Replacing red meat and processed red meat for white meat, fish, legumes or eggs is associated with lower risk of incidence of metabolic syndrome

Higher global diet quality score is inversely associated with odds of metabolic syndrome among Iranian adults

BACKGROUND

Growing research underscores the significance of diet quality in the development of Metabolic Syndrome (MetS). Our study investigates the correlation between the Global Diet Quality Score (GDQS) and MetS, along with its components, in Iranian adults.

METHODS

This study utilizes data from the Yazd Health Study (YaHS) and includes a final analysis of 2,904 participants aged 20-70 years. Dietary data were gathered using food frequency questionnaires. MetS was defined in line with the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. GDQS was derived by totaling the points across all 25 food groups, with scores ranging from 0 to 49. To examine the association between GDQS and MetS, multivariable logistic regression analyses were conducted in both crude and adjusted models.

RESULTS

Participants who had the highest adherence to GDQS had a 20% lower chance of having MetS than those who had the lowest adherence after adjusting for confounding variables in Model II (T3 vs. T1: OR = 0.80; 95% CI: 0.46-0.99, P-trend = 0.045). There was no association between GDQS and MetS components including increased blood pressure, fasting blood glucose (FBG), triglyceride, abdominal obesity and reduced high-density lipoprotein (HDL) in crude and adjusted models.

CONCLUSION

higher adherence to GDQS was inversely related to odds of MetS. Further longitudinal and clinical trials investigations are required to confirm these associations.

Association between adequate dietary protein and all-cause and cardiovascular mortality in patients with selective glomerular hypofiltration syndrome

Aims: To determine the impact of dietary protein intake and protein sources on all-cause and cardiovascular mortality of selective glomerular hypofiltration syndrome (SGHS) patients. Methods: This study recruited participants from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2004. Cox proportional hazard models and competing risk models were employed to investigate the effects of dietary protein intake and protein sources on all-cause and cardiovascular mortality in SGHS patients. Additionally, Cox regression models utilizing restricted cubic splines (RCS) were used to explore potential non-linear associations. Results: Over a median follow-up period of 204 months, 20.71% (449/2168) participants died, with 5.40% (117/2168) experiencing cardiovascular mortality. In the fully adjusted model, participants with the highest dietary protein intake (Q4, ≥107.13 g d-1) exhibited a 40% reduced risk of all-cause mortality (HR: 0.60, 95% CI: 0.39 to 0.94) and an 88% reduced risk of cardiovascular mortality (HR: 0.12, 95% CI: 0.04 to 0.35) compared to those with the lowest dietary protein intake (Q1, < 57.93 g d-1). Notably, non-red meat protein sources were found to reduce the risk of all-cause and cardiovascular mortality, whereas no significant association was observed with red meat consumption. Conclusion: Adequate dietary protein intake has been linked to a decreased risk of all-cause and cardiovascular mortality in individuals with selective glomerular hypofiltration syndromes. This protective effect seems to be primarily associated with protein obtained from non-red meat sources.

Association of Dietary Protein Sources and Their Adequacy, Body Composition and Risk of Sarcopenic Obesity in South Korean Populations: A Cross-Sectional Study

Dietary protein sources and protein adequacy are crucial modulators of muscle quality and body composition. We investigated the association between dietary protein sources (and their adequacy) and body composition and the risk of sarcopenic obesity (SO) in South Korean populations. The participants (n = 1967) were classified into SO, obese, sarcopenia, and normal groups. A cross-sectional survey was conducted using the KS-15 questionnaire, short-form food frequency questionnaire, and anthropometric measurements. The percentage of body fat (male: 35.36 ± 0.51%; female: 44.14 ± 0.36%) was significantly high, while appendicular skeletal muscle (ASM; male: 36.39 ± 0.30%, female: 30.32 ± 0.19%) was low in the SO group. Beef and pork consumption was negatively associated with ASM (%) but positively associated with body fat (%) in the normal group and positively associated with ASM (kg/m2: beta = 0.002, p = 0.02) and BFM (kg: beta = 0.012, p = 0.03) in the SO group, respectively. The highest quintile (Q5: 173.6 g/day) showed a decreased risk of SO prevalence (AORs: 0.46, CI: 0.22-0.94) compared with that in the lowest quintile (Q1: 21.6 g/day) among the people with inadequacy protein intake. Daily poultry and egg intake was positively linked with body composition in the participants with SO, while red meat showed a negative effect on imbalanced body composition in participants in the normal and SO groups. Furthermore, a lower intake of poultry and eggs was strongly associated with SO prevalence in people who consumed inadequate amounts of daily dietary protein.

The association between consumption of red and processed meats with metabolic syndrome and its components in obese and overweight women: a cross-sectional study

OBJECTIVES

Previous studies have shown a relation between the consumption of different types of meats and chronic disorders. This study aims to investigate the association between red and processed meat intake with metabolic syndrome (MetS) and its components in healthy obese and overweight women.

METHODS

This cross-sectional study was conducted on Iranian women. The dietary assessment and body composition were measured by a validated food frequency questionnaire (FFQ) and bioelectrical impedance analysis, respectively. Blood samples were collected by standard protocols.

RESULTS

A total of 231 women (mean age 36.47 ± 8.44 years) were included in the current study. After controlling for potential confounders, there was a marginally significant associations between higher intake of processed meat with the MetS (OR:1.01, 95% CI: 0.94,2.94, P:0.06) and high serum triglycerides (TG) (OR:1.27, 95% CI: 0.94,2.98, P:0.07). There was a significant associations between high intake of red meats with lower odds of higher waist circumference (WC) (OR:0.31, 95% CI: 0.10,0.97, P:0.04). Also, there was a significant associations were found between high intake of processed meats with greater odds of having lower high-density lipoprotein cholesterol (HDL-c) (OR:0.64, 95% CI: 0.30,0.95, P:0.03).

CONCLUSIONS

The current study suggests that higher intakes of processed meat may be associated with the MetS in Iranian women with excess body weight, while this was not the case for red meat. More studies however are necessary in different communities to draw definitive conclusions.

Association of gestational metabolic syndrome with the Chinese Healthy Eating Index in mid-pregnancy: a cross-sectional study

BACKGROUND

This study aims to investigate the relationship between gestational metabolic syndrome (GMS) and the Chinese Healthy Eating Index (CHEI) in mid-pregnancy, and to identify potentially beneficial or high-risk dietary habits. We have developed a mid-pregnancy version of CHEI-2022, adapting the Chinese Healthy Eating Index to align with the food quantity recommendations outlined in the 2022 Dietary Guidelines for Chinese Residents for mid-pregnancy.

METHODS

Using the inclusion and exclusion criteria, data from 2411 mid-pregnant individuals were collected through interviews. The Total CHEI score and its component scores were determined through analysis of responses from the food frequency questionnaire. GMS diagnosis involved conducting physical examinations and performing blood biochemical tests. A logistic regression model was employed to analyze the relationship between GMS or related indices and both the total CHEI score and its component scores.

RESULTS

The study identified an overall GMS prevalence of 21.65% (522 out of 2411 participants). During mid-pregnancy, participants diagnosed with GMS exhibited higher BMI, FBG, 1hPBG, 2hPBG, TC, TG, HDL, SBP, as well as higher educational levels and daily activity, compared to those without GMS (P < 0.001). After adjusting for potential confounders, participants with higher total CHEI scores (≥ 80) were found to have lower odds of GMS or related indices (P < 0.05). Increasing dietary intake of potatoes, whole grains, beans, dark green vegetables, and fruits, as per the CHEI recommendations, was associated with reduced odds of GMS or related indices (P < 0.05).

CONCLUSION

A high-quality diet, as indicated by a total CHEI score of 80 or higher, and increased consumption of specific dietary components, namely potatoes, beans, dark green vegetables, and fruits, were found to effectively reduce the odds of GMS or related indices during mid-pregnancy.

Associations between Cardiometabolic Risk Factors and Increased Consumption of Diverse Legumes: A South African Food and Nutrition Security Programme Case Study

The programme aimed to improve selected cardiometabolic risk (CMR) variables using a nutritional intervention among farmers who reported hypertensive disorders as hindrances during agricultural activities. The intervention had two case controls (n = 103) [experimental group-EG (n = 53) and control group-CG (n = 50)] which were tracked and whose blood pressure measurements, dietary intake, blood indices for cholesterol concentration and glucose levels from pre- and post-intervention surveys after the baseline survey (n = 112) were analysed. The interval for data collection was 12 weeks (±120 days) after five legume varieties were consumed between 3 and 5 times a day, and servings were not <125 g per at least three times per week. Sixty-five per cent of farmers were above 60 years old, with mean age ranges of 63.3 (SD ± 6.3) years for women and 67.2 (SD ± 6.7) for men. The post-intervention survey revealed that EG blood results indicated nutrient improvement with p <= 0.05 for blood glucose (p = 0.003) and cholesterol (p = 0.001) as opposed to the CG. A trend analysis revealed that cholesterol (p = 0.033) and systolic blood pressure (SBP); (p = 0.013) were statistically significant when comparing genders for all study phases. Interventions focusing on legumes can improve hypertension and cardiovascular disease and fast-track the achievement of SGDs 3 and 12 through community-based programmes.

Migration Spurs Changes in the Human Microbiome: a Review

International migration often results in major changes in living environments and lifestyles, and these changes may lead to the observed increases in obesity and diabetes among foreign-born people after resettling in higher-income countries. A possible mechanism linking changes in living environments to the onset of health conditions may be changes in the microbiome. Previous research has shown that unfavorable changes in the composition of the microbiome can increase disposition to diseases such as diabetes, obesity, kidney disease, and inflammatory bowel disease. We investigated the relationship between human migration and microbiome composition through a review using microbiome- and migration-related search terms in PubMed and Web of Science. We included articles examining the gut, oral, or oropharyngeal microbiome in people who migrated internationally. Nine articles met eligibility criteria. All but one examined migration from a non-Western to a Western country. Four of these found a difference in the microbiome of migrants compared with non-migrating residents of their country of birth, seven found differences in the microbiome of migrants compared with the native-born population in the country of resettlement, and five found microbiome differences associated with duration of stay in the country of resettlement. Microbiome composition varies with country of birth, age at migration, time since immigration, and country of resettlement. The results suggest that migration may lead to changes in the microbiome; thus, microbiome characteristics are a plausible pathway to examine changes in health after resettlement in a new country.

Storage Stability of Meat Analogs Supplemented with Vegetable Oils

The addition of various oils to meat analog has been an important topic to improving its juiciness and tenderness. However, this causes a concern about oil leaching from the meat analog during long-term storage. Here, we aimed to assess the storage stability of vegetable-oil-supplemented meat analogs and analyze the effects of temperature and storage period on their physiochemical characteristics. The meat analogs were prepared by adding 30 g castor oil, orange oil, palm oil, shortening, or margarine vegetable oil based on 100 g of textured vegetable protein. They were then stored at -18 or -60 °C for 6 months and analyzed at one-month intervals. The meat analog supplemented with orange oil had the highest water content (64.85%; 66.07%), hardness (35.48 N; 34.05 N), and DPPH-radical-scavenging activity (30.01%; 30.87%) under -18 and -60 °C, respectively, as well as the highest liquid-holding capacity in different conditions. During frozen storage, temperature barely affected the meat quality. The storage stability of all meat analog samples was maintained for 6 months, although the quality was slightly reduced with an increase in storage duration. Coliform group bacteria were not detected regardless of the storage condition. In conclusion, all results supposed that orange oil can be a promising candidate for improving the juiciness and tenderness of meat analogs, and the quality of samples was maintained for at least 6 months under frozen storage. The findings of this study are relevant to the development and promotion of meat analog as an alternative to animal meat.

Plant bioactive compounds from Mediterranean diet improve risk factors for metabolic syndrome

Mediterranean (Med) dietary pattern consists of moderate or high consumption of foods that are linked to reduced risk factors for metabolic syndrome (MetS). This comprehensive review evaluates studies on Med diet-representative foods and beverages, such as red wine and olive oil, to understand the inverse associations of Med diet and MetS. The intake of dietary fibre, unsaturated fatty acids, vitamins, and polyphenols - including flavonoids and stilbenes - help to explain the benefits of Med diet on abdominal adiposity, glucose intolerance, hyperlipidaemia, and high blood pressure to some extent. Antioxidant and anti-inflammatory properties of polyphenols as well as the effects of unsaturated fatty acids on lipid metabolism are part of the underlying mechanisms. Overall, this review shows that dietary interventions using Med diet components improve MetS health markers in humans and/or rodents.

The association between meat consumption and muscle strength index in young adults: the mediating role of total protein intake and lean mass percentage

PURPOSE

The aim of this study was to analyse the associations between the consumption of different types of meat and the muscle strength index (MSI) and to examine whether this relationship is mediated by total protein intake (TPI) and lean mass percentage (LM%) in young adults.

METHODS

We conducted a cross-sectional study with first-year university students from Castilla-La Mancha, Spain. Different types of meat consumption (total, red, processed, and white and fish) were separately evaluated using a Food-Frequency Questionnaire. MSI was determined from the handgrip and standing long jump tests. ANCOVA models were used to test the mean differences in MSI by categories of meat consumption. Serial multiple mediation models were used to explore the mediating role of TPI and LM% in the relationship between meat consumption and MSI. All analyses were adjusted for age, sex, and socioeconomic level, identified through a directed acyclic graph. Additional analyses were performed with a small subsample including alcohol intake, tobacco smoking, physical activity, cardiorespiratory fitness, and total energy intake as covariates in the multiple mediation models.

RESULTS

A total of 230 students (mean age 21.1 ± 2.1 years, 66.5% women) were included in the analysis. Young adults with higher meat consumption (total, red, and white and fish) had higher MSI adjusted means than their peers with lower meat consumption (p < 0.05). These associations did not remain after controlling for TPI and LM%. In adjusted mediation analyses, a significant indirect effect was observed through TPI and LM% in the associations between each of the types of meat consumption and MSI. In the additional analyses, a greater effect of white and fish meat consumption on muscle strength through mediation of TPI and LM% was reported compared to red or processed meat consumption, and no significant effects were observed between processed meat consumption and MSI.

CONCLUSION

Higher consumption of total, red, and white and fish meat was associated with increased MSI in young adults. TPI and LM% mediated this relationship.

Physicochemical Characteristics of Meat Analogs Supplemented with Vegetable Oils

This study identified the effect of the type and concentration of vegetable oil on the quality of meat analogs and analyzed the differences in their physiochemical characteristics. Various vegetable oils, such as castor oil, orange oil, palm oil, shortening, and margarine, were added to meat analogs. The meat analog was prepared by adding 10, 20, 30, 40, and 50 g of each vegetable oil based on 100 g of textured vegetable protein. The cooking loss, water content, liquid-holding capacity, texture, and antioxidant content of the meat analogs were assessed, and a sensory evaluation was performed. The meat analog with orange oil had a higher water content than the others, regardless of the amount of added oil, and it had a relatively high liquid-holding capacity. The DPPH(2,2-diphenyl-1-picrylhydrazyl) radical scavenging activity of the meat analog with orange oil was higher than that of the others. The sensory evaluation also showed a decrease in soy odor and an increase in juiciness. Therefore, adding orange oil improves the preference, juiciness, soy odor, and quality of meat analogs. Our results demonstrate that orange oil has positive effects on the productivity of meat analogs and can help to improve meat analog consumption.

Consumption of rabbit meat in Brazil: Potential and limitations

Rabbit production is still small in Brazil and organization of its production chain is therefore necessary. The aim of this study was to investigate consumer perceptions of rabbit meat in the country. An online survey was conducted with 2614 participants. The responses were analyzed using the nonparametric Mann-Whitney U test. The survey revealed that the greatest acceptance of rabbit meat occurred in the population of adult men with a higher income and educational level who live in capital cities. Regional differences exist in Brazil. Consumption is more consolidated in the south region. The main limiting factor for rabbit meat consumption is the unavailability of the product. The limited availability of rabbit meat results in low consumption. Producers ensuring a regular supply of rabbit meat and verticalization by the industry are essential. These proposed actions were found to be even more important than demystify the image of the rabbit as a pet.

Molecular Profiling of DNA Methylation and Alternative Splicing of Genes in Skeletal Muscle of Obese Rabbits

DNA methylation and the alternative splicing of precursor messenger RNAs (pre-mRNAs) are two important genetic modification mechanisms. However, both are currently uncharacterized in the muscle metabolism of rabbits. Thus, we constructed the Tianfu black rabbit obesity model (obese rabbits fed with a 10% high-fat diet and control rabbits from 35 days to 70 days) and collected the skeletal muscle samples from the two groups for Genome methylation sequencing and RNA sequencing. DNA methylation data showed that the promoter regions of 599 genes and gene body region of 2522 genes had significantly differential methylation rates between the two groups, of which 288 genes had differential methylation rates in promoter and gene body regions. Analysis of alternative splicing showed 555 genes involved in exon skipping (ES) patterns, and 15 genes existed in differential methylation regions. Network analysis showed that 20 hub genes were associated with ubiquitinated protein degradation, muscle development pathways, and skeletal muscle energy metabolism. Our findings suggest that the two types of genetic modification have potential regulatory effects on skeletal muscle development and provide a basis for further mechanistic studies in the rabbit.

The long-term association of different dietary protein sources with metabolic syndrome

Due to scarce epidemiologic data linking dietary protein intakes and metabolic syndrome (MetS), we aim to determine the longitudinal association of different types of dietary protein with the incidence of MetS among Iranians adults. The study was conducted in the framework of the Isfahan Cohort Study (ICS) on 6504 adults, aged ≥ 35 years, and free of MetS at baseline. A validated food frequency questionnaire was used for assessing usual dietary intakes. MetS was defined according to the Joint Scientific Statement. Mixed-effects logistic regression was applied to examine the associations between changes in weekly frequency consumption of protein and MetS status. After a median follow-up of 11.25 years, in multivariate-adjusted model, each additional frequency consumption of total protein intake (OR 0.83; 95% CI 0.81–0.85), animal protein (OR 0.80; 95% CI 0.77–0.83), plant protein (OR 0.70; 95% CI 0.64–0.76), red meat (OR 0.74; 95% CI 0.70–0.78), poultry (OR 0.73; 95% CI 0.68–0.78), egg (OR 0.79; 95% CI 0.72–0.88) and nuts and seeds (OR 0.77; 95% CI 0.71–0.84) was associated with reduced risk of MetS. No significant association was found for processed meat (OR 0.96; 95% CI 0.87–1.01) and legumes and soy (OR 0.96; 95% CI 0.86–1.07) with MetS. Our results suggest an independent inverse association between total protein, animal and plant protein and the risk of MetS. These associations did not differ by sex. Although our results can be considered to be a strategy to reduce MetS risk by dietary guidelines, randomized clinical trials are required to confirm our findings.

The association between meat consumption and the metabolic syndrome: a cross-sectional study and meta-analysis

The findings regarding the associations between red meat, fish and poultry consumption, and the metabolic syndrome (Mets) have been inconclusive, and evidence from Chinese populations is scarce. A cross-sectional study was performed to investigate the associations between red meat, fish and poultry consumption, and the prevalence of the Mets and its components among the residents of Suzhou Industrial Park, Suzhou, China. A total of 4424 participants were eligible for the analysis. A logistic regression model was used to estimate the OR and 95 % CI for the prevalence of the Mets and its components according to red meat, fish and poultry consumption. In addition, the data of our cross-sectional study were meta-analysed under a random effects model along with those of published observational studies to generate the summary relative risks (RR) of the associations between the highest v. lowest categories of red meat, fish and poultry consumption and the Mets and its components. In the cross-sectional study, the multivariable-adjusted OR for the highest v. lowest quartiles of consumption was 1·23 (95 % CI 1·02, 1·48) for red meat, 0·83 (95 % CI 0·72, 0·97) for fish and 0·93 (95 % CI 0·74, 1·18) for poultry. In the meta-analysis, the pooled RR for the highest v. lowest categories of consumption was 1·20 (95 % CI 1·06, 1·35) for red meat, 0·88 (95 % CI 0·81, 0·96) for fish and 0·97 (95 % CI 0·85, 1·10) for poultry. The findings of both cross-sectional studies and meta-analyses indicated that the association between fish consumption and the Mets may be partly driven by the inverse association of fish consumption with elevated TAG and reduced HDL-cholesterol and, to a lesser extent, fasting plasma glucose. No clear pattern of associations was observed between red meat or poultry consumption and the components of the Mets. The current findings add weight to the evidence that the Mets may be positively associated with red meat consumption, inversely associated with fish consumption and neutrally associated with poultry consumption.

Association of Red Meat and Poultry Consumption With the Risk of Metabolic Syndrome: A Meta-Analysis of Prospective Cohort Studies

Objective: This study aims to investigate the association of red meat (processed and unprocessed) and poultry consumption with the risk of metabolic syndrome (MetS).

Methods: Prospective cohort studies on the association of red meat (processed and unprocessed) and poultry consumption with the risk of MetS were identified by comprehensive literature search in the PubMed, Web of Science, and Embase databases up to March 2021. The pooled relative risk (RR) of MetS with 95% CIs for the highest vs. lowest category of red meat or poultry consumption was extracted for meta-analysis.

Results: A total of nine prospective cohort studies were included in this study. Among them, eight studies were identified for red meat consumption. The overall multi-variable adjusted RR demonstrated that red meat consumption was associated with a higher risk of MetS (RR = 1.35, 95% CI: 1.13–1.62; P = 0.001). Moreover, four and three studies were specifically related to processed and unprocessed red meat consumption, respectively. Both processed (RR = 1.48, 95% CI: 1.11–1.97; P = 0.007) and unprocessed red meat (RR = 1.32, 95% CI: 1.14–1.54; P = 0.0003) consumption was associated with a higher risk of MetS. With regard to poultry consumption, three studies were included. The overall multi-variable adjusted RR suggested that poultry consumption was associated with lower risk of MetS (RR = 0.85, 95% CI: 0.75–0.97; P = 0.02).

Conclusions: The current evidence indicates that red meat (processed and unprocessed) consumption is associated with a higher risk of MetS, whereas, poultry consumption is associated with a lower risk of MetS. More well-designed randomized controlled trials are still needed to address the issues further.

Dietary and Lifestyle-Centered Approach in Gout Care and Prevention

PURPOSE OF REVIEW

We aim to provide a comprehensive review of the available literature to inform dietary recommendations for patients with gout and hyperuricemia that have the potential to simultaneously lower serum urate and reduce gout morbidity while addressing gout's cardiometabolic comorbidities holistically.

RECENT FINDINGS

The global burden of gout is rising worldwide, particularly in developed nations as well as in women. Patients with gout are often recommended to follow a low-purine (i.e., low-protein) diet to avoid purine-loading. However, such an approach may lead to increased consumption of unhealthy carbohydrates and fats, which in turn contributes to metabolic syndrome and subsequently raises serum urate levels and leads to adverse cardiovascular outcomes. On the other hand, several well-established diets for cardiometabolic health, such as the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets, in combination with weight loss for those who are overweight or obese, also have beneficial effects on relevant gout endpoints. It is important to recognize not only the direct effect of diet on hyperuricemia and gout, but its mediated effect through obesity and insulin resistance. Thus, several preeminent healthy dietary patterns that have proven benefits in cardiometabolic health have the power to holistically address not only gout morbidity but also its associated comorbidities that lead to premature mortality among patients with gout.

Animal Design Through Functional Dietary Diversity for Future Productive Landscapes

Pastoral livestock production systems are facing considerable societal pressure to reduce environmental impact, enhance animal welfare, and promote product integrity, while maintaining or increasing system profitability. Design theory is the conscious tailoring of a system for a specific or set of purposes. Then, animals—as biological systems nested in grazing environments—can be designed in order to achieve multi-faceted goals. We argue that phytochemical rich diets through dietary taxonomical diversity can be used as a design tool for both current animal product integrity and to develop future multipurpose animals. Through conscious choice, animals offered a diverse array of plants tailor a diet, which better meets their individual requirements for nutrients, pharmaceuticals, and prophylactics. Phytochemical rich diets with diverse arrangements of plant secondary compounds also reduce environmental impacts of grazing animals by manipulating the use of C and N, thereby reducing methane production and excretion of N. Subsequently functional dietary diversity (FDD), as opposed to dietary monotony, offers better nourishment, health benefits and hedonic value (positive reward increasing “liking” of feed), as well as the opportunity for individualism; and thereby eudaimonic well-being. Moreover, phytochemical rich diets with diverse arrangements of plant secondary compounds may translate in animal products with similar richness, enhancing consumer human health and well-being. Functional dietary diversity also allows us to design future animals. Dietary exposure begins in utero, continues through mothers' milk, and carries on in early-life experiences, influencing dietary preferences later in life. More specifically, in utero exposure to specific flavors cause epigenetic changes that alter morphological and physiological mechanisms that influence future “wanting,” “liking” and learning of particular foods and foodscapes. In this context, we argue that in utero and early life exposure to designed flavors of future multifunctional foodscapes allow us to graze future ruminants with enhanced multiple ecosystem services. Collectively, the strategic use of FDD allows us to “create” animals and their products for immediate and future food, health, and wealth. Finally, implementing design theory provides a link between our thoughtscape (i.e., the use of FDD as design) to future landscapes, which provides a beneficial foodscape to the animals, an subsequently to us.

Replacing the consumption of red meat with other major dietary protein sources and risk of type 2 diabetes mellitus: a prospective cohort study

BACKGROUND

Greater consumption of red meat has been associated with a higher risk of type 2 diabetes mellitus (T2DM). A decreased intake of red meat and simultaneous increased intake of other high-protein foods may be associated with a lower risk of T2DM. These analyses of specific food replacements for red meat may provide more accurate dietary advice.

OBJECTIVE

We examined the association between a decrease in intake of red meat accompanied by an increase in other major dietary protein sources and risk of T2DM.

METHODS

We prospectively followed 27,634 males in the Health Professionals Follow-up Study, 46,023 females in the Nurses' Health Study, and 75,196 females in the Nurses' Health Study II. Diet was assessed by a validated FFQ and updated every 4 y. Cox proportional hazards models adjusted for T2DM risk factors were used to model the food replacements. We calculated HRs and 95% CIs for the T2DM risk associated with replacements of 1 daily serving of red meat with another protein source.

RESULTS

During 2,113,245 person-years of follow-up, we identified 8763 incident T2DM cases from 1990 to 2013. In the pooled analyses, a decrease in total red meat intake during a 4-y period replaced with another common protein food was associated with a lower risk of T2DM in the subsequent 4-y period. The HR (95% CI) per 1 serving/d was 0.82 (0.75, 0.90) for poultry, 0.87 (0.77, 0.98) for seafood, 0.82 (0.78, 0.86) for low-fat dairy, 0.82 (0.77, 0.86) for high-fat dairy, 0.90 (0.81, 0.99) for eggs, 0.89 (0.82, 0.98) for legumes, and 0.83 (0.78, 0.89) for nuts. The associations were present for both unprocessed and processed red meat, although stronger for the replacement of processed red meat.

CONCLUSIONS

Replacing red meat consumption with other protein sources was associated with a lower risk of T2DM.

White Meat Consumption, All-Cause Mortality, and Cardiovascular Events: A Meta-Analysis of Prospective Cohort Studies

The association of meat consumption with mortality and morbidity for non-communicable diseases has been extensively studied. However, the relation of white meat consumption with health outcomes remains controversial. The present meta-analysis was conducted to comprehensively analyze the available evidence on the consistency and strength of the association between the consumption of white meat, death from any cause and incidence of fatal and non-fatal cardiovascular (CV) events. PubMed, Web of Science, Scopus and Embase databases were searched for articles published up to April 30, 2020. We included prospective cohort studies reporting relative risks and pertinent 95% confidence intervals (CI) for all-cause mortality and/or CV events (fatal or non-fatal). A total of 22 studies were included in the meta-analysis. Eleven studies (14 data sets) reported data on all-cause mortality, 10 studies (15 datasets) on cardiovascular disease (CVD) mortality and 10 studies (11 datasets) on non-fatal CV events. When comparing the highest versus the lowest consumption of white meat, the pooled OR and pertinent 95% CI were 0.94 (0.90, 0.97, p < 0.001) for all-cause mortality, 0.95 (0.89, 1.01, p = 0.13) for CV mortality, and 0.99 (0.95, 1.02, p = 0.48) for non-fatal CV events. In conclusion, the study shows for the first time a robust and inverse association between white meat consumption and all-cause mortality and a neutral association with CV mortality and morbidity. This highlights the importance of differentiating the meat types for what concerns their health effects and suggests that white meat might be a healthier alternative to read and processed meat consumption.

Western Dietary Patterns, Foods, and Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

An increasing number of epidemiological studies suggest that adherence to Western dietary patterns (WDPs) is associated with risk of gestational diabetes mellitus (GDM), but results remain inconsistent. Therefore, we conducted a systematic review and meta-analysis of the effect of WDPs and typical Western dietary foods on GDM. A literature search was performed in PubMed, Embase, Web of Knowledge, and the Cochrane Library up to December 2019. Cohort studies investigating the combined associations of WDPs with incidence of GDM were included. Reviewers were paired, and they independently reviewed and assessed studies, extracted data, and evaluated study quality. Pooled HRs were calculated using random-effects models. Heterogeneity and publication bias tests were also conducted. Twenty-one prospective cohort studies with 191,589 participants, including 12,331 women with GDM, were included in our analysis. The pooled risk ratio (RR) of WDPs was 1.52 (95% CI: 1.21, 1.91), indicating a significant association with GDM risk in Western countries. Potatoes (pooled RR: 1.12; 95% CI: 0.93, 1.35) showed a nonsignificant (P > 0.05) relation to GDM risk. However, consumption of animal meat (pooled RR: 1.35; 95% CI: 1.16, 1.57) and fast food (pooled RR: 1.75; 95% CI: 1.41, 2.19) showed a positive association with the risk of developing GDM. Subgroup analysis demonstrated that the consumption of red meat and processed red meat increased the risk of GDM more than either poultry or fish intake. Our study provides further evidence for understanding the relation between dietary factors and increased GDM risk and contributes to reducing the incidence of GDM through healthy diets.

Poultry and Fish Intake and Pancreatic Cancer Risk: A Systematic Review and Meta-Analysis

Although several epidemiological studies have investigated associations between poultry and fish consumption and pancreatic cancer (PC) risk, these findings have been inconsistent. The present study aimed to perform a meta-analysis to comprehensively evaluate these associations. We retrieved Eligible cohort studies and case-control studies published before February 2020 from the Medline, EMBASE, and Cochrane Library and applied a random or fixed effects model to calculate the pooled relative risk (RR) and the corresponding 95% confidence intervals (CI). Publication bias was detected using funnel plots, Begg's test, and Egger's test, and the study quality was evaluated using the Newcastle-Ottawa scale. We included 25 studies in the analyses. The pooled RR of PC for the highest vs. lowest poultry intake category was 1.14 (95% CI: 1.02-1.26) in cohort studies. There was no appreciable link between fish intake and PC risk (RR: 1.00, 95% CI: 0.93-1.07). Our results suggest that large amount of poultry intake may increase PC risk, while fish intake is unlikely to be linked to PC risk. These links require further investigation, particularly between poultry and PC.

[Reduction of red and processed meats in the Spanish population: What is its impact on total and cardiovascular mortality?]

Objetivo

Cuantificar el impacto de reducir el consumo de carnes rojas y procesadas sobre la mortalidad cardiovascular y la mortalidad total de la población adulta española, basado en 5 revisiones publicadas.

Participantes y mediciones principales

Se define la exposición como el consumo de ≥ 3 raciones/semana de carnes rojas o procesadas, y se consideran cuatro escenarios de población expuesta (30-60%). Con datos del Instituto Nacional de Estadística, se calcula la mortalidad ponderada en población española de 40-80 años y, utilizando los riesgos relativos (RR) y los intervalos de confianza (IC) al 95% publicados en 5 revisiones (RR = 0,88; IC 95%: 0,84-0,93 para mortalidad por todas las causas y RR = 0,92; IC 95%: 0,90-0,93 para la mortalidad cardiovascular), se calculó la tasa de mortalidad en expuestos y no expuestos. Multiplicando esas tasas por el número de expuestos, se obtuvo el número de muertes atribuibles.

Resultados

Asumiendo un 60% de población española de 40-80 años expuesta, el número de muertes anuales de causa cardiovascular que se podrían evitar consumiendo < 3 raciones/semana de carnes rojas o procesadas con un IC 95% está entre 2.112 y 3.055. Si la población expuesta fuese un 30% se podrían evitar entre 1.079 y 1.577 muertes.

Conclusiones

Incluso bajo el supuesto más conservador, el beneficio poblacional de reducir el consumo de carnes rojas o procesadas sobre la mortalidad cardiovascular y total sería muy importante. Las conclusiones de las revisiones mencionadas contradicen sus propios resultados y contribuyen a un estado de confusión que representa un daño a la salud pública.

Intake of Animal Source Foods in Relation to Risk of Metabolic Syndrome

Metabolic syndrome (MetS) is a prevalent disorder associated with diabetes and cardiovascular diseases. Lifestyle and occupation can increase the risk of developing MetS. Since dietary pattern is a major component of lifestyle, this study aimed to determine the relationship between consumption of animal source foods (ASFs) and MetS among food suppliers. This cross-sectional study was conducted on 112 male food suppliers. We measured anthropometric indices, body composition, and blood pressure of the participants. Blood biochemistry was determined using 5 mL fasting blood samples. MetS was defined based on the guidelines described by the International Diabetes Federation (IDF). ASF intake, including dairy products, eggs, red meat, poultry, and fish, was assessed using food frequency questionnaires. Overall, 46.4% of participants had MetS. Participants who consumed dairy 3∼5 times/d and more than 5 times/d had lower risk of MetS [odds ratios (OR): 0.18 (confidence interval (CI) 95%: 0.05∼0.62) and OR: 0.20 (CI 95%: 0.06∼0.67), respectively] compared with participants in the lowest tertile. The risk of hypertension was significantly decreased in participants who consumed dairy products >5 times/d [OR: 0.22 (CI 95%: 0.07∼0.67)]. Other ASFs were not associated against the risk of MetS in crude and adjusted models. Our findings indicated that adhering to dairy products can decrease the risk of MetS. Higher adherence to dairy products was also protective against hypertension in these participants.

A systematic review and meta-analysis of the association between fish consumption and risk of metabolic syndrome

AIMS

Results regarding the association between fish intake and risk of metabolic syndrome (MetS) are ambiguous. Therefore, this study aims to evaluate whether there is an association between fish consumption and risk of MetS.

DATA SYNTHESIS

A comprehensive literature search was conducted of PubMed, Embase, ScienceDirect and Google Scholar up to August 2019. A random-effects model was used to pool the risk of MetS in the highest category of fish consumption compared with the lowest one. Subgroup analysis was conducted based on country of region, gender, dietary tool, MetS definition, energy adjustment and sample size. A dose-response of analysis of fish intake and risk of MetS was also conducted. Twelve studies with a total of 16 effect sizes (10 cross-sectional and six cohort) were included. An inverse association was observed between fish intake and risk of MetS in cohort (OR = 0.80, 95% CI: 0.66, 0.96; P = 0.017, I² = 62.9%) but not cross-sectional studies (OR = 0.80, 95% CI: 0.70, 1.02; P = 0.085, I² = 50.1%). Subgroup analysis suggested that the results were influenced by all the included variables but sample size. A significant non-linear association was observed between fish intake levels and risk of MetS (P-value for non-linearity = 0.010).

CONCLUSION

An inverse association existed between fish intake and risk of MetS when combining data from prospective cohort studies. Further studies are needed to confirm such an effect.

Diet and nutrient status of legume consumers in Sweden: a descriptive cross-sectional study

Background

Legumes are nutrient-dense foods and can be an environmentally sustainable alternative to meat consumption. Data on legume intake are scarce and data on legume consumption in Sweden are lacking. This study investigated dietary intake and dietary patterns, together with iron, vitamin D, and folate status, in relation to legume consumption in Sweden.

Methods

Cross-sectional dietary and biomarker data (n 1760) from the 2011 Riksmaten national survey were analyzed. All legume foods (including soy) were identified from 4-day dietary records and ferritin, folate, and vitamin D status in a subgroup (n 280). Participants were classified into non-consumers and quartiles of legume intake. Principal Component Analysis (PCA) was performed to uncover dietary patterns associated with legume intake. Partial Least Square (PLS) regression was used to identify variables associated with variations in legume consumption.

Results

Legumes were consumed by 44% of the population, with mean (SD) intake of 138 (84) g/d in the highest and 11 (5) g/d in the lowest quartiles. Among consumers, 6% reported being vegetarian, compared with 0.9% among non-consumers. Legume consumers drank less alcohol, but had higher intakes of energy, dietary fiber, folate, thiamin, and several minerals, and more often met recommended intake levels for folate and fiber, critical nutrients in Sweden. Biomarker status did not differ with legume intake. PCA revealed multiple loadings on legumes that generally reflected healthier eating habits for legume-consuming women. PLS revealed that vegetarianism was most influential for high legume intake. Other influential variables were high fruit, tea, nut, and seed intakes. High intake of meat, sodas, fast foods, and sweet foods, together with omnivorism, were influential for low legume intake. The associations were similar for men and women.

Conclusions

This study supports dietary recommendations on inclusion of legumes in a healthy diet. Greater focus on assessment of legume intake is necessary to explore the population-wide health effects of legumes as sustainable meat alternatives, and to reinforce national nutritional guidelines.

Perceived barriers to healthy eating and adherence to dietary guidelines: Nationwide study

BACKGROUND

People report many barriers that prevent them from achieving a healthy diet. Whether perceived barriers are associated with dietary behavior remains unclear.

OBJECTIVE

To assess the association between barriers to healthy eating and adherence to the Swiss dietary guidelines.

METHODS

Cross-sectional data from the Swiss Health Survey 2012 (N = 15,450; 53% women). Barriers included price, daily habits, taste, gluttony, lack of time, lack of willpower, limited options in restaurants, in supermarkets, no social support, and social opposition. The associations between barriers and adherence to Swiss dietary guidelines were assessed using multivariable logistic regression.

RESULTS

Daily habits (odds ratio; 95% confidence interval: 0.91; 0.85-0.98) and taste (0.85; 0.79-0.91) were associated with lower adherence to the guidelines for fruits, while price (1.13; 1.06-1.21) and limited options in restaurants (1.33; 1.23-1.45) and in supermarkets (1.18; 1.03-1.35) were associated with higher adherence. Taste was associated with lower adherence to the guidelines for vegetables (0.72; 0.66-0.78), while price (1.20; 1.11-1.30), gluttony (1.17; 1.04-1.31), social group opposition (1.48; 1.18-1.85) and limited options in restaurants (1.56; 1.42-1.72) and in supermarkets (1.25; 1.07-1.47) were associated with higher adherence. Daily habits (0.82; 0.75-0.90), time (0.86; 0.78-0.94), lack of willpower (0.78; 0.70-0.87), and gluttony (0.86; 0.76-0.98) were associated with lower adherence to the guidelines for fish, whereas price (1.09; 1.01-1.19), and limited options in restaurants (1.26; 1.14-1.39) and supermarkets (1.40; 1.20-1.63) were associated with higher adherence. Daily habits (0.89; 0.82-0.97), taste (0.66; 0.61-0.72), lack of willpower (0.84; 0.76-0.92) and gluttony (0.66; 0.58-0.75) were associated with lower adherence to the guidelines for meat. Time (0.88; 0.78-0.99) was associated with lower adherence to the guidelines for dairy, while gluttony (1.26; 1.09-1.46) was associated with higher adherence. Daily habits was associated with lower adherence (0.91; 0.85-0.97) to the guidelines for liquids, while limited options in restaurants was associated with higher adherence (1.12; 1.03-1.22).

CONCLUSION

In the Swiss adult population, several self-reported barriers to healthy eating appear to hinder adherence to the dietary guidelines, while other commonly reported barriers are linked to higher adherence.

Animal and Plant Protein Sources and Cardiometabolic Health

The sources or types of protein in the diet have long been overlooked regarding their link to cardiometabolic health. The picture is complicated by the fact that animal and plant proteins are consumed along with other nutrients and substances which make up the "protein package" so plant and animal protein come with clear nutrient clusters. This review aimed at deciphering the relation between plant and animal protein and cardiometabolic health by examining different nutritional levels (such as amino acids, protein type, protein foods, protein patterns, and associated overall dietary and nutrient patterns) and varying levels of scientific evidence [basic science, randomized controlled trials (RCTs), observational data]. Plant protein in Western countries is a robust marker of nutrient adequacy of the diet, whereas the contribution of animal protein is highly heterogeneous. Yet recent data from large cohorts have confirmed that total and animal proteins are associated with the risk of cardiovascular disease and diabetes, even when fully adjusting for lifestyle and dietary or nutritional factors. Here again, there is marked variability depending on the type of animal protein. Protein from processed red meat and total red meat on the one hand, and from legumes, nuts, and seeds on the other, are often reported at the extremes of the risk range. RCTs using purified proteins have contributed little to the topic to date, inasmuch as the findings cannot readily be extrapolated to current or near-future diets, but RCTs studying whole protein foods have shown a beneficial effect of pulses. Despite the fact that many of the benefits of plant protein reported in observational or interventional studies may stem from the protein package that they convey and the nutrients that they displace, there are also important indications that protein per se may affect cardiometabolic health via the many amino acids that are present in typically contrasting levels in plant compared with animal proteins.

Red meat and dietary iron intakes are associated with some components of metabolic syndrome: Tehran Lipid and Glucose Study

BACKGROUND

This study was conducted to investigate whether the daily consumption of haem, non-haem, total iron and red meat can affect the occurrence of metabolic syndrome (MetS) and its components.

METHODS

Eligible adults (n = 4654) were selected from among participants of the Tehran Lipid and Glucose Study with an average follow-up of 3.8 years. Dietary intakes were assessed using a valid and reliable semi-quantitative food frequency questionnaire. Anthropometrics and biochemical variables were evaluated at baseline and follow-up examinations. The occurrence of MetS and its components were assessed in relation to haem, non-haem, total iron and red meat intakes.

RESULTS

There was no relationship between different types of dietary iron and red meat intakes and the incidence of MetS in the Tehranian population. Risk of hypertension decreased from quartiles 1 to 4 for haem iron (HR: 1.00, 0.92, 0.81, 0.80, P_trend < 0.01) and red meat intake (HR: 1.00, 0.89, 0.84, 0.77, P_trend < 0.01). The association between hyperglycemia and the fourth quartile of total iron intake was significant (HR = 1.98, 95% CI 1.08-3.63); and the risk of high triglyceride appeared to increase in higher quartiles of total iron intake (HR: 1.00, 1.17, 1.49, 1.75, P_trend = 0.01) compared to lower quartiles.

CONCLUSION

Our study suggests a potentially protective relationship of haem and moderate red meat intake against development of high blood pressure; and higher intake of total iron is related to hyperglycemia and high triglyceride.

Determinants of Adherence to Healthy Eating Patterns in a Population of Children and Adolescents: Evidence on the Mediterranean Diet in the City of Mataró (Catalonia, Spain)

Despite its benefits, the Mediterranean diet (MD) is being abandoned or not adopted by young generations in most Mediterranean countries. In Spain, up to 69% of the child and adolescent population has been found to have suboptimal adherence to the MD. The aim of this study was to analyze which factors are associated with an optimal adherence to the MD in school-age children and adolescents from Mataró, Spain. A cross-sectional study was performed on 1177 children and adolescents aged between 6 and 18 years from Mataró. The Mediterranean Diet Quality Index for Children and Adolescents (KIDMED index) was used to evaluate adherence to a MD. We found that over 59% of subjects showed suboptimal adherence to a MD, with this prevalence being higher for secondary school than for primary school children. The factors positively associated with following an optimal MD were the mother's education level, children at the primary school level, the absence of distractions at breakfast, and regular physical activity. The availability of spending money was negatively associated with the likelihood of optimal adherence to a MD. Future research should study more in-depth the possible causality between the factors studied and adherence to a MD.

Unscrambling the relations of egg and meat consumption with type 2 diabetes risk

Background

Meat intake is associated with increased risk of type 2 diabetes (T2D). It is not clear if egg intake is associated with T2D risk because purported associations may be due to concurrent consumption of eggs with meat.

Objective

Our aim was to differentiate any associations between meat and egg consumption and the risk of T2D.

Design

In this longitudinal study, 55,851 participants of the Adventist Health Study 2 who were free of diabetes provided demographic, anthropometric, and dietary data at baseline. Meat and egg intakes were assessed with a validated quantitative food-frequency questionnaire. Responses to 2 follow-up questionnaires determined incident T2D cases. Multivariate-adjusted logistic regression was used to determine relations between meat and egg intake and incident T2D.

Results

T2D cases identified during a mean 5.3 y of follow-up totaled 2772. Meat intake of >0 to <25 g/d, ≥25 to <70 g/d, and ≥70 g/d significantly increased the risk of T2D compared with no meat intake (OR: 1.29; 95% CI: 1.16, 1.44; OR: 1.42; 95% CI: 1.25, 1.61; and OR: 1.65; 95% CI: 1.39, 1.96, respectively; P-trend < 0.0001). Egg intake compared with no egg intake was not associated with T2D risk. A significant meat-egg interaction (P = 0.019) showed that within every category of egg intake, there was an incremental rise in T2D risk as meat intake increased. However, within categories of meat intake, increasing egg intake did not increase the risk of T2D except among nonmeat-eaters consuming ≥5 eggs/wk (OR: 1.52; 95% CI: 1.09, 2.12).

Conclusions

Meat consumption, but not egg consumption, is independently associated with T2D risk. Egg intake seems not to increase T2D risk further with meat intake. Our findings suggest that the purported egg-T2D risk relation in US populations may be biased due to failure to investigate egg-meat interactions. Further investigations are needed to ascertain T2D risk among nonmeat-eaters with high egg intakes.

Substitution of red meat with poultry or fish and risk of type 2 diabetes: a Danish cohort study

PURPOSE

We examined associations between substitution of red meat (total, processed and unprocessed, low fat and high fat) with poultry or fish and substitution of processed red meat with unprocessed red meat and the risk of type 2 diabetes.

METHODS

A cohort of 53,163 participants from the Danish Diet, Cancer and Health study were followed for incident type 2 diabetes (6879 cases; median follow-up time 15.4 years). Diet was assessed by a validated 192-item food frequency questionnaire at baseline. Adjusted Cox proportional hazard models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for type 2 diabetes associated with specified food substitutions of 150 g/week.

RESULTS

Replacing total red meat with fish was associated with a lower risk of type 2 diabetes [HR 0.96 (95% CI 0.94, 0.99)] as was replacement of processed red meat with poultry or fish [HR poultry 0.96 (95% CI 0.93, 0.99)]; HR fish 0.94 [(95% CI 0.91, 0.97)]. Replacing low fat red meat or high fat red meat with fish was associated with a lower risk of type 2 diabetes whereas similar substitutions, with poultry, were not. Replacing processed red meat with unprocessed red meat was also associated with a lower risk of type 2 diabetes [HR 0.96 (95% CI 0.93, 0.99)].

CONCLUSIONS

Replacing processed red meat with poultry, replacing total or processed red meat with fish, and replacing processed red meat with unprocessed red meat were all associated with a lower risk of type 2 diabetes.

Characterization of the Degree of Food Processing in Relation With Its Health Potential and Effects

Up today technological processes are intended to produce safe and palatable food products. Yet, it is also expected that processing produces healthy and sustainable foods. However, due to the dramatic increase of chronic diseases prevalence worldwide, i.e., obesity, type 2 diabetes, cardiovascular diseases, and some cancers, ultraprocessing has been pointed out as producing unhealthy foods, rich in energy and poor in protective micronutrients and fiber, i.e., "empty" calories. Indeed the 1980s saw massive arrivals of ultraprocessed foods in supermarkets, i.e., fractionated-recombined foods with added ingredients and/or additives. Epidemiological studies clearly emphasized that populations adhering the most to ultraprocessed foods, e.g., processed meat, refined grains, ultraprocessed plant-based foods, and/or sweetened beverages, exhibited the higher prevalence of chronic diseases. This prompted researchers to classify foods according to their degree of processing as with the international NOVA classification (i.e., un/minimally processed, processed, and ultraprocessed foods). More and more studies showed that such a classification makes sense for health. Overall one distinguishes three categories of processes: mechanical, thermal, and fermentative treatments, this latter being the more favorable to food health potential. This chapter has therefore several ambitions: (1) to review association between degree of food processing and chronic disease risk prevalence; (2) to explore the impact of technological processes on food health potential considering both matrix and compositional effects; (3) to discuss the need for classifying food according to their degree of processing in future epidemiological studies; and (4) to analyze consequences of adhering to a more holistic paradigm in both food processing and nutrition.

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.

Influence of Haem, Non-Haem, and Total Iron Intake on Metabolic Syndrome and Its Components: A Population-Based Study

Studies suggest that haem, non-haem iron and total iron intake may be related to non-communicable diseases, especially metabolic syndrome. This study was undertaken to investigate the association of haem, non-haem iron and total iron intake with metabolic syndrome and its components. A cross-sectional population-based survey was performed in 2008, enrolling 591 adults and elderly adults living in São Paulo, Brazil. Dietary intake was measured by two 24 h dietary recalls. Metabolic syndrome was defined as the presence of at least three of the following: hypertension, hyperglycaemia, dyslipidaemia and central obesity. The association between different types of dietary iron and metabolic syndrome was evaluated using multiple logistic regression. After adjustment for potential confounders, a higher haem iron intake was positively associated with metabolic syndrome and with elevated triglyceride levels. A higher total iron intake was positively associated with hyperglycaemia. Non-haem iron intake was positively associated with hyperglycaemia in the fourth quintile. In conclusion, this study suggests that the different types of dietary iron are associated with metabolic syndrome, elevated triglyceride levels and hyperglycaemia. In addition, it emphasises the importance of investigating the roles of dietary iron in health outcomes, since its consumption may have different impacts on health.

The Mediterranean diet, an environmentally friendly option: evidence from the Seguimiento Universidad de Navarra (SUN) cohort

OBJECTIVE

How food is produced and consumed has consequences for ecosystems, such as resource use and greenhouse gas (GHG) emission among others. The Mediterranean diet (MedDiet) was proposed as a sustainable dietary model, due to its nutritional, environmental, economic and sociocultural dimensions. However, further evidence is needed. Thus, our objective was to evaluate the impact on resource (land, water and energy) use and GHG emission of better adherence to the MedDiet in a Mediterranean Spanish cohort.

DESIGN

We analysed the dietary pattern of participants through a validated FFQ. The outcomes were land use, water and energy consumption and GHG emission according to MedDiet adherence. The specific environmental footprints of food item production and processing were obtained from different available life-cycle assessments.

SETTING

Spanish university graduates.

SUBJECTS

Participants (n 20 363) in the Seguimiento Universidad de Navarra (SUN) cohort.

RESULTS

Better adherence to the MedDiet was associated with lower land use (-0·71 (95 % CI -0·76, -0·66) m2/d), water consumption (-58·88 (95 % CI -90·12, -27·64) litres/d), energy consumption (-0·86 (95 % CI -1·01, -0·70) MJ/d) and GHG emission (-0·73 (95 % CI -0·78, -0·69) kg CO2e/d). A statistically significant linear trend (P<0·05) was observed in all these analyses.

CONCLUSIONS

In this Mediterranean cohort, better adherence to the MedDiet was an eco-friendly option according to resource consumption and GHG emission.

Is meat consumption associated with depression? A meta-analysis of observational studies

BACKGROUND

A number of epidemiological studies have examined the effect of meat consumption on depression. However, no conclusion has been reached. The aim of this study was to examine the relationship between meat consumption and depression.

METHODS

The electronic databases of PUBMED and EMBASE were searched up to March 2017, for observational studies that examined the relationship between meat consumption and depression. The pooled odds ratio (OR) for the prevalence of depression and the relative risk (RR) for the incidence of depression, as well as their corresponding 95% confidence interval (CI), were calculated respectively (the highest versus the lowest category of meat consumption).

RESULTS

A total of eight observational studies (three cross-sectional, three cohort and two case-control studies) were included in this meta-analysis. Specifically, six studies were related to the prevalence of depression, and the overall multi-variable adjusted OR suggested no significant association between meat consumption and the prevalence of depression (OR = 0.89, 95% CI: 0.65 to 1.22; P = 0.469). In contrast, for the three studies related to the incidence of depression, the overall multi-variable adjusted RR evidenced an association between meat consumption and a moderately higher incidence of depression (RR = 1.13, 95% CI: 1.03 to 1.24; P = 0.013).

CONCLUSIONS

Meat consumption may be associated with a moderately higher risk of depression. However, it still warrants further studies to confirm such findings due to the limited number of prospective studies.

Dietary poultry intake and the risk of stroke: A dose-response meta-analysis of prospective cohort studies

BACKGROUND & AIMS

We performed a meta-analysis to illuminate and quantify the potential relationship between poultry intake and risk of stroke through summarizing available evidence using a dose-response meta-analysis of prospective cohort studies.

METHODS

Pertinent prospective cohort studies attained using electronic searches through PubMed, and Scopus up to September 25th, 2017. Relative risks (RR) s with corresponding 95% confidence intervals (CIs) of the highest versus the lowest for cohort studies were evaluated using DerSimonian and Laird random-effects models to find combined RRs. We also assessed the dose-response effect of this relationship.

RESULTS

A total of 7 studies involving 354 718 participants were met inclusion criteria. The pooled RR of total stroke risk was [RR = 0.92 95% CI, 0.82, 1.03, I² = 19.8%, P_{heterogeneity} = 0.28] for the highest versus lowest categories of poultry intake. Subgroup analysis showed an inverse associations for the US people [RR = 0.86 95% CI, 0.77, 0.95, I² = 0.0%, P_{heterogeneity} = 0.38] and women [RR = 0.83, 95% CI, 0.72, 0.93, I² = 0.0%, P_{heterogeneity} = 0.63]. We did not obtain any significant association in the subtypes of strokes with highest versus lowest poultry intake [Ischemic stroke (RR = 0.91; 95% CI: 0.79, 1.02, I² = 0.0%, p = 0.93), Hemorrhagic (RR = 0.82; 95% CI: 0.59, 1.04, I² = 20.5%, P_{heterogeneity} = 0.28)]. One serving per week increment in poultry intake was not associated with the risk of stroke (RR: 1.00, 95% CI: 0.96, 1.03, I² = 69.0%, P_{heterogeneity} = 0.004). Nonlinear dose-response meta-analysis showed lower risk of stroke at consumption ∼1 serving/week.

CONCLUSION

Our meta-analysis revealed that poultry intake is not associated with total stroke risk; furthermore, an inverse relationship in US population and females must be interpreted with caution.

Red meat intake in chronic kidney disease patients: Two sides of the coin

Red meat is an important dietary source of high biological value protein and micronutrients such as vitamins, iron, and zinc that exert many beneficial functions. However, high consumption of animal protein sources, especially red meat, results in an increased intake of saturated fat, cholesterol, iron, and salt, as well as an excessive acid load. Red meat intake may lead to an elevated production of uremic toxins by the gut microbiota, such as trimethylamine n-oxide (TMAO), indoxyl sulfate, and p-cresyl sulfate. These uremic toxins are associated with increased risk for cardiovascular (CV) mortality. Limiting the intake of red meat in patients with chronic kidney disease (CKD) thus may be a good strategy to reduce CV risk, and may slow the progression of kidney disease. In the present review, we discuss the role of red meat in the diet of patients with CKD. Additionally, we report on a pilot study that focused on the effect of a low-protein diet on TMAO plasma levels in nondialysis CKD patients.

Dietary fat quantity and quality modifies advanced glycation end products metabolism in patients with metabolic syndrome

SCOPE

Advanced glycation end products (AGEs) increase in dysmetabolic conditions. Lifestyle, including diet, has shown be effective in preventing the development of metabolic syndrome (MetS). We investigated whether AGE metabolism is affected by diets with different fat quantity and quality in MetS patients.

METHODS AND RESULTS

A randomized, controlled trial assigned 75 MetS patients to one of four diets: high SFA (HSFA), high MUFA (HMUFA), and two low-fat, high-complex carbohydrate diets (LFHCC) supplemented with long-chain n-3 PUFA or placebo for 12-weeks each. Dietary and serum AGE [methylglyoxal (MG: lysine-MG-H1) and N-carboxymethyllysine] levels and gene expression related to AGE metabolism in peripheral blood mononuclear cells (AGER1, RAGE, GloxI, and Sirt1 mRNA) were determined. HMUFA diet reduced serum AGE (sAGE) and RAGE mRNA, increased AGER1 and GloxI mRNA levels compared to the other diets. LFHCC n-3 diet reduced sAGE levels and increased AGER1 mRNA levels compared to LFHCC and HSFA diets. Multiple regression analyses showed that sMG and AGER1 mRNA appeared as significant predictors of oxidative stress/inflammation-related parameters.

CONCLUSIONS

Low AGE content in HMUFA diet reduces sAGEs and modulates the gene expression related to AGE metabolism in MetS patients, which may be used as a therapeutic approach to reduce the incidence of MetS and related chronic diseases.

Total and subtypes of dietary fat intake and risk of type 2 diabetes mellitus in the Prevención con Dieta Mediterránea (PREDIMED) study

Background: The associations between dietary fat and cardiovascular disease have been evaluated in several studies, but less is known about their influence on the risk of diabetes.Objective: We examined the associations between total fat, subtypes of dietary fat, and food sources rich in saturated fatty acids and the incidence of type 2 diabetes (T2D).Design: A prospective cohort analysis of 3349 individuals who were free of diabetes at baseline but were at high cardiovascular risk from the PREvención con DIeta MEDiterránea (PREDIMED) study was conducted. Detailed dietary information was assessed at baseline and yearly during the follow-up using a food frequency questionnaire. Multivariable Cox proportional hazards models were used to estimate T2D HRs and 95% CIs according to baseline and yearly updated fat intake.Results: We documented 266 incident cases during 4.3 y of follow-up. Baseline saturated and animal fat intake was not associated with the risk of T2D. After multivariable adjustment, participants in the highest quartile of updated intake of saturated and animal fat had a higher risk of diabetes than the lowest quartile (HR: 2.19; 95% CI: 1.28, 3.73; and P-trend = 0.01 compared with HR: 2.00; 95% CI: 1.29, 3.09; and P-trend < 0.01, respectively). In both the Mediterranean diet and control groups, participants in the highest quartile of updated animal fat intake had an ∼2-fold higher risk of T2D than their counterparts in the lowest quartile. The consumption of 1 serving of butter and cheese was associated with a higher risk of diabetes, whereas whole-fat yogurt intake was associated with a lower risk.Conclusions: In a Mediterranean trial focused on dietary fat interventions, baseline intake of saturated and animal fat was not associated with T2D incidence, but the yearly updated intake of saturated and animal fat was associated with a higher risk of T2D. Cheese and butter intake was associated with a higher risk of T2D, whereas whole-fat yogurt intake was associated with a lower risk of T2D. This trial was registered at www.isrctn.com as ISRCTN35739639.