The associations between whole grain and refined grain intakes and serum C-reactive protein

Plant-based diets and all-cause and cause-specific mortality among patients with cardiovascular disease: a population-based cohort study

The role of plant-based diets in preventing premature death among patients with cardiovascular disease (CVD) has remained unknown. We aim to explore the association of plant-based dietary patterns with all-cause and cause-specific mortality among patients with CVD. A total of 10 824 participants with CVD at the baseline were followed up in the UK Biobank. We constructed three types of plant-based diet indexes [an overall plant-based diet index (PDI), a healthful PDI (hPDI), and an unhealthful PDI (uPDI)] by assigning different weights to various food groups from web-based 24 h dietary recall questionnaires. The national death registry documented the primary causes of death. The Cox proportional hazards regression models were utilized to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. Over a median of 9.5 years follow-up, 1273 death cases were ascertained. After multivariable adjustment, PDI had an inverse correlation with all-cause mortality [HRT3 vs. T1: 0.81 (0.70-0.94), Ptrend = 0.005] and marginal inverse association with CVD mortality [HRT3 vs. T1: 0.78 (0.61-0.99), Ptrend = 0.038], while uPDI displayed a positive correlation with all-cause mortality [HRT3 vs. T1: 1.33 (1.16-1.53), Ptrend < 0.001], CVD, and cancer mortality. Additionally, in mediation analyses, serum concentration of C-reactive protein (CRP) accounted for 6.2%, 4.0%, and 5.1% of the relationship between uPDI and all-cause, CVD, and cancer mortality, respectively. No significant associations were detected between hPDI and mortality. Our findings support dietary guidelines that recommend limiting the consumption of unhealthy plant-based foods.

Postprandial Effects of Four Test Meals Containing Wholegrain Rye or Refined Wheat Foods on Circulating Incretins, Ghrelin, Glucose, and Inflammatory Markers

BACKGROUND

High intake of whole grains has consistently been associated with reduced risk of obesity, coronary artery disease, and type 2 diabetes. Dietary interventions have shown beneficial metabolic effects of whole grains, but the metabolic response varies with different types of cereals.

OBJECTIVES

We evaluate the metabolic effects of substituting refined wheat with wholegrain rye foods within a complex diet, examining the day-long postprandial response of glucose-dependent insulinotropic peptide (GIP), glucagon-like peptide-1 (GLP-1), ghrelin, glucose, and inflammatory biomarkers in individuals with overweight and obesity.

METHODS

Twenty-nine healthy adults with body mass index of 32 ± 9 kg/m2 were randomly assigned to 3 intervention days, separated by 1-wk washout. Participants adhered to a hypocaloric diet rich in wholegrain rye for 1 intervention and refined wheat for the second intervention and were randomly assigned to either diet for the third intervention with continuous blood sampling.

RESULTS

No differences in GIP, GLP-1, or ghrelin levels were found between the diets when measured throughout the whole intervention day. GIP total area under the curve after the rye-based lunch was 31% (P < 0.05) lower compared with the wheat-based lunch, and ghrelin concentrations were 29% (P < 0.05) lower after the rye-based dinner. Baseline Homeostatic Model Assessment for Insulin Resistance-adjusted model showed 61% (P = 0.015) lower whole-day GLP-1 and 40% (P = 0.03) lower GIP after the rye-based diet. Day-long glucose incremental area under the curve was 30% (P < 0.001) lower after the rye-based diet, and glycemic variability was measured as SD reduced (-0.13 mmol/L, P = 0.04). The rye-based diet compared with refined wheat induced higher glycoprotein N-acetylation A, as measured by z-scores (0.36, P = 0.014).

CONCLUSIONS

Overall, no day-long differences in gut hormone levels were observed, but the wholegrain rye-based compared with refined wheat-based dinner showed lower postprandial ghrelin concentrations. The rye-based diet improved day-long glycemic control in individuals with overweight and obesity. Observations of diet-induced inflammation after whole-grain rye intake warrant further investigation.

TRIAL REGISTRATION NUMBER

This study was registered at Clinical Trials Registry of clinicaltrials.gov (NCT05004584): https://clinicaltrials.gov/study/NCT05004584?locStr=Gothenburg,%20Sweden&country=Sweden&state=V%C3%A4stra%20G%C3%B6taland%20County&city=Gothenburg&distance=50&term=appetite&aggFilters=status:com&rank=1.

Leisure activity engagement attenuates the risks of cognitive impairment induced by unhealthy plant-based diets: a nationwide cohort study

OBJECTIVE

We intended to reveal the joint effects between LAE and uPDI on cognition in Chinese older adults.

METHODS

Data were collected from the Chinese Longitudinal Healthy Longevity Survey. In total, 10,617 individuals aged 65 years and above without cognitive impairment or dementia at baseline were enrolled in 2008 and followed up in 2011, 2014, and 2018. The uPDI and the scores of LAE were derived from survey responses, and both were categorized into three groups (low, intermediate, and high). Individuals with a Mini-Mental State Examination (MMSE) score lower than 18 were considered to have cognitive impairment. Cox proportional hazards models were employed to explore the joint association of uPDI and LAE on cognitive impairment, followed by restricted cubic spline (RCS) to observe the effects of the continuous-type variable of uPDI and the scores of LAE on the risk of cognitive impairment. Stratified analysis was applied to examine the association of LAE with cognitive impairment in uPDI groups (high uPDI vs. low uPDI).

RESULTS

Compared to participants maintained low scores of LAE and high uPDI, those who maintained high scores of LAE and low uPDI had a decreased risk of cognitive impairment (HR = 0.52, 95% CI, 0.43-0.62). The findings of the stratified analysis demonstrated that the protective effects of high scores of LAE on cognition was pronounced in individuals with low uPDI (HR = 0.61, 95% CI: 0.47-0.79) and those with high uPDI (HR = 0.63, 95% CI: 0.51-0.78).

CONCLUSIONS

In this cohort study, a higher score of uPDI, which indicated higher intake of salt-preserved vegetables, sugars, and refined grains, was associated with an increased risk of cognitive impairment, whereas this association may be mitigated by regular engagement in leisure activities.

Association of the Korean-specific food-based index of dietary inflammatory potential with the risk of mild cognitive impairment in Korean older adults

OBJECTIVES

This study aimed to examine the association between the food-based index of dietary inflammatory potential (FBDI) and the risk of mild cognitive impairment (MCI) in Korean older adults.

METHODS

The subjects were 798 Korean adults aged 60 years and older. The FBDI was calculated based on the intake of 7 anti-inflammatory and 3 inflammatory food groups. Cognitive function was assessed using the Korean version of the Mini-Mental State Examination. A general linear model and multiple logistic regression were applied to assess the association between FBDI and the risk of MCI.

RESULTS

As the FBDI increased, the intake of white rice, cookies/candies, and sweetened drinks tended to increase, but the intake of niacin, β-carotene, calcium, and potassium tended to decrease (p for trend<0.05). The highest FBDI group had a higher MCI risk (odds ratio [OR], 1.60; 95% confidence interval [CI], 1.01 to 2.52) than the lowest FBDI group, adjusted for gender, age, and education level; and this trend was significant in a fully adjusted model (p for trend=0.039). No significant associations were found in men after adjusting for confounding factors. Among women, MCI risk increased as the FBDI increased (p for trend=0.007); and the highest FBDI group had a higher MCI risk (OR, 2.22; 95% CI, 1.04 to 4.74) than the lowest FBDI group in a fully adjusted model.

CONCLUSIONS

These results suggest that the appropriate intake of anti-inflammatory foods and nutrients may be associated with a reduced risk of MCI among older adults.

Obesity-associated inflammation countered by a Mediterranean diet: the role of gut-derived metabolites

The prevalence of obesity has increased dramatically worldwide and has become a critical public health priority. Obesity is associated with many co-morbid conditions, including hypertension, diabetes, and cardiovascular disease. Although the physiology of obesity is complex, a healthy diet and sufficient exercise are two elements known to be critical to combating this condition. Years of research on the Mediterranean diet, which is high in fresh fruits and vegetables, nuts, fish, and olive oil, have demonstrated a reduction in numerous non-communicable chronic diseases associated with this diet. There is strong evidence to support an anti-inflammatory effect of the diet, and inflammation is a key driver of obesity. Changes in diet alter the gut microbiota which are intricately intertwined with human physiology, as gut microbiota-derived metabolites play a key role in biological pathways throughout the body. This review will summarize recent published studies that examine the potential role of gut metabolites, including short-chain fatty acids, bile acids, trimethylamine-N-oxide, and lipopolysaccharide, in modulating inflammation after consumption of a Mediterranean-like diet. These metabolites modulate pathways of inflammation through the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, toll-like receptor 4 signaling, and macrophage driven effects in adipocytes, among other mechanisms.

Composition of Whole Grain Dietary Fiber and Phenolics and Their Impact on Markers of Inflammation

Inflammation is an important biological response to any tissue injury. The immune system responds to any stimulus, such as irritation, damage, or infection, by releasing pro-inflammatory cytokines. The overproduction of pro-inflammatory cytokines can lead to several diseases, e.g., cardiovascular diseases, joint disorders, cancer, and allergies. Emerging science suggests that whole grains may lower the markers of inflammation. Whole grains are a significant source of dietary fiber and phenolic acids, which have an inverse association with the risk of inflammation. Both cereals and pseudo-cereals are rich in dietary fiber, e.g., arabinoxylan and β-glucan, and phenolic acids, e.g., hydroxycinnamic acids and hydroxybenzoic acids, which are predominantly present in the bran layer. However, the biological mechanisms underlying the widely reported association between whole grain consumption and a lower risk of disease are not fully understood. The modulatory effects of whole grains on inflammation are likely to be influenced by several mechanisms including the effect of dietary fiber and phenolic acids. While some of these effects are direct, others involve the gut microbiota, which transforms important bioactive substances into more beneficial metabolites that modulate the inflammatory signaling pathways. Therefore, the purpose of this review is twofold: first, it discusses whole grain dietary fiber and phenolic acids and highlights their potential; second, it examines the health benefits of these components and their impacts on subclinical inflammation markers, including the role of the gut microbiota. Overall, while there is promising evidence for the anti-inflammatory properties of whole grains, further research is needed to understand their effects fully.

Associations between healthy food groups and platelet-activating factor, lipoprotein-associated phospholipase A2 and C-reactive protein: a cross-sectional study

PURPOSE

To investigate the association between pro-inflammatory markers platelet-activating factor (PAF), lipoprotein-associated phospholipase A2 (Lp-PLA2), hsCRP, and intake of core food groups including fruit, cruciferous and other vegetables, grains, meat and poultry, fish and seafood, nuts and legumes, and dairy.

METHODS

A cross-sectional study was conducted. 100 adults (49 ± 13 years, 31% male) with variable cardiovascular disease risk were recruited. Data were collected in 2021 and 2022. Fasting PAF, Lp-PLA2 activity, hsCRP and usual dietary intake (via a validated food frequency questionnaire) were measured. Intake of foods were converted into serves and classified into food groups. Correlations and multiple regressions were performed with adjustment for confounders.

RESULTS

A one-serve increase in cruciferous vegetables per day was associated with 20-24% lower PAF levels. An increase of one serve per day of nuts and legumes was associated with 40% lower hsCRP levels. There were small correlations with PAF and Lp-PLA2 and cheese, however, these were not significant at the Bonferroni-adjusted P < 0.005 level.

CONCLUSION

The lack of associations between PAF and Lp-PLA2 and other healthy foods may be due to confounding by COVID-19 infection and vaccination programs which prevents any firm conclusion on the relationship between PAF, Lp-PLA2 and food groups. Future research should aim to examine the relationship with these novel markers and healthy food groups in a non-pandemic setting.

Whole grain intake, diet quality and risk factors of chronic diseases: results from a population-based study in Finnish adults

OBJECTIVES

Better diet quality of whole grain consumers could contribute to the associations between whole grain intake and chronic disease risk factors. We examined whole grain intake in relation to diet quality and chronic disease risk factors (anthropometrics, blood pressure, cholesterol, triglycerides, C-reactive protein and glucose) and the role of diet quality in whole grains' associations with each risk factor.

METHODS

Our data included 5094 Finnish adults who completed a validated food frequency questionnaire and participated in a health examination within the National FinHealth 2017 Study. We assessed diet quality by the modified Baltic Sea Diet Score. P trends were calculated across whole grain intake quintiles by linear regression analysis. Interactions were assessed by including an interaction term in the analyses.

RESULTS

Higher whole grain intake was associated with slightly better diet quality compared with lower intakes in both sexes (P < 0.001). Whole grain intake was inversely associated with body mass index (P < 0.001), waist circumference (P < 0.001) and total cholesterol (P = 0.02) in men. Adjusting for medication use attenuated the inverse associations with diastolic blood pressure (P = 0.06) and HDL cholesterol (P = 0.14) in men. We observed no associations in women. Diet quality did not modify the associations between whole grain intake and chronic disease risk factors.

CONCLUSIONS

Our results suggest that whole grain intake was associated with small improvements in the chronic disease risk factors in men, regardless of diet quality. The sex differences may arise from varying health associations of whole grains from different cereal sources.

Empirical Dietary Inflammatory Pattern is positively associated with polycystic ovary syndrome: A case control study

Polycystic ovary syndrome (PCOS), as the most common endocrine disorder in women of reproductive age, is influenced by various factors. Because there is evidence linking inflammation with chronic diseases, we hypothesized that there is a relationship between an empirical dietary inflammatory pattern score (EDIP) with odds of PCOS among the adult population. This case control study was conducted on Tehranian women in Iran. A total of 494 participants (203 women with PCOS in the case group and 291 healthy people in the control group), aged 18 to 45 years, were recruited for the study. Demographic information, anthropometric indices, physical activity level, and dietary intake were collected by a trained nutritionist. EDIP score was calculated to estimate overall dietary inflammatory potential based on 18 food groups. Statistical analysis was performed with SPSS version 19. Based on the results, the mean age of participants in the case and control groups were 28.98 ± 5.43 and 30.15 ± 6.21 years, respectively. Individuals with PCOS had a significantly higher difference in EDIP score compared with healthy participants (2.03 ± 1.13 vs 1.70 ± 0.93, P < .001). Also, the odds ratio and 95% confidence interval for the risk of PCOS across quartiles of EDIP showed a significant direct relationship (P = .003). In conclusion, our study showed that there was a direct association between PCOS risk and EDIP score. Findings suggest that inflammatory index might be a potential mechanism linking diet and PCOS development.

Impact of Dietary Quality on Genital Oncogenic Human Papillomavirus Infection in Women

BACKGROUND

Most cervical cancers are directly linked to oncogenic or high-risk human papillomavirus (HR-HPV) infection. This study evaluates associations between diet quality and genital HPV infection in women.

METHODS

This study included 10 543 women from the 2003-2016 National Health and Nutrition Examination Survey. The outcome was the genital HPV infection status (HPV-negative, low-risk [LR] HPV, and HR-HPV). Dietary quality was evaluated using the Healthy Eating Index (HEI), in which a higher score indicates a better diet quality.

RESULTS

Women who did not consume total fruits (15.8%), whole fruits (27.5%), or green vegetables and beans (43%) had a significantly higher risk of HR-HPV infection than women who complied with the Dietary Guidelines for Americans (HR-HPV odds ratio = 1.76, 1.63, and 1.48 for a HEI score of 0 vs 5, respectively) after adjusting confounding factors. Similar results of these food components on LR-HPV infection were found. In addition, intake of whole grains and dairy was inversely associated with LR-HPV infection.

CONCLUSIONS

This study showed that women who did not eat fruits, dark-green vegetables, and beans had a higher risk of genital HR-HPV infection. Intake of these food components is suggested for women to prevent HPV carcinogenesis.