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Low E, D’Cunha NM, Georgousopoulou E, Naumovski N, Bacon R, Isbel S, Brocklehurst M, Reynolds M, Ryan D, Kellett J. Risk of Social Isolation as a Contributing Factor to Diet Quality in Community-Dwelling Older Persons Living in the Australian Capital Territory-A Pilot Study. Healthcare (Basel) 2024; 12:539. [PMID: 38470650 PMCID: PMC10930706 DOI: 10.3390/healthcare12050539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/09/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVES Social isolation is recognised as a risk factor in the inflammatory process. This study explored the association between social isolation and the Dietary Inflammatory Index (DII) in community-dwelling older persons. METHODS This cross-sectional pilot study recruited 107 community-dwelling people aged over 55 years living in the Australian Capital Territory. Participants completed an extensive food frequency questionnaire and provided anthropometric and sociodemographic data. Social isolation was evaluated using the Lubben Social Network Scale (LSNS). Diet quality was assessed using DII. RESULTS Average age was 70.1 (±8.61) years and 62.8% were female. The average DII score was -1.10 (±1.21), indicating an anti-inflammatory diet. Higher LSNS was associated with lower DII (b (95% CI) = -0.041 (-0.066, -0.17); p < 0.01) and was positively influenced by the number of people in household (b (95% CI) = 5.731 (2.336, 9.127); p = 0.001). CONCLUSION Increased risk of social isolation was associated with an increased tendency towards a more inflammatory diet. Reducing social isolation may decrease the inflammatory component of dietary intake for older persons living independently in the community.
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Affiliation(s)
- Elizabeth Low
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
- Centre for Ageing, Research and Translation, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia;
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
| | - Nathan M. D’Cunha
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
- Centre for Ageing, Research and Translation, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia;
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
| | - Ekavi Georgousopoulou
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
| | - Nenad Naumovski
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
- University of Canberra Research Institute for Sport and Exercise (UCRISE), University of Canberra, Canberra, ACT 2601, Australia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Kallithea, 17671 Athens, Greece
| | - Rachel Bacon
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
| | - Stephen Isbel
- Centre for Ageing, Research and Translation, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia;
- Discipline of Occupational Therapy, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia
| | - Megan Brocklehurst
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
| | - Matthew Reynolds
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
| | - Daena Ryan
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
| | - Jane Kellett
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia; (N.M.D.); (E.G.); (N.N.); (R.B.); (J.K.)
- Centre for Ageing, Research and Translation, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia;
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
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Tay E, Barnett D, Rowland M, Kerse N, Edlin R, Waters DL, Connolly M, Pillai A, Tupou E, Teh R. Sociodemographic and Health Indicators of Diet Quality in Pre-Frail Older Adults in New Zealand. Nutrients 2023; 15:4416. [PMID: 37892491 PMCID: PMC10610025 DOI: 10.3390/nu15204416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/09/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
This study aimed to identify sociodemographic and health indicators of diet quality in pre-frail community-dwelling older adults. Pre-frail older adults are those at risk of progression to clinical manifestations of frailty and are targets for preventative intervention. We previously reported that pre-frail older adults have reasonably good overall diet quality. However, further analyses found a low intake of energy, protein and several micronutrients. METHODS We collected detailed dietary intake from pre-frail (FRAIL scale 1-2) older adults using NZ Intake24, an online version of 24 h multiple pass dietary recall. Diet quality was ascertained with the Diet Quality Index-International (DQI-I). We used regression generalized linear models to determine predictors of diet quality as well as classification and regression tree (CART) analysis to examine the complex relationships between predictors and identified profiles of sub-groups of older adults that predict diet quality. RESULTS The median age in this sample (n = 468) was 80.0 years (77.0-84.0). Living with others, a high deprivation index and a higher BMI were independent predictors of poorer diet quality. With CART analysis, we found that those with a BMI > 29 kg/m2, living with others and younger than 80 years were likely to have a lower diet quality. CONCLUSIONS We found that BMI, living arrangement and socioeconomic status were independent predictors of diet quality in pre-frail older adults, with BMI being the most important variable in this sample when the interaction of these variables was considered. Future research is needed to determine the similarities and/or differences in the profile of subgroups of older adults with poorer diet quality.
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Affiliation(s)
- Esther Tay
- Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Auckland 1023, New Zealand; (E.T.); (N.K.); (E.T.)
| | - Daniel Barnett
- Department of Statistics, Faculty of Science, University of Auckland, Auckland 1010, New Zealand; (D.B.); (A.P.)
| | - Maisie Rowland
- Human Nutrition Research Centre, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK;
| | - Ngaire Kerse
- Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Auckland 1023, New Zealand; (E.T.); (N.K.); (E.T.)
| | - Richard Edlin
- Health Systems Group, School of Population Health, University of Auckland, Auckland 1023, New Zealand;
| | - Debra L. Waters
- Department of Medicine, University of Otago, Dunedin 9016, New Zealand;
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9016, New Zealand
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87106, USA
| | - Martin Connolly
- Department of Geriatric Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand;
| | - Avinesh Pillai
- Department of Statistics, Faculty of Science, University of Auckland, Auckland 1010, New Zealand; (D.B.); (A.P.)
| | - Evelingi Tupou
- Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Auckland 1023, New Zealand; (E.T.); (N.K.); (E.T.)
| | - Ruth Teh
- Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Auckland 1023, New Zealand; (E.T.); (N.K.); (E.T.)
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Hoveling LA, Lepe A, Boissonneault M, de Beer JAA, Smidt N, de Kroon MLA, Liefbroer AC. Educational inequalities in metabolic syndrome prevalence, timing, and duration amongst adults over the life course: a microsimulation analysis based on the lifelines cohort study. Int J Behav Nutr Phys Act 2023; 20:104. [PMID: 37667275 PMCID: PMC10478481 DOI: 10.1186/s12966-023-01495-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/29/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Educational inequalities in metabolic syndrome (MetS) are a growing public health concern. Intervening on modifiable factors may help reduce these inequalities, but there is a need for evidence on the long-term impact of intervening on these factors. Thus, we simulate the development of educational inequalities in MetS across the life course and assess the impact of intervening on the modifiable factors that contribute to these inequalities. METHODS We used data from the prospective multigenerational Dutch Lifelines Cohort Study to estimate the required input for a continuous-time microsimulation. The microsimulation projects the development of educational inequalities in MetS between ages 18 and 65, and assesses the potential benefit of intervening on smoking, alcohol use, diet quality, and health literacy. FINDINGS The likelihood of ever experiencing MetS between ages 18 and 65 varies from 32.5% among high educated women to 71.5% among low educated men. On average, 27.6% more individuals with low education will ever experience MetS between ages 18 and 65 compared to those with high education. Additionally, individuals with low education generally will develop MetS 2.3 years earlier, and will spend an extra 2.6 years with MetS, compared to individuals with high education. Changes to smoking behaviours in individuals with low education produced the largest effect; it would reduce inequalities in prevalence, timing and duration by an average of 7.5%, 9.5%, and 6.9%, respectively. CONCLUSIONS Interventions targeting the modifiable factors included in this study, especially smoking, could help reduce the estimated educational inequalities in MetS over the life course.
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Affiliation(s)
- Liza A Hoveling
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands.
| | - Alexander Lepe
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
| | - Michael Boissonneault
- Netherlands Interdisciplinary Demographic Institute (NIDI)-KNAW, University of Groningen, PO Box 11650, The Hague, 2502 AR, The Netherlands
| | - Joop A A de Beer
- Netherlands Interdisciplinary Demographic Institute (NIDI)-KNAW, University of Groningen, PO Box 11650, The Hague, 2502 AR, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
| | - Marlou L A de Kroon
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Aart C Liefbroer
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
- Netherlands Interdisciplinary Demographic Institute (NIDI)-KNAW, University of Groningen, PO Box 11650, The Hague, 2502 AR, The Netherlands
- Department of Sociology, Vrije Universiteit Amsterdam, De Boelelaan 1081, Amsterdam, 1081 HV, The Netherlands
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Larsen K, Rydz E, Peters CE. Inequalities in Environmental Cancer Risk and Carcinogen Exposures: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095718. [PMID: 37174236 PMCID: PMC10178444 DOI: 10.3390/ijerph20095718] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/11/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023]
Abstract
Background: Cancer is the leading cause of death in Canada and a major cause of death worldwide. Environmental exposure to carcinogens and environments that may relate to health behaviors are important to examine as they can be modified to lower cancer risks. Built environments include aspects such as transit infrastructure, greenspace, food and tobacco environments, or land use, which may impact how people move, exercise, eat, and live. While environments may play a role in overall cancer risk, exposure to carcinogens or healthier environments is not equitably spread across space. Exposures to carcinogens commonly concentrate among socially and/or economically disadvantaged populations. While many studies have examined inequalities in exposure or cancer risk, this has commonly been for one exposure. Methods: This scoping review collected and synthesized research that examines inequities in carcinogenic environments and exposures. Results: This scoping review found that neighborhoods with higher proportions of low-income residents, racialized people, or same-sex couples had higher exposures to carcinogens and environments that may influence cancer risk. There are currently four main themes in research studying inequitable exposures: air pollution and hazardous substances, tobacco access, food access, and other aspects of the built environment, with most research still focusing on air pollution. Conclusions: More work is needed to understand how exposures to these four areas intersect with other factors to reduce inequities in exposures to support longer-term goals toward cancer prevention.
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Affiliation(s)
- Kristian Larsen
- Health Canada, Office of Environmental Health, Healthy Environments and Consumer Safety Branch, Environmental and Radiation Health Science Directorate, Ottawa, ON K1A 0K9, Canada
- CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Department of Geography and Planning, University of Toronto, Toronto, ON M5S 3G3, Canada
- Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, ON M5B 2K3, Canada
| | - Ela Rydz
- CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Cheryl E Peters
- CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Prevention, Screening and Hereditary Cancer, BC Cancer, Vancouver, BC V5Z 4E6, Canada
- Population and Public Health, British Columbia Centre for Disease Control, Vancouver, BC V5Z 4R4, Canada
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Kouiti M, Ortega-Rico C, Arrebola JP, Gracia-Arnaiz M, Larrea-Killinger C. Demographic and Socioeconomic Factors Associated to Fruits and Vegetables Consumption in Elderly Europeans: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3442. [PMID: 36834135 PMCID: PMC9962118 DOI: 10.3390/ijerph20043442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Several epidemiological studies stress the association between a diet based on high fruits and vegetables intake and a better health condition. However, elderly Europeans cannot manage the recommended fruits and vegetables consumption. This systematic review aims to explore the main factors related to fruits and vegetables consumption in elderly Europeans. We conducted literature searches on Medline, Scopus, and Web of Science from inception to May 2022. Published articles including data related to certain fruits and vegetables consumption among elderly Europeans were selected. The New Castle-Ottawa Scale and National Heart, Lung, and Blood Institute tools were used for methodological quality assessment by two authors independently. A total of 60 articles were retrieved, and data from twenty-one high-quality cross-sectional studies and five moderate-to-high-quality cohort studies, including a total of 109,516 participants, were synthesized. Associated factors mostly analyzed were those relating to demographic and socioeconomic status, such as sex, age, marital status, educational level, and income. However, the findings show a high discrepancy. Some evidence suggests a possible positive association, while other evidence shows an inverse or no association at all. The relationship between demographic and socioeconomic factors with fruits and vegetables consumption is not at all clear. More epidemiological studies with an appropriate design and corresponding statistical methods are required.
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Affiliation(s)
- Malak Kouiti
- Department of Preventive Medicine and Public Health, Universidad de Granada, 18071 Granada, Spain
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat 26000, Morocco
| | - Carmen Ortega-Rico
- Department of Preventive Medicine and Public Health, Universidad de Granada, 18071 Granada, Spain
| | - Juan Pedro Arrebola
- Department of Preventive Medicine and Public Health, Universidad de Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), Avda. de Madrid, 15. Pabellón de Consultas Externas 2, 2a Planta, 18012 Granada, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Mabel Gracia-Arnaiz
- Department of Anthropology, Philosophy and Social Work, Universitat Rovira i Virgili, Av., 43002 Tarragona, Spain
| | - Cristina Larrea-Killinger
- Department of Social and Cultural Anthropology, University of Barcelona, 08001 Barcelona, Spain
- Food Observatory (ODELA), University of Barcelona, 08001 Barcelona, Spain
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Tsofliou F, Vlachos D, Hughes C, Appleton KM. Barriers and Facilitators Associated with the Adoption of and Adherence to a Mediterranean Style Diet in Adults: A Systematic Review of Published Observational and Qualitative Studies. Nutrients 2022; 14:4314. [PMID: 36296998 PMCID: PMC9607475 DOI: 10.3390/nu14204314] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 11/16/2022] Open
Abstract
The Mediterranean diet (MedDiet) has been linked with physical and mental health benefits. Previous research, however, suggests that adoption and adherence to a Mediterranean diet might be difficult for people who live outside of the Mediterranean region. The aim of this systematic review was to investigate the factors that influence adoption and adherence to a Mediterranean style diet in adults aged 18 years old and over, as identified in published observational and qualitative studies. Following registration of our protocol on PROSPERO (ID: CRD42018116515), observational and qualitative studies of adults' perceptions and experiences relevant to following a Mediterranean style diet were identified using systematic searches of databases: MEDLINE, the Cochane Library, CINAHL, Web of Science and Scopus, over all years of records until February 2022. A narrative synthesis was then undertaken. Of 4559 retrieved articles, 18 studies fulfilled our inclusion criteria and were included. Factors influencing adoption and adherence to a MedDiet were identified and categorized as: financial, cognitive, socio-cultural, motivational, lifestyle, accessibility & availability, sensory & hedonic and demographic. Similar barriers and facilitators are often reported in relation to healthy eating or the consumption of specific healthy foods, with a few exceptions. These exceptions detailed concerns with specific components of the MedDiet; considerations due to culture and traditions, and concerns over a cooler climate. Suggestions for overcoming these barriers and facilitators specific to adoption and adherence to the Mediterranean diet are offered. These data will inform the development of future studies of robust methodology in eating behaviour change which offer pragmatic approaches for people to consume and maintain healthy diets.
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Affiliation(s)
- Fotini Tsofliou
- Department of Rehabilitation and Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
| | - Dimitrios Vlachos
- Department of Rehabilitation and Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
| | - Christina Hughes
- Department of Rehabilitation and Sport Sciences, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
| | - Katherine M. Appleton
- Department of Psychology, Faculty of Science and Technology, Talbot Campus, Bournemouth University, Fern Barrow, Bournemouth BH12 5BB, UK
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Møller M, Kjær SK, Lindquist S, Brown Frandsen CL, Albieri V, Viuff JH, Nøhr B, Olsen A, Jensen A. Risk of colorectal cancer after use of fertility drugs-results from a large Danish population-based cohort of women with infertility. Fertil Steril 2022; 118:738-747. [PMID: 36041966 DOI: 10.1016/j.fertnstert.2022.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To study the association between use of fertility drugs and colorectal cancer among women with infertility. DESIGN Population-based cohort study. SETTING Not applicable. PATIENT(S) The study cohort was obtained from the Danish Infertility Cohort and consisted of all women with infertility aged 20-45 years living in Denmark during 1995-2017. INTERVENTION(S) Information on the use of specific types of fertility drugs, colorectal cancer diagnoses, covariates, and vital status were obtained from the Danish Infertility Cohort and Danish national registers. MAIN OUTCOME MEASURE(S) Cox proportional hazard models adjusted for potential confounders were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for colorectal cancer overall and rectal and colon cancer separately. RESULTS(S) Among 148,036 women in the final study cohort, 205 women were diagnosed with colorectal cancer. Ever use of clomiphene citrate (CC) was associated with a lower rate of colorectal cancer (unadjusted HR, 0.67; 95% CI, 0.51-0.89; adjusted HR, 0.68; 95% CI, 0.50-0.93). However, the lower rate was only seen among women who first used CC >8 years ago (unadjusted HR, 0.56; 95% CI, 0.41-0.76; adjusted HR, 0.52; 95% CI, 0.36-0.75). No marked associations were found between the use of any of other types of fertility drugs and colorectal cancer. The results for colon and rectal cancer analyzed separately were similar, except for a suggestion of a decreased risk of rectal cancer associated with the use of gonadotropins (adjusted HR, 0.46; 95% CI, 0.20-1.08). CONCLUSION(S) Among women with infertility, the use of most types of fertility drugs was not associated with colorectal cancer. However, CC may decrease the risk of colorectal cancer and gonadotropins might decrease the risk of rectal cancer, but we cannot rule out that these findings may be more related to the underlying conditions in these women or are chance findings. Consequently, the results from this study should be investigated further in large epidemiological studies.
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Affiliation(s)
- Maria Møller
- Lifestyle, Reproduction and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjær
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sofie Lindquist
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Vanna Albieri
- Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jakob Hansen Viuff
- Diet, Cancer and Health, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Bugge Nøhr
- The Fertility Clinic, Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Anja Olsen
- Nutrition and Biomarkers, Danish Cancer Society Reseach Center, Copenhagen, Denmark; Institute of Public Health, Aarhus University, Aarhus, Denmark
| | - Allan Jensen
- Lifestyle, Reproduction and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.
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Wang L, Huang W, Zhao C, Hu Y, Cui S. Exploring the environment-nutrition-obesity effects associated with food consumption in different groups in China. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 317:115287. [PMID: 35642807 DOI: 10.1016/j.jenvman.2022.115287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/24/2022] [Accepted: 05/08/2022] [Indexed: 06/15/2023]
Abstract
Unsustainable diet is one of the main reasons for the nutrition-health-environment trilemma. However, information on environment-nutrition-obesity effects associated with food consumption is still limited. This study analyzes these diet-related impacts of different groups classified by various socio-economic attributes: location, gender, age, income, education, and occupation. We applied the samples in China Health and Nutrition Survey and divided them into advantaged group and dis-advantaged group according to the probability of access to more nutritious food. Results show that the advantaged groups had higher and more rapidly increasing dietary and nutrition quality than their counterpart during 1997-2011. On the contrary, the non-advantaged group' body mass index increased faster. Meanwhile, the high-income group as well as government and professional & technological workers have passed the criterion for overweight. The environmental footprints, i.e., nitrogen, phosphorus, carbon, and water footprints, of high-income group were higher 89%, 70%, 98%, and 41% than low-income group, respectively. Notably, food consumption sustainability of each group has declined, and the non-advantaged groups' is much more sustainable. We concluded that inequality existed and tends to expand in food consumption and its related impacts of different socio-economic groups. A reformed responsibility allocation system is needed during dietary transition for better environmental management. Strategies to improve dietary quality for advantaged group focus on improving the types of high-quality protein foods, such as milk and seafood, while the non-advantaged group can choose to increase the types of high-quality but relatively cheap foods like vegetables and fruits considering the availability and living cost.
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Affiliation(s)
- Lan Wang
- Key Research Institute of Yellow River Civilization and Sustainable Development & Collaborative Innovation Center on Yellow River Civilization jointly built by Henan Province and Ministry of Education, Henan University, Kaifeng, 475001, China; Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, 361021, China; University of Chinese Academy of Sciences, No. 19(A) Yuquan Road, Beijing, 100049, China
| | - Wei Huang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, 361021, China; University of Chinese Academy of Sciences, No. 19(A) Yuquan Road, Beijing, 100049, China; Xiamen Key Lab of Urban Metabolism, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, 361021, China
| | - Chuan Zhao
- Graduate School of Environmental Studies, Tohoku University, Sendai, 980-8579, Japan
| | - Yuanchao Hu
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, 430079, China.
| | - Shenghui Cui
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, 361021, China; University of Chinese Academy of Sciences, No. 19(A) Yuquan Road, Beijing, 100049, China.
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Spatial Differences in Diet Quality and Economic Vulnerability to Food Insecurity in Bangladesh: Results from the 2016 Household Income and Expenditure Survey. SUSTAINABILITY 2022. [DOI: 10.3390/su14095643] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The study explored the spatial differences in diet quality and economic vulnerability to food insecurity with the association of sociodemographic characteristics at the household level in Bangladesh. This study was a secondary data analysis of Household Income and Expenditure Survey (HIES) data of 2016. Both statistical and spatial analyses were applied while assessing diet qualities in terms of the household dietary diversity score (HDDS), percentage of food energy from staples (PFES), and percentage of expenditure on food (PEF) as an indicator of the economic vulnerability to food insecurity (EVFI). The study’s findings revealed that the quality of people’s diets worsened as they moved from urban to rural area, and EVFI increased as they moved from the center to the periphery of the country. Nationally, the average HDDS was about 6.3, and the average PFES per household per day was about 70.4%. The spatial distribution of HDDS and PFES showed that rural regions in terms of settlements and the north, northwest and southeast regions had mostly low diet diversity. Besides, the average PEF per household per day was about 54%, with the highest in Mymensingh (57.4%) and the lowest in Dhaka division (50.2%). The average PEF in the households illustrated was highest in rural (55.2%) and lowest in the city (45.7%). Overall, based on the PEF at the sub-district level, the medium level of vulnerability comprised the highest share (69%) in Bangladesh. Age, gender, literacy, educational qualification and religion of the household’s head along with the number of earners, monthly income, area of settlements and divisions were significantly correlated with HDDS, PFES and EVFI. The study findings suggest that targeted interventions, including access to education, women empowerment and employment generation programs should be implemented in peripheral areas (north, northwest and southeast) to increase diet quality and minimize economic vulnerability to achieve sustainable food and nutrition security in Bangladesh.
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Dietary Patterns among Older People and the Associations with Social Environment and Individual Factors in Taiwan: A Multilevel Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073982. [PMID: 35409665 PMCID: PMC8998054 DOI: 10.3390/ijerph19073982] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/24/2022] [Accepted: 03/24/2022] [Indexed: 11/16/2022]
Abstract
Individual factors relating to dietary behaviors are widely explored. However, the effects of social environment on dietary patterns for the older people are less explored. The purpose of this study was to identify dietary patterns among older people in Taiwan and to examine the relationship of dietary patterns with social environment and individual factors. The current study used the 2013–2016 Nutrition and Health Survey in Taiwan. The sample was representative at the national and city levels. Only those who were aged 55 years old and above were included for analysis (n = 2922); the mean age of the participants was 68.62 (SD = 8.76). The city-level data, including population characteristics, food availability, and age-friendly city indicators, were obtained from the open data and survey report of government. Three dietary patterns were identified: high protein-vegetable (41.6%), high sweets and low protein-vegetables (37.9%), and high viscera and fats (20.5%). The results of multilevel multinomial logistic regressions showed that marital status, economic status, education, drinking alcohol, dietary belief, living a the city with more food availability, and bus accessibility were related to dietary patterns. Dietary patterns are related to the individual-level factors and social environment. Healthy dietary beliefs and age-friendly environments are beneficial to promoting healthy dietary patterns.
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11
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Hosseini SH, Farag M, Hosseini SZ, Vatanparast H. Behavioral factors are perhaps more important than income in determining diet quality in Canada. SSM Popul Health 2022; 17:101001. [PMID: 35005185 PMCID: PMC8715369 DOI: 10.1016/j.ssmph.2021.101001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 11/25/2021] [Accepted: 12/11/2021] [Indexed: 12/01/2022] Open
Abstract
This study examines the importance of income in determining the diet quality of Canadian adults measured based on Nutrient Rich Food Index version 9.3. We used the latest available data on Canadians' consumption of foods and nutrients from the Canadian Community Health Survey-Nutrition 2015. The Canada' Food Guide classification was used for categorizing food groups based on types of food and their healthiness. Unsupervised and supervised machine learning models were employed in order to examine the links between income and the choice of foods. We first employed cluster analysis to identify the dietary patterns among individuals included in the sample and then we examined whether the intakes of various food groups across the identified clusters vary by income levels. Further, we evaluated the association between diet quality and income using Lasso Regression to determine the most important predictors of diet quality among adults in Canada. The results of both cluster analysis and regularized regression model suggested that behavioral factors and cultural backgrounds are more important determinants of diet quality among adults in Canada.
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Affiliation(s)
- Seyed H. Hosseini
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada
| | - Marwa Farag
- School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada
| | - Seyedeh Zeinab Hosseini
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada
- School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada
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12
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Danko A, Naughton M, Spees C, Bittoni AM, Krok-Schoen JL. Diet Quality and the Number of Comorbidities Are Associated with General Health Among Older Female Cancer Survivors. J Aging Health 2021; 33:908-918. [PMID: 34814773 DOI: 10.1177/08982643211018923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective: We aimed to investigate the associations between diet quality, general health, and comorbidities among older female cancer survivors. Methods: Participants (n = 171) completed one-time surveys to assess health-related quality of life (RAND-36), diet quality (Healthy Eating Index (HEI-2015)), and number of comorbidities. Additional demographic and clinical variables were collected. Descriptive statistics, analysis of covariance, correlations, and linear regressions were utilized. Results: A positive correlation was found between HEI-2015 and general health subscale scores (r = .26, p = .002). A negative correlation was found between the number of comorbidities and general health (r = -.21, p = .02). Being white (β = -.24, p = .02) and having fewer comorbidities (β = -.22, p = .04) were significantly associated with higher general health. Being unmarried (β = .24, p = .02) and having higher education (β = .32, p = .002) were significantly associated with higher HEI-2015 scores. Discussion: Healthcare providers should seek guidance from registered dietitian nutritionists for nutritional education to promote optimal nutritional status, thus contributing to improved general health among this growing population.
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Affiliation(s)
- Allison Danko
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, 51121Ohio State University, Columbus, OH, USA
| | - Michelle Naughton
- 549472The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.,Department of Internal Medicine, College of Medicine, 24600Ohio State University, Columbus, OH, USA
| | - Colleen Spees
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, 51121Ohio State University, Columbus, OH, USA.,549472The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Anna Maria Bittoni
- 549472The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Jessica L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, 51121Ohio State University, Columbus, OH, USA.,549472The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
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Hoveling LA, Liefbroer AC, Bültmann U, Smidt N. Understanding socioeconomic differences in metabolic syndrome remission among adults: what is the mediating role of health behaviors? Int J Behav Nutr Phys Act 2021; 18:147. [PMID: 34753498 PMCID: PMC8577003 DOI: 10.1186/s12966-021-01217-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 10/21/2021] [Indexed: 11/21/2022] Open
Abstract
Background Although the incidence of metabolic syndrome (MetS) strongly varies based on individuals’ socioeconomic position (SEP), as yet no studies have examined the SEP-MetS remission relationship. Our aim is to longitudinally assess the associations between SEP measures education, income and occupational prestige, and MetS remission, and whether these associations are mediated by health behaviors, including physical activity, smoking, alcohol intake and diet quality. Methods A subsample (n = 16,818) of the adult Lifelines Cohort Study with MetS at baseline was used. MetS remission was measured upon second assessment (median follow-up time 3.8 years), defined according to NCEP-ATPIII criteria. To estimate direct associations between SEP, health behaviors and MetS remission multivariable logistic regression analyses were used. To estimate the mediating percentages of health behaviors that explain the SEP-MetS remission relationship the Karlson-Holm-Breen method was used. Analyses were adjusted for age, sex, the other SEP measures and follow-up time. Results At the second assessment, 42.7% of the participants experienced MetS remission. Education and income were positively associated with MetS remission, but occupational prestige was not. The association between education and MetS remission could partly (11.9%) be explained by health behaviors, but not the association between income and MetS remission. Conclusions Individuals with higher education more often experienced remission from MetS, mainly because individuals with higher education were more likely to have healthier behaviors. However, individuals with higher income more often experienced MetS remissions, regardless of their health behaviors. The occupational prestige of individuals was not associated with MetS remission. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01217-5.
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Affiliation(s)
- Liza A Hoveling
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700, RB, Groningen, The Netherlands.
| | - Aart C Liefbroer
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700, RB, Groningen, The Netherlands.,Netherlands Interdisciplinary Demographic Institute, PO Box 11650, 2502, AR, The Hague, The Netherlands.,Department of Sociology, Vrije Universiteit Amsterdam, De Boelelaan, 1081, HV, Amsterdam, The Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700, RB, Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700, RB, Groningen, The Netherlands
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14
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The Effect of A Weight-Loss Diet in Women Doing Reformer Pilates: A 12-Week Evaluation. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.1004825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Hoveling LA, Liefbroer AC, Bültmann U, Smidt N. Understanding socioeconomic differences in incident metabolic syndrome among adults: What is the mediating role of health behaviours? Prev Med 2021; 148:106537. [PMID: 33798530 DOI: 10.1016/j.ypmed.2021.106537] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/04/2021] [Accepted: 03/28/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND The incidence of metabolic syndrome (MetS) strongly varies by socioeconomic position (SEP), but little is known about the mediating role of health behaviours in this association. This study examines the associations between the SEP measures, education, income and occupational prestige, and incident MetS and whether the associations are mediated by health behaviours, including physical activity, smoking, alcohol intake and diet quality. METHODS A subsample (n = 85,910) of the adult Lifelines Cohort Study without MetS at baseline was used. MetS was measured at the second assessment (median follow-up time 3.8 years) defined according to the NCEP-ATPIII criteria. Direct associations between SEP, health behaviours and incident MetS were estimated using multivariable logistic regression analyses. The mediating percentages of health behaviours explaining the associations between SEP and incident MetS were estimated using the Karlson-Holm-Breen method. Analyses were independent of age, sex, the other SEP measures and follow-up time. RESULTS Education and occupational prestige were inversely associated with MetS. Income was not associated with MetS. Health behaviours explained only partly (13.8%) the association between education and MetS, with smoking as the strongest mediating factor (8.8%). Health behaviours played also a minor role (2.7%) in explaining occupational MetS differences, with physical activity as the strongest suppressing factor (-9.4%). CONCLUSION Individuals with more years of education or a higher occupational prestige had a lower risk to develop MetS. This was mainly because of non-smoking, less excessive alcohol intake and a higher diet quality. However, individuals with a higher SEP were more often physically inactive.
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Affiliation(s)
- Liza A Hoveling
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, PO Box 30.001, 9700 RB Groningen, the Netherlands.
| | - Aart C Liefbroer
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, PO Box 30.001, 9700 RB Groningen, the Netherlands; Netherlands Interdisciplinary Demographic Institute, PO Box 11650, 2502 AR The Hague, the Netherlands; Vrije Universiteit Amsterdam, Department of Sociology, De Boelelaan 1081, 1081 HV Amsterdam, the Netherlands
| | - Ute Bültmann
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, PO Box 30.001, 9700 RB Groningen, the Netherlands
| | - Nynke Smidt
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, PO Box 30.001, 9700 RB Groningen, the Netherlands
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To what extent do dietary costs explain socio-economic differences in dietary behavior? Nutr J 2020; 19:88. [PMID: 32838789 PMCID: PMC7446174 DOI: 10.1186/s12937-020-00608-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 08/17/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Low socio-economic position is associated with consumption of lower quality diets, which may be partly explained by the cost of healthier diets. Therefore, we aimed to investigate the mediating role of dietary costs in the association between educational level and diet quality. METHODS We used cross-sectional data from Dutch older adults (N = 9399) in the EPIC-NL cohort. Participants provided information about their own and their partners' highest attained educational level (as proxy for socio-economic position). Dietary behavior was assessed using a food frequency questionnaire from which we derived two diet-quality scores, including the Dutch Healthy Diet index 2015 (DHD15-index) and the Dietary Approaches to Stop Hypertension (DASH) diet. Dietary cost estimates were based on food price data from food stores, and linked to reported consumption of food items. Multiple regression analyses and bootstrapping were used examine the mediating role of dietary cost in the association between educational level and diet quality. RESULTS Mean age of participants was 70 (SD: 10) years and 77% were women. Dietary costs significantly mediated the association between educational level and diet quality, except for high versus middle individual educational level and the DHD15-index. Depending on the dietary and educational indicator, dietary costs explained between 2 and 7% of the association between educational level and diet quality. Furthermore, associations were found to be modified by sex and age. For the DHD15-index, mediation effects were only present in females and adults older than 65 years, and for the DASH diet mediation effects were only present in females and strongest amongst adults older than 65 years compared to adults younger than 65 years. CONCLUSION Dietary costs seems to play a modest role in explaining educational differences in diet quality in an older Dutch population. Further research is needed to investigate which other factors may explain SEP differences in diet quality.
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Alhusseini N, Alqahtani A. COVID-19 pandemic's impact on eating habits in Saudi Arabia. J Public Health Res 2020; 9:1868. [PMID: 33024727 PMCID: PMC7512943 DOI: 10.4081/jphr.2020.1868] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/02/2020] [Indexed: 01/10/2023] Open
Abstract
Background: COVID-19 virus has been reported as a pandemic in March 2020 by the WHO. Having a balanced and healthy diet routine can help boost the immune system, which is essential in fighting viruses. Public Health officials enforced lockdown for residents resulting in dietary habits change to combat sudden changes. Design and Methods: A cross-sectional study was conducted through an online survey to describe the impact of the COVID-19 pandemic on the eating habits, quality and quantity of food intake among adults in Saudi Arabia. SPSS version 24 was used to analyze the data. Comparison between general dietary habits before and during COVID-19 for ordinal variables was performed by Wilcoxon Signed Rank test, while McNemar test was performed for nominal variables. The paired samples t-test was used to compare the total scores for food quality and quantity before and during COVID-19 periods. Results: 2706 adults residing in Riyadh completed the survey. The majority (85.6%) of the respondents reported eating homecooked meals on a daily basis during COVID-19 as compared to 35.6% before (p<0.001). The mean score for the quality of food intake was slightly higher (p=0.002) before the COVID-19 period (16.46±2.84) as compared to the during period (16.39±2.79). The quantity of food mean score was higher (p<0.001) during the COVID-19 period (15.70±2.66) as compared to the before period (14.62±2.71). Conclusion: Dietary habits have changed significantly during the COVID-19 pandemic among Riyadh residents. Although some good habits increased, the quality and the quantity of the food was compromised. Public Health officials must focus on increased awareness on healthy eating during pandemics to avoid negative consequences. Future research is recommended to better understand the change in dietary habits during pandemics using a detailed food frequency questionnaire.
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18
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Kim T, Choi SD, Xiong S. Epidemiology of fall and its socioeconomic risk factors in community-dwelling Korean elderly. PLoS One 2020; 15:e0234787. [PMID: 32559206 PMCID: PMC7304594 DOI: 10.1371/journal.pone.0234787] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 06/02/2020] [Indexed: 11/19/2022] Open
Abstract
Although falls in older people are a major public health problem globally, to date there are scarce reports on socioeconomic risk factors for falls. The aim of the present study was to investigate the epidemiology of fall, its associated socioeconomic risk factors and relative importance among community-dwelling Korean elderly. Secondary analysis of national survey data with 31,684 community-dwelling Korean elderly was performed. Eleven socioeconomic factors (age, gender, household type, marital status, education level, current occupation, past occupation, income, wealth, number of children, and relationship satisfaction) were selected for analysing their associations with the epidemiology of fall through complex sample analysis and logistic regressions. Results showed that 15.9%~25.1% of community-dwelling Korean elderly experienced fall yearly. The groups with significantly higher fall risks were identified as older aged, being female, not married or widowed, less educated, unemployed, and having lower relationship satisfaction. Gender (adjusted odds ratio-AOR = 1.548) and relationship satisfaction (AOR = 1.276) were the utmost important fall risk factors, indicating being older female with lower relationship satisfaction were the foremost socioeconomic characteristics for risk of falling. These findings could contribute to better understanding of the socioeconomic fall risk profiles among Korean elderly and effective strategies for fall prevention.
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Affiliation(s)
- Taekyoung Kim
- Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Yuseong-gu, Daejoen, Republic of Korea
| | - Sang D. Choi
- Department of Occupational and Environmental Safety and Health, University of Wisconsin, Whitewater, Wisconsin, United States of America
| | - Shuping Xiong
- Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Yuseong-gu, Daejoen, Republic of Korea
- * E-mail:
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19
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Hashimoto A, Murakami K, Kobayashi S, Suga H, Sasaki S. Associations of Education With Overall Diet Quality Are Explained by Different Food Groups in Middle-aged and Old Japanese Women. J Epidemiol 2020; 31:280-286. [PMID: 32418938 PMCID: PMC7940974 DOI: 10.2188/jea.je20200030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background The disparity of overall diet quality by personal educational attainment has been a public issue. However, it remains unknown which food groups contribute to the disparity. This cross-sectional study assesses which food groups explain associations between education and overall diet quality in Japanese women. Methods A total of 3,788 middle-aged (mean age, 47.7 years) and 2,188 older women (mean age, 74.4 years), who lived in 47 prefectures in Japan, provided data on their education (low, middle, and high) and dietary intakes from a diet history questionnaire. A diet quality score (possible score 0–70) was calculated based on seven food components. Mean diet quality scores, with adjustment for lifestyle and neighborhood variables, were estimated by education using a general linear model, and Dunnett’s multiple comparison was conducted. Additionally, mean scores of each food component were estimated by education and compared using the same manner. Results After adjustment for lifestyle and neighborhood variables, mean diet quality score of high or middle education was higher than low education for both generations. Middle-aged women with high and middle education had higher scores of ‘milk’, ‘snacks, confection, and beverages’, ‘fruits’, and ‘vegetable dishes’ than those with low education. Older women with high and middle education had higher scores of ‘sodium from seasonings’ and ‘fruits’ than those with low education. Conclusions This study suggests that positive associations between education and diet quality are explained by different food groups in middle-aged and older Japanese women, which are independent of lifestyle and neighborhood variables.
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Affiliation(s)
- Ayumi Hashimoto
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo
| | - Kentaro Murakami
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo
| | - Satomi Kobayashi
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo
| | - Hitomi Suga
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo
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Ikram MA, Brusselle G, Ghanbari M, Goedegebure A, Ikram MK, Kavousi M, Kieboom BCT, Klaver CCW, de Knegt RJ, Luik AI, Nijsten TEC, Peeters RP, van Rooij FJA, Stricker BH, Uitterlinden AG, Vernooij MW, Voortman T. Objectives, design and main findings until 2020 from the Rotterdam Study. Eur J Epidemiol 2020; 35:483-517. [PMID: 32367290 PMCID: PMC7250962 DOI: 10.1007/s10654-020-00640-5] [Citation(s) in RCA: 298] [Impact Index Per Article: 74.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/23/2020] [Indexed: 12/19/2022]
Abstract
The Rotterdam Study is an ongoing prospective cohort study that started in 1990 in the city of Rotterdam, The Netherlands. The study aims to unravel etiology, preclinical course, natural history and potential targets for intervention for chronic diseases in mid-life and late-life. The study focuses on cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, otolaryngological, locomotor, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. Since 2016, the cohort is being expanded by persons aged 40 years and over. The findings of the Rotterdam Study have been presented in over 1700 research articles and reports. This article provides an update on the rationale and design of the study. It also presents a summary of the major findings from the preceding 3 years and outlines developments for the coming period.
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Affiliation(s)
- M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Guy Brusselle
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Brenda C T Kieboom
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Caroline C W Klaver
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robert J de Knegt
- Department of Gastroenterology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Tamar E C Nijsten
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robin P Peeters
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frank J A van Rooij
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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Sanchez-Cabrero R. Mejora de la satisfacción corporal en la madurez a través de un programa específico de imagen corporal. UNIVERSITAS PSYCHOLOGICA 2020. [DOI: 10.11144/javeriana.upsy19.mscm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Se compara la mejora lograda en satisfacción corporal por un programa específico de intervención en imagen corporal en personas mayores con los resultados obtenidos en programas de intervención y animación social, con el propósito de valorar si son significativamente mejores que otros programas de carácter social. De ser así, resulta relevante intervenir específicamente sobre la satisfacción corporal durante la vejez para evitar otros problemas relacionados como la depresión o la baja autoestima. En el estudio, se analizan las conexiones encontradas entre el género, la edad y la presencia de pareja sentimental estable, como características de gran importancia para la satisfacción corporal. Los resultados muestran que, aunque la relevancia de la satisfacción corporal durante esa etapa es cualitativamente diferente a edades anteriores, la intervención específica en imagen corporal es significativamente más efectiva que otros programas preventivos o que la maduración experimental.
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van der Toorn JE, Cepeda M, Kiefte-de Jong JC, Franco OH, Voortman T, Schoufour JD. Seasonal variation of diet quality in a large middle-aged and elderly Dutch population-based cohort. Eur J Nutr 2020; 59:493-504. [PMID: 30734846 PMCID: PMC7058580 DOI: 10.1007/s00394-019-01918-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 01/29/2019] [Indexed: 11/23/2022]
Abstract
PURPOSE Several studies have reported seasonal variation in intake of food groups and certain nutrients. However, whether this could lead to a seasonal pattern of diet quality has not been addressed. We aimed to describe the seasonality of diet quality, and to examine the contribution of the food groups included in the dietary guidelines to this seasonality. METHODS Among 9701 middle-aged and elderly participants of the Rotterdam Study, a prospective population-based cohort, diet was assessed using food-frequency questionnaires (FFQ). Diet quality was measured as adherence to the Dutch dietary guidelines, and expressed in a diet quality score ranging from 0 to 14 points. The seasonality of diet quality and of the food group intake was examined using cosinor linear mixed models. Models were adjusted for sex, age, cohort, energy intake, physical activity, body mass index, comorbidities, and education. RESULTS Diet quality had a seasonal pattern with a winter-peak (seasonal variation = 0.10 points, December-peak) especially among participants who were men, obese and of high socio-economic level. This pattern was mostly explained by the seasonal variation in the intake of legumes (seasonal variation = 3.52 g/day, December-peak), nuts (seasonal variation = 0.78 g/day, January-peak), sugar-containing beverages (seasonal variation = 12.96 milliliters/day, June-peak), and dairy (seasonal variation = 17.52 g/day, June-peak). CONCLUSIONS Diet quality varies seasonally with heterogeneous seasonality of food groups counteractively contributing to the seasonal pattern in diet quality. This seasonality should be considered in future research on dietary behavior. Also, season-specific recommendations and policies are required to improve diet quality throughout the year.
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Affiliation(s)
- Janine E van der Toorn
- Department of Epidemiology, Erasmus MC, University Medical Centre, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Magda Cepeda
- Department of Epidemiology, Erasmus MC, University Medical Centre, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, University Medical Centre, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- Leiden University College, The Hague, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Centre, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Centre, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Josje D Schoufour
- Department of Epidemiology, Erasmus MC, University Medical Centre, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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23
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Alferink LJM, Kiefte-de Jong JC, Erler NS, de Knegt RJ, Hoorn EJ, Ikram MA, Janssen HLA, Metselaar HJ, Franco OH, Darwish Murad S. Diet-Dependent Acid Load-The Missing Link Between an Animal Protein-Rich Diet and Nonalcoholic Fatty Liver Disease? J Clin Endocrinol Metab 2019; 104:6325-6337. [PMID: 30977830 DOI: 10.1210/jc.2018-02792] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 04/08/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Our group recently showed that animal protein was independently associated with nonalcoholic fatty liver disease (NAFLD). We hypothesize that this may be explained by a high diet-dependent acid load [dietary acid load (DAL)]. METHODS This cross-sectional study is embedded in a prospective population-based cohort. We estimated DAL proxies via food-frequency questionnaires using potential renal acid load (PRAL; using dietary protein, phosphorus, potassium, calcium, and magnesium intake), net endogenous acid production (NEAP; using protein and potassium intake), and the animal protein-to-potassium ratio (A:P). We defined NAFLD using ultrasound after excluding secondary steatogenic causes. We used logistic regression models-adjusted for sociodemographic, lifestyle, and metabolic traits-on categorized [quartile (Q)1 to 4] and continuous DAL proxies (allowing for nonlinearity) and NAFLD. RESULTS We included 3882 participants, of which 1337 had NAFLD. All DAL proxies were higher, meaning more acidic, in individuals with NAFLD (PRAL, -2.9 vs -5.5 mEq/d; NEAP, 37.0 vs 35.1 mEq/d; and A:P, 13.3 vs 12.4; all P < 0.001). The highest Q of DAL proxies was associated with NAFLD independent of sociodemographic and lifestyle confounders, but significance dissipated after correction for metabolic confounders and multiple testing. However, the P value for nonlinearity was significant in all DAL proxies (P < 0.001). Natural cubic splines performed better with than without DAL proxies in the fully adjusted model (all P ≤ 0.038). The highest probability of NAFLD was found for an acidic diet. CONCLUSIONS This study showed an independent nonlinear association between an acidic diet and NAFLD. Further studies with acid-base biomarkers are needed, but our findings might provide a mechanistic explanation for the harmful association between an animal protein-rich diet and NAFLD.
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Affiliation(s)
- Louise J M Alferink
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, LUMC-Campus, VA The Hague, Netherlands
| | - Nicole S Erler
- Department of Biostatistics, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
| | - Robert J de Knegt
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
| | - Ewout J Hoorn
- Division of Nephrology and Transplantation, Department of Internal Medicine, Erasmus MC, CN Rotterdam, Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
| | - Harry L A Janssen
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
- Toronto Centre of Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Herold J Metselaar
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Sarwa Darwish Murad
- Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, CA Rotterdam, Netherlands
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24
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Verspoor E, Voortman T, van Rooij FJA, Rivadeneira F, Franco OH, Kiefte-de Jong JC, Schoufour JD. Macronutrient intake and frailty: the Rotterdam Study. Eur J Nutr 2019; 59:2919-2928. [PMID: 31728680 PMCID: PMC7501120 DOI: 10.1007/s00394-019-02131-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/29/2019] [Indexed: 02/04/2023]
Abstract
Purpose To investigate the longitudinal association between the macronutrient composition of the diet and frailty. Methods Data were obtained from 5205 Dutch middle-aged and older adults participating in the Rotterdam Study. Frailty was measured using a frailty index based on the accumulation of 38 health-related deficits, score between 0 and 100, and a higher score indicating more frailty. Frailty was assessed at baseline and 11 years later (range of 23 years). Macronutrient intake was assessed using food-frequency questionnaires. The association between macronutrients and frailty over time was evaluated using multivariable linear regression, adjusted for the frailty index at baseline, energy intake, and other relevant confounders. All analyses were performed in strata of BMI. Results Median frailty index score was 13.8 points (IQR 9.6; 19.1) at baseline and increased by a median of 2.3 points (IQR − 2.0; 7.6) after 11 years. Overall, we found no significant associations between intake of carbohydrates or fat and frailty over time. We did observe a significant positive association between an iso-energetic intake of 10 g protein and frailty over time (β 0.31 (95% CI 0.06; 0.55)) which was mainly driven by animal protein (β 0.31 (95% CI 0.07; 0.56)). It did not depend on whether it was substituted fat or carbohydrates. Conclusions Our findings suggest that a reduction in the intake of animal protein may improve the overall health status over time in a relatively healthy population. More research is needed on the optimal macronutrient composition of the diet and frailty in more vulnerable populations. Electronic supplementary material The online version of this article (10.1007/s00394-019-02131-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eline Verspoor
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Frank J A van Rooij
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center/LUMC Campus, The Hague, The Netherlands
| | - Josje D Schoufour
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Faculty of Sports and Nutrition, ACHIEVE-Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
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25
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Social life characteristics in relation to adherence to the Mediterranean diet in older adults: findings from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) study. Public Health Nutr 2019; 23:439-445. [PMID: 31439074 DOI: 10.1017/s1368980019002350] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present study aimed to explore the associations between social life and adherence to a healthy dietary pattern, the Mediterranean diet (MD), in a population-representative cohort of older people. DESIGN Cross-sectional study. Adherence to the MD was evaluated by an a priori score; tertiles of the score, indicating low, medium and high adherence, were used in the analyses. Social life was assessed by a questionnaire evaluating participation in leisure-time activities and the number of social contacts; primary occupation was also recorded and job characteristics were further explored. SETTING Community-dwelling older adults. PARTICIPANTS Adults from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) study (n 1933; age range 65-99 years). RESULTS Each unit increase in the number of social contacts/month and in the frequency score of intellectual, social and physical activities was associated with a 1·6, 6·8, 4·8 and 13·7 % increase in the likelihood of a participant being in the high MD adherence group, respectively. The analysis by age group revealed that younger elderly participants had a 1·4, 8·4 and 11·3 % higher likelihood to be in the high adherence group for each unit increase in the number of social contacts/month and in the frequency score of engagement in intellectual and physical activities, respectively. Similar associations were found for older elderly participants with high compared with low MD adherence, except for the intellectual activities. CONCLUSIONS The present results suggest that high MD adherence is associated with good social life, suggesting a clustering of health-promoting lifestyle factors in older adults.
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26
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Association of Smoking-Related Knowledge, Attitude, and Practices (KAP) with Nutritional Status and Diet Quality: A Cross-Sectional Study in China. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5897478. [PMID: 31531358 PMCID: PMC6720361 DOI: 10.1155/2019/5897478] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/23/2019] [Accepted: 07/28/2019] [Indexed: 12/18/2022]
Abstract
Background Smoking is the second leading cause of death. Limited studies are available about smoking and overall diet quality. The current study was aimed at finding an association of s-KAP (smoking-related knowledge, attitude, and practices) with nutritional status and diet quality. Methodology The current study was a cross-sectional community-based study conducted in Jurong city, China. Validated questionnaires were used for the collection of data regarding s-KAP and dietary intake. Correlation and multivariate linear regression analysis were used for the association of s-KAP scores with diet quality scores and nutritional status. Results The total numbers of participants were 7998 with a mean age of 59.3±11.4 years, including 38.5% males and 41.5% females. s-KAP scores were categorized into two groups, i.e., High s-KAP group and low s-KAP group. The High s-KAP group had significantly higher (P<0.05) diet scores and BMI but lower (P<0.05) WC (waist circumference) and WHR (waist to hip ratio) than the Low s-KAP group. Independent positive association (P<0.05) of s-KAP scores with diet scores was observed after the adjustment for age, gender, physical activity, alcohol consumptions, monthly income, and anthropometric measures (BMI, WC, and WHR). Similarly, smoking was positively associated (P<0.05) with diet scores after adjustment for covariates. Conclusion In conclusion, the higher s-KAP scores indicated more knowledge regarding the harmful consequences of the smoking outcomes, positive attitude, less smoking practices, and having a good plan to quit smoking. Individuals with high s-KAP scores had good diet quality and lower adiposity measures. Furthermore, s-KAP scores and smoking status were having an independent positive association with diet scores.
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27
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Alferink LJ, Kiefte-de Jong JC, Erler NS, Veldt BJ, Schoufour JD, de Knegt RJ, Ikram MA, Metselaar HJ, Janssen HLA, Franco OH, Darwish Murad S. Association of dietary macronutrient composition and non-alcoholic fatty liver disease in an ageing population: the Rotterdam Study. Gut 2019; 68:1088-1098. [PMID: 30064987 DOI: 10.1136/gutjnl-2017-315940] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 06/28/2018] [Accepted: 07/01/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE A healthy lifestyle is the first-line treatment in non-alcoholic fatty liver disease (NAFLD), but specific dietary recommendations are lacking. Therefore, we aimed to determine whether dietary macronutrient composition is associated with NAFLD. DESIGN Participants from the Rotterdam Study were assessed on (1) average intake of macronutrients (protein, carbohydrate, fat, fibre) using a Food Frequency Questionnaire and (2) NAFLD presence using ultrasonography, in absence of excessive alcohol, steatogenic drugs and viral hepatitis. Macronutrients were analysed using the nutrient density method and ranked (Q1-Q4). Logistic regression analyses were adjusted for sociodemographic, lifestyle and metabolic covariates. Moreover, analyses were adjusted for and stratified by body mass index (BMI) (25 kg/m2). Also, substitution models were built. RESULTS In total, 3882 participants were included (age 70±9, 58% female). NAFLD was present in 1337 (34%) participants of whom 132 were lean and 1205 overweight. Total protein was associated with overweight NAFLD after adjustment for sociodemographic and lifestyle covariates (ORQ4vsQ1 1.40; 95% CI 1.11 to 1.77). This association was driven by animal protein (ORQ4vsQ1 1.54; 95% CI 1.20 to 1.98). After adjustment for metabolic covariates, only animal protein remained associated with overweight NAFLD (ORQ4vsQ1 1.36; 95% CI 1.05 to 1.77). Monosaccharides and disaccharides were associated with lower overall NAFLD prevalence (ORQ4vsQ1 0.66; 95% CI 0.52 to 0.83) but this effect diminished after adjustment for metabolic covariates and BMI. No consistent associations were observed for fat subtypes or fibre. There were no substitution effects. CONCLUSION This large population-based study shows that high animal protein intake is associated with NAFLD in overweight, predominantly aged Caucasians, independently of well-known risk factors. Contrary to previous literature, our results do not support a harmful association of monosaccharides and disaccharides with NAFLD.
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Affiliation(s)
- Louise Jm Alferink
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.,Department of Global Public Health, Leiden University College, The Hague, The Netherlands
| | - Nicole S Erler
- Department of Biostatistics, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Bart J Veldt
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.,Department of Gastroenterology and Hepatology, Reinier de Graaf Hospital, Delft, The Netherlands
| | - Josje D Schoufour
- Department of Epidemiology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Robert J de Knegt
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Herold J Metselaar
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Harry LA Janssen
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.,Toronto Centre of Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Sarwa Darwish Murad
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
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28
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Santoro A, Bazzocchi A, Guidarelli G, Ostan R, Giampieri E, Mercatelli D, Scurti M, Berendsen A, Surala O, Jennings A, Meunier N, Caumon E, Gillings R, Kadi F, Capel F, Cashman KD, Pietruszka B, Feskens EJM, De Groot LCPGM, Battista G, Salvioli S, Franceschi C. A Cross-Sectional Analysis of Body Composition Among Healthy Elderly From the European NU-AGE Study: Sex and Country Specific Features. Front Physiol 2018; 9:1693. [PMID: 30555339 PMCID: PMC6283977 DOI: 10.3389/fphys.2018.01693] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 11/09/2018] [Indexed: 12/31/2022] Open
Abstract
Body composition (BC) is an emerging important factor for the characterization of metabolic status. The assessment of BC has been studied in various populations and diseases such as obesity, diabetes, endocrine diseases as well as physiological and paraphysiological conditions such as growth and aging processes, and physical training. A gold standard technique for the assessment of human BC at molecular level is represented by dual-energy X-ray absorptiometry (DXA), which is able to precisely assess the body mass (and areal bone mineral density-aBMD) on a regional and whole-body basis. For the first time, within the framework of the NU-AGE project, BC has been assessed by means of a whole-body DXA scan in 1121 sex-balanced free-living, apparently healthy older adults aged 65–79 years enrolled in 5 European countries (Italy, France, United Kingdom, Netherlands, and Poland). The aim of this analysis is to provide a complete profile of BC in healthy elderly participants from five European countries and to investigate country- and sex-related differences by state-of-the-art DXA technology. To compare BC data collected in different centers, specific indexes and ratios have been used. Non-parametric statistical tests showed sex-specific significant differences in certain BC parameters. In particular, women have higher fat mass (FM) (Fat/Lean mass ratio: by 67%, p < 2.2e-16) and lower lean mass (Lean Mass index: by -18%, p < 2.2e-16) than men. On the other hand, men have higher android FM than women (Android/gynoid FM ratio: by 56%, p < 2.2e-16). Interesting differences also emerged among countries. Polish elderly have higher FM (Fat/Lean mass ratio: by 52%, p < 2.2e-16) and lower lean mass (Skeletal Mass index: by -23%, p < 2.2e-16) than elderly from the other four countries. At variance, French elderly show lower FM (Fat/Lean mass ratio: by -34%, p < 2.2e-16) and higher lean mass (Skeletal Mass index: by 18%, p < 2.2e-16). Moreover, five BC profiles in women and six in men have been identified by a cluster analysis based on BC parameters. Finally, these data can serve as reference for normative average and variability of BC in the elderly populations across Europe.
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Affiliation(s)
- Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,C.I.G. Interdepartmental Centre "L. Galvani", Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Giulia Guidarelli
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Rita Ostan
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,C.I.G. Interdepartmental Centre "L. Galvani", Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Enrico Giampieri
- Department of Physics, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Maria Scurti
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Institute of Neurological Sciences (IRCCS), Bologna, Italy
| | - Agnes Berendsen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Olga Surala
- Department of Human Nutrition, Warsaw University of Life Sciences - SGGW, Warsaw, Poland
| | - Amy Jennings
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | | | | | - Rachel Gillings
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Fawzi Kadi
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Frederic Capel
- Unité de Nutrition Humaine, INRA, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Barbara Pietruszka
- Department of Human Nutrition, Warsaw University of Life Sciences - SGGW, Warsaw, Poland
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Lisette C P G M De Groot
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Giuseppe Battista
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Stefano Salvioli
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,C.I.G. Interdepartmental Centre "L. Galvani", Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.,Institute of Neurological Sciences (IRCCS), Bologna, Italy
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29
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Cano-Ibáñez N, Bueno-Cavanillas A, Martínez-González MA, Corella D, Salas-Salvadó J, Zomeño MD, García-de-la-Hera M, Romaguera D, Martínez JA, Barón-López FJ, García-Ríos A, Estruch R, García-Molina L, Alonso Gómez Á, Tur JA, Tinahones F, Serra-Majem L, Cubelos-Fernández N, Lapetra J, Vázquez C, Pintó X, Vidal J, Daimiel L, Gaforio JJ, Matía P, Ros E, Diez-Espino J, Fernández-Carrión R, Basora J, Fitó M, Zazo JM, Colom A, Toledo E, Díaz-López A, Muñoz MÁ, Ruiz-Canela M, Gea A. Dietary Intake in Population with Metabolic Syndrome: Is the Prevalence of Inadequate Intake Influenced by Geographical Area? Cross-Sectional Analysis from PREDIMED-Plus Study. Nutrients 2018; 10:E1661. [PMID: 30400355 PMCID: PMC6266979 DOI: 10.3390/nu10111661] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 10/28/2018] [Accepted: 10/31/2018] [Indexed: 12/30/2022] Open
Abstract
Inadequate diet influences chronic diseases such as cardiovascular disease (CVD), the leading cause of death in Spain. CVD figures vary from one geographical region to another; this could be associated with different food choices. Our aim was to analyse the influence of geographical area on nutrient intakes among the Spanish adult population with Metabolic Syndrome (MetS). We analysed cross-sectional baseline data from the PREDIMED-Plus study: 6646 Spanish adults, aged 55⁻75 years, with overweight/obesity and MetS in four geographical areas. A validated 143-item Food Frequency Questionnaire (FFQ) was used to assess energy and nutrient intakes. The prevalence of inadequate nutrient intake was estimated according to Dietary Reference Intakes (DRIs). Multivariable-adjusted logistic regression was used to assess the relationship between geographical area (North, Central, East and South areas) and inadequate nutrient intake. People in the North area consumed significantly lower amounts of vegetables and fish but more sugar and alcohol (p < 0.001) than other areas. Dietary fibre, vitamin A, E, calcium and magnesium intakes were all lower among men of North area than in the other areas (p < 0.001). Sex (women), non-smoker and physical activity were also associated to adequate nutrient intake. Geographical area influences nutrient intakes. Its effect on dietary quality should be taken into account when planning food policies.
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Grants
- FPU14/03630 Ministerio de Educación, Cultura y Deporte
- PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14-00696, PI14/01206, PI14/01919, PI14/00853 Instituto de Salud Carlos III
- Advanced Research Grant 2013-2018; 340918 European Research Council
- 2013ACUP00194 Recercaixa
- PI0458/2013 Consejería de Salud, Junta de Andalucía
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Affiliation(s)
- Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, University of Granada, 18011 Granada, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, 18011 Granada, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Miguel A Martínez-González
- Department of Preventive Medicine and Public Health, Medical School, University of Navarre, 31008 Pamplona, Spain.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Dolores Corella
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain.
| | - Jordi Salas-Salvadó
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, 43002 Reus, Spain.
| | - M Dolors Zomeño
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), 08003 Barcelona, Spain.
- Human Nutrition Unit, Blanquerna-Ramon Llull University, 08001 Barcelona, Spain.
| | - Manoli García-de-la-Hera
- CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, 28029 Madrid, Spain.
- Miguel Hernández University, ISABIAL-FISABIO, 03202 Alicante, Spain.
| | - Dora Romaguera
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain.
| | - J Alfredo Martínez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra, 31008 Pamplona, Spain.
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.
| | - F Javier Barón-López
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Public Health, University of Málaga-IBIMA, 29016 Málaga, Spain.
| | - Antonio García-Ríos
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, 14004 Córdoba, Spain.
| | - Ramón Estruch
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain.
| | - Laura García-Molina
- Department of Preventive Medicine and Public Health, University of Granada, 18011 Granada, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Ángel Alonso Gómez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Cardiology, OSI ARABA, University Hospital Araba, University of the Basque Country (UPV/EHU), 48940 Vitoria-Gasteiz, Spain.
| | - Josep A Tur
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Spain.
| | - Francisco Tinahones
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, 29010 Málaga, Spain.
| | - Lluis Serra-Majem
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Institute for Biomedical Research, University of Las Palmas de Gran Canaria, 35016 Las Palmas, Spain.
| | | | - José Lapetra
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria, 41013 Sevilla, Spain.
| | - Clotilde Vázquez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Endocrinology, Fundación Jiménez-Díaz, 28040 Madrid, Spain.
| | - Xavier Pintó
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain.
| | - Josep Vidal
- Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, 08036 Barcelona, Spain.
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain.
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, 28049 Madrid, Spain.
| | - José Juan Gaforio
- CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, 28029 Madrid, Spain.
- Centro de Estudios Avanzados en Olivar y Aceites de Oliva, University of Jaén, 23071 Jaén, Spain.
| | - Pilar Matía
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Emilio Ros
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigació Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, 08036 Barcelona, Spain.
| | - Javier Diez-Espino
- Department of Preventive Medicine and Public Health, Medical School, University of Navarre, 31008 Pamplona, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Servicio Navarro de Salud, Osasunbidea, 31002 Pamplona, Spain.
| | - Rebeca Fernández-Carrión
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain.
| | - Josep Basora
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, 43002 Reus, Spain.
| | - Montse Fitó
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), 08003 Barcelona, Spain.
| | - Juan Manuel Zazo
- CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Institute of Health, 28029 Madrid, Spain.
- Miguel Hernández University, ISABIAL-FISABIO, 03202 Alicante, Spain.
| | - Antoni Colom
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain.
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, Medical School, University of Navarre, 31008 Pamplona, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Andrés Díaz-López
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
- Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, 43002 Reus, Spain.
| | - Miguel Ángel Muñoz
- Primary Care Division of Barcelona, Institut Català de la Salud-IDIAP Jordi Gol, 08007 Barcelona, Spain.
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, Medical School, University of Navarre, 31008 Pamplona, Spain.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, Medical School, University of Navarre, 31008 Pamplona, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, 28029 Madrid, Spain.
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de Haas SCM, de Jonge EAL, Voortman T, Graaff JSD, Franco OH, Ikram MA, Rivadeneira F, Kiefte-de Jong JC, Schoufour JD. Dietary patterns and changes in frailty status: the Rotterdam study. Eur J Nutr 2018; 57:2365-2375. [PMID: 28744573 PMCID: PMC6182690 DOI: 10.1007/s00394-017-1509-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 07/11/2017] [Indexed: 10/27/2022]
Abstract
PURPOSE To determine the associations between a priori and a posteriori derived dietary patterns and a general state of health, measured as the accumulation of deficits in a frailty index. METHODS Cross-sectional and longitudinal analysis embedded in the population-based Rotterdam Study (n = 2632) aged 45 years. Diet was assessed at baseline (year 2006) using food frequency questionnaires. Dietary patterns were defined a priori using an existing index reflecting adherence to national dietary guidelines and a posteriori using principal component analysis. A frailty index was composed of 38 health deficits and measured at baseline and follow-up (4 years later). Linear regression analyses were performed using adherence to each of the dietary patterns as exposure and the frailty index as outcome (all in Z-scores). RESULTS Adherence to the national dietary guidelines was associated with lower frailty at baseline (β -0.05, 95% CI -0.08, -0.02). Additionally, high adherence was associated with lower frailty scores over time (β -0.08, 95% CI -0.12, -0.04). The PCA revealed three dietary patterns that we named a "Traditional" pattern, high in legumes, eggs and savory snacks; a "Carnivore" pattern, high in meat and poultry; and a "Health Conscious" pattern, high in whole grain products, vegetables and fruit. In the cross-sectional analyses adherence to these patterns was not associated with frailty. However, adherence to the "Traditional" pattern was associated with less frailty over time (β -0.09, 95% CI -0.14, -0.05). CONCLUSION No associations were found for adherence to a "healthy" pattern or "Carnivore" pattern. However, Even in a population that is relatively young and healthy, adherence to dietary guidelines or adherence to the Traditional pattern could help to prevent, delay or reverse frailty levels.
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Affiliation(s)
- Sandra C M de Haas
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- VU University Amsterdam, Amsterdam, The Netherlands
| | - Ester A L de Jonge
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Internal Medicine, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jolien Steenweg-de Graaff
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Internal Medicine, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Global Public Health, Leiden University College The Hague, P.O. Box 13228, 2501 EE, The Hague, The Netherlands
| | - Josje D Schoufour
- Department of Epidemiology, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
- Department of Internal Medicine, University Medical Centre, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
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31
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Sanders MGH, Pardo LM, Ginger RS, Kiefte-de Jong JC, Nijsten T. Association between Diet and Seborrheic Dermatitis: A Cross-Sectional Study. J Invest Dermatol 2018; 139:108-114. [PMID: 30130619 DOI: 10.1016/j.jid.2018.07.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/11/2018] [Accepted: 07/18/2018] [Indexed: 01/28/2023]
Abstract
Current treatments for seborrheic dermatitis provide only temporary relief. Therefore, identifying modifiable lifestyle factors may help reduce disease burden. The objective of this study was to determine whether specific dietary patterns or total antioxidant capacity are associated with seborrheic dermatitis. Participants of the Rotterdam Study with a skin examination and a food frequency questionnaire were included. Total antioxidant capacity was assessed on the basis of ferric reducing antioxidant potential of each food item. Dietary patterns were identified with principal component analysis (PCA). Multivariable logistic regression analyses were used to assess the association between total antioxidant capacity, dietary pattern-derived PCA factors, and seborrheic dermatitis adjusted for confounders. In total, 4,379 participants were included, of whom 636 (14.5%) had seborrheic dermatitis. The PCA identified vegetable, Western, fat-rich and fruit dietary patterns. The fruit pattern was associated with a 25% lower risk (quartile 1 vs. quartile 4: adjusted odds ratio = 0.76, 95% confidence interval = 0.58-0.97, P = 0.03), and the Western pattern with a 47% increased risk (quartile 1 vs. quartile 4: adjusted odds ratio = 1.47; 95% confidence interval = 0.98-2.20, P = 0.03), but only for females. Other factors were not associated with seborrheic dermatitis. In conclusion, a high fruit intake was associated with less seborrheic dermatitis, whereas high adherence to a "Western" dietary pattern in females was associated with more seborrheic dermatitis.
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Affiliation(s)
| | - Luba M Pardo
- Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands
| | - Rebecca S Ginger
- Unilever Research and Development, Colworth Science Park, Sharnbrook, UK
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands; Leiden University College, The Hague, The Netherlands
| | - Tamar Nijsten
- Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands.
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32
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Mulder M, Kiefte-de Jong JC, Goessens WHF, de Visser H, Ikram MA, Verbon A, Stricker BH. Diet as a risk factor for antimicrobial resistance in community-acquired urinary tract infections in a middle-aged and elderly population: a case-control study. Clin Microbiol Infect 2018; 25:613-619. [PMID: 30099137 DOI: 10.1016/j.cmi.2018.07.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/13/2018] [Accepted: 07/29/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVES There is an ongoing debate as to what extent antimicrobial resistance (AMR) can be transmitted from animals to humans via the consumption of animal products. Because epidemiological data on the role of diet in AMR in humans are lacking, we investigated this association between diet and AMR for different antimicrobial drugs in Escherichia coli (E. coli) in urinary tract infections (UTIs). METHODS Susceptibility of E. coli in urinary cultures and information on diet (with food frequency questionnaires) were obtained from participants of the Rotterdam study, a population-based prospective cohort study. The association between intake of several food groups (meat, seafood, eggs, dairy products, crops) and resistance of E. coli to several antimicrobial drugs (amoxicillin, amoxicillin-clavulanic acid, trimethoprim, sulfamethoxazole-trimethoprim, first-generation cephalosporins, cefotaxime, nitrofurantoin, norfloxacin) was studied. RESULTS Urinary cultures with E. coli were obtained from 612 individuals, of whom 481 (78.6%) were women. Resistance rates varied from 246/611 (40.3%) for amoxicillin and 167/612 (27.3%) for trimethoprim to only 29/612 (4.7%) for nitrofurantoin and 16/462 (3.5%) for cefotaxime. A higher intake of chicken was associated with cefotaxime resistance (OR 2.18; 95% CI 1.05-4.51 per tertile increase); a higher intake of pork was associated with norfloxacin resistance (OR 1.42; 95% CI 1.04-1.95 per quartile increase). In contrast, a higher intake of cheese was associated with lower AMR to amoxicillin (OR 0.84; 95% CI 0.72-0.99 per quartile increase) and amoxicillin-clavulanic acid (OR 0.67; 95% CI 0.53-0.86 per quartile increase). CONCLUSIONS These findings support the hypothesis that diet may play a role in the AMR of E. coli in UTIs.
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Affiliation(s)
- M Mulder
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Youth and Healthcare Inspectorate, Utrecht, The Netherlands
| | - J C Kiefte-de Jong
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Leiden University College, The Hague, The Netherlands; Department of Public Health and Primary Care / LUMC Campus the Hague, Leiden, The Netherlands
| | - W H F Goessens
- Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
| | - H de Visser
- Star-Medisch Diagnostisch Centrum, The Netherlands
| | - M A Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A Verbon
- Department of Public Health and Primary Care / LUMC Campus the Hague, Leiden, The Netherlands; Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - B H Stricker
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Youth and Healthcare Inspectorate, Utrecht, The Netherlands; Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
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33
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Trajanoska K, Schoufour JD, Darweesh SK, Benz E, Medina-Gomez C, Alferink LJ, Lahousse L, Brusselle G, Stricker B, Darwish Murad S, Zillikens MC, Uitterlinden AG, Ikram MA, Franco OH, Rivadeneira F. Sarcopenia and Its Clinical Correlates in the General Population: The Rotterdam Study. J Bone Miner Res 2018; 33:1209-1218. [PMID: 29502340 DOI: 10.1002/jbmr.3416] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/25/2018] [Accepted: 02/19/2018] [Indexed: 01/01/2023]
Abstract
Sarcopenia, a complex multifactorial condition, is characterized by loss of muscle mass and function, which increases progressively with age. The existence of different definitions has contributed to the large variation in the prevalence estimates of sarcopenia. We aimed to estimate the prevalence of sarcopenia in the general population using the European Working Group on Sarcopenia in Older People (EWGSOP) proposed definition and compared baseline demographic and clinical characteristics between the nonsarcopenia, presarcopenia, and sarcopenia individuals, with particular emphasis on the overlap with osteoporosis and fracture risk. We studied 5911 subjects at a mean age of 69.2 years (55.8% female) with data on sarcopenia participating in the Rotterdam Study, a prospective population-based cohort study in Rotterdam, the Netherlands. Presarcopenia was defined as having only low muscle mass, whereas sarcopenia was defined based on the presence of low muscle mass, plus either low muscle strength or low physical performance. The prevalence of presarcopenia and sarcopenia was 5.9% and 4.4%, respectively. Individuals with sarcopenia were older, more often males, smokers, with less optimal dietary intake, and more often disabled with lower physical activity. Although the prevalence of fractures was higher in individuals with low lean mass (presarcopenic [16.6%] and sarcopenic [23.5%]) compared with the no sarcopenic group (15.5%), the differences were not present after correcting for age and sex. There were no statistical differences in the prevalence of chronic diseases, with the exception of a higher prevalence of COPD in presarcopenic (29.1%) and sarcopenic (26.9%) individuals compared with nonsarcopenic (13.4%) individuals. Osteoporotic individuals with (odds ratio [OR] = 2.59, 95% confidence interval [CI] 1.41-4.45) and without sarcopenia (OR = 2.75, 95% CI 2.01-3.75) had similar elevated risk of nonvertebral fractures. The presence of sarcopenia appears to be independent of chronic diseases with the exception of COPD and more related to lifestyle factors and disabilities. Sarcopenic individuals in the general population are at no greater risk of fracture than what is determined by their low bone mineral density. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Katerina Trajanoska
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Josje D Schoufour
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sirwan Kl Darweesh
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Elizabeth Benz
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Carolina Medina-Gomez
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Louise Jm Alferink
- Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Lies Lahousse
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Respiratory Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Guy Brusselle
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Respiratory Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Bruno Stricker
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sarwa Darwish Murad
- Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Andre G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
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34
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Brinkman S, Voortman T, Kiefte-de Jong JC, van Rooij FJ, Ikram MA, Rivadeneira F, Franco OH, Schoufour JD. The association between lifestyle and overall health, using the frailty index. Arch Gerontol Geriatr 2018; 76:85-91. [DOI: 10.1016/j.archger.2018.02.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/02/2018] [Accepted: 02/06/2018] [Indexed: 11/26/2022]
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