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Yang W, Zhao X, Liu M. Exploring the Factors Behind Regional Differences in Physical Fitness of Geological University Students. J Racial Ethn Health Disparities 2024; 11:2022-2036. [PMID: 37432560 DOI: 10.1007/s40615-023-01670-x] [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: 03/28/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 07/12/2023]
Abstract
The intention of this study is to investigate the distribution of physical fitness of the geographical students. The indicators among freshmen at a Chinese geological university and compare their fitness levels with students from other types of institutions. The research revealed that students at higher latitudes exhibited greater physical strength but were less athletic than those at lower latitudes. Spatial dependence on physical fitness was more pronounced in males than in females, particularly for indicators characterizing athletic capacity. Influencing factors such as PM10, air temperature, rainfall, eggs consumption, grain consumption, and GDP which were identified as the major climate, dietary structure, and economic level were examined. Revised:PM10, air temperature and eggs consumption, factors influencing the spatial distribution of male physical fitness across the country. Rainfall, grains consumption and GDP, factors influencing the spatial distribution of female physical fitness across the country. respectively. These factors were found to affect males (42.43%) more than females (25.33%). These findings highlight the significance of regional differences in students' physical fitness levels, with students in geological universities demonstrating better overall physical fitness compared to their counterparts at other schools. Consequently, it is essential to develop tailored physical education strategies for students in various regions, taking into account local economic, climatic, and dietary factors. This study offers a greater explanation of physical fitness disparities between the Chinese university students as well as provides insights for designing effective physical education programs.
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Affiliation(s)
- Wenge Yang
- Department of Physical Education, China University of Geosciences (Beijing), Beijing, 100083, China.
| | - Xuanli Zhao
- Department of Physical Education, China University of Geosciences (Beijing), Beijing, 100083, China
| | - Mingxing Liu
- Department of Physical Education, China University of Geosciences (Beijing), Beijing, 100083, China
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Kaur S. Barriers to consumption of fruits and vegetables and strategies to overcome them in low- and middle-income countries: a narrative review. Nutr Res Rev 2023; 36:420-447. [PMID: 36004512 DOI: 10.1017/s0954422422000166] [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] [Indexed: 11/06/2022]
Abstract
This review provides an overview of the barriers to the consumption of fruits and vegetables (FVs) as well as strategies to improve the intake of FVs in low- and middle-income countries (LMICs). The importance of the consumption of FVs and its role in disease prevention are discussed briefly. Trends in the consumption of FVs in LMICs are also summarised. The WHO recommends that every individual should consume at least five servings or 400 grams of FVs per day. Epidemiological and clinical investigations have demonstrated that FVs contain numerous bioactive compounds with health-protecting activities. Despite their health benefits, the intake of FVs in LMICs remains low. Major barriers identified were socio-demographic factors, environmental conditions, individual and cultural factors, and macrosystem influences. These barriers may be lowered at the household, school, community, and national level through multi-component interventions including behaviour change communication (BCC) initiatives, nutrition education (NE), gardening initiatives, farm to institution programs (FIPs), food baskets, cash transfers, nutrition-agriculture policy and program linkages, and food-market environment-based strategies. This review has research implications due to the positive outcomes of strategies that lower such barriers and boost consumption of FVs in LMICs.
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Affiliation(s)
- Sukhdeep Kaur
- Department of Food and Nutrition, Punjab Agricultural University, Ludhiana, Punjab141004, India
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Hizli-Guldemir H, Saleki N, Sezer FE, Yoldas-Ilktac H, Akman C, Ersoy G, Garipagaoglu M. Vegetable and Fruit Consumption and Its Relationship with Body Mass Index in Adults: A Cross-Sectional and Seasonal Research from Türkiye. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:1168-1179. [PMID: 37199339 DOI: 10.1080/09603123.2023.2214504] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/12/2023] [Indexed: 05/19/2023]
Abstract
This study examines the relationship between fruit and vegetable consumption and the BMI in Türkiye. In this cross-sectional study, which 6332 adults were included, fruit and vegetable consumption, and preferences were collected. The quantities of vegetables and fruits were classified based on the WHO and the national recommendations. Of the adults (33.39 ± 12.59 years), 52.9% of men and 39.7% of women had an above-normal BMI. Based on WHO recommendations, overweight and obese people consumed less vegetables and fruits compared to their counterparts (ORs for women, overweight: 1.2, obese: 1.3; ORs for men, overweight: 1.3, obese: 1.5; 95% CI). The regression analysis revealed that the quantities of vegetable and fruit intake were higher in young individuals, men, and married people. Although the majority consume more than 400 g/day of vegetables and fruits, the intake is inadequate in people with obesity.
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Affiliation(s)
- Hilal Hizli-Guldemir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Anadolu University, Eskisehir, Turkey
| | - Neda Saleki
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Fatma Elif Sezer
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Havvanur Yoldas-Ilktac
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - Cansu Akman
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Gulgun Ersoy
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Muazzez Garipagaoglu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Fenerbahce University, Istanbul, Turkey
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Li SY, Leung JCS, Lu ZH, Kwok TCY. Quantity and Variety of Fruit and Vegetable Intake with Changes in Measures of Adiposity among Community-Dwelling Chinese Older Adults. Nutrients 2023; 15:4096. [PMID: 37836380 PMCID: PMC10574446 DOI: 10.3390/nu15194096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The association between fruit and vegetable intake, considering both quantity and variety, and weight change among older adults remains controversial. We aimed to investigate the association between fruit and vegetable intake, variety, and changes in adiposity measures among community-dwelling Chinese older adults. METHODS A total of 2944 participants aged ≥65 years from Hong Kong communities were included. Fruit and vegetable intake was estimated by a locally validated food frequency questionnaire. Adiposity measures (weight, body mass index (BMI), waist circumference, fat and lean mass) were assessed at baseline and the year four follow-up. Restricted cubic spline and logistic models were performed to estimate the associations between fruit and vegetable intake, variety, and changes in adiposity measures. RESULTS A nonlinear association between vegetable intake and weight change was found, following a J-shape curve. Increased vegetable intake was associated with less increases in weight, BMI, and fat mass among those below median intakes. However, these associations became insignificant at higher intakes (all P-nonlinearity < 0.05). The ORs (95% CIs) for weight gain across the quartiles of vegetable intake were as follows: 1.00 (reference), 0.81 (0.56, 1.17), 0.55 (0.36, 0.83), and 0.88 (0.58, 1.33). Similar patterns were observed in overweight and normal weight participants, but not in those with low body weight. No associations with weight change were found for fruit intake or fruit and vegetable variety. CONCLUSIONS Moderate vegetable intake was associated with less weight gain among community-dwelling Chinese older adults, but not in those with low body weight. No association was observed between fruit intake or variety with weight change.
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Affiliation(s)
- Shu-Yi Li
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Jason C. S. Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhi-Hui Lu
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Timothy C. Y. Kwok
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
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Nouri M, Shateri Z, Faghih S. The relationship between intake of fruits, vegetables and dairy products with overweight and obesity in a large sample in Iran: Findings of STEPS 2016. Front Nutr 2023; 9:1082976. [PMID: 36733471 PMCID: PMC9886861 DOI: 10.3389/fnut.2022.1082976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Background The present study aimed to investigate the association between fruits and vegetables (FVs) and dairy product intake with body weight based on the data from the nationwide Stepwise approach to surveillance (STEPS) survey in Iran. Methods STEPS is a national-based cross-sectional study conducted on 3,0541 people selected by stratified cluster random sampling in Iran from April to November 2016. The outcome of the current study was body mass index (BMI) which was classified as normal weight, underweight, overweight, and obese. Also, as exposure variables, dietary intakes of fruits, vegetables and dairy products were extracted from the STEPS questionnaires. Multinomial logistic regression was used to evaluate the association between dairy products, FVs consumption, and BMI category in the crude and adjusted models. Results In the adjusted model, we observed 41% [odd ratio (OR) = 0.59; 95% confidence intervals (CI): 0.50, 0.68, P < 0.001], 27% (OR = 0.73; 95% CI: 0.62, 0.84, P < 0.001), and 26% (OR = 0.74; 95% CI: 0.63, 0.87, P < 0.001) lower odds of being overweight, and 46% (OR = 0.54; 95% CI: 0.46, 0.64, P < 0.001), 29% (OR = 0.71; 95% CI: 0.60, 0.84, P < 0.001), and 21% (OR = 0.79; 95% CI: 0.65, 0.95, P = 0.014) decrease in obesity odds among the participants who consumed 1, 2, and more than 2 servings of fruits per day in comparison to less than one serving, respectively. Also, we observed participants who consumed 1, 2, and more than 2 servings in comparison to less than one serving of dairy products per day had 31% (OR = 0.69; 95% CI: 0.58, 0.81, P < 0.001), 23% (OR = 0.77; 95 %CI: 0.65, 0.91, P = 0.002), and 21% (OR = 0.79; 95% CI: 0.67, 0.94, P = 0.011) lower odds of being overweight and 47% (OR = 0.53; 95% CI: 0.44, 0.64, P < 0.001), 36% (OR = 0.64; 95% CI: 0.53, 0.77, P < 0.001), and 32% (OR = 0.68; 95% CI: 0.56, 0.83, P < 0.001) lower odds of obesity, respectively. In addition, compared to participants who consumed less than 2 servings of vegetables per day, participants who consumed 2, 3, and more than 3 servings had 40% (OR = 0.60; 95% CI: 0.47, 0.76, P < 0.001), 29% (OR = 0.71; 95% CI: 0.56, 0.90, P = 0.006), and 26% (OR = 0.74; 95% CI: 0.57, 0.96, P = 0.027) lower odds of being overweight, respectively. Furthermore, we observed 36% lower odds of obesity among participants who ate 2 servings of vegetables per day compared to less than 2 serving (OR = 0.64; 95% CI: 0.49, 0.84, P = 0.002). Conclusion Our findings showed that intake of FVs and dairy products is associated with a healthier weight status in adults. Further studies are needed to confirm these findings.
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Affiliation(s)
- Mehran Nouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran,Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zainab Shateri
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran,Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,*Correspondence: Shiva Faghih,
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Association between Obesity and Intake of Different Food Groups among Japanese with Type 2 Diabetes Mellitus—Japan Diabetes Clinical Data Management Study (JDDM68). Nutrients 2022; 14:nu14153034. [PMID: 35893888 PMCID: PMC9331232 DOI: 10.3390/nu14153034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/19/2022] [Accepted: 07/19/2022] [Indexed: 12/04/2022] Open
Abstract
Background: We investigated the association between various food groups and obesity in Japanese patients with type 2 diabetes. Methods: 2070 patients with type 2 diabetes who attended 26 diabetes clinics throughout Japan were analyzed and were divided into obese and non-obese groups. Intakes of food groups determined by a food frequency questionnaire were compared. Odds ratios for obesity for quartiles of individual food groups were calculated using a logistic regression model. Results: Non-obese patients consumed a larger variety of food groups than obese patients, with the diets of non-obese individuals closer to the traditional Japanese diet characterized by fish, seaweed, and soybeans/soy products. Among 21 food groups, low vegetable intake and high sweets intake were the most strongly associated with obesity in both men and women. Low intake of both fruits and vegetables and the combination of high intake of sweets and low intake of fruits were associated with obesity. Conclusions: Food groups and their combinations that were strongly associated with obesity in Japanese patients with type 2 diabetes were identified. Our findings also suggested an inverse association between the traditional Japanese diet and obesity.
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Lalusu EY, Ramli R, Sattu M, Sutady F, Otoluwa AS. Unhealthy Food Consumption Pattern and Nutritional Status among Adolescents: A Cross-sectional Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Nutritional balance is needed during adolescence for health and optimal growth. The aim of the study is to analyse the nutritional status and food consumption patterns of adolescents in Luwuk.
Methods: This study was conducted with a cross-sectional design involving 385 adolescents at four high schools (grade 10-12). The sample was divided into four schools and selected by the accidental sampling method. Food consumption patterns were assessed using a World Health Organization-designed Global School-based Student Health Survey questionnaire (modified for Indonesia). Nutritional status is based on the results of anthropometric. Data were analysed using frequency distribution and inferential analysis.
Results: Of the total 385 adolescents studied, there were 4.7% adolescents overweight and 2.3% were obese. On the other hand, there are also 10.6% thin adolescents and 4.4% with very thinness. 49.9% of adolescents do not consume fruit, 22.3% do not eat vegetables, 23.5% drink soft drinks with carbonated >=1 time per day, 54.8% eat fast food >=1 day a week, 66 .5% rarely or never breakfast, 58.2% never bring lunch and 18.7% usually eat street snacks.
Conclusion: Some adolescents in Luwuk City had nutritional problems and unhealthy food consumption patterns. A nutritional surveillance program is needed for adolescents which includes monitoring nutritional status, consumption patterns, and risk factors related to nutrition.
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Fujihara K, Nogawa S, Saito K, Horikawa C, Takeda Y, Cho K, Ishiguro H, Kodama S, Nakagawa Y, Matsuzaka T, Shimano H, Sone H. Carrot Consumption Frequency Associated with Reduced BMI and Obesity through the SNP Intermediary rs4445711. Nutrients 2021; 13:3478. [PMID: 34684477 PMCID: PMC8538500 DOI: 10.3390/nu13103478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/25/2021] [Accepted: 09/28/2021] [Indexed: 11/16/2022] Open
Abstract
It is unclear whether genetic interactions are involved in the association between vegetable intake and reduced body mass index (BMI) or obesity. We conducted a comprehensive search for single nucleotide polymorphisms (SNPs) which are associated with the interaction between vegetable intake frequency and BMI or obesity. We performed a genome-wide association analysis to evaluate the genetic interactions between self-reported intake of vegetables such as carrot, broccoli, spinach, other green vegetables (green pepper and green beans), pumpkin, and cabbage with BMI and obesity, which is defined as a BMI ≥ 25.0 kg/m2 in the Japanese population (n = 12,225). The mean BMI and prevalence of obesity was 23.9 ± 3.4 kg/m2 and 32.3% in men and 22.1 ± 3.8 kg/m2 and 17.3% in in women, respectively. A significant interaction was observed between rs4445711 and frequency of carrot intake on BMI (p = 4.5 × 10-8). This interaction was slightly attenuated after adjustment for age, sex, alcohol intake, smoking, physical activity and the frequency of total vegetable intake (p = 2.1 × 10-7). A significant interaction was also observed between rs4445711 and frequency of carrot intake on obesity (p = 2.5 × 10-8). No significant interactions that were the same as the interaction between frequency of carrot intake and rs4445711 were observed between the intake frequency of broccoli, spinach, other green vegetables, pumpkin or cabbage and BMI or obesity. The frequency of carrot consumption is implicated in reducing BMI by the intermediary of rs4445711. This novel genetic association may provide new clues to clarify the association between vegetable intake and BMI or obesity.
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Affiliation(s)
- Kazuya Fujihara
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata 951-8510, Japan; (K.F.); (Y.T.); (K.C.); (H.I.); (S.K.)
| | - Shun Nogawa
- Genequest Inc., Tokyo 108-0014, Japan; (S.N.); (K.S.)
| | - Kenji Saito
- Genequest Inc., Tokyo 108-0014, Japan; (S.N.); (K.S.)
| | - Chika Horikawa
- Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture, Niigata 950-8680, Japan;
| | - Yasunaga Takeda
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata 951-8510, Japan; (K.F.); (Y.T.); (K.C.); (H.I.); (S.K.)
| | - Kaori Cho
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata 951-8510, Japan; (K.F.); (Y.T.); (K.C.); (H.I.); (S.K.)
| | - Hajime Ishiguro
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata 951-8510, Japan; (K.F.); (Y.T.); (K.C.); (H.I.); (S.K.)
| | - Satoru Kodama
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata 951-8510, Japan; (K.F.); (Y.T.); (K.C.); (H.I.); (S.K.)
| | - Yoshimi Nakagawa
- Department of Research and Development, University of Toyama Institute of Natural Medicine, Tomaya 930-8555, Japan;
| | - Takashi Matsuzaka
- Department of Internal Medicine, University of Tsukuba School of Medicine, Tsukuba 305-8577, Japan; (T.M.); (H.S.)
| | - Hitoshi Shimano
- Department of Internal Medicine, University of Tsukuba School of Medicine, Tsukuba 305-8577, Japan; (T.M.); (H.S.)
| | - Hirohito Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata 951-8510, Japan; (K.F.); (Y.T.); (K.C.); (H.I.); (S.K.)
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Lim CGY, Whitton C, Rebello SA, van Dam RM. Diet Quality and Lower Refined Grain Consumption are Associated With Less Weight Gain in a Multi-Ethnic Asian Adult Population. J Nutr 2021; 151:2372-2382. [PMID: 33978192 DOI: 10.1093/jn/nxab110] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/18/2021] [Accepted: 03/26/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND The prevalence of obesity is increasing in many Asian countries. However, longitudinal data on the impacts of dietary factors on weight gain in Asian populations are sparse. OBJECTIVES We evaluated the relationship between changes in intakes of nutrients, foods, and beverages and diet quality and long-term changes in body weight. METHODS We used data (n = 3064) from the Singapore Multi-Ethnic Cohort, a prospective cohort including Chinese, Indian, and Malay residents aged 21-65 years. Dietary intakes were assessed using an FFQ, and body weight and waist circumference were measured during health examinations. Diet quality was evaluated using the Dietary Approaches to Stop Hypertension (DASH) and Alternative Healthy Eating Index (AHEI-2010) scores. Data were collected at baseline (2004-2010) and follow-up (2011-2016), with a mean follow-up of 6.0 years. Linear regression was used to assess the associations between dietary changes and weight change, adjusted for socio-demographic and lifestyle variables. RESULTS Improvements in dietary quality scores (DASH, -0.34 kg per 5 points; AHEI-2010, -0.35 kg per 10 points) and replacement of carbohydrates with protein (-0.44 kg per 5% of energy) were significantly associated with less weight gain. Increased intakes of white rice (+0.25 kg per serving/d), soft drinks (+0.69 kg), red meat (+0.58 kg), and poultry with skin (+0.74 kg) were directly associated with weight gain. The replacement of 1 serving per day of white rice with whole grains (-0.68 kg), vegetables (-0.33 kg), poultry without skin (-0.79 kg), and eggs (-0.87 kg) was associated with less weight gain. Similar associations were observed between changes in dietary factors and changes in waist circumference. CONCLUSIONS Among Asian adults, increasing dietary quality, reducing soft drink consumption, and replacing white rice with whole grains, vegetables, and selected high-protein foods was associated with less weight gain.
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Affiliation(s)
- Charlie G Y Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Clare Whitton
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,School of Public Health, Curtin University, Perth, Australia
| | - Salome A Rebello
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Shatwan IM, Alhinai EA, Alawadhi B, Surendran S, Aljefree NM, Almoraie NM. High Adherence to the Mediterranean Diet Is Associated with a Reduced Risk of Obesity among Adults in Gulf Countries. Nutrients 2021; 13:nu13030995. [PMID: 33808684 PMCID: PMC8003341 DOI: 10.3390/nu13030995] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 02/07/2023] Open
Abstract
The Mediterranean diet (MedDiet) is considered as a good example of a healthy dietary pattern that has protective effects on obesity. The aim of the present study was to assess the adherence of adults from three Gulf countries (Saudi Arabia, Oman, and Kuwait) to the MedDiet and its association with obesity risk. A cross-sectional study was conducted on 961 men and women (75.7%) aged 20–55 years old. Waist circumference (WC), and hip circumference (HC) were measured waist/hip ratio (WHR) and body mass index (BMI) were calculated. A validated 14-item Questionnaire was used to measure adherence to MedDiet. The mean of the adherence to MedDiet score was 5.9 ± 2.03 for the total sample. An inverse association was observed between the adherence to MedDiet and BMI after adjusting for potential confounders (p = 0.0003 in total participants, and p = 0.001 in women only). A protective effect was seen with a higher adherence to the MedDiet on HC, suggesting that a greater adherence to the MedDiet was associated with a decreased HC (p = 0.04 in total participants, and p = 0.01 in women only). In conclusion, low adherence to the MedDiet among participants from three gulf countries was associated with increased obesity indicators, BMI, and HC.
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Affiliation(s)
- Israa M. Shatwan
- Food and Nutrition Department, Human Sciences and Design Faculty, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (N.M.A.); (N.M.A.)
- Correspondence:
| | - Eiman A. Alhinai
- Dietetics Department, Al Nahdha Hospital, Ministry of Health, Ruwi 937, Muscat PC 112, Oman;
| | - Balqees Alawadhi
- The Public Authority of Applied Education and Training (PAAET), Department of Food and Nutritional Sciences, College of Health Sciences, Shuwaikh, Kuwait;
| | - Shelini Surendran
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK;
| | - Najlaa M. Aljefree
- Food and Nutrition Department, Human Sciences and Design Faculty, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (N.M.A.); (N.M.A.)
| | - Noha M. Almoraie
- Food and Nutrition Department, Human Sciences and Design Faculty, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (N.M.A.); (N.M.A.)
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11
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Yuan S, Ming-Wei L, Qi-Qiang H, Larsson SC. Egg, cholesterol and protein intake and incident type 2 diabetes mellitus: Results of repeated measurements from a prospective cohort study. Clin Nutr 2021; 40:4180-4186. [PMID: 33593662 DOI: 10.1016/j.clnu.2021.01.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 12/15/2020] [Accepted: 01/28/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND & AIMS Epidemiological evidence on the associations of egg, cholesterol and protein intake with risk of type 2 diabetes is inconsistent. Therefore, we conducted this study to explore these associations among Chinese adults. METHODS Data from 4 waves (2004, 2006, 2009 and 2011) of the China Health and Nutrition Survey were used. A multistage random-cluster sampling method was employed to recruit the participants in both rural and urban areas. We included individuals who participated in 2004 and any waves afterwards. Those 1) below 18 years of age; 2) with diabetes at baseline; or 3) with extreme energy intake (men: <800 kcal or >6000 kcal; women: <600 kcal or >4000 kcal) were excluded. Respondents were classified into four groups according to quartiles of egg, cholesterol and protein intake per day. Numbers of eggs per day were calculated by dividing egg intake in grams by 50 g. Diagnosis of type 2 diabetes was self-reported. Logistic generalized estimation equation models were employed. RESULTS There were 7312 individuals included in 2004, 6390 in 2006, 4826 in 2009 and 4963 in 2011. The mean age of participants at baseline was 48.3 years and 47.2% were men. Over an average of 5.8-y follow-up, 209 developed type 2 diabetes. After adjustment for demographic, lifestyle and dietary confounders, the odds ratio of type 2 diabetes for those in the highest compared with the lowest protein intake quartile was 2.38 (95% CI: 1.43, 3.98). The odds ratio of individuals with ≥3 eggs/day versus none was 3.76 (95% CI, 2.05, 6.90). Cholesterol intake was not associated with type 2 diabetes. CONCLUSIONS Individuals with the highest protein intake had over a 2-fold increased risk of type 2 diabetes compared with those with the lowest protein intake. A high intake of egg, but not dietary cholesterol, was associated with type 2 diabetes. This association warrants further investigation.
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Affiliation(s)
- Shuai Yuan
- School of Health Sciences, Wuhan University, Donghu Rd. 115, Wuhan City, Hubei Province, Wuhan, PR China; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Liu Ming-Wei
- School of Health Sciences, Wuhan University, Donghu Rd. 115, Wuhan City, Hubei Province, Wuhan, PR China.
| | - He Qi-Qiang
- School of Health Sciences, Wuhan University, Donghu Rd. 115, Wuhan City, Hubei Province, Wuhan, PR China.
| | - Susanna C Larsson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
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Davis JN, Pérez A, Asigbee FM, Landry MJ, Vandyousefi S, Ghaddar R, Hoover A, Jeans M, Nikah K, Fischer B, Pont SJ, Richards D, Hoelscher DM, Van Den Berg AE. School-based gardening, cooking and nutrition intervention increased vegetable intake but did not reduce BMI: Texas sprouts - a cluster randomized controlled trial. Int J Behav Nutr Phys Act 2021; 18:18. [PMID: 33485354 PMCID: PMC7825209 DOI: 10.1186/s12966-021-01087-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 01/14/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Although school garden programs have been shown to improve dietary behaviors, there has not been a cluster-randomized controlled trial (RCT) conducted to examine the effects of school garden programs on obesity or other health outcomes. The goal of this study was to evaluate the effects of a one-year school-based gardening, nutrition, and cooking intervention (called Texas Sprouts) on dietary intake, obesity outcomes, and blood pressure in elementary school children. METHODS This study was a school-based cluster RCT with 16 elementary schools that were randomly assigned to either the Texas Sprouts intervention (n = 8 schools) or to control (delayed intervention, n = 8 schools). The intervention was one school year long (9 months) and consisted of: a) Garden Leadership Committee formation; b) a 0.25-acre outdoor teaching garden; c) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school-year; and d) nine monthly parent lessons. The delayed intervention was implemented the following academic year and received the same protocol as the intervention arm. Child outcomes measured were anthropometrics (i.e., BMI parameters, waist circumference, and body fat percentage via bioelectrical impedance), blood pressure, and dietary intake (i.e., vegetable, fruit, and sugar sweetened beverages) via survey. Data were analyzed with complete cases and with imputations at random. Generalized weighted linear mixed models were used to test the intervention effects and to account for clustering effect of sampling by school. RESULTS A total of 3135 children were enrolled in the study (intervention n = 1412, 45%). Average age was 9.2 years, 64% Hispanic, 47% male, and 69% eligible for free and reduced lunch. The intervention compared to control resulted in increased vegetable intake (+ 0.48 vs. + 0.04 frequency/day, p = 0.02). There were no effects of the intervention compared to control on fruit intake, sugar sweetened beverages, any of the obesity measures or blood pressure. CONCLUSION While this school-based gardening, nutrition, and cooking program did not reduce obesity markers or blood pressure, it did result in increased vegetable intake. It is possible that a longer and more sustained effect of increased vegetable intake is needed to lead to reductions in obesity markers and blood pressure. CLINICAL TRIALS NUMBER NCT02668744 .
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Affiliation(s)
- Jaimie N Davis
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA.
| | - Adriana Pérez
- Michael & Susan Dell Center for Healthy Living - Department of Biostatistics and Data Science - The University of Texas Health (UTHealth) Science Center at Houston, Austin Campus, Austin, USA
| | - Fiona M Asigbee
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Matthew J Landry
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Sarvenaz Vandyousefi
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Reem Ghaddar
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Amy Hoover
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Matthew Jeans
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Katie Nikah
- Department of Nutritional Sciences, University of Texas at Austin, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA
| | - Brian Fischer
- Michael & Susan Dell Center for Healthy Living - Department of Biostatistics and Data Science - The University of Texas Health (UTHealth) Science Center at Houston, Austin Campus, Austin, USA
| | - Stephen J Pont
- Department of Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Daphne Richards
- Texas A&M AgriLife Extension Service, Travis County, Austin, USA
| | - Deanna M Hoelscher
- Michael & Susan Dell Center for Healthy Living - Department of Health Promotion and Behavioral Sciences - UTHealth Science Center at Houston, Austin Campus, Austin, USA
| | - Alexandra E Van Den Berg
- Michael & Susan Dell Center for Healthy Living - Department of Health Promotion and Behavioral Sciences - UTHealth Science Center at Houston, Austin Campus, Austin, USA
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Du Y, Duan X, Zheng M, Zhao W, Huang J, Lao L, Weng F, Lin DE, Yang Z, Li H, Liu X, Deng H. Association Between Eating Habits and Risk of Obstructive Sleep Apnea: A Population-Based Study. Nat Sci Sleep 2021; 13:1783-1795. [PMID: 34675726 PMCID: PMC8517635 DOI: 10.2147/nss.s325494] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/09/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The effect of dietary factors on OSA remains unclear. This study was to investigate the association of obstructive sleep apnea (OSA) with individual and overall effects of eating habits among adult Chinese. METHODS A total of 9733 participants were selected from the baseline survey of the Guangzhou Heart Study. OSA was ascertained by Berlin Questionnaire. Food consumption was collected using a food frequency questionnaire, and eating patterns were extracted by principal component analysis. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated by the logistic regression model. RESULTS After adjustment for confounders, fried food intake with ≥1/week was associated with an increased risk of OSA (OR: 1.77, 95% CI: 1.37-2.27), while fruit consumption of ≥1/day was associated with a 26% reduced risk of OSA (OR: 0.74, 95% CI: 0.62-0.88). Three eating patterns were defined and labeled as pattern I, II, and III. Eating pattern III which had higher factor loadings of animal innards, fried food, salted food, carbonate, and non-carbonated beverages was associated with an increased risk of OSA (OR: 1.30, 95% CI: 1.09-1.55) when comparing the highest with the lowest tertile of pattern score, after adjusting for confounders; every 1-unit increment of pattern III score was associated with an increased risk of OSA (OR: 1.09, 95% CI: 1.04-1.14). Neither pattern I nor pattern II was observed to be associated with OSA risk. CONCLUSION A higher frequency intake of fruits was associated with a reduced OSA risk and a diet with higher levels of consumption of animal innards, fried food, salted food, carbonated beverages, and non-carbonated beverages may increase the risk of OSA.
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Affiliation(s)
- Yan Du
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xueru Duan
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Murui Zheng
- Guangzhou Center for Disease Control and Prevention, Guangzhou, People's Republic of China
| | - Wenjing Zhao
- Department of Public Health, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Jun Huang
- Department of Geriatrics, Institute of Geriatrics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, People's Republic of China
| | - Lixian Lao
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, People's Republic of China
| | - Fan Weng
- Guangzhou Yuexiu District Center for Disease Control and Prevention, Guangzhou, People's Republic of China
| | - Dan-Er Lin
- Guangzhou Baiyun District Center for Disease Control and Prevention, Guangzhou, People's Republic of China
| | - Zhenxiao Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Haiyi Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xudong Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Hai Deng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, People's Republic of China
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Dietary nutrient intake related to higher grade cervical intraepithelial neoplasia risk: a Chinese population-based study. Nutr Metab (Lond) 2020; 17:100. [PMID: 33292305 PMCID: PMC7708219 DOI: 10.1186/s12986-020-00521-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 10/29/2020] [Indexed: 12/31/2022] Open
Abstract
Background Dietary nutrient intake plays a significant role in carcinogenesis. Few studies have investigated the association between dietary nutrient intake and cervical intraepithelial neoplasia (CIN) risk in China. Methods Data on 2304 women from an ongoing cohort comprising 40,000 women from China in 2014 were included. Study randomly selected 218 out of 2304 people as subjects during 2019. All participants were surveyed through in-person interviews, physical examinations, and laboratory tests. Clinical data were obtained from physical examinations and laboratory tests. Dietary intakes were assessed using a semiquantitative food frequency questionnaire. Nutrition intakes from 26 food sources were calculated using a comprehensive validated database. Descriptive statistics were used to describe the frequency and proportion, and mean and standard deviation of the demographic characteristics. Characteristics were examined for significant differences, and Pearson chi-square tests were used for categoric variables. Logistic regression was used to obtain odds ratios (ORs) and confidence intervals (CIs) for CIN risk in each nutrient intake quartile relative to that in the highest quartile. Results The food frequency questionnaire exhibited acceptable reproducibility and reasonable validity in assessing nutrient intakes among these women. After adjusting for multiple confounders, several dietary nutrients showed significant associations with CIN2+ risk. Low dietary folate intake was associated with the risk of CIN2+ (first versus fourth quartile: OR = 1.55, 95% CI 1.03–2.33). Similar results were also observed for vitamin B6 (OR = 1.63, 95% CI 1.08–2.46), vitamin C (OR = 1.59, 95% CI 1.05–2.42), niacin (OR = 1.65, 95% CI 1.08–2.51), and vitamin K (second versus fourth quartile: OR = 1.60, 95% CI 1.05–2.44). Conclusions Low folate; vitamin B6, C, and K; and niacin intakes were associated with CIN2+ risk. Nutrients may influence the development of higher grade CIN and cervical cancer.
Trial registration The study was registered in the Chinese Clinical Trial Register (ChiCTR-ROC-15006479) (https://www.chictr.org.cn).
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Dreher ML, Ford NA. A Comprehensive Critical Assessment of Increased Fruit and Vegetable Intake on Weight Loss in Women. Nutrients 2020; 12:nu12071919. [PMID: 32610460 PMCID: PMC7399879 DOI: 10.3390/nu12071919] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 12/16/2022] Open
Abstract
No previous reviews or meta-analyses have specifically assessed the effects of increased fruit and vegetable (FV) intake on weight loss with a primary focus on women. Several studies show differences between men and women in how increased FV intake affects their weight loss and maintenance, risk of becoming overweight or obese, and the influence of eating speed and frequency on weight control. This analysis provides a comprehensive and visual assessment of the effects of increasing FV intake and long-term weight change from observational studies and weight loss from randomized controlled trials (RCTs) in women. Consistent evidence from prospective studies and RCTs shows that increased intake of FV is a chief contributor to weight loss in women. This effect is enhanced with concurrent dietary restriction of high energy density (ED) or high-fat foods. Yet, the type of FV differentially impacts weight loss in women. Whole FV intake may influence weight through a variety of mechanisms including a reduction in eating rate, providing a satisfying, very-low to low energy density, low glycemic load or low-fat content. Also, FV are the primary source of dietary fiber, which can provide additional support for weight loss in women when consumed at adequate levels.
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Affiliation(s)
- Mark L. Dreher
- Nutrition Science Solutions, LLC, 900 S Rainbow Ranch Rd, Wimberley, TX 78676, USA;
| | - Nikki A. Ford
- Avocado Nutrition Center, 25212 Marguerite Pkwy Ste. 250, Mission Viejo, CA 92692, USA
- Correspondence: ; Tel.: +1-949-341-3250
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García-Gómez L, Romero-Rebollar C, Hartmann C, Siegrist M, Ferreira G, Gutierrez-Aguilar R, Villalpando S, Pacheco-Lopez G. Food Disgust Scale: Spanish Version. Front Psychol 2020; 11:165. [PMID: 32116959 PMCID: PMC7020908 DOI: 10.3389/fpsyg.2020.00165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 01/22/2020] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The Food Disgust Scale (FDS) was recently developed and validated in Swiss adult population. This study aims to: (1) validate the FDS for the first time in a Spanish-speaking Mexican population, (2) correlate food disgust sensitivity with picky eating measures, and (3) explore the association between food disgust sensitivity and body mass index (BMI). MATERIALS AND METHODS A Spanish version of the FDS (FDS-Sp) and its short version (FDS-Sp short) were tested with confirmatory factor analysis (CFA) in order to test the original item/factor structure. Bivariate correlations were performed to determine the association between FDS-Sp/FDS-Sp short scores and picky eating. Lastly, hierarchical linear regression analysis was carried out to determine the relationship between food disgust sensitivity and BMI. RESULTS The factor structure of the FDS was replicated and acceptable internal consistency values were observed for FDS-Sp subscales (α varied between 0.781 and 0.955). Moreover, FDS-Sp subscales and FDS-Sp short were correlated with picky eating. Higher score in VEGI subscale of the FDS-Sp was a significant predictor for higher BMI, explaining 4% of the variance. CONCLUSION FDS-Sp is a useful, reliable and robust psychometric instrument to measure the sensitivity to unpleasant food situations in a Mexican adult Spanish-speaking population. A relationship between food disgust sensitivity and picky eating, selective eating behaviors and neophobia in Mexicans was confirmed. BMI is multifactorial and only one subscale of FDS-Sp is a significant predictor for BMI status. These results are helpful to continue exploring food disgust in diverse populations.
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Affiliation(s)
- Leonor García-Gómez
- Health Sciences Department, Metropolitan Autonomous University (UAM), Campus Lerma, Lerma, Mexico
- Department of Research in Smoking and COPD, National Institute of Respiratory Diseases (INER) Ismael Cosio Villegas, Mexico City, Mexico
| | - César Romero-Rebollar
- Health Sciences Department, Metropolitan Autonomous University (UAM), Campus Lerma, Lerma, Mexico
| | - Christina Hartmann
- Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH) Zurich, Zurich, Switzerland
| | - Michael Siegrist
- Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH) Zurich, Zurich, Switzerland
| | | | - Ruth Gutierrez-Aguilar
- Research Division, School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
- Laboratory of Metabolic Diseases: Obesity and Diabetes, Children’s Hospital of Mexico (HIM) Federico Gómez, Mexico City, Mexico
| | - Salvador Villalpando
- Department of Gastroenterology & Nutrition, Children’s Hospital of Mexico (HIM) Federico Gómez, Mexico City, Mexico
| | - Gustavo Pacheco-Lopez
- Health Sciences Department, Metropolitan Autonomous University (UAM), Campus Lerma, Lerma, Mexico
- Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH) Zurich, Zurich, Switzerland
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Dreher ML. Whole Fruits and Fruit Fiber Emerging Health Effects. Nutrients 2018; 10:E1833. [PMID: 30487459 PMCID: PMC6315720 DOI: 10.3390/nu10121833] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/21/2018] [Accepted: 11/22/2018] [Indexed: 02/07/2023] Open
Abstract
Less than 10% of most Western populations consume adequate levels of whole fruits and dietary fiber with typical intake being about half of the recommended levels. Evidence of the beneficial health effects of consuming adequate levels of whole fruits has been steadily growing, especially regarding their bioactive fiber prebiotic effects and role in improved weight control, wellness and healthy aging. The primary aim of this narrative review article is to examine the increasing number of health benefits which are associated with the adequate intake of whole fruits, especially fruit fiber, throughout the human lifecycle. These potential health benefits include: protecting colonic gastrointestinal health (e.g., constipation, irritable bowel syndrome, inflammatory bowel diseases, and diverticular disease); promoting long-term weight management; reducing risk of cardiovascular disease, type 2 diabetes and metabolic syndrome; defending against colorectal and lung cancers; improving odds of successful aging; reducing the severity of asthma and chronic obstructive pulmonary disease; enhancing psychological well-being and lowering the risk of depression; contributing to higher bone mineral density in children and adults; reducing risk of seborrheic dermatitis; and helping to attenuate autism spectrum disorder severity. Low whole fruit intake represents a potentially more serious global population health threat than previously recognized, especially in light of the emerging research on whole fruit and fruit fiber health benefits.
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Affiliation(s)
- Mark L Dreher
- Nutrition Science Solutions, LLC, Wimberley, 78676 TX, USA.
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