Association of dietary patterns of American adults with bone mineral density and fracture

The Influences of Macronutrients on Bone Mineral Density, Bone Turnover Markers, and Fracture Risk in Elderly People: A Review of Human Studies

Osteoporosis is a health condition that involves weak bone mass and a deteriorated microstructure, which consequently lead to an increased risk of bone fractures with age. In elderly people, a fracture attributable to osteoporosis elevates mortality. The objective of this review was to examine the effects of macronutrients on bone mineral density (BMD), bone turnover markers (BTMs), and bone fracture in elderly people based on human studies. A systematic search was conducted in the PubMed®/MEDLINE® database. We included human studies published up to April 2023 that investigated the association between macronutrient intake and bone health outcomes. A total of 11 meta-analyses and 127 individual human studies were included after screening the records. Carbohydrate consumption seemed to have neutral effects on bone fracture in limited studies, but human studies on carbohydrates' effects on BMD or/and BTMs are needed. The human studies analyzed herein did not clearly show whether the intake of animal, vegetable, soy, or milk basic proteins has beneficial effects on bone health due to inconsistent results. Moreover, several individual human studies indicated an association between eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and osteocalcin. Further studies are required to draw a clear association between macronutrients and bone health in elderly people.

Trends in Dietary Carbohydrates, Protein, and Fat Intake and Diet Quality Among Chinese Adults, 1991-2015: Results from the China Health and Nutrition Survey

OBJECTIVE

Dietary transitions in China have undergone rapid changes in over the last three decades. The purpose of this study to describe trends in the macronutrient consumption, the sources of those nutrients, and the diet quality among Chinese adults.

DESIGN

Longitudinal China Health and Nutrition Survey (CHNS) cohort analysis. Main outcomes are dietary energy intake from total carbohydrate, protein and fat and their subtypes, as well as food sources of carbohydrates, protein, and fat, and the China Dietary Guidelines Index 2018 (CDGI-2018).

SETTING

CHNS (1991, 2000, 2009, 2015).

PARTICIPANTS

Data from the longitudinal 1991, 2000, 2009, and 2015 China Health and Nutrition Survey (CHNS) of adults aged 18 years or older, who had complete demographic information.

RESULTS

The estimated mean energy intake from total carbohydrate decreased from 62.6% to 50.6% between 1991 and 2015, while the mean energy intake from total protein increased from 12.6% to just 13.1% and the mean energy intake from total fat significantly increased from 24.0% to 35.8% (P < 0.001 for trend). Decreases were observed in evaluated mean energy from low-quality carbohydrates (from 53.6% to 41.7%) and incomplete protein (from 9.3% to 7.5%), while increases were seen in estimated mean energy from high-quality protein (from 3.3% to 5.5%), high-quality fat (from 9.1% to 16.7 %), and low-quality fat (from 14.9% to 19.0%). Low-quality carbohydrates, primarily those derived from refined grains, decreased from 52.2% to 36.2%. The diet quality as measured by CDGI-2018 improved, with the estimated mean increasing from 41.7 to 52.4 (P < 0.01 for trend).

CONCLUSION

For Chinese adults, there was a significant change in the macronutrient composition over the previous few decades. The percentage of energy consumed from carbohydrates significantly decreased, however the percentage of energy consumed from total fat significantly increased. Additionally, the diet quality remains suboptimal.

Association between Healthy Eating Index-2015 total and component food scores with osteoporosis in middle-aged and older Americans: a cross-sectional study with U.S. National Health and Nutrition Examination Survey

We used NHANES data to explore the association between dietary quality estimated by the HEI-2015 and osteoporosis in middle-aged and elderly US adults. We found that higher dietary quality is significantly associated with a reduced risk of osteoporosis among middle-aged and elderly Americans.

INTRODUCTION

Through this research, we assess whether increasing the overall dietary quality reduces the risk of osteoporosis.

METHODS

For our analyses, we combined data collected from four NHANES 2-year cycles (2007-2008, 2009-2010, 2013-2014, and 2017-2018), including 10,033 participants. Associations between osteoporosis and HEI-2015 total/component scores among middle-aged and elderly adults were examined using logistic regression models. Osteoporosis was defined as femur neck BMD values equal to or less than 2.5 standard deviations (SDs) below the mean of the young adult reference group, and dietary intake data were obtained from two NHANES 24-h recall interviews.

RESULTS

After multivariable adjustment, middle-aged and elderly populations with quintile 4 (OR: 0.54, 95% CI 0.34, 0.84; P = 0.007) and quintile 5 HEI-2015 total scores (OR: 0.43, 95% CI 0.26, 0.70; P = 0.001) were associated with reduced odds of osteoporosis compared with quintile 1. Higher intake of total vegetables, greens and beans, total fruits, whole fruits, and whole grains was associated with decreased odds of osteoporosis among elderly adults. Surprisingly, saturated fat intake can also protect against osteoporosis.

CONCLUSION

Higher dietary quality estimated from HEI-2015 total and component food scores was significantly associated with a reduced risk of osteoporosis among the middle-aged and elderly Americans participating in NHANES included in this study.

Association between bone mineral content and dietary patterns among Brazilian adults from Viçosa, Minas Gerais: a population-based study

ABSTRACT Objective The aim of the study was to investigate if there is an association between dietary patterns and bone mineral content among Brazilian adults. Methods This is a cross-sectional, population-based study. Bone health was assessed using dual-energy x-ray absorptiometry. The dietary pattern was obtained using a food frequency questionnaire. An exploratory factor analysis obtained the dietary patterns. Linear regression was used for the multivariate analysis. The research was conducted with adult individuals (20-59 years old) of both sexes residing in the city of Viçosa, MG, Brazil (n=572). Results Two distinct dietary patterns were identified: a “meats and alcoholic drinks” pattern, composed of condiments, alcoholic drinks, dough-based foods, and savory snacks; and a “local traditional” pattern, composed of eggs, beans, trooper’s beans, margarine, butter, olive oil, coffee and tea, cereals, and tubers (factor loadings ≥0.20). Having verified the associations considering the confounding factors, we identified that the bone mineral content for males was positively associated with the “local traditional” dietary pattern (β=0.058; 95% CI: 0.003–0.112; p=0.036), and for females an inverse association with the “meats and alcoholic drinks” pattern was found (β=-0.057; 95% CI: -0.110 -0.003; p=0.037). Conclusion We identified a positive association between the local traditional dietary pattern and bone health.

The Association Between Dietary Inflammatory Potential and Sex Hormones in Male Children and Adolescents Aged 6-19 Years

Aims

This study aimed to assess the relationship between dietary inflammatory index (DII) and sex hormones in male children and adolescents aged 6-19 years.

Methods

We obtained data from the 2013-2016 National Health and Nutrition Examination Survey (NHANES). Male participants aged 6-19 years old with the complete data of DII and sex hormones were included. Weighted multiple regression analysis and subgroup analysis were preformed to estimate the independent relationship between DII and sex hormones.

Results

A total of 1717 male participants with the average age of 13.02 ± 3.82 years were enrolled, of whom 41.3% (n=713) were children and 58.47% (n=1004) were adolescents. In children, mean DII was 0.18 ± 1.67, with scores ranging from -4.53 to 4.08. As for adolescents, the mean DII was 0.36 ± 1.98, mean total testosterone (TT) was 376.94 ± 206.69 ng/dl overall. A negative association between DII with TT and estradiol (E2) was observed (TT: β=-11.97, P=0.0006; E2: β=-0.45, P=0.0108) in male adolescent. Subgroup analysis and interaction test results indicated that this association was similar in male adolescents with different body mass index. No statistically significant association was observed in children.

Conclusions

Pro-inflammatory diet was associated with lower TT and E2 level in male adolescent, while no association with statistical significance between them was observed in male children. However, more studies are still needed to validate the causal relationship between DII and sex hormones.

The Association Between Dietary Inflammatory Index and Parathyroid Hormone in Adults With/Without Chronic Kidney Disease

Aims: We aimed to assess the association between dietary inflammation index (DII) with parathyroid hormone (PTH) and hyperparathyroidism (HP) in adults with/without chronic kidney disease (CKD).

Methods: Data were obtained from the 2003–2006 National Health and Nutrition Examination Survey (NHANES). The participants who were <18 years old, pregnant, or missing the data of DII, PTH, and CKD were excluded. DII was calculated based on a 24-h dietary recall interview for each participant. Weighted multivariable regression analysis and subgroup analysis were conducted to estimate the independent relationship between DII with PTH and the HP in the population with CKD/non-CKD.

Results: A total of 7,679 participants were included with the median DII of −0.24 (−2.20 to 1.80) and a mean PTH level of 43.42 ± 23.21 pg/ml. The average PTH was 45.53 ± 26.63 pg/ml for the participants in the highest tertile group compared with 41.42 ± 19.74 pg/ml in the lowest tertile group (P < 0.0001). The rate of HP was 11.15% overall, while the rate in the highest DII tertile was 13.28 and 8.60% in the lowest DII tertile (P < 0.0001). The participants with CKD tended to have higher PTH levels compared with their counterparts (61.23 ± 45.62 vs. 41.80 ± 19.16 pg/ml, P < 0.0001). A positive association between DII scores and PTH was observed (β = 0.46, 95% CI: 0.25, 0.66, P ≤ 0.0001), and higher DII was associated with an increased risk of HP (OR = 1.05, 95% CI: 1.02, 1.08, P = 0.0023). The results from subgroup analysis indicated that this association was similar in the participants with different renal function, gender, age, BMI, hypertension, and diabetes statuses and could also be appropriate for the population with CKD.

Conclusions: Higher consumption of a pro-inflammatory diet appeared to cause a higher PTH level and an increased risk of HP. Anti-inflammatory dietary management may be beneficial to reduce the risk of HP both in the population with and without CKD.

Is a Healthy Diet Also Suitable for the Prevention of Fragility Fractures?

Osteoporosis and sarcopenia contribute to the risk of fracture in the population. These conditions share common features, and it is known that a healthy diet may have beneficial effects on both, theoretically resulting in fewer fractures. The present narrative review gives an overview of recent epidemiological research related to the association between healthy diets/dietary patterns, bone health and fragility fractures. The review also gives a brief overview on general dietary recommendations and advice as the cornerstone of public health nutrition. Although muscle health and sarcopenia contribute to the risk of fractures, these endpoints were not the focus of this review. Healthy diets are nutrient dense and contain bioactive components that are needed for the constant remodeling of the skeleton and to slow the rate of bone loss and muscle wasting, thus contributing to the prevention of fragility fractures. Compliance with healthy dietary patterns were predominantly found to be inversely associated with bone outcomes, although this was not entirely consistent across all studies. Different a priori diet scores, such as the Mediterranean diet score and the Dietary Inflammatory Index, as well as a posteriori data driven dietary patterns, such as the prudent or healthy dietary pattern, were inversely associated with fragility fractures in different populations. In conclusion, different healthy dietary patterns may contribute to bone health and less fractures. Following current dietary guidelines is thus advisable for the prevention of fragility fractures.

Nutrients in the Prevention of Osteoporosis in Patients with Inflammatory Bowel Diseases

The chronic character of inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, results in various complications. One of them is osteoporosis, manifested by low bone mineral density, which leads to an increased risk of fractures. The aetiology of low bone mineral density is multifactorial and includes both diet and nutritional status. Calcium and vitamin D are the most often discussed nutrients with regard to bone mineral density. Moreover, vitamins A, K, C, B12; folic acid; calcium; phosphorus; magnesium; sodium; zinc; copper; and selenium are also involved in the formation of bone mass. Patients suffering from inflammatory bowel diseases frequently consume inadequate amounts of the aforementioned minerals and vitamins or their absorption is disturbed, resulting innutritional deficiency and an increased risk of osteoporosis. Thus, nutritional guidelines for inflammatory bowel disease patients should comprise information concerning the prevention of osteoporosis.

Diet-Related Factors, Physical Activity, and Weight Status in Polish Adults

Obesity is a serious problem for both the individual and society due to its health and economic consequences. Therefore, there is a need to focus on factors which explain this phenomenon and may be useful in preventing future occurrence. The aim of this study was to determine the lifestyle factors coexisting with increased body mass index (BMI ≥ 25 kg/m²) in Polish adults, including factors related to diet (dietary patterns-DPs; dietary restrictions; number of meals; frequency of snacking, eating out, and ordering home delivery meals), physical activity, and sociodemographic characteristics. A cross-sectional quantitative survey was carried out in 2016 amongst 972 Polish adults under the Life Style Study (LSS). To determine the factorscoexisting with BMI ≥ 25 kg/m², the logistic regression model was developed. Women were less likely to be overweight or obese compared to men. The likelihood of BMI ≥ 25 kg/m² increased with age by 4% in each subsequent year of life. Frequent consumption of fruits and vegetables, adhering to restrictions in quantity of food consumed and at least moderate physical activity during leisure time decreased the likelihood of BMI ≥ 25 kg/m². More frequent consumption of meat and eating five or more meals a day increased the likelihood of BMI ≥ 25 kg/m². Diet-related factors explained the developed model better than factors related to physical activity, however, age and gender were the factors most strongly correlated with BMI ≥ 25 kg/m². Therefore, development of strategies to prevent and reduce overweight and obesity should focus on the demographic characteristics of the population, and then on teaching behaviors conducive for reducing the amount of food consumed, especially meat. However, physical activity in leisure time should also be included in the prevention of obesity.

Greater Dietary Inflammatory Index score is associated with higher likelihood of chronic kidney disease

Chronic kidney disease (CKD) is described as a progressive alteration of kidney function, resulting from multiple factors, including behaviours. We investigated the association of the Dietary Inflammatory Index (DII®) with prevalent CKD in adult Americans. National Health and Nutrition Examination Survey participants with measured data on kidney function markers from 2005 to 2012 were included in this study. Prevalent CKD was based on an estimated glomerular filtration rate (eGFR) <60 ml/min per 1·73 m2 or urinary albumin/creatinine≥30 mg/g. Energy-adjusted DII (E-DIITM) scores were calculated from 24-h dietary recalls. Statistical analyses accounted for the survey design and sample weights. We included 21 649 participants, with 1634 (6·8 %) having prevalent CKD. Participants with high E-DII scores had greater BMI, fasting blood glucose and systolic blood pressure, and were more likely to be diabetic or hypertensive (all P<0·001) compared with those with lower E-DII scores. In regression models adjusted for age, sex, race, fasting blood glucose, blood pressure, BMI, hypertension and diabetes status, mean eGFR significantly decreased across increasing quartiles of E-DII, whereas serum uric acid level and log urinary albumin:creatinine ratio significantly increased (all P<0·001). Prevalent CKD increased from 5·3 % in the lowest to 9·3 % in the highest E-DII quartile (P=0·02). In multivariable-adjusted logistic regression models, the odds of prevalent CKD were 29 % higher in the highest compared with the lowest E-DII quartile. Pro-inflammatory diet is associated with declining kidney function and high prevalence of CKD. Dietary changes that reduce inflammation have a potential to prevent CKD.

Is There a Difference in Serum Vitamin D Levels and Bone Mineral Density According to Body Mass Index in Young Adult Women?

Background

In the life cycle, bone mineral density (BMD) is the most optimal condition in the 20s. In Korea, vitamin D deficiency status is very serious in Korean women due to recent lack of activity, weight polarization, and inadequate nutritional intake. The purpose of this study was to compare serum vitamin D and BMD according to obesity status in Korean young adult women.

Methods

A total of 143 female college students participated in the research. Body fat and lean body status were analyzed using a body composition analyzer. Nutrient intakes of the subjects were assessed by 3-days food record method. The BMDs was measured by dual energy X-ray absorptiometry. The subjects were divided into normal weight group and obesity group on their body mass index.

Results

Obesity group showed significantly higher weight, body fat (%), and body fat (kg) than normal weight group and T-scores of lumbar-2 spines were significantly lower. Obesity group showed high triglyceride and low-density lipoprotein cholesterol levels and vitamin D levels were significantly lower. Physical fitness and activity status showed that sit and reach and sit up were significantly lower in obesity group. The intake of carbohydrates was higher in the obesity group than in the normal weight group, and the intake of vitamin C and vitamin D was significantly lower. Factors affecting serum vitamin D were analyzed as body fat (%), lumbar-2 T-score, triglyceride, and carbohydrate intake.

Conclusions

Obese women need more effort to manage their serum vitamin D status and balanced nutrition to prevent bone loss.

High-fat and high-glucose microenvironment decreases Runx2 and TAZ expression and inhibits bone regeneration in the mouse

BACKGROUND

Type 2 diabetes mellitus (T2DM) and hyperlipidemia are negatively related to bone regeneration. The aim of this study was to evaluate the effect of high-fat and high-glucose microenvironment on bone regeneration and to detect the expression of runt-related transcription factor 2 (Runx2) and transcriptional co-activator with PDZ-binding domain (TAZ) during this process.

METHODS

After establishing a high-fat and high-glucose mouse model, a 1 mm × 1.5 mm bone defect was developed in the mandible. On days 7, 14, and 28 after operation, bone regeneration was evaluated by hematoxylin-eosin staining, Masson staining, TRAP staining, and immunohistochemistry, while Runx2 and TAZ expression were detected by immunohistochemistry, RT-PCR, and Western blot analysis.

RESULTS

Our results showed that the inhibition of bone regeneration in high-fat and high-glucose group was the highest among the four groups. In addition, the expression of Runx2 in high-fat, high-glucose, and high-fat and high-glucose groups was weaker than that in the control group, but the expression of TAZ only showed a decreasing trend in the high-fat and high-glucose group during bone regeneration.

CONCLUSIONS

In conclusion, these results suggest that high-fat and high-glucose microenvironment inhibits bone regeneration, which may be related to the inhibition of Runx2 and TAZ expression.

Can Dietary Intake of Vitamin C-Oriented Foods Reduce the Risk of Osteoporosis, Fracture, and BMD Loss? Systematic Review With Meta-Analyses of Recent Studies

Background: Several epidemiological studies have been performed to evaluate the association of dietary intake of vitamin C-oriented foods (DIVCF) with risk of fracture and bone mineral density (BMD) loss, but the results remain controversial. Therefore, we conducted a systematic meta-analysis to assess this correlation. Methods: We searched EmBase, PubMed, Web of Science, and the Chinese database CNKI for relevant articles published up to August 2019. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated using the random- or fixed-effects model. Discrepancies were resolved by consultation with a third expert. Results: A total of 13 eligible articles (including 17 studies) with 19,484 subjects were identified for the present meta-analysis. The pooled RR of hip fracture for the highest vs. lowest category was 0.66 (95% CI, 0.47-0.94) for DIVCF, i.e., people with a greater frequency of Vitamin C uptake had a 34% (95% CI, 6%-53%) lower prevalence of hip fracture. In subgroup analyses stratified by study design, gender, and age, the negative associations were statistically significant. Furthermore, the statistical analysis of the association between DIVCF and risk of osteoporosis (RR, 0.66; 95% CI, 0.48-0.92), BMD at the lumbar spine (pooled r, 0.15; 95% CI, 0.09-0.23), and BMD at the femoral neck (pooled r, 0.20; 95% CI, 0.11-0.34) showed beneficial effects of DIVCF. Conclusion: Our meta-analysis indicates that DIVCF is negatively associated with the risk of hip fracture, osteoporosis, and BMD loss, suggesting that DIVCF decreases the risk of hip fracture, osteoporosis, and BMD loss.

The Associations between Dietary Patterns and Short Sleep Duration in Polish Adults (LifeStyle Study)

Short sleep duration appears to put adults at risk of excessive energy intake and obesity; less is known specifically about how sleep quantity relates to dietary patterns. Therefore, the aim of this study was to assess the associations of dietary patterns (DPs) with short sleep duration. The data were collected in November 2016 through a cross-sectional quantitative survey among 972 Polish adults with both normal weight and excessive weight. Principal components analysis (PCA) was conducted to derive DPs. Logistic regression analysis was used to verify associations between short sleep duration (independent variable) and DPs (dependent variables). Five DPs ('Fast foods & sweets'-FF&S; 'Meat & meat products'-M&MP; 'Fruit & vegetable'-F&V; 'Wholemeal food'-WF; and 'Fruit & vegetable juices'-F&VJ) were identified. Adults whose diet was based both on fruit and vegetables (OR 0.62, 95% CI: 0.44⁻0.88; p < 0.01) and on fast food and sweets (OR 0.63, 95% CI: 0.44⁻0.99; p < 0.01) were less likely to be short sleepers on weekdays. On weekdays short sleep duration was associated with smaller odds of FF&S both for men (OR 0.58, 95% CI: 0.33⁻0.97; p < 0.05) and for women (OR 0.61, 95% CI: 0.38⁻0.98; p < 0.05), and with smaller odds of F&V (OR 0.34, 95% CI: 0.20⁻0.58; p < 0.001) for men. Short sleep duration on weekend days was associated with a smaller odds of F&VJ (OR 0.56, 95% CI: 0.30⁻0.96; p < 0.05- only in crude model) and higher odds of F&V (OR 1.70, 95% CI: 1.02⁻3.11; p < 0.05) for women, and with a smaller odds of FF&S (OR 0.37, 95% CI: 0.17⁻0.79; p < 0.05) for men. The number of significant associations between dietary patterns and sleep duration was higher among people with normal weight and overweight compared to those with BMI ≥ 30. We found that both short sleep duration on weekdays and weekend days was associated with some dietary patterns including both healthy and unhealthy DPs. Gender significantly differed these relationships in groups with normal and excessive weight. Findings of the study confirmed the potential effectiveness of combined use of sleep duration and dietary patterns in the development of recommendations for prevention of obesity. Future studies are called for to evaluate these links using dietary patterns identified according to food intake.

Adiposity mediates the association between whole grain consumption, glucose homeostasis and insulin resistance: findings from the US NHANES

Background

Growing evidence suggests an inverse association between whole grain (WG) consumption and insulin resistance (IR) or inflammation. However, it is still unclear whether adiposity plays a role in this relationship.

We investigated whether the associations between WG intake with IR, glucose homeostasis and inflammation are mediated by adiposity in US adults.

Methods

The 2005–2010 National Health and Nutrition Examination Surveys participants were included. WG intake was assessed and markers of IR and glucose homeostasis, inflammation, general and central adiposity. Analysis of co-variance and mediation analysis were applied, while accounting for survey design.

Results

Overall 16,621 participants were included in this analysis (mean age = 47.1 years, 48.3% men). After adjustment for age, gender, and race, mean C-reactive protein (CRP), apolipoprotein B (apo-B), fasting blood glucose (FBG), insulin, homeostatic model assessment of IR (HOMA-IR) and β cell function (HOMA-β), hemoglobin A_1c (HbA_1c), and 2 h glucose after an oral glucose tolerance test decreased with increasing quarters of WG (all p < 0.001). Body mass index (BMI) had significant mediation effects on the associations between WG intake and CRP, apo-B, fasting glucose, insulin, HOMA-IR, HOMA-B, HbA_1c, triglyceride to high density lipoprotein-cholesterol (TG:HDL-C) ratio and triglyceride-glucose (TyG) index (all p < 0.05) after adjustment for age, gender, race/ethnicity, educational status, smoking and level of physical activity. Both waist circumference (WC) and anthropometrically predicted visceral adipose tissue (apVAT) mediated the association between WG intakes with CRP, FBG, HbA_1c, TG:HDL-C ratio and TyG index, i.e. WC and apVAT had indirect effect (all p < 0.05).

Conclusion

Our findings provide insights into the favourable impact of WG consumption on IR and inflammation, which may be affected by both central and visceral adiposity, i.e. the link between WG with IR and inflammation is more mediated in overweight/obese compared with lean individuals.

Serum lipophilic antioxidants levels are associated with leucocyte telomere length among US adults

BACKGROUND

To examine the association between serum concentrations of antioxidant and telomere length (TL) in U.S adults.

METHODS

Participants of the National Health and Nutrition Examination Survey (NHANES) with data available on TL measures from 2001 to 2002 were included. Serum lipophilic antioxidants level was measured using high performance liquid chromatography with photodiode array detection. We used analysis of co-variance and multivariable-adjusted linear regression models, accounting for the survey design and sample weights.

RESULTS

Of the 5992 eligible participants, 47.5% (n = 2844) were men. The mean age was 46.9 years overall, 47.2 years in men and 46.6 in women (p = 0.071). In age, sex, race, education, marital status, adiposity, smoking, C-reactive protein adjusted linear regressions, antioxidant, serum α-carotene, trans-β-carotene, cis- β-carotene, β-cryptoxanthin and combined Lutein/zeaxanthin were positively and significantly associated with TL (all p < 0.001).

CONCLUSIONS

Our findings support a possible positive association between serum concentrations of lipophylic antioxidant and TL. The implications of this association deserve further investigation.

Food Patterns are Associated with Likelihood of CKD in US Adults

We investigated the association between dietary patterns and prevalent chronic kidney diseases (CKD), in participants of the 2005–2012 US National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2012, who had measured data on dietary intake and kidney function. Analyse of covariance (ANCOVA) and logistic regression models were employed to account for the survey design and sample weights. A total of 21,649 eligible participants (634 with and 20,015 without prevalent CKD) were included in the final analysis. Three food patterns together explained 50.8% of the variance of the dietary nutrients consumption. The first food pattern was representative of a diet containing high levels of saturated and mono-unsaturated fatty acids; the second food pattern comprised vitamins and trace elements; and the third food pattern was mainly representative of polyunsaturated fatty acids. The odd of prevalent CKD decreased across increasing quarters of vitamins and trace elements, so that the top quarter was associated with a 53% (95%CI: 42–62%) lower odds of CKD in age, sex and race adjusted logistic regression models. These results suggest that vitamins and trace elements intake are associated with lower risk of prevalent CKD.