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Al-Farhan AK, Weatherspoon LJ, Pfeiffer KA, Li W, Carlson JJ. Dietary Quality Evidenced by the Healthy Eating Index and Cardiovascular Disease Risk Factors in Kuwaiti Schoolchildren. Nutrients 2024; 16:1243. [PMID: 38674933 PMCID: PMC11053461 DOI: 10.3390/nu16081243] [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: 02/22/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Poor dietary quality is associated with adiposity and other risks of cardiovascular disease (CVD) in children. In Kuwait, although children's food choices are a concern, no studies have evaluated dietary quality relative to the risk of CVD in Kuwaiti schoolchildren. This study hypothesized that dietary quality using the Healthy Eating Index (HEI) is associated with CVD risk factors in children and that there are associated sex differences. OBJECTIVE Our main objective was to evaluate the dietary quality of schoolchildren and investigate whether poor HEI scores are associated with CVD risk and if there are sex differences. METHODS This was a cross-sectional study of Kuwaiti fifth graders (n = 313; 53% girls; mean age = 10.4 ± 0.4 years) who completed an adapted Block Kids 2004 food frequency questionnaire. Anthropometric, blood pressure, and biochemical data were also measured. HEI-2010 and HEI-2015 scores were calculated. STATISTICS A general linear model and logistic regression were applied, controlling for moderate-vigorous physical activity (MVPA) and screen time (ST). RESULTS The total HEI-2010 and HEI-2015 scores were 58 and 52 points, respectively; a trend analysis indicated that more girls than boys had poor (≤50 points) HEI-2015 scores (p < 0.063). The maximum scores for total vegetables (p < 0.001), dairy (p < 0.034), and fatty acids (p < 0.01) were significantly higher in girls, while the maximum scores for whole grains (p < 0.046) and protein (p < 0.006), but not sodium (p < 0.009), were higher in boys. Obesity was inversely associated with poor total HEI 2010 and HEI 2015 scores (OR: 0.347, 95% CI: 0.234 - 0.516, p < 0.001 and OR: 0.561, 95% CI: 0.391-0.805, p < 0.002, respectively). However, the correlation was lost after adjustment for possible confounding factors. CONCLUSIONS Dietary quality for children overall in this study was low, and there was only a weak association between poor scores and elevated blood pressure and none between scores and obesity. These findings have public health implications and warrant further investigation and attention.
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Affiliation(s)
- Abdulaziz Kh. Al-Farhan
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (L.J.W.); (J.J.C.)
- The Public Authority for Applied Education and Training, The College of Nursing, Shuwaikh 23167, Kuwait
| | - Lorraine J. Weatherspoon
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (L.J.W.); (J.J.C.)
| | - Karin A. Pfeiffer
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA;
| | - Wei Li
- Department of Dietetics & Nutrition, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | - Joseph J. Carlson
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (L.J.W.); (J.J.C.)
- Department of Radiology, Michigan State University, East Lansing, MI 48824, USA
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Zhu Y, Wang Z. Association between joint physical activity and healthy dietary patterns and hypertension in US adults: cross-sectional NHANES study. BMC Public Health 2024; 24:855. [PMID: 38504199 PMCID: PMC10953194 DOI: 10.1186/s12889-024-18346-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/12/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Lack of physical activity (PA), poor dietary habits, or other unhealthy lifestyle behaviors are potential modifiable risk factors for hypertension. It has been sufficiently demonstrated in previous studies that physical activity or healthy dietary patterns can reduce the risk of hypertension. However, no research focused on the joint effects of PA and healthy dietary patterns on hypertension in a representative sample of adults. METHODS We used data collected from the 2007-2018 National Health and Nutrition Examination Survey. Healthy dietary patterns were assessed with the Healthy Eating Index 2015 (HEI-2015), and PA was measured using the metabolic equivalent minutes per week reported in questionnaires. We created four lifestyle categories based on the HEI-2015 and PA: (1) unhealthy diet and physically inactive (less than recommended PA), (2) healthy diet but physically inactive, (3) unhealthy diet but physically active (recommended PA), (4) healthy diet and physically active. Logistic regression was used to evaluate the association between joint PA and HEI-2015 and hypertension. RESULTS A total of 24,453 participants were enrolled in the study. Compared with unhealthy diet and physically inactive individuals, only healthy diet and physically active participants (adjusted odds ratio [AOR]: 0.77, 95% CI 0.65-0.9) were negatively associated with hypertension, while healthy diet but physically inactive participants (AOR: 0.89, 95% CI 0.76-1.03) and unhealthy diet but physically active participants (AOR: 0.9, 95% CI 0.76-1.06) were not associated with hypertension. CONCLUSION In a representative sample of US adults, our findings suggest that individuals with recommended PA and healthy dietary patterns have a lower risk of hypertension than those with an unhealthy diet or less than recommended PA. Healthy eating habits and regular PA are potential preventive precautions against hypertension.
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Affiliation(s)
- Yanzhou Zhu
- Department of Geriatrics, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, 355000, China
| | - Zhigang Wang
- Department of Geriatrics, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, 355000, China.
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Felix PV, Pereira JL, Fisberg RM. Associations between Four Diet Quality Indexes and High Blood Pressure among Adults: Results from the 2015 Health Survey of Sao Paulo. Nutrients 2024; 16:629. [PMID: 38474757 DOI: 10.3390/nu16050629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Several dietary quality indexes (DQIs) have been proposed to investigate adherence to a healthy diet. However, only a few studies have been conducted to investigate their association with high blood pressure (BP) in Brazil. In the present work, we examine the association between four established DQIs-2020 Healthy Eating Index (HEI-2020), Dietary Approaches to Stop Hypertension (DASH), Alternative Healthy Eating Index (AHEI), and Brazilian Healthy Eating Index (BHEI)-and high BP in a cross-sectional sample of Brazilian adults from the 2015 Health Survey of São Paulo with Focus on Nutrition. Based on two 24 h recalls adjusted for the within-person variation, higher HEI-2020 and BHEI total scores were inversely related to elevated BP (HEI-2020: OR 0.94, BHEI: OR 0.95). Individuals at the second quartile (OR 0.33) and the fourth quartile of BHEI (OR 0.35), as well as individuals with higher scores on dairy components (HEI-2020: OR 0.80, BHEI: OR 0.83, DASH: OR 0.75), and fruit components (AHEI: OR 0.82, HEI-2020: OR 0.72, BHEI: OR 0.77, DASH: OR 0.79) also presented lower odds for the occurrence of elevated BP. In conclusion, healthier diet quality using the HEI-2020 and BHEI indexes and the fruit and dairy components were identified as protective factors for high BP.
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Affiliation(s)
- Paula Victoria Felix
- Department of Nutrition, School of Public Health, University of São Paulo, Sao Paulo 01246-904, Brazil
| | - Jaqueline Lopes Pereira
- Department of Nutrition, School of Public Health, University of São Paulo, Sao Paulo 01246-904, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, Sao Paulo 01246-904, Brazil
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Weng J, Mao Y, Xie Q, Sun K, Kong X. Gender differences in the association between healthy eating index-2015 and hypertension in the US population: evidence from NHANES 1999-2018. BMC Public Health 2024; 24:330. [PMID: 38297284 PMCID: PMC10829399 DOI: 10.1186/s12889-023-17625-0] [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: 07/05/2023] [Accepted: 12/31/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Diet has long been recognized as an important modifiable risk factor for hypertension. Herein, our research goal was to decipher the association of healthy eating index-2015 (HEI-2015) with hypertension, and to explore potential gender differences. METHODS We collected the cross-sectional data of 42,391 participants of the National Health and Nutrition Examination Survey (NHANES) 1999-2018. The association of HEI-2015 with hypertension was estimated using weighted multivariate logistic regression, with restricted cubic spline (RCS) regression being adopted to examine the nonlinearity of this association in both genders, and the stability of the results were examined by sensitivity analysis. We also performed subgroup analysis to detect potential difference in the link between HEI-2015 and hypertension stratified by several confounding factors. RESULTS After eliminating potential confounding bias, the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for hypertension across higher HEI-2015 quartiles were 0.93 (0.85-1.03), 0.84 (0.77-0.93), and 0.78 (0.72-0.86) compared to the lowest quartile, respectively. HEI-2015 was nonlinearly and inversely associated with hypertension in all participants. The gender-specific RCS curves presented a U-shaped correlation in males, while showed a linear and inverse correlation in females. Besides, subgroup analyses showed a lower risk of hypertension in participants who were females, younger than 40 years, Whites, obese, and diabetic patients. CONCLUSIONS We determined a nonlinear and inverse association between HEI-2015 and hypertension in the US general population, and revealed a remarkable gender difference when adhering to a HEI-2015 diet for preventing hypertension.
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Affiliation(s)
- Jiayi Weng
- Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215008, China
| | - Yukang Mao
- Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215008, China
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Qiyang Xie
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Kangyun Sun
- Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215008, China.
| | - Xiangqing Kong
- Department of Cardiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215008, China.
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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Yuan L, Jiang Q, Zhai Y, Zhao Z, Liu Y, Hu F, Qian Y, Sun J. Association between Plant-based Diet and Risk of Chronic Diseases and All-Cause Mortality in Centenarians in China: A Cohort Study. Curr Dev Nutr 2024; 8:102065. [PMID: 38234579 PMCID: PMC10792746 DOI: 10.1016/j.cdnut.2023.102065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 01/19/2024] Open
Abstract
Background Numerous studies have suggested the health benefits of a plant-based dietary pattern. However, whether this dietary pattern is associated with health benefits for centenarians remains unexplored. Our study aimed to investigate the correlation between 16 widely consumed Chinese food items and the incidence rates of chronic diseases and all-cause mortality among centenarians. Methods We conducted a dietary survey on 3372 centenarians with an average age of 102.33 y in China. After rigorous screening, we identified 2675 centenarians, who underwent a 10-y follow-up study with all-cause mortality as the primary outcome. We developed 6 dietary patterns on the basis of the food consumption frequency of each participant. To model the impact of missing values, we employed multiple imputation methods, verifying the robustness of models. Results The overall plant-based diet index (PDI), healthy plant-based diet index (hPDI), unhealthy plant-based diet index (uPDI), healthy plant-based foods index (HPF), unhealthy plant-based foods index (uHPF), and animal-based foods index (AF) scores among centenarians in China were 46.95 ± 6.29, 44.43 ± 5.76, 51.09 ± 6.26, 21.63 ± 4.79, 9.91 ± 2.41, and 14.59 ± 3.58, respectively. High scores of PDI, hPDI, and HPF were associated with a lower risk of chronic diseases. In the 10-y follow-up study, 92.90% of centenarians have died. The high scores of the PDI (HRPDI = 0.81), hPDI (HRhPDI = 0.79), and HPF (HRHPF = 0.81) scores were significantly associated with a lower risk of death compared with the low scores. Conversely, the high AF score (HRAF = 1.17) was significantly associated with a higher risk of death compared with the low scores. Conclusion Despite the fact that a higher score in both a predominantly plant-based dietary pattern and a healthy dietary pattern can decrease the death among centenarians, not all HPFs have this effect. A higher AF predicted a higher risk of mortality, whereas higher PDI, hPDI, and HPF were associated with a lower risk of mortality among Chinese centenarians.
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Affiliation(s)
- Lei Yuan
- Department of Health Management, Faculty of Military Health Service, Naval Medical University, Shanghai, China
| | - QinQin Jiang
- Department of Health Management, Faculty of Military Health Service, Naval Medical University, Shanghai, China
| | - Yinghong Zhai
- Clinical Research Unit, School of Medicine, Shanghai 9th People's Hospital Affiliated to Shanghai JiaoTong University, Shanghai, China
| | - Zhe Zhao
- Department of Health Management, Faculty of Military Health Service, Naval Medical University, Shanghai, China
| | - Yijun Liu
- Department of Health Management, Faculty of Military Health Service, Naval Medical University, Shanghai, China
| | - Fangyuan Hu
- Department of Medical Service, Naval Hospital of Eastern Theater, Zhoushan, China
| | - Yi Qian
- College of Health Management, Southern Medical University, Guangzhou, China
| | - Jinhai Sun
- Department of Health Management, Faculty of Military Health Service, Naval Medical University, Shanghai, China
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Pasdar Y, Moradi F, Cheshmeh S, Sedighi M, Saber A, Moradi S, Bonyani M, Najafi F. Major dietary patterns and dietary inflammatory index in relation to dyslipidemia using cross-sectional results from the RaNCD cohort study. Sci Rep 2023; 13:19075. [PMID: 37925569 PMCID: PMC10625524 DOI: 10.1038/s41598-023-46447-8] [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: 02/08/2023] [Accepted: 11/01/2023] [Indexed: 11/06/2023] Open
Abstract
Dyslipidemia can increase the risk of heart attack and stroke due to the restriction of blood flow through the blood vessels. Dietary modification is an appropriate approach to reducing this phenomenon. This cross-sectional study aimed to evaluate major dietary patterns and the dietary inflammatory index (DII) in relation to dyslipidemia. 5954 participants in the Ravansar non-communicable diseases (RaNCD) cohort study were eligible for this study. Dyslipidemia was diagnosed based on the lipid profile under consideration of the RaNCD physician. Dietary patterns were assessed by principal component analysis. The three identified dietary patterns included (1) plant-based pattern; (2) high protein and sugar pattern; and (3) energy-dense dense pattern. DII was also calculated based on the dietary information from a validated semi-quantitative food frequency questionnaire (FFQ). We found that higher adherence to DII was significantly associated with increased odds of dyslipidemia after adjusting for age, sex, and physical activity (OR: 1.24; CI 95% 1.09-1.42). Additionally, higher adherence to the high protein and sugar diet and an energy-dense diet was significantly associated with higher odds for dyslipidemia (OR: 1.31; CI 95% 1.16-1.49) and (OR: 1.28; CI 95% 1.12-1.46). Nevertheless, according to our results, following plant-based diet had no association with dyslipidemia in both crude and adjusted models. Our findings revealed that greater adherence to DII, a high-protein, high-sugar diet, and an energy-dense diet can have undesirable effects on dyslipidemia.
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Affiliation(s)
- Yahya Pasdar
- Department of Nutrition Sciences, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fardin Moradi
- Student Research Committee, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sahar Cheshmeh
- Molecular and Experimental Nutritional Medicine Department, University of Potsdam, Nuthetal, Germany
| | - Mohammad Sedighi
- Student Research Committee, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Saber
- Department of Nutrition Sciences, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shima Moradi
- Student Research Committee, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Mitra Bonyani
- Medical Education Development Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
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Li F, Zhang Y, Pan L, Chen H. Effects of dietary patterns on the all-cause mortality and cardiovascular disease mortality in patients with hypertension: A cohort study based on the NHANES database. Clin Cardiol 2023; 46:1353-1370. [PMID: 37587785 PMCID: PMC10642326 DOI: 10.1002/clc.24118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Hypertension (HTN) patients have higher risk of all-cause and cardiovascular disease (CVD)-specific mortality. Dietary patterns have been reported related to the risk of mortality, but their roles in HTN patients is unclear. HYPOTHESIS To explore the relationships between different dietary patterns and all-cause/CVD-specific mortality and provide dietary guidance for HTN patients' prognosis improvement. METHODS Data of 27 618 HTN patients were extracted from the National Health and Nutrition Examination Survey (NHANES) database in this retrospective cohort study. The associations between Healthy Eating Index (HEI)-2015, Alternate Healthy Eating Index (AHEI)-2010, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean (MED) diet and all-cause and CVD-specific mortality were explored using univariate and multivariate Cox regression analyses with hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analyses of age, gender, body mass index, and comorbidity were also performed. RESULTS The median follow-up time was 83 months. A total of 3462 patients died for all-cause and 1064 died due to CVD. After adjusting for covariates, we found that high adherence to AHEI-2010 (HR = 0.84 for all-cause; HR = 0.72 for CVD), and MED (HR = 0.84 for all-cause; HR = 0.77 for CVD) diet were associated with decreased risks of both all-cause and CVD-specific mortality. In patients who aged ≥65 years old, were normal/overweight, without complications, the relationships between different dietary patterns and risk of mortality were different. CONCLUSION High scores of AHEI-2010 and MED may be associated with decreased risks of all-cause and CVD-specific mortality in patients with HTN.
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Affiliation(s)
- Fang Li
- Department of CardiologyThe Second Hospital of Hebei Medical UniversityShijiazhuangHebeiPeople's Republic of China
| | - Yanping Zhang
- Department of Urological SurgeryThe Second Hospital of Hebei Medical UniversityShijiazhuangHebeiPeople's Republic of China
| | - Lina Pan
- Department of Internal MedicineWuji County People's HospitalShijiazhuangHebeiPeople's Republic of China
| | - Hui Chen
- Department of CardiologyThe Second Hospital of Hebei Medical UniversityShijiazhuangHebeiPeople's Republic of China
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Ghadiri M, Soltani M, Rajabzadeh-Dehkordi M, Gerami S, Shateri Z, Nouri M, Gargari BP. The relation between dietary quality and healthy eating index with bone mineral density in osteoporosis: a case-control study. BMC Musculoskelet Disord 2023; 24:584. [PMID: 37464347 DOI: 10.1186/s12891-023-06704-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND In this study, we aimed to illustrate the association between the Healthy Eating Index (HEI) and Dietary Quality Index (DQI) with bone mineral density (BMD) among postmenopausal Iranian women with osteoporosis compared to the healthy control. METHODS In the current case-control study, 131 postmenopausal women with osteoporosis and 131 healthy postmenopausal women participated. Dual-energy X-ray absorptiometry was used to assess the lumbar vertebrae and femoral neck BMD. The subjects completed a validated food frequency questionnaire (FFQ), and then HEI and DQI were calculated based on the FFQ data. Crude and adjusted multivariable logistic regression was used to assess the relation between HEI and DQI with the odds of the femoral and lumbar BMD. RESULTS According to the results, participants in the last tertile of HEI were more likely to have higher femoral and lumbar BMD in the crude model (odds ratio (OR) = 0.38; 95% confidence interval (CI): 0.20-0.71 and OR = 0.20; 95% CI: 0.10-0.40, respectively) and also in the adjusted model (OR = 0.40; 95% CI: 0.20-0.78 and OR = 0.20; 95% CI: 0.10-0.41, respectively). Also, in terms of DQI-I, participants in the last tertile were more likely to have higher femoral and lumbar BMD in the crude model (OR = 0.23; 95% CI: 0.12-0.45 and OR = 0.29; 95% CI: 0.15-0.55, respectively) and also in the adjusted model (OR = 0.29; 95% CI: 0.14-0.58 and OR = 0.34; 95% CI: 0.17-0.67, respectively). CONCLUSIONS The results of the current study supported the hypothesis that high-quality diets with healthy patterns can be clinically effective in maintaining bone health. Thus, recommendations regarding the consumption of nutrient-rich food groups in a healthy diet can serve as a practical non-pharmacological strategy against osteoporosis.
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Affiliation(s)
- Marzieh Ghadiri
- Student Research Committee, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mitra Soltani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Milad Rajabzadeh-Dehkordi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shirin Gerami
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zainab Shateri
- Department of Nutrition and Biochemistry, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Mehran Nouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Bahram Pourghassem Gargari
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
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Madsen H, Sen A, Aune D. Fruit and vegetable consumption and the risk of hypertension: a systematic review and meta-analysis of prospective studies. Eur J Nutr 2023:10.1007/s00394-023-03145-5. [PMID: 37106252 DOI: 10.1007/s00394-023-03145-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/03/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE A high fruit and vegetable intake has been associated with reduced risk of hypertension; however, results have been inconsistent and it is unclear whether specific types of fruits and vegetables are particularly beneficial. This systematic review and meta-analysis aimed to summarize the published prospective studies on fruit and vegetable consumption and risk of hypertension. METHODS Embase and PubMed databases were searched for relevant prospective studies up to 15th May 2022. Random effects models were used to calculate summary relative risks (RRs) and 95% confidence intervals (CIs) for the association between fruit and vegetable intake and risk of hypertension. Strength of evidence was assessed using World Cancer Research Fund (WCRF) criteria. RESULTS Eighteen prospective studies (451 291 participants, 145 492 cases) were included. The summary RR (95% CI) of hypertension per 200 g/day was 0.97 (0.95-0.99, I2 = 68%, n = 8) for fruits and vegetables, 0.93 (0.89-0.98, I2 = 77%, n = 10) for fruits, and 1.00 (0.98-1.02, I2 = 38%, n = 10) for vegetables. Reductions in risk were observed up to 800 g/day for fruits and vegetables, and 550 g/day for fruits, and these two associations were considered probably causal using WCRF criteria. Inverse associations were observed for apples or pears, blueberries, raisins or grapes, avocado, broccoli, carrots and lettuce, while positive associations were observed for cantaloupe, Brussels sprouts, cruciferous vegetables, and total and fried potatoes (n = 2-5). CONCLUSION A high intake of fruit and vegetables combined, and total fruit was associated with reduced risk of hypertension, while results for fruit and vegetable subtypes were mixed and need further study.
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Affiliation(s)
- Helga Madsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Abhijit Sen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Center for Oral Health Services and Research (TkMidt), Trondheim, Norway
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK.
- Department of Nutrition, Oslo New University College, Oslo, Norway.
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital Ullevål, Oslo, Norway.
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Koemel NA, Senior AM, Benmarhnia T, Holmes A, Okada M, Oulhote Y, Parker HM, Shah S, Simpson SJ, Raubenheimer D, Gill TP, Laouali N, Skilton MR. Diet Quality, Microbial Lignan Metabolites, and Cardiometabolic Health among US Adults. Nutrients 2023; 15:nu15061412. [PMID: 36986142 PMCID: PMC10054147 DOI: 10.3390/nu15061412] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
The gut microbiome has been shown to play a role in the relationship between diet and cardiometabolic health. We sought to examine the degree to which key microbial lignan metabolites are involved in the relationship between diet quality and cardiometabolic health using a multidimensional framework. This analysis was undertaken using cross-sectional data from 4685 US adults (age 43.6 ± 16.5 years; 50.4% female) participating in the National Health and Nutrition Examination Survey for 1999–2010. Dietary data were collected from one to two separate 24-hour dietary recalls and diet quality was characterized using the 2015 Healthy Eating Index. Cardiometabolic health markers included blood lipid profile, glycemic control, adiposity, and blood pressure. Microbial lignan metabolites considered were urinary concentrations of enterolignans, including enterolactone and enterodiol, with higher levels indicating a healthier gut microbial environment. Models were visually examined using a multidimensional approach and statistically analyzed using three-dimensional generalized additive models. There was a significant interactive association between diet quality and microbial lignan metabolites for triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, insulin, oral glucose tolerance, adiposity, systolic blood pressure, and diastolic blood pressure (all p < 0.05). Each of these cardiometabolic health markers displayed an association such that optimal cardiometabolic health was only observed in individuals with both high diet quality and elevated urinary enterolignans. When comparing effect sizes on the multidimensional response surfaces and model selection criteria, the strongest support for a potential moderating relationship of the gut microbiome was observed for fasting triglycerides and oral glucose tolerance. In this study, we revealed interactive associations of diet quality and microbial lignan metabolites with cardiometabolic health markers. These findings suggest that the overall association of diet quality on cardiometabolic health may be affected by the gut microbiome.
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Affiliation(s)
- Nicholas A. Koemel
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
- Sydney Medical School, The University of Sydney, Sydney 2006, Australia
| | - Alistair M. Senior
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
- School of Life and Environmental Sciences, The University of Sydney, Sydney 2006, Australia
- Sydney Centre for Precision Data Science, The University of Sydney, Sydney 2006, Australia
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, CA 92093, USA
| | - Andrew Holmes
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
- School of Life and Environmental Sciences, The University of Sydney, Sydney 2006, Australia
| | - Mirei Okada
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
- School of Life and Environmental Sciences, The University of Sydney, Sydney 2006, Australia
| | - Youssef Oulhote
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 01003, USA
| | - Helen M. Parker
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
- Sydney Medical School, The University of Sydney, Sydney 2006, Australia
| | - Sanam Shah
- “Exposome and Heredity” Team, CESP, Paris-Saclay University, UVSQ, University Paris-Sud, Inserm, Gustave Roussy, F-94805 Villejuif, France
| | - Stephen J. Simpson
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
- School of Life and Environmental Sciences, The University of Sydney, Sydney 2006, Australia
| | - David Raubenheimer
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
- School of Life and Environmental Sciences, The University of Sydney, Sydney 2006, Australia
| | - Timothy P. Gill
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia
- Sydney Medical School, The University of Sydney, Sydney 2006, Australia
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney 2006, Australia
| | - Nasser Laouali
- Scripps Institution of Oceanography, University of California, San Diego, CA 92093, USA
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 01003, USA
- “Exposome and Heredity” Team, CESP, Paris-Saclay University, UVSQ, University Paris-Sud, Inserm, Gustave Roussy, F-94805 Villejuif, France
- Correspondence: (N.L.); (M.R.S.)
| | - Michael R. Skilton
- Sydney Medical School, The University of Sydney, Sydney 2006, Australia
- Correspondence: (N.L.); (M.R.S.)
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Association between overall dietary quality and constipation in American adults: a cross-sectional study. BMC Public Health 2022; 22:1971. [PMID: 36303148 PMCID: PMC9615246 DOI: 10.1186/s12889-022-14360-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/09/2022] [Accepted: 10/04/2022] [Indexed: 11/26/2022] Open
Abstract
Background Constipation seriously affects people’s life quality, and dietary adjustment has been one of the effective methods. Overall dietary quality has been reported to be associated with some diseases, while its association with constipation has not been reported. This study aims to explore the association between overall dietary quality and constipation. Methods A cross-sectional study was designed and data were extracted from National Health and Nutrition Examination Survey (NHANES). Overall dietary quality was assessed by healthy eating index-2015 (HEI-2015), and constipation was defined by either stool consistency or stool frequency. The association between overall dietary quality or components of HEI-2015 and constipation was assessed using logistic regression, with results expressed as odds ratio (OR) and 95% confidence intervals (95%CI). Subgroup analysis was conducted according to age and gender. Results A total of 13,945 participants were eligible, with 1,407 in constipation group and 12,538 in non-constipation group. Results showed that higher adherence to HEI-2015 was associated with reduced odds of constipation (OR: 0.98, 95%CI: 0.98–0.99) after adjusting potential confounders. Further, we found higher intake of total fruits, whole fruits, total vegetables, greens and beans, whole grains, total protein foods, seafood and plant proteins, and higher fatty acids ratio decreased the odds of constipation, while higher intake of sodium increased the odds (all P < 0.05). We also found negative association between HEI-2015 and constipation in participants with male sex, female sex, age ≥ 65 years, and age < 65 years (all P < 0.05). Conclusion We found higher adherence to HEI-2015 decreased the odds of constipation, suggesting that increasing HEI-2015 adherence may be one of effective methods to alleviate constipation. Supplementary information The online version contains supplementary material available at 10.1186/s12889-022-14360-w.
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Lobene AJ, Smiljanec K, Axler MR, Ramos-Gonzalez M, Lennon SL. Greater adherence to healthy dietary patterns is associated with lower diastolic blood pressure and augmentation index in healthy, young adults. Nutr Res 2022; 106:60-71. [PMID: 36126530 PMCID: PMC10335482 DOI: 10.1016/j.nutres.2022.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 11/20/2022]
Abstract
More than two-thirds of cardiovascular disease (CVD) deaths worldwide are attributable to dietary factors. Blood pressure variability (BPV), endothelial dysfunction, and arterial stiffness are important CVD risk factors. Although studies show a link between consuming a healthy diet and lower BPV and stiffness and improved endothelial function, research in young, healthy adults is scarce. We hypothesized that, in young, healthy adults, diet quality would be inversely associated with BPV and arterial stiffness and positively associated with endothelial function. This cross-sectional study included 56 healthy young adults (34 women/22 men, age 26.7 ± 0.8 years, body mass index 23.4 ± 0.4 kg/m2, blood pressure [BP] 113/69 mmHg). Three-day diet records were used to calculate two Dietary Approaches to Stop Hypertension (DASH) diet scores, the alternative Mediterranean Diet (aMED) score, and the Healthy Eating Index-2015 (HEI-2015) based on the 2015-2020 Dietary Guidelines for Americans. Twenty-four-hour ambulatory BP data were used to calculate average real variability of systolic and diastolic BP. Endothelial function was assessed by flow-mediated dilation, and arterial stiffness was assessed by pulse wave velocity and augmentation index (AIx). Overall, the HEI-2015 was inversely associated with 24-hour diastolic BP (DBP) and daytime DBP, and the aMED score was inversely associated with AIx. In our exploratory analyses, the Fung DASH score was inversely associated with 24-hour DBP and daytime DBP in women, but not men. These findings suggest that consuming a diet that aligns with the DASH diet, the Mediterranean diet, and/or the 2015-2020 Dietary Guidelines for Americans is associated with cardiovascular benefits in healthy, young adults.
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Affiliation(s)
- Andrea J Lobene
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
| | - Katarina Smiljanec
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
| | - Michael R Axler
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
| | - Macarena Ramos-Gonzalez
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
| | - Shannon L Lennon
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, 19713.
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Pasdar Y, Moradi S, Saedi S, Moradinazar M, Rahmani N, Hamzeh B, Najafi F. Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet in relation to age-associated poor muscle strength; a cross-sectional study from the Kurdish cohort study. Sci Rep 2022; 12:11866. [PMID: 35831466 PMCID: PMC9279400 DOI: 10.1038/s41598-022-16120-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 07/05/2022] [Indexed: 11/09/2022] Open
Abstract
The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is an eating pattern associated with multiple health benefits, including the conservation of skeletal muscle. The Hand Grip Strength (HGS) is the most frequently used indicator of muscle functional capacity and muscle strength for clinical purposes. The current study aims to investigate the association between adherence to MIND diet and prevention of age-associated decline in muscle strength among the Kurdish population in Iran. This cross-sectional study was performed using data from Ravansar non-communicable diseases (RaNCD) cohort study on 3181 adults (48.5% men) aged 35–65 years. The dietary intake of the studied participants was assessed using a 114-item food frequency questionnaire (FFQ) developed by RaNCD cohort study. The MIND diet and the major dietary patterns were identified based on the participants’ dietary intake and three dietary patterns emerged including plant-based diet, high protein diet, and unhealthy diet. Hand grip strength (HGS) was measured using a hand-held hydraulic handgrip dynamometer and poor HGS was defined as HGS less than 32.8 and 20.5 kg in men and women, respectively. Compared with participants in the lowest category of MIND diet, those in the highest category had lower odds of poor HGS (OR: 0.65; CI 95%: 0.51–0.83). Furthermore, participants who were in third tertiles of plant-based and high protein diet were more likely 37% and 33% lower odds ratio of poor HGS (OR: 0.63; CI 95%: 0.5–0.79), (OR: 0.67; CI 95%: 0.54–0.84), respectively. On the other hand, greater adherence to the unhealthy diet was increased odds of poor HGS (OR: 1.39; CI 95%: 1.11–1.74). Overall, our findings suggest that adherence to the MIND diet and high protein diet may be associated with higher HGS, while adherence to the unhealthy diet can increase the odds of age-associated poor HGS in the Kurdish population.
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Affiliation(s)
- Yahya Pasdar
- Department of Nutritional Sciences, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shima Moradi
- Department of Nutritional Sciences, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Saman Saedi
- Department of Animal Science, College of Agriculture, Shiraz University, Shiraz, Iran.
| | - Mehdi Moradinazar
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Negin Rahmani
- Julius Maximillian University of Wuerzburg, Wuerzburg, Germany
| | - Behrooz Hamzeh
- Environmental Determinates of Health Research Center, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- School of Public Health, Communing Developmental and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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