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Oh TK, Song IA. Prior Evaluation of Nutritional Status and Mortality in Patients with Sepsis in South Korea. Nutrients 2023; 15:5040. [PMID: 38140299 PMCID: PMC10745302 DOI: 10.3390/nu15245040] [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: 11/01/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Our objective was to determine whether nutritional status correlates with mortality in sepsis patients. Data from a nationwide registration database were utilized for this population-based cohort study. The study subjects comprised adults who received standard health examinations before being admitted to the hospital for sepsis and were diagnosed with sepsis between 2018 and 2020. Nutrition scores were evaluated using the Nutritional Lifestyle Assessment Tool in South Korea. Overall, 2482 patients with sepsis were included in this study. The 90-day and 1-year mortality rates in patients with sepsis were 26.8% (664/2482) and 34.2% (848/2482), respectively. In the covariate-adjusted multivariable logistic regression model, a 1-point increase in nutrition score was associated with a decrease in 90-day mortality in patients with sepsis (odds ratio [OR]: 0.98, 95% confidence interval [CI]: 0.97, 0.98; p = 0.025). In the covariate-adjusted multivariable Cox regression model, a 1-point increase in nutrition score was associated with a decrease in 1-year mortality in patients with sepsis (hazard ratio [H.R.]: 0.99, 95% CI: 0.98, 0.99; p = 0.035). Our results suggest that adequate dietary intake and healthy eating habits might protect against mortality among sepsis patients.
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Affiliation(s)
- Tak Kyu Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 03080, Republic of Korea;
- Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul 01811, Republic of Korea
| | - In-Ae Song
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 03080, Republic of Korea;
- Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul 01811, Republic of Korea
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Böttcher-Loschinski R, Rial Saborido J, Böttcher M, Kahlfuss S, Mougiakakos D. Lipotoxicity as a Barrier for T Cell-Based Therapies. Biomolecules 2022; 12:biom12091182. [PMID: 36139021 PMCID: PMC9496045 DOI: 10.3390/biom12091182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/19/2022] Open
Abstract
Nowadays, T-cell-based approaches play an increasing role in cancer treatment. In particular, the use of (genetically engineered) T-cells has heralded a novel era for various diseases with previously poor outcomes. Concurrently, the relationship between the functional behavior of immune cells and their metabolic state, known as immunometabolism, has been found to be an important determinant for the success of immunotherapy. In this context, immune cell metabolism is not only controlled by the expression of transcription factors, enzymes and transport proteins but also by nutrient availability and the presence of intermediate metabolites. The lack of as well as an oversupply of nutrients can be detrimental and lead to cellular dysfunction and damage, potentially resulting in reduced metabolic fitness and/or cell death. This review focusses on the detrimental effects of excessive exposure of T cells to fatty acids, known as lipotoxicity, in the context of an altered lipid tumor microenvironment. Furthermore, implications of T cell-related lipotoxicity for immunotherapy will be discussed, as well as potential therapeutic approaches.
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Affiliation(s)
- Romy Böttcher-Loschinski
- Department of Hematology and Oncology, University Hospital Magdeburg, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany
- Correspondence:
| | - Judit Rial Saborido
- Medical Department 5–Hematology and Oncology, University Hospital Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Martin Böttcher
- Department of Hematology and Oncology, University Hospital Magdeburg, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany
- Health Campus Immunology, Infectiology, and Inflammation (GCI3), Medical Center, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany
| | - Sascha Kahlfuss
- Health Campus Immunology, Infectiology, and Inflammation (GCI3), Medical Center, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany
- Institute of Molecular and Clinical Immunology, Medical Faculty, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany
- CHaMP, Center for Health and Medical Prevention, Otto-von-Guericke-University Magdeburg, 39120 Magdeburg, Germany
| | - Dimitrios Mougiakakos
- Department of Hematology and Oncology, University Hospital Magdeburg, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany
- Medical Department 5–Hematology and Oncology, University Hospital Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg, 91054 Erlangen, Germany
- Health Campus Immunology, Infectiology, and Inflammation (GCI3), Medical Center, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany
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Saberi-Karimian M, Ghazizadeh H, Kabirian M, Barati E, Sheikh Andalibi MS, Khakpour S, Safari M, Baghshani MR, Parizadeh SM, Tayefi M, Ferns GA, Ghayour-Mobarhan M. Association of Healthy Eating Index and the Alternative Healthy Eating Index with the cell blood count indices. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021038. [PMID: 33988183 PMCID: PMC8182590 DOI: 10.23750/abm.v92i2.9108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 01/19/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES There is an association between diet quality and markers of inflammation. We aimed to investigate the relationship between diet quality with cell blood count (CBC) and inflammatory indices such as red cell distribution width (RDW) and white blood cell count (WBC). STUDY DESIGN A total of 367 male subjects aged 20-69 yrs, who were employees of Shahid Hasheminejad Gas Processing Company (SGPC) completed the study. METHODS All participants completed a questionnaire that contained questions about demography. Standard protocols were used for measuring anthropometric indices in all subjects. Blood samples were collected after a 12 hrs fast from all participants. Biochemical parameters were determined in all participants using an auto-analyzer (Eppendorf, Germany). Systolic and diastolic blood pressure were measured using a standard mercury sphygmomanometer. CBC was measured using the Sysmex auto analyser system (KX-21 N). The HEI/AHEI scores extracted from a validated food frequency questionnaire (FFQ) to evaluate the diet quality. Data analyses were performed using SPSS 16 (SPSS Inc., IL, and USA). RESULTS A total of 674 men (aged 43.68±9.09 yrs) completed the study. The CBC indices were not significantly different between the HEI/AHEI classifications among the Iranian men (p-value >0.05 for all variables). Moreover, there was no association between HEI/ AHEI with the CBC indices in our population (p-value >0.05 for all variables). CONCLUSIONS In summary, there was no association between the diet quality with the cell blood count parameters among Iranian men.
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Affiliation(s)
- Maryam Saberi-Karimian
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Hamideh Ghazizadeh
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Marzieh Kabirian
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Elham Barati
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | | | - Smaneh Khakpour
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mina Safari
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | | | - Seyed Mostafa Parizadeh
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Maryam Tayefi
- Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK.
| | - Majid Ghayour-Mobarhan
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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The influence of Tumor Necrosis Factor-alpha gene polymorphism on oxidative stress in patients with oral precancerous lesions and oral cancer. GENE REPORTS 2019. [DOI: 10.1016/j.genrep.2019.100525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Alam I, Alam W, Aljuraiban GS, Abulmeaty M, Shivappa N, Razak S. Nutritional, immunological and antioxidant defense status of outpatients diagnosed with colorectal cancer - a case-control study of the little-studied population. Nutr Cancer 2019; 72:1307-1320. [PMID: 31591902 DOI: 10.1080/01635581.2019.1673448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This cross-sectional study was conducted to investigate nutritional and immunological status of colorectal cancer (CRC) patients in a little-studied population from developing country, Pakistan. Data on 81 CRC patients and 37 healthy controls (HCs) were collected on nutritional status, nutrient intake, percent body fat (%BF), selected immunological parameters, phytochemical index (PI), healthy eating index (HEI), and prognostic nutrition index (PNI). Blood samples were used for immunological and antiradical defense potential (expressed as 50% hemolysis time; HT50). Results show 40/81 (49.4%) patients reported weight loss in past 3-6 mo, Significant differences were found in HEI values between patients vs. HCs, and between patients in low vs. high PNI groups (P, for all trends <0.05). Patients in the higher PNI group were heavier, had higher % BF, higher energy intake, and higher PI score as compared to patients in the low PNI group (P < 0.05). Low PNI was positively associated with non-significantly lower CD4:CD8 ratios, higher B-cells and NK cells (P, for all trends >0.05), but with significantly higher hs-CRP levels, and lower HT50 values (P, for all trends <0.001). In conclusion, CRC patients in a little-studied population have compromised nutritional and immunological health with lower HEI and PNI scores.
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Affiliation(s)
- Ifitikhar Alam
- Clinical Nutrition Program, Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Wajid Alam
- Oral and Maxillofacial Surgery, Khyber College of Dentistry, KPK, Peshawar, Pakistan
| | - Ghadeer S Aljuraiban
- Clinical Nutrition Program, Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mahmoud Abulmeaty
- Clinical Nutrition Program, Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA
| | - Suhail Razak
- Clinical Nutrition Program, Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Adherence to Mediterranean-style diet and risk of sepsis in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Br J Nutr 2018; 120:1415-1421. [PMID: 30375291 PMCID: PMC6753832 DOI: 10.1017/s0007114518002866] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Sepsis – syndrome of infection complicated by organ dysfunction – is responsible for over 750 000 hospitalisations and 200 000 deaths in the USA annually. Despite potential nutritional benefits, the association of diet and sepsis is unknown. Therefore, we sought to determine the association between adherence to a Mediterranean-style diet (Med-style diet) and long-term risk of sepsis in the REasons for Geographic Differences in Stroke (REGARDS) cohort. We analysed data from REGARDS, a population-based cohort of 30 239 community-dwelling adults age ≥45 years. We determined dietary patterns from a baseline FFQ. We defined Med-style diet as a high consumption of fruit, vegetables, legumes, fish, cereal and low consumption of meat, dairy products, fat and alcohol categorising participants into Med-style diet tertiles (low: 0–3, moderate: 4–5, high: 6–9). We defined sepsis events as hospital admission for serious infection and at least two systematic inflammatory response syndrome criteria. We used Cox proportional hazard models to determine the association between Med-style diet tertiles and first sepsis events, adjusting for socio-demographics, lifestyle factors, and co-morbidities. We included 21 256 participants with complete dietary data. Dietary patterns were: low Med-style diet 32⋅0%, moderate Med-style diet 42⋅1% and high Med-style diet 26⋅0%. There were f 109 (5⋅2%) first sepsis events. High Med-style diet was independently associated with sepsis risk; low Med-style diet referent, moderate Med-style diet adjusted hazard ratio (HR) 0⋅93 (95% CI 0⋅81, 1⋅08), high Med-style diet adjusted HR=0⋅74 (95% CI 0⋅61, 0⋅88). High Med-style diet adherence is associated with lower risk of sepsis. Dietary modification may potentially provide an option for reducing sepsis risk.
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Arnold K, Weinhold KR, Andridge R, Johnson K, Orchard TS. Improving Diet Quality Is Associated with Decreased Inflammation: Findings from a Pilot Intervention in Postmenopausal Women with Obesity. J Acad Nutr Diet 2018; 118:2135-2143. [PMID: 30139630 DOI: 10.1016/j.jand.2018.05.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 05/15/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Chronic inflammation is associated with obesity, morbidity, and mortality in postmenopausal women. OBJECTIVE The objective of this pilot study was to determine preliminary feasibility and efficacy of a dietary intervention to improve diet quality and lower inflammation. DESIGN The study had a single-arm, pre- and posttest design. PARTICIPANTS/SETTING Fourteen postmenopausal women (body mass index >30 [calculated as kg/m2]) from the greater Columbus, OH, area participated between August 2015 and April 2016. INTERVENTION This was a 12-week individualized dietary intervention targeting lower consumption of added sugars and increased fiber and fatty fish. MAIN OUTCOME MEASURES Primary outcomes of this analysis were serum tumor necrosis factor α receptor-2 (TNFαR-2), interleukin-6 (IL-6), and high sensitivity C-reactive protein (hsCRP); other outcomes included intake of targeted food components and Healthy Eating Index-2010 (HEI-2010) scores calculated from food frequency questionnaires at baseline, end of intervention (week 12 [WK12]), and 24-week (WK24) follow-up. STATISTICAL ANALYSES PERFORMED Repeated measures analysis of variance and partial Pearson correlations, respectively, were used to assess changes in outcomes and associations between dietary variables and inflammatory markers, controlling for percent weight change. RESULTS Mean levels of TNFαR-2 decreased pre- to postintervention (P<0.01) and remained reduced at WK24 (P<0.001). Mean intake of added sugars and n-3-rich fish improved from baseline to WK12 and remained better at WK24 (all P<0.001); mean fiber intake did not change significantly (P=0.66; baseline to WK24). Mean HEI-2010 score increased (P<0.001; baseline to WK12). Change in HEI-2010 score inversely correlated with change in TNFαR-2 (P<0.05; baseline to WK24). Change in added sugars directly correlated with change in TNFαR-2 (P<0.05; baseline to WK24), but inversely correlated with change in hsCRP (P<0.05; baseline to WK12, and WK12 to WK24). All participants lost weight by WK12 (P<0.001). CONCLUSIONS These pilot intervention findings suggest that improving diet quality is associated with decreases in TNFαR-2.
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Khan S, Wirth MD, Ortaglia A, Alvarado CR, Shivappa N, Hurley TG, Hebert JR. Design, Development and Construct Validation of the Children's Dietary Inflammatory Index. Nutrients 2018; 10:nu10080993. [PMID: 30061487 PMCID: PMC6115957 DOI: 10.3390/nu10080993] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 07/20/2018] [Accepted: 07/24/2018] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To design and validate a literature-derived, population-based Children's Dietary Inflammatory Index (C-DII)TM. DESIGN The C-DII was developed based on a review of literature through 2010. Dietary data obtained from children in 16 different countries were used to create a reference database for computing C-DII scores based on consumption of macronutrients, vitamins, minerals, and whole foods. Construct validation was performed using quantile regression to assess the association between C-reactive protein (CRP) concentrations and C-DII scores. DATA SOURCES All data used for construct validation were obtained from children between six and 14 years of age (n = 3300) who participated in the U.S. National Health and Nutrition Examination Survey (NHANES) (2005⁻2010). RESULTS The C-DII was successfully validated with blood CRP concentrations in this heterogeneous sample of 3300 children from NHANES (52% male; 29% African American, 25% Mexican American; mean age 11 years). The final model was adjusted for sex, age, race, asthma, body mass index (BMI), and infections. Children in level 3 (i.e., quartiles 3 and 4 combined) of the C-DII (i.e., children with the most pro-inflammatory diets) had a CRP value 0.097 mg/dL higher than that in level 1 (i.e., quartile 1) for CRP values at the 75th percentile of CRP using quantile regression (p < 0.05). CONCLUSION The C-DII predicted blood CRP concentrations among children 6⁻14 years in the NHANES. Further construct validation with CRP and other inflammatory markers is required to deepen understanding of the relationship between the C-DII and markers of inflammation in children.
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Affiliation(s)
- Samira Khan
- Statewide Cancer Prevention and Control Program (CPCP), Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
- Connecting Health Innovations, LLC, Columbia, SC 29201, USA.
| | - Michael D Wirth
- Statewide Cancer Prevention and Control Program (CPCP), Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
- Connecting Health Innovations, LLC, Columbia, SC 29201, USA.
- Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
- College of Nursing, University of South Carolina, Columbia, SC 29208, USA.
| | - Andrew Ortaglia
- Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
| | - Christian R Alvarado
- Statewide Cancer Prevention and Control Program (CPCP), Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
- Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
| | - Nitin Shivappa
- Statewide Cancer Prevention and Control Program (CPCP), Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
- Connecting Health Innovations, LLC, Columbia, SC 29201, USA.
- Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
| | - Thomas G Hurley
- Statewide Cancer Prevention and Control Program (CPCP), Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
- Connecting Health Innovations, LLC, Columbia, SC 29201, USA.
| | - James R Hebert
- Statewide Cancer Prevention and Control Program (CPCP), Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
- Connecting Health Innovations, LLC, Columbia, SC 29201, USA.
- Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
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Andersen CJ. Impact of Dietary Cholesterol on the Pathophysiology of Infectious and Autoimmune Disease. Nutrients 2018; 10:E764. [PMID: 29899295 PMCID: PMC6024721 DOI: 10.3390/nu10060764] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/02/2018] [Accepted: 06/11/2018] [Indexed: 01/02/2023] Open
Abstract
Cellular cholesterol metabolism, lipid raft formation, and lipoprotein interactions contribute to the regulation of immune-mediated inflammation and response to pathogens. Lipid pathways have been implicated in the pathogenesis of bacterial and viral infections, whereas altered lipid metabolism may contribute to immune dysfunction in autoimmune diseases, such as systemic lupus erythematosus, multiple sclerosis, and rheumatoid arthritis. Interestingly, dietary cholesterol may exert protective or detrimental effects on risk, progression, and treatment of different infectious and autoimmune diseases, although current findings suggest that these effects are variable across populations and different diseases. Research evaluating the effects of dietary cholesterol, often provided by eggs or as a component of Western-style diets, demonstrates that cholesterol-rich dietary patterns affect markers of immune inflammation and cellular cholesterol metabolism, while additionally modulating lipoprotein profiles and functional properties of HDL. Further, cholesterol-rich diets appear to differentially impact immunomodulatory lipid pathways across human populations of variable metabolic status, suggesting that these complex mechanisms may underlie the relationship between dietary cholesterol and immunity. Given the Dietary Guidelines for Americans 2015⁻2020 revision to no longer include limitations on dietary cholesterol, evaluation of dietary cholesterol recommendations beyond the context of cardiovascular disease risk is particularly timely. This review provides a comprehensive and comparative analysis of significant and controversial studies on the role of dietary cholesterol and lipid metabolism in the pathophysiology of infectious disease and autoimmune disorders, highlighting the need for further investigation in this developing area of research.
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Orchard T, Yildiz V, Steck SE, Hébert JR, Ma Y, Cauley JA, Li W, Mossavar-Rahmani Y, Johnson KC, Sattari M, LeBoff M, Wactawski-Wende J, Jackson RD. Dietary Inflammatory Index, Bone Mineral Density, and Risk of Fracture in Postmenopausal Women: Results From the Women's Health Initiative. J Bone Miner Res 2017; 32:1136-1146. [PMID: 28019686 PMCID: PMC5413384 DOI: 10.1002/jbmr.3070] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 12/20/2016] [Accepted: 12/21/2016] [Indexed: 12/18/2022]
Abstract
Previous studies suggest that bone loss and fracture risk are associated with higher inflammatory milieu, potentially modifiable by diet. The primary objective of this analysis was to evaluate the association of the dietary inflammatory index (DII), a measure of the inflammatory potential of diet, with risk of hip, lower-arm, and total fracture using longitudinal data from the Women's Health Initiative Observational Study and Clinical Trials. Secondarily, we evaluated changes in bone mineral density (BMD) and DII scores. DII scores were calculated from baseline food frequency questionnaires (FFQs) completed by 160,191 participants (mean age 63 years) without history of hip fracture at enrollment. Year 3 FFQs were used to calculate a DII change score. Fractures were reported at least annually; hip fractures were confirmed by medical records. Hazard ratios for fractures were computed using multivariable-adjusted Cox proportional hazard models, further stratified by age and race/ethnicity. Pairwise comparisons of changes in hip BMD, measured by dual-energy X-ray absorptiometry from baseline, year 3, and year 6 were analyzed by quartile (Q1 = least inflammatory diet) of baseline DII scores in a subgroup of women (n = 10,290). Mean DII score improved significantly over 3 years (p < 0.01), but change was not associated with fracture risk. Baseline DII score was only associated with hip fracture risk in younger white women (HR Q4,1.48; 95% CI, 1.09 to 2.01; p = 0.01). There were no significant associations among white women older than 63 years or other races/ethnicities. Women with the least inflammatory DII scores had less loss of hip BMD (p = 0.01) by year 6, despite lower baseline hip BMD, versus women with the most inflammatory DII scores. In conclusion, a less inflammatory dietary pattern was associated with less BMD loss in postmenopausal women. A more inflammatory diet was associated with increased hip fracture risk only in white women younger than 63 years. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Tonya Orchard
- Department of Human Sciences, Human Nutrition Program, The Ohio State University, Columbus, OH, USA
| | - Vedat Yildiz
- Women's Health Initiative Midwest Regional Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Susan E Steck
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Yunsheng Ma
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jane A Cauley
- Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Wenjun Li
- Health Statistics and Geography Lab, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Maryam Sattari
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Meryl LeBoff
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Rebecca D Jackson
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
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Shank LM, Tanofsky-Kraff M, Kelly NR, Schvey NA, Marwitz SE, Mehari RD, Brady SM, Demidowich AP, Broadney MM, Galescu OA, Pickworth CK, Yanovski SZ, Yanovski JA. Pediatric Loss of Control Eating and High-Sensitivity C-Reactive Protein Concentrations. Child Obes 2017; 13:1-8. [PMID: 27732055 PMCID: PMC5278829 DOI: 10.1089/chi.2016.0199] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Loss of control (LOC) eating in youth is associated with excess body weight and adiposity. After adjusting for fat mass, youth with LOC eating have higher blood pressure and higher low-density lipoprotein cholesterol compared to youth without LOC eating. Increased inflammation may account for this relationship, although few data have examined this hypothesis. Therefore, this study explored the association between LOC eating and high-sensitivity C-reactive protein (hsCRP), a marker of inflammation. METHODS We investigated hsCRP concentrations in relation to LOC eating in a convenience sample of 194 youth (age 14.3 ± 2.1 years; 63.9% female; BMI-z 1.64 ± 1.06). The presence of LOC eating in the past month was assessed by the Eating Disorder Examination interview. Serum hsCRP was measured by enzyme-linked immunosorbent assay. Adiposity was measured by air displacement plethysmography or dual-energy x-ray absorptiometry. We compared hsCRP in those with and without LOC eating in analyses accounting for sex, adiposity, height, depressive symptoms, and eating psychopathology. RESULTS Youth with LOC eating had significantly greater hsCRP than youth without LOC eating (p = 0.02), after accounting for all covariates. The number of LOC eating episodes in the past month was positively associated with hsCRP (p = 0.01). The relationship between LOC eating and hsCRP was not mediated by depressive symptoms or eating psychopathology (ps > 0.05). CONCLUSIONS Youth with disinhibited eating may manifest increased chronic inflammation. Those with LOC eating may be an important subgroup at risk for adverse health outcomes associated with both chronic inflammation and obesity. Future research should examine whether hsCRP concentrations mediate the relationship between LOC eating and its association with cardiometabolic risk.
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Affiliation(s)
- Lisa M. Shank
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Nichole R. Kelly
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Natasha A. Schvey
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Shannon E. Marwitz
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Rim D. Mehari
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Sheila M. Brady
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Andrew P. Demidowich
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Miranda M. Broadney
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Ovidiu A. Galescu
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Courtney K. Pickworth
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Office of Obesity Research, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
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12
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Chen HJ, Wang Y, Cheskin LJ. Relationship between frequency of eating and cardiovascular disease mortality in U.S. adults: the NHANES III follow-up study. Ann Epidemiol 2016; 26:527-533. [PMID: 27397905 DOI: 10.1016/j.annepidem.2016.06.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 06/03/2016] [Accepted: 06/06/2016] [Indexed: 01/08/2023]
Abstract
PURPOSE This study examined longitudinal relationship between baseline daily eating frequency and all-cause and cardiovascular disease (CVD) mortality among U.S. adults. METHODS The Third National Health and Nutrition Examination Survey (1988-1992) participants were followed through 2006. Nonpregnant adults >17 years old (n = 6884) whose dietary recall was of good quality and had fasted at least 8 hours before physical examinations were eligible for this analysis. Frequency of eating was derived from 24-hour dietary recalls. Main outcomes included all-cause and CVD mortality during follow-up, based on National Death Index data. RESULTS During follow-up (median time: 176 months), 1280 subjects died, 503 of them from CVD. Adults reporting eating ≥6 times/day had a lower hazard ratio for CVD mortality than those reporting eating 4 times/day (hazard ratio = 0.68; 95% confidence interval, 0.43-1.08; test for trend, P = .011). The gradient of CVD mortality risk by eating frequency was significant for the groups with ≥2500 kcal of total energy intake (test for trend, P = .037). CONCLUSIONS Eating frequency was inversely associated with CVD mortality, which was especially marked for people reporting high total energy intake. Nevertheless, public health recommendations should be cautious, as eating frequency was positively associated with total energy intake, which could promote weight gain.
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Affiliation(s)
- Hsin-Jen Chen
- Institute and Department of Public Health, National Yang-Ming University, Taipei, Taiwan; Global Obesity Prevention Center at Johns Hopkins, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
| | - Youfa Wang
- Global Obesity Prevention Center at Johns Hopkins, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Systems-Oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY
| | - Lawrence J Cheskin
- Global Obesity Prevention Center at Johns Hopkins, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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13
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Gutiérrez OM, Judd SE, Voeks JH, Carson AP, Safford MM, Shikany JM, Wang HE. Diet patterns and risk of sepsis in community-dwelling adults: a cohort study. BMC Infect Dis 2015; 15:231. [PMID: 26072206 PMCID: PMC4465736 DOI: 10.1186/s12879-015-0981-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/09/2015] [Indexed: 11/15/2022] Open
Abstract
Background Sepsis is the syndrome of body-wide inflammation triggered by infection and is a major public health problem. Diet plays a vital role in immune health but its association with sepsis in humans is unclear. Methods We examined 21,404 participants with available dietary data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national cohort of 30,239 black and white adults ≥45 years of age living in the US. The primary exposures of interest were five empirically derived diet patterns identified via factor analysis within REGARDS participants: “Convenience” (Chinese and Mexican foods, pasta, pizza, other mixed dishes), “Plant-based” (fruits, vegetables), “Southern” (added fats, fried foods, organ meats, sugar-sweetened beverages), “Sweets/Fats” (sugary foods) and “Alcohol/Salads” (alcohol, green-leafy vegetables, salad dressing). The main outcome of interest was investigator-adjudicated first hospitalized sepsis events. Results A total of 970 first sepsis events were observed over ~6 years of follow-up. In unadjusted analyses, greater adherence to Sweets/Fats and Southern patterns was associated with higher cumulative incidence of sepsis, whereas greater adherence to the Plant-based pattern was associated with lower incidence. After adjustment for sociodemographic, lifestyle and clinical factors, greater adherence to the Southern pattern remained associated with higher risk of sepsis (hazard ratio [HR] comparing the fourth to first quartile, HR 1.39, 95 % CI 1.11,1.73). Race modified the association of the Southern diet pattern with sepsis (Pinteraction = 0.01), with the Southern pattern being associated with modestly higher adjusted risk of sepsis in black as compared to white participants (HR comparing fourth vs. first quartile HR 1.42, 95 % CI 0.75,2.67 vs. 1.21, 95 % CI 0.93,1.57, respectively). Conclusion A Southern pattern of eating was associated with higher risk of sepsis, particularly among black participants. Determining reasons for these findings may help to devise strategies to reduce sepsis risk. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-0981-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Orlando M Gutiérrez
- Departments of Medicine, University of Alabama at Birmingham, ZRB 614, 1720 2nd AVE S, Birmingham, AL, 35294-0006, USA. .,Departments of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Suzanne E Judd
- Departments of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Jenifer H Voeks
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USA.
| | - April P Carson
- Departments of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Monika M Safford
- Departments of Medicine, University of Alabama at Birmingham, ZRB 614, 1720 2nd AVE S, Birmingham, AL, 35294-0006, USA.
| | - James M Shikany
- Departments of Medicine, University of Alabama at Birmingham, ZRB 614, 1720 2nd AVE S, Birmingham, AL, 35294-0006, USA.
| | - Henry E Wang
- Departments of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Kim S, Rimando J, Sandler DP. Fruit and vegetable intake and urinary levels of prostaglandin E₂ metabolite in postmenopausal women. Nutr Cancer 2015; 67:580-6. [PMID: 25811232 DOI: 10.1080/01635581.2015.1011787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Prostaglandin E2 (PGE2) is an inflammatory mediator that plays key roles in promoting tumor development and progression. Urinary concentration of a major PGE2 metabolite (PGE-M) has been recently proposed as a promising cancer biomarker. Using dietary intake data from 600 postmenopausal women aged 50-74 years, we examined cross-sectional relationships between fruit and vegetable intake and urinary levels of PGE-M, determined using liquid chromatography/tandem mass spectrometry. After multivariable adjustment, increasing consumption of fruits, but not vegetables, was associated with reduced levels of urinary PGE-M (P for linear trend = 0.02), with geometric means of 5.8 [95% confidence interval (CI): 5.2-6.6] in the lowest quintile versus 4.8 (95% CI: 4.3-5.4) in the highest quintile (Q5) of fruit consumption. A better quality diet, indicated by higher scores on the Healthy Eating Index, was also associated with decreased PGE-M (P for linear trend <0.01). The lack of association with vegetable intake may be related to variation in antioxidant capacities of the major dietary sources of fruits and vegetables for the study participants. Our findings suggest that urinary PGE-M may be modifiable by a healthy diet that follows current national dietary guideline. Further studies are warranted to assess potential utility of urinary PGE-M in assessing cancer prevention efficacy.
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Affiliation(s)
- Sangmi Kim
- a Department of Medicine, Section of Hematology/Oncology, Medical College of Georgia, Georgia Regents University Cancer Center , Augusta , Georgia , USA
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15
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Shivappa N, Hébert JR, Rietzschel ER, De Buyzere ML, Langlois M, Debruyne E, Marcos A, Huybrechts I. Associations between dietary inflammatory index and inflammatory markers in the Asklepios Study. Br J Nutr 2015; 113:665-71. [PMID: 25639781 PMCID: PMC4355619 DOI: 10.1017/s000711451400395x] [Citation(s) in RCA: 317] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Previous research has shown that nutrients and certain food items influence inflammation. However, little is known about the associations between diet, as a whole, and inflammatory markers. In the present study, we examined the ability of a FFQ-derived dietary inflammatory index (DII) to predict inflammation. Data from a Belgian cross-sectional study of 2524 generally healthy subjects (age 35-55 years) were used. The DII is a population-based, literature-derived dietary index that was developed to predict inflammation and inflammation-related chronic diseases. The DII was calculated from FFQ-derived dietary information and tested against inflammatory markers, namely C-reactive protein (CRP), IL-6, homocysteine and fibrinogen. Analyses were performed using multivariable logistic regression, adjusting for energy, age, sex, BMI, smoking status, education level, use of non-steroidal anti-inflammatory drugs, blood pressure, use of oral contraceptives, anti-hypertensive therapy, lipid-lowering drugs and physical activity. Multivariable analyses showed significant positive associations between the DII and the inflammatory markers IL-6 (>1·6 pg/ml) (OR 1·19, 95 % CI 1·04, 1·36) and homocysteine (>15 μmol/l) (OR 1·56, 95 % CI 1·25, 1·94). No significant associations were observed between the DII and the inflammatory markers CRP and fibrinogen. These results reinforce the fact that diet, as a whole, plays an important role in modifying inflammation.
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Affiliation(s)
- Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 241, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - James R. Hébert
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 241, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | | | | | - Michel Langlois
- Asklepios Core-Lab, Department of Laboratory Medicine, AZ St-Jan, Brugge, Belgium
| | - Evi Debruyne
- Asklepios Core-Lab, Department of Laboratory Medicine, AZ St-Jan, Brugge, Belgium
| | - Ascensión Marcos
- Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Madrid, Spain
| | - Inge Huybrechts
- Department of Public Health, Ghent University, Ghent, Belgium
- Dietary Exposure Assessment Group, International Agency for Research on Cancer, Lyon, France
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Akbaraly TN, Shipley MJ, Ferrie JE, Virtanen M, Lowe G, Hamer M, Kivimaki M. Long-term adherence to healthy dietary guidelines and chronic inflammation in the prospective Whitehall II study. Am J Med 2015; 128:152-160.e4. [PMID: 25305231 PMCID: PMC4315808 DOI: 10.1016/j.amjmed.2014.10.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 09/29/2014] [Accepted: 10/01/2014] [Indexed: 01/02/2023]
Abstract
BACKGROUND Inflammation plays an important role in the cause of cardiovascular diseases and may contribute to the association linking an unhealthy diet to chronic age-related diseases. However, to date the long-term associations between diet and inflammation have been poorly described. Our aim was to assess the extent to which adherence to a healthy diet and dietary improvements over a 6-year exposure period prevented subsequent chronic inflammation over a 5-year follow-up in a large British population of men and women. METHODS Data were drawn from 4600 adults (mean ± standard deviation, age 49.6 ± 6.1 years, 28% were women) from the prospective Whitehall cohort II study. Adherence to a healthy diet was measured using Alternative Healthy Eating Index (AHEI) scores in 1991-1993 (50.7 ± 11.9 points) and 1997-1999 (51.6 ± 12.4 points). Chronic inflammation, defined as average levels of serum interleukin-6 from 2 measures 5 years apart, was assessed in 1997-1999 and 2002-2004. RESULTS After adjustment for sociodemographic factors, health behaviors, and health status, participants who maintained a high AHEI score (ie, a healthy diet, n = 1736, 37.7%) and those who improved this score over time (n = 681, 14.8%) showed significantly lower mean levels of interleukin-6 (1.84 pg/mL, 95% confidence interval [CI], 1.71-1.98 and 1.84 pg/mL, 95% CI, 1.70-1.99, respectively) than those who had a low AHEI score (n = 1594, 34.6%) over the 6-year exposure period (2.01 pg/mL, 95% CI, 1.87-2.17). CONCLUSIONS These data suggest that maintaining and improving adherence to healthy dietary recommendations may reduce the risk of long-term inflammation.
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Affiliation(s)
- Tasnime N Akbaraly
- Inserm U710, Montpellier, F-34000, France; University Montpellier II, Montpellier, France; EPHE, Paris, France; Department of Epidemiology and Public Health, University College London, London, United Kingdom.
| | - Martin J Shipley
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Jane E Ferrie
- Department of Epidemiology and Public Health, University College London, London, United Kingdom; School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | | | - Gordon Lowe
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Mark Hamer
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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de Jong AJ, Kloppenburg M, Toes REM, Ioan-Facsinay A. Fatty acids, lipid mediators, and T-cell function. Front Immunol 2014; 5:483. [PMID: 25352844 PMCID: PMC4195378 DOI: 10.3389/fimmu.2014.00483] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 09/22/2014] [Indexed: 12/19/2022] Open
Abstract
Research toward the mechanisms underlying obesity-linked complications has intensified during the last years. As a consequence, it has become clear that metabolism and immunity are intimately linked. Free fatty acids and other lipids acquired in excess by current feeding patterns have been proposed to mediate this link due to their immune modulatory capacity. The functional differences between saturated and unsaturated fatty acids, in combination with their dietary intake are believed to modulate the outcome of immune responses. Moreover, unsaturated fatty acids can be oxidized in a tightly regulated and specific manner to generate either potent pro-inflammatory or pro-resolving lipid mediators. These oxidative derivatives of fatty acids have received detailed attention during the last years, as they have proven to have strong immune modulatory capacity, even in pM ranges. Both fatty acids and oxidized fatty acids have been studied especially in relation to macrophage and T-cells functions. In this review, we propose to focus on the effect of fatty acids and their oxidative derivatives on T-cells, as it is an active area of research during the past 5 years. The effect of fatty acids and their derivatives on activation and proliferation of T-cells, as well as the delicate balance between stimulation and lipotoxicity will be discussed. Moreover, the receptors involved in the interaction between free fatty acids and their derivatives with T-cells will be summarized. Finally, the mechanisms involved in modulation of T-cells by fatty acids will be addressed, including cellular signaling and metabolism of T-cells. The in vitro results will be placed in context of in vivo studies both in humans and mice. In this review, we summarize the latest findings on the immune modulatory function of lipids on T-cells and will point out novel directions for future research.
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Affiliation(s)
- Anja J de Jong
- Department of Rheumatology, Leiden University Medical Centre , Leiden , Netherlands
| | - Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Centre , Leiden , Netherlands
| | - René E M Toes
- Department of Rheumatology, Leiden University Medical Centre , Leiden , Netherlands
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A randomized clinical trial of nutrition education for improvement of diet quality and inflammation in Iranian obese women. J Nutr Metab 2014; 2014:605782. [PMID: 25349725 PMCID: PMC4202200 DOI: 10.1155/2014/605782] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 09/20/2014] [Indexed: 01/17/2023] Open
Abstract
Background. Obesity is considered as a low grade inflammation condition. The aim of this study was to investigate the effect of nutritional education on diet quality and biomarkers of inflammation in Iranian obese women. Method. Sixty obese women voluntarily participated in this randomized clinical trial and were randomly assigned to intervention or control group (n = 30). Intervention group was instructed to attend nutrition education sessions (1 hr/wk, for 3 months) in small groups. Diet quality scores were measured by Healthy Eating Index (HEI). Anthropometric indices and serum concentration of hs-CRP, TNF-α, and adiponectin were measured at the baseline and end of the intervention. Results. There were no significant differences in anthropometric indices of participants between the two groups at the end of intervention (P > 0.05). However, the total HEI score was significantly higher in the educated group compared to the control group after intervention (P < 0.05). The educated group also showed significant lower concentration of TNF-α and hs-CRP and higher levels of adiponectin than the control group at the end of study (P < 0.05). Conclusions. Our results provide limited evidence that higher dietary quality contributes to reduced inflammation in obese women. This effect could be independent of the weight loss.
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Spector JT, De Roos AJ, Ulrich CM, Sheppard L, Sjödin A, Wener MH, Wood B, McTiernan A. Plasma polychlorinated biphenyl concentrations and immune function in postmenopausal women. ENVIRONMENTAL RESEARCH 2014; 131:174-180. [PMID: 24721136 PMCID: PMC4019676 DOI: 10.1016/j.envres.2014.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 02/04/2014] [Accepted: 03/11/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Polychlorinated biphenyl (PCB) exposure has been associated with non-Hodgkin lymphoma in several studies, and the immune system is a potential mediator. OBJECTIVES We analyzed associations of plasma PCBs with immune function measures. We hypothesized that higher plasma PCB concentrations are associated with lower immune function cross-sectionally, and that increases in PCB concentrations over a one year period are associated with decreases in immune function. METHODS Plasma PCB concentrations and immune function [natural killer (NK) cell cytotoxicity and PHA-induced T-lymphocyte proliferation (PHA-TLP)] were measured at baseline and one year in 109 postmenopausal overweight women participating in an exercise intervention study in the Seattle, Washington (USA) area. Mixed models, with adjustment for body mass index and other potential confounders, were used to estimate associations of PCBs with immune function cross-sectionally and longitudinally. RESULTS Associations of PCBs with immune function measures differed across groups of PCBs (e.g., medium- and high-chlorinated and dioxin-like [mono-ortho-substituted]) and by the time frame for the comparison (cross-sectional vs. longitudinal). Higher concentrations of medium- and high-chlorinated PCBs were associated with higher PHA-TLP cross-sectionally but not longitudinally. The mean decrease in 0.5 µg/mL PHA-TLP/50.0 pmol/g-lipid increase in dioxin-like PCBs over one year was 51.6 (95% confidence interval 2.7, 100.5; P=0.039). There was no association between plasma PCBs and NK cytotoxicity. CONCLUSIONS These results do not provide strong evidence of impaired cellular immunity from PCB exposure. Larger longitudinal studies with greater variability in PCB exposures are needed to further examine temporal associations of PCBs with immune function.
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Affiliation(s)
- June T Spector
- Department of Environmental & Occupational Health Sciences, School of Public Health, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA.
| | - Anneclaire J De Roos
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, P.O. Box 19024, Seattle, WA 98109, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Cornelia M Ulrich
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Cancer Prevention Program, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, P.O. Box 19024, Seattle, WA 98109, USA; National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany.
| | - Lianne Sheppard
- Department of Environmental & Occupational Health Sciences, School of Public Health, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Andreas Sjödin
- National Center for Environmental Health, CDC, 4770 Buford Highway NE, Atlanta, GA 30341, USA.
| | - Mark H Wener
- Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA.
| | - Brent Wood
- Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA.
| | - Anne McTiernan
- Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA; Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, P.O. Box 19024, Seattle, WA 98109, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
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Barbaresko J, Koch M, Schulze MB, Nöthlings U. Dietary pattern analysis and biomarkers of low-grade inflammation: a systematic literature review. Nutr Rev 2013; 71:511-27. [PMID: 23865797 DOI: 10.1111/nure.12035] [Citation(s) in RCA: 401] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The purpose of the present literature review was to investigate and summarize the current evidence on associations between dietary patterns and biomarkers of inflammation, as derived from epidemiological studies. A systematic literature search was conducted using PubMed, Web of Science, and EMBASE, and a total of 46 studies were included in the review. These studies predominantly applied principal component analysis, factor analysis, reduced rank regression analysis, the Healthy Eating Index, or the Mediterranean Diet Score. No prospective observational study was found. Patterns identified by reduced rank regression as being statistically significantly associated with biomarkers of inflammation were almost all meat-based or "Western" patterns. Studies using principal component analysis or a priori-defined diet scores found that meat-based or "Western-like" patterns tended to be positively associated with biomarkers of inflammation, predominantly C-reactive protein, while vegetable- and fruit-based or "healthy" patterns tended to be inversely associated. While results of the studies were inconsistent, interventions with presumed healthy diets resulted in reductions of almost all investigated inflammatory biomarkers. In conclusion, prospective studies are warranted to confirm the reported findings and further analyze associations, particularly by investigating dietary patterns as risk factors for changes in inflammatory markers over time.
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Affiliation(s)
- Janett Barbaresko
- Department of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Bonn, Germany.
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Jarvandi S, Davidson NO, Jeffe DB, Schootman M. Influence of lifestyle factors on inflammation in men and women with type 2 diabetes: results from the National Health and Nutrition Examination Survey, 1999-2004. Ann Behav Med 2013; 44:399-407. [PMID: 22865468 DOI: 10.1007/s12160-012-9397-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Type 2 diabetes is associated with low-grade systemic inflammation, increasing the risk for various adverse health outcomes. PURPOSE Our objective was to investigate the association between C-reactive protein (CRP), a marker for systemic inflammation, and lifestyle factors in a national sample of people with type 2 diabetes. METHODS This study analyzed data from 1,086 men and women with diabetes, who completed the 1999-2004 NHANES. Lifestyle factors included diet quality, body mass index (BMI), smoking, and physical activity. RESULTS Stratified logistic regression showed that for both men and women, BMI was a strong predictor of elevated CRP after adjusting for age, energy intake, race/ethnicity, medications, diabetes duration, and glycosylated hemoglobin. However, among men, but not among women, the likelihood of elevated CRP increased with lower diet quality and physical inactivity. CONCLUSIONS Among people with type 2 diabetes, higher levels of CRP were associated with lower diet quality and physical inactivity among men, and with obesity among both men and women.
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Affiliation(s)
- Soghra Jarvandi
- Division of Health Behavior Research, Washington University School of Medicine, Saint Louis, MO 63108, USA.
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Lee M, Chae SW, Cha YS, Cho MS, Oh HY, Kim MK. Development of a Korean Diet Score (KDS) and its application assessing adherence to Korean healthy diet based on the Korean Food Guide Wheels. Nutr Res Pract 2013; 7:49-58. [PMID: 23424060 PMCID: PMC3572226 DOI: 10.4162/nrp.2013.7.1.49] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 01/09/2013] [Accepted: 01/09/2013] [Indexed: 01/06/2023] Open
Abstract
The most critical point in the assessment of adherence to dietary guidelines is the development of a practical definition for adherence, such as a dietary pattern score. The purpose of this study was to develop the Korean Diet Score (KDS) based on the Korean Food Balance Wheel and to examine the association of KDS with various lifestyle characteristics and biochemical factors. The dietary data of 5,320 subjects from the 4th Korean National Health and Nutritional Examination Survey were used for the final analysis. The food guide was composed of six food group categories; 'grain dishes', 'fish and meat dishes', 'vegetable dishes', 'fruits', 'milk' and 'oils and sugars'. Based on the recommended serving numbers for each group, the scores measuring adherence to this food guide were calculated from the dietary information from the 24-hour dietary recall questionnaire, and then its correlation with various characteristics was assessed. KDS was significantly associated with several clinical, lifestyle and socioeconomic factors as well as diagnosed disease history. The higher quintile group of KDS showed a significantly lower level in fasting blood glucose, systolic blood pressure, triglycerides, current smoking and drinking as well as higher leisure time activity, house income and education. Furthermore, the KDS quintile group of women was inversely associated with hypertension, osteoporosis and diabetes. A higher KDS quintile was characterized with a higher intake of several critical nutrients, such as Ca, Fe and vitamins as well as a desirable nutrition balance such as the ratio of macronutrients. Our results demonstrate that KDS is a beneficial tool in assessing the adherence to a healthy diet based on the Korean dietary guidelines. We suggest that KDS could be a useful indicator for evaluating the dietary balance of the Korean population.
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Affiliation(s)
- Myoungsook Lee
- Research Institute of Obesity Sciences and Department of Food and Nutrition, Sungshin Women's University, Seoul 136-742, Korea
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Dutta A, Bhattacharya P, Lahiri T, Ray MR. Immune cells and cardiovascular health in premenopausal women of rural India chronically exposed to biomass smoke during daily household cooking. THE SCIENCE OF THE TOTAL ENVIRONMENT 2012; 438:293-298. [PMID: 23010103 DOI: 10.1016/j.scitotenv.2012.08.065] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 08/06/2012] [Accepted: 08/16/2012] [Indexed: 06/01/2023]
Abstract
Changes in cells of the immune system are important indicators of systemic response of the body to air pollution. The aim of this study was to investigate the immunological changes in rural women who have been cooking exclusively with biomass for the past 5 years or more and compare the findings with women cooking exclusively with liquefied petroleum gas (LPG). We conducted a cross-sectional analysis of the associations between indices of indoor air pollution (IAP) and a set of immune assays. Biomass users illustrated marked suppression in the total number of T-helper (CD4+) cells and B (CD19+) cells while appreciable rise was documented in the number of CD8+ T-cytotoxic cells and CD16+CD56+ natural killer (NK) cells. A consistent finding among biomass users was rise in regulatory T (Treg) cells. Among biomass users, peripheral lymphocyte subpopulations, Treg cells, and the number of typical monocytes (CD16-CD64+ cells), antigen presenting types (CD16+CD64- cells) and plasmacytoid cells (CD16-CD64- cells) were found to be significantly altered in those who daily cooked with dung in comparison to wood and crop residue users (p<0.05). Biomass users who cooked in kitchens adjacent to their living areas had significant changes in peripheral lymphocyte subpopulations, typical monocytes (CD16-CD64+) with high phagocytic activity and antigen presenting monocytes (CD16+CD64-) against women who cooked in separate kitchens (p<0.01). This study has shown that women who cooked exclusively with biomass fuel had alterations in immune defense compared with their neighbors who cooked with LPG.
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Affiliation(s)
- Anindita Dutta
- College of Environmental Sciences and Engineering, Peking University, Beijing, China.
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Dietary patterns, inflammation and the metabolic syndrome. DIABETES & METABOLISM 2012; 39:99-110. [PMID: 23062863 DOI: 10.1016/j.diabet.2012.08.007] [Citation(s) in RCA: 191] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Revised: 06/10/2012] [Accepted: 08/16/2012] [Indexed: 11/21/2022]
Abstract
AIM The study of dietary patterns offers a comprehensive, real-life approach towards examining the complex diet and disease relationship. The simultaneous association of dietary patterns with inflammation and the metabolic syndrome (MetS) has not been extensively reviewed. This report reviews the association of dietary patterns with inflammation in the context of the MetS. METHODS Original English-language research studies with humans were identified via MEDLINE, using inflammation, MetS, whole diets and dietary patterns as keywords. The findings were carefully examined and synthesized along consistent axes. RESULTS Many observational and a few prospective studies, as well as some randomized controlled trials (RCTs), support an inverse association between a Mediterranean dietary pattern and markers of inflammation. The link is generally independent of traditional cardiovascular disease (CVD) risk factors and weight loss. The few studies that have examined the association between following a healthy dietary pattern, evaluated using various diet quality scores, and inflammation report an inverse association; however, this association was attenuated upon adjusting for CVD risk factors. A Mediterranean dietary pattern has also been associated with a reduced risk of the MetS in several cross-sectional studies and a few prospective studies conducted with healthy people. Few RCTs (lasting 1-2years) have confirmed the benefits of following a Mediterranean diet on MetS risk in obese individuals, in those with the MetS or in those at CVD risk. The evidence, albeit limited, for a link between healthy diets based on other diet quality scores and the MetS supports a similar inverse association for the primary and secondary prevention of the MetS. CONCLUSION Adhering to healthy diets such as the Mediterranean diet and/or national dietary guidelines can reduce inflammation and the MetS.
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Saiki O, Kuhara M, Kikuchi N, Shiraishi S, Uda H. Evaluation of lasting high levels of CRP among the patients with metabolic syndrome. Inflammation 2012; 35:730-5. [PMID: 21809045 DOI: 10.1007/s10753-011-9368-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
"Low-grade" systemic inflammation is common findings in patients with metabolic syndrome (MetS). When we assessed 256 MetS patients, we found eight patients who presented high levels of C-reactive protein (CRP) which are between 40 and 15 mg/L for more than 3 years. They have not satisfied any criteria of inflammatory diseases such as rheumatoid arthritis and the area of visceral fat estimated by computed tomography was more than 200 cm(2). All the other MetS patients of visceral fat over 200 cm(2) presented low levels of CRP which are less than 10 mg/L. Insulin resistance and ultrasound study of carotid plaques showed no differences between high and low levels of CRP patients. There are a series of MetS patients who show high levels of CRP without clinical symptoms of inflammatory diseases. High levels of CRP merely cannot be explained by visceral fat area, insulin resistance, or carotid plaques.
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Affiliation(s)
- Osamu Saiki
- Shiraishi Hospital, Matsumoto-cho 1-5-9, Imabari City, Ehime 794-0041, Japan.
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Yates BC, Pullen CH, Santo JB, Boeckner L, Hageman PA, Dizona PJ, Walker SN. The influence of cognitive-perceptual variables on patterns of change over time in rural midlife and older women's healthy eating. Soc Sci Med 2012; 75:659-67. [PMID: 22365936 DOI: 10.1016/j.socscimed.2012.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 11/10/2011] [Accepted: 01/04/2012] [Indexed: 01/15/2023]
Abstract
Although studies demonstrate that dietary interventions for healthy adults can result in beneficial dietary changes, few studies examine when and how people change in response to these interventions, particularly in rural populations. The purpose of this study was to examine patterns of change over time in healthy eating behaviors in midlife and older women in response to a one-year health-promoting intervention, and to examine what predictors (perceived benefits, barriers, self-efficacy, and family support for healthy eating) influence the changes during the intervention and follow-up. Data for this secondary analysis were from the Wellness for Women community-based trial. Women (N = 225) between the ages of 50-69 in rural Nebraska, U.S.A., were recruited. A repeated-measures experimental design was used with randomization of two rural counties to intervention (tailored newsletter) or comparison (standard newsletter) groups. Eating behavior was measured by the Healthy Eating Index. The predictor variables were assessed using standard measures. Data analysis was done using latent growth curve modeling. The tailored newsletter group was successful in improving their healthy eating behavior compared to the standard newsletter group during the one-year intervention, at the end of the intervention, and during the follow-up phase. Family support at the end of the intervention was positively associated with healthy eating at the end of the intervention. Perceived barriers had the strongest impact on healthy eating behavior at all time points. Compared to participants in the standard newsletter group, those in the tailored newsletter group perceived more family support and fewer barriers for healthy eating at the end of the intervention (mediation effects). Based on these findings, both family support and perceived barriers should be central components of interventions focused on healthy eating behavior in rural midlife and older women.
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Affiliation(s)
- Bernice C Yates
- College of Nursing, University of Nebraska, 985330 Nebraska Medical Center, Omaha, NE 68198-5330, USA.
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Hlebowicz J, Persson M, Gullberg B, Sonestedt E, Wallström P, Drake I, Nilsson J, Hedblad B, Wirfält E. Food patterns, inflammation markers and incidence of cardiovascular disease: the Malmö Diet and Cancer study. J Intern Med 2011; 270:365-76. [PMID: 21443679 DOI: 10.1111/j.1365-2796.2011.02382.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the associations between food patterns constructed using cluster analysis and markers of systemic and vascular inflammation, and incident cardiovascular disease (CVD) after 13 years of follow-up. DESIGN Population-based, prospective cohort study. SETTING AND SUBJECTS Cluster analysis identified six food patterns from 43 food group variables among 4999 subjects, aged 45-68 years, who participated in the Malmö Diet and Cancer cardiovascular programme between 1991 and 1994. Lipoprotein-associated phospholipase A(2) (Lp-PLA(2) ), C-reactive protein concentration and white blood cell (WBC) count were measured using blood samples at baseline. Incidence of CVD (coronary events and ischaemic stroke) was monitored over 13 years of follow-up. RESULTS The fibre-rich bread pattern was associated with favourable effects on WBC count in women, and the low-fat and high-fibre pattern with favourable effects on Lp-PLA(2) mass in women, and on Lp-PLA(2) activity in men. However, the milk fat and sweets and cakes patterns were both associated with adverse effects; the former on WBC count in women and on Lp-PLA(2) mass in men, and the latter on WBC count and Lp-PLA(2) mass in women. The milk fat and sweets and cakes patterns were associated with increased CVD risk in women. CONCLUSIONS The results of this study support the present Nordic dietary recommendations indicating that diets rich in high-fibre, low-fat and low-sugar foods are favourably associated with markers of inflammation and, potentially, with CVD risk.
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Affiliation(s)
- J Hlebowicz
- Center for Emergency and Clinical Science, Department of Cardiology; Lund University, Skåne University Hospital, Malmö, Sweden.
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Nieman DC, Henson DA, Sha W. Ingestion of micronutrient fortified breakfast cereal has no influence on immune function in healthy children: a randomized controlled trial. Nutr J 2011; 10:36. [PMID: 21510864 PMCID: PMC3094279 DOI: 10.1186/1475-2891-10-36] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Accepted: 04/21/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study investigated the influence of 2-months ingestion of an "immune" nutrient fortified breakfast cereal on immune function and upper respiratory tract infection (URTI) in healthy children during the winter season. METHODS Subjects included 73 children (N=42 males, N=31 females) ranging in age from 7 to 13 years (mean±SD age, 9.9±1.7 years), and 65 completed all phases of the study. Subjects were randomized to one of three groups--low, moderate, or high fortification--with breakfast cereals administered in double blinded fashion. The "medium" fortified cereal contained B-complex vitamins, vitamins A and C, iron, zinc, and calcium, with the addition of vitamin E and higher amounts of vitamins A and C, and zinc in the "high" group. Immune measures included delayed-typed hypersensitivity, global IgG antibody response over four weeks to pneumococcal vaccination, salivary IgA concentration, natural killer cell activity, and granulocyte phagocytosis and oxidative burst activity. Subjects under parental supervision filled in a daily log using URTI symptoms codes. RESULTS Subjects ingested 3337±851 g cereal during the 2-month study, which represented 14% of total diet energy intake and 20-85% of selected vitamins and minerals. Despite significant increases in nutrient intake, URTI rates and pre- to- post-study changes in all immune function measures did not differ between groups. CONCLUSIONS Data from this study indicate that ingestion of breakfast cereal fortified with a micronutrient blend for two winter months by healthy, growing children does not significantly influence biomarkers for immune function or URTI rates.
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Affiliation(s)
- David C Nieman
- Human Performance Lab, North Carolina Research Campus, Kannapolis, NC 28081, USA.
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Development of a diet quality index assessing adherence to the Swedish nutrition recommendations and dietary guidelines in the Malmö Diet and Cancer cohort. Public Health Nutr 2011; 14:835-45. [DOI: 10.1017/s1368980010003848] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo develop a diet quality index (DQI) that assesses adherence to the Swedish nutrition recommendations (SNR) and the Swedish dietary guidelines (SDG).DesignA cross-sectional study within the Malmö Diet and Cancer (MDC) cohort. A diet history method collected dietary data, a structured questionnaire lifestyle and socio-economic information, and anthropometric data were collected by direct measurements. The index (DQI-SNR) included six components: SFA, PUFA, fish and shellfish, dietary fibre, fruit and vegetables, and sucrose.SettingMalmö, Sweden.SubjectsMen (n 4525) and women (n 8491) of the MDC cohort enrolled from September 1994 to October 1996.ResultsFor participants with high DQI-SNR scores, nutrient and food intakes were close to recommendations. However, most of the study population exceeded the recommended intake for SFA (98 %) and few reached recommended intakes for dietary fibre (24 %), fruit and vegetables (32 %), vitamin D (18 %) and folate (2 %). A high DQI-SNR score was positively associated with age, physical activity, not smoking, past food habit change, education and socio-economic status. Individuals with high scores were more likely to have a diabetes diagnosis or experienced a cardiovascular event.ConclusionsResults suggest that the DQI-SNR is a useful tool for assessing adherence to the SNR 2005 and the SDG in the MDC cohort. No index has previously been developed with the aim of evaluating adherence to the current dietary recommendations in Sweden. Further validation of the DQI-SNR, and evaluation of its utility, is needed.
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Williams L, Ulrich CM, Larson T, Wener MH, Wood B, Chen-Levy Z, Campbell PT, Potter J, McTiernan A, Roos AJD. Fine particulate matter (PM₂.₅) air pollution and immune status among women in the Seattle area. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2011; 66:155-65. [PMID: 21864104 DOI: 10.1080/19338244.2010.539636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Changes in immune status have been suggested as a possible biologic mechanism by which particulate matter (PM) air pollution could lead to adverse health effects. The authors studied associations between ambient PM₂.₅ and immune status among 115 postmenopausal, overweight women in the greater Seattle, Washington, area. The authors evaluated 3-day, 30-day, and 60-day average PM₂.₅ values in relation to inflammation markers (C-reactive protein, serum amyloid A, interleukin-6) and functional assays of cellular immunity (natural killer cell cytotoxicity, T-lymphocyte proliferation) at 3 time points for each woman during 1 year. Three-day averaged PM₂.₅ was inversely associated with anti-CD3-stimulated lymphocyte proliferation. There were no notable associations between the inflammation markers and PM₂.₅. If additional studies confirm our findings, then future health effect assessments for PM₂.₅ should consider changes in cellular immunity as an endpoint that may lead to overt clinical disease.
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Affiliation(s)
- Lori Williams
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
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Tardivo AP, Nahas-Neto J, Nahas EAP, Maesta N, Rodrigues MAH, Orsatti FL. Associations between healthy eating patterns and indicators of metabolic risk in postmenopausal women. Nutr J 2010; 9:64. [PMID: 21143838 PMCID: PMC3004808 DOI: 10.1186/1475-2891-9-64] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Accepted: 12/08/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since human diets contain many components that may work synergistically to prevent or promote disease, assessing diet quality may be informative. The purpose of this study was to investigate the association between quality diet, by using Healthy Eating Index (HEI), and metabolic risk indicators in postmenopausal women. METHODS This cross-sectional study included a total of 173 Brazilian women, aged 45-75 years, seeking healthcare at a public outpatient center. Food consumption assessed by 24 h-recall food inquiry was used to calculate HEI scores: >80 implied diet good, 80-51 diet "needed improvement", and <51 diet poor. Anthropometric data included: body mass index (BMI = weight/height(2)), waist-circumference (WC), body fat (%BF) and lean mass (%LM). Data on total cholesterol (TC), high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC), and triglycerides (TG) were also collected. Fisher's Exact test, and logistic regression method (to determine odds ratio, OR) were used in the statistical analysis. RESULTS Overweight and obesity were observed in 75.7% of the participants. Excessive %BF (> 35%) was observed in 56.1%, while %LM was reduced (< 70%) in 78.1%. WC was elevated (≥88 cm) in 72.3%. Based on HEI values, diet quality was good in 3% (5/173), needed improvement in 48.5% (84/173), and was poor in 48.5% (84/173) of the cases. In this group, 75% of women had high intakes of lipids (> 35%), predominantly saturated and monounsaturated fat. On average, plasma TC, LDLC, and TG levels were higher than recommended in 57.2%, 79.2% and 45.1% of the women, respectively, while HDLC was low in 50.8%. There was association between HEI scores and the %BF that it was higher among women with HEI score < 80 (p = 0.021). There were not observed significant risk associations between HEI and lipid profile. CONCLUSION Among the Brazilian postmenopausal women attending a public outpatient clinic, diet was considered to need improvement or to be of poor quality, attributed to high saturated fat ingestion, which probably caused a negative impact on metabolic risk indicators, namely body composition.
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Affiliation(s)
- Ana P Tardivo
- Department of Gynecology and Obstetrics, Botucatu Medical School, UNESP- Sao Paulo State University, Brazil
| | - Jorge Nahas-Neto
- Department of Gynecology and Obstetrics, Botucatu Medical School, UNESP- Sao Paulo State University, Brazil
| | - Eliana AP Nahas
- Department of Gynecology and Obstetrics, Botucatu Medical School, UNESP- Sao Paulo State University, Brazil
| | - Nailza Maesta
- Nutrition and Exercise Metabolism Center of Department of Public Health, Botucatu Medical School, UNESP- Sao Paulo State University, Brazil
| | - Marcio AH Rodrigues
- Department of Gynecology and Obstetrics, Botucatu Medical School, UNESP- Sao Paulo State University, Brazil
| | - Fabio L Orsatti
- Department of Gynecology and Obstetrics, Botucatu Medical School, UNESP- Sao Paulo State University, Brazil
- Nutrition and Exercise Metabolism Center of Department of Public Health, Botucatu Medical School, UNESP- Sao Paulo State University, Brazil
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George SM, Neuhouser ML, Mayne ST, Irwin ML, Albanes D, Gail MH, Alfano CM, Bernstein L, McTiernan A, Reedy J, Smith AW, Ulrich CM, Ballard-Barbash R. Postdiagnosis diet quality is inversely related to a biomarker of inflammation among breast cancer survivors. Cancer Epidemiol Biomarkers Prev 2010; 19:2220-8. [PMID: 20716617 DOI: 10.1158/1055-9965.epi-10-0464] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Inflammation and immune response have potential prognostic implications for breast cancer survivors. We examined how postdiagnosis diet quality is cross-sectionally related to biomarkers of inflammation and adipose-derived hormones among breast cancer survivors and determined whether physical activity or body size modified any observed associations. METHODS Participants included 746 women diagnosed with stage 0 to IIIA breast cancer. Thirty months after diagnosis, the women completed food frequency questionnaires. We scored diet quality with the Healthy Eating Index (HEI)-2005. Serum concentrations of C-reactive protein (CRP), serum amyloid A, leptin, and adiponectin were measured in fasting 30 mL blood samples. Log biomarker values were regressed on quartiles of HEI-2005 scores in multivariate models, and beta scores were exponentiated and expressed as geometric means within quartiles of HEI-2005 scores. RESULTS Women with better versus poor quality postdiagnosis diets, as defined by higher HEI-2005 scores (Q4 versus Q1), had lower concentrations of CRP (1.6 mg/L versus 2.5 mg/L), but no significant difference in concentrations of serum amyloid A, leptin, or adiponectin. Among women not engaging in recreational physical activity after diagnosis, better diet quality was associated with lower CRP concentrations (2.5 mg/L versus 5.0 mg/L), but no association was observed among women engaging in any recreational physical activity (1.4 mg/L versus 1.6 mg/L; P heterogeneity = 0.03). CONCLUSIONS Among breast cancer survivors, a better-quality diet seems to be associated with lower levels of chronic inflammation. IMPACT Lower levels of chronic inflammation have been associated with improved survival after breast cancer.
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Affiliation(s)
- Stephanie M George
- Yale School of Public Health, Division of Chronic Disease Epidemiology, New Haven, Connecticut, USA.
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Green tea minimally affects biomarkers of inflammation in obese subjects with metabolic syndrome. Nutrition 2010; 27:206-13. [PMID: 20605696 DOI: 10.1016/j.nut.2010.01.015] [Citation(s) in RCA: 130] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Revised: 01/12/2010] [Accepted: 01/22/2010] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Green tea (Camellia sinensis) has shown to exert cardioprotective benefits in observational studies. The objective of this clinical trial was to assess the effects of green tea on features of metabolic syndrome and inflammation in obese subjects. METHODS We conducted a randomized controlled trial in obese subjects with metabolic syndrome. Thirty-five subjects [(mean ± SE) age 42.5 ± 1.7 y, body mass index 36.1 ± 1.3 kg/m(2)] completed the 8-wk study and were randomly assigned to receive green tea (4 cups/d), green tea extract (2 capsules and 4 cups water/d), or no treatment (4 cups water/d). Both the beverage and extract groups had similar dosing of epigallocatechin-3-gallate, the active green tea polyphenol. Fasting blood samples were collected at screening, 4 and 8 wk of the study. RESULTS Green tea beverage or extract supplementation did not significantly alter features of metabolic syndrome or biomarkers of inflammation including adiponectin, C-reactive protein, interleukin-6, interleukin-1β, soluble vascular cell adhesion molecule-1, soluble intercellular adhesion molecule-1, leptin, or leptin:adiponectin ratio. However, both green tea beverage and extracts significantly reduced plasma serum amyloid alpha versus no treatment (P < 0.005). CONCLUSION This study suggests that the daily consumption of green tea beverage or extracts for 8 wk was well tolerated but did not affect the features of metabolic syndrome. However, green tea significantly reduced plasma serum amyloid alpha, an independent cardiovascular disease risk factor, in obese subjects with metabolic syndrome.
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McEligot AJ, Mouttapa M, Ziogas A, Anton-Culver H. Diet and predictors of dietary intakes in women with family history of breast and/or ovarian cancer. Cancer Epidemiol 2009; 33:419-23. [PMID: 19833573 PMCID: PMC2789869 DOI: 10.1016/j.canep.2009.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Revised: 09/02/2009] [Accepted: 09/16/2009] [Indexed: 02/08/2023]
Abstract
BACKGROUND Dietary intakes of vegetable, fruit, fiber, folate, and B vitamins have been associated with reduced breast and/or ovarian cancer risk. However, few studies have assessed dietary intakes and factors associated with diet in women with family history of breast and/or ovarian cancer (FHBOC). We examined dietary intakes and predictors of diet in women with FHBOC (n=211) enrolled in a population-based cancer family registry. METHODS We assessed diet via a food frequency questionnaire, family history by telephone and demographic variables by questionnaire. Descriptive statistics were performed, and multivariate linear regression analyses were conducted to examine variables [body mass index (BMI), age, parity, energy intake, alcohol use, smoking and education] associated with dietary intakes. RESULTS Mean daily intakes were: 2.57 vegetable servings [+/-standard deviation (SD) 1.22], 1.56 fruit servings (+/-0.9), 11.21g fiber (+/-5.32) and 33.85% energy from fat (+/-9.05), 241.98microg folate (+/-120.80) and 1.33mg vitamin B6 (+/-0.62). Regression analyses showed that younger age, smoking, lower education and higher BMI had a significant association with decreasing vegetable, fruit and/or fiber intakes. BMI had a significant positive association with % energy from fat. Similar results were observed when assessing independent variables with micronutrient intakes studied. CONCLUSIONS These data suggest that women with FHBOC should be encouraged to meet dietary guidelines for cancer prevention. Specifically, public health dietary interventions should target women with FHBOC who are smokers, less educated, have a higher BMI and are younger. Such interventions may potentially reduce breast and/or ovarian cancer risk in this population.
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Affiliation(s)
- Archana J McEligot
- California State University, Fullerton, Department of Health Science, United States.
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Bressan J, Hermsdorff HHM, Zulet MÁ, Martínez JA. Impacto hormonal e inflamatório de diferentes composições dietéticas: ênfase em padrões alimentares e fatores dietéticos específicos. ACTA ACUST UNITED AC 2009; 53:572-81. [DOI: 10.1590/s0004-27302009000500010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Accepted: 06/02/2009] [Indexed: 11/22/2022]
Abstract
A adoção de um padrão alimentar saudável, caracterizado pelo consumo de frutas, hortaliças, carnes magras, lácteos desnatados, frutos secos e moderada ingestão de óleos vegetais e álcool, é um fator determinante para um menor risco de doenças crônicas como a obesidade, a síndrome metabólica e as doenças cardiovasculares. Esse efeito benéfico pode ser explicado, pelo menos em parte, por seu papel modulador sobre biomarcadores da sensibilidade insulínica, da aterogênese, bem como os de inflamação e de função endotelial. Por outra parte, a ingestão de componentes específicos da dieta como os ácidos graxos insaturados (oleico e alfa-linolênico) e os micronutrientes com propriedades antioxidantes (vitaminas A, E e C; selênio e zinco) vêm sendo discutida, em razão de sua potencial ação protetora perante a ocorrência das doenças crônicas e possíveis benefícios na regulação hormonal, metabólica e inflamatória que esses fatores dietéticos podem proporcionar dentro de um tratamento nutricional para a obesidade e a síndrome metabólica.
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Williams LA, Ulrich CM, Larson T, Wener MH, Wood B, Campbell PT, Potter JD, McTiernan A, De Roos AJ. Proximity to traffic, inflammation, and immune function among women in the Seattle, Washington, area. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:373-8. [PMID: 19337511 PMCID: PMC2661906 DOI: 10.1289/ehp.11580] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Accepted: 10/14/2008] [Indexed: 05/20/2023]
Abstract
BACKGROUND Traffic-related air pollution has been associated with adverse health outcomes, and the immune system may be a biologic mediator of health effects. OBJECTIVES We analyzed associations between living near major roads and immune status as measured by five immune assays. We hypothesized that living near a freeway, arterial, or truck route would be associated with increased inflammation and decreased immune function. METHODS We used a geographic information system (GIS) to determine residential proximity to major roads among 115 postmenopausal, overweight women in the greater Seattle, Washington (USA), area whose immunity was assessed at the baseline visit of an exercise intervention trial. We evaluated three inflammatory markers (C-reactive protein, serum amyloid A, and interleukin-6) and two functional assays of cellular immunity [natural killer (NK) cell cytotoxicity and T-lymphocyte proliferation]. RESULTS Women living within 150 m of arterial roads had 21% lower NK cytotoxicity compared with women who lived farther from an arterial [mean cytotoxicity, 19.5%; 95% confidence interval (CI), 15.6-23.5%; vs. mean cytotoxicity, 24.8%; 95% CI, 22.0-27.5%], after adjustment for both individual-level and census tract-level demographic characteristics. This association was limited to women who reported exercising near traffic. Fewer women lived near freeways and truck routes. Markers of inflammation and lymphocyte proliferation did not consistently differ according to proximity to major roads. CONCLUSIONS If the observed association between residential proximity to traffic and decreased NK cytotoxicity is confirmed in other populations, our results may have implications for local land use policy.
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Affiliation(s)
- Lori A. Williams
- Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
| | - Cornelia M. Ulrich
- Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Timothy Larson
- Department of Civil and Environmental Engineering, College of Engineering, University of Washington, Seattle, Washington, USA
| | - Mark H. Wener
- Department of Laboratory Medicine
- Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | | | - Peter T. Campbell
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - John D. Potter
- Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Anne McTiernan
- Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Anneclaire J. De Roos
- Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Address correspondence to A.J. De Roos, Fred Hutchinson Cancer Research Center, Program in Epidemiology, 1100 Fairview Ave. N, M4-B874, Seattle, WA 98109-1024 USA. Telephone: (206) 667-7315. Fax: (206) 667-4787. E-mail:
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Jacobs DR, Sluik D, Rokling-Andersen MH, Anderssen SA, Drevon CA. Association of 1-y changes in diet pattern with cardiovascular disease risk factors and adipokines: results from the 1-y randomized Oslo Diet and Exercise Study. Am J Clin Nutr 2009; 89:509-17. [PMID: 19116328 DOI: 10.3945/ajcn.2008.26371] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We hypothesized that favorable changes in dietary patterns would lead to a reduction in body size and an improvement in metabolic status. OBJECTIVE The objective was to study changes in diet patterns relative to changes in body size, blood pressure, and circulating concentrations of lipids, glucose, insulin, adiponectin, and other cytokines in the context of a 1-y randomized intervention study. DESIGN For 1 y, 187 men aged 45 +/- 2 y, approximately 50% of whom met the criteria of the metabolic syndrome, were randomly assigned to a diet protocol (n = 45), an exercise protocol (n = 48), a protocol of diet plus exercise (n = 58), or a control protocol (n = 36). A previously defined a priori diet score was created by summing tertile rankings of 35 food group variables; a higher score generally reflected recommended dietary changes in the trial (mean +/- SD at baseline: 31 +/- 6.5; range: 15-47). RESULTS Over the study year, the diet score increased by approximately 2 +/- 5.5 in both diet groups, with a decrease of an equivalent amount in the exercise and control groups. The weight change was -3.5 +/- 0.6 kg/10-point change in diet score (P < 0.0001), similarly within each intervention group, independently of the change in energy intake or baseline age and smoking status. Weight change was attenuated but remained significant after adjustment for intervention group and percentage body fat. Subjects with an increased diet score had more favorable changes in other body size variables, systolic blood pressure, and blood lipid, glucose, insulin, and adiponectin concentrations. Change in diet score was unrelated to resistin and several cytokines. CONCLUSION The change toward a more favorable diet pattern was associated with improved body size and metabolic profile.
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Affiliation(s)
- David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.
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Dietary quality indices and human health: a review. Maturitas 2009; 62:1-8. [PMID: 19128905 DOI: 10.1016/j.maturitas.2008.11.021] [Citation(s) in RCA: 144] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2008] [Revised: 11/24/2008] [Accepted: 11/24/2008] [Indexed: 11/22/2022]
Abstract
Indices are composite tools aiming to measure and quantify a variety of clinical conditions, behaviors, attitudes and beliefs that are difficult to be measured quantitatively and accurately. In this review, the methodology used to develop dietary indices and their relationship with health determinants and outcomes is discussed. In brief, the already proposed indices are adequate tools concerning the evaluation of diet quality, but they have shown moderate predictive ability in relation to chronic diseases and health determinants. The aforementioned weaknesses could be attributed to: inappropriate selection of the components (i.e., number or content of dietary information), selection of small number of cut-off points for each component and/or equal contribution of all index items to the calculation of the total score. Nevertheless, dietary indices are important tools to evaluate not only the diet quality, but also the relationship between dietary habits and several health outcomes.
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