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Wismayer R, Kiwanuka J, Wabinga H, Odida M. Dietary risk factors for colorectal cancer in Uganda: a case-control study. BMC Nutr 2024; 10:88. [PMID: 38898481 PMCID: PMC11186163 DOI: 10.1186/s40795-024-00894-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 06/05/2024] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION Low-income countries in East Africa have a lower incidence of colorectal cancer (CRC) than high-income countries; however, the incidence has steadily increased in the last few decades. In Uganda, the extent to which genetic and environmental factors, particularly dietary factors, contribute to the aetiology of CRC is unclear. Therefore, the objective of our study was to determine the relationship between dietary factors and CRC in Uganda. METHODS We conducted a case-control study and recruited 128 cases and 256 controls, matched for age (± 5 years) and sex. Data regarding the frequency of consumption of the dietary factors were obtained from all the participants using an interview-based questionnaire. The potential dietary risk factors and protective factors evaluated included the type and frequency of meat consumed and the type and frequency of high-fibre foods consumed. The frequency was either 4 or more times/week, 2-3 times/week, once/week or never. Conditional logistic regression analyses were used to determine the odds ratios associated with the different risk and protective factors. RESULTS The median age (IQR) for the case participants was 55.5 (43-67.5) years, and that of the control participants was 54 (42-65) years. The male-to-female ratio was 1:1 for all the participants. Factors significantly associated with CRC cases included:- the consumption of boiled beef 2-3 times/week (aOR:3.24; 95% CI: 1.08-9.69; p < 0.035). Consumption of high-fibre foods, including:- millet for ≥ 4 times/week (aOR: 0.23; 95% CI: 0.09-0.62; p = 0.003)), spinach for ≥ 4 times/week (aOR:0.32; 95% CI: 0.11-0.97; p = 0.043), and potatoes 2-3 times/week (aOR: 0.30; 95% CI: 0.09-0.97; p = 0.044), were protective against CRC. Boiled cassava showed a tendency to reduce the likelihood of CRC when consumed ≥ 4 times/week (aOR:0.38; 95% CI: 0.12-1.18) however this did not reach statistical significance (p = 0.093). CONCLUSIONS The consumption of boiled beef increases the risk of CRC, while the intake of high-fibre foods may reduce the risk of CRC among Ugandans. We recommend nutritional educational programmes to increase public awareness regarding the protective role of a high-fibre diet and to limit the intake of cooked meat in our Ugandan population.
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Affiliation(s)
- Richard Wismayer
- Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda.
- Department of Surgery, Faculty of Health Sciences, Equator University for Science and Technology, Masaka, Uganda.
- Department of Surgery, Faculty of Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda.
- Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Julius Kiwanuka
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Henry Wabinga
- Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Michael Odida
- Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Pathology, Faculty of Medicine, Gulu University, Gulu, Uganda
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Teng C, Lu W, Che J, Wu Y, Meng D, Shan Y. Association of Pro-Inflammatory Diet, Smoking, and Alcohol Consumption with Bladder Cancer: Evidence from Case-Control and NHANES Studies from 1999 to 2020. Nutrients 2024; 16:1793. [PMID: 38892724 PMCID: PMC11174752 DOI: 10.3390/nu16111793] [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: 04/16/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND AND PURPOSE Diet might be a modifiable factor in preventing cancer by modulating inflammation. This study aims to explore the association between the dietary inflammatory index (DII) score and the risk of bladder cancer (BC). METHODS A total of 112 BC patients and 292 control subjects were enrolled in a case-control trial. Additionally, we tracked a total of 109 BC patients and 319 controls, whose propensity scores were obtained from the Nutrition Examination Survey (NHANES) database spanning from 1999 to 2020. The baseline index and dietary intake data were assessed using a food frequency questionnaire (FFQ). DII scores were calculated based on the dietary intake of 20 nutrients obtained from participants and categorized into four groups. The association between the inflammatory potential of the diet and BC risk was investigated using multivariate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS High DII scores were associated with a pro-inflammatory diet and a higher risk of BC, with higher DII scores positively associated with a higher risk of BC (quartiles 4 vs. 1, ORs 4.89, 95% CIs 2.09-11.25 p < 0.001). Specifically, this might promote BC development by inducing oxidative stress and affecting DNA repair mechanisms. This result was consistent with the NHANES findings (quartiles 4 vs. 1, ORs 2.69, 95% CIs 1.25-5.77, p = 0.006) and further supported the association of pro-inflammatory diet and lifestyle factors with the risk of BC. CONCLUSIONS Diets with the highest pro-inflammatory potential were associated with an increased risk of BC. By adjusting lifestyle factors, individuals might effectively lower their DII, thereby reducing the risk of developing BC. The results are consistent with the NHANES cohort.
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Affiliation(s)
- Chunying Teng
- Department of Food Science and Engineering, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin 150001, China;
| | - Weihong Lu
- Department of Food Science and Engineering, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin 150001, China;
| | - Jiawen Che
- School of Public Health, Wenzhou Medical University, Wenzhou 325000, China; (J.C.); (Y.W.); (D.M.)
| | - Yanhong Wu
- School of Public Health, Wenzhou Medical University, Wenzhou 325000, China; (J.C.); (Y.W.); (D.M.)
| | - Danqun Meng
- School of Public Health, Wenzhou Medical University, Wenzhou 325000, China; (J.C.); (Y.W.); (D.M.)
| | - Yujuan Shan
- School of Public Health, Wenzhou Medical University, Wenzhou 325000, China; (J.C.); (Y.W.); (D.M.)
- Southern Zhejiang Institute of Radiation Medicine and Nuclear Technology, Wenzhou Medical University, Wenzhou 325035, China
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Contillo AT, Chun OK, Rodriguez NR. Considerations for a protein-focused screening instrument in clinical nutrition assessment. Clin Nutr ESPEN 2023; 58:111-116. [PMID: 38056993 DOI: 10.1016/j.clnesp.2023.09.915] [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: 02/08/2023] [Revised: 09/11/2023] [Accepted: 09/16/2023] [Indexed: 12/08/2023]
Abstract
Physiological stress during injury and surgery negatively impacts protein balance and muscle mass maintenance. Adequate perioperative protein intake may attenuate muscle atrophy to maintain and facilitate functional recovery, particularly in older adults; yet, screening tools routinely used in clinical settings do not specifically assess protein intake when assessing nutrition risk. Although assessing malnutrition is a priority, suboptimal protein intake in non-malnourished patients should also be identified given protein's critical role in muscle health. This opinion paper highlights the potential for using a clinically appropriate protein-focused screener for rapid and efficient characterization of protein intake.
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Affiliation(s)
- Allison T Contillo
- University of Connecticut, Department of Nutritional Sciences, Storrs, CT, 06269, USA.
| | - Ock K Chun
- University of Connecticut, Department of Nutritional Sciences, Storrs, CT, 06269, USA.
| | - Nancy R Rodriguez
- University of Connecticut, Department of Nutritional Sciences, Storrs, CT, 06269, USA.
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Gorbachev V, Nikitin I, Velina D, Zhuchenko N, Kosenkov AN, Sokolov A, Zavalishin I, Stolyarova A, Nikulchev E. The Impact of Social Well-Being on Population Diet Nutritional Value and Antiradical Status. Foods 2023; 12:2619. [PMID: 37444358 DOI: 10.3390/foods12132619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/29/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
The paper presents the result of assessing the antiradical status of consumers (in the context of Russia) in connection with their well-being. This approach is based on a multistage study, in which the results of sociological surveys were applied, as well as estimates of the antiradical potential (ARP) of diets obtained using neural networks, bootstrapping the chemical composition of diets, and calculating reference values using mathematical models. The paper presents data collected from residents living in the territories of at least 21 regions and cities of Russia: Magadan, Saint Petersburg, Moscow, Krasnodar, Lipetsk, Vladivostok, Novosibirsk, Omsk, Voronezh, etc. A total of 1001 people were interviewed, which, according to our calculations, gives a margin of error in value of approximately 3.1%. To calculate the lack of vitamins in the diets of residents of the Russian Federation, data on the chemical composition of food products from the FNDDS database were used. The assessment of dietary habits showed a lack of vitamins below the recommended level in 73% of Russians for vitamin D, 59% for retinol, 38% for β-carotenes, 13% for vitamin E, and 6% for ascorbic acid. The study showed that at least 36% of the Russian population has a low antiradical status, while it was found that "poor" consumers are more likely to consume economically more expensive foods (in terms of their nutritional value). The "poor" segments of the population consume 180-305% more canned food and 38-68% more sweet carbonated drinks than other social groups, but their consumption of vegetables is 23-48% lower. On the contrary, "wealthy" consumers consume 17-25% more complex (varied) dishes, 10-68% more fresh vegetables, and 8-39% more fish. From the obtained values it follows that consumers with low levels of ARP in their diets are in a group with an increased probability of a number of "excess" diseases (diseases of the cardiovascular system, obesity, etc.). In general, the ARP values of food consumed for low-income segments of the population were 2.3 times lower (the ratio was calculated as the percentage of consumers below the level of 11,067 equivalents necessary for the disposal of free radicals generated in the human body per day) than for those who can afford expensive food (consumers with high income). A simple increase in consumption of unbalanced foods, in our opinion, will only contribute to the entry of these consumers into the "average diet trap". All this makes it imperative to develop comprehensive measures to create a new concept of public catering; otherwise, we can expect a reduction in both the health of the population and the performance of the economy of the whole country.
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Affiliation(s)
- Victor Gorbachev
- Research Laboratory of Nutritional Systems Biotechnology, The Plekhanov Russian University of Economics, 36 Stremyanny Per., 117997 Moscow, Russia
| | - Igor Nikitin
- Research Laboratory of Nutritional Systems Biotechnology, The Plekhanov Russian University of Economics, 36 Stremyanny Per., 117997 Moscow, Russia
- Department of Biotechnology of Food Products from Plant and Animal Raw Materials, K.G. Razumovsky Moscow State University of Technologies and Management (the First Cossack University), 73 Zemlyanoy Val, 109004 Moscow, Russia
| | - Daria Velina
- Research Laboratory of Nutritional Systems Biotechnology, The Plekhanov Russian University of Economics, 36 Stremyanny Per., 117997 Moscow, Russia
- Department of Biotechnology of Food Products from Plant and Animal Raw Materials, K.G. Razumovsky Moscow State University of Technologies and Management (the First Cossack University), 73 Zemlyanoy Val, 109004 Moscow, Russia
| | - Natalia Zhuchenko
- Department of Medical Genetics, I.M. Sechenov First Moscow State Medical University, 8-2 Trubetskaya Str., 119435 Moscow, Russia
| | - Alexander N Kosenkov
- Department of Hospital Surgery, I.M. Sechenov First Moscow State Medical University, 8-2 Trubetskaya Str., 119435 Moscow, Russia
| | - Andrey Sokolov
- Mental-Health Clinic No. 1 Named after N.A. Alexeev, 2 Zagorodnoe Shosse, 117152 Moscow, Russia
| | - Igor Zavalishin
- Higher School of Public Administration, Financial University under the Government of the Russian Federation, 49 Leningradsky Prospekt, 125167 Moscow, Russia
| | - Alla Stolyarova
- Department of Management and Economics, State University of Humanities and Social Studies, 30 St. Zelenaya, 140400 Kolomna, Russia
| | - Evgeny Nikulchev
- Department of Digital Data Processing Technologies, MIREA-Russian Technological University, 78 Vernadsky Avenue, 119454 Moscow, Russia
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Peterson L, Lee H, Huybrechts I, Biessy C, Neuhouser ML, Haaland B, Krick B, Gunter M, Schulze MB, Jannasch F, Coletta AM, Hardikar S, Chaix A, Bauer CX, Xiao Q, Playdon MC. Reliability estimates for assessing meal timing derived from longitudinal repeated 24-hour dietary recalls. Am J Clin Nutr 2023; 117:964-975. [PMID: 36921904 PMCID: PMC10206325 DOI: 10.1016/j.ajcnut.2023.02.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 02/17/2023] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Regulating meal timing may have efficacy for improving metabolic health for preventing or managing chronic disease. However, the reliability of measuring meal timing with commonly used dietary assessment tools needs characterization prior to investigating meal timing and health outcomes in epidemiologic studies. OBJECTIVES To evaluate the reliability of estimating meal timing parameters, including overnight fasting duration, the midpoint of overnight fasting time, the number of daily eating episodes, the period with the largest percentage of daily caloric intake, and late last eating episode (> 09:00 pm) from repeated 24-h dietary recalls (24HRs). METHODS Intraclass correlation coefficients (ICC), Light's Kappa estimates, and 95% CIs were calculated from repeated 24HR administered in 3 epidemiologic studies: The United States-based Interactive Diet and Activity Tracking in AARP (IDATA) study (n = 996, 6 24HR collected over 12-mo), German EPIC-Potsdam Validation Study (European Prospective Investigation into Cancer and Nutrition Potsdam Germany cohort) (n = 134, 12 24HR collected over 12-mo) and EPIC-Potsdam BMBF-II Study (Federal Ministry of Education and Research, "Bundesministerium für Bildung und Forschung") (n = 725, 4 24HR collected over 36 mo). RESULTS Measurement reliability of overnight fasting duration based on a single 24HR was "poor" in all studies [ICC range: 0.27; 95% CI: 0.23, 0.32 - 0.46; 95% CI: 0.43, 0.50]. Reliability was "moderate" with 3 24HR (ICC range: 0.53; 95% CI: 0.47, 0.58 in IDATA, 0.62; 95% CI: 0.52, 0.69 in the EPIC-Potsdam Validation Study, and 0.72; 95% CI: 0.70-0.75 in the EPIC-Potsdam BMBF-II Study). Results were similar for the midpoint of overnight fasting time and the number of eating episodes. Reliability of measuring late eating was "fair" in IDATA (Light's Kappa: 0.30; 95% CI: 0.21, 0.39) and "slight" in the EPIC-Potsdam Validation study and the EPIC-Potsdam BMBF-II study (Light's Kappa: 0.19; 95% CI: 0.15, 0.25 and 0.09; 95% CI: 0.06, 0.12, respectively). Reliability estimates differed by sex, BMI, weekday, and season of 24HR administration in some studies. CONCLUSIONS Our results show that ≥ 3 24HR over a 1-3-y period are required for reliable estimates of meal timing variables.
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Affiliation(s)
- Lacie Peterson
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department Nutrition, Dietetics and Food Sciences, Utah State University, Logan, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Hyejung Lee
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Inge Huybrechts
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Carine Biessy
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Marian L Neuhouser
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Benjamin Haaland
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Benjamin Krick
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Marc Gunter
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany; NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Franziska Jannasch
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany; NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany
| | - Adriana M Coletta
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States; Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States
| | - Sheetal Hardikar
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Amandine Chaix
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States; Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States
| | - Cici X Bauer
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Qian Xiao
- Department of Epidemiology, Human Genetics, and Environmental Science, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Mary C Playdon
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States.
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Rigutto-Farebrother J, Ahles S, Cade J, Murphy KJ, Plat J, Schwingshackl L, Roche HM, Shyam S, Lachat C, Minihane AM, Weaver C. Perspectives on the application of CONSORT guidelines to randomised controlled trials in nutrition. Eur J Nutr 2023:10.1007/s00394-023-03137-5. [PMID: 37099211 DOI: 10.1007/s00394-023-03137-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/21/2023] [Indexed: 04/27/2023]
Abstract
PURPOSE Reporting guidelines facilitate quality and completeness in research reporting. The CONsolidated Standards Of Reporting Trials (CONSORT) statement is widely applied to dietary and nutrition trials but has no extension specific to nutrition. Evidence suggests poor reporting in nutrition research. The Federation of European Nutrition Societies led an initiative to make recommendations for a nutrition extension to the CONSORT statement towards a more robust reporting of the evidence base. METHODS An international working group was formed of nutrition researchers from 14 institutions in 12 different countries and on five continents. Using meetings over a period of one year, we interrogated the CONSORT statement specifically for its application to report nutrition trials. RESULTS We provide a total of 28 new nutrition-specific recommendations or emphasised recommendations for the reporting of the introduction (three), methods (twelve), results (five) and discussion (eight). We also added two additional recommendations that were not allocated under the standard CONSORT headings. CONCLUSION We identify a need to provide guidance in addition to CONSORT to improve the quality and consistency of the reporting and propose key considerations for further development of formal guidelines for the reporting of nutrition trials. Readers are encouraged to engage in this process, provide comments and conduct specific studies to inform further work on the development of reporting guidelines for nutrition trials.
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Affiliation(s)
- Jessica Rigutto-Farebrother
- Human Nutrition Laboratory, Institute for Food, Nutrition and Health, ETH Zürich, Zürich, Switzerland.
- Laboratory for Nutrition and Metabolic Epigenetics, Institute for Food, Nutrition and Health, LFV E14.1, Schmelzbergstrasse 7, 8092, Zurich, Switzerland.
- Global Center for the Development of the Whole Child, University of Notre Dame, South Bend, USA.
| | - Sanne Ahles
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
- BioActor BV, Maastricht, The Netherlands
| | - Janet Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Karen J Murphy
- Clinical and Health Sciences, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
| | - Jogchum Plat
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Helen M Roche
- Nutrigenomics Research Group, UCD Conway Institute, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
- Institute for Global Food Security, School of Biological Sciences, Queens University Belfast, Belfast, UK
| | - Sangeetha Shyam
- Centre for Translational Research, Institute for Research, Development, and Innovation (IRDI), International Medical University, Kuala Lumpur, Malaysia
- Departament de Bioquímica i Biotecnologia, Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Universitat Rovira i Virgili, Unitat de Nutrició Humana, Instituto de Salud Carlos III (ISCIII), Reus, Spain
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Ghent University, Ghent, Belgium
| | - Anne-Marie Minihane
- Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia (UEA), Norwich, UK
- Norwich Institute of Healthy Ageing, UEA, Norwich, UK
| | - Connie Weaver
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, USA
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7
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Sobiecki JG, Imamura F, Davis CR, Sharp SJ, Koulman A, Hodgson JM, Guevara M, Schulze MB, Zheng JS, Agnoli C, Bonet C, Colorado-Yohar SM, Fagherazzi G, Franks PW, Gundersen TE, Jannasch F, Kaaks R, Katzke V, Molina-Montes E, Nilsson PM, Palli D, Panico S, Papier K, Rolandsson O, Sacerdote C, Tjønneland A, Tong TYN, van der Schouw YT, Danesh J, Butterworth AS, Riboli E, Murphy KJ, Wareham NJ, Forouhi NG. A nutritional biomarker score of the Mediterranean diet and incident type 2 diabetes: Integrated analysis of data from the MedLey randomised controlled trial and the EPIC-InterAct case-cohort study. PLoS Med 2023; 20:e1004221. [PMID: 37104291 PMCID: PMC10138823 DOI: 10.1371/journal.pmed.1004221] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/15/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Self-reported adherence to the Mediterranean diet has been modestly inversely associated with incidence of type 2 diabetes (T2D) in cohort studies. There is uncertainty about the validity and magnitude of this association due to subjective reporting of diet. The association has not been evaluated using an objectively measured biomarker of the Mediterranean diet. METHODS AND FINDINGS We derived a biomarker score based on 5 circulating carotenoids and 24 fatty acids that discriminated between the Mediterranean or habitual diet arms of a parallel design, 6-month partial-feeding randomised controlled trial (RCT) conducted between 2013 and 2014, the MedLey trial (128 participants out of 166 randomised). We applied this biomarker score in an observational study, the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study, to assess the association of the score with T2D incidence over an average of 9.7 years of follow-up since the baseline (1991 to 1998). We included 22,202 participants, of whom 9,453 were T2D cases, with relevant biomarkers from an original case-cohort of 27,779 participants sampled from a cohort of 340,234 people. As a secondary measure of the Mediterranean diet, we used a score estimated from dietary-self report. Within the trial, the biomarker score discriminated well between the 2 arms; the cross-validated C-statistic was 0.88 (95% confidence interval (CI) 0.82 to 0.94). The score was inversely associated with incident T2D in EPIC-InterAct: the hazard ratio (HR) per standard deviation of the score was 0.71 (95% CI: 0.65 to 0.77) following adjustment for sociodemographic, lifestyle and medical factors, and adiposity. In comparison, the HR per standard deviation of the self-reported Mediterranean diet was 0.90 (95% CI: 0.86 to 0.95). Assuming the score was causally associated with T2D, higher adherence to the Mediterranean diet in Western European adults by 10 percentiles of the score was estimated to reduce the incidence of T2D by 11% (95% CI: 7% to 14%). The study limitations included potential measurement error in nutritional biomarkers, unclear specificity of the biomarker score to the Mediterranean diet, and possible residual confounding. CONCLUSIONS These findings suggest that objectively assessed adherence to the Mediterranean diet is associated with lower risk of T2D and that even modestly higher adherence may have the potential to reduce the population burden of T2D meaningfully. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000602729 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=363860.
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Affiliation(s)
- Jakub G. Sobiecki
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Courtney R. Davis
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Stephen J. Sharp
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Albert Koulman
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Nutritional Biomarker Laboratory, National Institute for Health Research Biomedical Research Centre, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Jonathan M. Hodgson
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - Marcela Guevara
- Navarra Public Health Institute, Pamplona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Ju-Sheng Zheng
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Key Laboratory of Growth Regulation and Translation Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Catalina Bonet
- Unit of Nutrition and Cancer, Catalan Institute of Oncology—ICO, L’Hospitalet de Llobregat, Barcelona, Spain
- Nutrition and Cancer Group, Bellvitge Biomedical Research Institute—IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Sandra M. Colorado-Yohar
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Insitute of Health, Strassen, Luxembourg
- Center of Epidemiology and Population Health UMR 1018, Inserm, Paris South—Paris Saclay University, Gustave Roussy Institute, Villejuif, France
| | - Paul W. Franks
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - Franziska Jannasch
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Esther Molina-Montes
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Institute of Nutrition and Food Technology (INYTA) ‘José Mataix’, Biomedical Research Centre, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Nutrition and Food Science, University of Granada, Granada, Spain
| | | | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network—ISPRO, Florence, Italy
| | - Salvatore Panico
- Department of Mental, Physical Health and Preventive Medicine, University “L. Vanvitelli”, Naples, Italy
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Olov Rolandsson
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Turin, Italy
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tammy Y. N. Tong
- Department of Mental, Physical Health and Preventive Medicine, University “L. Vanvitelli”, Naples, Italy
| | - Yvonne T. van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - John Danesh
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- British Heart Foundation Cambridge Centre of Excellence, Division of Cardiovascular Medicine, Addenbrooke’s Hospital, Cambridge, United Kingdom
- Department of Human Genetics, Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom
- Health Data Research UK Cambridge, University of Cambridge, Cambridge, United Kingdom
| | - Adam S. Butterworth
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Elio Riboli
- School of Public Health, Imperial College London, London, United Kingdom
| | - Karen J. Murphy
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Nicholas J. Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Nita G. Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
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Roy A, Sarkar A. Bayesian semiparametric multivariate density deconvolution via stochastic rotation of replicates. Comput Stat Data Anal 2023. [DOI: 10.1016/j.csda.2023.107706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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9
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Cole JB, Westerman KE, Manning AK, Florez JC, Hirschhorn JN. Genetic heritability as a tool to evaluate the precision of 24-hour recall dietary questionnaire variables in UK Biobank. Front Genet 2023; 13:1070511. [PMID: 36685884 PMCID: PMC9845390 DOI: 10.3389/fgene.2022.1070511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/09/2022] [Indexed: 01/06/2023] Open
Abstract
A variety of statistical approaches in nutritional epidemiology have been developed to enhance the precision of dietary variables derived from longitudinal questionnaires. Correlation with biomarkers is often used to assess the relative validity of these different approaches, however, validated biomarkers do not always exist and are costly and laborious to collect. We present a novel high-throughput approach which utilizes the modest but importantly non-zero influence of genetic variation on variation in dietary intake to compare different statistical transformations of dietary variables. Specifically, we compare the heritability of crude averages with Empirical Bayes weighted averages for 302 correlated dietary variables from multiple 24-hour recall questionnaires in 177 K individuals in UK Biobank. Overall, the crude averages for frequency of consumption are more heritable than their Empirical Bayes counterparts only when the reliability of that item across questionnaires is high (measured by intra-class correlation), otherwise, the Empirical Bayes approach (for both unreliably measured frequencies and for average quantities independent of reliability) leads to higher heritability estimates. We also find that the more heritable versions of each dietary variable lead to stronger underlying statistical associations with specific genetic loci, many of which have well-known mechanisms, further supporting heritability as an alternative metric for relative validity in nutritional epidemiology and beyond.
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Affiliation(s)
- Joanne B. Cole
- Programs in Metabolism and Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
- Division of Endocrinology, Boston Children’s Hospital, Boston, MA, United States
- Department of Biomedical Informatics, University of Colorado School of Medicine, Aurora, CO, United States
| | - Kenneth E. Westerman
- Programs in Metabolism and Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA, United States
| | - Alisa K. Manning
- Programs in Metabolism and Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
- Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA, United States
| | - Jose C. Florez
- Programs in Metabolism and Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Joel N. Hirschhorn
- Programs in Metabolism and Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, United States
- Division of Endocrinology, Boston Children’s Hospital, Boston, MA, United States
- Department of Genetics, Harvard Medical School, Boston, MA, United States
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10
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Do we eat what we buy? Relative validity of grocery purchase data as an indicator of food consumption in the LoCard study. Br J Nutr 2022; 128:1780-1788. [PMID: 34657639 DOI: 10.1017/s0007114521004177] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The validity of grocery purchase data as an indicator of food consumption is uncertain. This paper investigated (1) the associations between food consumption and grocery purchases using automatically accumulated purchase data and (2) whether the strength of the associations differed in certain sub-populations. The participants filled in a FFQ, and a major Finnish retailer issued us with their loyalty-card holders' grocery purchase data covering the 1- and 12-month periods preceding the FFQ. We used gamma statistics to study the association between thirds/quarters of FFQ and grocery purchase data (frequency/amount) separately for eighteen food groups among the 11 983 participants. Stratified analyses were conducted for subgroups based on sex, family structure, educational level, household income and self-estimated share of purchases from the retailer. We also examined the proportion of participants classified into the same, adjacent, subsequent and opposite categories using the FFQ and purchase data. The gammas ranged from 0·12 (cooked vegetables) to 0·75 (margarines). Single households had stronger gammas than two-adult families, and participants with > 60 % of purchases from the retailer had stronger gammas. For most food groups, the proportion of participants classified into the same or adjacent category was > 70 %. Most discrepancies were observed for fresh/cooked vegetables, berries and vegetable oils. Even though the two methods did not categorise all food groups similarly, we conclude that grocery purchase data are able to describe food consumption in an adult population, and future studies should consider purchase data as a resource-saving and moderately valid measure in large samples.
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11
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Chen J, Jahn HJ, Sun HZ, Ning Z, Lu W, Ho KF, Ward TJ. Validity of using ambient concentrations as surrogate exposures at the individual level for fine particle and black carbon: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 312:120030. [PMID: 36037851 DOI: 10.1016/j.envpol.2022.120030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/13/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Exposure measurement error is an important source of bias in epidemiological studies. We assessed the validity of employing ambient (outdoor) measurements as proxies of personal exposures at individual levels focusing on fine particles (PM2.5) and black carbon (BC)/elemental carbon (EC) on a global scale. We conducted a systematic review and meta-analysis and searched databases (ISI Web of Science, Scopus, PubMed, Ovid MEDLINE®, Ovid Embase, and Ovid BIOSIS) to retrieve observational studies in English language published from 1 January 2006 until 5 May 2021. Correlation coefficients (r) between paired ambient (outdoor) concentration and personal exposure for PM2.5 or BC/EC were standardized as effect size. We used random-effects meta-analyses to pool the correlation coefficients and investigated the causes of heterogeneity and publication bias. Furthermore, we employed subgroup and meta-regression analyses to evaluate the modification of pooled estimates by potential mediators. This systematic review identified thirty-two observational studies involving 1744 subjects from ten countries, with 28 studies for PM2.5 and 11 studies for BC/EC. Personal PM2.5 exposure is more strongly correlated with ambient (outdoor) concentrations (0.63, 95% confidence interval [CI]: 0.57-0.68) than personal BC/EC exposure (0.49, 95% CI: 0.38-0.59), with significant differences in ṝ (0.14, 95% CI: 0.03-0.25; p < 0.05). The results demonstrated that the health status of participants was a significant modifier of pooled correlations. In addition, the personal to ambient (P/A) ratio for PM2.5 and average ambient BC/EC levels were potential effect moderators of the pooled ṝ. The funnel plots and Egger's regression test indicated inevident publication bias. The pooled estimates were robust through sensitivity analyses. The results support the growing consensus that the validity coefficient of proxy measures should be addressed when interpreting results from epidemiological studies to better understand how strong health outcomes are affected by different levels of PM2.5 and their components.
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Affiliation(s)
- Jiayao Chen
- Department of Real Estate and Construction, Faculty of Architecture, The University of Hong Kong, Hong Kong, China; Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen, China.
| | - Heiko J Jahn
- Faculty of Human Sciences, University of Kassel, Kassel, Germany
| | - Haitong Zhe Sun
- Centre for Atmospheric Science, Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK; Department of Earth Sciences, University of Cambridge, Cambridge CB2 3EQ, UK
| | - Zhi Ning
- Division of Environment and Sustainability, Hong Kong University of Science and Technology, Hong Kong, China
| | - Weisheng Lu
- Department of Real Estate and Construction, Faculty of Architecture, The University of Hong Kong, Hong Kong, China
| | - Kin Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Tony J Ward
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
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12
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Hu Y, Tang D, Yang F, Dai S, Xiao X, Zhao X. The impacts of measurement errors on a dietary pattern analyses:a simulation study based on dietary data from the China Multi-Ethnic Cohort (CMEC) study. Am J Clin Nutr 2022; 116:523-530. [PMID: 35388875 DOI: 10.1093/ajcn/nqac092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 02/15/2022] [Accepted: 04/04/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Measurement error is a significant challenge in nutritional epidemiology research. Compared with traditional, isolated-nutrient research, dietary-pattern studies provide a more comprehensive approach to chronic disease prevention and have become popular in recent years. However, few studies have examined the impacts of measurement errors on dietary pattern analyses. OBJECTIVES We investigated the impacts of measurement errors on the 2 most commonly used dietary pattern derivation methods: principal component factor analysis (PCFA) and K-means cluster analysis (KCA). METHODS We conducted a simulation study by taking the dietary data collected in the China Multi-Ethnic Cohort study as the "true values" and adding linear measurement errors for each food group to consider both systematic and random errors. We investigated the impacts of measurement errors from 2 aspects: distortion of the derived dietary patterns and estimated associations between the dietary patterns and disease. RESULTS For both systematic and random errors, larger measurement errors caused more serious distortion of dietary patterns derived by PCFA and KCA, with consistency rates ranging from 67.5% to 100% and from 13.4% to 88.4%, respectively. In addition, for both systematic and random errors, larger measurement errors caused greater attenuation effects on the association coefficients. For a beneficial association (coefficient, -0.5), the estimated coefficients ranged from -0.287 to -0.450 and from -0.231 to -0.394 in the PCFA and KCA, respectively. For a harmful association (coefficient, 0.5), the estimated coefficients ranged from 0.295 to 0.449 and from -0.003 to 0.373 in the PCFA and KCA, respectively. Dietary patterns derived by PCFA with factor loadings of low discrepancies and dietary patterns derived by KCA with small cluster sample sizes are more vulnerable to measurement error. CONCLUSIONS Measurement errors could distort dietary patterns and attenuate the dietary pattern-disease association. The stability of dietary patterns under measurement errors differs when using PCFA and KCA.
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Affiliation(s)
- Yifan Hu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Dan Tang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Fan Yang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Suyao Dai
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiong Xiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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13
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Wan F, Pan F, Ayonrinde O, Adams LA, Mori TA, Beilin LJ, O'Sullivan TA, Olynyk JK, Oddy WH. Prospective dietary polyunsaturated fatty acid intake is associated with trajectories of fatty liver disease: an 8 year follow-up study from adolescence to young adulthood. Eur J Nutr 2022; 61:3987-4000. [PMID: 35780424 PMCID: PMC9596520 DOI: 10.1007/s00394-022-02934-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 06/07/2022] [Indexed: 11/29/2022]
Abstract
Background and aim Dietary fat intake has long been associated with fatty liver. Our study aimed to determine the effect of dietary fats on longitudinal fatty liver index (FLI) trajectories from adolescence to young adulthood.
Methods Nine hundred eighty-five participants in the Raine Study, Perth, Western Australia, Australia, had cross-sectional assessments at ages 14, 17, 20 and 22 years, during which anthropometric measurements and blood tests were obtained. FLI trajectories were derived from the longitudinal FLI results. Dietary fat intake was measured with a semi-quantitative food frequency questionnaire at 14 years and log multinominal regression analyses were used to estimate relative risks.
Results Three FLI trajectories were identified and labelled as stable-low (79.1%, N = 782), low-to-high (13.9%, N = 132), and stable-high (7%, N = 71). The low-to-high group associated with an increased intake of the long-chain polyunsaturated fatty acids EPA, DPA and DHA (RR 1.27, 95% CI 1.10–1.48) relative to the stable-low group. Compared to the stable-low group, omega-6 and the ratio of omega-6 to omega-3 in the stable-high group were associated with an increased relative risk of 1.34 (95% CI 1.02–1.76) and 1.10 (95% CI 1.03–1.16), respectively.
Conclusion For those at high risk of fatty liver in early adolescence, high omega-6 fatty acid intake and a high ratio of omega-6 to omega-3 fatty acids are associated with increased risk of fatty liver. There should be caution in assuming these associations are causal due to possible undetected and underestimated confounding factors.
Supplementary Information The online version contains supplementary material available at 10.1007/s00394-022-02934-8.
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Affiliation(s)
- Fuzhen Wan
- Nutritional Epidemiology, Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Feng Pan
- Nutritional Epidemiology, Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Oyekoya Ayonrinde
- Medical School, The University of Western Australia, Perth, WA, Australia.,Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch University, Perth, WA, Australia.,Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Leon A Adams
- Medical School, The University of Western Australia, Perth, WA, Australia.,Department of Hepatology, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Trevor A Mori
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Lawrence J Beilin
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Therese A O'Sullivan
- School of Medical and Health Science, Edith Cowan University, Perth, WA, Australia
| | - John K Olynyk
- Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch University, Perth, WA, Australia.,School of Medical and Health Science, Edith Cowan University, Perth, WA, Australia
| | - Wendy H Oddy
- Nutritional Epidemiology, Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.
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Machine learning can improve the development of evidence-based dietary guidelines. Public Health Nutr 2022; 25:2566-2569. [PMID: 35757839 DOI: 10.1017/s1368980022001392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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15
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Xie X, Guo B, Xiao X, Yin J, Wang Z, Jiang X, Li J, Long L, Zhou J, Zhang N, Zhang Y, Chen T, Kangzhuo B, Zhao X. Healthy dietary patterns and metabolic dysfunction-associated fatty liver disease in less-developed ethnic minority regions: a large cross-sectional study. BMC Public Health 2022; 22:118. [PMID: 35038997 PMCID: PMC8764858 DOI: 10.1186/s12889-021-12486-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Little is known about the associations between healthy dietary patterns and metabolic dysfunction-associated fatty liver disease (MAFLD) in less-developed ethnic minority regions (LEMRs), where the prevalence of MAFLD is increasing rapidly and dietary habits are quite different from those in developed countries. Moreover, a significant subset of MAFLD individuals in LEMRs are nonobese, but the efficacy of dietary patterns on MAFLD individuals with different obese statuses is also unclear. We aimed to test the associations of two wildly recommended a priori dietary patterns-Alternate Mediterranean diet (AMED) and Dietary Approaches to Stop Hypertension (DASH)-with the risk of MAFLD in the total population, and further in nonobese and obese individuals. METHODS We recruited 99,556 participants in the China Multi-Ethnic Cohort Study, an ongoing cohort study in less-developed southwest China. Using validated food frequency questionnaire, each participant was assigned an AMED score and a DASH score. MAFLD was ascertained as hepatic steatosis on ultrasound together with diabetes, overweight/obesity, or two other metabolic risk factors. We performed logistic regression with inverse probability of exposure weighting (IPEW) to examine associations between two dietary patterns and MAFLD, adjusting for potential confounders under the guidance of directed acyclic graphs. Further, analyses were stratified by body mass index. RESULTS We included 66,526 participants (age 49.5±11.0; 62.6% women), and the prevalence of MAFLD was 16.1%. Participants in the highest quintile of DASH score showed strong inverse associations with risks of MAFLD (OR = 0.85; 95% CI, 0.80-0.91; Ptrend < 0.001) compared with participants in the lowest quintile. The association between DASH and nonobese MAFLD (OR = 0.69; 95% CI, 0.61-0.78; Ptrend < 0.001) was stronger (I2 = 78.5 % ; Pheterogeneity = 0.001) than that with obese MAFLD (OR = 0.90; 95% CI, 0.83-0.98; Ptrend = 0.002). There was a null association between AMED and MAFLD risk. CONCLUSIONS In LEMRs, a DASH diet but not AMED was associated with MAFLD. The relationship appeared to be more pronounced in nonobese MAFLD individuals than in obese MAFLD individuals.
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Affiliation(s)
- Xiaofen Xie
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, People's South Road, Chengdu, 610041, China
| | - Bing Guo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, People's South Road, Chengdu, 610041, China
| | - Xiong Xiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, People's South Road, Chengdu, 610041, China
| | - Jianzhong Yin
- School of Public Health, Kunming Medical University, Kunming, China
- Baoshan College of Traditional Chinese Medicine, Kunming, China
| | - Ziyun Wang
- School of Public Health, the key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Xiaoman Jiang
- Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Jingzhong Li
- Tibet Center for Disease Control and Prevention, Lhasa, China
| | - Lu Long
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, People's South Road, Chengdu, 610041, China
| | - Junmin Zhou
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, People's South Road, Chengdu, 610041, China
| | - Ning Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, People's South Road, Chengdu, 610041, China
| | - Yuan Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, People's South Road, Chengdu, 610041, China
| | - Ting Chen
- Chongqing Municipal Center for Disease Control and Prevention, No.8, Changjiang 2nd Road, Chongqin, 400042, China.
| | - Baima Kangzhuo
- Tibet University, No.10, East Tibet University Road, Lhasa, 850000, China.
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No.16, People's South Road, Chengdu, 610041, China.
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16
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Dai S, Xiao X, Xu C, Jiao Y, Qin Z, Meng J, Zuo H, Zeng P, Tang D, Wu X, Nima Q, Quzong D, Zhao X. Association of Dietary Approaches to Stop Hypertension diet and Mediterranean diet with blood pressure in less-developed ethnic minority regions. Public Health Nutr 2022; 25:1-29. [PMID: 35029141 PMCID: PMC9991676 DOI: 10.1017/s1368980022000106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We aimed to investigate the association of Dietary Approaches to Stop Hypertension (DASH)-style diet and Mediterranean-style diet with blood pressure in less-developed ethnic minority regions (LMERs). DESIGN Cross-sectional study. SETTING Dietary intakes were assessed by a validated food frequency questionnaire. Dietary quality was assessed by the DASH-style diet score and the alternative Mediterranean-style diet (aMED) score. The association between dietary quality and blood pressure was evaluated using multivariate linear regression model. We further examined those associations in subgroups of blood pressure level. PARTICIPANTS A total of 81433 adults from the China Multi-Ethnic Cohort (CMEC) study were included in this study. RESULTS In the overall population, compared with the lowest quintile, the highest quintile of DASH-style diet score was negatively associated with systolic BP (coefficient: -2.78, 95% CI: -3.15 to -2.41; P-trend<0.001), while the highest quintile of aMED score had a weaker negative association with systolic BP (coefficient: -1.43, 95% CI: -1.81 to -1.05; P-trend<0.001). Both dietary indices also showed a weaker effect on diastolic BP (coefficient for DASH-style diet: -1.06, 95% CI: -1.30 to -0.82; coefficient for aMED: -0.43, 95% CI: -0.68 to -0.19). In the subgroup analysis, both dietary indices showed a stronger beneficial effect on systolic BP in the hypertension group than in either of the other subgroups. CONCLUSION Our results indicated that the healthy diet originating from Western developed countries can also have beneficial effects on blood pressure in LEMRs. DASH-style diet may be a more appropriate recommendation than aMED as part of a dietary strategy to control blood pressure, especially in hypertensive patients.
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Affiliation(s)
- Suyao Dai
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin South Road, Chengdu, Sichuan610041, China
| | - Xiong Xiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin South Road, Chengdu, Sichuan610041, China
| | - Chuanzhi Xu
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yan Jiao
- Chongqing Municipal Centre for Disease Control and Prevention, Chongqing, China
| | - Zixiu Qin
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou, China
| | - Jiantong Meng
- Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Haojiang Zuo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin South Road, Chengdu, Sichuan610041, China
| | - Peibin Zeng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin South Road, Chengdu, Sichuan610041, China
| | - Dan Tang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin South Road, Chengdu, Sichuan610041, China
| | - Xinyu Wu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin South Road, Chengdu, Sichuan610041, China
| | - Qucuo Nima
- Tibet Centre for Disease Control and Prevention CN, No. 21, Linkuo North Road, Chengguan District, Lhasa, Tibet Autonomous Region850000, China
| | - Deji Quzong
- Tibet University, No.10, East Tibet University Road, Lhasa, Tibet Autonomous Region850000, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin South Road, Chengdu, Sichuan610041, China
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Ashrafi RA, Ahola AJ, Rosengård-Bärlund M, Saarinen T, Heinonen S, Juuti A, Marttinen P, Pietiläinen KH. Computational modelling of self-reported dietary carbohydrate intake on glucose concentrations in patients undergoing Roux-en-Y gastric bypass versus one-anastomosis gastric bypass. Ann Med 2021; 53:1885-1895. [PMID: 34714211 PMCID: PMC8567939 DOI: 10.1080/07853890.2021.1964035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/29/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Our aim was to investigate in a real-life setting the use of machine learning for modelling the postprandial glucose concentrations in morbidly obese patients undergoing Roux-en-Y gastric bypass (RYGB) or one-anastomosis gastric bypass (OAGB). METHODS As part of the prospective randomized open-label trial (RYSA), data from obese (BMI ≥35 kg/m2) non-diabetic adult participants were included. Glucose concentrations, measured with FreeStyle Libre, were recorded over 14 preoperative and 14 postoperative days. During these periods, 3-day food intake was self-reported. A machine learning model was applied to estimate glycaemic responses to the reported carbohydrate intakes before and after the bariatric surgeries. RESULTS Altogether, 10 participants underwent RYGB and 7 participants OAGB surgeries. The glucose concentrations and carbohydrate intakes were reduced postoperatively in both groups. The relative time spent in hypoglycaemia increased regardless of the operation (RYGB, from 9.2 to 28.2%; OAGB, from 1.8 to 37.7%). Postoperatively, we observed an increase in the height of the fitted response curve and a reduction in its width, suggesting that the same amount of carbohydrates caused a larger increase in the postprandial glucose response and that the clearance of the meal-derived blood glucose was faster, with no clinically meaningful differences between the surgeries. CONCLUSIONS A detailed analysis of the glycaemic responses using food diaries has previously been difficult because of the noisy meal data. The utilized machine learning model resolved this by modelling the uncertainty in meal times. Such an approach is likely also applicable in other applications involving dietary data. A marked reduction in overall glycaemia, increase in postprandial glucose response, and rapid glucose clearance from the circulation immediately after surgery are evident after both RYGB and OAGB. Whether nondiabetic individuals would benefit from monitoring the post-surgery hypoglycaemias and the potential to prevent them by dietary means should be investigated.KEY MESSAGESThe use of a novel machine learning model was applicable for combining patient-reported data and time-series data in this clinical study.Marked increase in postprandial glucose concentrations and rapid glucose clearance were observed after both Roux-en-Y gastric bypass and one-anastomosis gastric bypass surgeries.Whether nondiabetic individuals would benefit from monitoring the post-surgery hypoglycaemias and the potential to prevent them by dietary means should be investigated.
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Affiliation(s)
- Reza A. Ashrafi
- Department of Computer Science, Helsinki Institute for Information Technology HIIT, Aalto University, Helsinki, Finland
| | - Aila J. Ahola
- Faculty of Medicine, Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Department of Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Milla Rosengård-Bärlund
- Obesity Center, Endocrinology, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tuure Saarinen
- Faculty of Medicine, Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
- Department of Gastrointestinal Surgery, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Sini Heinonen
- Faculty of Medicine, Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
| | - Anne Juuti
- Department of Gastrointestinal Surgery, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Pekka Marttinen
- Department of Computer Science, Helsinki Institute for Information Technology HIIT, Aalto University, Helsinki, Finland
| | - Kirsi H. Pietiläinen
- Faculty of Medicine, Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
- Obesity Center, Endocrinology, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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18
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Peralta M, Heskey C, Shavlik D, Knutsen S, Mashchak A, Jaceldo-Siegl K, Fraser GE, Orlich MJ. Validity of FFQ Estimates of Total Sugars, Added Sugars, Sucrose and Fructose Compared to Repeated 24-h Recalls in Adventist Health Study-2 Participants. Nutrients 2021; 13:nu13114152. [PMID: 34836407 PMCID: PMC8622229 DOI: 10.3390/nu13114152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 01/01/2023] Open
Abstract
Sugar intake is a potentially important aspect of diet which has not previously been validated in the Adventist Health Study-2 (AHS-2). We sought to validate the food frequency questionnaire (FFQ) measurement of total sugars, added sugars, sucrose, and fructose against multiple 24-h dietary recalls (recalls) in AHS-2 participants. Food consumption data from a self-administered FFQ and six recalls from 904 participants were combined with nutrient profile data to estimate daily sugar intake. Validity was evaluated among all participants and by race. FFQ and recall means were compared and correlation coefficients (Spearman’s, energy-adjusted log-transformed Pearson’s, deattenuated Pearson’s) were calculated. Mean total energy, total sugars, and fructose intake were higher in the FFQ, whereas added sugars and sucrose were higher in recalls. The energy-adjusted (log-transformed) deattenuated correlations among all participants were: total sugars (r = 0.42, 95% CI 0.32–0.52), added sugars (r = 0.50, 95% CI 0.36–0.59), sucrose (r = 0.32, 95% CI 0.23–0.42), and fructose (r = 0.50, 95% CI 0.40–0.59). We observed moderate validity for added sugars and fructose and low-moderate validity for total sugars and sucrose measured by the AHS-2 FFQ in this population. Dietary sugar estimates from this FFQ may be useful in assessing possible associations of sugars intake with health outcomes.
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Affiliation(s)
- Mericarmen Peralta
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (C.H.); (D.S.); (S.K.); (A.M.); (K.J.-S.); (G.E.F.); (M.J.O.)
- Correspondence:
| | - Celine Heskey
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (C.H.); (D.S.); (S.K.); (A.M.); (K.J.-S.); (G.E.F.); (M.J.O.)
| | - David Shavlik
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (C.H.); (D.S.); (S.K.); (A.M.); (K.J.-S.); (G.E.F.); (M.J.O.)
| | - Synnove Knutsen
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (C.H.); (D.S.); (S.K.); (A.M.); (K.J.-S.); (G.E.F.); (M.J.O.)
| | - Andrew Mashchak
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (C.H.); (D.S.); (S.K.); (A.M.); (K.J.-S.); (G.E.F.); (M.J.O.)
| | - Karen Jaceldo-Siegl
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (C.H.); (D.S.); (S.K.); (A.M.); (K.J.-S.); (G.E.F.); (M.J.O.)
| | - Gary E. Fraser
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (C.H.); (D.S.); (S.K.); (A.M.); (K.J.-S.); (G.E.F.); (M.J.O.)
| | - Michael J. Orlich
- School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA; (C.H.); (D.S.); (S.K.); (A.M.); (K.J.-S.); (G.E.F.); (M.J.O.)
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19
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McGrattan AM, Stephan BCM, Shannon OM, Mazidi M, Gilchrist M, Smallwood M, Winyard P, McMahon N, Blekkenhorst LC, Mohan D, Bandinelli S, Robinson L, Ferrucci L, Siervo M. Independent and interactive associations of dietary nitrate and salt intake with blood pressure and cognitive function: a cross-sectional analysis in the InCHIANTI study. Int J Food Sci Nutr 2021; 73:491-502. [PMID: 34783276 DOI: 10.1080/09637486.2021.1993157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Blood pressure (BP) control is a key target for interventions to reduce cognitive decline. This cross-sectional study explored associations between objective (24-hour urine excretion) and subjective (food frequency questionnaire [FFQ]) measures of dietary sodium and nitrate intakes with cognitive function and resting BP in the InCHIANTI cohort. Baseline data from 989 participants aged >50 years were included. In fully adjusted models, participants with concurrent high nitrate and low sodium (Odds Ratio (OR)=0.49, 95%CI 0.32-0.76, p = 0.001) and high nitrate and high sodium (OR = 0.49, 95%CI 0.32-0.77, p = 0.002) 24-hour urinary concentrations had lower odds of high BP than participants with low nitrate and high sodium concentrations. We found no significant associations between sodium and nitrate intakes (24-hour urinary concentrations and FFQ) and poor cognitive performance. Urinary nitrate excretion was associated with lower BP and results appeared to be independent of sodium intake. Further analyses in longitudinal studies are required to substantiate these findings.
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Affiliation(s)
- Andrea M McGrattan
- School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Oliver M Shannon
- Faculty of Medical Sciences, Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Mohsen Mazidi
- Department of Twin Research & Genetic Epidemiology, King's College London, London, UK.,Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Mark Gilchrist
- Institute of Biomedical and Clinical Sciences, University of Exeter and NIHR Exeter Clinical Research Facility, Exeter, Devon, UK
| | | | - Paul Winyard
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Nicholas McMahon
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, QLD, Australia
| | - Lauren C Blekkenhorst
- School of Medical and Health Sciences, Institute for Nutrition Research, Edith Cowan University, Perth, WA, Australia.,Medical School, The University of Western Australia, Perth, WA, Australia
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Stefania Bandinelli
- Laboratory of Clinical Epidemiology, InCHIANTI Study Group, LHTC Local Health Tuscany Center, Florence, Italy
| | - Louise Robinson
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle up-on Tyne, UK
| | - Luigi Ferrucci
- Biomedical Research Centre, National Institute on Aging, NIH, Baltimore, MD, USA
| | - Mario Siervo
- School of Life Sciences, University of Nottingham, Nottingham, UK
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20
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Lim CKM, Lim JH, Ibrahim I, Chan YM, Zakaria NF, Yahya R, Daud ZAM. Bioelectrical Impedance Analysis Derived-Phase Angle as a Pragmatic Tool to Detect Protein Energy Wasting among Multi-Ethnic Hemodialysis Patients. Diagnostics (Basel) 2021; 11:diagnostics11101745. [PMID: 34679443 PMCID: PMC8534349 DOI: 10.3390/diagnostics11101745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/04/2021] [Accepted: 09/19/2021] [Indexed: 11/16/2022] Open
Abstract
Protein-energy wasting (PEW) is a devastating metabolic derangement that leads to increased morbidity and mortality in hemodialysis (HD) patients. This study aimed to determine the diagnostic test accuracy of bioelectrical impedance analysis derived-phase angle (PhA) in detecting PEW among HD patients. This was a multi-centre, cross-sectional study conducted amongst 152 multi-ethnic HD patients in Klang Valley, Malaysia. PEW was assessed using the International Society of Renal Nutrition and Metabolism criteria as the reference method. PhA was measured using a multi-frequency bioelectrical impedance spectroscopy at 50 kHz. Multiple and logistic regressions were used to determine factors associated with PhA and PEW diagnosis, respectively. A receiver operating characteristics curve analysis was used to establish the gender-specific PhA cut-offs to detect PEW. PEW existed in 21.1% of the HD patients. PhA was found as an independent predictor of PEW (adjOR = 0.308, p = 0.001), with acceptable to excellent discriminative performance (adjAUCmale = 0.809; adjAUCfemale = 0.719). Male patients had higher PhA cut-off compared to female patients (4.26° vs. 3.30°). We concluded that PhA is a valid and pragmatic biomarker to detect PEW in multi-ethnic Malaysian HD patients and a gender-specific cut-off is necessary, attributed to the gender differences in body composition.
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Affiliation(s)
- Cordelia-Kheng-May Lim
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia; (C.-K.-M.L.); (J.-H.L.); (I.I.); (Y.-M.C.)
| | - Jun-Hao Lim
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia; (C.-K.-M.L.); (J.-H.L.); (I.I.); (Y.-M.C.)
| | - Imliya Ibrahim
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia; (C.-K.-M.L.); (J.-H.L.); (I.I.); (Y.-M.C.)
| | - Yoke-Mun Chan
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia; (C.-K.-M.L.); (J.-H.L.); (I.I.); (Y.-M.C.)
- Research Center of Excellent (RCoE) Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia
- Department of Dietetics, Hospital Pengajar Universiti Putra Malaysia, UPM Serdang 43400, Malaysia
| | - Nor Fadhlina Zakaria
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia;
| | - Rosnawati Yahya
- Department of Nephrology, Hospital Kuala Lumpur, Kuala Lumpur 50586, Malaysia;
| | - Zulfitri Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia; (C.-K.-M.L.); (J.-H.L.); (I.I.); (Y.-M.C.)
- Research Center of Excellent (RCoE) Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia
- Department of Dietetics, Hospital Pengajar Universiti Putra Malaysia, UPM Serdang 43400, Malaysia
- Correspondence: ; Tel.: +603-9769-2431
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21
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Xiao X, Qin Z, Lv X, Dai Y, Ciren Z, Yangla Y, Zeng P, Ma Y, Li X, Wang L, Hu Y, Yang F, Fan C, Tang D, Dai S, Zhang N, Xie X, Yin J, Zhao X. Dietary patterns and cardiometabolic risks in diverse less-developed ethnic minority regions: results from the China Multi-Ethnic Cohort (CMEC) Study. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 15:100252. [PMID: 34528018 PMCID: PMC8383007 DOI: 10.1016/j.lanwpc.2021.100252] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 01/09/2023]
Abstract
Background In Western developed countries, food-based dietary patterns have been associated with the risk of cardiometabolic diseases, but little is known about such associations in less developed ethnic minority regions (LEMRs), where the cardiometabolic disease burden is growing rapidly and food patterns differ substantially. Methods Between May 2018 and September 2019, we recruited 99556 participants aged 30-79 years from the China Multi-Ethnic Cohort (CMEC) Study. We measured habitual dietary intake with validated food frequency questionnaire (FFQ) and then calculated dietary pattern scores for two of the most studied a priori dietary patterns, i.e., Dietary Approaches to Stop Hypertension (DASH) and alternative Mediterranean (aMED) style diets, and three a posteriori dietary patterns. Four cardiometabolic risks, including hypertension, diabetes, dyslipidaemia and metabolic syndrome (MetS), were newly diagnosed by medical examination and blood tests. We estimated adjusted odds ratios (OR) relating various dietary pattern scores to cardiometabolic risks using marginal structural models under the guidance of directed acyclic graphs. For the above associations, we further calculated the proportion mediated by overweight (PM) using regression-based mediation analysis for better public health implications. Findings The final study sample consisted of 68834 participants. Among them, we newly diagnosed 12803 hypertension, 3527 diabetes, 16342 hyperlipidaemia, and 8198 MetS cases. Overall, all 5 dietary patterns showed considerable associations with risks of hypertension and MetS. Comparing the highest with the lowest quintiles, the DASH score showed the strongest inverse associations with risks of hypertension (OR=0.74, 95% CI:0.70-0.79; PM=10%) and MetS (OR=0.79, 95% CI:0.74-0.85; PM=35%); conversely, scores of the localized a posteriori Yunnan-Guizhou plateau dietary pattern in LEMRs showed the strongest positive associations with risks of hypertension (OR=1.44, 95% CI:1.35-1.52; PM=10%) and MetS (OR=1.35, 95% CI:1.26-1.46; PM=33%), with all P values for trend <0.001. These associations were consistent in various subgroups defined by sex, age, smoking and physical activity, but with magnitudes that differed substantially across different ethnic regions and urbanicity. By investigating the single-component effects of dietary patterns, the dairy intake component contributed a major proportion to the beneficial effects of DASH (41.9% for hypertension and 100.5% for MetS). Interpretation Substantial socioeconomic status and ethnic disparities in diet quality and related cardiometabolic risks were seen in LEMRs, with hypertension being the top diet-related cardiometabolic risk. Our findings support that DASH provides superior dietary guidance compared to aMED for reducing cardiometabolic risks in LEMRs. In particular, the dairy intake encouraged by DASH may produce considerable beneficial effects. Funding This study was funded by the National Key R&D Program of China; full funding sources listed in the acknowledgements.
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Affiliation(s)
- Xiong Xiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zixiu Qin
- the key Laboratory of Environmental Pollution Monitoring and Disease Control, School of Public Health, Guizhou Medical University, Guiyang, China
| | - Xiaoyan Lv
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Yingxue Dai
- Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Zhuoga Ciren
- Tibet Center for Disease Control and Prevention, Lhasa, China
| | | | | | - Yue Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiang Li
- Institute of Surveying and Mapping, Information Engineering University, Zhengzhou, China
| | - Lina Wang
- School of Computer and Communication Engineering, Zhengzhou University of Light Industry, Zhengzhou, China
| | - Yifan Hu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Fan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chaonan Fan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Dan Tang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Suyao Dai
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ning Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaofen Xie
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jianzhong Yin
- School of Public Health, Kunming Medical University; Baoshan College of Traditional Chinese Medicine, Kunming, China
- Prof Jianzhong Yin, School of Public Health, Kunming Medical University; Baoshan College of Traditional Chinese Medicine, Kunming, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Correspondence to: Prof Xing Zhao, Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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22
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Vaillant MF, Agier L, Martineau C, Philipponneau M, Romand D, Masdoua V, Behar M, Nesseler C, Achamrah N, Laubé V, Lambert K, Dusquesnoy MN, Albaladejo L, Lathière T, Bosson JL, Fontaine E. Food intake and weight loss of surviving inpatients in the course of COVID-19 infection: A longitudinal study of the multicenter NutriCoviD30 cohort. Nutrition 2021; 93:111433. [PMID: 34482098 PMCID: PMC8314865 DOI: 10.1016/j.nut.2021.111433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/06/2021] [Accepted: 07/18/2021] [Indexed: 12/15/2022]
Abstract
Objectives NutriCoviD30 is a longitudinal multicenter cohort study that aimed to provide nutritional objective data of inpatients during COVID-19 infection. The aims of this study were to describe the nutritional effects of COVID-19 infection on adult inpatients on the short- to mid-term (≤30 d after hospital discharge), using food intake and weight measurements and to identify factors associated with a decrease in food intake and weight. Methods Food intake and weight trajectories, as well as clinical signs of the disease, preexisting chronic diseases, and nutritional strategies were collected and analyzed during the course of the disease. Their association was estimated using mixed-effect regression modeling. Patients were recruited from French university hospitals from May to July 2020. For the 403 included patients (mean 62.2 ± 14.2 y of age; 63% men), median (interquartile range [IQR]) hospital length of stay was 13 d (IQR = 8, 20), and 30% of patients were admitted to the intensive care unit. Results Patients declared a median 70% food intake decrease in the acute phase, and the disease resulted in an average loss of 8% of predisease weight (corresponding to –6.5 kg). Although most patients recovered their usual food intake 1 month after hospital discharge, they only regained half of their weight loss, such that malnutrition, which affected 67% of patients during hospitalization, persisted in 41%. Patients with overweight, obesity, and diabetes reported an additional weight loss of >1.5% of their initial bodyweight during hospitalization and recovery phase. Conclusions To prevent malnutrition and its long-term effects, mainly combined with a rapid weight loss predominantly affecting lean body mass, implementation of nutritional support is needed for COVID-19 inpatients. It should be started early in the course of the infection, and be extended up to the recovery phase.
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Affiliation(s)
| | - Lydiane Agier
- Data-stat Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Caroline Martineau
- Dietetics Department, Toulouse University Hospital, Hôpital La Grave, Toulouse, France
| | - Manon Philipponneau
- Dietetics Department, Hospices Civils de Lyon, Croix-Rousse Hospital, Lyon, France
| | - Dorothée Romand
- Dietetics Department, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | | | - Marie Behar
- Dietetics Department, AP-HP, Bichat Hospital, Paris, France
| | | | - Najate Achamrah
- Department of Nutrition, Rouen University Hospital, Rouen, France
| | | | - Karine Lambert
- Dietetics Department, AP-HP, Tenon Hospital, Paris, France
| | | | - Laura Albaladejo
- Dietetics Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Thomas Lathière
- Physiotherapy School, Grenoble Alpes University Hospital, Grenoble, France
| | - Jean-Luc Bosson
- ThEMAS Team, TIMC-IMAG Laboratory, Grenoble Alpes University, and Data-stat Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Eric Fontaine
- Laboratory of Fundamental and Applied and Bioenergetics, Grenoble Alpes University, and Department of Nutrition, Grenoble Alpes University Hospital, Grenoble, France
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23
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Watanabe D, Yoshida T, Yoshimura E, Nanri H, Goto C, Ishikawa-Takata K, Ebine N, Fujita H, Kimura M, Yamada Y. Doubly labelled water-calibration approach attenuates the underestimation of energy intake calculated from self-reported dietary assessment data in Japanese older adults. Public Health Nutr 2021; 25:1-11. [PMID: 34472428 PMCID: PMC9991602 DOI: 10.1017/s1368980021003785] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/10/2021] [Accepted: 08/25/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Self-reported energy intake (EI) estimation may incur systematic errors that could be attenuated through biomarker calibration. We aimed to confirm whether calibrated EI was comparable to total energy expenditure (TEE) measured using the doubly labelled water (DLW) technique. DESIGN Cross-sectional study. SETTING General older population from the Kyoto-Kameoka Study, Japan. PARTICIPANTS This study included sub- and main cohorts of 72 and 8058 participants aged≥ 65 years, respectively. EI was evaluated using a validated FFQ, and calibrated EI was obtained using a previously developed equation based on the DLW method. TEE was considered representative of true EI and also measured using the DLW method. We used a Wilcoxon signed-rank test and correlation analysis to compare the uncalibrated and calibrated EI with TEE. RESULTS In the sub-cohort, the median TEE, uncalibrated EI and calibrated EI were 8559 kJ, 7088 kJ and 9269 kJ, respectively. The uncalibrated EI was significantly lower than the TEE (median difference = -1847 kJ; interquartile range (IQR): -2785 to -1096), although the calibrated EI was not (median difference = 463 kJ; IQR: -330 to 1541). The uncalibrated (r = 0·275) and calibrated EI (r = 0·517) significantly correlated with TEE. The reproducibility was higher for calibrated EI (interclass correlation coefficient (ICC) = 0·982) than for uncalibrated EI (ICC = 0·637). Similar findings were observed when stratifying the sample by sex. For medians, uncalibrated EI was lower (about 17 %) than calibrated EI in the main cohort. CONCLUSIONS Biomarker calibration may improve the accuracy of self-reported dietary intake estimation.
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Affiliation(s)
- Daiki Watanabe
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo162-8636, Japan
- Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto621-8555, Japan
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo162-8636, Japan
- Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto621-8555, Japan
| | - Eiichi Yoshimura
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo162-8636, Japan
| | - Hinako Nanri
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo162-8636, Japan
| | - Chiho Goto
- Department of Health and Nutrition, Faculty of Health and Human Life, Nagoya Bunri University, Aichi, Japan
| | - Kazuko Ishikawa-Takata
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo162-8636, Japan
- Faculty of Applied Biosciences, Tokyo University of Agriculture, Tokyo, Japan
| | - Naoyuki Ebine
- Faculty of Health and Sports Science, Doshisha University, Kyoto, Japan
| | - Hiroyuki Fujita
- Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto621-8555, Japan
- Department of Bioscience and Biotechnology, Faculty of Bioenvironmental Science, Kyoto University of Advanced Science, Kyoto, Japan
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto621-8555, Japan
- Laboratory of Applied Health Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Nursing, Doshisha Women’s College of Liberal Arts, Kyoto, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo162-8636, Japan
- Institute for Active Health, Kyoto University of Advanced Science, 1-1 Nanjo Otani, Sogabe-cho, Kameoka-city, Kyoto621-8555, Japan
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24
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Klau S, Hoffmann S, Patel CJ, Ioannidis JP, Boulesteix AL. Examining the robustness of observational associations to model, measurement and sampling uncertainty with the vibration of effects framework. Int J Epidemiol 2021; 50:266-278. [PMID: 33147614 PMCID: PMC7938511 DOI: 10.1093/ije/dyaa164] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The results of studies on observational associations may vary depending on the study design and analysis choices as well as due to measurement error. It is important to understand the relative contribution of different factors towards generating variable results, including low sample sizes, researchers' flexibility in model choices, and measurement error in variables of interest and adjustment variables. METHODS We define sampling, model and measurement uncertainty, and extend the concept of vibration of effects in order to study these three types of uncertainty in a common framework. In a practical application, we examine these types of uncertainty in a Cox model using data from the National Health and Nutrition Examination Survey. In addition, we analyse the behaviour of sampling, model and measurement uncertainty for varying sample sizes in a simulation study. RESULTS All types of uncertainty are associated with a potentially large variability in effect estimates. Measurement error in the variable of interest attenuates the true effect in most cases, but can occasionally lead to overestimation. When we consider measurement error in both the variable of interest and adjustment variables, the vibration of effects are even less predictable as both systematic under- and over-estimation of the true effect can be observed. The results on simulated data show that measurement and model vibration remain non-negligible even for large sample sizes. CONCLUSION Sampling, model and measurement uncertainty can have important consequences for the stability of observational associations. We recommend systematically studying and reporting these types of uncertainty, and comparing them in a common framework.
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Affiliation(s)
- Simon Klau
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.,Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Sabine Hoffmann
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.,LMU Open Science Center, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Chirag J Patel
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - John Pa Ioannidis
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA.,Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA.,Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA.,Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, CA, USA.,Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Anne-Laure Boulesteix
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany.,LMU Open Science Center, Ludwig-Maximilians-Universität München, Munich, Germany
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25
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Dunietz GL, Jansen EC, Hershner S, O'Brien LM, Peterson KE, Baylin A. Parallel Assessment Challenges in Nutritional and Sleep Epidemiology. Am J Epidemiol 2021; 190:954-961. [PMID: 33089309 DOI: 10.1093/aje/kwaa230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/05/2020] [Accepted: 10/15/2020] [Indexed: 12/19/2022] Open
Abstract
Sleep has been consistently linked to health outcomes in clinical studies, but only in recent years has sleep become a focus in epidemiologic studies and public health. In particular, the sizable prevalence of insufficient sleep in the population warrants well-designed epidemiologic studies to examine its impact on public health. As a developing field, sleep epidemiology encounters methodological challenges similar to those faced by nutritional epidemiology research. In this article, we describe a few central challenges related to assessment of sleep duration in population-based studies in comparison with measurement challenges in nutritional epidemiology. In addition, we highlight 3 strategies applied in nutritional epidemiology to address measurement challenges and suggest ways these strategies could be implemented in large-scale sleep investigations.
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26
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Karabegović I, Portilla-Fernandez E, Li Y, Ma J, Maas SCE, Sun D, Hu EA, Kühnel B, Zhang Y, Ambatipudi S, Fiorito G, Huang J, Castillo-Fernandez JE, Wiggins KL, de Klein N, Grioni S, Swenson BR, Polidoro S, Treur JL, Cuenin C, Tsai PC, Costeira R, Chajes V, Braun K, Verweij N, Kretschmer A, Franke L, van Meurs JBJ, Uitterlinden AG, de Knegt RJ, Ikram MA, Dehghan A, Peters A, Schöttker B, Gharib SA, Sotoodehnia N, Bell JT, Elliott P, Vineis P, Relton C, Herceg Z, Brenner H, Waldenberger M, Rebholz CM, Voortman T, Pan Q, Fornage M, Levy D, Kayser M, Ghanbari M. Epigenome-wide association meta-analysis of DNA methylation with coffee and tea consumption. Nat Commun 2021; 12:2830. [PMID: 33990564 PMCID: PMC8121846 DOI: 10.1038/s41467-021-22752-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 03/26/2021] [Indexed: 02/03/2023] Open
Abstract
Coffee and tea are extensively consumed beverages worldwide which have received considerable attention regarding health. Intake of these beverages is consistently linked to, among others, reduced risk of diabetes and liver diseases; however, the mechanisms of action remain elusive. Epigenetics is suggested as a mechanism mediating the effects of dietary and lifestyle factors on disease onset. Here we report the results from epigenome-wide association studies (EWAS) on coffee and tea consumption in 15,789 participants of European and African-American ancestries from 15 cohorts. EWAS meta-analysis of coffee consumption reveals 11 CpGs surpassing the epigenome-wide significance threshold (P-value <1.1×10-7), which annotated to the AHRR, F2RL3, FLJ43663, HDAC4, GFI1 and PHGDH genes. Among them, cg14476101 is significantly associated with expression of the PHGDH and risk of fatty liver disease. Knockdown of PHGDH expression in liver cells shows a correlation with expression levels of genes associated with circulating lipids, suggesting a role of PHGDH in hepatic-lipid metabolism. EWAS meta-analysis on tea consumption reveals no significant association, only two CpGs annotated to CACNA1A and PRDM16 genes show suggestive association (P-value <5.0×10-6). These findings indicate that coffee-associated changes in DNA methylation levels may explain the mechanism of action of coffee consumption in conferring risk of diseases.
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Affiliation(s)
- Irma Karabegović
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Genetic Identification, Erasmus University Medical Center, Rotterdam, the Netherlands
- Epidemiology and Microbial Genomics, National Health Laboratory, Dudelange, Luxembourg
| | | | - Yang Li
- Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jiantao Ma
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland and the Framingham Heart Study, Framingham, MA, USA
| | - Silvana C E Maas
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Genetic Identification, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Daokun Sun
- Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Emily A Hu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brigitte Kühnel
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Yan Zhang
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Srikant Ambatipudi
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- AMCHSS, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
- Epigenetics Group, International Agency for Research on Cancer (IARC), Lyon, Cedex 08, France
| | - Giovanni Fiorito
- Laboratory of Biostatistics, Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, St Mary's Campus, Imperial College London, Norfolk Place, London, UK
| | - Jian Huang
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, St Mary's Campus, Imperial College London, Norfolk Place, London, UK
- UK Dementia Research Institute at Imperial College London, London, UK
- Imperial College NIHR Biomedical Research Centre, London, UK
| | - Juan E Castillo-Fernandez
- Department of Twin Research and Genetic Epidemiology, Kings College London, London, UK
- Epigenetics Programme, Babraham Institute, Cambridge, UK
| | - Kerri L Wiggins
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, CHRU, Seattle, WA, USA
| | - Niek de Klein
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sara Grioni
- Epidemiology and Prevention Unit, IRCCS National Cancer Institute Foundation, Milan, Italy
| | - Brenton R Swenson
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, CHRU, Seattle, WA, USA
| | - Silvia Polidoro
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, St Mary's Campus, Imperial College London, Norfolk Place, London, UK
- Italian Institute for Genomic Medicine (IIGM, former HuGeF), c/o IRCCS Candiolo, Candiolo, Italy
| | - Jorien L Treur
- Department of Psychiatry, Amsterdam UMC, Amsterdam, the Netherlands
| | - Cyrille Cuenin
- Epigenetics Group, International Agency for Research on Cancer (IARC), Lyon, Cedex 08, France
| | - Pei-Chien Tsai
- Department of Twin Research and Genetic Epidemiology, Kings College London, London, UK
- Department of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
- Genomic Medicine Research Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ricardo Costeira
- Department of Twin Research and Genetic Epidemiology, Kings College London, London, UK
| | - Veronique Chajes
- Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Kim Braun
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Niek Verweij
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Genomics plc, Park End St, Oxford, UK
| | - Anja Kretschmer
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Lude Franke
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Oncode Institute, Utrecht, The Netherlands
| | - Joyce B J van Meurs
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robert J de Knegt
- Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Abbas Dehghan
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, St Mary's Campus, Imperial College London, Norfolk Place, London, UK
- UK Dementia Research Institute at Imperial College London, London, UK
| | - Annette Peters
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sina A Gharib
- Computational Medicine Core at Center for Lung Biology, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, CHRU, Seattle, WA, USA
| | - Jordana T Bell
- Department of Twin Research and Genetic Epidemiology, Kings College London, London, UK
| | - Paul Elliott
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, St Mary's Campus, Imperial College London, Norfolk Place, London, UK
- UK Dementia Research Institute at Imperial College London, London, UK
- Imperial College NIHR Biomedical Research Centre, London, UK
- Health Data Research UK-London, London, UK
| | - Paolo Vineis
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, St Mary's Campus, Imperial College London, Norfolk Place, London, UK
| | - Caroline Relton
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Zdenko Herceg
- Epigenetics Group, International Agency for Research on Cancer (IARC), Lyon, Cedex 08, France
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research, University of Heidelberg, Heidelberg, Germany
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Qiuwei Pan
- Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Myriam Fornage
- Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Daniel Levy
- Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland and the Framingham Heart Study, Framingham, MA, USA
| | - Manfred Kayser
- Department of Genetic Identification, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
- Department of Genetics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Hoffmann S, Schönbrodt F, Elsas R, Wilson R, Strasser U, Boulesteix AL. The multiplicity of analysis strategies jeopardizes replicability: lessons learned across disciplines. ROYAL SOCIETY OPEN SCIENCE 2021; 8:201925. [PMID: 33996122 PMCID: PMC8059606 DOI: 10.1098/rsos.201925] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 03/22/2021] [Indexed: 05/05/2023]
Abstract
For a given research question, there are usually a large variety of possible analysis strategies acceptable according to the scientific standards of the field, and there are concerns that this multiplicity of analysis strategies plays an important role in the non-replicability of research findings. Here, we define a general framework on common sources of uncertainty arising in computational analyses that lead to this multiplicity, and apply this framework within an overview of approaches proposed across disciplines to address the issue. Armed with this framework, and a set of recommendations derived therefrom, researchers will be able to recognize strategies applicable to their field and use them to generate findings more likely to be replicated in future studies, ultimately improving the credibility of the scientific process.
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Affiliation(s)
- Sabine Hoffmann
- LMU Open Science Center, Ludwig-Maximilians-Universität München, Munich, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, Medical School, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Felix Schönbrodt
- LMU Open Science Center, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Psychology, Psychological Methods and Assessment, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Ralf Elsas
- LMU Open Science Center, Ludwig-Maximilians-Universität München, Munich, Germany
- Institute for Finance and Banking, Munich School of Management, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Rory Wilson
- Research Unit Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
| | - Ulrich Strasser
- Department of Geography, University of Innsbruck, Innsbruck, Austria
| | - Anne-Laure Boulesteix
- LMU Open Science Center, Ludwig-Maximilians-Universität München, Munich, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, Medical School, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Statistics, Faculty of Mathematics, Computer Science and Statistics, Ludwig-Maximilians-Universität München, Munich, Germany
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28
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Using Oral Microbiota Data to Design a Short Sucrose Intake Index. Nutrients 2021; 13:nu13051400. [PMID: 33919427 PMCID: PMC8143301 DOI: 10.3390/nu13051400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 01/04/2023] Open
Abstract
Excessive sucrose consumption is associated with numerous health problems, including dental caries, and is considered to play a critical role in shaping the human microbiota. Here, we aimed to confirm the association between sucrose exposure and oral microbiota profile, develop a short food-based index capturing variation among sucrose consumers and validate it against oral microbiota and dental caries in a derivation cohort with 16- to 79-year-old participants (n = 427). Intake and food preferences were recorded by questionnaires and saliva microbiota by 16S rDNA sequencing. Taxonomic similarities clustered participants into five clusters, where one stood out with highest sucrose intake and predicted sugar related metabolic pathways but lowest species diversity in the microbiota. Multivariate modelling of food intake and preferences revealed foods suitable for a sucrose index. This, similarly to sucrose intake, was related to bacterial pattern and caries status. The validity of the sucrose index was replicated in the population-based Gene-Lifestyle Interactions in Dental Endpoints (GLIDE, n = 105,520 Swedish adults) cohort. This suggested that the index captured clinically relevant variation in sucrose intake and that FFQ derived information may be suitable for screening of sucrose intake in the clinic and epidemiological studies, although adjustments to local consumption habits are needed.
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29
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Owen EJ, Patel S, Flannery O, Dew TP, O'Connor LM. Derivation and Validation of a Total Fruit and Vegetable Intake Prediction Model to Identify Targets for Biomarker Discovery Using the UK National Diet and Nutrition Survey. J Nutr 2021; 151:962-969. [PMID: 33484153 DOI: 10.1093/jn/nxaa406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/21/2020] [Accepted: 11/23/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Dietary assessments in research and clinical settings are largely reliant on self-reported questionnaires. It is acknowledged that these are subject to measurement error and biases and that objective approaches would be beneficial. Dietary biomarkers have been purported as a complementary approach to improve the accuracy of dietary assessments. Tentative biomarkers have been identified for many individual fruits and vegetables (FVs), but an objective total FV intake assessment tool has not been established. OBJECTIVES To derive and validate a prediction model of total FV intake (TFVpred) to inform future biomarker studies. METHODS Data from the National Diet and Nutrition Survey (NDNS) were used for this analysis. A modeling group (MG) consisting of participants aged >11 years from the NDNS years 5-6 was created (n = 1746). Intake data for 96 FVs were analyzed by stepwise regression to derive a model that satisfied 3 selection criteria: SEE ≤80, R2 >0.7, and ≤10 predictors. The TFVpred model was validated using comparative data from a validation group (VG) created from the NDNS years 7-8 (n = 1865). Pearson's correlation coefficients were assessed between observed and predicted values in the MG and VG. Bland-Altman plots were used to assess agreement between TFVpred estimates and total FV intake. RESULTS A TFVpred model, comprised of tomatoes, apples, carrots, bananas, pears, strawberries, and onions, satisfied the selection criteria (R2 = 0.761; SEE = 78.81). Observed and predicted total FV intake values were positively correlated in the MG (r = 0.872; P < 0.001; R2 = 0.761) and the VG (r = 0.838; P < 0.001; R2 = 0.702). In the MG and VG, 95.0% and 94.9%, respectively, of TFVpred model residuals were within the limits of agreement. CONCLUSIONS Intakes of a concise FV list can be used to predict total FV intakes in a UK population. The individual FVs included in the TFVpred model present targets for biomarker discovery aimed at objectively assessing total FV intake.
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Affiliation(s)
- Elliot J Owen
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom.,Future Food Beacon of Excellence, University of Nottingham, Sutton Bonington, United Kingdom
| | - Sumaiya Patel
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Orla Flannery
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Tristan P Dew
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom.,Future Food Beacon of Excellence, University of Nottingham, Sutton Bonington, United Kingdom.,School of Biosciences, University of Nottingham, Sutton Bonington, United Kingdom
| | - Laura M O'Connor
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
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30
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Saint-Maurice PF, Sampson JN, Keadle SK, Willis EA, Troiano RP, Matthews CE. Reproducibility of Accelerometer and Posture-derived Measures of Physical Activity. Med Sci Sports Exerc 2020; 52:876-883. [PMID: 31688655 DOI: 10.1249/mss.0000000000002206] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE The present study estimated the long-term reproducibility of accelerometer-based measures over 6 months in adults and the implications for statistical power, and attenuation in regression coefficients for future activity-disease studies. METHODS We used data from 914 adults in the Interactive Diet and Activity Tracking in AARP study. Participants wore an activPAL 3 (AP) and an ActiGraph GT3X (AG) twice, 6 months apart. AP measures included time spent sitting or lying, standing, and stepping, whereas AG measures included time spent in sedentary, light, and moderate-to-vigorous physical activity (PA). Reproducibility of each metric and implications for epidemiological studies were determined based on intraclass correlation coefficients (ICC; 95% confidence interval). RESULTS The ICC values for AP estimates were 0.58 (95% confidence interval, 0.53-0.63) for sitting, 0.62 (0.57-0.67) for standing, and 0.57 (0.51-0.62) for stepping. The ICC values for AG were 0.56 (0.50-0.61) for sedentary, 0.54 (0.49-0.60) for light PA, and 0.58 (0.52-0.63) for moderate-to-vigorous PA. Modeling showed that increasing the number of replicate administrations to two or three resulted in the most noticeable increases in ICC values, statistical power, and reductions in attenuation coefficients. For example, administering the AP twice reduced within-subject variability by half and resulted in an increase in the ICC associated with sitting time from 0.58 to 0.74. Similar comparisons for AG and measure of sedentary time resulted in an increase in ICC values from 0.56 to 0.72. Increasing the number of replicate administrations from one to two reduced the attenuation in activity-outcome associations from 40% to 25%. CONCLUSION Accelerometer-based classifications of activity are moderately stable over time, but there is considerable within-subject variability that needs to be considered when estimating usual activity in future studies.
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Affiliation(s)
- Pedro F Saint-Maurice
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, HHS, Rockville, MD
| | - Joshua N Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, HHS, Rockville, MD
| | | | | | - Richard P Troiano
- Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, HHS, Rockville, MD
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, HHS, Rockville, MD
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31
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Burstyn I. Occupational epidemiologist's quest to tame measurement error in exposure. GLOBAL EPIDEMIOLOGY 2020. [DOI: 10.1016/j.gloepi.2020.100038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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32
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Haghighatdoost F, Sadeghian R, Clark CCT, Abbasi B. Higher Dietary Acid Load Is Associated With an Increased Risk of Calcium Oxalate Kidney Stones. J Ren Nutr 2020; 31:467-474. [PMID: 32981831 DOI: 10.1053/j.jrn.2020.08.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 08/10/2020] [Accepted: 08/13/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Diet-dependent net acid load may influence the risk of kidney stone formation by affecting calcium and citrate excretion. However, to date, little research has investigated the relationship between dietary acid load and kidney stones. Therefore, this study sought to assess whether a diet high in potential acid load was related to the risk of calcium oxalate stone formation. METHODS This case-control study was conducted on 430 participants (including 215 newly diagnosed patients with calcium oxalate stones and 215 controls matched for sex and age). Dietary intake was assessed using a validated food frequency questionnaire over the preceding year. Dietary acid load was estimated based on the potential renal acid load (PRAL) and net endogenous acid production (NEAP). The association between dietary acid load indices and kidney stone was examined using multivariable logistic regression. RESULTS Mean PRAL (standard error) was significantly lower in cases versus controls (-5.3 ± 1.3 vs. -1.7 ± 1.3, P = .048). Corresponding values for NEAP were 39.4 ± 0.8 and 41.8 ± 0.8, respectively (P = .032). After adjustment for potential confounders, the odds ratios (95% confidence intervals) of calcium oxalate stones in the top tertile of PRAL and NEAP were 1.45 (0.89-2.38, P = .136) and 1.88 (1.14-3.09, P = .013), respectively. Adjustment for potassium and protein in 2 separate models did not substantially change the results. CONCLUSIONS A diet high in potential acid load, measured by NEAP, was associated with higher risk of calcium oxalate stone formation, independent of potassium and protein intake. Prospective longitudinal studies are warranted to confirm the veracity of our results.
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Affiliation(s)
- Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reyhaneh Sadeghian
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Behnood Abbasi
- Department of Nutrition, Electronic Health and Statistics Surveillance Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran.
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Validation and calibration of the Eating Assessment in Toddlers FFQ (EAT FFQ) for children, used in the Growing Up Milk - Lite (GUMLi) randomised controlled trial. Br J Nutr 2020; 125:183-193. [PMID: 32799967 DOI: 10.1017/s0007114520002664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The Eating Assessment in Toddlers FFQ (EAT FFQ) has been shown to have good reliability and comparative validity for ranking nutrient intakes in young children. With the addition of food items (n 4), we aimed to re-assess the validity of the EAT FFQ and estimate calibration factors in a sub-sample of children (n 97) participating in the Growing Up Milk - Lite (GUMLi) randomised control trial (2015-2017). Participants completed the ninety-nine-item GUMLi EAT FFQ and record-assisted 24-h recalls (24HR) on two occasions. Energy and nutrient intakes were assessed at months 9 and 12 post-randomisation and calibration factors calculated to determine predicted estimates from the GUMLi EAT FFQ. Validity was assessed using Pearson correlation coefficients, weighted kappa (κ) and exact quartile categorisation. Calibration was calculated using linear regression models on 24HR, adjusted for sex and treatment group. Nutrient intakes were significantly correlated between the GUMLi EAT FFQ and 24HR at both time points. Energy-adjusted, de-attenuated Pearson correlations ranged from 0·3 (fibre) to 0·8 (Fe) at 9 months and from 0·3 (Ca) to 0·7 (Fe) at 12 months. Weighted κ for the quartiles ranged from 0·2 (Zn) to 0·6 (Fe) at 9 months and from 0·1 (total fat) to 0·5 (Fe) at 12 months. Exact agreement ranged from 30 to 74 %. Calibration factors predicted up to 56 % of the variation in the 24HR at 9 months and 44 % at 12 months. The GUMLi EAT FFQ remained a useful tool for ranking nutrient intakes with similar estimated validity compared with other FFQ used in children under 2 years.
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Ravelli MN, Schoeller DA. Traditional Self-Reported Dietary Instruments Are Prone to Inaccuracies and New Approaches Are Needed. Front Nutr 2020; 7:90. [PMID: 32719809 PMCID: PMC7350526 DOI: 10.3389/fnut.2020.00090] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/15/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Diet is a modifiable behavior that influences an individual's health. Because of this, diet assessment is an important component of public health surveillance, evaluating response to community health interventions, and monitoring individual compliance to medical interventions. Diet assessments are usually performed using one of three basic methods: diet recall, diet diaries, or food frequency questionnaires. Although these three assessment instruments have displayed a strong agreement between themselves, when reported intake is compared with intake measured using quantitative nutrient biomarkers, investigators have identified systematic misreporting errors for all three of these self-reported dietary instruments. Aims: This work aims to summarize the state of knowledge regarding misreporting and why it impedes diet–health research and to introduce advances in the collection and the treatment of dietary data. Methods: This work reviews and summarizes published data on misreporting and the recent efforts to reduce such errors. Results: The evidence demonstrates a strong and consistent systematic underreporting of energy intake (EIn) across adults and children studies. Underreporting of EIn has been found to increase with body mass index (BMI), and the differences between macronutrient reports indicate that not all foods are underreported equally. Protein is least underreported, but which specific foods are commonly underreported are not known. Conclusions: Because energy underreporting varies as a function of BMI, self-reported EIn should not be used for the study of energy balance in the study of obesity. The between-individual variability in the underreporting of self-reported intake of energy and other nutrients attenuates diet–disease relationships. Recent efforts to correct for underreporting have reduced misreporting of diet outcomes, but improvements have been incremental in nature and more research is needed to validate and extend these efforts.
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Affiliation(s)
- Michele N Ravelli
- Department of Neurology, University of Wisconsin, Madison, WI, United States
| | - Dale A Schoeller
- Nutritional Sciences and Biotechnology Center, University of Wisconsin, Madison, WI, United States
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Gallo V. Amyotrophic lateral sclerosis on the scale. Neurology 2020; 94:339-340. [DOI: 10.1212/wnl.0000000000008675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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36
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Novak B, Holler P, Jaunig J, Ruf W, van Poppel MNM, Sattler MC. Do we have to reduce the recall period? Validity of a daily physical activity questionnaire (PAQ24) in young active adults. BMC Public Health 2020; 20:72. [PMID: 31948416 PMCID: PMC6966869 DOI: 10.1186/s12889-020-8165-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 01/07/2020] [Indexed: 01/14/2023] Open
Abstract
Background Combining the strengths of physical activity (PA) diaries and questionnaires may be needed to improve the unsatisfying measurement quality of existing PA questionnaires. This study investigated the construct validity of a short PA questionnaire (Physical Activity Questionnaire for 24 h [PAQ24]) with a recall period of one day. Methods In this cross-sectional study, participants completed the PAQ24 on seven consecutive days while wearing an accelerometer (GENEActiv). Thereafter, the Global Physical Activity Questionnaire (GPAQ) was completed. Spearman correlation coefficients and Bland-Altman analysis were used to assess construct validity. Results Overall, 50 active adults (11 women, mean age = 25.1 ± 2.5) participated. Relative agreements between Total PA of PAQ24 and accelerometer were 0.37 ≤ ρ ≤ 0.72 for each day with satisfying agreement on five out of seven days. Weekly relative agreement for Total PA was moderate (ρ = 0.44). Relative agreements between PAQ24 and GPAQ were ρ = 0.43 for Total PA. Daily and weekly absolute agreements were poor indicated by wide limits of agreement. Conclusions In contrast to weekly Total PA, the majority of daily results of the PAQ24 showed satisfying construct validity. A short recall period may improve the measurement quality of PA questionnaires, but measurement errors and the costs of multiple administrations must be considered in future studies.
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Affiliation(s)
- B Novak
- Institute of Sport Science, University of Graz, Graz, Austria
| | - P Holler
- Institute of Sport Science, University of Graz, Graz, Austria.,Department of Public Health, Institute for Health Promotion and Disease Prevention (IfGP), Graz, Austria
| | - J Jaunig
- Institute of Sport Science, University of Graz, Graz, Austria
| | - W Ruf
- Institute of Sport Science, University of Graz, Graz, Austria.,Institute of Sport Science, German University of Health and Sports, Berlin, Germany
| | | | - M C Sattler
- Institute of Sport Science, University of Graz, Graz, Austria.
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Validity of a dish composition database for estimating protein, sodium and potassium intakes against 24 h urinary excretion: comparison with a standard food composition database. Public Health Nutr 2020; 23:1297-1306. [PMID: 31896376 DOI: 10.1017/s1368980019003550] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE We assessed the validity of a recently developed dish composition database (DCD) against urinary biomarkers compared with a standard food composition database (FCD). DESIGN Intakes of protein, Na and K were estimated by 2 × 24 h urine collections and by 4 d dietary record data based on the DCD (including 128 dishes) or FCD (including 1878 foods). SETTING Japan. PARTICIPANTS A total of 161 men and 163 women aged 20-69 years. RESULTS Compared with the 24 h urine-based estimates, the median intakes estimated using the DCD and FCD differed significantly for protein and Na in men and for Na and K in women. Deattenuated Spearman correlation coefficients using 24 h urine-based estimates for the intakes of protein, Na and K were lower in the DCD (respectively: 0·26, 0·15 and 0·44 in men; 0·22, 0·27 and 0·22 in women) than those in the FCD (respectively: 0·43, 0·40 and 0·59 in men; 0·33, 0·45 and 0·42 in women). When data on dish portion size reported by participants were used for estimation instead of standard portion-size data based on the DCD, the accuracy of the estimated median intakes did not change notably, whereas the deattenuated correlation coefficients improved (for protein, Na and K respectively: 0·32, 0·31 and 0·56 in men; 0·31, 0·41 and 0·39 in women). CONCLUSIONS The DCD supported by individual-level information on dish portion size showed fair to moderate validity in ranking individuals according to their intakes of protein, Na and K, similar to the FCD.
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Carter JL, Lewington S, Piernas C, Bradbury K, Key TJ, Jebb SA, Arnold M, Bennett D, Clarke R. Reproducibility of dietary intakes of macronutrients, specific food groups, and dietary patterns in 211 050 adults in the UK Biobank study. J Nutr Sci 2019; 8:e34. [PMID: 31723428 PMCID: PMC6842574 DOI: 10.1017/jns.2019.31] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 09/19/2019] [Accepted: 09/20/2019] [Indexed: 01/21/2023] Open
Abstract
To detect modest associations of dietary intake with disease risk, observational studies need to be large and control for moderate measurement errors. The reproducibility of dietary intakes of macronutrients, food groups and dietary patterns (vegetarian and Mediterranean) was assessed in adults in the UK Biobank study on up to five occasions using a web-based 24-h dietary assessment (n 211 050), and using short FFQ recorded at baseline (n 502 655) and after 4 years (n 20 346). When the means of two 24-h assessments were used, the intra-class correlation coefficients (ICC) for macronutrients varied from 0·63 for alcohol to 0·36 for polyunsaturated fat. The ICC for food groups also varied from 0·68 for fruit to 0·18 for fish. The ICC for the FFQ varied from 0·66 for meat and fruit to 0·48 for bread and cereals. The reproducibility was higher for vegetarian status (κ > 0·80) than for the Mediterranean dietary pattern (ICC = 0·45). Overall, the reproducibility of pairs of 24-h dietary assessments and single FFQ used in the UK Biobank were comparable with results of previous prospective studies using conventional methods. Analyses of diet-disease relationships need to correct for both measurement error and within-person variability in dietary intake in order to reliably assess any such associations with disease in the UK Biobank.
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Affiliation(s)
- Jennifer L. Carter
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sarah Lewington
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Kathryn Bradbury
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Timothy J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Susan A. Jebb
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Matthew Arnold
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Derrick Bennett
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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40
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Shi L, Brunius C, Bergdahl IA, Johansson I, Rolandsson O, Donat Vargas C, Kiviranta H, Hanhineva K, Åkesson A, Landberg R. Joint Analysis of Metabolite Markers of Fish Intake and Persistent Organic Pollutants in Relation to Type 2 Diabetes Risk in Swedish Adults. J Nutr 2019; 149:1413-1423. [PMID: 31209490 DOI: 10.1093/jn/nxz068] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/13/2019] [Accepted: 03/20/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND There is conflicting evidence regarding the association between fish intake and type 2 diabetes (T2D) incidence, possibly owing to measurement errors in self-reported intake and coexposure to persistent organic pollutants (POPs) present in fish. OBJECTIVE The aim of this study was to identify plasma metabolites associated with fish intake and to assess their association with T2D risk, independently of POPs, in Swedish adults. METHODS In a case-control study nested in the Swedish Västerbotten Intervention Programme, fasting plasma samples from 421 matched T2D case-control pairs of men and women aged 30-60 y at baseline and 10-y follow-up samples from a subset of 149 pairs were analyzed using untargeted metabolomics. Moreover, 16 plasma POPs were analyzed for the 149 pairs who had repeated samples available. Fish-related plasma metabolites were identified using multivariate modelling and partial correlation analysis. Reproducibility of metabolites and metabolite patterns, derived via principal component analysis (PCA), was assessed by intraclass correlation. A unique component of metabolites unrelated to POPs was dissected by integrating metabolites and POPs using 2-way orthogonal partial least squares regression. ORs of T2D were estimated using conditional logistic regression. RESULTS We identified 31 metabolites associated with fish intake that had poor to good reproducibility. A PCA-derived metabolite pattern strongly correlated with fish intake (ρ = 0.37, P < 0.001) but showed no association with T2D risk. Integrating fish-related metabolites and POPs led to a unique metabolite component independent of POPs, which tended to be inversely associated with T2D risk (OR: 0.75; 95% CI: 0.54, 1.02, P = 0.07). This component mainly consisted of metabolites reflecting fatty fish intake. CONCLUSIONS Our results suggest that fatty fish intake may be beneficial for T2D prevention, after removing the counteractive effects of coexposure to POPs in Swedish adults. Integrating metabolite markers and POP exposures appears a promising approach to advance the understanding of associations between fish intake and T2D incidence.
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Affiliation(s)
- Lin Shi
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Carl Brunius
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Ingvar A Bergdahl
- Department of Biobank Research.,Department of Public Health and Clinical Medicine
| | | | | | | | - Hannu Kiviranta
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Kati Hanhineva
- LC-MS Metabolomics Center, Kuopio, Finland.,Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Agneta Åkesson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Rikard Landberg
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden.,Department of Public Health and Clinical Medicine
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Trinquart L, Erlinger AL, Petersen JM, Fox M, Galea S. Applying the E Value to Assess the Robustness of Epidemiologic Fields of Inquiry to Unmeasured Confounding. Am J Epidemiol 2019; 188:1174-1180. [PMID: 30874728 DOI: 10.1093/aje/kwz063] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 02/27/2019] [Accepted: 03/04/2019] [Indexed: 12/13/2022] Open
Abstract
We explored the use of the E value to gauge the robustness of fields of epidemiologic inquiry to unmeasured confounding. We surveyed nutritional and air pollution studies that found statistically significant associations between exposures and incident outcomes. For 100 studies in each field, we extracted adjusted relative effect estimates and associated confidence intervals. We inverted estimates where necessary so that all effects were greater than 1. We calculated E values for both the effect estimate and the lower limit of the 95% confidence interval. Nutritional studies were smaller than air pollution studies (median participants per study, 40,652 vs. 72,460). More than 90% of nutritional studies categorized the exposure, whereas 89% of air pollution studies analyzed the exposure as a continuous variable. The median relative effect was 1.33 in nutrition and 1.16 in air pollution. The corresponding median E values for the estimates were 2.00 and 1.59, respectively. E values for the 95% confidence intervals had median values of 1.39 and 1.26, respectively. Little to moderate unmeasured confounding could explain away most observed associations. The E value is necessarily larger for smaller studies that reach statistical significance, making cross-field comparison difficult. The E value for the 95% confidence interval might be a more useful measure in reports of epidemiologic observational studies.
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Affiliation(s)
- Ludovic Trinquart
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Adrienne L Erlinger
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Julie M Petersen
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Matthew Fox
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
| | - Sandro Galea
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
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Allehdan SS, Tayyem RF, Agraib LM, Thekrallah FM, Asali FF. Relative Validity and Reproducibility of a Food Frequency Questionnaire to Assess Food Group Intake in Pregnant Jordanian Women. J Acad Nutr Diet 2019; 119:1349-1361. [PMID: 31031107 DOI: 10.1016/j.jand.2019.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 01/11/2019] [Accepted: 02/14/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Research on the relationship between maternal diet and pregnancy outcomes requires valid dietary assessment tools in pregnancy. OBJECTIVE This study aimed to develop and examine the relative validity and reproducibility of a quantitative food frequency questionnaire (FFQ) to estimate food group intake in a sample of pregnant Jordanian women. DESIGN In this validation study, food group intake from a culturally sensitive quantitative FFQ was compared with food group intake from three 24-hour dietary recalls. PARTICIPANTS AND SETTING The validation study was conducted from 2015 to 2017 at the maternity clinics in Jordan University Hospital among 131 healthy singleton pregnant Jordanian women. Of these women, 30 also took part in the reproducibility phase, which involved repeated completion of the FFQ in a time frame of 1 month. Pregnant women who had gestational diabetes, preeclampsia, and chronic diseases were excluded. MAIN OUTCOME MEASURES Relative validity and reproducibility of a 117-item quantitative FFQ used to estimate usual food intake over a period of 1 month. STATISTICAL ANALYSES PERFORMED Intraclass correlation coefficients and weighted κ statistics were calculated to test the reproducibility between the two administrations of the FFQ. Pearson correlations were estimated to validate the FFQ against 24-hour dietary recalls. Cross-classification and Bland-Altman plots were used to examine the agreement between the two dietary assessment methods. RESULTS The intraclass correlation coefficients between the two FFQs ranged from 0.24 for legumes to 0.93 for processed meats. A moderate level of agreement was observed between two FFQs. De-attenuated and energy-adjusted correlations ranged from 0.08 for sweets and sugar to 0.93 for sugary drinks. On average, 50.9% and 45.2% of participants were classified by the FFQ and the 24-hour dietary recalls into the same quartile based on their crude and energy-adjusted food group intake, respectively. Bland-Altman plots showed satisfactory agreement between two methods for most food groups. CONCLUSIONS The FFQ showed moderate reproducibility and good relative validity for most food groups.
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Wu Y, Hoffman FO, Apostoaei AI, Kwon D, Thomas BA, Glass R, Zablotska LB. Methods to account for uncertainties in exposure assessment in studies of environmental exposures. Environ Health 2019; 18:31. [PMID: 30961632 PMCID: PMC6454753 DOI: 10.1186/s12940-019-0468-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 03/20/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Accurate exposure estimation in environmental epidemiological studies is crucial for health risk assessment. Failure to account for uncertainties in exposure estimation could lead to biased results in exposure-response analyses. Assessment of the effects of uncertainties in exposure estimation on risk estimates received a lot of attention in radiation epidemiology and in several studies of diet and air pollution. The objective of this narrative review is to examine the commonly used statistical approaches to account for exposure estimation errors in risk analyses and to suggest how each could be applied in environmental epidemiological studies. MAIN TEXT We review two main error types in estimating exposures in epidemiological studies: shared and unshared errors and their subtypes. We describe the four main statistical approaches to adjust for exposure estimation uncertainties (regression calibration, simulation-extrapolation, Monte Carlo maximum likelihood and Bayesian model averaging) along with examples to give readers better understanding of their advantages and limitations. We also explain the advantages of using a 2-dimensional Monte-Carlo (2DMC) simulation method to quantify the effect of uncertainties in exposure estimates using full-likelihood methods. For exposures that are estimated independently between subjects and are more likely to introduce unshared errors, regression calibration and SIMEX methods are able to adequately account for exposure uncertainties in risk analyses. When an uncalibrated measuring device is used or estimation parameters with uncertain mean values are applied to a group of people, shared errors could potentially be large. In this case, Monte Carlo maximum likelihood and Bayesian model averaging methods based on estimates of exposure from the 2DMC simulations would work well. The majority of reviewed studies show relatively moderate changes (within 100%) in risk estimates after accounting for uncertainties in exposure estimates, except for the two studies which doubled/tripled naïve estimates. CONCLUSIONS In this paper, we demonstrate various statistical methods to account for uncertain exposure estimates in risk analyses. The differences in the results of various adjustment methods could be due to various error structures in datasets and whether or not a proper statistical method was applied. Epidemiological studies of environmental exposures should include exposure-response analyses accounting for uncertainties in exposure estimates.
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Affiliation(s)
- You Wu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, 2nd floor, Box 0560, San Francisco, CA 94143 USA
- Center for Design and Analysis, Amgen, Inc., 1 Amgen Center Dr., Thousand Oaks, CA 91320 USA
| | - F. Owen Hoffman
- Oak Ridge Center for Risk Analysis, Inc., 102 Donner Drive, Oak Ridge, TN USA
| | - A. Iulian Apostoaei
- Oak Ridge Center for Risk Analysis, Inc., 102 Donner Drive, Oak Ridge, TN USA
| | - Deukwoo Kwon
- Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Avenue, Miami, FL USA
| | - Brian A. Thomas
- Oak Ridge Center for Risk Analysis, Inc., 102 Donner Drive, Oak Ridge, TN USA
| | - Racquel Glass
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, 2nd floor, Box 0560, San Francisco, CA 94143 USA
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, 2nd floor, Box 0560, San Francisco, CA 94143 USA
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Gormley IC, Bai Y, Brennan L. Combining biomarker and self-reported dietary intake data: A review of the state of the art and an exposition of concepts. Stat Methods Med Res 2019; 29:617-635. [PMID: 30943855 DOI: 10.1177/0962280219837698] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Classical approaches to assessing dietary intake are associated with measurement error. In an effort to address inherent measurement error in dietary self-reported data there is increased interest in the use of dietary biomarkers as objective measures of intake. Furthermore, there is a growing consensus of the need to combine dietary biomarker data with self-reported data. A review of state of the art techniques employed when combining biomarker and self-reported data is conducted. Two predominant methods, the calibration method and the method of triads, emerge as relevant techniques used when combining biomarker and self-reported data to account for measurement errors in dietary intake assessment. Both methods crucially assume measurement error independence. To expose and understand the performance of these methods in a range of realistic settings, their underpinning statistical concepts are unified and delineated, and thorough simulation studies are conducted. Results show that violation of the methods' assumptions negatively impacts resulting inference but that this impact is mitigated when the variation of the biomarker around the true intake is small. Thus there is much scope for the further development of biomarkers and models in tandem to achieve the ultimate goal of accurately assessing dietary intake.
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Affiliation(s)
- Isobel Claire Gormley
- School of Mathematics and Statistics, University College Dublin, Dublin, Ireland.,Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - Yuxin Bai
- School of Mathematics and Statistics, University College Dublin, Dublin, Ireland.,School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Lorraine Brennan
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland.,Institute of Food and Health, University College Dublin, Dublin, Ireland.,Conway Institute, University College Dublin, Dublin, Ireland
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Mogul DB, Brereton N, Carson KA, Pittarelli M, Daniel H, Torbenson M, Schwarz KB. Development of a Dietary Methyl Donor Food Frequency Questionnaire to Assess Folate and Vitamin B 12 Status in Children with Chronic Hepatitis B Virus Infection. J Pediatr 2018; 203:41-46.e2. [PMID: 30243534 DOI: 10.1016/j.jpeds.2018.07.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/10/2018] [Accepted: 07/26/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To develop a dietary methyl donor food frequency questionnaire (DMD-FFQ) that is validated in a cohort of US children and to determine whether the consumption of folate and vitamin B12, principal DMDs, correlates with HBV DNA levels and its methylation density. STUDY DESIGN We developed a semiquantitative DMD-FFQ to estimate intake of folate and vitamin B12 and validated this instrument against a 24-hour dietary recall and biomarkers-red blood cell folate, serum vitamin B12, and homocysteine-in 35 children with chronic HBV infection without other medical comorbidities. Estimates of DMD, as well as the serum biomarkers, were correlated with the methylation density of HBV CpG island 2 and HBV DNA levels. RESULTS Folate per kilogram of body weight by the DMD-FFQ correlated positively with 24-hour recall (r = 0.60; P < .001) and red blood cell folate (r = 0.40; P = .02), and negatively with homocysteine (r = -0.54; P < .001). Vitamin B12 per kilogram by DMD-FFQ also correlated positively with 24-hour recall (r = 0.57; P < .001) and serum vitamin B12 (r = 0.36, P = .04), and negatively with homocysteine (r = -0.44; P = .008). Neither DMD intake (from DMD-FFQ or 24-hour recall) nor serum biomarkers correlated with HBV DNA levels or its methylation density. CONCLUSIONS Our DMD-FFQ correlates well with a 24-hour recall and circulating biomarkers. Although little evidence existed that consumption of these micronutrients correlated with HBV replication, this tool could prove useful for investigating epigenetic modification by diet for several pediatric diseases.
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Affiliation(s)
- Douglas B Mogul
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Johns Hopkins University School of Medicine, Baltimore, MD.
| | - Nga Brereton
- Institute for Clinical and Translational Research, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kathryn A Carson
- Institute for Clinical and Translational Research, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Maria Pittarelli
- Institute for Clinical and Translational Research, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Hubert Daniel
- Department of Pathology, Johns Hopkins Hospital, Baltimore, MD
| | | | - Kathleen B Schwarz
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Johns Hopkins University School of Medicine, Baltimore, MD
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Martín-Calvo N, Martínez-González MÁ. Controversy and debate: Memory-Based Methods Paper 4. J Clin Epidemiol 2018; 104:136-139. [DOI: 10.1016/j.jclinepi.2018.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 06/18/2018] [Accepted: 08/03/2018] [Indexed: 12/12/2022]
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47
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Nevalainen J, Erkkola M, Saarijärvi H, Näppilä T, Fogelholm M. Large-scale loyalty card data in health research. Digit Health 2018; 4:2055207618816898. [PMID: 30546912 PMCID: PMC6287323 DOI: 10.1177/2055207618816898] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 11/06/2018] [Indexed: 02/02/2023] Open
Abstract
Objective To study the characteristics of large-scale loyalty card data obtained in Finland, and to evaluate their potential and challenges in health research. Methods We contacted the holders of a certain loyalty card living in a specific region in Finland via email, and requested their electronic informed consent to obtain their basic background characteristics and grocery expenditure data from 2016 for health research purposes. Non-participation and the characteristics and expenditure of the participants were mainly analysed using summary statistics and figures. Results The data on expenditure came from 14,595 (5.6% of those contacted) consenting loyalty card holders. A total of 68.5% of the participants were women, with an average age of 46 years. Women and residents of Helsinki were more likely to participate. Both young and old participants were underrepresented in the sample. We observed that annual expenditure represented roughly two-thirds of the nationally estimated annual averages. Customers and personnel differed in their characteristics and expenditure, but not so much in their most frequently bought items. Conclusions Loyalty card data from a major retailer enabled us to reach a large, heterogeneous sample with fewer resources than conventional surveys of the same magnitude. The potential of the data was great because of their size, coverage, objectivity, and long periods of dynamic data collection, which enables timely investigations. The challenges included bias due to non-participation, purchases in other stores, the level of detail in product grouping, and the knowledge gaps in what is being consumed and by whom. Loyalty card data are an underutilised resource in research, and could be used not only in retailers’ activities, but also for societal benefit.
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Affiliation(s)
- Jaakko Nevalainen
- Health Sciences/Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Hannu Saarijärvi
- Business Studies/Faculty of Management, University of Tampere, Tampere, Finland
| | - Turkka Näppilä
- Health Sciences/Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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Shi L, Brunius C, Johansson I, Bergdahl IA, Lindahl B, Hanhineva K, Landberg R. Plasma metabolites associated with healthy Nordic dietary indexes and risk of type 2 diabetes-a nested case-control study in a Swedish population. Am J Clin Nutr 2018; 108:564-575. [PMID: 30060042 PMCID: PMC6288641 DOI: 10.1093/ajcn/nqy145] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 06/01/2018] [Indexed: 12/14/2022] Open
Abstract
Background Epidemiologic evidence on the association of a healthy Nordic diet and future type 2 diabetes (T2D) is limited. Exploring metabolites as biomarkers of healthy Nordic dietary patterns may facilitate investigation of associations between such patterns and T2D. Objectives We aimed to identify metabolites related to a priori-defined healthy Nordic dietary indexes, the Baltic Sea Diet Score (BSDS) and Healthy Nordic Food Index (HNFI), and evaluate associations with the T2D risk in a case-control study nested in a Swedish population-based prospective cohort. Design Plasma samples from 421 case-control pairs at baseline and samples from a subset of 151 healthy controls at a 10-y follow-up were analyzed with the use of untargeted liquid chromatography-mass spectrometry metabolomics. Index-related metabolites were identified through the use of random forest modelling followed by partial correlation analysis adjustment for lifestyle confounders. Metabolite patterns were derived via principal component analysis (PCA). ORs of T2D were estimated via conditional logistic regression. Reproducibility of metabolites was assessed by intraclass correlation (ICC) in healthy controls. Associations were also assessed for 10 metabolites previously identified as linking a healthy Nordic diet with T2D. Results In total, 31 metabolites were associated with BSDS and/or HNFI (-0.19 ≤ r ≤ 0.21, 0.10 ≤ ICC ≤ 0.59). Two PCs were determined from index-related metabolites: PC1 strongly correlated to the indexes (r = 0.27 for BSDS, r = 0.25 for HNFI, ICC = 0.45) but showed no association with T2D risk. PC2 was weakly associated with the indexes, but more strongly with foods not part of the indexes, e.g., pizza, sausages, and hamburgers. PC2 was also significantly associated with T2D risk. Predefined metabolites were confirmed to be reflective of consumption of whole grains, fish, or vegetables, but not related to T2D risk. Conclusions Our study did not support an association between healthy Nordic dietary indexes and T2D. However, foods such as hamburger, sausage, and pizza not covered by the indexes appeared to be more important for T2D risk in the current population.
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Affiliation(s)
- Lin Shi
- Department of Molecular Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden,Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden,Address correspondence to LS (e-mail: ; )
| | - Carl Brunius
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Ingegerd Johansson
- Departments of Odontology, Section of Cariology, Biobank Research, Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Ingvar A Bergdahl
- Departments of Biobank Research, Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Bernt Lindahl
- Departments of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Kati Hanhineva
- LC-MS Metabolomics Center, Kuopio, Finland,Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Rikard Landberg
- Department of Molecular Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden,Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
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