; n=20 817 men and women) and the SMCC (Swedish Mammography Cohort Clinical [n=4650 women]). A set of 184 protein cardiovascular disease biomarkers were measured with 2 high-throughput, multiplex immunoassays. Discovery and replication multivariable linear regression analyses were used to investigate the associations between the principal component analysis-generated dietary patterns and the cardiovascular disease-associated protein biomarkers, first in the EpiHealth (n=2240) and then in the Swedish Mammography Cohort Clinical. Four main dietary patterns were identified in the EpiHealth, and 3 patterns were identified in the Swedish Mammography Cohort Clinical. The healthy and the Western/traditional patterns were found in both cohorts. In the EpiHealth, 57 protein biomarkers were associated with 3 of the dietary patterns, and 41 of these associations were replicated in the Swedish Mammography Cohort Clinical, with effect estimates ranging from 0.057 to 0.083 (P-value range, 5.0×10-2-1.4×10-9) for each SD increase in the relative protein concentration. Independent associations were established between dietary patterns and the 21 protein biomarkers. Two proteins, myeloperoxidase and resistin, were associated with both the healthy and the light meal pattern but in opposite directions. Conclusions We have discovered and replicated independent associations between dietary patterns and 21 biomarkers linked to cardiovascular disease, which have a role in the pathways related to inflammation, endothelial and immune function, cell adhesion, and metabolism.
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Affiliation(s)
- Eva Warensjö Lemming
- Section of OrthopedicsDepartment of Surgical SciencesUppsala UniversityUppsalaSweden
| | - Liisa Byberg
- Section of OrthopedicsDepartment of Surgical SciencesUppsala UniversityUppsalaSweden
| | - Karl Stattin
- Section of OrthopedicsDepartment of Surgical SciencesUppsala UniversityUppsalaSweden
| | - Shafqat Ahmad
- Department of Medical SciencesUppsala UniversityUppsalaSweden
- Preventive Medicine DivisionBrigham and Women's HospitalHarvard Medical SchoolBostonMA
- Department of NutritionHarvard T.H. Chan School of Public HealthBostonMA
| | - Lars Lind
- Department of Medical SciencesUppsala UniversityUppsalaSweden
| | - Sölve Elmståhl
- Division of Geriatric MedicineDepartment of Clinical SciencesLund UniversityLundSweden
| | - Susanna C. Larsson
- Section of OrthopedicsDepartment of Surgical SciencesUppsala UniversityUppsalaSweden
- Division of Nutritional EpidemiologyInstitute of Environmental MedicineKarolinska InstitutetStockholmSweden
| | - Alicja Wolk
- Section of OrthopedicsDepartment of Surgical SciencesUppsala UniversityUppsalaSweden
- Division of Nutritional EpidemiologyInstitute of Environmental MedicineKarolinska InstitutetStockholmSweden
| | - Karl Michaëlsson
- Section of OrthopedicsDepartment of Surgical SciencesUppsala UniversityUppsalaSweden
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9
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Ternus DL, Henn RL, Bairros F, Costa JSD, Olinto MTA. Dietary patterns and their association with sociodemographic and behavioral factors: 2015 Women's Health Research, São Leopoldo (RS). REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22:e190026. [PMID: 30942332 DOI: 10.1590/1980-549720190026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 05/15/2018] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Dietary patterns may be more predictive of disease risk than individual nutrients or foods. OBJECTIVE To identify dietary patterns and associated factors among adult women. METHOD Population-based cross-sectional study with 1,128 women, aged 20 to 69 years, living in São Leopoldo, Rio Grande do Sul. Food intake was assessed with a frequency questionnaire. The principal component analysis identified dietary patterns. We estimated crude and adjusted prevalence ratios using Poisson regression with robust variance. RESULTS Threedietary patterns - responsible for 25.8% of the total variance - were identified: healthy (fruits, vegetables, and whole foods); risk (ultra-processed foods); and Brazilian (rice and beans). The healthy pattern showed the largest percentage of explained variation (11.62%). The probability of adherence to the healthy pattern increased linearly with age and schooling and was higher among ex-smokers [prevalence ratio (PR)=1.22; confidence interval of 95% (95%CI) 1.04 - 1.42]. Younger women and those with better schooling had more chances of adhering to the risk pattern. The probability of adherence to the Brazilian pattern increased as schooling decreased and was higher among non-white women (PR = 1.29; 95%CI 1.04- 1.59). CONCLUSIONS While adherence to healthy and risk patterns behaved differently according to women's age, it was similar regarding schooling. Socioeconomic conditions defined adherence to the Brazilian pattern.
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Affiliation(s)
- Daiane Luisa Ternus
- Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos - São Leopoldo (RS), Brasil
| | - Ruth Liane Henn
- Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos - São Leopoldo (RS), Brasil
| | - Fernanda Bairros
- Departamento de Assistência e Orientação Profissional, Bacharelado em Saúde Coletiva, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Juvenal Soares da Costa
- Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos - São Leopoldo (RS), Brasil
| | - Maria Teresa Anselmo Olinto
- Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos - São Leopoldo (RS), Brasil.,Departamento de Nutrição, Universidade Federal de Ciências da Saúde de Porto Alegre - Porto Alegre (RS), Brasil
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10
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Fabiani R, Naldini G, Chiavarini M. Dietary Patterns in Relation to Low Bone Mineral Density and Fracture Risk: A Systematic Review and Meta-Analysis. Adv Nutr 2019; 10:219-236. [PMID: 30657847 PMCID: PMC6416046 DOI: 10.1093/advances/nmy073] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/09/2018] [Accepted: 08/23/2018] [Indexed: 12/17/2022] Open
Abstract
Low bone mineral density (BMD) and osteoporosis-related fractures constitute a considerable public health burden. Several studies have demonstrated the association between diet and bone health. We performed a systematic review to provide an estimate of the association between different dietary patterns defined through the use of a posteriori methods and fracture or low BMD risk. A literature search on PubMed, Web of Science, and Scopus databases, up to March 2018, was performed to identify all eligible case-control, prospective, or cross-sectional studies involving subjects of both sexes and any age. Random-effects models were used. Heterogeneity and publication bias were evaluated. Stratified analyses were conducted on study characteristics. The meta-analysis includes 20 studies and identifies 3 prevalent dietary patterns: "Healthy," "Milk/dairy," and "Meat/Western." From the 10 studies on fracture, adherence to the "Healthy" pattern reduced the risk, particularly in older people (OR: 0.79; 95% CI: 0.66, 0.95; P = 0.011) and in Eastern countries (OR: 0.64; 95% CI: 0.43, 0.97; P = 0.037), whereas the risk increased with the "Meat/Western" pattern, especially for older people (OR: 1.11; 95% CI: 1.04, 1.18, P = 0.001), in those with hip fractures (OR: 1.15; 95% CI: 1.05, 1.25; P = 0.002), and in Western countries (OR: 1.10; 95% CI: 1.07, 1.14; P < 0.0001). Analyses on low BMD showed a reduced risk in the "Healthy" pattern, particularly for younger people (OR: 0.62; 95% CI: 0.44, 0.89; P = 0.009). The "Meat/Western" pattern increased low BMD risk, especially in older people (OR: 1.31; 95% CI: 1.05, 1.64; P = 0.015). The "Milk/dairy" pattern resulted in the strongest reduction in low BMD risk; when stratifying, this effect remained significant (e.g., older women-OR: 0.57; 95% CI: 0.46, 0.70; P < 0.0001). Nutrition is an important modifiable factor affecting bone health. The "Healthy" and "Milk/dairy" patterns are associated with a reduced risk of low BMD and fracture. In contrast, the "Western" pattern is inversely associated.
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Affiliation(s)
| | - Giulia Naldini
- School of Specialization in Hygiene and Preventive Medicine
| | - Manuela Chiavarini
- Department of Experimental Medicine, Section of Public Heath, University of Perugia, Perugia, Italy
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11
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Shaw SC, Parsons CM, Fuggle NR, Edwards MH, Robinson SM, Dennison EM, Cooper C, Ward KA. Diet Quality and Bone Measurements Using HRpQCT and pQCT in Older Community-Dwelling Adults from the Hertfordshire Cohort Study. Calcif Tissue Int 2018; 103:494-500. [PMID: 29931462 PMCID: PMC6174074 DOI: 10.1007/s00223-018-0445-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/14/2018] [Indexed: 01/10/2023]
Abstract
There are few data describing associations between dietary patterns and bone microarchitecture. This study investigated the relationship between diet quality and HRpQCT and pQCT measures in older adults. Data were available for 184 men and 166 women. Dietary data were collected at baseline (1998-2003) using an administered food frequency questionnaire. A 'prudent' diet score (PDS) was identified using principal component analysis and used as an indicator of dietary quality. HRpQCT and pQCT images were acquired at follow-up in 2012, from the non-dominant distal radius and tibia using Scanco XtremeCT and Stratec XCT2000 instrument scanners, respectively. The mean (SD) PDS was - 0.24 (1.23) for men and 0.62 (1.14) for women. In women, a significant positive relationship was found between baseline dietary pattern and total and trabecular area at both the radius and the tibia, measured by HRpQCT. Similar trends were observed with pQCT parameters. Positive associations were observed for tibia total area (38% slice). At the radius, significant positive associations were found for total area (4% slice) and polar strength strain index (33% slice). All relationships remained robust to adjustment. For men, although patterns were similar, there were no significant associations for HRpQCT outcomes. Significant associations were observed for baseline PDS and polar strength strain and total area (66% slice) at the radius, measured by pQCT. Our data suggest that diets high in fruit, vegetables, oily fish and whole grain cereals in early old age are associated with greater bone size but not volumetric bone density or microarchitecture in later life in women.
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Affiliation(s)
- S C Shaw
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS FT, Southampton, UK
| | - C M Parsons
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - N R Fuggle
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - M H Edwards
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - S M Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS FT, Southampton, UK
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.
- Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS FT, Southampton, UK.
- National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, OX3 7LE, UK.
| | - K A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- MRC Elsie Widdowson Laboratory, Cambridge, UK
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12
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Lan QY, Liao GC, Zhou RF, Chen PY, Wang XY, Chen MS, Chen YM, Zhu HL. Dietary patterns and primary liver cancer in Chinese adults: a case-control study. Oncotarget 2018; 9:27872-27881. [PMID: 29963244 PMCID: PMC6021235 DOI: 10.18632/oncotarget.23910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/30/2017] [Indexed: 12/13/2022] Open
Abstract
Introduction Healthy dietary patterns may prevent many chronic diseases, and is emphasized by 2015 US dietary guideline, but it remains unclear which dietary patterns may be benefit to prevention of primary liver cancer (PLC). Materials and Methods We recruited 782 PLC cases and 1:1 age- and sex-matched controls in Guangzhou, China. Habitual dietary intake was assessed by face-to-face interview using a 79-item food frequency questionnaire, and used to explore dietary patterns by factor analysis. Results Three dietary patterns were identified: 1) an urban prudent dietary pattern (UPDP) characterized by high in dairy products, eggs, mushrooms, nuts and soy foods, but low in refined grains; 2) a traditional Cantonese dietary pattern (TCDP) consisting of a high intake of fruit and vegetables, fish, Cantonese soup, and Chinese herb tea; and 3) a high meat and preserved food pattern (MPFP). Multivariable analyses showed favorable associations for the first two dietary patterns, but unfavorable association for the last one (all p-trend < 0.01). Odds ratios (95% CI) of PLC for the highest (vs. lowest) quartile of pattern scores of the three patterns were 0.25 (0.18–0.35), 0.61 (0.46–0.82), and 1.98 (1.46–2.69), respectively. Conclusions Our findings suggest that the UPDP and TCDP were associated with lower, whereas the MPFP with higher, risk of PLC.
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Affiliation(s)
- Qiu-Ye Lan
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People's Republic of China
| | - Gong-Cheng Liao
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People's Republic of China
| | - Rui-Fen Zhou
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People's Republic of China
| | - Pei-Yan Chen
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People's Republic of China
| | - Xiao-Yan Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People's Republic of China
| | - Min-Shan Chen
- Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Center, Guangzhou 510060, People's Republic of China
| | - Yu-Ming Chen
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People's Republic of China
| | - Hui-Lian Zhu
- School of Public Health, Sun Yat-Sen University, Guangzhou 510080, People's Republic of China
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