Association among acrylamide, blood insulin, and insulin resistance in adults

Ultra-processed foods - a scoping review for Nordic Nutrition Recommendations 2023

Ultra-processed foods (UPFs) are increasingly consumed worldwide and have been linked to several chronic diseases. This paper aims to describe the totality of the available evidence regarding UPFs in relation to health-related outcomes as a basis for setting food-based dietary guidelines for the Nordic Nutrition Recommendations 2023. Systematic literature searches were conducted to identify systematic reviews, meta-analyses, randomized controlled trials (RCTs), and prospective cohort studies examining the association between UPF intake and non-communicable diseases or mortality. A total of 12 systematic reviews (including five meta-analyses) and 44 original research studies (43 prospective cohort studies and one RCT) were included. All original research studies were deemed to be of good methodological quality. The current evidence supports that greater consumption of UPFs is associated with weight gain and increased risk of obesity, cardiovascular disease, type 2 diabetes, and all-cause mortality. The available literature also supports an association between UPFs and hypertension, cancer, and depression; however, the limited number of studies and subjects investigated preclude strong conclusions. Due to the highly diverse nature of UPFs, additional studies are warranted, with special emphasis on disentangling mediating mechanisms, whether nutritional or non-nutrient based. Nevertheless, the available evidence regarding UPFs in relation to weight gain, CVD, type 2 diabetes, and all-cause mortality is considered strong enough to support dietary recommendations to limit their consumption.

Acrylamide, an air pollutant, enhances allergen-induced eosinophilic lung inflammation via group 2 innate lymphoid cells

Air pollution significantly impacts the aggravation of asthma. Exposure to acrylamide, a volatile organic compound in tobacco smoke, is associated with elevated risks of allergy-related outcomes among active smokers. As group 2 innate lymphoid cells (ILC2s) can act as an environmental sensor and significantly contribute to protease allergen-induced lung inflammation, we aimed to elucidate the causal relationship and how inhaled acrylamide worsens allergic lung inflammation via ILC2s. Intranasal acrylamide exposure at nanomolar levels significantly enhanced allergen-induced or recombinant mouse interleukin-33-induced lung inflammation in C57BL/6 mice or Rag1-/- mice, respectively. The cardinal features of lung inflammation included accumulated infiltration of ILC2s and eosinophils. Transcriptomic analysis revealed a gene expression pattern associated with proliferation-related pathways in acrylamide-treated ILC2s. Western blotting revealed significantly higher expression of Ras and phospho-Erk in acrylamide-treated ILC2s than the control, suggesting Ras-Erk signaling pathway involvement. Ex vivo and in vitro analysis showed that acrylamide treatment mainly increased Ki-67+ ILC2s and the cell number of ILC2s whereas PD98059, a highly selective Erk inhibitor, effectively counteracted the acrylamide effect. Intratracheal administration of acrylamide-treated ILC2s significantly enhanced eosinophil infiltration in Rag1-/- mice. This study suggests that airborne acrylamide may enhance the severity of allergen-induced airway eosinophilic inflammation, partly via altering ILC2 proliferative activity.

Ultra-processed Food Intake and Risk of Type 2 Diabetes in Korean Adults

BACKGROUND

Several studies from the United States and European countries reported a positive association between ultra-processed food intake and diabetes risk. However, little is known about the association in Asian populations. It is also unknown about the individual ultra-processed food items that are most unfavorably associated with diabetes risk.

OBJECTIVE

We examined the associations of ultra-processed food intake (combined, as well as individual ultra-processed food items) with the risk of type 2 diabetes.

METHODS

This prospective analysis included 7438 participants aged 40-69 y from the Korean Genome and Epidemiology Study Ansan-Ansung cohort. Dietary intake was assessed at baseline using a 103-item semiquantitative food-frequency questionnaire. Ultra-processed foods were classified using the Nova definition. Incident type 2 diabetes cases were identified via follow-up interviews and health examination. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounders.

RESULTS

During the follow-up (2001-2019; median: 15 y), a total of 1187 type 2 diabetes cases were identified. Compared with the lowest quartile of ultra-processed food intake, the highest quartile was positively associated with diabetes risk [HR (95% CI) = 1.34 (1.13, 1.59), P-trend = 0.002]. The association did not change after additional adjustment for diet quality or BMI. Among individual ultra-processed food items, a higher consumption of ham/sausage [per 1% increase in the weight ratio: HR (95% CI) = 1.40 (1.05, 1.86)], instant noodles [1.07 (1.02, 1.11)], ice cream [1.08 (1.03, 1.13)], and carbonated beverages [1.02 (1.00, 1.04)] were associated with an increased risk of type 2 diabetes, whereas a higher intake of candy/chocolate was associated with a decreased risk [0.78 (0.62, 0.99)].

CONCLUSIONS

Our data suggest that the high intake of ultra-processed foods, particularly ham/sausage, instant noodles, ice cream, and carbonated beverages, is associated with an increased risk of type 2 diabetes in Korean adults.

Examining the proportions of food addiction among women with and without polycystic ovarian syndrome who do and do not take hormonal birth control

Polycystic ovarian syndrome (PCOS) is a reproductive disorder driven by insulin resistance. Insulin resistance may increase weight gain and increase the rewarding intake of ultra-processed foods (UPFs). Individuals with PCOS may be more susceptible to the reinforcing properties of UPFs, increasing the risk to consume UPFs in addictive-like ways, operationalized by food addiction (FA). Additionally, hormonal birth control, commonly prescribed to women with PCOS, are found to increase food cravings and overeating. This study examined the relationships between PCOS status, FA, and hormonal birth control use. The study sample (N = 365, assigned female at birth) was drawn from Amazon Mechanical Turk, with half of the sample (n = 181) reporting having PCOS and the other half not (n = 184). Participants answered questions about women's reproductive health (i.e., PCOS, hormonal birth control use) and completed the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0). A chi-square test found that 51.9 % of participants with PCOS (M = 6.23, SD = 3.82) met diagnostic criteria for FA (assessed by the mYFAS 2.0) compared to 16.8 % of participants without PCOS (M = 2.47, SD = 3.39). A hierarchical linear regression found independent main effects of PCOS status (β = 0.40, t(352) = 8.61, p < .001) and hormonal birth control use (β = 0.16, t(351) = 3.59, p < .001), to be associated with higher mYFAS symptom count scores. No differences were found between the types of hormonal birth control participants reported taking. The finding suggests that FA is an overlooked, understudied psychological condition impacting these individuals in weight loss treatments. Future studies are needed to understand the relationship between FA and PCOS in clinical samples.

Ultra-processed food consumption and exposure to acrylamide in a nationally representative sample of the US population aged 6 years and older

Ultra-processed food (UPF) consumption has been associated with cardiovascular disease and cancer. Acrylamide is a probable human carcinogen commonly found in foods that are processed at high temperatures. The aim of this study was to examine the association between dietary energy contribution of UPF and acrylamide exposure, in the US. Among the 4418 participants from cross-sectional 2013-2016 National Health and Nutrition Examination Survey, aged 6+ years, with hemoglobin biomarkers of acrylamide exposure, 3959 that completed the first 24-h dietary recall and had information on all covariates were included in the study. UPF were identified based on the Nova classification system, a four-group food classification based on the extent and purpose of industrial food processing. Linear regression was used to compare average acrylamide and glycidamide hemoglobin (HbAA+HbGA) concentrations across quintiles of daily energy contribution of UPF. Adjusted geometric means of acrylamide and glycidamide hemoglobin concentrations increased monotonically from the lowest to the highest quintile of UPF consumption in the overall population. Compared to the lowest quintile, the highest quintile had 9.1% higher levels of HbAA+HbGA (94.1 vs. 86.3 pmol/g Hb). These positive associations were statistically significant among males and in the young adult population and were largely driven by UPF which are known potential sources of acrylamide. The main effects remained unchanged when excluding current smokers. As both acrylamides and UPF have been previously associated with cardiovascular disease and cancer, our results suggest that acrylamides in UPF may partially explain previously observed links between UPF consumption and these health outcomes.

The effects of long-term almond consumption on whole-body insulin sensitivity, postprandial glucose responses, and 48 h continuous glucose concentrations in males and females with prediabetes: a randomized controlled trial

PURPOSE

Findings concerning the effects of almond consumption on glucose metabolism are inconsistent which might relate to body weight gain. The effects of long-term almond consumption on glucose metabolism are investigated in a free-living setting without detailed dietary instructions in males and females with overweight/obesity and prediabetes.

METHODS

Forty-three participants volunteered in this randomized, cross-over trial with a 5-months control and intervention period and a 2-months wash-out. In the intervention period participants daily consumed 50 g whole almonds. At the end of both periods insulin sensitivity was assessed by a hyperinsulinemic euglycemic clamp, and postprandial glucose responses, and 48 h continuous glucose concentrations were measured.

RESULTS

Almond consumption significantly decreased insulin sensitivity (P = 0.002), and increased postprandial glucose concentrations (P = 0.019), as well as fasting insulin concentrations (P = 0.003) as compared to the control period. The AUCs for 24 h glucose concentrations were not significantly different between control and intervention (P = 0.066). Almond consumption also significantly increased BMI (P = 0.002), and waist circumference (P = 0.013), supported by the concurrent increased energy intake (P = 0.031). The effects on glucose metabolism could only partly be explained by the observed weight gain as the almond effect remained after correcting for BMI changes.

CONCLUSIONS

In participants with prediabetes, long-term almond consumption showed adverse effects on insulin sensitivity and glucose metabolism. As almonds seemed not to have fully replaced other food items, it might be necessary to provide more supporting guidelines on how to incorporate energy-dense nuts into healthy diets to prevent type 2 diabetes development.

CLINICAL TRIAL REGISTRATION

This clinical trial was registered in February 2018 as NCT03419702.

Potato consumption, polygenic scores, and incident type 2 diabetes: An observational study

Whether the consumption of different processed potatoes is detrimental to type 2 diabetes (T2D) is highly debated. This study aimed to assess the relations between potato consumption and the risk of T2D and whether the relationship was modified by the genetic predisposition to T2D. We included 174,665 participants from the UK Biobank at baseline. Potato consumption was evaluated using the 24-hour dietary questionnaire. The genetic risk score (GRS) was calculated based on 424 variants associated with T2D. After adjustment for demographic, lifestyle, and dietary factors, the consumption of total potatoes was significantly and positively associated with T2D risk [hazard ratio (HR) comparing two or more servings/day with non-consumers was 1.28 (95% CI: 1.13-1.45)]. HRs (95% CIs) of T2D for each 1-SD increment in boiled/baked potatoes, mashed potatoes, and fried potatoes were 1.02 (0.99-1.05), 1.05 (1.02-1.08), and 1.05 (1.02-1.09), respectively. There were no significant interactions between the consumption of total or different processed potatoes and overall GRS on T2D risk. Theoretically, replacing one serving/day of total potatoes with the same amount of non-starchy vegetables was related to a 12% (95% CI: 0.84-0.91) lower T2D risk. These results showed the positive associations of the consumption of total potatoes, mashed potatoes or fried potatoes and genetic risk with higher incident T2D. An unhealthy potato-based diet is associated with higher diabetes risk regardless of genetic risk.

Food contaminants and potential risk of diabetes development: A narrative review

The number of people diagnosed with diabetes continues to increase, especially among younger populations. Apart from genetic predisposition and lifestyle, there is increasing scientific and public concern that environmental agents may also contribute to diabetes. Food contamination by chemical substances that originate from packaging materials, or are the result of chemical reactions during food processing, is generally recognized as a worldwide problem with potential health hazards. Phthalates, bisphenol A (BPA) and acrylamide (AA) have been the focus of attention in recent years, due to the numerous adverse health effects associated with their exposure. This paper summarizes the available data about the association between phthalates, BPA and AA exposure and diabetes. Although their mechanism of action has not been fully clarified, in vitro, in vivo and epidemiological studies have made significant progress toward identifying the potential roles of phthalates, BPA and AA in diabetes development and progression. These chemicals interfere with multiple signaling pathways involved in glucose and lipid homeostasis and can aggravate the symptoms of diabetes. Especially concerning are the effects of exposure during early stages and the gestational period. Well-designed prospective studies are needed in order to better establish prevention strategies against the harmful effects of these food contaminants.

The association between dietary acrylamide intake and the risk of type 2 diabetes incidence in the Tehran lipid and glucose study

This study aimed at investigating the association of acrylamide consumption with the incidence of type 2 diabetes (T2D) in adults. The 6022 subjects of the Tehran lipid and glucose study participants were selected. The acrylamide content of food items were summed and computed cumulatively across follow up surveys. Multivariable Cox proportional hazard regression analyses were performed to estimate the hazards ratio (HR) and 95% confidence interval (CI) of incident T2D. This study was done on men and women, respectively aged 41.5 ± 14.1 and 39.2 ± 13.0 years. The mean ± SD of dietary acrylamide intake was 57.0 ± 46.8 µg/day. Acrylamide intake was not associated with the incidence of T2D after adjusting for confounding variables. In women, a higher acrylamide intake was positively associated with T2D [HR (CI) for Q4: 1.13 (1.01-1.27), P trend: 0.03] after adjusting for confounding factors. Our results demonstrated that dietary intake of acrylamide was associated with an increased risk of T2D in women.

Ultra-processed foods and human health: from epidemiological evidence to mechanistic insights

Epidemiological studies have suggested a role for ultra-processed foods in numerous chronic inflammatory diseases such as inflammatory bowel diseases and metabolic syndrome. Preclinical and clinical studies are accumulating to better decipher the effects of various aspects of food processing and formulation on the aetiology of chronic, debilitating inflammatory diseases. In this Review, we provide an overview of the current data that highlight an association between ultra-processed food consumption and various chronic diseases, with a focus on epidemiological evidence and mechanistic insights involving the intestinal microbiota.

Association between Ultra-Processed Food Consumption and Diabetes in Chinese Adults-Results from the China Health and Nutrition Survey

Aims: We aimed to assess the association between ultra-processed food (UPF) consumption with diabetes in Chinese adults. Methods: This study included 12,849 eligible adults aged 20 years and over attending at least two surveys in the China Nutrition and Health Survey during 1997−2011. Food intake at each survey was assessed by a 3-day 24-h dietary recall method. UPF was defined based on the NOVA classification. Diabetes was obtained from questionnaires and/or ascertained by fasting blood tests. The association of diabetes with UPF was examined using mix effect logistic regression adjusting for potential confounding factors. Results: The mean age of the participants was 43.3 (SD 14.8) years. The age and gender adjusted mean UPF intake increased four times and the prevalence of diabetes increased eight times in 1997−2011. Compared with non-consumers, the odds ratios (95% CI) of diabetes for those with mean UPF consumption of 1−19 g/day, 20−49 g/day, and ≥50 g/day were 1.21 (0.98, 1.48), 1.49 (1.19, 1.86), and 1.40 (1.08, 1.80), respectively (p trend < 0.001) after adjusted for the measured covariates including lifestyle factors (smoking, alcohol drinking, and physical activity), BMI and hypertension. Conclusions: both UPF consumption and prevalence of diabetes increased among adults in China during 1997−2011. Higher UPF consumption was positively associated with diabetes.

Maternal acrylamide exposure during pregnancy and fetal growth: A systematic review and dose-response meta-analysis of epidemiological studies

BACKGROUND

Acrylamide is a food contaminant linked to developmental toxicity in animals and possibly in humans.

OBJECTIVES

We performed a systematic review and dose-response meta-analysis of epidemiological studies evaluating the relationship between maternal acrylamide exposure during pregnancy and the risk of being small for gestational age (SGA) and birth weight, birth head circumference and birth length.

METHODS

We performed the literature search in PubMed, Scopus, and Web of Science, until June 6th, 2022. Studies carried out in mother-newborn pairs, assessing maternal acrylamide exposure during pregnancy, either via dietary assessments or biomarkers i.e., hemoglobin adducts of acrylamide (AA-Hb) and glycidamide (GA-Hb), and evaluating birth outcomes were included. We employed a random-effects model to assess the pooled effect estimates and their 95% confidence intervals (CI) for the association between acrylamide exposure and birth outcomes. Risk of Bias for Nutrition Observational Studies tool was used for bias assessment.

RESULTS

Out of 169 records identified, five original studies were eligible, including 53,870 mother-newborn pairs in total. Means were 21.9 μg/day for estimated dietary acrylamide exposure (3 studies), and 18.4 and 14.9 pmol/g for AA-Hb and GA-Hb, respectively (2 studies). Higher risk of SGA and lower birth weight and head circumference were observed in the highest quartile of AA-Hb [odds ratio (OR): 1.20 (95% CI: 1.08; 1.33); mean difference (MD): -131 g (95% CI: -204; -58) and -0.31 cm (95% CI: -0.58; -0.04), respectively], and GA-Hb [OR: 1.36 (95% CI: 1.13; 1.64), MD: -161 g (95% CI: -271; -52); and MD: -0.38 cm (95% CI: -0.66; -0.10), respectively], whereas a lower birth length was observed only in the highest quartile of GA-Hb (MD: -0.85 cm (95% CI: -1.38; -0.33). Results from the dose-response meta-analysis between increasing maternal acrylamide exposure during pregnancy and birth weight showed no clear evidence of a deviation from linearity.

CONCLUSIONS

Overall, our findings strengthen the evidence of an adverse effect of maternal acrylamide exposure during pregnancy on fetal growth. These results encourage to increase preventive actions towards lowering acrylamide exposure in the population.

Associations of Hemoglobin Adducts of Acrylamide and Glycidamide with Prevalent Metabolic Syndrome in a Nationwide Population-Based Study

Environmental and dietary exposures to acrylamide (AA) have been linked with various metabolic-related outcomes, but the results are mixed. However, the association between long-term exposure to AA and the prevalence of metabolic syndrome (MetS) remains unknown. In this study, we aimed to assess the relationship between hemoglobin adducts of AA, biomarkers of internal exposure to AA, and MetS prevalence among a U.S. nationwide population. MetS patients were defined by meeting three or more of the following five characteristics: elevated blood pressure, high fasting glucose, abdominal obesity, hypertriglyceridemia, and lower high-density lipoprotein cholesterol (HDL-C). Multivariate-adjusted logistic regression models and restricted cubic spline models were used to analyze the associations between AA hemoglobin biomarkers and MetS prevalence. A total of 1552 MetS cases were documented. After adjustment for the potential confounders, the odds ratios (95% confidence intervals) of MetS prevalence in the highest quartile of AA hemoglobin biomarkers were 0.60 (0.40-0.89), 1.26 (0.84-1.89), 0.93 (0.71-1.21), and 1.61 (1.18-2.20) for HbAA, HbGA, the sum of HbAA and HbGA (HbAA + HbGA), and the ratio of HbGA to HbAA (HbGA/HbAA), compared with the lowest quartile, respectively. HbAA was significantly and inversely associated with blood pressure, fasting glucose, abdominal obesity, hypertriglyceridemia, and low HDL-C, while the HbGA/HbAA ratio was also positively associated with abdominal obesity, hypertriglyceridemia, and low HDL-C. The restricted cubic spline models revealed a positive relationship between the HbGA/HbAA ratio and the prevalence of MetS, while the HbAA level was inversely associated with MetS prevalence. Our current findings provided epidemiological evidence that HbAA and the HbGA/HbAA ratio were significantly associated with MetS prevalence among general U.S. adults. Further studies should be conducted to examine the association between internal exposure to AA and MetS prevalence.

The Association Between Exposure to Acrylamide and Mortalities of Cardiovascular Disease and All-Cause Among People With Hyperglycemia

Background

Acrylamide is a common environmental volatile organic compound that humans are frequently exposed to in their daily lives. However, whether exposure to acrylamide is associated with long-term survival in patients with hyperglycemia remains largely unknown.

Methods and Results

A total of 3,601 hyperglycemic people were recruited in this study, including 1,247 people with diabetes and 2,354 people with pre-diabetes, who enrolled in the National Health and Nutrition Examination survey (2003–2004, 2005–2006, and 2013–2014). The acrylamide exposure was measured by the serum hemoglobin adduct of acrylamide (HbAA) and glycidamide (HbGA), and the ratio of HbAA and HbGA (HbAA/HbGA) was calculated, which were all categorized into quintiles. The National Death Index was used to identify the participants' death information until 2015. Cox proportional hazards (CPHs) regression models were performed to examine the survival relationship between these biomarkers and mortality. During the 28,652 person-year follow-up, 268 deaths due to the cardiovascular disease (CVD) were documented. After adjustment for multiple confounders, compared with participants in the lowest quintile of HbAA/HbGA, the participants in the highest quintile were more likely to die due to CVD (hazard ratio [HR] = 1.61, 95% CI: 1.09–2.39) and all-cause (HR = 1.59, 95% CI: 1.25–2.01). Moreover, subgroup analysis showed that the highest quintile of HbAA/HbGA in the people with diabetes or pre-diabetes was related to mortalities risk of CVD (HRdiabetes = 1.92, 95% CI: 1.11–3.31; HRpre−diabetes = 1.78, 95% CI: 1.01–3.14) and all-cause mortality (HRdiabetes = 1.81, 95% CI: 1.27–2.58; HRpre−diabetes = 1.59, 95% CI: 1.14–2.20). Additionally, no significant association between the levels of HbAA or HbGA and CVD mortality was observed among people with diabetes or pre-diabetes.

Conclusion

Higher levels of HbAA/HbGA are associated with greater mortalities of CVD and all-cause among hyperglycemic people.

Acrylamide and Potential Risk of Diabetes Mellitus: Effects on Human Population, Glucose Metabolism and Beta-Cell Toxicity

Diabetes mellitus is a frequent endocrine disorder characterized by hyperglycemia. Acrylamide (AA) is food contaminant formed during the high-temperature processing of food rich in carbohydrates and low in proteins. Recent human epidemiological studies have shown a potential association between AA exposure and the prevalence of diabetes in the general population. In male rats, AA treatment promoted pancreatic islet remodeling, which was determined by alpha-cell expansion and beta-cell reduction, while in female rats AA caused hyperglycemia and histopathological changes in pancreatic islets. In vitro and in vivo rodent model systems have revealed that AA induces oxidative stress in beta cells and that AA impairs glucose metabolism and the insulin signaling pathway. Animal studies have shown that diabetic rodents are more sensitive to acrylamide and that AA aggravates the diabetic state. In this review, we provide an overview of human epidemiological studies that examined the relation between AA exposure and glucose disorders. In addition, the effects of AA treatment on pancreatic islet structure, beta-cell function and glucose metabolism in animal models are comprehensively analyzed with an emphasis on sex-related responses. Furthermore, oxidative stress as a putative mechanism of AA-induced toxicity in beta cells is explored. Finally, we discuss the effects of AA on diabetics in a rodent model system.

Evaluation of the Quality Characteristics and Development of a Puffed-Rice Snack Enriched with Honeybee (Apis mellifera L.) Drone Pupae Powder

Edible insect ingredients have gained importance as environmental-friendly energy sources world-wide; the honeybee (Apis mellifera L.) drone pupae has gained prominence as a nutritional material. In this study, bee drone pupae were processed under different heating and drying conditions and incorporated into a puffed-rice snack with honey. The sensory, physicochemical, nutritional and microbial qualities of drone pupae powders were tested. The deep-fried and hot-air dried powder was selected; the values of 5.54% (powder) and 2.13% (honey) were obtained on optimization with honey by response surface methodology. Subsequently, the puffed-rice snack product enriched with drone pupae powder was stored at different temperatures for 180 days. The prepared product showed a higher content of proteins, fats, amino acids, and fatty acids compared to the control. The high content of a few minerals were maintained in the processed powder and the product, whereas heavy metals were not detected. The storage test indicated acceptable sensory qualities and safety results, considering important quality parameters. Thus, drone pupae powder and the developed product can be consumed as nutritional food materials; the quality characteristics can be improved through optimal processing.

Metabolic perturbations and health impact from exposure to a combination of multiple harmful Maillard reaction products on Sprague-Dawley rats

The present study aimed to investigate the metabolic perturbations and health impact of the co-accumulation of Maillard reaction products (MRPs), including acrylamide, harmane, and N^ε-(carboxymethyl)lysine (CML), via serum biochemical and histopathological examinations as well as metabolomic analysis. Sprague-Dawley rats were treated with acrylamide (2 mg per kg body weight [bw]), harmane (1 mg per kg bw), CML (2 mg per kg bw), and combinations of these MRPs. Harmane did not cause adverse effects on the health of rats, whereas acrylamide and CML resulted in significantly (P < 0.05) decreased insulin sensitivity (HOMA-IR > 1), increased oxidative stress levels, and pathological injuries to the pancreas, liver, and gastrocnemius. Owing to the antioxidant and anti-diabetic activities of harmane, the effects of the combination of the MRPs on oxidative stress levels, blood glucose metabolism, and pathological injuries to the pancreas and gastrocnemius were relieved. However, new health problems, including pathological injury of the kidneys and increased cancer risk, were observed. Metabolomic analysis revealed that this may be related to the effects of MRPs on the arginine biosynthesis pathway, which resulted in the abnormal metabolism of fumaric acid and the tricarboxylic acid cycle. These results indicated that the mechanisms of the combined effect of MRPs and their effects on health cannot be predicted from the effects of individual MRPs.

Vitamin D mediates the association between acrylamide hemoglobin biomarkers and obesity

Mediation analysis aims to discover the role of intermediate variables from exposure to disease. The current study was performed to evaluate how vitamin D mediates the association between acrylamide hemoglobin biomarkers and obesity. Data were collected on 10,377 adults participating in the National Health and Nutrition Examination Survey (NHANES) 2003-2006 and 2013-2014 aged ≥ 18 years. Obesity was assessed through body mass index and abdominal circumference measurements. Generalized linear and restricted cubic spline (RCS) regression were used to estimate the association between vitamin D and acrylamide hemoglobin biomarkers, and the mediation effect of vitamin D was also discussed. After adjusting for potentially confounding factors, vitamin D had strong negative associations with serum concentrations of acrylamide hemoglobin adducts (HbAA, HbGA, and HbAA + HbGA). The RCS plots demonstrated that vitamin D was inversely and nonlinearly associated with HbAA and HbAA + HbGA while inversely and linearly associated with HbGA, and also a striking difference when vitamin D was lower than 60 nmol/L. Mediation analysis suggested that a negative correlation between acrylamide and obesity was mediated by vitamin D. The current study is expected to offer a fresh perspective on reducing the toxicity of acrylamide.

Hemoglobin adducts of acrylamide in human blood - What has been done and what is next?

Acrylamide forms in many commonly consumed foods. In animals, acrylamide causes tumors, neurotoxicity, developmental and reproductive effects. Acrylamide crosses the placenta and has been associated with restriction of intrauterine growth and certain cancers. The impact on human health is poorly understood and it is impossible to say what level of dietary exposure to acrylamide can be deemed safe as the assessment of exposure is uncertain. The determination of hemoglobin (Hb) adducts from acrylamide is increasingly being used to improve the exposure assessment of acrylamide. We aim to outline the literature on Hb adduct levels from acrylamide in humans and discuss methodological issues and research gaps. A total of 86 studies of 27,966 individuals from 19 countries were reviewed. Adduct levels were highest in occupationally exposed individuals and smokers. Levels ranged widely from 3 to 210 pmol/g Hb in non-smokers and this wide range suggests that dietary exposure to acrylamide varies largely. Non-smokers from the US and Canada had slightly higher levels as compared with non-smokers from elsewhere, but differences within studies were larger than between studies. Large studies with exposure assessment of acrylamide and related adduct forming compounds from diet during early-life are encouraged for the evaluation of health effects.

Ultra-Processed Food Consumption and Adult Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis

(1) Background: Recent individual studies have demonstrated that consumption of ultra-processed food (UPF) may be related to type two diabetes mellitus (T2DM). We aimed to synthesize the results from these individual studies by conducting an updated systematic review and meta-analysis of observational studies evaluating the association between UPF consumption and the risk of T2DM. (2) Methods: A systematic search was conducted using ISI Web of Science, PubMed/MEDLINE and Scopus electronic databases from inception up to August 2021. Data were extracted from five studies (one cross-sectional study and four cohort studies, totaling 230,526 adults from four different countries). Risk ratios (RR) of pooled results were estimated using a random-effects model. (3) Results: Our results revealed that higher UPF consumption was significantly associated with an increased risk of T2DM (RR = 1.74; 95% CI: 1.36, 2.22; I² = 68.9%; p < 0.001; n = 5). Linear dose-response analysis indicated that each 10% increase in UPF consumption (kcal/d) was associated with a 15% higher risk of T2DM (RR = 1.15; 95% CI: 1.06, 1.26; I² = 86.0%; p < 0.001; n = 5) among adults. Non-linear dose-response analysis demonstrated a positive linear association between UPF consumption and T2DM (p_nonlinearity = 0.13, p_{dose-response} < 0.001; n = 5) among adults. (4) Conclusions: A higher intake of UPF was significantly associated with an increased risk of T2DM. However, underlying mechanisms remain unknown and future experimental studies are warranted.

Short-term exposure to acrylamide exacerbated metabolic disorders and increased metabolic toxicity susceptibility on adult male mice with diabetes

Diabetes mellitus is a common endocrine metabolic disorder, and previous studies have shown that diabetics are more sensitive to the toxic environmental contaminants. Acrylamide (ACR) is both an industrially multipurpose compound and a common endogenous food contaminant to which people are frequently exposed and at high risk. However, the toxicity of ACR on diabetes hasn't attracted much attention. In this study, both healthy mice and diabetic mice received ACR administration orally to investigate the ACR-induced metabolic toxicity, mechanism and susceptibility to ACR toxicity in adult diabetic male mice. The results showed that ACR significantly increased FBG level and decreased bodyweight, serum lipid and liver lipid biomarkers (TC, TG, LDL-C, HDL-C) levels as well as expression of lipid and glucose metabolism-related genes in diabetic mice, indicating that ACR can exacerbate metabolic disorders of glucose and lipid in diabetic male mice. Moreover, ACR exposure significantly increased levels of MDA and COX-2), decreased GSH level and antioxidant enzyme activity (SOD, GSH-PX and CAT) by downregulating expression of Nrf2 and Keap1 in diabetic mice. Factorial analysis showed ACR had a more significant disturbance in diabetic mice compared with healthy mice. Our results indicated that ACR exposure can cause oxidative stress and inflammatory damage, which can exacerbate abnormal glucose and lipid metabolism. This work helps to elucidate the effects and underlying mechanisms of ACR-induced metabolic toxicity in adults with diabetes.

Association between Acrylamide Hemoglobin Adduct Levels and Depressive Symptoms in US Adults: NHANES 2013-2016

Acrylamide (AA) is widely present in heat-processed carbohydrate-rich food, cigarette smoke, and the environment. Prolonged exposure to AA may cause central nervous system damage. However, few epidemiologic studies assessed the association between hemoglobin adduct levels of AA or its metabolite glycidamide (GA) and depressive symptoms. We included 3595 US adults (≥18 years) from the National Health and Nutrition Examination Survey (NHANES) 2013-2016. Data for hemoglobin adduct levels from AA and GA (HbAA and HbGA) were used as a measure of internal dose. Depressive symptom data were from mental health questionnaires and measured by nine-item Patient Health Questionnaire (PHQ-9) scores. Results of logistic regression models showed a positive association between HbAA in quartile 4 and depressive symptoms with ORs and 95% CI of 2.47 (1.29, 4.77) [OR_{continuous HbAA} and 95% CI: 1.006 (1.000, 1.013)], but an inverse association was detected in quartiles 2 and 3 of HbGA/HbAA [0.62 (0.38, 0.99) and 0.54 (0.32, 0.92), respectively]. Especially, an association between HbAA and depressive symptoms was strengthened in smokers, in age 18-39 and 40-59 years and BMI 25-30 kg/m² groups. Further explorations are needed to study the found associations between HbAA, HbGA, and depressive symptoms.

Negative Association between Acrylamide Exposure and Metabolic Syndrome Markers in Adult Population

Metabolic syndrome encompasses multiple conditions that increase the risk of cardiovascular disease, and exposure to environmental chemicals can cause metabolic syndrome. This cross-sectional study analyzed data from the US National Health and Nutrition Examination Survey (2003-2006) on 4318 adult participants to assess the association between acrylamide (AA) exposure and metabolic syndrome. Concentrations of hemoglobin-adducted AA (HbAA) and hemoglobin-adducted glycidamide (HbGA) were evaluated. Metabolic syndrome markers related to HbAA and HbGA and the effect of exposure to AA and GA on the prevalence of metabolic syndrome were studied by ANOVA and multivariate logistic regression analyses, respectively. HbAA concentration inversely correlated with the number of metabolic syndrome markers (p < 0.05). An increased HbAA concentration was noted with reduced high triglyceride and low high-density lipoprotein cholesterol levels in the adjusted model (p < 0.05). High fasting plasma glucose level significantly correlated with HbGA concentration in the adjusted model. In conclusion, AA exposure alters metabolic syndrome markers in adults. Additional clinical and animal studies will clarify the role of AA exposure at different stages in the progression of metabolic syndrome-related diseases.

The protective effects of 18β-glycyrrhetinic acid against acrylamide-induced cellular damage in diabetic rats

This study was aimed at elucidating the protective effects of 18β-glycyrrhetinic acid (18βGA) against acrylamide (Acr)-induced cellular damage in diabetic rats. Rats were randomly assigned into eight groups (n = 8) following 12 h of fasting: control group, a single dose of 50 mg/kg streptozotocin (STZ) intraperitoneally (diabetic group), 50 mg/kg 18βGA orally after 2 weeks from STZ injection (18βGA group), 20 mg/kg Acr after 1month from STZ injection (Acr group), STZ plus Acr (STZ-Acr group), STZ plus 18βGA (STZ-18βGA group), Acr plus 18βGA (Acr-18βGA group), or STZ plus Acr plus 18βGA (STZ-Acr-18βGA group). Administration of 18βGA alone increased GSH, GSH-PX, SOD, and CAT in both liver and kidneys. While STZ injection was associated with diabetic and oxidative stress changes as indicated by the higher serum glucose, cholesterol, creatinine, IL-1β, IL-6, TNF-α, and antioxidant enzyme activities, together with increased lipid peroxides and decreased antioxidant biomarkers in the liver and kidneys. Similarly, the co-administration of STZ and Acr was associated with similar, more augmented effects, compared to STZ alone. The administration of 18βGA normalized STZ and Acr-induced elevations in oxidative defense variables in the liver and kidney tissues and blood biomarkers. Thus, our study demonstrated that the damaging effects of Acr were more exaggerated in diabetic rats. Furthermore, it showed the ability of 18βGA to inhibit reactive oxygen species generation and restore the antioxidant defenses in diabetic rats with Acr-induced liver and kidney cytotoxicity.

Gestational acrylamide exposure and biomarkers of fetal growth: Probing the mechanism underlying the association between acrylamide and reduced fetal growth

INTRODUCTION

Four epidemiological studies have shown a negative association between prenatal acrylamide exposure and birth size. In order to shed light on the possible underlying mechanism(s), we analysed associations between acrylamide biomarkers and biomarkers related to fetal growth.

METHODS

In newborns of the ENVIRONAGE birth cohort (n ranges from 215 to 434), we investigated the association between prenatal acrylamide exposure (acrylamide and glycidamide hemoglobin adduct levels in cord blood) and thyroid hormones (TSH, T3, T4 and the ratio of T4 to T3 in cord plasma), insulin-related factors (cord plasma insulin and IGF1, and placental IGF2), neurotrophins (cord plasma BDNF, and placental NGF, NT3 and NT4), and cord plasma homocysteine and progesterone, using multiple linear regression analysis. In addition, we investigated whether the biomarkers mediated the associations between prenatal acrylamide exposure and birth outcomes.

RESULTS

We observed lower cord plasma TSH (-10.2% [95% CI: -15.0, -4.3]) and higher placental NGF levels (10.0% [95% CI 3.7, 17.4]) for a twofold increase of acrylamide adducts, a decrease in the ratio of cord plasma free T4 and free T3 with higher acrylamide and glycidamide adducts of -2.9% (95% CI: -5.7, -0.1) and -3.9% (95% CI: -6.2, -1.6) for a twofold increase in acrylamide and glycidamide adduct levels, respectively, and higher cord plasma free T3 with increases in both acrylamide and glycidamide adducts of 2.8% (95% CI: 0.2, 5.6) and 3.6% (95% CI: 0.8, 6.6) for a twofold increase in acrylamide and glycidamide adduct levels, respectively. Additionally, a twofold increase in glycidamide adducts was associated with lower cord plasma insulin levels, particularly among newborns of non-smoking mothers (-11.2% [95% CI: -19.5, -0.1]). Cord plasma insulin seemed to mediate the association between glycidamide adducts and birth weight.

CONCLUSIONS

A decrease in cord plasma insulin levels may be (a marker of) a mechanism by which gestational acrylamide exposure is associated with decreased fetal growth. The possible health consequences of the associations between gestational acrylamide exposure and thyroid hormones and neurotrophins warrant future study.

Associations of acrylamide with non-alcoholic fatty liver disease in American adults: a nationwide cross-sectional study

BACKGROUND

Acrylamide (AA) is a toxicant to humans, but the association between AA exposure and the risk of non-alcoholic fatty liver disease (NAFLD) remains unclear. In this study, our objective is to examine the cross-sectional association between AA exposure and the risk of NAFLD in American adults.

METHODS

A total of 3234 individuals who took part in the National Health and Nutrition Examination Survey (NHANES) 2003-2006 and 2013-2016 were enrolled in the study. NAFLD was diagnosed by the U.S. Fatty Liver Index. Multivariable logistic regression models were applied to estimate the association between AA and NAFLD in the whole group and the non-smoking group.

RESULTS

We discovered that in the whole group, serum hemoglobin adducts of AA (HbAA) were negatively associated with the prevalence of NAFLD after adjustment for various covariables (P for trend < 0.001). Compared with individuals in the lowest HbAA quartiles, the odds ratios (ORs) with 95% confidence intervals (CIs) in the highest HbAA quartiles were 0.61 (0.46-0.81) and 0.57 (0.36-0.88) in the whole group and the non-smoking group, respectively. In contrast, HbGA/HbAA showed a significantly positive correlation with the prevalence of NAFLD in both groups (P for trend < 0.001). In addition, HbGA was not significantly associated with NAFLD in the whole group or the non-smoking group.

CONCLUSIONS

HbAA is negatively associated with NAFLD whereas HbGA/HbAA is positively associated with NAFLD in adults in the U.S. Further studies are needed to clarify these relationships.

Acrylamide exposure and pulmonary function reduction in general population: The mediating effect of systemic inflammation

Acrylamide exposure along with resultant potential adverse health effects have attracted global concern, and the World Health Organization calls for more and urgent studies on the health risks from acrylamide. However, the association and mechanism between acrylamide exposure and pulmonary dysfunction remain unclear. Our goals were to investigate the relationship of internal acrylamide exposure with lung function reduction, and the potential mediating role of systematic inflammation in that relationship. Our study was conducted within the Wuhan-Zhuhai cohort. Urinary biomarkers of acrylamide exposure (N-acetyl-S-(2-carbamoylethyl)-l-cysteine, AAMA; N-acetyl-S-(2-carbamoyl-2-hydroxyethyl)-l-cysteine, GAMA) and lung function were determined among 3271 general adults, of whom 2595 had test results of systemic inflammatory marker plasma C-reactive protein (CRP). We employed linear mixed models to assess the relations among urinary acrylamide metabolites, pulmonary function and plasma CRP, and PRODCLIN program to evaluate the mediating role of CRP. We observed that urinary acrylamide metabolites were inversely and dose-dependently related to lung function (P trend<0.05). Each 1-unit increment in log-transformed level of AAMA, GAMA, or AAMA+GAMA (ΣUAAM) was significantly (P < 0.05) related to a 59.9-, 64.2-, or 64.3-mL reduction in FVC, and a 53.9-, 59.7-, or 58.5-mL reduction in FEV₁, respectively. Such relationships were independent of smoking, and were significant in physically inactive rather than physically active participants. AAMA (β = 0.10), GAMA (β = 0.16) and ΣUAAM (β = 0.12) were significantly (P < 0.05) related to increased CRP, which was significantly (P < 0.05) related to reduced FVC (β = -55.3) and FEV₁ (β = -40.6). We further found that increased CRP significantly (P < 0.05) mediated 6.34-11.1% of the urinary acrylamide metabolites-associated lung function reductions. For the first time, our findings suggested that exposure to acrylamide in daily life was related to reduced lung function and increased systemic inflammation in general population, and systemic inflammation further mediated acrylamide-associated lung function reduction, indicating a potential mechanistic role of systemic inflammation underlying pulmonary dysfunction from acrylamide exposure.

Pre-Gestational Consumption of Ultra-Processed Foods and Risk of Gestational Diabetes in a Mediterranean Cohort. The SUN Project

We aimed to investigate the relationship between the pre-gestational consumption of ultra-processed foods (UPF) and the risk of gestational diabetes (GDM). We carried out a prospective study among 3730 Spanish women of the SUN cohort who reported at least one pregnancy after baseline recruitment. Cases of GDM were identified among women with a confirmed diagnosis of GDM. UPF consumption was assessed through a validated, semi-quantitative food frequency questionnaire and the frequency of UPF consumption was categorized in tertiles. We identified 186 cases of GDM. In the pooled sample, we did not observe a significant association of UPF with the risk of GDM. When we stratified by age, the multivariate OR for the third tertile of UPF consumption compared with the lowest one was 2.05 (95% CI 1.03, 4.07) in women aged ≥30 years at baseline (P_trend = 0.041). The association remained significant in a sensitivity analysis after changing many of our assumptions and adjusting for additional confounders. No association between a higher UPF consumption and GDM risk was observed in women aged 18–29 years. The pre-gestational UPF consumption may be a risk factor for GDM, especially in women aged 30 years or more. Confirmatory studies are needed to validate these findings.

Association of acrylamide and glycidamide haemoglobin adduct levels with diabetes mellitus in the general population

The frequency and duration of exposure to acrylamide (AA) from the environment and diet are associated with a range of adverse health effects. However, whether long-term AA exposure is related to diabetes mellitus (DM) remains unknown. Data from 3577 adults in the National Health and Nutrition Examination Survey (NHANES) 2005-2006 and 2013-2016 aged ≥ 20 years was analysed. The main analyses applied multivariate logistic regression and restricted cubic spline models to investigate the associations between DM and AA haemoglobin biomarkers, including haemoglobin adducts of acrylamide and glycidamide (HbAA and HbGA), the sum of HbAA and HbGA (HbAA + HbGA), and the ratio of HbGA to HbAA (HbGA/HbAA) levels. After multivariable adjustment, the odds ratios (95% confidence intervals) for DM comparing the highest with the lowest AA haemoglobin biomarker quartiles were 0.71 (0.55, 0.93), 0.92 (0.71, 1.18), 0.80 (0.62, 1.03) and 1.95 (1.51, 2.51) for HbAA, HbGA, HbAA + HbGA and HbGA/HbAA, respectively. The restricted cubic spline model demonstrated that HbAA was linearly and inversely associated with risk of DM (P for trend = 0.013), while HbGA/HbAA was nonlinearly and positively associated with the prevalence of DM (P for trend <0.001). These results support for epidemiological evidence that the HbAA and HbGA/HbAA are significantly associated with DM. Further studies are warranted to infer the causal role of AA exposure in the prevalence of DM.

Association of acrylamide hemoglobin biomarkers with serum lipid levels in general US population: NHANES 2013-2016

The aim of present study was to investigate the association of acrylamide (AA) hemoglobin biomarkers and serum lipids level in a general population. Data set of our study were extracted from an open database - National Health and Nutrition Examination Surveys (NHANES) 2013-2016. In total 2899 participants were enrolled. The associations between AA hemoglobin parameters [hemoglobin adducts of AA (HbAA) and glycidamide (HbGA), total of HbAA and HbGA (HbAA+HbGA), and ratio of HbGA to HbAA (HbGA/HbAA)] and lipid levels [total cholesterol (TC), triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C)] were analyzed. Generalized linear models and restricted cubic spline plots were conducted to address the relationship between lipid levels and acrylamide markers. Comparing the lowest quantiles, HbGA and HbGA/HbAA both remained a significant trend regardless of lipid types. Analyses using a generalized linear model with restricted cubic spline and validated with regression models, all 4 AA parameters demonstrated a linear association and positive correlation with TG. Furthermore, there were also opposite nonlinear association between HbGA/HbAA and LDL-C (positive correlation), and HbGA/HbAA and HDL-C (negative correlation). Further analysis with threshold effect analysis or regression analysis showed HbGA and HbGA/HbAA remained significant association with all TC, TG, LDL-C, and HDL-C. The hemoglobin adducts AA parameters as long-term exposure biomarkers are associated with the atherosclerotic lipid changes in a population of US adults.

Cord blood acrylamide levels and birth size, and interactions with genetic variants in acrylamide-metabolising genes

BACKGROUND

Up to now, 3 epidemiological studies have shown clear inverse associations between prenatal acrylamide exposure and birth size. In addition to studying the association between acrylamide and birth size, we investigated the interaction between acrylamide and polymorphisms in acrylamide-metabolising genes, with the aim of probing the causality of the inverse relationship between acrylamide and fetal growth.

METHODS

We investigated the association between prenatal acrylamide exposure (acrylamide and glycidamide hemoglobin adduct levels (AA-Hb and GA-Hb) in cord blood) and birth weight, length and head circumference in 443 newborns of the ENVIRONAGE (ENVIRonmental influence ON AGEing in early life) birth cohort. In addition, we studied interaction with single nucleotide polymorphisms (SNPs) in CYP2E1, EPHX1 and GSTP1, using multiple linear regression analysis.

RESULTS

Among all neonates, the body weight, length and head circumference of neonates in the highest quartile was - 101 g (95% CI: - 208, 7; p for trend = 0.12), - 0.13 cm (95% CI: - 0.62, 0.36; p for trend = 0.69) and - 0.41 cm (- 0.80, - 0.01; p for trend = 0.06) lower, respectively, compared to neonates in the lowest quartile of AA-Hb in cord blood, For GA-Hb, the corresponding effect estimates were - 222 g (95% CI: - 337, - 108; p for trend = 0.001), - 0.85 (95% CI: - 1.38, - 0.33; p for trend = 0.02) and - 0.55 (95% CI: - 0.98, - 0.11; p for trend = 0.01), respectively. The associations for GA-Hb were similar or stronger in newborns of non-smoking mothers. There was no statistically significant interaction between acrylamide exposure and the studied genetic variations but there was a trend of stronger inverse associations with birth weight and head circumference among newborns with homozygous wildtypes alleles for the CYP2E1 SNPS and with variant alleles for a GSTP1 SNP (rs1138272).

CONCLUSIONS

Prenatal dietary acrylamide exposure, specifically in the form of its metabolite glycidamide, was inversely associated with birth weight, length and head circumference. The interaction pattern with SNPs in CYP2E1, although not statistically significant, is an indication for the causality of this association. Other studies are needed to corroborate this finding.

Western Dietary Patterns, Foods, and Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

An increasing number of epidemiological studies suggest that adherence to Western dietary patterns (WDPs) is associated with risk of gestational diabetes mellitus (GDM), but results remain inconsistent. Therefore, we conducted a systematic review and meta-analysis of the effect of WDPs and typical Western dietary foods on GDM. A literature search was performed in PubMed, Embase, Web of Knowledge, and the Cochrane Library up to December 2019. Cohort studies investigating the combined associations of WDPs with incidence of GDM were included. Reviewers were paired, and they independently reviewed and assessed studies, extracted data, and evaluated study quality. Pooled HRs were calculated using random-effects models. Heterogeneity and publication bias tests were also conducted. Twenty-one prospective cohort studies with 191,589 participants, including 12,331 women with GDM, were included in our analysis. The pooled risk ratio (RR) of WDPs was 1.52 (95% CI: 1.21, 1.91), indicating a significant association with GDM risk in Western countries. Potatoes (pooled RR: 1.12; 95% CI: 0.93, 1.35) showed a nonsignificant (P > 0.05) relation to GDM risk. However, consumption of animal meat (pooled RR: 1.35; 95% CI: 1.16, 1.57) and fast food (pooled RR: 1.75; 95% CI: 1.41, 2.19) showed a positive association with the risk of developing GDM. Subgroup analysis demonstrated that the consumption of red meat and processed red meat increased the risk of GDM more than either poultry or fish intake. Our study provides further evidence for understanding the relation between dietary factors and increased GDM risk and contributes to reducing the incidence of GDM through healthy diets.

Impact of ultra-processed food consumption on metabolic health

PURPOSE OF REVIEW

Ultra-processed foods (UPF) have been associated with poor diet quality and adverse health outcomes. Our aim in this review is to summarize recent research assessing the impact of UPF consumption, classified according to the NOVA system, on outcomes related to metabolic health.

RECENT FINDINGS

Thirty recent studies with different design, quality and target population have investigated the impact of UPF consumption on parameters related to metabolic health, which were organized into: metabolic syndrome; body weight change and obesity indicators; blood pressure and hypertension; glucose profile, insulin resistance and type 2 diabetes; other metabolic risks and cardiovascular diseases and mortality. Most of the studies demonstrated adverse associations between high UPF consumption and metabolic health, mainly those with robust design and involving adults.

SUMMARY

Most of the latest findings have revealed an adverse impact of high UPF consumption on metabolic health, including cardiovascular diseases and mortality. Scientific evidence is accumulating towards the necessity of curbing UPF consumption worldwide at different life stages. Nevertheless, other studies are needed to confirm the causality between UPF consumption and metabolic health in diverse scenarios and to better elucidate all likely mechanisms involved in this relationship.

Impacto do consumo de alimentos ultraprocessados na saúde de crianças, adolescentes e adultos: revisão de escopo

O objetivo deste trabalho foi realizar uma revisão de escopo da literatura acerca da associação entre o consumo de alimentos ultraprocessados e desfechos em saúde. A busca foi realizada nas bases PubMed, Web of Science e LILACS. Foram elegíveis os estudos que avaliaram a associação entre o consumo de alimentos ultraprocessados identificados com base na classificação NOVA e os desfechos em saúde. O processo de revisão resultou na seleção de 63 estudos, os quais foram analisados em termos de qualidade com base em ferramenta do Instituto Nacional de Saúde dos Estados Unidos. Os desfechos encontrados incluíram indicadores de obesidade, marcadores de risco metabólico, diabetes, doenças cardiovasculares, câncer, asma, depressão, fragilidade, doenças gastrointestinais e mortalidade. A evidência foi particularmente consistente para obesidade (ou indicadores relacionados a ela) em adultos, cuja associação com o consumo de ultraprocessados foi demonstrada, com efeito dose-resposta, em estudos transversais com amostras representativas de cinco países, em quatro grandes estudos de coorte e em um ensaio clínico randomizado. Grandes estudos de coorte também encontraram associação significativa entre o consumo de alimentos ultraprocessados e o risco de doenças cardiovasculares, diabetes e câncer, mesmo após ajuste para obesidade. Dois estudos de coorte demonstraram associação do consumo de alimentos ultraprocessados com depressão e quatro estudos de coorte com mortalidade por todas as causas. Esta revisão sumarizou os resultados de trabalhos que descreveram a associação entre o consumo de alimentos ultraprocessados e as diversas doenças crônicas não transmissíveis e seus fatores de risco, o que traz importantes implicações para a saúde pública.

Processed potatoes intake and risk of type 2 diabetes: a systematic review and meta-analysis of nine prospective cohort studies

The current cohort study shows the inconsistent association between potato consumption and the risk of type 2 diabetes mellitus (T2DM). Therefore, we conducted a systematic review and dose-response meta-analysis of published prospective cohort studies to quantitatively estimate this association. We searched PubMed, Embase, MEDLINE, Web of Knowledge, and the Cochrane Library up to September 2019 for all published articles. Seven of the articles reported nine cohort studies with 383,211 participants, with 23,189 T2DM cases that met the inclusion criteria and were included for our analysis. The results of random effects model pooled relative risk (RR) showed an association between potato intake and the risk of T2DM (pooled RR = 1.13, 95% CI: 1.02-1.26, p > 0.01). In the subgroup analysis, French fries, long-term follow-up, large sample size, and high-quality studies were associated with an increased T2DM risk. Further, a linear dose-response analysis indicated that 100 g/day increment of total potato (RR = 1.05, 95% CI: 1.02-1.08) and French fries (RR = 1.10, 95% CI: 1.07-1.14) consumption may increase the risk of T2DM by 5% and 10%, respectively. Our meta-analysis showed that potato consumption, especially French fries consumption, was associated with increased T2DM risk.

Bayesian shrinkage estimation of high dimensional causal mediation effects in omics studies

Causal mediation analysis aims to examine the role of a mediator or a group of mediators that lie in the pathway between an exposure and an outcome. Recent biomedical studies often involve a large number of potential mediators based on high-throughput technologies. Most of the current analytic methods focus on settings with one or a moderate number of potential mediators. With the expanding growth of -omics data, joint analysis of molecular-level genomics data with epidemiological data through mediation analysis is becoming more common. However, such joint analysis requires methods that can simultaneously accommodate high-dimensional mediators and that are currently lacking. To address this problem, we develop a Bayesian inference method using continuous shrinkage priors to extend previous causal mediation analysis techniques to a high-dimensional setting. Simulations demonstrate that our method improves the power of global mediation analysis compared to simpler alternatives and has decent performance to identify true nonnull contributions to the mediation effects of the pathway. The Bayesian method also helps us to understand the structure of the composite null cases for inactive mediators in the pathway. We applied our method to Multi-Ethnic Study of Atherosclerosis and identified DNA methylation regions that may actively mediate the effect of socioeconomic status on cardiometabolic outcomes.

Association between acrylamide exposure and sex hormones in males: NHANES, 2003-2004

Introduction

Acrylamide is widely present in heat-processed food, cigarette smoke and environment. Reproductive toxicity was reported in animals treated with acrylamide, particularly in males. The reproductive toxicity of acrylamide and its active metabolite, glycidamide, was reported to be mainly mediated through DNA damage in spermatocytes. However, the effect of acrylamide on sex hormones in men is unknown.

Methods

There were 468 male subjects (age ≧ 12 years) enrolled to determine the relationships between hemoglobin adducts of acrylamide (HbAA) and hemoglobin adducts of glycidamide (HbGA) with several sex hormones using the National Health and Nutrition Examination Survey (NHANES), 2003 to 2004. All potential confounding variables in the data set were properly adjusted.

Results

We found that one unit increase in the natural log-transformed HbAA level was associated with an increase in natural log transformed serum inhibin B level by 0.10 (SE = 0.05; P = 0.046), and natural log transformed serum sex hormone binding globulin (SHBG) by 0.15 (SE = 0.15; P = 0.036). With respect to HbGA, one unit increase in the natural log-transformed HbGA level was associated with an increase in natural log transformed serum anti-Müllerian Hormone (AMH) level by 0.31 (SE = 0.00; P = 0.003).

Conclusion

In this representative cohort, we identified positive associations between acrylamide exposure and several sex hormones in men. The HbAA is positively associated with inhibin B and SHBG, and HbGA is positively associated with AMH. Other than genotoxicity, our findings suggested that altered sex hormones might also play a role in acrylamide-related reproductive toxicity in males.

Relationship between gestational acrylamide exposure and offspring's growth: a systematic review and meta-analysis of cohort studies

OBJECTIVE

To estimate the current evidence regarding the association between gestational acrylamide (AA) exposure and offspring's growth.

DESIGN

Systematic review and meta-analysis.

SETTING

A systematic literature search for relevant publications was conducted using PubMed, Medline, Embase, Web of Science databases from inception to 26 April 2019. The standardised mean difference (SMD) or OR with 95 % CI was selected as the effect sizes and was calculated using a random effects model.

RESULTS

Five cohort studies including 54 728 participants were identified. Offspring's birth weight was significantly lower in high AA exposure group than in low AA exposure group (SMD -0·05, 95 % CI -0·09, -0·02, P = 0·005). There was also an association between maternal AA exposure and small for gestational age (OR 1·14, 95 % CI 1·06, 1·23, P < 0·001). In addition, pooled ORs suggested that children had a high risk of developing overweight/obesity in the future in maternal high AA exposure group (OR 1·14, 95 % CI 1·08, 1·21, P < 0·001 at age 3; OR 1·13, 95 % CI 1·07, 1·19, P < 0·001 at age 5; OR 1·09, 95 % CI 1·02, 1·16, P = 0·020 at age 8).

CONCLUSIONS

These findings have important implications for conducting health education, providing guidance on maternal diet and developing an appropriate dietary strategy for pregnant women to reduce dietary AA exposure.

Ultraprocessed Food Consumption and Risk of Type 2 Diabetes Among Participants of the NutriNet-Santé Prospective Cohort

Importance

Ultraprocessed foods (UPF) are widespread in Western diets. Their consumption has been associated in recent prospective studies with increased risks of all-cause mortality and chronic diseases such as cancer, cardiovascular diseases, hypertension, and dyslipidemia; however, data regarding diabetes are lacking.

Objective

To assess the associations between consumption of UPF and risk of type 2 diabetes (T2D).

Design, Setting, and Participants

In this population-based prospective cohort study, 104 707 participants aged 18 years or older from the French NutriNet-Santé cohort (2009-2019) were included. Dietary intake data were collected using repeated 24-hour dietary records (5.7 per participant on average), designed to register participants' usual consumption for more than 3500 different food items. These were categorized according to their degree of processing by the NOVA classification system.

Main Outcomes and Measures

Associations between UPF consumption and risk of T2D were assessed using cause-specific multivariable Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors).

Results

A total of 104 707 participants (21 800 [20.8%] men and 82 907 [79.2%] women) were included. Mean (SD) baseline age of participants was 42.7 (14.5) years. Absolute T2D rates in the lowest and highest UPF consumers were 113 and 166 per 100 000 person-years, respectively. Consumption of UPF was associated with a higher risk of T2D (multi-adjusted hazard ratio [HR] for an absolute increment of 10 in the percentage of UPF in the diet, 1.15; 95% CI, 1.06-1.25; median follow-up, 6.0 years; 582 252 person-years; 821 incident cases). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet, for other metabolic comorbidities (HR, 1.13; 95% CI, 1.03-1.23), and for weight change (HR, 1.13; 95% CI, 1.01-1.27). The absolute amount of UPF consumption (grams per day) was consistently associated with T2D risk, even when adjusting for unprocessed or minimally processed food intake (HR for a 100 g/d increase, 1.05; 95% CI, 1.02-1.08).

Conclusions and Relevance

In this large observational prospective study, a higher proportion of UPF in the diet was associated with a higher risk of T2D. Even though these results need to be confirmed in other populations and settings, they provide evidence to support efforts by public health authorities to recommend limiting UPF consumption.

Trial Registration

ClinicalTrials.gov Identifier: NCT03335644.

Association of acrylamide hemoglobin biomarkers with obesity, abdominal obesity and overweight in general US population: NHANES 2003-2006

Exposure to chemical contaminants is considered as one of risk factors to the current epidemic of obesity. Acrylamide (AA) is a ubiquitous chemical contaminant in environmental waste, mainstream cigarette smoke and carbohydrate-rich foods, and widely used in industrial manufacturers and cosmetics. Few studies have highlighted the association of daily exposure to AA with obesity-related outcomes. We analyzed data from 8364 participants who aged 20-85years and were recruited in National Health and Nutrition Examination Surveys (NHANES) 2003-2006. We established the model of PROC Survey Logistic regressions via using AA biomarkers in blood, hemoglobin adducts of acrylamide and glycidamide (HbAA and HbGA), as the measure of internal exposure to AA, and assessing obesity, abdominal obesity and overweight with body mass index (BMI) or waist circumference (WC). After the adjustment of sociodemographic variables, lifestyle behaviors, and health-related factors, the ratio of HbGA to HbAA (HbGA/HbAA) was significantly associated with obesity (p for trend<0.0001). The odd ratios (ORs) with 95% confidence intervals (CIs) of HbGA/HbAA across increasing quartiles were 1.740 (1.413-2.144), 2.604 (2.157-3.144), and 2.863 (2.425-3.380) compared with the lowest quartile. HbGA was positively associated with obesity [OR (95% CI): 1.226 (1.041-1.443), 1.283 (1.121-1.468), and 1.398 (1.165-1.679); p for trend=0.0004], while HbAA was inversely associated with obesity [OR (95% CI): 0.839 (0.718-0.980), 0.713 (0.600-0.848), and 0.671 (0.554-0.811); p for trend<0.0001]. Negative associations were found between the sum of HbAA and HbGA (HbAA+HbGA) and the body weight outcomes. Similar associations were also observed between the hemoglobin biomarkers of AA and abdominal obesity as well as overweight. Thus, the hemoglobin adducts of AA as long-term internal exposure biomarkers are strongly associated with obesity-related outcomes in a population of US adults.

Associations of hemoglobin biomarker levels of acrylamide and all-cause and cardiovascular disease mortality among U.S. adults: National Health and Nutrition Examination Survey 2003-2006

BACKGROUND

The potential hazards of acrylamide (AA) have been proposed due to its lifelong exposure. However, the association between AA exposure and mortality remains unclear.

OBJECTIVES

We evaluated the prospective association of AA hemoglobin adducts (HbAA and HbGA) with all-cause and cardiovascular disease (CVD) mortality in U.S. population from National Health and Nutrition Examination Survey (NHANES) 2003-2006.

METHODS

We followed 5504 participants who were ≥25 years of age for an average of 6.7 years at the baseline examination with annual linkage to the NHANES statistics database. Using AA hemoglobin biomarkers [HbAA, HbGA, sum of HbAA and HbGA (HbAA + HbGA), and ratio of HbGA to HbAA (HbGA/HbAA)], we determined mortality from all-causes and CVD through Cox proportional hazard regression analysis with multivariable adjustments both in non-smoker group and smoker group. In addition, subgroup analyses and sensitivity analyses were further conducted.

RESULTS

After adjusting for sociodemographic, life behavioral and cardiovascular risk factors in non-smoker group, HbAA was positively associated with all-cause mortality (p for trend = 0.0197) and non-CVD mortality (p for trend = 0.0124). HbGA and HbGA/HbAA were inversely associated with all-cause mortality (p for trend = 0.0117 and 0.0098, respectively) and CVD mortality (p for trend=0.0009 and 0.0036, respectively). The multivariable adjusted hazard ratios (HRs) [95% confidence intervals (CIs)] of the upper three quartiles were 0.472 (95% CI: 0.283-0.786), 0.517 (95% CI: 0.299-0.894) and 0.470 (95% CI: 0.288-0.766) between HbGA/HbAA and all-cause mortality comparing with the lowest quartile, respectively. No significant associations were found between HbAA + HbGA and mortality in non-smoker group, and between all AA hemoglobin biomarkers and mortality in smoker group.

CONCLUSIONS

Hemoglobin biomarker levels of AA were strongly associated with mortality in general U.S. non-smoker adults. These findings proposed a continuous public health concern in relation to environmental and dietary exposure to AA.

Subchronic exposure to acrylamide leads to pancreatic islet remodeling determined by alpha cell expansion and beta cell mass reduction in adult rats

Acrylamide (AA) is a toxic substance, used to synthesize polymers for industrial and laboratory processes. Also, AA is a food contaminant formed during the high temperature preparation of carbohydrate-rich food. The main subject of this study was to examine effects of subchronic AA treatment on the islets of Langerhans of adult rats. Adult male Wistar rats were orally treated with 25 or 50 mg/kg bw of AA for 3 weeks. Qualitative and quantitative immunohistochemical evaluation of glucagon and insulin expression and stereological analyses of pancreatic alpha and beta cells were performed. Serum insulin and glucose levels were measured. Analysis of glucagon-immunostained sections revealed a dose-dependent increase of intensity of glucagon immunopositive signal, alpha cell surface and numerical densities, volume density of alpha cell nuclei and nucleocytoplasmic ratio in AA-treated groups compared to the control. In insulin-immunolabeled pancreatic sections in AA-treated animals was observed decrease of intensity of insulin immunopositive signal, beta cell surface, numerical and volume densities and volume density of beta cell cytoplasm. Serum insulin and glucose concentrations remained unchanged after both AA treatments. The number of islets of Langerhans was not affected by AA treatment. Our results suggest that AA subchronic treatment of adult rats leads to remodeling of islet of Langerhans characterized by alpha cell expansion and beta cell mass reduction.

Effects of subchronic acrylamide treatment on the endocrine pancreas of juvenile male Wistar rats

Acrylamide (AA) is a well-known industrial monomer with carcinogenic, mutagenic, neurotoxic and endocrine disruptive effects on living organisms. AA has been the subject of renewed interest owing to its presence in various food products. We investigated the potential adverse effects of oral AA treatment on the endocrine pancreas of juvenile rats using histochemical, immunohistochemical, stereological and biochemical methods. Thirty juvenile male Wistar rats were divided into one control and two AA treatment groups: one treated with 25 mg/kg AA and the other treated with 50 mg/kg AA for 21 days. We found a significant decrease in β-cell mass. The significant decrease in β-cell optical density and unchanged blood glucose levels indicate that normoglycemia in AA treated rats may result from intensive exocytosis of insulin-containing secretory granules. By contrast with β-cells, we observed increased α-cell mass. The slight increase in α-cell cytoplasmic volume suggests retention of glucagon in α-cells, which is consistent with the significant increase in α-cell optical density for AA treated animals. The number of islets of Langerhans did not change significantly in AA treated groups. Our findings suggest that AA treatment causes decreased β-cell mass and moderate α-cell mass increase in the islets of Langerhans of juvenile male Wistar rats.

Relationships between acrylamide and glycidamide hemoglobin adduct levels and allergy-related outcomes in general US population, NHANES 2005-2006

BACKGROUND

Acrylamide-induced immunotoxicity and allergic dermatitis have been reported in animal experiments and clinical reports, respectively. However, epidemiological evidence from the general population is limited.

OBJECTIVES

The purpose of the present study was to estimate the associations between acrylamide exposure and allergy-related outcomes in the general US population.

METHODS

A total of 6982 subjects were selected from the National Health and Nutrition Examination Survey 2005-2006 (NHANES). Internal exposure was measured by the hemoglobin adducts of acrylamide (HbAA) and its metabolite glycidamide (HbGA). Allergy-related outcomes including asthma, hay fever, allergy, itchy rash, sneeze, wheeze and eczema were obtained by self-administered questionnaires. Allergic sensitization was assessed by the total immunoglobulin E (IgE) levels. The associations of HbAA and HbGA quartiles with allergy-related outcomes were calculated using logistic regression models with multivariable adjustments. Analyses were additionally stratified according to age, gender and serum cotinine levels.

RESULTS

When setting quartile 1 of HbAA as reference, the odds ratios (ORs) [95% confidence intervals (CIs)] of quartile 2 to 4 for eczema were 1.18 (0.79-1.76), 1.14 (0.73-1.78) and 1.58 (1.14-2.18), respectively (p_trend = 0.002). Individuals at the highest quartile of HbGA had significantly elevated likelihoods of itchy rash (OR = 1.37, 95% CI = 1.02-1.83, p_trend = 0.032) and eczema (OR = 1.45, 95% CI = 1.06-1.97, p_trend = 0.044). The stratification analyses indicated various results in different subgroups.

CONCLUSIONS

This study indicated significant associations between HbAA and HbGA levels and the likelihoods of allergy-related outcomes in the general US population, depending on age, gender and smoke exposure status. These findings suggested potential public health concerns for the widespread exposure to acrylamide.

Effects of acrylamide graded doses on metallothioneins I and II induction and DNA fragmentation: Bochemical and histomorphological changes in the liver of adult rats

The present study investigates the toxic effects of acrylamide (ACR) administered to rats at two doses on (i) oxidative stress and disruption of pro-oxidant/antioxidant balance in hepatic cells and (ii) its correlation with metallothioneins (MTs) genes expression, DNA damage and histomorphological changes. Treated rats with 20 and 40 mg/kg body weight of ACR led to an increase in malondialdehyde, hydrogen peroxide, advanced oxidation protein products, protein carbonyl levels as well as an alteration in the antioxidant status. Total MT content in the liver and MT I and MT II genes induction were increased. Plasma transaminases activities, albumin, total protein and glucose levels were also increased, while alkaline phosphatase activity was decreased. Moreover, total cholesterol (TC), triglyceride, low-density lipoprotein cholesterol (LDL-C) levels, TC/high-density lipoprotein cholesterol (HDL-C) and LDL-C/HDL-C ratios were increased, while HDL-C decreased in a dose-dependent manner. A random DNA degradation was observed only in the liver of ACR-treated rats with the highest dose. These changes were confirmed by histopathological observations.