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Lim GH, Neelakantan N, Lee YQ, Park SH, Kor ZH, van Dam RM, Chong MFF, Chia A. Dietary Patterns and Cardiovascular Diseases in Asia: A Systematic Review and Meta-Analysis. Adv Nutr 2024; 15:100249. [PMID: 39009489 DOI: 10.1016/j.advnut.2024.100249] [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: 03/25/2024] [Revised: 04/29/2024] [Accepted: 05/23/2024] [Indexed: 07/17/2024] Open
Abstract
With emerging Asian-derived diet quality indices and data-driven dietary patterns available, we aimed to synthesize the various dietary patterns and quantify its association with cardiovascular diseases (CVDs) among Asian populations. We systematically searched PubMed, Embase, Scopus, and Web of Science for observational studies in South, Southeast, and East Asia. Dietary patterns were grouped "high-quality," which included high intakes of three or more of the following food groups: 1) fruits and vegetables, 2) whole grains, 3) healthy protein sources (legumes and nuts, fish and seafood, low-fat dairy, and lean meat and poultry), and 4) liquid plant oils. High-quality patterns were further subcategorized based on their derivation methods: non-Asian indices, Asian indices, data-driven patterns, and plant-based indices. Dietary patterns were grouped "low-quality," which included high intakes of two or more of the following: 5) ultraprocessed food, 6) beverages and foods with added sugars, 7) foods high in salt, and 8) alcoholic beverages. Data-driven dietary patterns characterized by animal food sources were labeled "animal-based," and studies using dietary diversity scores were labeled "diet diversity indices." Dietary patterns that could not be meaningfully categorized were summarized narratively. Study-specific effect estimates were pooled using a random-effects model. Forty-one studies were included in this review. Higher adherence to high-quality dietary patterns in the top compared with bottom tertile defined by non-Asian indices (RR: 0.78; 95% CI: 0.69, 0.88; GRADE: moderate), Asian indices (RR: 0.84; 95% CI: 0.79, 0.90; GRADE: low), and data-driven patterns (RR: 0.81; 95% CI: 0.74, 0.89; GRADE: moderate) were associated with lower CVD risk. Plant-based, low-quality, animal-based, and diet diversity indices dietary patterns were not associated with CVD. Associations of Asian diet quality indices and CVD risk were weaker than those with non-Asian indices, highlighting the need for current Asian diet quality criteria to be updated to better capture the impact of diet on CVD. The systematic review and meta-analysis was registered at PROSPERO as CRD42021244318.
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Affiliation(s)
- Gladys Huiyun Lim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Nithya Neelakantan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Yu Qi Lee
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Su Hyun Park
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Zhi Heng Kor
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Department of Nutrition and Exercise Sciences and Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A∗STAR), Singapore
| | - Airu Chia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
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Harvey A, Mannette J, Sigall-Boneh R, Macintyre B, Parrott M, Cahill L, Connors J, Otley A, Haskett J, van Limbergen J, Grant S. Co-Development of Three Dietary Indices to Facilitate Dietary Intake Assessment of Pediatric Crohn's Disease Patients. CAN J DIET PRACT RES 2024:1-8. [PMID: 38634640 DOI: 10.3148/cjdpr-2024-005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Literature on dietary behaviours of the pediatric Crohn's Disease (CD) population and the relationship between dietary intake and CD activity is limited. Three dietary indices were developed and tested to conduct dietary pattern analysis in pediatric patients with CD consuming a free diet following remission induction via exclusive enteral nutrition (n = 11). Index scores underwent descriptive and inferential analysis. The mean adjusted scores (out of 100) for the Pediatric Western Diet Index, Pediatric Prudent Diet Index, and Pediatric-Adapted 2010 Alternate Healthy Eating Index (PA2010-AHEI) were 29.82 ± 15.22, 34.25 ± 15.18, and 51.50 ± 11.69, respectively. The mean Western-to-Prudent ratio was 0.94 ± 0.55. A significant correlation (r = -0.71) and relationship (F[1, 9] = 9.04, P < 0.05, R2 = 0.501) between the Western-to-Prudent ratio and PA2010-AHEI was found. The results suggest participants were not following a Western or Prudent diet, and were consuming foods not captured by the indices. More research is needed to describe dietary intake of individuals with CD, validate dietary indices in diverse samples, and explore the utility of these indices in CD assessment and treatment. The co-authors hope this work will stimulate/inspire subsequent interprofessional, dietitian-led research on this topic.
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Affiliation(s)
| | | | - Rotem Sigall-Boneh
- The E. Wolfson Medical Center, Pediatric Gastroenterology and Nutrition Unit, Holon, Israel
| | | | | | - Leah Cahill
- Dalhousie University, Halifax, NS
- Queen Elizabeth II Health Sciences Centre, Halifax, NS
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Anthony Otley
- Dalhousie University, Halifax, NS
- The E. Wolfson Medical Center, Pediatric Gastroenterology and Nutrition Unit, Holon, Israel
| | | | - Johan van Limbergen
- IWK Health Centre, Halifax, NS
- Dalhousie University, Halifax, NS
- Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology Metabolism, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Shannan Grant
- Mount Saint Vincent University, Halifax, NS
- IWK Health Centre, Halifax, NS
- Dalhousie University, Halifax, NS
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Luong R, Ribeiro R, Naganathan V, Blyth F, Waite LM, Handelsman DJ, Le Couteur DG, Seibel MJ, Hirani V. Empirically derived dietary patterns are associated with major adverse cardiovascular events, all-cause mortality, and congestive cardiac failure in older men: The Concord Health and Ageing in Men Project. J Nutr Health Aging 2024; 28:100020. [PMID: 38388114 DOI: 10.1016/j.jnha.2023.100020] [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: 07/31/2023] [Accepted: 10/10/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND Diet is associated with major adverse cardiovascular events (MACE). OBJECTIVE We evaluated the associations between empirically derived dietary patterns and MACE. DESIGN Prospective cohort study. SETTING The Concord Health and Ageing in Men Project, Sydney, Australia. PARTICIPANTS 539 community-dwelling older Australian men aged 75 years and older. METHODS Men underwent dietary assessment using a validated dietitian-administered diet history questionnaire. Cox regression analyses were conducted between MACE and the three dietary patterns identified from factor analysis. Five-point MACE comprised of all-cause mortality, myocardial infarction (MI), congestive cardiac failure (CCF), coronary revascularisation, and/or ischaemic stroke. Four-point MACE included the four endpoints of MI, CCF, coronary revascularisation, and/or ischaemic stroke, and excluded all-cause mortality. RESULTS At a median of 5.3 (IQR 4.6-6.3) years of follow-up, the incidences were: five-point MACE 31.2% (n = 168); four-point MACE excluding all-cause mortality 17.8% (n = 96); all-cause mortality 20.1% (n = 111); CCF 11.3% (n = 61); MI 3.7% (n = 20); stroke 3.2% (n = 17); and coronary revascularisation 3.1% (n = 15). In fully adjusted analyses, compared to the bottom tertile, the middle tertile of 'vegetables-legumes-seafood' dietary pattern was associated with reduced five-point MACE (HR 0.67 [95% CI: 0.45, 0.99, P = .047]), and CCF (HR 0.31 [95% CI: 0.15, 0.65, P = .002]), whilst the middle tertile of 'wholegrains-milk-other fruits' dietary pattern was associated with increased five-point MACE (HR 1.78 [95% CI: 1.17, 2.70, P = .007]), four-point MACE (HR 1.92 [95% CI: 1.12, 3.30, P = .018]), and CCF (HR 2.33 [95% CI: 1.17, 4.65, P = .016]). For the 'discretionary-starchy vegetables-processed meats' dietary pattern, a higher score was associated with increased five-point MACE (HR 1.33 [95% CI: 1.09, 1.62, P = .004]), and all-cause mortality (HR 1.63 [95% CI: 1.26, 2.12, P < .001]), and compared to the bottom tertile, the top tertile was associated with increased all-cause mortality (HR 2.26 [95% CI: 1.27, 4.00, P = .005]). CONCLUSION Older men may benefit from consuming a 'vegetables-legumes-seafood' dietary pattern rather than 'discretionary-starchy vegetables-processed meats' and 'wholegrains-milk-other fruits' dietary patterns for the prevention of MACE.
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Affiliation(s)
- Rebecca Luong
- Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia.
| | - Rosilene Ribeiro
- Charles Perkins Centre, The University of Sydney, NSW, Australia; School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, NSW, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Hospital, The University of Sydney, Concord, NSW, Australia; Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Concord, NSW, Australia
| | - Fiona Blyth
- ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney, NSW, Australia; School of Public Health, The University of Sydney, NSW, Australia
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Hospital, The University of Sydney, Concord, NSW, Australia; Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Concord, NSW, Australia
| | - David J Handelsman
- ANZAC Research Institute, The University of Sydney, Concord, NSW, Australia; Andrology Department, Concord Hospital, Concord, NSW, Australia
| | - David G Le Couteur
- Charles Perkins Centre, The University of Sydney, NSW, Australia; ANZAC Research Institute, The University of Sydney, Concord, NSW, Australia
| | - Markus J Seibel
- Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Concord, NSW, Australia; ANZAC Research Institute, The University of Sydney, Concord, NSW, Australia
| | - Vasant Hirani
- Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia; Centre for Education and Research on Ageing, Concord Hospital, The University of Sydney, Concord, NSW, Australia; ANZAC Research Institute, The University of Sydney, Concord, NSW, Australia
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Rahman A, Baharlouei P, Koh EHY, Pirvu DG, Rehmani R, Arcos M, Puri S. A Comprehensive Analysis of Organic Food: Evaluating Nutritional Value and Impact on Human Health. Foods 2024; 13:208. [PMID: 38254509 PMCID: PMC10814746 DOI: 10.3390/foods13020208] [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: 12/02/2023] [Revised: 12/23/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024] Open
Abstract
In recent years, organic agriculture has gained more popularity, yet its approach to food production and its potential impact on consumers' health and various environmental aspects remain to be fully discovered. The goal of organic farming practices is to maintain soil health, sustain ecological systems, maintain fairness in its relationship with the environment and protect the environment in its entirety. Various health benefits have been associated with higher consumption of organic foods. This review identified some of these health benefits, including a reduction in obesity and body mass index (BMI), improvements in blood nutrient composition as well as reductions in maternal obesity and pregnancy-associated preeclampsia risks. Furthermore, organic food consumption can reduce the development of non-Hodgkin lymphoma (NHL) and colorectal cancers. Upon reviewing the existing literature regarding the nutritional value of organic foods, it was found that organic food contained higher levels of iron, magnesium and vitamin C. However, the evidence available to draw definitive causations remains limited due to study biases, short study durations and confounding variables; thus, it cannot be concluded that the organic diet provides any related health benefits. In this review, we provided essential insights and statistical analysis from the evidence available and consider study limitations to evaluate the potential of organic food consumption in positively impacting human health.
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Affiliation(s)
- Azizur Rahman
- Centre for Climate Change Research, University of Toronto, ONRamp at UTE, Toronto, ON M5G 1L5, Canada; (P.B.); (E.H.Y.K.); (D.G.P.); (R.R.); (M.A.); (S.P.)
- A.R. Environmental Solutions, ICUBE-University of Toronto, Mississauga, ON L5L 1C6, Canada
| | - Parnian Baharlouei
- Centre for Climate Change Research, University of Toronto, ONRamp at UTE, Toronto, ON M5G 1L5, Canada; (P.B.); (E.H.Y.K.); (D.G.P.); (R.R.); (M.A.); (S.P.)
- Physiology and Human Biology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Eleanor Hui Yan Koh
- Centre for Climate Change Research, University of Toronto, ONRamp at UTE, Toronto, ON M5G 1L5, Canada; (P.B.); (E.H.Y.K.); (D.G.P.); (R.R.); (M.A.); (S.P.)
- A.R. Environmental Solutions, ICUBE-University of Toronto, Mississauga, ON L5L 1C6, Canada
| | - Diana Gabby Pirvu
- Centre for Climate Change Research, University of Toronto, ONRamp at UTE, Toronto, ON M5G 1L5, Canada; (P.B.); (E.H.Y.K.); (D.G.P.); (R.R.); (M.A.); (S.P.)
- A.R. Environmental Solutions, ICUBE-University of Toronto, Mississauga, ON L5L 1C6, Canada
| | - Rameesha Rehmani
- Centre for Climate Change Research, University of Toronto, ONRamp at UTE, Toronto, ON M5G 1L5, Canada; (P.B.); (E.H.Y.K.); (D.G.P.); (R.R.); (M.A.); (S.P.)
- A.R. Environmental Solutions, ICUBE-University of Toronto, Mississauga, ON L5L 1C6, Canada
| | - Mateo Arcos
- Centre for Climate Change Research, University of Toronto, ONRamp at UTE, Toronto, ON M5G 1L5, Canada; (P.B.); (E.H.Y.K.); (D.G.P.); (R.R.); (M.A.); (S.P.)
- A.R. Environmental Solutions, ICUBE-University of Toronto, Mississauga, ON L5L 1C6, Canada
| | - Simron Puri
- Centre for Climate Change Research, University of Toronto, ONRamp at UTE, Toronto, ON M5G 1L5, Canada; (P.B.); (E.H.Y.K.); (D.G.P.); (R.R.); (M.A.); (S.P.)
- A.R. Environmental Solutions, ICUBE-University of Toronto, Mississauga, ON L5L 1C6, Canada
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Gaesser GA. Refined grain intake and cardiovascular disease: Meta-analyses of prospective cohort studies. Trends Cardiovasc Med 2024; 34:59-68. [PMID: 36075506 DOI: 10.1016/j.tcm.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 08/08/2022] [Accepted: 08/31/2022] [Indexed: 10/14/2022]
Abstract
Refined grains are included as part of an unhealthy, or Western, dietary pattern, which has been shown to be associated with increased risk of cardiovascular disease (CVD). To clarify the association between refined grain intake and CVD risk, Pubmed and Scopus databases were searched for relevant cohort studies from database inception to June 30, 2022. Only studies that examined refined grains as a distinct consumption category and not as part of a dietary pattern, were included. Meta-analyses were performed using Cochrane's RevMan 5.4.1 software, applying inverse variance risk ratios in random effects models for each outcome of interest. Heterogeneity was assessed with Cochrane's Q (chi2) and I2 statistics. Meta-analyses of hazard ratios (HR) and 95% confidence intervals (CI) obtained from 17 prospective cohort studies (>875,000 participants) indicated that refined grain intake was not associated with risk of CVD (HR = 1.08, 95% CI, 0.99-1.18, I2 = 70%; 9 cohorts), stroke (HR = 1.06, 95% CI 0.92-1.23, I2 = 70%; 9 cohorts), or heart failure (HR = 0.95, 95% CI 0.77-1.16, I2 = 10%; 5 cohorts). White rice intake was also not associated with risk of CVD (HR = 0.93, 95% CI 0.86-1.00, I2 = 25%; 7 cohorts) or stroke (HR = 1.03, 95% CI 0.93-1.14, I2 = 22%; 7 cohorts). No significant publication bias was evident (Egger's test P values all > 0.05). The lack of association between refined grain intake and CVD risk was observed in meta-analyses of studies that restricted analyses to only staple grain foods (e.g., bread, cereal, pasta, white rice), as well as for meta-analyses of studies that included both staple and indulgent grain foods (e.g., cakes, cookies, doughnuts, brownies, muffins, pastries). Probable confounding from unmeasured variables in studies included in the meta-analyses diminishes the overall quality of evidence. Although refined grains are included as a component of the Western dietary pattern, the results of the meta-analyses suggest that refined grains do not contribute to the higher CVD risk associated with this unhealthy dietary pattern. This information should be considered in formulation of future dietary recommendations.
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Affiliation(s)
- Glenn A Gaesser
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, United States.
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Zheng J, Zhu T, Li F, Wu H, Jiang S, Shivappa N, Hébert JR, Li X, Li Y, Wang H. Diet Quality and Mortality among Chinese Adults: Findings from the China Health and Nutrition Survey. Nutrients 2023; 16:94. [PMID: 38201925 PMCID: PMC10780502 DOI: 10.3390/nu16010094] [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: 10/27/2023] [Revised: 11/28/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
The association between diet quality and all-cause mortality in Chinese population is unclear. We aimed to study the associations of three a priori diet quality indices-including the Diet Quality Index-International (DQI-I), Chinese Healthy Eating Index (CHEI), and energy-adjusted Dietary Inflammatory Index (E-DII)-and their included components with all-cause mortality. We used baseline data from the 2004, 2006, 2009, and 2011 waves of the China Health and Nutrition Survey (CHNS). We used a multivariable-adjusted Cox model to examine the associations between DQI-I, CHEI, and E-DII with all-cause mortality. During a mean of 7 years of follow-up, a total of 461 deaths occurred among 12,914 participants. For DQI-I, there were significant inverse associations with mortality for the variety score (HRQ4 vs. Q1 = 0.69, 95%CI = 0.52-0.92) and overall balance score (HR>0 vs. 0 = 0.81, 95%CI = 0.66-0.91). The adequacy score of CHEI was associated with 40% less risk of all-cause mortality (HRQ4 vs. Q1 = 0.60, 95%CI = 0.43-0.84). E-DII was not associated with mortality. An estimated 20.1%, 13.9%, and 31.3% of total mortality would be averted if the DQI-I variety score, DQI-I overall balance score, and CHEI adequacy score improved from the bottom to the top quartile, respectively. Improving diet quality, especially improving diet variety and adequacy, and having a more balanced diet may reduce all-cause mortality in Chinese adults.
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Affiliation(s)
- Jiali Zheng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Tianren Zhu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Fangyu Li
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA;
| | - Han Wu
- Division of Noncommunicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China;
| | - Shuo Jiang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - James R. Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Xiaoguang Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Yan Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
| | - Hui Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (T.Z.); (S.J.); (X.L.); (Y.L.)
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Tholla TS, Sawicki CM, Bhupathiraju SN. The Intersection Between COVID-19, Cardiovascular Disease, and Diet: a Review. Curr Atheroscler Rep 2023; 25:643-652. [PMID: 37646976 DOI: 10.1007/s11883-023-01138-7] [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] [Accepted: 08/08/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE OF REVIEW Cardiovascular disease (CVD) is one of the top comorbidities associated with COVID-19-both pre- and post-infection. This review examines the relationships between COVID-19 infection and cardiovascular health, with a specific focus on diet as an important modifiable risk factor. RECENT FINDINGS Pandemic era studies of individuals battling and recovering from COVID-19 infection suggest a strong link between metabolic diseases, such as CVD, and SARS-CoV-2 infection susceptibility and severity. Other studies also demonstrate how COVID-19 lockdown policies and quarantine recommendations led to drastic lifestyle changes associated with increased CVD risk, such as reduced physical activity and lower diet quality. At the same time, new research is emerging that plant-based diets, which have previously been associated with lower CVD risk, may lower COVID-19 infection rates and severity of symptoms. Diet, COVID-19, and CVD intersect through complex biological mechanisms and related behavioral factors evidenced by clinical trials and epidemiological studies. Diet may be a critical tool for modifying risk of communicable and non-communicable conditions in the post-pandemic world.
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Affiliation(s)
- Tanusha S Tholla
- Chobanian and Avedisian School of Medicine, Boston University, Boston, MA, USA
| | - Caleigh M Sawicki
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Room 338, 181 Longwood Ave, Boston, MA, 02115, USA
| | - Shilpa N Bhupathiraju
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Room 338, 181 Longwood Ave, Boston, MA, 02115, USA.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Abe C, Imai T, Sezaki A, Miyamoto K, Kawase F, Shirai Y, Sanada M, Inden A, Kato T, Sugihara N, Shimokata H. Global Association between Traditional Japanese Diet Score and All-Cause, Cardiovascular Disease, and Total Cancer Mortality: A Cross-Sectional and Longitudinal Ecological Study. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:660-667. [PMID: 36219452 DOI: 10.1080/27697061.2022.2130472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/07/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Studies conducted on Japanese people have suggested that a traditional Japanese diet contributes to good health, longevity, and protection against several non-communicable diseases. However, it is unknown whether traditional Japanese dietary patterns are associated with all-cause mortality, cardiovascular disease, and cancer mortality globally. The purpose of this cross-sectional and longitudinal ecological study is to clarify the global association between the traditional Japanese diet score (TJDS) and all-cause, cardiovascular disease, and total cancer mortality. METHODS Data on food supply and all-cause mortality, cardiovascular disease mortality, total cancer mortality, and covariables by country were obtained from a relevant internationally available database. TJDS by country was calculated from eight food groups and the total score ranged from -8 to 8, with higher scores indicating greater adherence to a traditional Japanese diet. We evaluated the cross-sectional and 10-year longitudinal association between TJDS and all-cause, cardiovascular disease, and total cancer mortality using 2009 as the baseline in 142 countries with populations of more than one million. A cross-sectional analysis and a longitudinal analysis were performed using three general linear models or three linear mixed models with different covariables. RESULTS In cross-sectional models controlled for fully-adjusted covariables, TJDS was negatively associated with all-cause mortality (β ± standard error; -43.819 ± 11.741, p < 0.001), cardiovascular disease mortality (-22.395 ± 4.638, p < 0.001), and total cancer mortality (-3.893 ± 1.048, p < 0.001). In 10-year longitudinal models controlled for fully-adjusted covariables, TJDS was significantly negatively associated with all-cause mortality (-31.563 ± 7.695, p < 0.001), cardiovascular disease mortality (-16.249 ± 4.054, p < 0.001), and total cancer mortality (-3.499 ± 0.867, p < 0.001). CONCLUSIONS This cross-sectional and longitudinal ecological study suggests that the traditional Japanese diet is associated with lower all-cause mortality, cardiovascular disease mortality, and total cancer mortality, worldwide.
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Affiliation(s)
- Chisato Abe
- Department of Food and Nutrition, Tsu City College, Mie, Japan
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
| | - Tomoko Imai
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Food Science and Nutrition, Doshisha Women's College of Liberal Arts, Kyoto, Japan
| | - Ayako Sezaki
- Department of Food Sciences and Human Nutrition, Ryukoku University, Shiga, Japan
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Aichi, Japan
| | - Keiko Miyamoto
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Nursing, Nagoya University of Arts and Sciences, Aichi, Japan
| | - Fumiya Kawase
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Nutrition, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Aichi, Japan
| | - Yoshiro Shirai
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Food and Nutritional Environment, Kinjo Gakuin University, Aichi, Japan
| | - Masayo Sanada
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Nursing, Heisei College of Health Sciences, Gifu, Japan
| | - Ayaka Inden
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Aichi, Japan
- Clinical Nutrition Unit, Hamamatsu University Hospital, Shizuoka, Japan
| | - Takumi Kato
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Nutrition Division, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Aichi, Japan
| | - Norie Sugihara
- Faculty of Health and Social Services, Kanagawa University of Human Services, Kanagawa, Japan
| | - Hiroshi Shimokata
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Aichi, Japan
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9
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Stuber JM, Lakerveld J, Beulens JWJ, Mackenbach JD. Better understanding determinants of dietary guideline adherence among Dutch adults with varying socio-economic backgrounds through a mixed-methods exploration. Public Health Nutr 2023; 26:1172-1184. [PMID: 36700250 PMCID: PMC10348427 DOI: 10.1017/s1368980023000228] [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: 07/21/2022] [Revised: 12/05/2022] [Accepted: 01/20/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Low dietary guideline adherence is persistent, but there is limited understanding of how individuals with varying socio-economic backgrounds reach a certain dietary intake. We investigated how quantitative and qualitative data on dietary guidelines adherence correspond and complement each other, to what extent determinants of guideline adherence in quantitative data reflect findings on determinants derived from qualitative data and which of these determinants emerged as interdependent in the qualitative data. DESIGN This mixed-methods study used quantitative questionnaire data (n 1492) and qualitative data collected via semi-structured telephone interviews (n 24). Quantitative data on determinants and their association with total guideline adherence (scored 0-150) were assessed through linear regression. Directed content analysis was used for qualitative data. SETTING Dutch urban areas. PARTICIPANTS Adults aged 18-65 years. RESULTS A range of determinants emerged from both data sources, for example higher levels of cognitive restraint (β 5·6, 95 % CI 4·2, 7·1), habit strength of vegetables (β 4·0, 95 % CI 3·3, 4·7) and cooking skills (β 4·7, 95 % CI 3·5, 5·9), were associated with higher adherence. Qualitative data additionally suggested the influence of food prices, strong dietary habits and the social aspect of eating, and for the determinants cognitive restraint, habit strength related to vegetables, food prices and home cooking, some variation between interviewees with varying socio-economic backgrounds emerged in how these determinants affected guideline adherence. CONCLUSIONS This mixed-methods exploration provides a richer understanding of why adults with varying socio-economic backgrounds do or do not adhere to dietary guidelines. Results can guide future interventions promoting healthy diets across populations.
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Affiliation(s)
- Josine M Stuber
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
| | - Jeroen Lakerveld
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
| | - Joline WJ Beulens
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Joreintje D Mackenbach
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
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10
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Mohseni M, Mohammadifard N, Hassannejad R, Aghabozorgi M, Shirani F, Sadeghi M, Roohafza H, Sarrafzadegan N. Longitudinal association of dietary habits and the risk of cardiovascular disease among Iranian population between 2001 and 2013: the Isfahan Cohort Study. Sci Rep 2023; 13:5364. [PMID: 37005461 PMCID: PMC10067824 DOI: 10.1038/s41598-023-32387-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 03/27/2023] [Indexed: 04/04/2023] Open
Abstract
There has been a steady rise in the incidence of cardiovascular disease (CVD) in the Iranian population. The aim of this study is to investigate the association between Global Dietary Index (GDI) and CVD risk among the Iranian adult population. This study was conducted based on Isfahan Cohort Study, a longitudinal study that collected data between 2001 and 2013 on 6405 adults. Dietary intakes were assessed by a validated food frequency questionnaire to calculate GDI. All participants were followed every two years by phone call to ask about death, any hospitalization, or cardiovascular events to examine CVD events. The Average age of participants was 50.70 ± 11.63 and the median of GDI score was 1 (IQR: 0.29). A total of 751 CVD events (1.4 incidence rate, per 100 person-year) occurred during 52,704 person-years of follow-up. One-unit GDI increase was associated with a higher risk of MI by 72% (HR: 1.72; 95% CI 1.04-2.84), stroke by 76% (HR: 1.76; 95% CI 1.09-2.85) and CVD by 30% (HR: 1.48; 95% CI 1.02-2.65). In addition, a one-unit GDI increase was associated with a higher risk of coronary heart disease more than 2 times (HR: 2.32; 95% CI 1.50-3.60) and CVD mortality and all-cause mortality over than 3 times [(HR: 3.65; 95% CI 1.90-7.01) and (HR: 3.10; 95% CI 1.90-5.06), respectively]. Higher GDI had a significant relationship with the increased risk of CVD events and all-cause mortality. Further epidemiological studies in other populations are suggested to confirm our findings.
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Affiliation(s)
- Maryam Mohseni
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Razieh Hassannejad
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Aghabozorgi
- Senior Endocrine Dietitian and Credentialed Diabetes Educator, Departments of Dietetics, and Endocrinology and Diabetes, Fiona Stanley and Fremantle Hospitals Group, Perth, Australia
| | - Fatemeh Shirani
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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11
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Wang W, Liu Y, Li Y, Luo B, Lin Z, Chen K, Liu Y. Dietary patterns and cardiometabolic health: Clinical evidence and mechanism. MedComm (Beijing) 2023; 4:e212. [PMID: 36776765 PMCID: PMC9899878 DOI: 10.1002/mco2.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/31/2022] [Accepted: 01/11/2023] [Indexed: 02/08/2023] Open
Abstract
For centuries, the search for nutritional interventions to underpin cardiovascular treatment and prevention guidelines has contributed to the rapid development of the field of dietary patterns and cardiometabolic disease (CMD). Numerous studies have demonstrated that healthy dietary patterns with emphasis on food-based recommendations are the gold standard for extending lifespan and reducing the risks of CMD and mortality. Healthy dietary patterns include various permutations of energy restriction, macronutrients, and food intake patterns such as calorie restriction, intermittent fasting, Mediterranean diet, plant-based diets, etc. Early implementation of healthy dietary patterns in patients with CMD is encouraged, but an understanding of the mechanisms by which these patterns trigger cardiometabolic benefits remains incomplete. Hence, this review examined several dietary patterns that may improve cardiometabolic health, including restrictive dietary patterns, regional dietary patterns, and diets based on controlled macronutrients and food groups, summarizing cutting-edge evidence and potential mechanisms for CMD prevention and treatment. Particularly, considering individual differences in responses to dietary composition and nutritional changes in organ tissue diversity, we highlighted the critical role of individual gut microbiota in the crosstalk between diet and CMD and recommend a more precise and dynamic nutritional strategy for CMD by developing dietary patterns based on individual gut microbiota profiles.
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Affiliation(s)
- Wenting Wang
- National Clinical Research Centre for Chinese Medicine Cardiology Xiyuan Hospital China Academy of Chinese Medical Sciences Beijing China
| | - Yanfei Liu
- National Clinical Research Centre for Chinese Medicine Cardiology Xiyuan Hospital China Academy of Chinese Medical Sciences Beijing China
| | - Yiwen Li
- National Clinical Research Centre for Chinese Medicine Cardiology Xiyuan Hospital China Academy of Chinese Medical Sciences Beijing China
| | - Binyu Luo
- National Clinical Research Centre for Chinese Medicine Cardiology Xiyuan Hospital China Academy of Chinese Medical Sciences Beijing China
| | - Zhixiu Lin
- Faculty of Medicine The Chinese University of Hong Kong Hong Kong
| | - Keji Chen
- National Clinical Research Centre for Chinese Medicine Cardiology Xiyuan Hospital China Academy of Chinese Medical Sciences Beijing China
| | - Yue Liu
- National Clinical Research Centre for Chinese Medicine Cardiology Xiyuan Hospital China Academy of Chinese Medical Sciences Beijing China
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12
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Rodríguez-González P, Iglesias D, Fernandez-Rio J, Gao Z. Effectiveness of interventions using apps to improve physical activity, sedentary behavior and diet: An umbrella review. Complement Ther Clin Pract 2023; 50:101711. [PMID: 36509032 DOI: 10.1016/j.ctcp.2022.101711] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/09/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022]
Abstract
Technology has been recently found to be an effective tool to deliver public health interventions [1]. More specifically, the effects of interventions using apps to improve health have been targeted lately [2]. The goal of the present study was to conduct a systematic review of systematic reviews to summarize the scientific evidence. Three research questions were formulated to guide the research: RQ1. Are interventions using apps effective to improve PA? RQ2. Are interventions using apps effective to improve sedentary behavior? RQ3. Are interventions using apps effective to improve diet? This review of reviews was registered with PROSPERO (CRD42022345909). Systematic reviews were included following the PICOTS framework (population, intervention, comparator, outcomes, time and setting). In addition, reviews with several research objectives were included only when they comprised more than two-thirds of the studies analyzing one or more of the objectives of this review. As a result, 12 systematic reviews were selected for data extraction. Findings uncovered that apps could be effective to improve individuals' PA, sedentary behavior and diet. However, elements like the intervention components, the context/environment/setting, the length of the intervention or the population targeted should be carefully considered in future studies.
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Affiliation(s)
- Pablo Rodríguez-González
- School of Kinesiology, University of Minnesota Twin Cities, USA; Faculty of Teacher Training and Education, University of Oviedo, Asturias, Spain
| | - Damián Iglesias
- Teacher Training College, University of Extremadura, Cáceres, Spain
| | - Javier Fernandez-Rio
- Faculty of Teacher Training and Education, University of Oviedo, Asturias, Spain
| | - Zan Gao
- School of Kinesiology, University of Minnesota Twin Cities, USA.
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13
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He C, Wang W, Chen Q, Shen Z, Pan E, Sun Z, Lou P, Zhang X. Association between dietary patterns and stroke in patients with type 2 diabetes mellitus in China: a propensity score-matched analysis. Public Health Nutr 2022; 25:1-25. [PMID: 35356874 PMCID: PMC9991648 DOI: 10.1017/s1368980022000763] [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: 04/17/2021] [Revised: 02/09/2022] [Accepted: 03/21/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to examine the impact of different dietary patterns on stroke outcomes among type 2 diabetes mellitus (T2DM) patients in China. DESIGN Participants were enrolled by a stratified random cluster sampling method in the study. After collecting dietary data using a quantified food frequency questionnaire, latent class analysis was used to identify dietary patterns, and propensity score matching was used to reduce confounding effects between different dietary patterns. Binary logistic regression and conditional logistic regression were used to analyze the relationship between dietary patterns and stroke in patients with T2DM. SETTING A cross-sectional survey available from December 2013 to January 2014. PARTICIPANTS A total of 13731 Chinese residents aged 18 years or over. RESULTS Two dietary patterns were identified: 61.2% of T2DM patients were categorized in the High-fat dietary pattern while 38.8% of patients were characterized by the Balanced dietary pattern. Compared to the High-fat dietary pattern, the Balanced dietary pattern was associated with reduced stroke risk (OR=0.63, 95%CI: 0.52-0.76, P<0.001) after adjusting for confounding factors. The protective effect of the balanced model did not differ significantly (interaction P>0.05). CONCLUSION This study provides sufficient evidence to support the dietary intervention strategies to prevent stroke effectively. Maintaining a Balanced dietary pattern, especially with moderate consumption of foods rich in quality protein and fresh vegetables in T2DM patients, might decrease the risk of stroke in China.
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Affiliation(s)
- Chenlu He
- School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, Jiangsu221004, China
| | - Wei Wang
- School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, Jiangsu221004, China
| | - Qian Chen
- School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, Jiangsu221004, China
| | - Ziyuan Shen
- School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, Jiangsu221004, China
| | - Enchun Pan
- Huai´an Center for Disease Control and Prevention, Huai´an, Jiangsu, China
| | - Zhongming Sun
- Huai´an Center for Disease Control and Prevention, Huai´an, Jiangsu, China
| | - Peian Lou
- Xuzhou Center for Disease Control and Prevention, Xuzhou, Jiangsu, China
| | - Xunbao Zhang
- School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, Jiangsu221004, China
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14
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Tanisawa K, Ito T, Kawakami R, Usui C, Kawamura T, Suzuki K, Sakamoto S, Ishii K, Muraoka I, Oka K, Higuchi M. Association Between Dietary Patterns and Different Metabolic Phenotypes in Japanese Adults: WASEDA'S Health Study. Front Nutr 2022; 9:779967. [PMID: 35155537 PMCID: PMC8829333 DOI: 10.3389/fnut.2022.779967] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/03/2022] [Indexed: 12/12/2022] Open
Abstract
Although many studies have reported that a posteriori dietary pattern is associated with metabolic health, there is little evidence of an association between dietary patterns and different metabolic phenotypes. The present study aimed to examine the association between major dietary patterns and different metabolic phenotypes (metabolically healthy non-obese [MHNO], metabolically unhealthy non-obese [MUNO], metabolically healthy obese [MHO], and metabolically unhealthy obese [MUO]) in middle-aged and elderly Japanese adults. This cross-sectional study enrolled 2,170 Japanese adults aged ≥40 years. The four different metabolic phenotypes were determined based on the presence of obesity, abdominal obesity, hypertension, hyperglycemia, and dyslipidemia. The major dietary patterns were determined using principal component analysis based on energy-adjusted food intake. Two dietary patterns were identified: the healthy dietary pattern, which was characterized by a high intake of vegetables, fruits, potatoes, soy products, mushrooms, seaweeds, and fish; and the alcohol dietary pattern, which was characterized by a high intake of alcoholic beverages, liver, chicken, and fish. The healthy dietary pattern was associated with the MHNO and MHO phenotypes (MUNO and MUO as reference groups, respectively), and the multivariate-adjusted odds ratios (ORs) (95% confidence intervals [CIs]) in the highest quartile of healthy dietary pattern score with the lowest quartile as the reference category were 2.10 (1.40–3.15) and 1.86 (1.06–3.25), respectively. Conversely, the alcohol dietary pattern was inversely associated with the MHNO and MHO phenotypes, while the multivariate-adjusted ORs (95% CIs) in the highest quartile of the alcohol dietary pattern score with the lowest quartile as the reference category were 0.63 (0.42–0.94) and 0.45 (0.26–0.76), respectively. There were no significant interactions between sex and healthy/alcohol dietary patterns in the prevalence of the MHNO and MHO phenotypes. In conclusion, the present study's findings suggest that major dietary patterns are associated with different metabolic phenotypes in middle-aged and elderly Japanese adults. These findings provide useful evidence for maintaining metabolic health through diet regardless of obesity status.
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Affiliation(s)
- Kumpei Tanisawa
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
- *Correspondence: Kumpei Tanisawa
| | - Tomoko Ito
- Waseda Institute for Sport Sciences, Tokorozawa, Japan
- Department of Food and Nutrition, Tokyo Kasei University, Tokyo, Japan
| | - Ryoko Kawakami
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Chiyoko Usui
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Takuji Kawamura
- Waseda Institute for Sport Sciences, Tokorozawa, Japan
- Research Center for Molecular Exercise Science, University of Physical Education, Budapest, Hungary
| | | | - Shizuo Sakamoto
- Faculty of Sport Science, Surugadai University, Saitama, Japan
| | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Isao Muraoka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Mitsuru Higuchi
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
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15
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Qin C, Lv J, Yu C, Guo Y, Bian Z, Gao M, Du H, Yang L, Chen Y, Shen L, Zhou S, Chen J, Chen Z, Li L. Dietary patterns and cardiometabolic diseases in 0.5 million Chinese adults: a 10-year cohort study. Nutr J 2021; 20:74. [PMID: 34479555 PMCID: PMC8418004 DOI: 10.1186/s12937-021-00730-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 07/26/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The effect of the overall diet quality on cardiometabolic diseases has been well studied in the Western population. However, evidence is still in need regarding dietary patterns depicting unique Chinese dietary habits and their associations with cardiometabolic diseases. METHODS A prospective cohort recruited around 0.5 million Chinese residents aged 30-79 years from 10 diverse survey sites during 2004-08. Dietary patterns were obtained using factor analysis based on the habitual consumption of 12 food groups collected at baseline. Among 477,465 eligible participants free of prior heart disease, stroke and cancer, linkages to multiple registries and health insurance database recorded 137,715 cardiovascular diseases (CVD) and 17,412 diabetes cases (among 451,846 non-diabetic participants) until 31 December 2017. Adjusted hazard ratios (HRs) were estimated to compare the risks of cardiometabolic diseases across quintiles of dietary pattern scores using the Cox regression. RESULTS Two dietary patterns were derived: the traditional northern pattern, characterised by wheat, other staples, egg and dairy products; and the modern pattern, featured with fresh fruit, meat, poultry, fish, dairy products and soybean. Adherence to either dietary pattern was associated with lower risks of major cardiometabolic diseases in a dose-response relationship way. After multivariate adjustment, participants adhering to the traditional northern pattern the most had an 8% (95%CI: 5-11%) lower risk of CVD in comparison with those adhering the least. Corresponding risk reductions were 12% (11-32%) for haemorrhagic stroke (HS), 14% (8-19%) for ischaemic stroke (IS), and 15% (6-24%) for diabetes, respectively. When comparing extreme quintiles of the modern pattern, the adjusted HR of HS was 0.67 (95%CI: 0.59-0.77). Corresponding HRs were 0.89 (0.86-0.92) for CVD, 0.88 (0.77-0.99) for MCE, 0.85 (0.80-0.89) for IS, and 0.89 (0.81, 0.97) for diabetes. CONCLUSION Among Chinese adults, both traditional northern and modern dietary patterns were associated with lower risks of cardiovascular disease and diabetes beyond other risk factors.
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Affiliation(s)
- Chenxi Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
- Peking University Institute of Environmental Medicine, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China.
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Meng Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China
| | - Huaidong Du
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
| | - Ling Yang
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
| | - Yiping Chen
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
| | - Leijia Shen
- The Second hospital of Tongxiang, Tongxiang, Zhejiang Province, China
| | - Songgen Zhou
- Wuzhen Town Health Centres, Tongxiang, Zhejiang Province, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing, 100191, China.
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16
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Kobayashi T, Zhao W, Ukawa S, Wakai K, Tsushita K, Kawamura T, Ando M, Tamakoshi A. Association between frequency of snacking and all-cause mortality among community-dwelling young-old adults: An age-specific prospective cohort study. Geriatr Gerontol Int 2021; 21:697-704. [PMID: 34173313 DOI: 10.1111/ggi.14209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/23/2021] [Accepted: 05/23/2021] [Indexed: 11/26/2022]
Abstract
AIM We aimed to clarify whether snacking habits decrease the risk of all-cause mortality in an older Japanese population. METHODS The study participants were 64- or 65-year-old community-dwelling residents recruited each survey year from 1996 through 2005. Data on the frequency of snacking and other lifestyle factors were obtained during the baseline survey using self-administered questionnaires, and the participants were followed up annually until the end of 2017. In total, 2943 participants (1484 men and 1459 women) were eligible. All-cause mortality was compared among participants grouped by frequency of snacking (no snacking, one to four times/week, or every day). RESULTS The number of deaths recorded over the study period of 43 204 person-years was 357 (24.1%) for men and 173 (11.9%) for women. The mean ± standard deviations for the follow-up period were 14.2 ± 4.9 years in men and 15.2 ± 4.5 years in women. Cox proportional hazard regression analyses showed that after adjusting for potential confounding factors, the hazard ratios for women were 0.64 (95% confidence interval [CI], 0.43-0.94) in the group that had a habit of snacking one to four times/week, and 0.93 (95% CI 0.63-1.36) in the group that had a habit of snacking every day compared with those in the no snacking group. These associations were not observed among men. CONCLUSIONS A moderate frequency of snacking slightly decreases the risk of all-cause mortality among women. Our findings might be useful for improving the nutrition statuses in older female adults. Geriatr Gerontol Int 2021; 21: 697-704.
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Affiliation(s)
- Tohru Kobayashi
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan.,Department of Food Science and Human Wellness, Rakuno Gakuen University, Ebetsu, Japan
| | - Wenjing Zhao
- Department of Public Health, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Shigekazu Ukawa
- Research Unit of Advanced Interdisciplinary Care Science, Osaka City University Graduate School of Human Life Science, Osaka, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuyo Tsushita
- Comprehensive Health Science Center, Aichi Health Promotion Foundation, Higashiura-Cho, Japan
| | | | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
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17
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Does diet map with mortality? Ecological association of dietary patterns with chronic disease mortality and its spatial dependence in Switzerland. Br J Nutr 2021; 127:1037-1049. [PMID: 33971997 PMCID: PMC8924527 DOI: 10.1017/s0007114521001525] [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] [Indexed: 11/29/2022]
Abstract
We investigated the associations between dietary patterns and chronic disease mortality in Switzerland using an ecological design and explored their spatial dependence, i.e. the tendency of near locations to present more similar and distant locations to present more different values than randomly expected. Data of the National Nutrition Survey menuCH (n 2057) were used to compute hypothesis- (Alternate Healthy Eating Index (AHEI)) and data-driven dietary patterns. District-level standardised mortality ratios (SMR) were calculated using the Swiss Federal Statistical Office mortality data and linked to dietary data geographically. Quasipoisson regression models were fitted to investigate the associations between dietary patterns and chronic disease mortality; Moran’s I statistics were used to explore spatial dependence. Compared with the first, the fifth AHEI quintile (highest diet quality) was associated with district-level SMR of 0·95 (95 % CI 0·93, 0·97) for CVD, 0·91 (95 % CI 0·88, 0·95) for ischaemic heart disease (IHD), 0·97 (95 % CI 0·95, 0·99) for stroke, 0·99 (95 % CI 0·98, 1·00) for all-cancer, 0·98 (95 % CI 0·96, 0·99) for colorectal cancer and 0·93 (95 % CI 0·89, 0·96) for diabetes. The Swiss traditional and Western-like patterns were associated with significantly higher district-level SMR for CVD, IHD, stroke and diabetes (ranging from 1·02 to 1·08) compared with the Prudent pattern. Significant global and local spatial dependence was identified, with similar results across hypothesis- and data-driven dietary patterns. Our study suggests that dietary patterns partly contribute to the explanation of geographic disparities in chronic disease mortality in Switzerland. Further analyses including spatial components in regression models would allow identifying regions where nutritional interventions are particularly needed.
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18
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Nouri F, Sadeghi M, Mohammadifard N, Roohafza H, Feizi A, Sarrafzadegan N. Longitudinal association between an overall diet quality index and latent profiles of cardiovascular risk factors: results from a population based 13-year follow up cohort study. Nutr Metab (Lond) 2021; 18:28. [PMID: 33691729 PMCID: PMC7948330 DOI: 10.1186/s12986-021-00560-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/04/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are associated with an unhealthy lifestyle, including poor diet. Indices reflecting the overall quality of diets are more effective than single food or nutrient-based approaches in clarifying the diet disease relationship. The present study aims to use latent variable modeling to examine the longitudinal joint relationships between the latent profiles of CVDs risk factors and the diet quality index (DQI). METHODS A total of 4390 Iranian adults aged 35 and older within the framework of the Isfahan Cohort Study were included in the current secondary analysis. DQI focused on food groups, including fast foods, sweets, vegetables, fruits, fats, and proteins, based on a validated food frequency questionnaire. The score of DQI has a range between 0 (indicating healthy and high diet quality) and 2 (indicating unhealthy and low diet quality). Blood pressure (BP), anthropometric measurements, blood glucose, serum lipids, and high-sensitivity C-Reactive Protein (hs-CRP) were measured according to standard protocols in 2001, 2007, and 2013 to evaluate the profiles of CVDs risk factors. A Bayesian Multidimensional Graded Responses Linear Mixed Model was used for data analysis. RESULTS At baseline, the participants' mean ± standard deviation age was 50.09 ± 11.21, and 49.5% of them were male. Three latent profiles of CVDs risk factors were derived: (1) Fit Pre-Metabolic Syndrome (FPMS) profile characterized by normal anthropometric indices and some impaired metabolic risk factors; (2) DysLipoproteinemia Central Obese (DLCO) profile with abdominal obesity and impaired low-density lipoprotein cholesterol as well as other normal risk factors; (3) Impaired Laboratory Inflammatory State (ILIS) profile with impaired high-density lipoprotein cholesterol and hs-CRP and other normal risk factors. In general, higher scores of the extracted latent profiles indicated more impaired function in the related risk factors. After controlling for various potential fixed and time-varying confounding variables, a significant positive longitudinal association was found between FPMS, DLCO, and ILIS profiles and DQI (β (95% CrI): 0.26 (0.03,0.51), 0.14 (0.01,0.27), and 0.24 (0.11,0.38), respectively), demonstrating that lower overall diet quality was associated with more impaired function of the related risk factors. CONCLUSIONS More adherence to a healthy quality diet is associated with lower levels of all emerging latent profiles of CVDs risk factors. Increasing the knowledge of the community about the importance of the quality of consumed foods may help to prevent CVDs. It is recommended that further investigations, particularly interventional studies, be conducted to confirm our results.
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Affiliation(s)
- Fatemeh Nouri
- Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Hezar Jerib Street, 8174673461, Isfahan, Iran
| | - Noushin Mohammadifard
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Hezar Jerib Street, 8174673461, Isfahan, Iran.
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Hoang T, Kim H, Kim J. Dietary Intake in Association with All-Cause Mortality and Colorectal Cancer Mortality among Colorectal Cancer Survivors: A Systematic Review and Meta-Analysis of Prospective Studies. Cancers (Basel) 2020; 12:cancers12113391. [PMID: 33207660 PMCID: PMC7697273 DOI: 10.3390/cancers12113391] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Given that an extensive range of dietary factors has not been investigated among colorectal cancer (CRC) survivors to date, we carried out a systematic review and meta-analysis to determine the effects of both prediagnostic and postdiagnostic dietary intake on all-cause mortality and CRC-specific mortality among CRC survivors. In total, 45 studies were included in the final analysis of 35 food items, 8 macronutrients, 27 micronutrients, 2 dietary patterns, and 13 dietary indexes in association with all-cause mortality and CRC-specific mortality. We found that an unhealthy dietary pattern increased the risks of both all-cause mortality and CRC-specific mortality. The role of prediagnostic and postdiagnostic intake such as macronutrients and fatty acids could be different in the risk of all-cause mortality. Overall, comprehensive evidence for the effect of substantial numbers of prediagnostic and postdiagnostic dietary items on mortality outcomes is reported in this study. Abstract We carried out a systematic review and meta-analysis to determine the effects of both prediagnostic and postdiagnostic dietary intake on all-cause mortality and CRC-specific mortality among CRC survivors. An extensive search of PubMed and Embase was conducted to identify eligible studies. We applied a random-effects model to estimate the pooled relative risks (RRs)/hazard ratios (HRs) and their 95% confidence intervals (CIs). As a result, a total of 45 studies were included in the final analysis. Pooled effect sizes from at least three study populations showed that whole grains and calcium were inversely associated with all-cause mortality, with RRs/HRs (95% CIs) of 0.83 (0.69–0.99) and 0.84 (0.73–0.97), respectively. In contrast, a positive association between an unhealthy dietary pattern and both all-cause mortality (RR/HR = 1.47, 95% CI = 1.05–2.05) and CRC-specific mortality (RR/HR = 1.52, 95% CI = 1.13–2.06) was observed among CRC survivors. In the subgroup analysis by CRC diagnosis, prediagnostic and postdiagnostic dietary intake such as carbohydrates, proteins, lipids, and fiber were observed to have different effects on all-cause mortality. Overall, an unhealthy dietary pattern increased the risks of both all-cause mortality and CRC-specific mortality. The role of prediagnostic and postdiagnostic intake of dietary elements such as macronutrients and fatty acids could be different in the risk of all-cause mortality.
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Talegawkar SA, Lancki N, Jin Y, Siddique J, Gadgil M, Kanaya AM, Schneider JA, Van Horn L, De Koning L, Kandula NR. Social network characteristics are correlated with dietary patterns among middle aged and older South Asians living in the United States (U.S.). BMC Nutr 2020; 6:40. [PMID: 32944264 PMCID: PMC7488332 DOI: 10.1186/s40795-020-00368-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 08/03/2020] [Indexed: 11/13/2022] Open
Abstract
Background Social and cultural norms, operating through social networks, may influence an individual’s dietary choices. We examined correlations between social network characteristics and dietary patterns among South Asians in the United States (U.S.) Methods Data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Social Network study were analyzed among 756 participants (mean age = 59 y standard deviation [SD] = 9 y; 44% women). A culturally adapted, validated food frequency questionnaire was used for dietary assessment. A posteriori dietary patterns using principal component analysis were named 1) animal protein, 2) fried snacks, sweets and high-fat dairy, and 3) fruits, vegetables, nuts and legumes. Social network characteristics were assessed using a standard egocentric approach, where participants (egos) self-reported data on perceived dietary habits of their network members. Partial correlations between social network characteristics and egos’ dietary patterns were examined. Results The mean social network size of egos was 4.2 (SD = 1.1), with high proportion of network members being family (72%), South Asian ethnicity (89%), and half having daily contact. Animal protein pattern scores were negatively correlated with fruits and cooked vegetables consumption of network. Fried snacks, sweets and high-fat dairy pattern scores were positively correlated with sugar-sweetened beverages, South Asian sweets, fried/fast foods and ghee (clarified butter) consumption of network. Fruits, vegetables, nuts and legumes pattern scores were positively correlated with vegetables, fruits, and brown rice/quinoa consumption of network. Conclusions Network member characteristics and their perceived dietary behaviors were correlated with dietary patterns of egos. Dietary intervention studies among South Asians should consider social network characteristics as candidate components for dietary intervention.
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Affiliation(s)
- Sameera A Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Nicola Lancki
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 420 E Superior, Rubloff Building 6th Floor, Chicago, IL 60611 USA
| | - Yichen Jin
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Juned Siddique
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 420 E Superior, Rubloff Building 6th Floor, Chicago, IL 60611 USA
| | - Meghana Gadgil
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA USA
| | - Alka M Kanaya
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA USA
| | | | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 420 E Superior, Rubloff Building 6th Floor, Chicago, IL 60611 USA
| | - Lawrence De Koning
- Department of Pathology and Laboratory Medicine, The University of Calgary, Calgary, Alberta Canada
| | - Namratha R Kandula
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 420 E Superior, Rubloff Building 6th Floor, Chicago, IL 60611 USA
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Fresán U, Martínez-González MA, Segovia-Siapco G, Sabaté J, Bes-Rastrollo M. A three-dimensional dietary index (nutritional quality, environment and price) and reduced mortality: The "Seguimiento Universidad de Navarra" cohort. Prev Med 2020; 137:106124. [PMID: 32437702 DOI: 10.1016/j.ypmed.2020.106124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 04/25/2020] [Accepted: 05/03/2020] [Indexed: 10/24/2022]
Abstract
Several healthy diet indices have been associated with mortality risk. However, the ideal diet should not only be healthy but also environmentally friendly and affordable. The study aimed to determine if a new Sustainable Diet Index (SDI), which takes into account the nutritional quality, environmental impacts and market price of diets, was associated with all-cause and cause-specific mortality. Using data from the "Seguimiento Universidad de Navarra" Project, a prospective cohort study of Spanish university graduates, the study included 15,492 participants who were recruited between December 1999 and March 2014 and followed-up for a median of 10 years. Cox regression was used to determine the relationship of SDI and its components with all-cause and cause-specific mortality risk. Hazard ratios with adjustment for several confounders were calculated. The weights for the foods contributing to the SDI were assessed with multiple regression analyses and variability with nested regression analyses. The highest quartile of the SDI scores was associated with a 59% relative reduction in all-cause mortality (HR 0.41, 95% CI 0.23-0.75; ptrend < 0.001) and 79% reduction in cardiovascular mortality (HR 0.21, 95% CI 0.05-0.85; ptrend < 0.001). SDI was positively correlated with beans and potato consumption but negatively correlated with red meat intake. Red and processed meats, fatty dairy products and fish consumption accounted for most of the variability in the SDI. Altogether, dietary patterns accounting not only for nutritional quality of the food but also the impact on the environment and affordability could still provide health benefits.
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Affiliation(s)
- Ujué Fresán
- University of Navarra, Medical School, Department of Preventive Medicine and Public Health, Irunlarrea 1, 31008 Pamplona, Spain; CIBER Epidemiología y Salud Pública (CIBER-ESP), Instituto de Salud Carlos III, Monforte de Lemos Avenue 5, 28029 Madrid, Spain; Instituto de Salud Pública y Laboral de Navarra, Calle Leyre 15, 31003 Pamplona, Spain; Loma Linda University, School of Public Health, 24951 Circle Dr Nichol Hall, Loma Linda, CA 92350-1718, USA.
| | - Miguel A Martínez-González
- University of Navarra, Medical School, Department of Preventive Medicine and Public Health, Irunlarrea 1, 31008 Pamplona, Spain; Harvard University, Harvard TH Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA; Navarra Institute for Health Research (IdisNa), Irunlarrea 3, 31008 Pamplona, Spain; CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Carlos III Institute of Health, Monforte de Lemos Avenue 5, 28029 Madrid, Spain.
| | - Gina Segovia-Siapco
- Loma Linda University, School of Public Health, 24951 Circle Dr Nichol Hall, Loma Linda, CA 92350-1718, USA.
| | - Joan Sabaté
- Loma Linda University, School of Public Health, 24951 Circle Dr Nichol Hall, Loma Linda, CA 92350-1718, USA.
| | - Maira Bes-Rastrollo
- University of Navarra, Medical School, Department of Preventive Medicine and Public Health, Irunlarrea 1, 31008 Pamplona, Spain; Navarra Institute for Health Research (IdisNa), Irunlarrea 3, 31008 Pamplona, Spain; CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Carlos III Institute of Health, Monforte de Lemos Avenue 5, 28029 Madrid, Spain.
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22
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Healthy and unhealthy dietary patterns and the risk of chronic disease: an umbrella review of meta-analyses of prospective cohort studies. Br J Nutr 2020; 124:1133-1144. [PMID: 32600500 DOI: 10.1017/s0007114520002330] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We aimed to fully review the association of empirical dietary patterns with the risk of non-communicable chronic diseases and to rate the quality of the evidence. Published meta-analyses of observational studies investigating the association of empirically derived dietary patterns with the risk of chronic diseases were identified by searching PubMed and Scopus till September 2019. Two independent reviewers extracted the information and rated the quality of the evidence by NutriGrade score. For each meta-analysis, cross-sectional and case–control studies were excluded and then summary relative risk was recalculated by using a random-effects model. Sixteen meta-analyses of prospective cohort studies, reporting eighteen SRR for healthy dietary patterns and sixteen SRR for unhealthy patterns obtained from 116 primary prospective cohort studies with 4·8 million participants, were included. There was moderate quality of evidence for the inverse association of healthy dietary patterns with the risk of type 2 diabetes (T2D), fracture and colorectal and breast cancers. There was also low-quality evidence for the inverse relation between healthy dietary patterns and the risk of all-cause and cardiovascular mortality, depression, CHD and respiratory diseases. There was moderate quality of evidence for a positive association between unhealthy dietary patterns and the risk of T2D, fracture and the metabolic syndrome. Adopting a healthy dietary pattern may reduce the risk of T2D, CHD and premature death. More research is needed for outcomes for which the quality of the evidence was rated low, such as respiratory disease, mental illness and site-specific cancers.
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Lopes T, Zemlin AE, Erasmus RT, Faber M, Kengne AP. Assessment of the association of plant-based diets with cardiovascular disease risk profile in Africa: a systematic review and meta-analysis protocol. BMJ Open 2020; 10:e036792. [PMID: 32487581 PMCID: PMC7265011 DOI: 10.1136/bmjopen-2020-036792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Cardiovascular disease (CVD) is currently the leading cause of death worldwide. In Africa where infectious diseases are still the leading cause of death, the contribution of non-communicable diseases led by CVDs has significantly increased in recent years. The rise of CVDs in Africa is attributed at least in part to the adoption of sedentary behaviours and unhealthy eating habits, which are linked with urbanisation and westernisation of cultures. Dietary attributes associated with CVD risk have been less investigated in Africa. However, evidence from developed nations has reported a protective effect of healthy dietary patterns such as plant-based diets (PBDs) on cardiometabolic health. The current protocol is for a review aiming to assess existing evidence on the association of PBDs with CVD risk profile in African populations. METHODS AND ANALYSIS This protocol was developed following the 2015 guidelines of the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols. We will conduct a comprehensive search of the literature for published studies on PBDs in relation to CVD risk profile in African populations. Observational studies published between January 1990 and December 2019 will be screened. A search strategy using keywords and medical subject headings terms will be applied across multiple scientific databases including PubMed-Medline, Scopus and EBSCOhost and the African Journals Online platform. Manual searches of reference lists from relevant articles will be performed. Citations will be traced using the ISI Web of Science to further identify eligible studies. Grey literature will also be screened for relevant abstracts from conference proceedings, and experts in the field will be contacted where appropriate. Two investigators will independently screen all the titles and abstracts to determine which records are eligible for full-text review. Subsequently, two investigators will review the eligible full text using the selection criteria. A third investigator will be consulted to resolve any discrepancies. Data will be extracted from studies that are eligible for the review. Meta-analysis will be performed for studies with similar or comparable methods and reported outcome measures. This will be performed overall, and by major study-level characteristics. Heterogeneity in the estimates across studies will be assessed and quantified with the use of Cochrane Q and I2 statistics, respectively. Publication biases will be investigated through funnel plots and Egger test of bias. Relevant sensitivity analyses will be performed to confirm the robustness of the findings. ETHICS AND DISSEMINATION The review will analyse data from published studies; therefore, it does not require ethical approval. The findings of the review will be submitted as part of a PhD thesis at Stellenbosch University, South Africa. Additionally, the findings will be presented at conferences and published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42020159862.
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Affiliation(s)
- Tatum Lopes
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, Tygerberg, South Africa
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, Western Cape, South Africa
| | - Annalise E Zemlin
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, Western Cape, South Africa
- National Health Laboratory Service (NHLS), Tygerberg Hospital, University of Stellenbosch, Cape Town, Western Cape, South Africa
| | - Rajiv T Erasmus
- Division of Chemical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, Western Cape, South Africa
| | - Mieke Faber
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, Tygerberg, South Africa
| | - Andre P Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, Tygerberg, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
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Karageorgou D, Magriplis E, Bakogianni I, Mitsopoulou AV, Dimakopoulos I, Micha R, Michas G, Ntouroupi T, Tsaniklidou SM, Argyri K, Chourdakis M, Panagiotakos DB, Zampelas A. Dietary patterns and cardiovascular disease in Greek adults: The Hellenic National Nutrition and Health Survey (HNNHS). Nutr Metab Cardiovasc Dis 2020; 30:201-213. [PMID: 31761547 DOI: 10.1016/j.numecd.2019.09.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 09/12/2019] [Accepted: 09/23/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIMS Empirically-derived dietary patterns have been shown to have both positive and adverse associations with cardiovascular disease (CVD). Yet, such associations remain unclear in the Greek population. The aim of this study was to investigate the association between empirically-derived dietary patterns and the presence of CVD and CVD-related medical conditions in a nationally representative sample of Greek adults. METHODS AND RESULTS Adult participants (≥20 years old) of the Hellenic National Nutrition and Health Survey (HNNHS) were included (N = 3552; 41.2% men; 43.7 years, SD: 18.1). Dietary patterns were derived by principal component analysis using 24-h recall data. The presence of dyslipidemia (elevated cholesterol and/or triglycerides), hypertension, coronary heart disease, and total CVD, was defined according to the International Clinical Diagnosis (ICD)-10 codes. Odds ratios of CVD outcomes were estimated across dietary patterns using multivariable logistic regression analysis. Three dietary patterns -Traditional (proxy Mediterranean), Western, and Prudent-were identified explaining 16.5% of the total variance in consumption. Logistic regression analysis, adjusted for age, sex, total caloric intake, sociodemographic characteristics, and other CVD risk factors, showed an inverse association between the Traditional dietary pattern and CVD presence (OR: 0.53; 95% CI: 0.30-0.95), and a positive association between the Western pattern and dyslipidemia (1.52; 1.02-2.26). No association was found between the Prudent pattern and CVD outcomes. CONCLUSION The variability of food intake combinations in the Greek population seem to be associated with the presence of CVD and CVD related conditions. Such findings are imperative for national monitoring and informed priority setting.
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Affiliation(s)
- Dimitra Karageorgou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Emmanouella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Ioanna Bakogianni
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Anastasia V Mitsopoulou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Ioannis Dimakopoulos
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Renata Micha
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - George Michas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Triantafyllia Ntouroupi
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Sophia M Tsaniklidou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Konstantina Argyri
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece
| | - Michail Chourdakis
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54 124 Thessaloniki, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Eleftheriou Venizelou 70, 176 76 Athens, Greece
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 118 55, Athens, Greece.
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Strain T, Wijndaele K, Sharp SJ, Dempsey PC, Wareham N, Brage S. Impact of follow-up time and analytical approaches to account for reverse causality on the association between physical activity and health outcomes in UK Biobank. Int J Epidemiol 2020; 49:162-172. [PMID: 31651957 PMCID: PMC7124507 DOI: 10.1093/ije/dyz212] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The advent of very large cohort studies (n > 500 000) has given rise to prospective analyses of health outcomes being undertaken after short (<4 years) follow-up periods. However, these studies are potentially at risk of reverse causality bias. We investigated differences in the associations between self-reported physical activity and all-cause and cardiovascular disease (CVD) mortality, and incident CVD, using different follow-up time cut-offs and methods to account for reverse causality bias. METHODS Data were from n = 452 933 UK Biobank participants, aged 38-73 years at baseline. Median available follow-up time was 7 years (for all-cause and CVD mortality) and 6.1 years (for incident CVD). We additionally analysed associations at 1-, 2- and 4-year cut-offs after baseline. We fit up to four models: (1) adjusting for prevalent CVD and cancer, (2) excluding prevalent disease, (3) and (4) Model 2 excluding incident cases in the first 12 and 24 months, respectively. RESULTS The strength of associations decreased as follow-up time cut-off increased. For all-cause mortality, Model 1 hazard ratios were 0.73 (0.69-0.78) after 1 year and 0.86 (0.84-0.87) after 7 years. Associations were weaker with increasing control for possible reverse causality. After 7-years follow-up, the hazard ratios were 0.86 (0.84-0.87) and 0.88 (0.86-0.90) for Models 1 and 4, respectively. Associations with CVD outcomes followed similar trends. CONCLUSIONS As analyses with longer follow-up times and increased control for reverse causality showed weaker associations, there are implications for the decision about when to analyse a cohort study with ongoing data collection, the interpretation of study results and their contribution to meta-analyses.
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Affiliation(s)
- Tessa Strain
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Stephen J Sharp
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Paddy C Dempsey
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- Physical Activity & Behavioural Epidemiology Laboratories, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Nick Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Søren Brage
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
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Sociodemographic and Regional Determinants of Dietary Patterns in Russia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17010328. [PMID: 31947733 PMCID: PMC6981481 DOI: 10.3390/ijerph17010328] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/18/2019] [Accepted: 12/31/2019] [Indexed: 02/07/2023]
Abstract
An empirical assessment of diets using a posteriori analysis allows us to define actual dietary patterns (DPs) in the food consumption structure of a population. This study represents an a posteriori assessment of DPs for the Russian population in general as well as their dependence on socio-demographic and regional parameters. The data were obtained from 21,923 individuals aged 25-64 years old from a Russian multicenter study of "Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation" conducted in 2013-2014. Cross-sectional study subjects were interviewed face-to-face in order to obtain data on their diet. DPs were defined using principal component analysis. Four DPs were specified as "Rational", "Salt", "Meat", and "Mixed"; all these variants together accounted for 55.9% of variance. Diets in gender and age groups corresponded to those for an all-Russian population; in several regions, the defined diets differed from the all-Russian ones. More favorable diet trends were observed among women, people with no family, people not working, and urban dwellers, and diet trends were more favorable with an increase in age, level of education, and material wealth. Thus, a posteriori DPs were defined for the Russian population, which were stable in sex/age groups and were mediated by the socio-demographic characteristics of the population.
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Brandhorst S, Longo VD. Dietary Restrictions and Nutrition in the Prevention and Treatment of Cardiovascular Disease. Circ Res 2019; 124:952-965. [PMID: 30870119 DOI: 10.1161/circresaha.118.313352] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death in many developed countries and remains one of the major diseases strongly affected by the diet. Nutrition can affect CVD directly by contributing to the accumulation of vascular plaques and also indirectly by regulating the rate of aging. This review summarizes research on nutrition and CVD incidence based on a multipillar system that includes basic research focused on aging, epidemiological studies, clinical studies, and studies of centenarians. The relevant research linking nutrition and CVD with focus on macronutrients and aging will be highlighted. We will review some of the most relevant studies on nutrition and CVD treatment, also focusing on interventions known to delay aging. We will discuss both everyday dietary compositions, as well as intermittent and periodic fasting interventions with the potential to prevent and treat CVD.
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Affiliation(s)
- Sebastian Brandhorst
- From the Longevity Institute, Davis School of Gerontology, University of Southern California, Los Angeles (S.B., V.D.L.)
| | - Valter D Longo
- From the Longevity Institute, Davis School of Gerontology, University of Southern California, Los Angeles (S.B., V.D.L.).,Institute of Molecular Oncology, Italian Foundation for Cancer Research, Milan (V.D.L.)
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Soltani S, Jayedi A, Shab-Bidar S, Becerra-Tomás N, Salas-Salvadó J. Adherence to the Mediterranean Diet in Relation to All-Cause Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Adv Nutr 2019; 10:1029-1039. [PMID: 31111871 PMCID: PMC6855973 DOI: 10.1093/advances/nmz041] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/11/2018] [Accepted: 03/25/2019] [Indexed: 02/07/2023] Open
Abstract
A previous meta-analysis provided convincing evidence for an inverse association between adherence to a Mediterranean diet (MedDiet) and the risk of all-cause mortality. Since then, 19 prospective studies have been published. We updated the evidence from these prospective studies and conducted a dose-response meta-analysis to test the linear and potential nonlinear dose-response associations between adherence to a MedDiet and the risk of all-cause mortality. The PubMed, Scopus, ISI Web of Knowledge, and Embase bibliographic databases were systematically searched up to August 24, 2018. Summary HRs were estimated with the use of a random-effects meta-analysis to assess the association between a 2-point increment in MedDiet adherence and the risk of all-cause mortality. Sensitivity and subgroup analyses were performed and potential publication bias was tested. Twenty-nine prospective studies with 1,676,901 participants and 221,603 cases of all-cause mortality were included in the final analysis. The pooled HR of all-cause mortality was 0.90 (95% CI: 0.89, 0.91; I2 = 81.1%) for a 2-point increment in adherence to a MedDiet. Subgroup analyses showed that a significant inverse association was stronger in participants who lived in the Mediterranean region compared with non-Mediterranean areas (HRs: 0.82 compared with 0.92, respectively), and in studies that used the Panagiotakos MedDiet score. A nonlinear dose-response meta-analysis indicated that the risk of all-cause mortality linearly decreased with the increase in adherence to a MedDiet. The robustness of findings was confirmed in the sensitivity analyses. In conclusion, low-quality evidence from prospective cohort studies suggests an inverse association between adherence to a MedDiet and the risk of all-cause mortality, especially in Mediterranean regions. An inverse linear dose-response relation was also observed between adherence to a MedDiet and the risk of all-cause mortality.
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Affiliation(s)
- Sepideh Soltani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Jayedi
- Food (Salt) Safety Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran,Address correspondence to SS-B (e-mail: )
| | - Nerea Becerra-Tomás
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, University Hospital of Sant Joan de Reus, Department of Biochemistry and Biotechnology, Faculty of Medicine and Health Sciences, Institut d'Investigació Sanitària Pere Virgili, Rovira i Virgili University, Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
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Ekmekcioglu C. Nutrition and longevity – From mechanisms to uncertainties. Crit Rev Food Sci Nutr 2019; 60:3063-3082. [DOI: 10.1080/10408398.2019.1676698] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Cem Ekmekcioglu
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Vienna, Austria
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The association of multimorbidity within cardio-metabolic disease domains with dietary patterns: A cross-sectional study in 129 369 men and women from the Lifelines cohort. PLoS One 2019; 14:e0220368. [PMID: 31393962 PMCID: PMC6687151 DOI: 10.1371/journal.pone.0220368] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 07/15/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Multimorbidity is considered a major challenge for current health care. Lifestyle interventions, as a broad and generic approach, may have the potential to improve the management of care among patients with multimorbidity. The objective of this study was to evaluate the association of multimorbidity defined within the cardiometabolic disease domains with dietary patterns, representing habitual dietary intake. DESIGN We studied 129 369 participants from the Lifelines Cohort study (42% male, 45±13 years (range 18-93)) in which diet was assessed using a 110-item food frequency questionnaire. A composite morbidity score was applied in multivariable ordered logistic regression to test the association with dietary patterns derived by principal components analysis, based on sex-specific dietary pattern scores. RESULTS Four dietary patterns were retained, accounting for 26.6% of the variation in overall diet. After control for potential confounders, men and women in the highest quintile of "meat, alcohol and potato pattern" and "snack pattern" had a higher likelihood of having higher morbidity scores than those in the lowest quintile (e.g. men: OR = 1.83(95% CI:1.71-1.97), OR = 1.18(95% CI 1.11-1.27 respectively). The opposite was observed with respect to the "bread and sweets pattern" and "vegetable, fish and fruit pattern" (e.g. women: OR = 0.88(95% CI: 0.81-0.96), OR = 0.86(95% CI 0.81-0.92 respectively). The association partially attenuated after adjusting for BMI, but the associations remained significant among men. CONCLUSIONS Robust associations between dietary patterns and multimorbidity within the cardiometabolic domain, in particular a "meat, alcohol and potato pattern", suggest an important opportunity of dietary interventions in multimobidity prevention. Generic prevention strategies based on population derived dietary patterns may have the potential to enhance lifestyle management among people with multimorbidity.
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Asadi Z, Shafiee M, Sadabadi F, Heidari-Bakavoli A, Moohebati M, Khorrami MS, Darroudi S, Heidari S, Hoori T, Tayefi M, Mohammadi F, Esmaeily H, Safarian M, Ghayour-Mobarhan M, Ferns GA. Association of dietary patterns and risk of cardiovascular disease events in the MASHAD cohort study. J Hum Nutr Diet 2019; 32:789-801. [PMID: 31332855 DOI: 10.1111/jhn.12669] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the principal cause of mortality and disability in Iranian adults. We aimed to evaluate the relationship between dietary patterns and CVD incidence in a large sample of adults in northeastern Iran. METHODS The present study comprised a prospective study of 5706 CVD-free men and women aged 35-65 years who participated in a cohort study. All of the participants were followed up for a 6-year period. Dietary patterns were derived from a 65-item validated food frequency questionnaire and the factor analysis method was used to determine dietary patterns. RESULTS We identified two major dietary patterns: (i) a Balanced dietary pattern (a high intake of green leafy vegetables, other vegetables, fruits, dairy products, red meats, poultry, seafoods, legumes and nuts, as well as a low intake of sugar) and (ii) a Western dietary pattern (a high intake of sugar, tea, egg, snacks, fast foods, potato, carbonated beverages, pickled foods, organs meat and butter) by factor analysis. The hazard ratio (HR) and 95% confidence intervals (CIs) of total CVD in the highest versus lowest tertiles of the Balanced pattern were 1.29 (95% CI = 0.67-2.47; P = 0.44). The HR and 95% CIs of CVD in the highest versus lowest tertiles of Western pattern were 2.21 (95% CI = 1.08-4.45; P = 0.03). CONCLUSIONS During the 6-year follow-up, we found that adherence to a Balanced dietary pattern was not significantly associated with CVD events. However, adherence to a Western dietary pattern was associated with a significantly increased risk of CVD events and its associated risk.
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Affiliation(s)
- Z Asadi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Shafiee
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - F Sadabadi
- Department of Modern Sciences and Technologies, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - A Heidari-Bakavoli
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Moohebati
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M S Khorrami
- Department of Modern Sciences and Technologies, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - S Darroudi
- Department of Modern Sciences and Technologies, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - S Heidari
- Department of Biology, Faculty of Sciences, Ferdowsi University of Mashhad, Mashhad, Iran
| | - T Hoori
- Department of Biology, Faculty of Sciences, Ferdowsi University of Mashhad, Mashhad, Iran
| | - M Tayefi
- Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran
| | - F Mohammadi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - H Esmaeily
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Safarian
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - G A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Brighton, Sussex, UK
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Karageorgou D, Magriplis E, Mitsopoulou A, Dimakopoulos I, Bakogianni I, Micha R, Michas G, Chourdakis M, Ntouroupi T, Tsaniklidou S, Argyri K, Panagiotakos D, Zampelas A, Fappa E, Theodoraki EM, Trichia E, Sialvera TE, Varytimiadi A, Spyreli E, Koutelidakis A, Karlis G, Zacharia S, Papageorgiou A, Chrousos G, Dedoussis G, Dimitriadis G, Manios I, Roma E. Dietary patterns and lifestyle characteristics in adults: results from the Hellenic National Nutrition and Health Survey (HNNHS). Public Health 2019; 171:76-88. [DOI: 10.1016/j.puhe.2019.03.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 01/26/2019] [Accepted: 03/21/2019] [Indexed: 10/26/2022]
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Aruoma OI, Hausman-Cohen S, Pizano J, Schmidt MA, Minich DM, Joffe Y, Brandhorst S, Evans SJ, Brady DM. Personalized Nutrition: Translating the Science of NutriGenomics Into Practice: Proceedings From the 2018 American College of Nutrition Meeting. J Am Coll Nutr 2019; 38:287-301. [DOI: 10.1080/07315724.2019.1582980] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Okezie I Aruoma
- California State University Los Angeles, Los Angeles, California, USA
- Southern California University of Health Sciences, Whittier, California, USA
| | | | - Jessica Pizano
- Nutritional Genomics Institute, SNPed, and OmicsDX, Chasterfield, Virginia, USA
| | - Michael A. Schmidt
- Advanced Pattern Analysis & Countermeasures Group, Boulder, Colorado, USA
- Sovaris Aerospace, Boulder, Colorado, USA
| | - Deanna M. Minich
- University of Western States, Portland, Oregon, USA
- Institute for Functional Medicine, Federal Way, Washington, USA
| | - Yael Joffe
- 3X4 Genetics and Manuka Science, Cape Town, South Africa
| | | | | | - David M. Brady
- University of Bridgeport, Bridgeport, Connecticut, USA
- Whole Body Medicine, Fairfield, Connecticut, USA
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Gaesser GA. Perspective: Refined Grains and Health: Genuine Risk, or Guilt by Association? Adv Nutr 2019; 10:361-371. [PMID: 30947337 PMCID: PMC6520038 DOI: 10.1093/advances/nmy104] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 10/24/2018] [Accepted: 11/01/2018] [Indexed: 01/07/2023] Open
Abstract
Refined grain intake is widely assumed to be associated with adverse health outcomes, including increased risk for cardiovascular disease (CVD), type 2 diabetes (T2D), and obesity. The 2015 Dietary Guidelines Advisory Committee recommended that to improve dietary quality, the US population should replace most refined grains with whole grains. This recommendation was based largely on results from studies that examined dietary patterns, not separate food groups. A Western dietary pattern typically includes red and processed meat, sugar-sweetened foods and beverages, French fries, and high-fat dairy products, as well as refined grains, and has been linked to increased risk of many chronic diseases. However, when evaluated as a distinct food category, 11 meta-analyses of prospective cohort studies, which included a total of 32 publications with data from 24 distinct cohorts, demonstrated that refined grain intake was not associated with all-cause mortality, T2D, CVD, coronary heart disease (CHD), stroke, hypertension, or cancer. By contrast, consumption of red and processed meat was consistently associated with increased risk of these same health outcomes. Refined grain consumption up to 6-7 servings/d (1 serving = 30 g) was not associated with higher risk of CHD, T2D, hypertension, or all-cause mortality. Moreover, total grain intake was not associated with risk of CVD, CHD, stroke, or cancer, but was associated with lower risk of all-cause mortality. Consequently, the recommendation to reduce refined grain intake based on results from studies linking a Western dietary pattern to numerous adverse health outcomes is contrary to a substantial body of published scientific evidence. Future research needs to better define refined grain intake to distinguish between staple grain foods and indulgent grain foods, and to better design randomized controlled trials to resolve discrepancies between results from observational studies and such trials with regard to determining the benefits of whole grains compared with refined grains.
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Affiliation(s)
- Glenn A Gaesser
- College of Health Solutions, Arizona State University, Phoenix, AZ,Address correspondence to GAG (e-mail: )
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Murakami K, Shinozaki N, Fujiwara A, Yuan X, Hashimoto A, Fujihashi H, Wang HC, Livingstone MBE, Sasaki S. A Systematic Review of Principal Component Analysis-Derived Dietary Patterns in Japanese Adults: Are Major Dietary Patterns Reproducible Within a Country? Adv Nutr 2019; 10:237-249. [PMID: 30785205 PMCID: PMC6416039 DOI: 10.1093/advances/nmy079] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Principal component analysis (PCA) has been widely used in nutritional epidemiology to derive dietary patterns. However, although PCA-derived dietary patterns are population-dependent, their reproducibility in different populations is largely unexplored. We aimed to investigate whether major dietary patterns are consistently identified among different populations within a country and, if so, how similar these dietary patterns are. We conducted a systematic review of PCA-derived dietary patterns in Japanese adults using PubMed and Web of Science for English articles and Ichushi-Web and CiNii databases for Japanese articles. We assessed the reproducibility of major dietary patterns using congruence coefficients (CCs), with values ≥0.80 considered to represent fair similarity. From 65 articles (80 studies) included in this review, 285 different dietary patterns were identified. Based on the names of these patterns, major dietary patterns were Western (n = 34), Japanese (n = 12), traditional (n = 10), traditional Japanese (n = 9), healthy (n = 18), and prudent (n = 9) patterns. When assessment was limited to high-quality data (i.e., studies based on a sample size ≥200 and use of a validated dietary assessment questionnaire or multiple-day dietary record), the median CC was low for Western (0.44), traditional (0.59), and traditional Japanese (0.31) patterns. Conversely, the median CC was 0.89 for healthy, 0.86 for prudent, and 0.80 for Japanese patterns; and the proportion of pairs with a CC ≥0.80 was 87.3%, 64.3%, and 50.0%, respectively. Characteristics shared among these 3 dietary patterns included higher intakes of mushrooms, seaweeds, vegetables, potatoes, fruits, pulses, and pickles. In conclusion, this systematic review showed that some of the major dietary patterns are relatively reproducible in different populations within a country, whereas others are not. This highlights the importance of careful interpretation of PCA-derived dietary patterns. Our findings in Japan should be confirmed in different countries and globally. This study was registered at https://www.crd.york.ac.uk/prospero/ as CRD42018087669.
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Affiliation(s)
- Kentaro Murakami
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan,Address correspondence to KM (e-mail: )
| | - Nana Shinozaki
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Aya Fujiwara
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Xiaoyi Yuan
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Ayumi Hashimoto
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Hitomi Fujihashi
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Han-Chieh Wang
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - M Barbara E Livingstone
- Nutrition Innovation Center for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan,Department of Social and Preventive Epidemiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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The associations of dietary patterns with all-cause mortality and other lifestyle factors in the elderly: An age-specific prospective cohort study. Clin Nutr 2019; 38:288-296. [DOI: 10.1016/j.clnu.2018.01.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 09/26/2017] [Accepted: 01/07/2018] [Indexed: 11/22/2022]
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Kaluza J, Håkansson N, Harris HR, Orsini N, Michaëlsson K, Wolk A. Influence of anti-inflammatory diet and smoking on mortality and survival in men and women: two prospective cohort studies. J Intern Med 2019; 285:75-91. [PMID: 30209831 DOI: 10.1111/joim.12823] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The associations between an anti-inflammatory diet and both all-cause and cause-specific mortality have been studied previously; however, the influence of an anti-inflammatory diet on survival time has not been investigated. Moreover, the potential modification of these associations by smoking status remains unclear. OBJECTIVE The aims of this study were to examine the associations between an anti-inflammatory diet index (AIDI) and all-cause and cause-specific mortality, to determine the association between the AIDI and differences in survival time and to assess effect modification by smoking status. METHODS The study population included 68 273 Swedish men and women (aged 45-83 years) at baseline. The anti-inflammatory potential of the diet was estimated using the validated AIDI, which includes 11 potential anti-inflammatory and five potential pro-inflammatory foods. Cox proportional hazards and Laplace regression were used to estimate hazard ratios and differences in survival time. RESULTS During 16 years of follow-up (1 057 959 person-years), 16 088 deaths [5980 due to cardiovascular disease (CVD) and 5252 due to cancer] were recorded. Participants in the highest versus lowest quartile of the AIDI had lower risks of all-cause (18% reduction, 95% CI: 14-22%), CVD (20%, 95% CI: 14-26%) and cancer (13%, 95% CI: 5-20%) mortality. The strongest inverse associations between the highest and lowest quartiles of AIDI and risk of mortality were observed in current smokers: 31%, 36% and 22% lower risks of all-cause, CVD and cancer mortality, respectively. The difference in survival time between current smokers in the lowest AIDI quartile and never smokers in the highest quartile was 4.6 years. CONCLUSION Adherence to a diet with high anti-inflammatory potential may reduce all-cause, CVD and cancer mortality and prolong survival time especially amongst smokers.
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Affiliation(s)
- J Kaluza
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Nutrition Research Laboratory, Department of Human Nutrition, Warsaw, University of Life Sciences-SGGW, Warsaw, Poland.,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - N Håkansson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - H R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - N Orsini
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - K Michaëlsson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - A Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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Roman G, Rusu A, Graur M, Creteanu G, Morosanu M, Radulian G, Amorin P, Timar R, Pircalaboiu L, Bala C. DIETARY PATTERNS AND THEIR ASSOCIATION WITH OBESITY: A CROSS-SECTIONAL STUDY. ACTA ENDOCRINOLOGICA-BUCHAREST 2019; -5:86-95. [PMID: 31149065 DOI: 10.4183/aeb.2019.86] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Context Scarce data on dietary habits in Eastern European countries is available and reports investigated individual food items and not dietary patterns in these populations. Objective To identify dietary patterns and to explore their association with obesity in a sample from Romanian population. Design Cross-sectional. Subjects and Methods This was an analysis of data collected from 1398 adult participants in ORO study. Data on lifestyle, eating habits and food frequency consumption were collected. Results By principal component analysis we identified 3 dietary patterns explaining 31.4% of the diet variation: High meat/High fat pattern, Western pattern and Prudent pattern. High meat/High fat pattern was associated with male gender, lower educational level, living in a rural, smoking and a higher probability for the presence of obesity (OR 1.2 [95%CI: 1.1-1.4]). Western pattern was associated with younger age, a higher level of physical activity and smoking. Prudent pattern was associated with older age, female gender, a higher level of physical activity, not smoking status and a lower probability for the presence of obesity (OR 0.8 [95%CI: 0.7-0.9]). Conclusions This study provides for the first-time information on the association between dietary patterns in adults from an Eastern European country and the presence of obesity.
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Affiliation(s)
- G Roman
- "Iuliu Hatieganu" University of Medicine and Pharmacy - Diabetes, Nutrition, Metabolic diseases, Cluj-Napoca, Romania
| | - A Rusu
- "Iuliu Hatieganu" University of Medicine and Pharmacy - Diabetes, Nutrition, Metabolic diseases, Cluj-Napoca, Romania
| | - M Graur
- "Gr.T.Popa" University of Medicine and Pharmacy - Diabetes, Nutrition, Metabolic diseases, Romania.,"St.Spiridon" Clinical Hospital - Diabetes, Nutrition, Metabolic diseases, Iasi, Romania
| | - G Creteanu
- Emergency County Hospital, Suceava, Romania
| | - M Morosanu
- "Dunarea de Jos" University, Galati, Romania
| | - G Radulian
- "Carol Davila" University of Medicine and Pharmacy, Romania.,"Prof. N. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases - Bucharest, Romania
| | - P Amorin
- University of Oradea, Faculty of Medicine and Pharmacy, Oradea, Romania
| | - R Timar
- "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | | | - C Bala
- "Iuliu Hatieganu" University of Medicine and Pharmacy - Diabetes, Nutrition, Metabolic diseases, Cluj-Napoca, Romania
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Chan RSM, Yu BWM, Leung J, Lee JSW, Auyeung TW, Kwok T, Woo J. How Dietary Patterns are Related to Inflammaging and Mortality in Community-Dwelling Older Chinese Adults in Hong Kong - A Prospective Analysis. J Nutr Health Aging 2019; 23:181-194. [PMID: 30697629 DOI: 10.1007/s12603-018-1143-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Studies examining dietary patterns and inflammageing in relation to mortality are limited. OBJECTIVE We examined the influence of various dietary patterns on all-cause and cardiovascular disease (CVD) mortality, taking into account demographics, lifestyle factors, and serum inflammatory markers. METHODS We conducted multivariate Cox regression analyses using data from a cohort of community-dwelling older Chinese adults (1,406 men, 1,396 women) in Hong Kong. Baseline interviewer administered questionnaires covered dietary intake estimation and dietary pattern generation from the food frequency questionnaire, demographic and lifestyle factors, cognitive function and depressive symptoms. Serum high-sensitivity C-reactive protein (hsCRP) and 25-hydroxyvitamin D (25OHD) were measured. All-cause and CVD mortality data at 14-year follow up were retrieved from an official database. RESULTS In men, higher hsCRP level was associated with lower Diet Quality Index-International (DQI-I) score, Mediterranean-DASH Intervention for Neurodegenerative Delay Diet (MIND) score, Okinawan diet score, "vegetables-fruits" pattern score and "snacks-drinks-milk" pattern score. Higher serum 25OHD level was associated with higher Mediterranean Diet Score (MDS) but lower "snacks-drinks-milk" pattern score. None of the dietary pattern scores was associated with all-cause or CVD mortality after adjusting for all covariates. In women, hsCRP level and serum 25OHD level were not associated with any dietary patterns. Higher DQI-I score (HR=0.77 (95% CIs: 0.59, 0.99) highest vs. lowest tertile, p-trend=0.038) and Okinawan diet score (HR=0.78 (95% CIs: 0.61, 1.00) highest vs lowest tertile, p-trend=0.046) was associated with a lower risk of all-cause mortality, whereas higher MIND score (HR=0.63 (95% CI: 0.36, 1.09) highest vs. lowest tertile, p-trend=0.045) was associated with a reduced risk of CVD morality in the multivariate adjusted model. CONCLUSION Higher DQI-I score and Okinawan diet score were associated with a lower risk of all-cause mortality, and higher adherence to the MIND diet was related to a reduced risk of CVD mortality in community-dwelling Chinese older women.
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Affiliation(s)
- R S M Chan
- Dr Ruth Chan, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, N.T., Hong Kong, Tel: 852-3505-2190, Fax: 852-2637-9215,
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Vidra N, Bijlsma MJ, Janssen F. Impact of Different Estimation Methods on Obesity-Attributable Mortality Levels and Trends: The Case of The Netherlands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2146. [PMID: 30274272 PMCID: PMC6210009 DOI: 10.3390/ijerph15102146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/26/2018] [Accepted: 09/27/2018] [Indexed: 01/28/2023]
Abstract
The available methodologies to estimate the obesity-attributable mortality fraction (OAMF) affect the levels found and hamper the construction of time series. Our aim was to assess the impact of using different techniques to estimate the levels and the trends in obesity-attributable mortality for The Netherlands between 1981 to 2013. Using Body Mass Index (BMI), all-cause and cause-specific mortality data, and worldwide and European relative risks (RRs), we estimated OAMFs using three all-cause approaches (partially adjusted, weighted sum, and the two combined) and one cause-of-death approach (Comparative Risk Assessment; CRA). We adjusted the CRA approach to purely capture obesity (BMI ≥ 30 kg/m²). The different approaches led to a range of estimates. The weighted sum method using worldwide RRs generated the lowest (0.9%) while the adjusted CRA approach using 2013 RRs generated the highest estimate (1.5%). Using European-specific RRs instead of worldwide RRs resulted in higher estimates. Most of the approaches revealed an increasing OAMF over the period 1981 to 2013 especially from 1993 onwards except for the adjusted CRA approach among women. Estimates of OAMF levels and trends differed depending on the method applied. Given the limited available data, we recommend using the weighted-sum method to compare obesity-attributable mortality across European countries over time.
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Affiliation(s)
- Nikoletta Vidra
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, PO Box 800, 9700 AV Groningen, The Netherlands.
| | - Maarten J Bijlsma
- Max Planck Institute for Demographic Research, Konrad-Zuse Str. 1, 18057 Rostock, Germany.
| | - Fanny Janssen
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, PO Box 800, 9700 AV Groningen, The Netherlands.
- Netherlands Interdisciplinary Demographic Institute, P.O. Box 11650, 2502 AR The Hague, The Netherlands.
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The Japanese food score and risk of all-cause, CVD and cancer mortality: the Japan Collaborative Cohort Study. Br J Nutr 2018; 120:464-471. [PMID: 29923480 DOI: 10.1017/s000711451800154x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Few studies have reported the association between the Japanese diet as food score and mortality. This study aimed to investigate adherence to the Japanese food score associated with all-cause, CVD and cancer mortality. A total of 58,767 (23,162 men and 35,605 women) Japanese participants aged 40-79 years, who enrolled in the Japan Collaborative Cohort Study between 1988 and 1990, were included. The Japanese food score was derived from the components of seven food groups (beans and bean products, fresh fishes, vegetables, Japanese pickles, fungi, seaweeds and fruits) based on the FFQ. The total score ranged from 0 to 7, and participants were divided into five categories based on scores (0-2, 3, 4, 5 and 6-7). Hazard ratios (HR) and 95 % CI for all-cause, CVD and cancer mortality based on sex were estimated using Cox proportional models. During the follow-up period until 2009, 11 692 participants with all-cause, 3408 with CVD and 4247 with cancer died. The multivariable HR in the 6-7 and 0-2 Japanese food score groups were 0·93 (95 % CI 0·86, 1·01) in men and 0·82 (95 % CI 0·75, 0·90) in women for all-cause mortality and 0·89 (95 % CI 0·76, 1·04) in men and 0·66 (95 % CI 0·56, 0·77) in women for CVD mortality. Our findings suggest that adherence to the Japanese food score consisting of food combinations characterised by a Japanese diet may help in preventing all-cause and CVD mortality, especially in women.
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Exploratory dietary patterns: a systematic review of methods applied in pan-European studies and of validation studies. Br J Nutr 2018; 120:601-611. [PMID: 30064527 PMCID: PMC6137382 DOI: 10.1017/s0007114518001800] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Besides a priori approaches, using previous knowledge about food characteristics, exploratory dietary pattern (DP) methods, using data at hand, are commonly applied. This systematic literature review aimed to identify exploratory methods on DP in pan-European studies and to inform the development of the DEterminants of DIet and Physical ACtivity (DEDIPAC) toolbox of methods suitable for use in future European studies. The search was conducted in three databases on prospective studies in healthy, free-living people across the whole life span. To identify validated DP methods, an additional search without regional restrictions was conducted. Studies including at least two European countries were retained. The search resulted in six pan-European studies applying principal component/factor analysis (PC/FA) (n 5) or cluster analysis (n 2). The criteria to retain PC/factors ranged from the application of the eigenvalue>1 criterion, the scree plot and/or the interpretability criterion. Furthermore, seven validation studies were identified: DP, derived by PC/FA (n 6) or reduced rank regression (RRR) (n 1) were compared using dietary information from FFQ (n 6) or dietary history (n 1) as study instrument and dietary records (n 6) or 24-h dietary recalls (n 1) as reference. The correlation coefficients for the derived DP ranged from modest to high. To conclude, PC/FA was predominantly applied using the eigenvalue criterion and scree plot to retain DP, but a better description of the applied criteria is highly recommended to enable a standardised application of the method. Research gaps were identified for the methods cluster analysis and RRR, as well as for validation studies on DP.
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Shikany JM, Safford MM, Bryan J, Newby PK, Richman JS, Durant RW, Brown TM, Judd SE. Dietary Patterns and Mediterranean Diet Score and Hazard of Recurrent Coronary Heart Disease Events and All-Cause Mortality in the REGARDS Study. J Am Heart Assoc 2018; 7:e008078. [PMID: 30005552 PMCID: PMC6064845 DOI: 10.1161/jaha.117.008078] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 05/28/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Previously, we reported on associations between dietary patterns and incident acute coronary heart disease (CHD) in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study. Here, we investigated the associations of dietary patterns and a dietary index with recurrent CHD events and all-cause mortality in REGARDS participants with existing CHD. METHODS AND RESULTS We included data from 3562 participants with existing CHD in REGARDS. We used Cox proportional hazards regression to examine the hazard of first recurrence of CHD events-definite or probable MI or acute CHD death-and all-cause mortality associated with quartiles of empirically derived dietary patterns (convenience, plant-based, sweets, Southern, and alcohol and salads) and the Mediterranean diet score. Over a median 7.1 years (interquartile range, 4.4, 8.9 years) follow-up, there were 581 recurrent CHD events and 1098 deaths. In multivariable-adjusted models, the Mediterranean diet score was inversely associated with the hazard of recurrent CHD events (hazard ratio for highest score versus lowest score, 0.78; 95% confidence interval, 0.62-0.98; PTrend=0.036). The Southern dietary pattern was adversely associated with the hazard of all-cause mortality (hazard ratio for Q4 versus Q1, 1.57; 95% confidence interval, 1.28-1.91; PTrend<0.001). The Mediterranean diet score was inversely associated with the hazard of all-cause mortality (hazard ratio for highest score versus lowest score, 0.80; 95% confidence interval, 0.67-0.95; PTrend=0.014). CONCLUSIONS The Southern dietary pattern was associated with a greater hazard of all-cause mortality in REGARDS participants. Greater adherence to the Mediterranean diet was associated with both a lower hazard of recurrent CHD events and all-cause mortality.
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Affiliation(s)
- James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, AL
| | - Monika M Safford
- Division of General Internal Medicine, Weill Cornell Medical College, New York, NY
| | - Joanna Bryan
- Division of General Internal Medicine, Weill Cornell Medical College, New York, NY
| | - P K Newby
- Department of Nutrition, Harvard T.H. Chan School of Public Health Harvard University, Boston, MA
| | - Joshua S Richman
- Division of Gastrointestinal Surgery, School of Medicine, University of Alabama at Birmingham, AL
| | - Raegan W Durant
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, AL
| | - Todd M Brown
- Division of Cardiovascular Disease, School of Medicine, University of Alabama at Birmingham, AL
| | - Suzanne E Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, AL
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Martini S, Cavalchi M, Conte A, Tagliazucchi D. The paradoxical effect of extra-virgin olive oil on oxidative phenomena during in vitro co-digestion with meat. Food Res Int 2018; 109:82-90. [DOI: 10.1016/j.foodres.2018.04.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/26/2018] [Accepted: 04/14/2018] [Indexed: 12/01/2022]
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Villani A, Sultana J, Doecke J, Mantzioris E. Differences in the interpretation of a modernized Mediterranean diet prescribed in intervention studies for the management of type 2 diabetes: how closely does this align with a traditional Mediterranean diet? Eur J Nutr 2018; 58:1369-1380. [PMID: 29943276 DOI: 10.1007/s00394-018-1757-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 06/20/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE AND METHODS Adherence to Mediterranean diet (MedDiet) is associated with the prevention and management of type 2 diabetes mellitus (T2DM). However, in intervention studies, there is discordance in the interpretation of a MedDiet. The purpose of this paper was to examine, synthesize, and develop a narrative review, exploring the qualitative differences in the interpretation of a modernized MedDiet prescribed as an intervention in clinical trials for the management of T2DM, and how closely this aligns with a traditional MedDiet. The 'traditional' MedDiet is often described as a dietary pattern high in unprocessed plant foods (fruits, vegetables, legumes, nuts, wholegrain cereals, and olive oil); moderate consumption of wine; low moderate in fish/shellfish; and an infrequent consumption of red meat, animal fats, vegetable oils, and processed foods. RESULTS AND CONCLUSIONS Synthesis of the reviewed literature demonstrates considerable variation in the qualitative interpretation of a MedDiet. We also identified inadequate reporting of MedDiet interventions, despite a number of studies referring to their intervention as a 'traditional' MedDiet. The majority of studies emphasized the same key dietary components and principles: an increased intake of vegetables, wholegrains, and the preferential consumption of white meat in substitute of red and processed meat and abundant use of olive oil. However, the reporting of specific dietary recommendations for fruit, legumes, nuts, bread, red wine, and fermentable dairy products were less consistent or not reported. Irrespective of the discordance in the interpretation of a MedDiet, a number of studies included in the present review reported improved glycaemic control and favorable cardiovascular outcomes with adherence to a Mediterranean-style diet. Nevertheless, greater clarity and depth of reporting amongst intervention studies is warranted for the refinement of a modernized MedDiet definition that is distinct from a prudent dietary pattern.
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Affiliation(s)
- Anthony Villani
- School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia.
| | - Jacinta Sultana
- School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, QLD, Australia
| | - Justin Doecke
- School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
| | - Evangeline Mantzioris
- School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
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Cárdenas-Fuentes G, Subirana I, Martinez-Gonzalez MA, Salas-Salvadó J, Corella D, Estruch R, Fíto M, Muñoz-Bravo C, Fiol M, Lapetra J, Aros F, Serra-Majem L, Tur JA, Pinto X, Ros E, Coltell O, Díaz-López A, Ruiz-Canela M, Schröder H. Multiple approaches to associations of physical activity and adherence to the Mediterranean diet with all-cause mortality in older adults: the PREvención con DIeta MEDiterránea study. Eur J Nutr 2018; 58:1569-1578. [PMID: 29696401 DOI: 10.1007/s00394-018-1689-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 04/13/2018] [Indexed: 01/26/2023]
Affiliation(s)
- Gabriela Cárdenas-Fuentes
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- PhD Programme in Biomedicine, Department of Experimental and Health Sciences, Universidad Pompeu Fabra, Barcelona, Spain
| | - Isaac Subirana
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel A Martinez-Gonzalez
- Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Pere Virgili Institute for Health Research, University Hospital of Sant Joan de Reus, Rovira i Virgili University, Reus, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain
| | - Ramon Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Montserrat Fíto
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Carlos Muñoz-Bravo
- Department of Public Health and Psychiatry, University of Málaga, Málaga, Spain
| | - Miguel Fiol
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Institute of Health Sciences, University of Balearic Islands and Son Espases Hospital, Palma de Mallorca, Spain
| | - José Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Research Unit, Seville, Spain
| | - Fernando Aros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Cardiology, University Hospital Araba, Vitoria, Spain
| | - Luis Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Josep A Tur
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Research Group on Community Nutrition and Oxidative Stress, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - Xavier Pinto
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Lipids and Vascular Risk Units, Internal Medicine, University Hospital of Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Lipid Clinic, Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Oscar Coltell
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Computer Languages and Systems, Universitat Jaume I, Castellon, Spain
| | - Andres Díaz-López
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Pere Virgili Institute for Health Research, University Hospital of Sant Joan de Reus, Rovira i Virgili University, Reus, Spain
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
- CIBER Epidemiologia y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
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Dietary patterns and cardiometabolic risk factors among adolescents: systematic review and meta-analysis. Br J Nutr 2018; 119:859-879. [DOI: 10.1017/s0007114518000533] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
AbstractThis study systematised and synthesised the results of observational studies that were aimed at supporting the association between dietary patterns and cardiometabolic risk (CMR) factors among adolescents. Relevant scientific articles were searched in PUBMED, EMBASE, SCIENCE DIRECT, LILACS, WEB OF SCIENCE and SCOPUS. Observational studies that included the measurement of any CMR factor in healthy adolescents and dietary patterns were included. The search strategy retained nineteen articles for qualitative analysis. Among retained articles, the effects of dietary pattern on the means of BMI (n 18), waist circumference (WC) (n 9), systolic blood pressure (n 7), diastolic blood pressure (n 6), blood glucose (n 5) and lipid profile (n 5) were examined. Systematised evidence showed that an unhealthy dietary pattern appears to be associated with poor mean values of CMR factors among adolescents. However, evidence of a protective effect of healthier dietary patterns in this group remains unclear. Considering the number of studies with available information, a meta-analysis of anthropometric measures showed that dietary patterns characterised by the highest intake of unhealthy foods resulted in a higher mean BMI (0·57 kg/m²; 95 % CI 0·51, 0·63) and WC (0·57 cm; 95 % CI 0·47, 0·67) compared with low intake of unhealthy foods. Controversially, patterns characterised by a low intake of healthy foods were associated with a lower mean BMI (−0·41 kg/m²; 95 % CI −0·46,−0·36) and WC (−0·43 cm; 95 % CI −0·52,−0·33). An unhealthy dietary pattern may influence markers of CMR among adolescents, but considering the small number and limitations of the studies included, further studies are warranted to strengthen the evidence of this relation.
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Dietary Patterns Are Associated with Cardiovascular and Cancer Mortality among Swiss Adults in a Census-Linked Cohort. Nutrients 2018. [PMID: 29518908 PMCID: PMC5872731 DOI: 10.3390/nu10030313] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Defining dietary guidelines requires a quantitative assessment of the influence of diet on the development of diseases. The aim of the study was to investigate how dietary patterns were associated with mortality in a general population sample of Switzerland. We included 15,936 participants from two population-based studies (National Research Program 1A (NRP1A) and Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA)—1977 to 1993) who fully answered a simplified 24-h dietary recall. Mortality data were available through anonymous record linkage with the Swiss National Cohort (follow-up of up to 37.9 years). Multiple correspondence analysis and hierarchical clustering were used to define data-driven qualitative dietary patterns. Mortality hazard ratios were calculated for all-cause, cancer and cardiovascular mortality using Cox regression. Two patterns were characterized by a low dietary variety (“Sausage and Vegetables”, “Meat and Salad”), two by a higher variety (“Traditional”, “High-fiber foods”) and one by a high fish intake (“Fish”). Males with unhealthy lifestyle (smokers, low physical activity and high alcohol intake) were overrepresented in the low-variety patterns and underrepresented in the high-variety and “Fish” patterns. In multivariable-adjusted models, the “Fish” (hazard ratio = 0.82, 95% CI (0.68–0.99)) and “High-fiber foods” (0.85 (0.72–1.00)) patterns were associated with lower cancer mortality. In men, the “Fish” (0.73 (0.55–0.97)) and “Traditional” (0.76 (0.59–0.98)) patterns were associated with lower cardiovascular mortality. In summary, our results support the notion that dietary patterns affect mortality and that these patterns strongly cluster with other health determinants.
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Tayyem RF, Al-Shudifat AE, Johannessen A, Bawadi HA, AbuMweis SS, Agraib LM, Allhedan SS, Haj-Husein I, Azab M. Dietary patterns and the risk of coronary heart disease among Jordanians: A case-control study. Nutr Metab Cardiovasc Dis 2018; 28:262-269. [PMID: 29237548 DOI: 10.1016/j.numecd.2017.10.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 10/24/2017] [Accepted: 10/30/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS Dietary pattern and lifestyle have been reported to be significant risk factors in the development of coronary heart diseases (CHD). The contribution degree of these dietary risk factors in CHD development in non-westernized countries is unclear. This study aimed to evaluate several dietary choices and their potential association with CHD. METHODS AND RESULTS A case-control study was conducted at Prince Hamza Hospital, a referral center for coronary angiography in Amman, Jordan. Four-hundred patients referring for elective coronary angiography with clinical suspicion of coronary artery disease were enrolled. Data was collected using interview-based questionnaires. Dietary patterns were derived using Principal Component Analysis. Multivariate logistic regression was used to estimate the relationship between dietary choices and CHD. Three dietary patterns were identified. The "Healthy Dietary Pattern", which presented a diet rich in olive oil, fruits, vegetables, legumes, whole grains, fish, and low meat intake, was associated with a significant decrease in the odds of CHD (OR = 0.53, 95% CI = 0.28-0.98). The "High-Fiber Pattern", which is mainly composed of legumes and bulgur, significantly reduced the odd of CHD (OR = 0.55, 95% CI = 0.27-0.92) for the fourth quartile compared to the first one. No significant association was found between CHD and the "Western Dietary Pattern", which is loaded with refined grains, sweets and deserts, sugary drinks, and deep fried foods. CONCLUSIONS The "Healthy Dietary Pattern" and the "High-Fiber Pattern" were associated with a decrease in odds of CHD among Jordanians.
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Affiliation(s)
- R F Tayyem
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman, Jordan.
| | - A E Al-Shudifat
- The Hashemite University, Faculty of Medicine, Zarqa, Jordan.
| | - A Johannessen
- The Hashemite University, Faculty of Medicine, Zarqa, Jordan; Centre for Imported and Tropical Diseases, Oslo University Hospital, Ullevål, PO Box 4956, 0424 Oslo, Norway.
| | - H A Bawadi
- Department of Human Nutrition, College of Health Sciences, Qatar University, Doha, Qatar.
| | - S S AbuMweis
- Department of Clinical Nutrition and Dietetics, Faculty of Allied Health Sciences, Hashemite University, Zarqa, Jordan.
| | - L M Agraib
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman, Jordan.
| | - S S Allhedan
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman, Jordan.
| | - I Haj-Husein
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman, Jordan.
| | - M Azab
- The Hashemite University, Faculty of Medicine, Zarqa, Jordan.
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50
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Mie A, Andersen HR, Gunnarsson S, Kahl J, Kesse-Guyot E, Rembiałkowska E, Quaglio G, Grandjean P. Human health implications of organic food and organic agriculture: a comprehensive review. Environ Health 2017; 16:111. [PMID: 29073935 PMCID: PMC5658984 DOI: 10.1186/s12940-017-0315-4] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 10/02/2017] [Indexed: 05/08/2023]
Abstract
This review summarises existing evidence on the impact of organic food on human health. It compares organic vs. conventional food production with respect to parameters important to human health and discusses the potential impact of organic management practices with an emphasis on EU conditions. Organic food consumption may reduce the risk of allergic disease and of overweight and obesity, but the evidence is not conclusive due to likely residual confounding, as consumers of organic food tend to have healthier lifestyles overall. However, animal experiments suggest that identically composed feed from organic or conventional production impacts in different ways on growth and development. In organic agriculture, the use of pesticides is restricted, while residues in conventional fruits and vegetables constitute the main source of human pesticide exposures. Epidemiological studies have reported adverse effects of certain pesticides on children's cognitive development at current levels of exposure, but these data have so far not been applied in formal risk assessments of individual pesticides. Differences in the composition between organic and conventional crops are limited, such as a modestly higher content of phenolic compounds in organic fruit and vegetables, and likely also a lower content of cadmium in organic cereal crops. Organic dairy products, and perhaps also meats, have a higher content of omega-3 fatty acids compared to conventional products. However, these differences are likely of marginal nutritional significance. Of greater concern is the prevalent use of antibiotics in conventional animal production as a key driver of antibiotic resistance in society; antibiotic use is less intensive in organic production. Overall, this review emphasises several documented and likely human health benefits associated with organic food production, and application of such production methods is likely to be beneficial within conventional agriculture, e.g., in integrated pest management.
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Affiliation(s)
- Axel Mie
- Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, 11883 Stockholm, Sweden
- Swedish University of Agricultural Sciences (SLU), Centre for Organic Food and Farming (EPOK), Ultuna, Sweden
| | - Helle Raun Andersen
- University of Southern Denmark, Department of Public Health, Odense, Denmark
| | - Stefan Gunnarsson
- Swedish University of Agricultural Sciences (SLU), Department of Animal Environment and Health, Skara, Sweden
| | - Johannes Kahl
- University of Copenhagen, Department of Nutrition, Exercise and Sports, Frederiksberg, Denmark
| | - Emmanuelle Kesse-Guyot
- Research Unit on Nutritional Epidemiology (U1153 Inserm, U1125 INRA, CNAM, Université Paris 13), Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité, Bobigny, France
| | - Ewa Rembiałkowska
- Warsaw University of Life Sciences, Department of Functional & Organic Food & Commodities, Warsaw, Poland
| | - Gianluca Quaglio
- Scientific Foresight Unit (Science and Technology Options Assessment [STOA]), Directorate-General for Parliamentary Research Services (EPRS), European Parliament, Brussels, Belgium
| | - Philippe Grandjean
- University of Southern Denmark, Department of Public Health, Odense, Denmark
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, USA
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