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Cui M, Wu H, Zhang H, Wei L, Qi X. Associations of dietary iron intake with cardiovascular disease risk and dyslipidemia among Chinese adults. Lipids Health Dis 2024; 23:67. [PMID: 38431652 PMCID: PMC10908143 DOI: 10.1186/s12944-024-02058-4] [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: 10/15/2023] [Accepted: 02/23/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Whether iron intake can affect cardiovascular disease (CVD) and dyslipidemia is controversial. However, few studies have focused on reducing the risk of CVD in people at risk for dyslipidemia. This study explored the linear relationship and possible nonlinear relationship between CVD and dyslipidemia. METHODS Dietary data were obtained from the China Health and Nutrition Survey between 2004 and 2015. The survey included 8173 participants older than 18 years. CVD risk was estimated by the Framingham risk score (FRS). Logistic regression analysis was used to determine whether iron intake affects CVD incidence and lipid profiles. The nonlinear association was tested with restricted cubic splines (RCSs). RESULTS For males, higher total iron intake [the fifth quintile (Q) vs. Q1 odds ratio (OR): 0.335, 95% confidence interval (CI): 0.248-0.453], heme iron intake (OR: 0.679, 95% CI: 0.492-0.937) and non-heme iron intake (OR: 0.362, 95% CI: 0.266-0.492) reduced CVD incidence. Heme iron intake increased high low-density lipoprotein cholesterol (LDL-C) (OR: 1.786, 95% CI: 1.226-2.602), high total cholesterol (TC) (OR: 2.404, 95% CI: 1.575-3.669), high triglyceride (TG) (OR: 1.895, 95% CI: 1.423-2.523), and low apolipoprotein A1/apolipoprotein B (ApoA-1/ApoB) risk (OR: 1.514, 95% CI: 1.178-1.945). Moderate non-heme iron intake reduced high-density lipoprotein cholesterol (HDL-C) incidence (Q5 vs. Q1 OR: 0.704, 95% CI: 0.507-0.979). For females, higher total iron intake (Q5 vs. Q1 OR: 0.362, 95% CI: 0.266-0.492) and non-heme iron intake (OR: 0.347, 95% CI: 0.154-0.781) reduced CVD incidence. Heme iron intake increased high LDL-C (OR: 1.587, 95% CI: 1.160-2.170) and high TC incidence (OR: 1.655, 95% CI: 1.187-2.309). CONCLUSIONS Men, especially those at risk of developing dyslipidemia, should consume non-heme rather than heme iron to reduce CVD incidence. For women, increased heme iron intake did not reduce CVD incidence. Therefore, women should minimize their heme iron intake to prevent dyslipidemia.
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Affiliation(s)
- Min Cui
- School of Medicine, Nankai University, Tianjin, China
| | - Hao Wu
- School of Medicine, Nankai University, Tianjin, China
- Department of Cardiology, Tianjin Union Medical Center, Tianjin, China
| | - Hanmo Zhang
- School of Medicine, Nankai University, Tianjin, China
| | - Liping Wei
- Department of Cardiology, Tianjin Union Medical Center, Tianjin, China
| | - Xin Qi
- School of Medicine, Nankai University, Tianjin, China.
- Department of Cardiology, Tianjin Union Medical Center, Tianjin, China.
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Han L, Zhao T, Zhang R, Hao Y, Jiao M, Wu Q, Liu J, Zhou M. Burden of Nutritional Deficiencies in China: Findings from the Global Burden of Disease Study 2019. Nutrients 2022; 14:nu14193919. [PMID: 36235572 PMCID: PMC9570758 DOI: 10.3390/nu14193919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
From 1990 to 2019, the age-standardized incidence rate of nutritional deficiencies in China remained stable. However, the age-standardized disability-adjusted life-years (DALY) rate of nutritional deficiencies decreased from 1990 to 2019. Data were extracted from the GBD 2019 datasets. Estimated annual percentage changes (EAPCs) were calculated to assess the incidence rate, and DALY trends of nutritional deficiencies. Measures were stratified by subtypes, regions, and age groups. In 2019, the age-standardized DALY rates of dietary iron deficiency and protein-energy malnutrition reached their highest levels. The main population groups with protein-energy malnutrition and dietary iron deficiency were adults over the age of 70 and children under the age of five. The latter group also had a greater burden of vitamin A deficiency. Zhejiang, Beijing, and Guangdong reported the highest age-standardized incidence rates of nutritional deficiencies, which mainly pertained to protein-energy malnutrition and vitamin A deficiency. Tibet, Xinjiang, and Hainan had the highest age-standardized DALY rates of nutritional deficiencies, which mainly pertained to dietary iron deficiency and protein-energy malnutrition.
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Affiliation(s)
- Liyuan Han
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo 315000, China
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China
| | - Tian Zhao
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo 315000, China
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China
| | - Ruijie Zhang
- Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo 315000, China
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China
| | - Yanhua Hao
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin 150081, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin 150000, China
| | - Mingli Jiao
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin 150081, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin 150000, China
| | - Qunhong Wu
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin 150081, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin 150000, China
| | - Jingjing Liu
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin 150081, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin 150000, China
- Correspondence: (J.L.); (M.Z.)
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- Correspondence: (J.L.); (M.Z.)
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Ren Z, Cao X, Li C, Zhang J, Li X, Song P, Zhu Y, Liu Z. Ferritin, transferrin, and transferrin receptor in relation to metabolic obesity phenotypes: Findings from the China Health and Nutrition Survey. Front Public Health 2022; 10:922863. [PMID: 36091521 PMCID: PMC9459082 DOI: 10.3389/fpubh.2022.922863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/04/2022] [Indexed: 01/22/2023] Open
Abstract
Background This study aimed to explore the relationship between iron markers and metabolic obesity phenotypes and the role of age. Methods Data were from the China Health and Nutrition Survey 2009. Metabolic obesity phenotypes included metabolically healthy with normal weight (MHNW), metabolically unhealthy with normal weight (MUNW), metabolically healthy with overweight/obesity (MHO), and metabolically unhealthy with overweight/obesity (MUO). Iron markers including ferritin, transferrin, and soluble transferrin receptor were calculated as Log and quartered. The linear regression and multinomial logistic regression were used to explore the association of iron markers with age and metabolic obesity phenotypes, respectively. Results Ferritin was linearly related with age, with β (95% confidence interval, CI) of 0.029 (0.027 to 0.032) and -0.005 (-0.007 to -0.002) for women and men. Transferrin was negatively associated with age in both men and women (β < -0.011). Furthermore, compared with participants in the quartile 1 ferritin group, those in the quartile 4 had increased odds of MUNW, MHO, and MUO, with odds ratio and 95% confidence interval (OR, 95% CI) of 3.06 (2.20 to 4.25), 1.66 (1.35 to 2.05), and 5.27 (4.17 to 6.66). Transferrin showed similar relationships with MUNW, MUO, and MHO; whereas transferrin receptor showed no significance. We also found joint associations of ferritin and transferrin with MUNW, MUO, and MHO. The interactive effect of ferritin and transferrin on MUO was significant (P = 0.015). Conclusion Increased ferritin and transferrin were associated with MUNW, MHO, and MUO. Age should be considered when investigating iron.
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Affiliation(s)
- Ziyang Ren
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xingqi Cao
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Chenxi Li
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingyun Zhang
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xueqin Li
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China,*Correspondence: Peige Song
| | - Yimin Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China,Yimin Zhu
| | - Zuyun Liu
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Center for Clinical Big Data and Analytics of the Second Affiliated Hospital and Department of Big Data in Health Science School of Public Health, Zhejiang University School of Medicine, Hangzhou, China,Zuyun Liu ;
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Ding J, Liu Q, Liu Z, Guo H, Liang J, Zhang Y. Associations of the Dietary Iron, Copper, and Selenium Level With Metabolic Syndrome: A Meta-Analysis of Observational Studies. Front Nutr 2022; 8:810494. [PMID: 35178418 PMCID: PMC8845519 DOI: 10.3389/fnut.2021.810494] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 12/21/2021] [Indexed: 12/11/2022] Open
Abstract
BackgroundEpidemiological studies have investigated the associations of dietary iron, copper, and selenium level with metabolic syndrome (MetS). However, their results are conflicting. This meta-analysis of observational study was, therefore, employed to investigate the associations above.MethodsA comprehensive literature search was employed using PubMed, Web of Science, Embase, and Scopus database up to October 2021 (no restriction was set for the initiate time). The pooled relative risk (RR) of MetS for the highest vs. lowest dietary iron, copper, and selenium level was estimated, respectively.ResultsA total of 14 observational studies (55,131 participants) were identified as meeting the inclusion criteria. Specifically, 7 studies were related to the dietary iron level. The overall multivariable adjusted RR demonstrated that the dietary iron level was positively associated with MetS (RR = 1.27, 95% CI: 1.12–1.44; p < 0.001). With regard to the dietary copper level, 7 studies were included for meta-analysis. The overall multivariable adjusted RR showed that the dietary copper level was inversely associated with MetS (RR = 0.85, 95% CI: 0.78–0.93; p < 0.001). In addition, 4 studies were specified for the dietary selenium level. The overall multivariable adjusted RR indicated that the dietary selenium level was inversely associated with MetS (RR = 0.77, 95% CI: 0.63–0.95; p = 0.01) as well.ConclusionOur results suggest that the dietary iron level is positively associated with MetS, whereas a negative association between the dietary copper and selenium level and MetS is obtained. Further large well-designed prospective cohort studies are warranted to elaborate on the issues examined in this study.
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Affiliation(s)
- Jun Ding
- Changsha Social Work College, Changsha, China
| | - Qi Liu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Ze Liu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
| | - Hongbin Guo
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jieyu Liang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yi Zhang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Yi Zhang
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5
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Neufingerl N, Eilander A. Nutrient Intake and Status in Adults Consuming Plant-Based Diets Compared to Meat-Eaters: A Systematic Review. Nutrients 2021; 14:nu14010029. [PMID: 35010904 PMCID: PMC8746448 DOI: 10.3390/nu14010029] [Citation(s) in RCA: 138] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/09/2021] [Accepted: 12/20/2021] [Indexed: 12/29/2022] Open
Abstract
Health authorities increasingly recommend a more plant-based diet, rich in fruits, vegetables, pulses, whole grains and nuts, low in red meat and moderate in dairy, eggs, poultry and fish which will be beneficial for both health and the environment. A systematic review of observational and intervention studies published between 2000 and January 2020 was conducted to assess nutrient intake and status in adult populations consuming plant-based diets (mainly vegetarian and vegan) with that of meat-eaters. Mean intake of nutrients were calculated and benchmarked to dietary reference values. For micronutrient status, mean concentrations of biomarkers were calculated and compared across diet groups. A total of 141 studies were included, mostly from Europe, South/East Asia, and North America. Protein intake was lower in people following plant-based diets compared to meat-eaters, but well within recommended intake levels. While fiber, polyunsaturated fatty acids (PUFA), folate, vitamin C, E and magnesium intake was higher, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake was lower in vegetarians and vegans as compared to meat-eaters. Intake and status of vitamin B12, vitamin D, iron, zinc, iodine, calcium and bone turnover markers were generally lower in plant-based dietary patterns compared to meat-eaters. Vegans had the lowest vitamin B12, calcium and iodine intake, and also lower iodine status and lower bone mineral density. Meat-eaters were at risk of inadequate intakes of fiber, PUFA, α-linolenic acid (ALA), folate, vitamin D, E, calcium and magnesium. There were nutrient inadequacies across all dietary patterns, including vegan, vegetarian and meat-based diets. As plant-based diets are generally better for health and the environment, public health strategies should facilitate the transition to a balanced diet with more diverse nutrient-dense plant foods through consumer education, food fortification and possibly supplementation.
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Association between nutritional and physical factors and anemia among schoolchildren aged 5 to 11 years in Beijing. Chin Med J (Engl) 2021; 134:1629-1631. [PMID: 34116528 PMCID: PMC8280090 DOI: 10.1097/cm9.0000000000001600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Guo Z, Xu J, Wang Y, Hu C, Shi K, Zhou J, Xia X, Zhou Y, Foyer CH, Yu J. The phyB-dependent induction of HY5 promotes iron uptake by systemically activating FER expression. EMBO Rep 2021; 22:e51944. [PMID: 34018302 DOI: 10.15252/embr.202051944] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/26/2021] [Accepted: 04/21/2021] [Indexed: 11/09/2022] Open
Abstract
Iron (Fe) deficiency affects global crop productivity and human health. However, the role of light signaling in plant Fe uptake remains uncharacterized. Here, we find that light-induced Fe uptake in tomato (Solanum lycopersicum L.) is largely dependent on phytochrome B (phyB). Light induces the phyB-dependent accumulation of ELONGATED HYPOCOTYL 5 (HY5) protein both in the leaves and roots. HY5 movement from shoots to roots activates the expression of FER transcription factor, leading to the accumulation of transcripts involved in Fe uptake. Mutation in FER abolishes the light quality-induced changes in Fe uptake. The low Fe uptake observed in phyB, hy5, and fer mutants is accompanied by lower photosynthetic electron transport rates. Exposure to red light at night increases Fe accumulation in wild-type fruit but has little effects on fruit of phyB mutants. Taken together, these results demonstrate that Fe uptake is systemically regulated by light in a phyB-HY5-FER-dependent manner. These findings provide new insights how the manipulation of light quality could be used to improve Fe uptake and hence the nutritional quality of crops.
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Affiliation(s)
- Zhixin Guo
- Department of Horticulture, Zhejiang University, Hangzhou, China
| | - Jin Xu
- Department of Horticulture, Zhejiang University, Hangzhou, China
| | - Yu Wang
- Department of Horticulture, Zhejiang University, Hangzhou, China
| | - Chaoyi Hu
- Department of Horticulture, Zhejiang University, Hangzhou, China
| | - Kai Shi
- Department of Horticulture, Zhejiang University, Hangzhou, China.,Key Laboratory of Horticultural Plants Growth and Development, Agricultural Ministry of China, Hangzhou, China
| | - Jie Zhou
- Department of Horticulture, Zhejiang University, Hangzhou, China.,Key Laboratory of Horticultural Plants Growth and Development, Agricultural Ministry of China, Hangzhou, China
| | - Xiaojian Xia
- Department of Horticulture, Zhejiang University, Hangzhou, China.,Key Laboratory of Horticultural Plants Growth and Development, Agricultural Ministry of China, Hangzhou, China
| | - Yanhong Zhou
- Department of Horticulture, Zhejiang University, Hangzhou, China.,Key Laboratory of Horticultural Plants Growth and Development, Agricultural Ministry of China, Hangzhou, China
| | - Christine H Foyer
- School of Biosciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, UK
| | - Jingquan Yu
- Department of Horticulture, Zhejiang University, Hangzhou, China
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8
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Iron intake with the risk of breast cancer among Chinese women: a case-control study. Public Health Nutr 2021; 24:5743-5755. [PMID: 33618790 DOI: 10.1017/s1368980021000471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The current study evaluated the associations between different forms and sources of Fe and breast cancer risk in Southern Chinese women. DESIGN Case-control study. We collected data on the consumption of Fe from different forms and food sources by using a validated FFQ. Multivariable logistic regression and restricted cubic spline (RCS) analysis was used to reveal potential associations between Fe intake and breast cancer risk. SETTING A case-control study of women at three major hospitals in Guangzhou, China. PARTICIPANTS From June 2007 to March 2019, 1591 breast cancer cases and 1622 age-matched controls were recruited. RESULTS In quartile analyses, Fe from plants and Fe from white meat intake were inversely associated with breast cancer risk, with OR of 0·65 (95 % CI 0·47, 0·89, Ptrend = 0·006) and 0·76 (95 % CI 0·61, 0·96, Ptrend = 0·014), respectively, comparing the highest with the lowest quartile. No associations were observed between total dietary Fe, heme or non-heme Fe, Fe from meat or red meat and breast cancer risk. RCS analysis demonstrated J-shaped associations between total dietary Fe, non-heme Fe and breast cancer, and reverse L-shaped associations between heme Fe, Fe from meat and Fe from red meat and breast cancer. CONCLUSION Fe from plants and white meat were inversely associated with breast cancer risk. Significant non-linear J-shaped associations were found between total dietary Fe, non-heme Fe and breast cancer risk, and reverse L-shaped associations were found between heme Fe, Fe from meat or red meat and breast cancer risk.
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Adair KE, Bowden RG. Ameliorating Chronic Kidney Disease Using a Whole Food Plant-Based Diet. Nutrients 2020; 12:E1007. [PMID: 32268544 PMCID: PMC7230354 DOI: 10.3390/nu12041007] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/24/2020] [Accepted: 04/01/2020] [Indexed: 12/18/2022] Open
Abstract
Novel approaches to ameliorating chronic kidney disease (CKD) are warranted as most patients are undiagnosed until they begin displaying symptoms of kidney failure. There is increasing evidence that a whole food plant-based (WFPB) diet may offer benefits that slow the progression of CKD, decrease the incidence cardiovascular disease, decrease rates of diabetes and obesity, and reduce inflammation and cholesterol, which in turn can delay kidney failure and the initiation of dialysis. While animal-based protein ingestion promotes an acidic environment, inflammation and renal hyperfiltration, study authors report plant-based protein can be alkaline-producing and anti-inflammatory and can contain renoprotective properties. Although there may be benefits to adopting a WFPB diet, macronutrient and micronutrient content should be carefully considered and adjusted to avoid malnutrition in CKD patients. Further research needs to be done in order to establish the biological plausibility and feasibility of a WFPB in individuals with diagnosed CKD.
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Affiliation(s)
- Kathleen E. Adair
- Department of Health, Human Performance and Recreation, Baylor University, One Bear Place #97303 Waco, TX 76798-7303, USA
| | - Rodney G. Bowden
- Robbins College of Health and Human Sciences, Baylor University, One Bear Place #97303 Waco, TX 76798-7303, USA;
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Du H, Guo Y, Bennett DA, Bragg F, Bian Z, Chadni M, Yu C, Chen Y, Tan Y, Millwood IY, Gan W, Yang L, Yao P, Luo G, Li J, Qin Y, Lv J, Lin X, Key T, Chen J, Clarke R, Li L, Chen Z. Red meat, poultry and fish consumption and risk of diabetes: a 9 year prospective cohort study of the China Kadoorie Biobank. Diabetologia 2020; 63:767-779. [PMID: 31970429 PMCID: PMC7054352 DOI: 10.1007/s00125-020-05091-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 12/12/2019] [Indexed: 01/07/2023]
Abstract
AIMS/HYPOTHESIS Previous evidence linking red meat consumption with diabetes risk mainly came from western countries, with little evidence from China, where patterns of meat consumption are different. Moreover, global evidence remains inconclusive about the associations of poultry and fish consumption with diabetes. Therefore we investigated the associations of red meat, poultry and fish intake with incidence of diabetes in a Chinese population. METHODS The prospective China Kadoorie Biobank recruited ~512,000 adults (59% women, mean age 51 years) from ten rural and urban areas across China in 2004-2008. At the baseline survey, a validated interviewer-administered laptop-based questionnaire was used to collect information on the consumption frequency of major food groups including red meat, poultry, fish, fresh fruit and several others. During ~9 years of follow-up, 14,931 incidences of new-onset diabetes were recorded among 461,036 participants who had no prior diabetes, cardiovascular diseases or cancer at baseline. Cox regression analyses were performed to calculate adjusted HRs for incident diabetes associated with red meat, poultry and fish intake. RESULTS At baseline, 47.0%, 1.3% and 8.9% of participants reported a regular consumption (i.e. ≥4 days/week) of red meat, poultry and fish, respectively. After adjusting for adiposity and other potential confounders, each 50 g/day increase in red meat and fish intake was associated with 11% (HR 1.11 [95% CI 1.04, 1.20]) and 6% (HR 1.06 [95% CI 1.00, 1.13]) higher risk of incident diabetes, respectively. For both, the associations were more pronounced among men and women from urban areas, with an HR (95% CI) of 1.42 (1.15, 1.74) and 1.18 (1.03, 1.36), respectively, per 50 g/day red meat intake and 1.15 (1.02, 1.30) and 1.11 (1.01, 1.23), respectively, per 50 g/day fish intake. There was no significant association between diabetes and poultry intake, either overall (HR 0.96 [95% CI 0.83, 1.12] per 50 g/day intake) or in specific population subgroups. CONCLUSIONS/INTERPRETATION In Chinese adults, both red meat and fish, but not poultry, intake were positively associated with diabetes risk, particularly among urban participants. Our findings add new evidence linking red meat and fish intake with cardiometabolic diseases. DATA AVAILABILITY Details of how to access the China Kadoorie Biobank data and rules of China Kadoorie Biobank data release are available from www.ckbiobank.org/site/Data+Access.
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Affiliation(s)
- Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK.
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Yu Guo
- Chinese Academy of Medical Sciences, no. 9 Dong Dan San Tiao, Dong Cheng District, Beijing, 100730, China.
| | - Derrick A Bennett
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Fiona Bragg
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Zheng Bian
- Chinese Academy of Medical Sciences, no. 9 Dong Dan San Tiao, Dong Cheng District, Beijing, 100730, China
| | - Mahmuda Chadni
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Peking University, Beijing, China
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Yunlong Tan
- Chinese Academy of Medical Sciences, no. 9 Dong Dan San Tiao, Dong Cheng District, Beijing, 100730, China
| | - Iona Y Millwood
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Wei Gan
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Pang Yao
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Guojin Luo
- Pengzhou CDC, Chengdu, Sichuan Province, China
| | - Jianguo Li
- Pengzhou CDC, Chengdu, Sichuan Province, China
| | - Yulu Qin
- NCDs Prevention and Control Department, Liuzhou CDC, Guangxi Autonomous Zone, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Peking University, Beijing, China
| | - Xu Lin
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, China
| | - Tim Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Peking University, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
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11
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He J, Fang A, Yu S, Shen X, Li K. Dietary Nonheme, Heme, and Total Iron Intake and the Risk of Diabetes in Adults: Results From the China Health and Nutrition Survey. Diabetes Care 2020; 43:776-784. [PMID: 32033991 PMCID: PMC7646206 DOI: 10.2337/dc19-2202] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 01/20/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Excessive iron intake has been linked to diabetes risk. However, the evidence is inconsistent. This study examined the association between dietary heme and nonheme iron intake and diabetes risk in the Chinese population. RESEARCH DESIGN AND METHODS We included 17,026 adults (8,346 men and 8,680 women) who were part of the China Health and Nutrition Survey (1991-2015) prospective cohort. Dietary intake was measured by three consecutive 24-h dietary recalls combined with a household food inventory. Diabetes cases were identified through a questionnaire. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs. RESULTS A total of 547 men and 577 women developed diabetes during 202,138 person-years of follow-up. For men, the adjusted HRs (95% CIs) for quintiles of nonheme iron intake were 1.00, 0.77 (0.58-1.02), 0.72 (0.54-0.97), 0.63 (0.46-0.85), and 0.87 (0.64-1.19) (P-nonlinearity = 0.0015). The corresponding HRs (95% CIs) for women were 1.00, 0.63 (0.48-0.84), 0.57 (0.43-0.76), 0.58 (0.43-0.77), and 0.67 (0.49-0.91) (P-nonlinearity < 0.0001). The dose-response curves for the association between nonheme iron and total iron intake and diabetes followed a reverse J shape in men and an L shape in women. No significant associations were observed between heme iron intake and diabetes risk. CONCLUSIONS Total iron and nonheme iron intake was associated with diabetes risk, following a reverse J-shaped curve in men and an L-shaped curve in women. Sufficient intake of nonheme or total iron might be protective against diabetes, while excessive iron intake might increase the risk of diabetes among men.
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Affiliation(s)
- Jingjing He
- School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing, China
| | - Aiping Fang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Siwang Yu
- School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing, China
| | - Xin Shen
- Peking University Cancer Hospital, Beijing, China
| | - Keji Li
- School of Public Health, Peking University Health Science Center, Beijing, China
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12
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Zhu Z, He Y, Wu F, Zhao L, Wu C, Lu Y, Zang J, Wang Z, Sun J, Huang J, Guo C, Ding G. The Associations of Dietary Iron, Zinc and Magnesium with Metabolic Syndrome in China's Mega Cities. Nutrients 2020; 12:nu12030659. [PMID: 32121232 PMCID: PMC7146276 DOI: 10.3390/nu12030659] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 02/20/2020] [Accepted: 02/26/2020] [Indexed: 12/29/2022] Open
Abstract
Background: Iron, zinc and magnesium perform differently in body metabolism but exist in similar food. This study was to evaluate the associations of dietary iron, zinc and magnesium with metabolic syndrome (MetS). Methods: A sample of a total of 5323 participants from four of China’s mega cities was included in the current study. Both a 3-day 24-h dietary recall and household condiment weighing were applied to assess dietary intake, respectively. Hierarchical logistic regression models were used to evaluate the associations of dietary iron, zinc and magnesium with MetS. Results: After adjusting for age, sex, region, years of education, physical activity level, intended physical exercises, smoking status, alcohol use, daily energy intake and mutual adjustment for dietary iron, zinc and magnesium, significant positive trends were found across quartiles of total dietary iron and the risk of MetS, as well as for magnesium and MetS (p value for trends = 0.01 and 0.02, respectively); dietary zinc was inversely associated with MetS risk (p value for trend < 0.01). Magnesium from grains and potato was positively associated with MetS (p value for trend < 0.01). Conclusions: Dietary iron and magnesium were positively associated with the risk of MetS, while zinc was inversely associated with the risk of MetS, in China’s mega cities. The positive association of magnesium with MetS could be a result confounding by other factors correlated with magnesium in grains and potato, which warrants further study.
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Affiliation(s)
- Zhenni Zhu
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 20036, China; (Z.Z.); (F.W.); (C.W.); (J.Z.); (Z.W.); (C.G.)
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (Y.H.); (L.Z.); (J.S.); (J.H.)
| | - Yuna He
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (Y.H.); (L.Z.); (J.S.); (J.H.)
| | - Fan Wu
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 20036, China; (Z.Z.); (F.W.); (C.W.); (J.Z.); (Z.W.); (C.G.)
| | - Liyun Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (Y.H.); (L.Z.); (J.S.); (J.H.)
| | - Chunfeng Wu
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 20036, China; (Z.Z.); (F.W.); (C.W.); (J.Z.); (Z.W.); (C.G.)
| | - Ye Lu
- Division of Non-Communicable Diseases Prevention and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 20036, China;
| | - Jiajie Zang
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 20036, China; (Z.Z.); (F.W.); (C.W.); (J.Z.); (Z.W.); (C.G.)
| | - Zhengyuan Wang
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 20036, China; (Z.Z.); (F.W.); (C.W.); (J.Z.); (Z.W.); (C.G.)
| | - Jing Sun
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (Y.H.); (L.Z.); (J.S.); (J.H.)
| | - Jian Huang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (Y.H.); (L.Z.); (J.S.); (J.H.)
| | - Changyi Guo
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai 20036, China; (Z.Z.); (F.W.); (C.W.); (J.Z.); (Z.W.); (C.G.)
| | - Gangqiang Ding
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing 100050, China; (Y.H.); (L.Z.); (J.S.); (J.H.)
- Correspondence: ; Tel.: +86-10-6623-7001
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13
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Zhu Y, Liu X, Li N, Cui L, Zhang X, Liu X, Yu K, Chen Y, Wan Z, Yu Z. Association Between Iron Status and Risk of Chronic Kidney Disease in Chinese Adults. Front Med (Lausanne) 2020; 6:303. [PMID: 31998726 PMCID: PMC6961557 DOI: 10.3389/fmed.2019.00303] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/02/2019] [Indexed: 12/19/2022] Open
Abstract
Background: Even though it is well-known that iron deficiency is the result of chronic kidney disease (CKD), whether iron will affect kidney function and disease in the general population is not clear. We thus conducted a nationwide cross-sectional study using data from the China Health and Nutrition Survey (CHNS) to assess the relationship of iron status with estimated glomerular filtration rate (eGFR) and CKD among general adults. Methods: A total of 8,339 adults from the China Health and Nutrition Survey in the wave of 2009 were included to assess the association between iron status and eGFR/CKD. Serum ferritin (SF), transferrin, soluble transferrin receptor (sTfR), and hemoglobin (Hb) were measured. The relationship of iron status and eGFR was evaluated by using multi-variable linear regression model. The effect of iron status on the odds of CKD was calculated by logistic regression model. Results: For the association between iron status and eGFR, every 100 μg/L increase in SF was correlated with 0.26 ml/min per 1.73 m2 (95% CI: 0.08-0.44) decrease in eGFR, and every 5 mg/L increase in sTfR was associated with a decrease of 6.00 ml/min per 1.73 m2 (95% CI: 3.79-8.21) in eGFR. There were no significant associations between Hb or transferrin with eGFR. For the association between iron status and CKD, every 5 g/L increase in sTfR was associated with an odds ratio of 3.72 (95% CI: 2.16-6.13) for CKD. The concentrations of Hb were associated with the odds of CKD in a U-shaped manner, with the lowest risk in the Hb range of 136-141 g/L. There was a positive correlation between SF concentration and CKD prevalence but not in a dose-response manner. The odds of CKD for participants in the highest tertile increased by 28% (98% CI: 1-63%) compared with those in the lowest tertile. Conclusion: The concentration of SF and sTfR was positively correlated with the odds of CKD, and Hb was associated with the odds of CKD in a U-shaped manner. Further large prospective researches are warranted to confirm these findings.
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Affiliation(s)
- Yongjian Zhu
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaozhuan Liu
- College of Food Science and Technology, Henan Agriculture University, Zhengzhou, China
| | - Ning Li
- College of Food Science and Technology, Henan Agriculture University, Zhengzhou, China
| | - Lingling Cui
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaofeng Zhang
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xinxin Liu
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Kailun Yu
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yao Chen
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhongxiao Wan
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zengli Yu
- School of Public Health, Zhengzhou University, Zhengzhou, China
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14
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Zhu Y, Chen G, Bo Y, Liu Y. Markers of iron status, blood pressure and incident hypertension among Chinese adults. Nutr Metab Cardiovasc Dis 2019; 29:830-836. [PMID: 31255378 DOI: 10.1016/j.numecd.2019.04.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/12/2019] [Accepted: 04/29/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND AIMS The evidence on the relationship between markers of iron, blood pressure and hypertension are limited and inconsistent. This prospective cohort study aimed to investigate the relationship of serum ferritin (SF), transferrin, soluble transferrin receptor (sTFR) and haemoglobin on blood pressure and incident hypertension in the China Health and Nutrition Survey (CHNS) study. METHODS AND RESULTS We studied 8337 adults aged 18 years old or above from CHNS in 2009 to investigate the association of markers of iron and blood pressure (BP). Among them, 4509 non-hypertensive participants who completed follow up were included to investigate the association of markers of iron and hypertension development. Linear regression model was used to assess the association between markers of iron and BP. Cox regression model was used to examine the association of markers of iron and hypertension development. SF and serum sTFR concentration had a non-significant effect on incident hypertension. Transferrin and haemoglobin concentrations were positively associated with incident hypertension. Compared to the participants with the lowest tertile of transferrin, those with the highest tertile had a higher risk of developing hypertension [HR: 1.26, 95% CI (1.04, 1.53), P = 0.017]. Similarly, participants with the highest tertile of haemoglobin had a significantly higher risk of incident hypertension [HR: 1.27, 95% CI (1.01, 1.59), P = 0.038]. CONCLUSION The current study found that haemoglobin and transferrin levels were positively associated with blood pressure and incident hypertension. Further research in different ethnic groups is required to confirm the association of the full range of markers of iron with BP and incident hypertension.
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Affiliation(s)
- Yongjian Zhu
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, China
| | - Gaiyun Chen
- Department of Nutrition, The First Affiliated Hospital of Zhengzhou University, China
| | - Yacong Bo
- Department of Nutrition, The First Affiliated Hospital of Zhengzhou University, China.
| | - Yanhua Liu
- Department of Nutrition, The First Affiliated Hospital of Zhengzhou University, China.
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15
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Total and Nonheme Dietary Iron Intake Is Associated with Metabolic Syndrome and Its Components in Chinese Men and Women. Nutrients 2018; 10:nu10111663. [PMID: 30400363 PMCID: PMC6266186 DOI: 10.3390/nu10111663] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 10/29/2018] [Accepted: 10/31/2018] [Indexed: 12/14/2022] Open
Abstract
The causal relationship between serum ferritin and metabolic syndrome (MetS) remains inconclusive. Dietary iron intake increases serum ferritin. The objective of this study was to evaluate associations of total, heme, and nonheme dietary iron intake with MetS and its components in men and women in metropolitan China. Data from 3099 participants in the Shanghai Diet and Health Survey (SDHS) obtained during 2012–2013 were included in this analysis. Dietary intake was assessed by 24-h diet records from 3 consecutive days. Multivariate generalized linear mixed models were used to evaluate the associations of dietary iron intake with MetS and its components. After adjustment for potential confounders as age, sex, income, physical exercise, smoking status, alcohol use, and energy intake, a positive trend was observed across quartiles of total iron intake and risk of MetS (p for trend = 0.022). Compared with the lowest quartile of total iron intake (<12.72 mg/day), the highest quartile (≥21.88 mg/day) had an odds ratio (95% confidence interval), OR (95% CI), of 1.59 (1.15,2.20). In addition, the highest quartile of nonheme iron intake (≥20.10 mg/day) had a 1.44-fold higher risk of MetS compared with the lowest quartile (<11.62 mg/day), and higher risks of MetS components were associated with the third quartiles of total and nonheme iron intake. There was no association between heme iron intake and risk of MetS (p for trend = 0.895). Associations for total and nonheme iron intake with MetS risk were found in men but not in women. Total and nonheme dietary iron intake was found to be positively associated with MetS and its components in the adult population in metropolitan China. This research also revealed a gender difference in the association between dietary iron intake and MetS.
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16
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Markers of Iron Status Are Associated with Risk of Hyperuricemia among Chinese Adults: Nationwide Population-Based Study. Nutrients 2018; 10:nu10020191. [PMID: 29425155 PMCID: PMC5852767 DOI: 10.3390/nu10020191] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/26/2018] [Accepted: 02/06/2018] [Indexed: 12/12/2022] Open
Abstract
Background: Elevated serum uric acid (SUA) involved in iron metabolism, has been increasingly recognized as a risk factor for gout and cardiovascular diseases. The objective of this study was to examine the associations between markers of iron status with risk of hyperuricemia (HU) in Chinese adult population. Methods: Data were extracted from the 2009 wave of the China Health and Nutrition Survey, consisting of 7946 apparently healthy adults. Serum ferritin (SF), transferrin, soluble transferrin receptors (sTfR), hemoglobin (Hb), high-sensitivity C-reactive protein (hs-CRP), and SUA were measured. Diet was assessed with three consecutive 24 h recalls. Demographic characteristics, smoking status, alcohol consumption, and physical activities were investigated using a structured questionnaire. Multilevel mixed-effects models were constructed to estimate the associations of SF, transferrin, sTfR, and Hb with SUA and the risk of HU. Results: The crude prevalence of HU was 16.1%. SF, transferrin, and Hb levels were positively associated with SUA and the risk of HU after adjustment for cluster effects and potential confounders (all p-trend < 0.05). Compared with participants in the lowest quartile of SF, those in the highest quartile had significantly higher SUA concentrations (β = 0.899 mg/dL, 95% confidence interval (CI): 0.788, 1.010; p < 0.001) and higher risk of HU (odds ratio (OR) = 3.086, 95% CI: 2.450, 3.888; p < 0.001). Participants with the highest quartile of transferrin had significantly higher SUA concentrations (β = 0.488 mg/dL, 95% CI: 0.389, 0.587; p < 0.001) and higher risk of HU (OR: 1.900; 95% CI: 1.579, 2.286; p < 0.001) when compared with those with the lowest quartile. In male participants, those in the highest quartile of Hb had significantly higher risk of HU when compared to the reference group (OR: 1.401, 95% CI: 1.104, 1.777; p < 0.01); however, this association was not found in female participants (OR: 1.093; 95% CI: 0.821, 1.455; p = 0.544). Conclusion: SF, transferrin, and Hb levels were positively associated with the risk of HU, and additional studies are needed to confirm the findings, as well as to elucidate their underlying mechanisms.
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17
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Young I, Parker HM, Rangan A, Prvan T, Cook RL, Donges CE, Steinbeck KS, O'Dwyer NJ, Cheng HL, Franklin JL, O'Connor HT. Association between Haem and Non-Haem Iron Intake and Serum Ferritin in Healthy Young Women. Nutrients 2018; 10:E81. [PMID: 29329258 PMCID: PMC5793309 DOI: 10.3390/nu10010081] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/07/2018] [Accepted: 01/09/2018] [Indexed: 12/30/2022] Open
Abstract
Iron is an essential micronutrient for human health and inadequate intake may result in iron deficiency (ID) or iron deficiency anaemia (IDA). Unlike other recent studies investigating iron status in young women, this cross-sectional study analysed dietary intake and biochemical data from healthy young (18-35 years) women (n = 299) to determine the association between both haem iron (HI) and non-haem iron (NHI) intakes and serum ferritin (SF). Dietary restraint and possible inflammation secondary to obesity were also measured and accounted for, and energy intake was adjusted for using the residuals method. Independent samples t-tests and chi-squared tests were performed, and factors found to be significantly different between iron replete (IR) and ID/IDA participants were analysed using general linear modelling. ID/IDA participants consumed significantly lower total energy than iron replete (IR) (p = 0.003). Lower energy intake was also associated with higher levels of dietary restraint (p = 0.001). Both HI and NHI were positively associated with SF with HI was found to be a stronger predictor (β = 0.128, p = 0.009) than NHI (β = 0.037, p = 0.028). The study demonstrates that intake of both HI and NHI, as well as adequate dietary energy, are associated with normal iron status levels in young women, and that restrained eaters may be at greater risk of low iron status.
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Affiliation(s)
- Isabel Young
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Helen M Parker
- Faculty of Health Science, Discipline of Exercise and Sports Science, The University of Sydney, Lidcombe, NSW 2414, Australia.
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Anna Rangan
- Nutrition and Dietetics Group, School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney, NSW 2006, Australia.
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Tania Prvan
- Department of Statistics, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2113, Australia.
| | - Rebecca L Cook
- Faculty of Health Science, Discipline of Exercise and Sports Science, The University of Sydney, Lidcombe, NSW 2414, Australia.
| | - Cheyne E Donges
- School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, NSW 2795, Australia.
| | - Kate S Steinbeck
- Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia.
- Sydney Medical School, Discipline of Child and Adolescent Health, The University of Sydney, Westmead, NSW 2145, Australia.
| | - Nicholas J O'Dwyer
- Faculty of Health Science, Discipline of Exercise and Sports Science, The University of Sydney, Lidcombe, NSW 2414, Australia.
- School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, NSW 2795, Australia.
| | - Hoi Lun Cheng
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
- Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia.
- Sydney Medical School, Discipline of Child and Adolescent Health, The University of Sydney, Westmead, NSW 2145, Australia.
| | - Janet L Franklin
- Sydney Medical School, Discipline of Child and Adolescent Health, The University of Sydney, Westmead, NSW 2145, Australia.
- Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
| | - Helen T O'Connor
- Faculty of Health Science, Discipline of Exercise and Sports Science, The University of Sydney, Lidcombe, NSW 2414, Australia.
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia.
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