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Sualeheen A, Khor BH, Lim JH, Balasubramanian GV, Chuah KA, Yeak ZW, Chinna K, Narayanan SS, Sundram K, Daud ZAM, Karupaiah T. Investigating the impact of dietary guidelines transition on cardiometabolic risk profile: a forensic analysis using diet quality metrics. Sci Rep 2024; 14:19983. [PMID: 39198625 PMCID: PMC11358446 DOI: 10.1038/s41598-024-70699-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 08/20/2024] [Indexed: 09/01/2024] Open
Abstract
Evaluating dietary guidelines using diet quality (DQ) offers valuable insights into the healthfulness of a population's diet. We conducted a forensic analysis using DQ metrics to compare the Malaysian Dietary Guidelines (MDG-2020) with its former version (MDG-2010) in relation to cardiometabolic risk (CMR) for an adult Malaysian population. A DQ analysis of cross-sectional data from the Malaysia Lipid Study (MLS) cohort (n = 577, age: 20-65yrs) was performed using the healthy eating index-2015 (HEI-2015) framework in conformation with MDG-2020 (MHEI2020) and MDG-2010 (MHEI2010). Of 13 dietary components, recommended servings for whole grain, refined grain, beans and legumes, total protein, and dairy differed between MDGs. DQ score associations with CMR, dietary patterns and sociodemographic factors were examined. Out of 100, total DQ scores of MLS participants were 'poor' for both MHEI2020 (37.1 ± 10.3) and MHEI2010 (39.1 ± 10.4), especially among young adults, males, Malays, and those frequently 'eating out' as well as those with greatest adherence to Sugar-Sweetened Beverages pattern and lowest adherence to Food Plant pattern. Both metrics shared similar correlations with CMR markers, with MHEI2020 exhibiting stronger correlations with WC, BF%, TG, insulin, HOMA2-IR, and smallLDL than MHEI2010, primarily attributed to reduced refined grain serving. Notably, participants with the highest adherence to MHEI2020 scores exhibited significantly reduced odds for elevated TG (AOR 0.44, 95% CI 0.21-0.93, p = 0.030), HOMA2-IR (AOR 0.44, 95% CI 0.21-0.88, p = 0.022), and hsCRP (AOR 0.54, 95% CI 0.31-0.96, p = 0.040, compared to those with the lowest adherence. Each 5-unit increase in MHEI2020 scores reduced odds for elevated BMI (- 14%), WC (- 9%), LDL-C (- 32%), TG (- 15%), HOMA2-IR (- 9%) and hsCRP (- 12%). While MHEI2020 scores demonstrated better calibration with CMR indicators, the overall sub-optimally 'poor' DQ scores of this population call for health promotion activities to target the public to achieve adequate intake of healthful fruits, non-starchy vegetables and whole grain, and moderate intake of refined grain, added sugar and saturated fat.
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Affiliation(s)
- Ayesha Sualeheen
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia
| | - Ban-Hock Khor
- Faculty of Food Science and Nutrition, University Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Jun-Hao Lim
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | | | - Khun-Aik Chuah
- Nutrition Program, Faculty of Health Sciences, University Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Zu-Wei Yeak
- Nutrition Program, Faculty of Health Sciences, University Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- Faculty of Business and Management, UCSI University, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Sreelakshmi Sankara Narayanan
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, 47500, Subang Jaya, Selangor, Malaysia
- Food Security and Nutrition Impact Lab, Taylor's University, 47500, Subang Jaya, Selangor, Malaysia
| | - Kalyana Sundram
- Malaysia Palm Oil Council, Menara Axis, 46100, Petaling Jaya, Selangor, Malaysia
| | - Zulfitri Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
- Department of Dietetics, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - Tilakavati Karupaiah
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, 47500, Subang Jaya, Selangor, Malaysia.
- Food Security and Nutrition Impact Lab, Taylor's University, 47500, Subang Jaya, Selangor, Malaysia.
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MetS Prevalence and Its Association with Dietary Patterns among Chinese Middle-Aged and Elderly Population: Results from a National Cross-Sectional Study. Nutrients 2022; 14:nu14245301. [PMID: 36558460 PMCID: PMC9788494 DOI: 10.3390/nu14245301] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/02/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022] Open
Abstract
The prevalence of metabolic syndrome (MetS) increased dramatically over the past years among adults in a separate province in China; little is known about newly diagnosed MetS in middle-aged and above residents nationwide. We investigated the prevalence of MetS and its components, the dietary patterns, and their relationship among the middle-aged and above population of China by using data from a national cross-sectional survey. General information involving lifestyles and health stations was collected, and dietary intake using a 3-day 24 h dietary recall and weighing method for edible oil and condiments was conducted. Height, weight, waist circumference, and blood pressure were measured, and fasting serum lipids and glucose were tested by trained clinical staff. Dietary patterns were derived from 23 food categories by using cluster analysis, and a multivariate logistic regression model was used to evaluate the odd ratio of MetS and its component across obtained dietary patterns. The estimated prevalence of MetS was 37.1% among 40,909 middle-aged and older participants in the study. Participants were classified into diversity pattern, northern pattern, and southern pattern that, respectively, accounted for 9.8%, 47.2%, and 43.0% of the total. Compared with those inclined to the northern pattern, participants prone to the southern pattern decreased the risk of MetS (OR = 0.81, 95%CI: 0.75- 0.87; p < 0.001), central obesity (OR = 0.70, 95%CI: 0.65−0.76; p < 0.001), and HDL-C (OR = 0.82, 95%CI: 0.76−0.89; p < 0.001), and elevated BP (OR = 0.86, 95%CI: 0.79−0.93; p < 0.001) respectively. However, participants of the southern pattern tended to have a higher risk of elevated glucose; the OR (95%CI) was 1.13 (1.05, 1.22; p = 0.002) after adjusting for potential confounding factors. Greater adherence to diverse dietary patterns was negatively related to the risk of central obesity and elevated blood pressure with an OR (95%CI) of 0.82 (0.71, 0.94; p = 0.005) and 0.77 (0.67, 0.88; p < 0.001), respectively. We concluded that dietary improvement and health promotion for MetS should be based on the district-specific nutritional status of the Chinese middle-aged and elderly population.
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Effects of diets containing proteins from fish muscles or fish by-products on the circulating cholesterol concentration in rodents: a systematic review and meta-analysis. Br J Nutr 2022:1-22. [PMID: 36268726 DOI: 10.1017/s000711452200349x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A high circulating cholesterol concentration is considered an important risk factor for the development of CVD. Since lean fish intake and fish protein supplementation have been associated with lower cholesterol concentration in some but not all clinical studies, the main aim of this study was to investigate the effect of diets containing proteins from fish muscles and fish by-products on the serum/plasma total cholesterol (TC) concentration in rodents. A systematic literature search was performed using the databases PubMed, Web of Science and Embase, structured around the population (rodents), intervention (type of fish and fraction, protein dose and duration), comparator (casein) and the primary outcome (circulating TC). Articles were assessed for risk of bias using the SYRCLE's tool. A meta-analysis was conducted in Review Manager v. 5·4·1 (the Cochrane Collaboration) to determine the effectiveness of proteins from fish on the circulating TC concentration. Thirty-nine articles were included in the systematic review and meta-analysis, with data from 935 rodents. The risk of bias is unclear since few of the entries in the SYRCLE's tool were addressed. Consumption of proteins from fish resulted in a significantly lower circulating TC concentration when compared with control groups (mean difference -0·24 mmol/l, 95 % CI - 0·34, -0·15, P < 0·00001), with high statistical heterogeneity (I2 = 71 %). To conclude, proteins from fish muscles and by-products show promise as a functional dietary ingredient or supplement by preventing high cholesterol concentration in rodents, thus reducing one of the most important risk factors for developing CVD.
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Huang X, Hui H, Zhu W, Chen N, Wei Y, Wang Z, Shi J. Effect of the interaction between alcohol and meat consumption on the hyperlipidaemia risk among elderly individuals: Evidence from Shanghai, China. Front Nutr 2022; 9:982626. [PMID: 36324622 PMCID: PMC9618893 DOI: 10.3389/fnut.2022.982626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/22/2022] [Indexed: 11/14/2022] Open
Abstract
Background Diet and other lifestyle habits may have an increased effect on blood lipids in older people. This study aimed to examine the associations between diet (meat, fish, and egg), alcohol consumption and blood lipids. Methods Surveillance data on chronic diseases and their risk factors were collected from Shanghai during 2017–2018. A Kish table was used for sampling 438 older adults, of whom 71 consumed alcohol. Logistic regression was used to test the relationships between diet, alcohol consumption and blood lipid levels in elderly individuals, and the marginal effects (MEs) were estimated. Results Dyslipidaemia was more common among drinkers than among nondrinkers (P < 0.01). Alcohol consumption was associated with dyslipidaemia (OR = 2.667, P < 0.01 for TC; OR = 1.919, P < 0.05 for LDL; OR = 3.412, P < 0.01 for TG), and consumption of more than 50 g of meat per day showed similar associations (OR = 3.227, P < 0.01 for TC; OR = 3.263, P < 0.01, for LDL; OR = 2.329, P < 0.01 for TG). The MEs of alcohol drinking and excessive meat consumption on the rate of dyslipidaemia were 0.324 for TC (P < 0.01), 0.255 for LDL (P < 0.05), and 0.174 for TG (P < 0.01). Discussion The risk of hyperlipidaemia was increased among elderly individuals with excessive meat and alcohol consumption, which also had an interactive effect.
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Affiliation(s)
- Xiaojing Huang
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Hong Hui
- General Department, Shanghai Baoshan District Gucun Town Community Health Service Center, Shanghai, China
| | - Wenqing Zhu
- Executive Office, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ning Chen
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Wei
- Key Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China
- *Correspondence: Yan Wei
| | - Zhaoxin Wang
- Health Management Center, First Affiliated Hospital of Hainan Medical University, Hainan, China
- School of Management, Hainan Medical University, Hainan, China
- Zhaoxin Wang
| | - Jianwei Shi
- Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Social Medicine and Health Management, School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Jianwei Shi
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Wu B, Qu Y, Lu Y, Ji S, Ding L, Li Z, Zhang M, Gu H, Sun Q, Ying B, Zhao F, Zheng X, Qiu Y, Zhang Z, Zhu Y, Cao Z, Lv Y, Shi X. Mercury may reduce the protective effect of sea fish consumption on serum triglycerides levels in Chinese adults: Evidence from China National Human Biomonitoring. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 311:119904. [PMID: 35961572 DOI: 10.1016/j.envpol.2022.119904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/12/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
Sea fish contain omega-3 polyunsaturated fatty acids (omega-3 PUFAs) which have been found to reduce triglyceride (TG) levels. However, sea fish may contain pollutants such as mercury which cause oxidative stress and increase TG levels. Therefore, the relationship between sea fish and TG remains unclear. We aimed to explore whether blood mercury (BHg) can affect the effect of sea fish consumption frequency on TG level among Chinese adults. A total of 10,780 participants were included in this study. BHg levels were measured using inductively coupled plasma mass spectrometry (ICP-MS). The associations of sea fish consumption frequency with BHg and TG levels as well as the association of BHg with TG levels were evaluated using multiple linear regression. Causal mediation analysis was used to evaluate the mediation effect of BHg levels on the association of sea fish consumption frequency with TG levels. The frequency of sea fish consumption showed a negative association with TG level. Compared with the participants who never ate sea fish, the TG level decreased by 0.193 mmol/L in those who ate sea fish once a week or more [β (95%CI): -0.193 (-0.370, -0.015)]. Significant positive associations were observed of BHg with TG levels. With one unit increase of log2-transformed BHg, the change of TG level was 0.030 mmol/L [0.030 (0.009, 0.051)]. The association between sea fish consumption and TG was mediated by log2-transformed BHg [total effect = -0.037 (-0.074, -0.001); indirect effect = 0.009 (0.004, 0.015)], and the proportion mediated by log2-transformed BHg was 24.25%. BHg may reduce the beneficial effect of sea fish consumption frequency on TG levels among Chinese adults. Overall, sea fish consumption has more benefits than harms to TG.
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Affiliation(s)
- Bing Wu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yingli Qu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yifu Lu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Saisai Ji
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liang Ding
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zheng Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Miao Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Heng Gu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qi Sun
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bo Ying
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Feng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xulin Zheng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yidan Qiu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zheng Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Ying Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhaojin Cao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuebin Lv
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
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Abstract
This study investigated the association between the different types of plant-based diets and dyslipidaemia in Korean adults using data from the nationally representative sample. Using the 2012–2016 Korea National Health and Nutrition Survey data, a total of 14 167 adults (≥19 years old) participated in this study. Dietary intake was assessed by a semi-quantitative FFQ. Three different plant-based diet indices (overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), unhealthful plant-based diet index (uPDI)), were calculated. Dyslipidaemia and its components (hypertriacylglycerolaemia, hypercholesterolaemia, low HDL-cholesterol, high LDL-cholesterol, use of anti-hyperlipidaemia agent) were measured. Multivariable logistic regression analysis was used to examine the associations between plant-based diet and dyslipidaemia and individual lipid disorders. Totally, 47% of overall population had dyslipidaemia. Individual in the highest quintile of uPDI had 22% greater odds of dyslipidaemia (95 % CI 1·05, 1·41) and 48 % higher odds of hypertriacylglycerolaemia (95 % CI 1·21, 1·81) and 16% higher odds of low HDL-cholesterol (OR: 1·16, 95 % CI 1·00, 1·35) than those in the lowest quintile of uPDI. PDI was associated with 16 % higher odds of low HDL-cholesterol, and hPDI was associated with 25% lower odds of high LDL-cholesterol. However, neither PDI nor hPDI was significantly associated with the prevalence of dyslipidaemia. Greater adherence to unhealthful plant-based diets was associated with greater odds of the dyslipidaemia and its components suggesting the importance of the quality of plant-based diet in South Korean adults for dyslipidaemia prevention.
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