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Hosseinpour-Niazi S, Niknam M, Amiri P, Mirmiran P, Einy E, Izadi N, Gaeini Z, Azizi F. The association between ultra-processed food consumption and health-related quality of life differs across lifestyle and socioeconomic strata. BMC Public Health 2024; 24:1955. [PMID: 39039502 PMCID: PMC11265477 DOI: 10.1186/s12889-024-19351-7] [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: 03/26/2024] [Accepted: 07/03/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND In this prospective study, we aimed to examine the association between ultra-processed foods and health-related quality of life (HRQoL) and to evaluate the effect of lifestyle and socioeconomic factors on this association. METHODS This study included 1766 adults (aged 18 to 78, 54.3% women), who took part in the Tehran Lipid and Glucose study. The Short-Form 12-Item Health Survey version 2 was used to determine HRQoL, which includes the physical component summary (PCS) and mental component summary (MCS) scores. Ultra-processed food consumption was assessed using a validated semi-quantitative food frequency questionnaire. Lifestyle (physical activity and smoking status) and socioeconomic factors (education level and employment status) were also determined. General linear models (GLM) were applied to estimate the mean (95% confidence interval) for MCS and PCS scores across the ultra-processed foods tertiles. Additionally, the effect of lifestyle and socioeconomic factors on the relationship between ultra-processed foods and HRQoL was examined using GLM. RESULTS The median consumption of ultra-processed foods was 11.9% (IQR: 8.2 to 16.8) of total energy intake. There was a significant inverse association between ultra-processed foods consumption and PCS, but not MCS, after adjustment for confounding factors. Significant interactions were observed between ultra-processed food consumption, sex, and occupation on PCS score (all P values < 0.001). The interaction test tended to be significant for smoking status, education levels, and physical activity levels. As ultra-processed food consumption increased, the PCS score significantly decreased in women (P = 0.043), low physical active subjects (P = 0.014), smokers (P = 0.015), and lower-educated individuals (P = 0.022). Non-employed individuals with higher ultra-processed food intake showed a decline in their PCS and MCS scores. While there was no significant difference in MCS score among different strata of lifestyle and socioeconomic status across tertiles of ultra-processed foods. CONCLUSIONS Higher intake of ultra-processed foods was associated with poorer physical health, particularly among women, those with unhealthy lifestyles, and low socioeconomic conditions.
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Affiliation(s)
- Somayeh Hosseinpour-Niazi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran.
| | - Mahdieh Niknam
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran.
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elaheh Einy
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Neda Izadi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran
| | - Zahra Gaeini
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Schorr KA, Agayn V, de Groot LCPGM, Slagboom PE, Beekman M. A plant-based diet index to study the relation between diet and disease risk among adults: a narrative review. J Nutr Health Aging 2024; 28:100272. [PMID: 38815475 DOI: 10.1016/j.jnha.2024.100272] [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: 12/01/2023] [Revised: 05/17/2024] [Accepted: 05/18/2024] [Indexed: 06/01/2024]
Abstract
Plant-based diets (PBD) may offer various health benefits and contribute to a sustainable way of life, but, if not planned correctly, may also confer risks, e.g., by focusing on plant foods with low nutrient density, such as foods primarily consisting of refined carbohydrates. A plant-based diet index (PDI) differentiating between a healthful, unhealthful, and overall PBD, offers a promising approach to standardize and compare studies and integrate results. In this review we (1) summarize current evidence on the PDI and disease risk of relevance to public health, (2) discuss the methodology of the PDI and how it can be sensibly applied in further studies and (3) indicate areas with a lack of knowledge, such as vulnerable populations. In summary, our amalgamation shows, that adherence to a healthier plant-based diet is associated with an 8-68% lower risk for metabolic risk factors, diabetes, and cardiovascular disease, while adherence to an unhealthier plant-based diet is associated with a 10-63% higher risk. Although differences in calculation methods and underlying diet patterns between populations should be accounted for, the PDI can be a useful tool to assess adherence to different plant-based diet patterns and their association with health outcomes in cohort studies across cultures.
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Affiliation(s)
- Kerstin A Schorr
- Innoso BV, Den Haag, The Neterhlands; Leiden University Medical Center, Leiden, The Netherlands.
| | | | | | | | - Marian Beekman
- Leiden University Medical Center, Leiden, The Netherlands
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Vasmehjani AA, Darabi Z, Ghayour-Mobarhan M, Ferns GA, Khayyatzadeh SS. The associations between plant-based dietary indices with depression and quality of life and insomnia among Iranian adolescent girls in 2015. Sci Rep 2024; 14:11683. [PMID: 38778083 PMCID: PMC11111745 DOI: 10.1038/s41598-024-61952-0] [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: 10/11/2023] [Accepted: 05/12/2024] [Indexed: 05/25/2024] Open
Abstract
Although previous research has explored the link between plant-based diets and mental health outcomes, there has been limited study on the quality levels of plant foods in this context. This study was conducted on 733 adolescent girls from cities in northeastern Iran. The validated Iranian version of the Insomnia Severity Index, SF-12v2 questionnaire and Persian version of the Beck Depression Inventory used to assess insomnia and poor quality of life (QoL) and depression, respectively. Dietary intakes assessed using a valid and reliable food frequency questionnaire. The association of scores of plant based dietary index (PDI) and poor QoL, depression and insomnia explored by binary logistic regression. The unadjusted model showed subjects in the highest quartile of healthy PDI had lower chances of insomnia than those in the lowest quartile (OR: 0.50; 95% CI 0.27-0.91, P = 0.024). The association persisted across various adjusted models. Subjects in the highest quartile of unhealthy PDI (uPDI) had higher chances of depression than those in the lowest quartile (OR: 1.83; 95% CI 1.09-3.08, P = 0.022). The significance of the association was maintained after adjusting for other confounders. A healthy plant-based dietary index is associated with a lower odds of insomnia. An unhealthy plant-based dietary index was associated to an increased chance of depression. Findings need to be confirmed by future studies.
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Affiliation(s)
- Azam Ahmadi Vasmehjani
- Research Center for Food Hygiene and Safety, School of Public Health Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Darabi
- Research Center for Food Hygiene and Safety, School of Public Health Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex, BN1 9PH, UK
| | - Sayyed Saeid Khayyatzadeh
- Research Center for Food Hygiene and Safety, School of Public Health Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Hu FB. Diet strategies for promoting healthy aging and longevity: An epidemiological perspective. J Intern Med 2024; 295:508-531. [PMID: 37867396 PMCID: PMC10939982 DOI: 10.1111/joim.13728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
In recent decades, global life expectancies have risen significantly, accompanied by a marked increase in chronic diseases and population aging. This narrative review aims to summarize recent findings on the dietary factors influencing chronic diseases and longevity, primarily from large cohort studies. First, maintaining a healthy weight throughout life is pivotal for healthy aging and longevity, mirroring the benefits of lifelong, moderate calorie restriction in today's obesogenic food environment. Second, the specific types or food sources of dietary fat, protein, and carbohydrates are more important in influencing chronic disease risk and mortality than their quantity. Third, some traditional diets (e.g., the Mediterranean, Nordic, and Okinawa) and contemporary dietary patterns, such as healthy plant-based diet index, the DASH (dietary approaches to stop hypertension) diet, and alternate healthy eating index, have been associated with lower mortality and healthy longevity. These patterns share many common components (e.g., a predominance of nutrient-rich plant foods; limited red and processed meats; culinary herbs and spices prevalent in global cuisines) while embracing distinct elements from different cultures. Fourth, combining a healthy diet with other lifestyle factors could extend disease-free life expectancies by 8-10 years. While adhering to core principles of healthy diets, it is crucial to adapt dietary recommendations to individual preferences and cultures as well as nutritional needs of aging populations. Public health strategies should aim to create a healthier food environment where nutritious options are readily accessible, especially in public institutions and care facilities for the elderly. Although further mechanistic studies and human trials are needed to better understand molecular effects of diet on aging, there is a pressing need to establish and maintain long-term cohorts studying diet and aging in culturally diverse populations.
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Affiliation(s)
- Frank B. Hu
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115. USA
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Jing H, Teng Y, Chacha S, Wang Z, Shi G, Mi B, Zhang B, Cai J, Liu Y, Li Q, Shen Y, Yang J, Kang Y, Li S, Liu D, Wang D, Yan H, Dang S. Is Increasing Diet Diversity of Animal-Source Foods Related to Better Health-Related Quality of Life among Chinese Men and Women? Nutrients 2023; 15:4183. [PMID: 37836467 PMCID: PMC10574670 DOI: 10.3390/nu15194183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/12/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Diet plays a crucial role in regulating individuals' lifestyles and is closely related to health. The intake of animal-sourced foods (ASF) provides the human body with high-quality protein and various micronutrients. This study aimed to investigate whether the diversity of animal foods has a positive impact on the health-related quality of life (HRQoL) among residents. The data came from the Shaanxi baseline survey of the Northwest Chinese Regional Ethnic Cohort Study, which recruited more than 100 thousand participants aged 35 to 74 from five provinces between June 2018 and May 2019. A total of 39,997 participants in Shaanxi (mean age: 50 years; 64% women) were finally included in this current study. The animal source food diet diversity score (ASFDDS) was established based on the frequency of consuming pork, mutton, beef, poultry, seafood, eggs, pure milk, and yogurt. The physical component score (PCS) and mental component score (MCS), ranging from 0 to 100 on the 12-Item Short Form Survey (SF-12), were used to assess participants' HRQoL. Better PCS/MCS was defined as scores higher than the 90th percentile. The results showed that men had a higher intake of ASF and ASFDDS than women. After adjusting for potential confounders, compared with those who never or rarely consumed animal foods, the likelihood of having better PCS and MCS increased by 16% (OR = 1.16, 95%CI: 1.01-1.34) and 24% (OR = 1.24, 95%CI: 1.03-1.448), respectively, in men with an ASFDDS ≥ 2. In women, a 34% increase (OR = l.34, 95%CI: 116-l.54) likelihood for better PCS was observed for an ASFDDS ≥ 2, but no association was observed for MCS. Increasing each specific animal source's food intake was associated with better PCS after adjusting for all covariates. However, for MCS, positive associations were only observed in seafood consumption among men and eggs among women. Restricted cubic splines showed a substantial dose-response association between intake frequency of animal-source foods and PCS, both in men and women. The study suggests that a diverse intake of animal-sourced foods can potentially improve the HRQoL of Chinese adults.
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Affiliation(s)
- Hui Jing
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Yuxin Teng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Samuel Chacha
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Ziping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Guoshuai Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Binyan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Jiaxin Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Yezhou Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Qiang Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Yuan Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Jiaomei Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Yijun Kang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Shanshan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Danmeng Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L7 8XZ, UK;
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
| | - Shaonong Dang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; (H.J.); (Y.T.); (S.C.); (Z.W.); (G.S.); (B.M.); (B.Z.); (J.C.); (Y.L.); (Q.L.); (Y.S.); (J.Y.); (Y.K.); (S.L.); (D.L.)
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Rosenfeld RM, Juszczak HM, Wong MA. Scoping review of the association of plant-based diet quality with health outcomes. Front Nutr 2023; 10:1211535. [PMID: 37637943 PMCID: PMC10447911 DOI: 10.3389/fnut.2023.1211535] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction The association of plant-based dietary patterns with health outcomes has traditionally been assessed without considering nutritional value. The plant-based dietary index (PDI), first published in 2016, overcomes this limitation with both a healthful PDI (hPDI) and an unhealthful PDI (uPDI), based on the quality of plant foods consumed plus the frequency of animal foods. We sought to summarize the breadth of research using the hPDI and uPDI to gain insight into how the quality of plant-based dietary patterns might be associated with health outcomes. Methods Scoping review of studies that used the PDI, hPDI, or uPDI to report associations with health outcomes. Multiple databases were searched from 2010 through April 2023 with 2 authors independently assessing eligibility and extracting data. In addition to assessing the association of the indices to health outcomes, we determined the frequency of concordant or discordant findings for hPDI versus PDI and for hPDI versus uPDI. Results We included 95 articles (54% longitudinal, 37% cross-sectional, and 9% case-control) with a median sample size of 3,646. Higher hPDI levels were associated with favorable health outcomes in 36% of comparisons (most often for obesity, mortality, diabetes, cardiovascular disease, and psychiatric disorders), compared to 25% for the PDI and only 2% for the uPDI. Conversely, higher levels of the uPDI were associated with unfavorable health outcomes in 33% of comparisons, in contrast to under 1% for the hPDI and 2% for the PDI. When the hPDI association to an outcome was discordant with the uPDI or PDI, the significance and directionality always favored the hPDI over the uPDI, and nearly always favored the hPDI over the PDI. Discussion Dietary indices that account for the quality of plant foods can show health benefits that might be missed by a generic plant-based index. A greater focus on the quality of plant foods could improve nutrition guidelines, raise awareness about the benefits of adding unrefined plant foods to the diet, and empower consumers to make incremental additions of such foods to displace unhealthy foods. We anticipate increasing use of indices that address food quality in future research.
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Affiliation(s)
- Richard M. Rosenfeld
- Department of Otolaryngology, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
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Ding K, Zeng J, Zhang X, Wang Y, Liang F, Wang L, Guo T, Moore JB, Li R. Changes in Plant-based Dietary Quality and Subsequent Risk of Cognitive Impairment among Older Chinese Adults: A National Community-based Cohort Study. Am J Clin Nutr 2023:S0002-9165(23)57911-9. [PMID: 37187294 DOI: 10.1016/j.ajcnut.2023.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND It is unclear how changes in plant-based dietary quality are linked to subsequent risk of cognitive impairment. This study aims to evaluate this relationship using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). METHODS A total of 6662 participants free of cognitive impairment in 2008 were included and followed up to 2018. Plant-based dietary quality was assessed by three indices: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). Changes in plant-based diet quality from 2008 to 2011 were classified into quintiles. We assessed incident cognitive impairment (from 2011 to 2018) by using the Mini-Mental State Examination (MMSE). Cox proportional-hazards models were performed. RESULTS We recorded 1571 incident cases of cognitive impairment during a median of 10 years of follow-up. Compared with participants whose plant-based diet had no change or was relatively stable over three years, the full-adjusted hazard ratios (HRs) with 95% confidence intervals (CI) for cognitive impairment were 0.77 (0.64, 0.93), 0.72 (0.60, 0.86), and 1.50 (1.27, 1.77) among participants with a large increase in PDI, hPDI, and uPDI, respectively. The HRs with 95% CI were 1.22 (1.02, 1.44), 1.30 (1.11, 1.54), and 0.80 (0.67, 0.96) among participants with a large decrease in PDI, hPDI, and uPDI, respectively. Every 10-point increase in PDI and hPDI was associated with 26% and 30% lower risk of cognitive impairment, while every 10-point increase in uPDI was associated with 36% higher risk. CONCLUSIONS Older adults with increased adherence to an overall plant-based diet and a healthful plant-based diet over three years have a lower risk of cognitive impairment, while those with increased adherence to an unhealthy plant-based diet had a higher risk of cognitive impairment.
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Affiliation(s)
- Kai Ding
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Jing Zeng
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Xinge Zhang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, China
| | - Yechuang Wang
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Fang Liang
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Lei Wang
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Taotao Guo
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Justin B Moore
- Department of Epidemiology & Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Rui Li
- School of Public Health, Wuhan University, Wuhan 430071, China; Center for Nurturing Care Research, School of Nursing; Center for Healthy Aging, School of Nursing, Wuhan University, Wuhan 430071, China.
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Associations between healthy lifestyle score and health-related quality of life among Chinese rural adults: variations in age, sex, education level, and income. Qual Life Res 2023; 32:81-92. [PMID: 35972617 DOI: 10.1007/s11136-022-03229-5] [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] [Accepted: 08/03/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE This study aimed to investigate the associations between overall lifestyles and HRQoL, as well as the variations in age, sex, education level, and income. METHODS A total of 23,402 participants from the Henan rural cohort were included. The healthy lifestyle score (HLS) consists of five lifestyle factors: smoking, alcohol drinking, physical activity, diet, and body mass index. HRQoL was assessed by the EQ-5D-5L questionnaire. The general linear model and Tobit regression model were utilized to assess the associations of HLS with visual analogue score (VAS) and utility index. RESULTS Compared with participants with an HLS of 0-2, the corresponding regression coefficients (β) and 95% confidence intervals (CI) of participants with an HLS of 3, 4, and 5 for VAS score were 1.09 (0.59, 1.59), 1.92 (1.38, 2.46), and 2.60 (1.83, 3.37); the corresponding β and 95% CI for utility index were 0.02 (0.01, 0.03), 0.05 (0.03, 0.06), and 0.06 (0.04, 0.07). Notably, these positive associations were greater among the elderly, female, and those with lower education level and average monthly income (p for interaction < 0.05). For instance, the corresponding β and 95% CI of individuals with an HLS of 5 for utility index in average monthly income < 500 RMB, 500-999 RMB, and ≥ 1000 RMB groups were 0.08 (0.05, 0.11), 0.06 (0.03, 0.09), and 0.02 (- 0.00, 0.05). CONCLUSION Engaging in healthier lifestyle habits was associated with a higher level of HRQoL, especially in the elderly, females, and those with low education level and average monthly income.
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Sotos-Prieto M, Struijk EA, Fung TT, Rodríguez-Artalejo F, Willett WC, Hu FB, Lopez-Garcia E. Association between the quality of plant-based diets and risk of frailty. J Cachexia Sarcopenia Muscle 2022; 13:2854-2862. [PMID: 36177985 PMCID: PMC9745455 DOI: 10.1002/jcsm.13077] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/11/2022] [Accepted: 08/18/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The Mediterranean diet and other dietary patterns rich in fruits and vegetables have been linked to lower risk of frailty in older adults. However, not all plant-based diets are necessarily healthful, and no previous study has evaluated the role of the quality of plant-based dietary patterns in frailty risk. Our aim was to assess the association between plant-based diet quality and risk of frailty. METHODS Prospective cohort consisted with 82 234 women aged ≥60 years from the Nurses' Health Study, who were followed from 1990 through 2014. The dates of analysis were April 14 to June 23, 2021. Dietary data were collected every 4 years using a validated semi-quantitative food frequency questionnaire. The plant-based diet quality was assessed with two indices (range 18-90 points): (a) healthful plant-based diet index (hPDI), where healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils and tea/coffee) received positive scores, while less healthy plant foods (fruit juices, sweetened beverages, refined grains, potatoes, and sweets/desserts) and animal foods received reverse scores; and (b) unhealthful plant-based diet index (uPDI) where positive scores were given to less healthy plant foods and reverse scores to healthy plant foods and animal foods. Frailty incidence was assessed every 4 years, being defined as having three or more of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses and weight loss ≥5%. Multivariable-adjusted Cox proportional-hazards models were used to estimate hazard ratios (HRs) and their 95% confidence interval (CI). RESULTS We identified 12 910 incident cases of frailty over 1 176 401 person-year follow-up. In the multivariable analysis, the hPDI was inversely associated with the risk of frailty (hazard ratio [HR] for the highest vs. lowest quintile: 0.77, 95% confidence interval: 0.72-0.81; P trend <0.001). In addition, a 10-unit increment in the hPDI was associated with a relative 15% lower risk of frailty. Conversely, a direct association was found between the uPDI and risk of frailty (HR highest vs. lowest quintile: 1.24 [1.17, 1.32], P trend <0.001). These associations were consistent for each frailty criterion, among participants with no frailty criteria at baseline, after excluding participants with diabetes, cancer and cardiovascular disease at baseline, for alternative versions of the plant-based diet indices (PDIs), in subgroup analysis by categories of potential confounders, and in latency analysis. CONCLUSIONS A healthful plant-based diet was associated with lower risk of frailty whereas an unhealthful plant-based diet was associated with higher risk.
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Affiliation(s)
- Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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Zhou YF, Lai JS, Chong MFF, Tong EH, Neelakantan N, Pan A, Koh WP. Association between changes in diet quality from mid-life to late-life and healthy ageing: the Singapore Chinese Health Study. Age Ageing 2022; 51:6782914. [PMID: 36315430 DOI: 10.1093/ageing/afac232] [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: 03/11/2022] [Revised: 07/10/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Few studies have evaluated the association between changes in diet quality from mid-life to late-life and healthy ageing. METHODS We included 12,316 Chinese adults aged 45-74 years at baseline (1993-1998) from the Singapore Chinese Health Study. Diet quality was measured using the Dietary Approaches to Stop Hypertension (DASH) scores at baseline and follow-up 3 interviews (2014-2016). Healthy ageing was assessed at follow-up 3 interviews, and was defined as absence of specific chronic diseases, good mental and overall self-perceived health, good physical functioning and absence of cognitive impairment, limitations in instrumental activities of daily living or function-limiting pain. Multivariable-adjusted logistic regression models were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between changes in DASH scores and healthy ageing. RESULTS Compared with participants who maintained relatively stable DASH scores, a >10% decrease in DASH score was associated with a 16% (95% CI, 4-26%) lower likelihood of healthy ageing, whereas a >10% increase in DASH score was associated with a 19% (95% CI, 3-37%) higher likelihood of healthy ageing. Compared with participants who were in the low-score group consistently, participants who increased their DASH scores from moderate-score at baseline to high-score at follow-up 3 had a 53% (95% CI, 21-92%) higher likelihood of healthy ageing, whereas those who were in the high-score group consistently had 108% (95% CI, 71-152%) higher likelihood of healthy ageing. CONCLUSIONS Improving diet quality from mid- to late-life was associated with a higher likelihood of healthy ageing.
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Affiliation(s)
- Yan-Feng Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun S Lai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Mary Foong-Fong Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Eunice Huiying Tong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Nithya Neelakantan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Systems Health Science of Zhejiang Province, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, China
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
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Voss ML, Currie CL. Sleep Quality and the Importance Women Place on Healthy Eating Interact to Influence Psychological Resilience. Am J Health Behav 2022; 46:285-293. [PMID: 35794754 DOI: 10.5993/ajhb.46.3.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: The impact women's daily habits may have on psychological resilience is not well understood. This cross-sectional analysis examined: (1) the impact of sleep quality on resilience, and (2) whether this association was modified by the importance women place on healthy eating. Methods: We collected data from 64 women (aged 18-67 years). The Pittsburgh Sleep Quality Index and Connor-Davidson Resilience Scale-10 assessed sleep quality and resilience, respectively, with lower scores indicating reduced resilience. One item assessed attitudes towards healthy eating. Linear regression models and 95% confidence intervals examined associations adjusted for age and income. Results: Reduced sleep quality was associated with a decreased resilience score (B=0.55, 95% CI: -1.06, -0.04, p=.04) when adjusted for age and income. After stratification, sleep quality and resilience were not associated among women who indicated healthy eating was very important. Among women who indicated healthy eating was less than very important, reduced sleep quality was associated with decreased psychological resilience (B=0.85, 95% CI: -1.55, -0.15, p=.02). Conclusions: Poor sleep quality was associated with reduced resilience among women. Placing a strong emphasis on healthy eating helped buffer the impact of poor sleep quality on women's psychological resilience.
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Affiliation(s)
- M L Voss
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - C L Currie
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada;,
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Kurnik-Łucka M, Grońska D, Wojnarski M, Pasieka P, Rząsa-Duran E, Gil K. Health-Related Quality of Life in Relation to Fruit and Vegetable Intake among Polish Pharmacists. Healthcare (Basel) 2022; 10:healthcare10050930. [PMID: 35628067 PMCID: PMC9141935 DOI: 10.3390/healthcare10050930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 01/25/2023] Open
Abstract
A direct association between health-related quality of life (HQoL) and nutrition remains unclear, although lifestyle habits are known to impact on human health. Thus, the aim of this study was to estimate an association between dietary habits, such as vegetable and fruit consumption, in particular, and HQoL. SF-36 (RAND-SF-36) and the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN) were addressed to Polish pharmacists with a valid professional license. After the preliminary verification, 667 pharmacists were included into the study, and altogether, 11 questions from the KomPAN questionnaire and all RAND-SF-36 multiple choice questions were processed for statistical analysis. All HQoL scores, excluding physical functioning and role-physical, were significantly higher in the group declaring fruit consumption ≥1 time per day (p < 0.005), while physical functioning (p = 0.008) and general health (p = 0.03) were significantly higher in the group declaring vegetable consumption ≥1 time per day. Thus, there is indeed a positive association between vegetable and fruit consumption and HQoL. Increased fruit intake could certainly impact on the health-related quality of life of Polish pharmacists, primarily in terms of mental functioning, while increased vegetable intake could impact in terms of physical functioning.
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Affiliation(s)
- Magdalena Kurnik-Łucka
- Department of Pathophysiology, Jagiellonian University Medical College, 31-008 Kraków, Poland; (D.G.); (M.W.); (P.P.); (K.G.)
- Correspondence: ; Tel.: +48-126-333-947
| | - Dominika Grońska
- Department of Pathophysiology, Jagiellonian University Medical College, 31-008 Kraków, Poland; (D.G.); (M.W.); (P.P.); (K.G.)
| | - Marcin Wojnarski
- Department of Pathophysiology, Jagiellonian University Medical College, 31-008 Kraków, Poland; (D.G.); (M.W.); (P.P.); (K.G.)
| | - Paweł Pasieka
- Department of Pathophysiology, Jagiellonian University Medical College, 31-008 Kraków, Poland; (D.G.); (M.W.); (P.P.); (K.G.)
| | | | - Krzysztof Gil
- Department of Pathophysiology, Jagiellonian University Medical College, 31-008 Kraków, Poland; (D.G.); (M.W.); (P.P.); (K.G.)
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Saturated Fat and Cardiovascular Health: Phenotype and Dietary Factors Influencing Interindividual Responsiveness. Curr Atheroscler Rep 2022; 24:391-398. [PMID: 35320834 DOI: 10.1007/s11883-022-01014-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Recent inconsistencies in nutrition research studies examining the influence of saturated fat (SFA) on cardiovascular disease (CVD) risk have led to substantial scientific debate and increased public confusion. This review will summarize metabolic characteristics and food-based factors that underlie interindividual responsiveness to SFA consumption. RECENT FINDINGS The magnitude of postprandial blood lipid responses to SFA intake is dependent on a number of individual factors including age, sex, and adiposity status. Further, the metabolic effects of SFA intake are influenced by the specific types of SFAs and the food matrix within which they are contained. Importantly, results from research examining the effects of SFA on CVD risk should be interpreted with consideration of the comparator nutrient (i.e., carbohydrate, monounsaturated fat, polyunsaturated fat). A more nuanced understanding of the multitude of factors mediating the influence of SFA on lipid metabolism and CVD risk might help resolve the current controversy and inform more precise personalized recommendations for future dietary guidelines.
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OUP accepted manuscript. Nutr Rev 2022; 80:2017-2028. [DOI: 10.1093/nutrit/nuac020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
Only a few studies have investigated the association between psychological stress and the healthfulness of plant-based diets while accounting for variances in age groups and regions. In light of this, this study aimed to identify the food groups that contribute the most to the relationship between the healthfulness of plant-based diets and psychological stress in female students in Saudi Arabia. This cross-sectional study, which included 401 female college students aged 19-35 years, collected data on blood, anthropometric indices, the perceived stress scale-10 (PSS-10) and diet using the Saudi food frequency questionnaire. An overall plant-based diet index (PDI), healthy PDI, and an unhealthy PDI (uPDI) were defined. Multiple linear regression analyses were applied to examine the associations between PSS-10 and PDI and hPDI and uPDI. No associations between the PSS-10 score and the overall PDI or uPDI scores were found; however, a six-point higher hPDI score was associated with a 0·16-point lower PSS-10 score (95 % CI, -0·24, -0·08) after controlling for lifestyle factors. Moreover, adjustments for healthy food groups, including vegetables and fruits, attenuated the association between the hPDI and PSS-10. In conclusion, healthy plant-based diets are associated with lower psychological stress in young Saudi women. This finding highlights the importance, especially for female students, of following diets that are not only plant-based but are also healthy and rich in fruits and vegetables.
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