Prospective study of dietary mushroom intake and risk of mortality: results from continuous National Health and Nutrition Examination Survey (NHANES) 2003-2014 and a meta-analysis

Mushroom consumption and hyperuricemia: results from the National Institute for Longevity Sciences-Longitudinal Study of Aging and the National Health and Nutrition Examination Survey (2007-2018)

BACKGROUND

Prior study reported that mushroom consumption was associated with a lower incidence of hyperuricemia, but there is limited evidence on this association. We conducted a collaborative study to investigate the association between mushroom intake and hyperuricemia in middle-aged and older populations.

METHODS

We used data from the National Health and Nutrition Examination Survey (NHANES) in the U.S. (2007-2018) and the National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA) in Japan (1997-2012). Consumption of mushroom (g/day) were measured by one- or two-day dietary recall in NHANES and by 3-day dietary records in the NILS-LSA. Hyperuricemia was defined using uric acid levels as > 420 μmol/L and > 350 μmol/L in NHANES for men and women, respectively; in the NILS-LSA, serum uric acid was repeatedly measured at baseline and follow-up surveys. Hyperuricemia was defined as uric acid levels > 416.4 μmol/L for men and ≥ 356.9 μmol/L for women. Logistic regression models in NHANES (cross-sectionally) and Generalized Estimation Equations in NILS-LSA (longitudinally) were performed.

RESULTS

A total of 5,778 NHANES participants (mean (SD) age: 53.2 (9.6) years) and 1,738 NILS-LSA (mean (SD) age: 53.5 (11.2) years) were included. Mushrooms were consumed by 5.7% of participants in NHANES and 81.2% in NILS-LSA. We did not observe a significant association between mushroom intakes and hyperuricemia in the NHANES men and women. However, in the NILS-LSA, compared to non-consumers, a higher mushroom intake was associated with a lower risk of incident hyperuricemia in men under 65 years old. The adjusted odds ratio (95% CI) for non-consumers, participants with middle, and the highest consumption of mushrooms were 1.00 (Ref.), 0.77 (0.44, 1.36), and 0.55 (0.31, 0.99), respectively (P-trend = 0.036). No association was found in women in NILS-LSA.

CONCLUSIONS

Mushroom consumption was associated with a lower risk of incident hyperuricemia in Japanese men.

Edible mushroom intake and risk of all-cause and cause-specific mortality: results from the Korean Genome and Epidemiology Study (KoGES) Cohort

Mushroom is rich in protein, fiber, vitamins, and essential amino acids. A relationship between mushroom consumption and a lower all-cause mortality risk has been reported. This study aimed to examine the association of mushroom consumption with all-cause and cause-specific mortality. Data were extracted from the Korean Genome and Epidemiology Study cohort. Mortality outcomes were confirmed from 2001-2020 death records provided by the Korea National Statistical Office. Mushroom intake was assessed using food frequency questionnaires and categorized into four groups: none, <1 serving per week, 1-3 servings per week, and ≥3 servings per week. Cox proportional hazard regression was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. The 152 828 participants ≥40 years had a mean age of 53.7 years. Over a mean 11.6-year follow-up, 7085 deaths were recorded. In men, consuming <1 and 1-3 servings per week of mushroom was associated with lower risks of all-cause (HR = 0.858, 95% CI = 0.793-0.929; HR = 0.902, 95% CI = 0.819-0.993) and cardiovascular disease (CVD) (HR = 0.767, 95% CI = 0.632-0.930; HR = 0.762, 95% CI = 0.601-0.967) mortality than non-consumption. In women, consuming <1 and 1-3 servings per week of mushrooms was associated with a lower risk of all-cause mortality (HR = 0.864, 95% CI = 0.784-0.952; HR = 0.869, 95% CI = 0.771-0.980) than non-consumption. This prospective cohort study demonstrated that low and medium mushroom consumption is associated with a lower risk of all-cause mortality in men and women. However, only men who consumed <1 and 1-3 servings per week of mushrooms exhibited a lower risk of CVD mortality.

Mushroom intake and cognitive performance among US older adults: the National Health and Nutrition Examination Survey, 2011-2014

Emerging evidence has suggested that mushrooms, which are a rich source of the potent antioxidants ergothioneine and glutathione as well as vitamin D, may have neuroprotective properties. This study investigated the association between mushroom consumption and cognitive performance in a nationally representative sample of US older adults. We analysed data from older adults aged ≥ 60 years from the 2011-2014 National Health and Nutrition Examination Survey. Mushroom intake was measured using up to two 24-h dietary recalls and was categorised into three groups (lowest, middle and highest). Cognitive function tests included the Animal Fluency (AF) Test; Consortium to Establish a Registry for Alzheimer's Disease Delayed Recall (CERAD-DR) and Word Learning (CERAD-WL); and Digit Symbol Substitution Test (DSST). Multivariable linear regression models were developed, adjusting for socio-demographics, major lifestyle factors, self-reported chronic diseases and dietary factors, including the Healthy Eating Index-2015 score and total energy. The study included 2840 participants. Compared with the lowest category of mushroom intake, participants in the highest category (median intake = 13·4 g /4184 KJ (1000 kcal)/d) had higher scores for DSST (β = 3·87; 95 % CI 0·30, 7·45; P for trend = 0·03) and CERAD-WL (β = 1·05; 95 % CI 0·0003, 2·10; P for trend = 0·04). Similar non-significant trends were observed for AF (β = 0·24; 95 % CI -2·26, 2·73; P for trend = 0·92) but not for the CERAD-DR. Greater mushroom intake was associated with certain cognitive performance tests, suggesting regular mushroom consumption may reduce the risk of cognitive decline.

Development, Relative Validity, and Reproducibility of a Short Food Frequency Questionnaire for the Japanese

We have developed a short food frequency questionnaire (FFQ) for use in assessing diet quality for Japan, with special reference to the prevention of non-communicable diseases. Here, we assessed the ranking performance of this FFQ and its reproducibility. We developed a 28-item (21 food groups and 7 beverage) FFQ with consideration to both Japanese dietary culture and evidence of disease prevention. Twenty-four university faculty members participated in the validation study. They completed 3-day photographic food record and answered the FFQ on the next day of the last food record (time 1) and a week later (time 2). We calculated Spearman correlation coefficients between intakes of food groups from photographic food records and the consumption frequency from the FFQs (ranking ability) and between the consumption frequency of food groups from the FFQs (time 1 and time 2) (reproducibility). Spearman correlation coefficients between the food records and FFQ (time 1) ranged from −0.12 to 0.86 (median 0.51). These values were comparable to those in comparison with FFQ (time 2). After energy adjustment of intakes from the food records, the corresponding values were somewhat weakened for many food groups. The correlation coefficients between two FFQs ranged from 0.14 to 0.96 (median 0.79). The short FFQ showed acceptable reproducibility and ability to rank the consumption of most food groups.

Joint Associations of Food Groups with All-Cause and Cause-Specific Mortality in the Mr. OS and Ms. OS Study: A Prospective Cohort

Despite continuous growth in dietary pattern research, the relative importance of each dietary component in the overall pattern and their joint effects on mortality risk have not been examined adequately. We explored the individual and joint associations of multiple food groups with all-cause and cause-specific mortality (cardiovascular disease (CVD) or cancer), by analyzing data from a cohort of 3995 Hong Kong Chinese older adults in the Mr. Osteoporosis (OS) and Ms. OS Study. Cox proportional hazards models were used to examine the associations of food groups with mortality risk. The individual and joint contribution of food groups to mortality risk has been quantified by a machine learning approach, i.e., the Quantile G-Computation. When comparing the highest with the lowest quartile of intake, dark green and leafy vegetables (hazard ratio (HR) = 0.82, 95% confidence interval (CI) = 0.70 to 0.96, Ptrend = 0.049), fruit (HR = 0.79, 95% CI = 0.68 to 0.93, Ptrend = 0.006), legumes (HR = 0.75, 95% CI = 0.63 to 0.87, Ptrend = 0.052), mushroom and fungi (HR = 0.76, 95% CI = 0.65 to 0.88, Ptrend = 0.023), soy and soy products (HR = 0.77, 95% CI = 0.66 to 0.90, Ptrend = 0.143), and whole grains (HR = 0.76, 95% CI = 0.65 to 0.89, Ptrend = 0.008) were inversely associated with all-cause mortality. Legume intake was associated with a lower risk of CVD mortality, while fruit, nuts, soy and soy products were associated with a lower risk of cancer mortality. From the Quantile G-Computation, whole grains, legumes, fruits, mushroom and fungi, soy and soy products had a higher relative weighting on mortality risk, and the joint effect of food groups was inversely associated with the mortality risk due to all-causes (HR = 0.39, 95% CI = 0.27 to 0.55), CVD (HR = 0.78, 95% CI = 0.67 to 0.91), and cancer (HR = 0.31, 95% CI = 0.15 to 0.65). From a sex-stratified analysis, most associations between food groups (whole grains, legumes, fruits, mushroom and fungi, soy and soy products) and mortality risk remained significant among men. In conclusion, whole grains, legumes, fruits, mushroom and fungi, soy and soy products were the main contributors to a reduction in mortality risk, and their joint effects were stronger than individual food groups. Moreover, the sex-specific association of sweets and desserts with cancer mortality may be worth further investigation.

Association of Mushrooms and Algae Consumption with Mortality among Chinese Older Adults: A Prospective Cohort Study

Mushrooms and algae are important sources of dietary bioactive compounds, but their associations with mortality remain unclear. We examined the association of mushrooms and algae consumption with subsequent risk of all-cause mortality among older adults. This study included 13,156 older adults aged 65 years and above in the Chinese Longitudinal Healthy Longevity Survey (2008–2018). Consumption of mushrooms and algae at baseline and age of 60 were assessed using a simplified food frequency questionnaire (FFQ). We used Cox proportional hazards models to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). During 74,976 person-years of follow-up, a total of 8937 death cases were documented. After adjustment for demographic, lifestyle, and other dietary factors, participants who consumed mushrooms and algae at least once per week had a lower risk of all-cause mortality than rare consumers (0–1 time per year) (HR = 0.86; 95% CI: 0.80–0.93). Compared to participants with rare intake at both age 60 and the study baseline (average age of 87), those who maintained regular consumptions over time had the lowest hazard of mortality (HR = 0.86; 95% CI: 0.76–0.98). Our findings supported the potential beneficial role of long-term consumption of mushrooms and algae in reducing all-cause mortality among older adults. Further studies are warranted to evaluate the health benefit for longevity of specific types of mushrooms and algae.

Vegan nutrition: a preliminary guide for health professionals

Since the beginning of the 21st century, interest in vegan diets has been rapidly increasing in most countries. Misconceptions about vegan diets are widespread among the general population and health professionals. Vegan diets can be health-promoting and may offer certain important advantages compared to typical Western (and other mainstream) eating patterns. However, adequate dietary sources/supplements of nutrients of focus specific to vegan diets should be identified and communicated. Without supplements/fortified foods, severe vitamin B12 deficiency may occur. Other potential nutrients of focus are calcium, vitamin D, iodine, omega-3 fatty acids, iron, zinc, selenium, vitamin A, and protein. Ensuring adequate nutrient status is particularly important during pregnancy, lactation, infancy, and childhood. Health professionals are often expected to be able to provide advice on the topic of vegan nutrition, but a precise and practical vegan nutrition guide for health professionals is lacking. Consequently, it is important and urgent to provide such a set of dietary recommendations. It is the aim of this article to provide vegan nutrition guidelines, based on current evidence, which can easily be communicated to vegan patients/clients, with the goal of ensuring adequate nutrient status in vegans.

Diet Sustainability Analyses Can Be Improved With Updates to the Food Commodity Intake Database

Diet sustainability analyses inform policymaking decisions and provide clinicians and consumers with evidence-based information to make dietary changes. In the United States, the Food Commodity Intake Database (FCID) provides a crosswalk for integrating nationally representative data on food intake from the National Health and Nutrition Examination Survey (NHANES) with data on sustainability outcomes from other publicly available databases. However, FCID has not been updated since 2010 and does not link with contemporary NHANES data, which limits further advancements in sustainability research. This study fills this research gap by establishing novel linkages between FCID and NHANES 2011-2018, comparing daily per capita food intake with and without these linkages, and making these data publicly available for use by other researchers. To update FCID, two investigators independently established novel data linkages, a third investigator resolved discrepancies, and a fourth investigator audited linkages for accuracy. Dietary data were acquired from nearly 45,000 adults from 2001 to 2018, and food intake was compared between updated vs. non-updated FCID versions. Total food intake from 2011 to 2018 was 5-23% higher using the updated FCID compared to the non-updated version, and intake was over 100% higher in some years for some food categories including poultry, eggs, legumes, starchy vegetables, and tropical oils (P < 0.001 for all comparisons). Further efforts may be needed to create new food composition data to reflect new products and reformulations that enter the food supply over time. This study removes a barrier to further diet sustainability analyses by establishing a data crosswalk between contemporary NHANES and other publicly available databases on agricultural resource use, environmental impacts, and consumer food expenditures.

Edible Mushrooms for Sustainable and Healthy Human Food: Nutritional and Medicinal Attributes

Global food production faces many challenges, including climate change, a water crisis, land degradation, and desertification. These challenges require research into non-traditional sources of human foods. Edible mushrooms are considered an important next-generation healthy food source. Edible mushrooms are rich in proteins, dietary fiber, vitamins, minerals, and other bioactive components (alkaloids, lactones, polysaccharides, polyphenolic compounds, sesquiterpenes, sterols, and terpenoids). Several bioactive ingredients can be extracted from edible mushrooms and incorporated into health-promoting supplements. It has been suggested that several human diseases can be treated with extracts from edible mushrooms, as these extracts have biological effects including anticancer, antidiabetic, antiviral, antioxidant, hepatoprotective, immune-potentiating, and hypo-cholesterolemic influences. The current study focuses on sustainable approaches for handling edible mushrooms and their secondary metabolites, including biofortification. Comparisons between edible and poisonous mushrooms, as well as the common species of edible mushrooms and their different bioactive ingredients, are crucial. Nutritional values and the health benefits of edible mushrooms, as well as different biomedical applications, have been also emphasized. Further research is needed to explore the economic sustainability of different medicinal mushroom bioactive compound extracts and their potential applications against emerging diseases such as COVID-19. New approaches such as nano-biofortification are also needed to supply edible mushrooms with essential nutrients and/or to increase their bioactive ingredients.

Searching for a Longevity Food, We Bump into Hericium erinaceus Primordium Rich in Ergothioneine: The “Longevity Vitamin” Improves Locomotor Performances during Aging

Phenotypic frailty is characterized by a progressive decline in physical functioning. During ageing, morphological and functional alterations involve the brain, and chief theories involve oxidative stress, free radical accumulation, and reduced antioxidant defenses as the most implicated mechanisms. From boosting the immune system to fighting senescence, medicinal mushrooms have been found to have a number of health and longevity benefits. Among them, Hericium erinaceus (He) has been demonstrated to display a variety of physiological effects, including anti-aging properties. Thus, He represents an attractive natural source for developing novel medicines and functional foods, based on the identification of its active ingredients and metabolites. Particularly, H. erinaceus primordium (He2) extract contains a high amount of Ergothioneine (ERGO), the longevity vitamin. Herein, we revealed the preventive effect of ERGO-rich He2 extract in a preclinical model, focusing on locomotor decline during ageing monitored through spontaneous behavioral test. This effect was accompanied by a significant decrease in some oxidative stress markers (NOS2, COX2) paralleled by an increase in P53, showed in cerebellar cortex cells and fibres by immunohistochemistry. In summary, we demonstrated the neuro-protective and preventive effects of He2 extract during aging, probably due to its peculiarly high ERGO content.

Diet-derived ergothioneine induces necroptosis in colorectal cancer cells by activating the SIRT3/MLKL pathway

Ergothioneine (Egt) is a dietary amino acid which acts as an antioxidant to protect against aging-related diseases. We investigated the anticancer properties of Egt in colorectal cancer cells (CRC). Egt treatment exerted cytotoxicity in a dose-dependent manner, induced reactive oxygen species accumulation, loss of mitochondrial membrane potential, and upregulation of the histone deacetylase SIRT3. Immunoblotting analysis indicated that the cell death occurred via necroptosis through activation of the RIP1/RIP3/MLKL pathway. An immunoprecipitation assay unveiled that the interaction between the terminal effector in necroptotic signaling MLKL and SIRT3 increased during the Egt treatment. SIRT3 gene silencing blocked the upregulation of MLKL and abolished the ability of Egt to induce necroptosis. The SIRT3-MLKL interaction may mediate the necroptotic effects of Egt in CRC, suggesting the potential of this dietary amino-thione in the prevention of CRC.

The antioxidant potential of different edible and medicinal mushrooms

Mushroom consumption has grown extraordinarily owing to their high nutritional value, desirable taste, and aroma. Mushrooms continue generating lots of interest chiefly in their consumption as food, as a cure for different ailments, as well as important goods for commerce throughout the globe owing to their dietary, antioxidant, and therapeutic values. Higher Ascomycetes and Basidiomycetes mushrooms have different properties with anticancer and immunological potential. They as well provide vital health benefits and display a wide-ranging continuum of pharmacological effects. The antioxidant activity of different mushrooms was reviewed for different radicals including DPPH, ABTS, OH, Nitrite, metals, and lipid peroxidation. The present review presents pharmacological activities of different species of edible and medicinal mushrooms. This review provides tangible evidence that these mushrooms are an excellent source of natural constituents and antioxidants with potential application in pharmaceuticals and in treating and managing different diseases.

Health Consequences of Improving the Content of Ergothioneine in the Food Supply

Ergothioneine (ERGO) is a potent antioxidant and anti-inflammatory amino acid that is highly bioavailable to humans from the diet. ERGO is now regarded by some as a "longevity vitamin" that has the potential to mitigate some chronic diseases of aging and thereby increase life expectancy when present in adequate amounts. However, only limited knowledge exists regarding ERGO content in the human diet. Since ERGO is produced primarily by fungi, mushrooms are known to be the leading dietary source, but ERGO is found in relatively low amounts throughout the food chain as a result of soil-borne fungi or bacteria passing it on to plants through their roots. Some conventional agricultural practices that negatively impact soil fungi, such as excessive soil disturbance (plowing), can significantly reduce ERGO content of food crops when compared to regenerative practices such as eliminating tillage of the soil (No-Till). This has led us to the concept that ERGO may be a definitive connection between soil health and human health.