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Wang P, Wang D, Sui J, Liu S, Kong Y, Lei H, Zhang M. The comprehensive relationship between combined anti-inflammatory and healthy diets and all-cause mortality in rheumatoid arthritis: results from NHANES 2003-2018. Arthritis Res Ther 2024; 26:226. [PMID: 39716234 DOI: 10.1186/s13075-024-03462-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 12/15/2024] [Indexed: 12/25/2024] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a chronic, systemic autoimmune inflammatory disorder. Diet is recognized as a modifiable factor that may influence inflammation and potentially accelerate RA progression. Nevertheless, the effects of diverse dietary patterns and their combined impact on RA progression and long-term mortality remain inadequately understood. This study examined the association between dietary patterns and mortality in patients with RA, focusing on the Healthy Eating Index (HEI-2015) and Dietary Inflammatory Index (DII) and evaluating their combined effects. METHODS The analysis included 2,069 patients with RA from the National Health and Nutrition Examination Survey (NHANES) spanning 2003-2018. Weighted multi-variable Cox regression models estimated the relationship between the DII, HEI-2015, combined dietary patterns, and all-cause mortality in patients with RA. Linear associations between the DII, HEI-2015, and all-cause mortality were analyzed using restricted cubic splines (RCS). Dietary factors associated with mortality were identified through the Least Absolute Shrinkage and Selection Operator (LASSO) method, and subgroup and sensitivity analyses were conducted to strengthen the findings. RESULTS Participants had a median age of 59 years (IQR: 48-69), with 42.1% male. Adjusting for potential confounders, the hazard ratio (HR) for individuals adhering to healthy and anti-inflammatory dietary patterns, as opposed to unhealthy and pro-inflammatory patterns, was 0.70 (95% CI: 0.53-0.92; adjusted P = 0.01; trend P = 0.02). In weighted Cox analyses of the DII and HEI-2015, higher quartiles showed no significant mortality risk difference from the lowest quartiles. The LASSO-Cox model identified 12 dietary components predictive of all-cause mortality in patients with RA, with an AUC of 0.749 (0.682-0.815) at 1 year, 0.763 (0.724-0.802) at 3 years, 0.783 (0.749-0.802) at 5 years, and 0.868 (0.712-0.938) for all death events. Kaplan-Meier analysis revealed that the low-risk dietary group exhibited significantly lower mortality compared to the high-risk group (P < 0.001). CONCLUSIONS These findings suggest that combining a higher HEI-2015 with a lower DII score correlates with reduced all-cause mortality risk among patients with RA, supporting dietary modification as a potential strategy to prevent premature death in this population.
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Affiliation(s)
- Penghe Wang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China
| | - Dongni Wang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China
| | - Jiayu Sui
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China
| | - Shuang Liu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China
| | - Yingjing Kong
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China
| | - Hongwei Lei
- Department of Rheumatology and Immunology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150001, PR China.
| | - Maomao Zhang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
- Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, China.
- State Key Laboratory of Frigid Zone Cardiovascular Diseases (SKLFZCD), Harbin, China.
- Department of Cardiology, Key Laboratory of Myocardial Ischemia, The Second Affiliated Hospital of Harbin Medical University, Chinese Ministry of Education, 246 Xuefu Road, Harbin, 150086, China.
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Beydoun HA, Beydoun MA, Kinney RL, Liu S, Yu R, Allison M, Wallace RB, Xiao Q, Liu L, Gradidge P, Jung SY, Tindle HA, Follis S, Brunner R, Tsai J. Pathways From Socioeconomic Factors to Major Cardiovascular Events Among Postmenopausal Veteran and Nonveteran Women: Findings From the Women's Health Initiative. J Am Heart Assoc 2024; 13:e037253. [PMID: 39673348 DOI: 10.1161/jaha.124.037253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 10/15/2024] [Indexed: 12/16/2024]
Abstract
BACKGROUND Cardiovascular disease (CVD) remains a leading cause of death for women in the United States, with veterans being at potentially higher risk than their nonveteran counterparts due to accelerated aging and distinct biopsychosocial mechanisms. We examined pathways between selected indicators of socioeconomic status (SES) such as education, occupation, household income, and neighborhood SES and major CVD events through lifestyle and health characteristics among veteran and nonveteran postmenopausal women. METHODS AND RESULTS A total of 121 286 study-eligible WHI (Women's Health Initiative) participants (3091 veterans and 118 195 nonveterans) were prospectively followed for an average of 17 years, during which 16 108 major CVD events were documented. Using generalized structural equations modeling coupled with survival analysis techniques, we estimated the effects of SES on major CVD events through smoking, body mass index, comorbidities, cardiometabolic risk factors, and self-rated health, controlling for WHI component, region, age, race, ethnicity, marital status, and health care provider access. Among veterans, SES characteristics were indirectly related to major CVD events through body mass index, comorbidities, cardiometabolic risk factors, and self-rated health. Among nonveterans, lower education (β= 0.2, P<0.0001), household income (β=+0.4, P<0.0001), and neighborhood SES (β=+0.2, P<0.0001) were positively related to major CVD events, and these relationships were partly mediated by body mass index, comorbidities, cardiometabolic risk factors, and self-rated health. Smoking played a mediating role only among nonveterans. CONCLUSIONS Nonveteran postmenopausal women exhibit more complex pathways between SES and major CVD events than their veteran counterparts, informing the design, conduct, and evaluation of preventive strategies targeting CVD by veteran status.
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Affiliation(s)
- Hind A Beydoun
- VA National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs Washington DC USA
- Department of Management, Policy, and Community Health, School of Public Health University of Texas Health Science Center at Houston Houston TX USA
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences National Institute on Aging Intramural Research Program Baltimore MD USA
| | - Rebecca L Kinney
- VA National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs Washington DC USA
- VA Central Western Massachusetts Healthcare System Leeds MA USA
- Department of Population and Quantitative Health Sciences University of Massachusetts Medical School Worcester MA USA
| | - Simin Liu
- Department of Epidemiology, School of Public Health Brown University Providence RI USA
| | - Rona Yu
- Department of Medicine Uniformed Services University Bethesda MD USA
| | - Matthew Allison
- Department of Family Medicine, School of Medicine University of California at San Diego San Diego CA USA
| | - Robert B Wallace
- Department of Epidemiology, College of Public Health University of Iowa Iowa City IA USA
| | - Qian Xiao
- Department of Epidemiology, School of Public Health University of Texas Health Science Center at Houston Houston TX USA
| | - Longjian Liu
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health Drexel University Philadelphia PA USA
| | - Philippe Gradidge
- Department of Exercise Science & Sports Medicine University of the Witwatersrand Johannesburg South Africa
| | - Su Yon Jung
- Jonsson Comprehensive Cancer Center, School of Nursing University of California, Los Angeles Los Angeles CA USA
- Department of Epidemiology, Fielding School of Public Health University of California, Los Angeles Los Angeles CA USA
| | - Hilary A Tindle
- Division of General Internal Medicine & Public Health, Department of Medicine Vanderbilt University Nashville TN USA
- Geriatric Research Education and Clinical Centers Veterans Affairs Tennessee Valley Healthcare System Nashville TN USA
| | - Shawna Follis
- Stanford Prevention Research Center, School of Medicine Stanford University Palo Alto CA USA
| | - Robert Brunner
- Department of Family and Community Medicine (Emeritus), School of Medicine University of Nevada (Reno) Reno NV USA
| | - Jack Tsai
- VA National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs Washington DC USA
- Department of Management, Policy, and Community Health, School of Public Health University of Texas Health Science Center at Houston Houston TX USA
- Department of Psychiatry Yale School of Medicine New Haven CT USA
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3
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Zhang Z, Wang P, Cui G, Li H. Higher HEI-2015 score is associated with reduced risk of fecal incontinence: insights from a large cross-sectional study. BMC Public Health 2024; 24:3221. [PMID: 39567930 PMCID: PMC11577588 DOI: 10.1186/s12889-024-20729-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 11/13/2024] [Indexed: 11/22/2024] Open
Abstract
OBJECTIVE Diet habit plays a vital role in fecal incontinence (FI) progression. However, it remains unknown whether dietary quality is related to FI. Our study sought to explore the relationship between healthy eating index-2015 (HEI-2015) score and FI among US adults. METHODS An analysis of data from the 2005-2010 National Health and Nutrition Examination Survey was conducted in our study. The Bowel Health Questionnaire defined FI as losing liquid, solid, or mucus stool at least monthly. The diet's quality was evaluated using HEI-2015 score. The odds ratios (ORs) and 95% confidence interval (95%CI) were calculated using multi-variable logistic regression models. RESULTS There were 11,452 participants, with 9.3% (1062/11452) who experienced FI. Compared with individuals with inadequate group (HEI score < 50), the adjusted OR values for HEI score and FI in average group (50 ≤ HEI score < 70) and optimal group (HEI score ≥ 70) were 0.89 (95%CI: 0.74-1.07, p = 0.214) and 0.69 (95%CI: 0.52-0.91, p = 0.011), respectively. Subsequent stratified analyses did not reveal any interactions. CONCLUSIONS High-quality diets are related with a lower risk of FI. Therefore, it is imperative to take into account the potential impact of diet on FI when devising strategies for the treatment and prevention.
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Affiliation(s)
- Zhuhui Zhang
- Department of Anorectal surgery, Guang' anmen Hospital, China Academy of Chinese Medical Sciences, 5 Beixiange, Xicheng District, Beijing, China
| | - Pengfei Wang
- Department of Traditional Chinese Medicine, Fujian Provincial Hospital, 134 East Street, Fuzhou, China
| | - Guoce Cui
- Department of Traditional Chinese Medicine Surgery, Beijing Shijitan Hospital, Capital Medical University, 10 Tieyi Road, Haidian District, Beijing, China
| | - Huashan Li
- Department of Anorectal surgery, Guang' anmen Hospital, China Academy of Chinese Medical Sciences, 5 Beixiange, Xicheng District, Beijing, China.
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Peña S, Frenn M, Garcia J, Gretebeck R, Singh M. Nutrition Literacy, Neighborhood, and Diet. Public Health Nurs 2024. [PMID: 39551612 DOI: 10.1111/phn.13488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 10/23/2024] [Accepted: 10/27/2024] [Indexed: 11/19/2024]
Abstract
OBJECTIVE This study examined the influence of nutrition literacy and neighborhood on diet quality within the Mexican-origin population residing in the United States, addressing a gap in existing literature that lacks focus on specific Latinx subgroups. DESIGN This study used a descriptive, correlational design to examine the relationships between nutrition literacy, neighborhood ranking, and diet quality. SAMPLE A total of 130 Mexican origin participants living in the United States completed all components of this study. MEASUREMENTS Participants completed demographics, the Nutrition Literacy Assessment Instrument (NLit), Area Deprivation Index (ADI), and Diet History Questionnaire III (DHQ3). RESULTS Compared to the national average of 59, participants' average score was 63.16. When examining subgroups of diet quality, participants scored poorly compared to the national average for saturated fats, seafood, and plant proteins. Nutrition literacy was a predictor of total protein foods, seafood, and plant proteins, while the ADI was a predictor of increased refined grains score. CONCLUSION The present study provides insights about the influencing factors of diet quality in this population. Given the essential role diet has in shaping health outcomes and preventing chronic illness, addressing dietary subgroups within the Latinx population is critical to accurately informing nursing interventions and patient education.
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Affiliation(s)
- Sylvia Peña
- Marquette University, Milwaukee, Wisconsin, USA
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Lee J, Helgeson E, Horning ML, Elgesma KM, Kubik MY, Fulkerson JA. Food Insecurity and Changes in Diet Quality and Body Mass Index z-Scores Among Elementary School Students. Child Obes 2024; 20:508-516. [PMID: 38546529 PMCID: PMC11535459 DOI: 10.1089/chi.2023.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
Background: Previous research has identified food insecurity as a risk factor for obesity but those studies employed cross-sectional designs and were largely focused on adults and young children. In addition, there is a paucity of studies examining the association between food insecurity and changes in children's overall diet quality. This study aimed to assess whether food insecurity is associated with subsequent changes in diet quality and BMI z-scores over 2 years among 7- to 12-year-old children. Methods: We used 2011-2019 secondary data (n = 404) from three randomized controlled trials in Minnesota. Food insecurity was identified using the U.S. Household Food Security Survey Module at baseline (Time 0). Diet quality was determined using the Healthy Eating Index (HEI)-2015 from 24-hour recalls, and BMI z-scores were calculated using measured height and weight. These two outcomes were measured at Time 0, Time 1 (10-12 months from Time 0), and Time 2 (15-24 months from Time 0). Results: Compared with children from food-secure households, those from food-insecure households experienced a 0.13 greater increase in BMI z-scores from Time 0 to Time 2 [95% confidence interval (CI): 0.04 to 0.21] and a 4.5 point increase in HEI-2015 from Time 0 to Time 1 (95% CI: 0.99 to 8.01). Conclusion: Household food insecurity may widen weight disparities among elementary school-aged children. Further studies are needed to identify the role of diet quality in weight changes among children with food insecurity. Clinical Trial Registration Number: NCT01538615, NCT02029976, NCT02973815.
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Affiliation(s)
- Jiwoo Lee
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Erika Helgeson
- Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | | | - Martha Y. Kubik
- School of Nursing, College of Public Health, George Mason University, Fairfax, VA, USA
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Kumar A, Gwalani P, Iyer PG, Wang KK, Falk GW, Ginsberg GG, Lightdale CJ, Del Portillo A, Lagana SM, Li Y, Li H, Genkinger J, Jin Z, Rustgi AK, Wang TC, Wang HH, Quante M, Abrams JA. Shifts in Serum Bile Acid Profiles Associated With Barrett's Esophagus and Stages of Progression to Esophageal Adenocarcinoma. Clin Transl Gastroenterol 2024; 15:e1. [PMID: 39166758 PMCID: PMC11500780 DOI: 10.14309/ctg.0000000000000762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 08/12/2024] [Indexed: 08/23/2024] Open
Abstract
INTRODUCTION Reflux bile acids are believed to promote esophageal adenocarcinoma (EAC), but the role of systemic bile acids is unknown. This study aimed to assess associations between systemic bile acids and stages of Barrett's esophagus (BE) progression. METHODS Subjects with and without BE were enrolled in this multicenter cross-sectional study. Targeted serum bile acid profiling was performed, and a subset of subjects completed a validated food frequency questionnaire. RNA sequencing was performed on BE or gastric cardia tissue to assess bile acid associations with gene expression. RESULTS A total of 141 subjects were enrolled with serum bile acids profiled (49 non-BE; 92 BE: 44 no dysplasia, 25 indefinite/low grade dysplasia, 23 high-grade dysplasia/EAC). Lower Healthy Eating Index score, older age, higher body mass index, and no proton pump inhibitor use were associated with increased levels of multiple bile acids. Global bile acid pools were distinct between non-BE and stages of BE neoplasia ( P = 0.004). Increasing cholic acid was associated with high-grade dysplasia/EAC compared with non-BE, even after adjusting for EAC risk factors (adjusted odds ratio 2.03, 95% confidence interval 1.11-3.71) as was the combination of unconjugated primary bile acids (adjusted odds ratio 1.81, 95% confidence interval 1.04-3.13). High cholic acid levels were associated with tissue gene expression changes including increased DNA replication and reduced lymphocyte differentiation genes. DISCUSSION Alterations in serum bile acids are independently associated with advanced neoplasia in BE and may contribute to neoplastic progression. Future studies should explore associated gut microbiome changes, proneoplastic effects of bile acids, and whether these bile acids, particularly cholic acid, represent potential biomarkers or viable therapeutic targets for advanced neoplasia in BE.
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Affiliation(s)
- Aarti Kumar
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Pranav Gwalani
- Division of Internal Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Prasad G. Iyer
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kenneth K. Wang
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Gary W. Falk
- Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Gregory G. Ginsberg
- Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Charles J. Lightdale
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Armando Del Portillo
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Stephen M. Lagana
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - Yun Li
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Hongzhe Li
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jeanine Genkinger
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Zhezhen Jin
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Anil K. Rustgi
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York, USA
- Digestive and Liver Disease Research Center, Columbia University Irving Medical Center, New York, New York, USA
| | - Timothy C. Wang
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York, USA
- Digestive and Liver Disease Research Center, Columbia University Irving Medical Center, New York, New York, USA
| | - Harris H. Wang
- Digestive and Liver Disease Research Center, Columbia University Irving Medical Center, New York, New York, USA
- Department of Systems Biology, Columbia University Irving Medical Center, New Yok, New York, USA
| | | | - Julian A. Abrams
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York, USA
- Digestive and Liver Disease Research Center, Columbia University Irving Medical Center, New York, New York, USA
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Kenney E, Adebiyi VO, Seligman HK, Ehmke MD, Guthrie JF, Coleman-Jensen A, Frongillo EA. Assessing and Monitoring Nutrition Security in the United States: A Narrative Review of Current Measures and Instruments. Curr Nutr Rep 2024; 13:639-667. [PMID: 38916806 PMCID: PMC11327197 DOI: 10.1007/s13668-024-00547-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE OF REVIEW Because nutrition plays a crucial role in the development of chronic diseases, ensuring nutrition security is important for promoting population health. Nutrition security is defined as having consistent and equitable access to healthy, safe, affordable foods essential to optimal health and well-being. Distinguished from food security, nutrition security consists of two constructs: healthy diets and nutritional status. The study aimed to identify population measures that reflect the important constructs of nutrition security (i.e., healthy diets and nutritional status) to inform U.S. nutrition security assessment and monitoring. RECENT FINDINGS Through a narrative review conducted across multiple databases, associations between subconstructs of healthy diets and nutritional status were identified. Of the six subconstructs that constitute healthy diets, nutrient adequacy and moderation were most often used to assess and monitor healthfulness of U.S. population diets and were associated with health outcomes. There is little evidence of an association between health outcomes and macronutrient balance or diversity in the U.S. Thirteen instruments were identified as potentially suitable for measuring at least one subconstruct of healthy diet in the population. This review highlights the importance of nutrition security in addressing population health challenges. It emphasizes the potential use of multiple instruments and measures to comprehensively monitor population nutrition security and inform intervention strategies. Identifying feasible and practical measures for assessing and monitoring nutrition security is imperative for advancing population health and mitigating the burden of chronic diseases.
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Affiliation(s)
- Emma Kenney
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I Building, 915 Greene Street, Columbia, SC, 29208, USA.
| | - Victoria O Adebiyi
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I Building, 915 Greene Street, Columbia, SC, 29208, USA
| | - Hilary K Seligman
- Division of General Internal Medicine and Center for Vulnerable Populations, University of California, San Francisco, CA, USA
| | - Mariah D Ehmke
- United States Department of Agriculture, Economic Research Service, Washington, DC, USA
| | - Joanne F Guthrie
- United States Department of Agriculture, Economic Research Service, Washington, DC, USA
| | - Alisha Coleman-Jensen
- United States Department of Agriculture, Economic Research Service, Washington, DC, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Discovery I Building, 915 Greene Street, Columbia, SC, 29208, USA
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Menotti A, Puddu PE, Piras P. Cardiovascular Risk Factors Predicting Cardiovascular and Cancer Deaths in a Middle-Aged Population Followed-Up for 61 Years until Extinction. J Cardiovasc Dev Dis 2024; 11:240. [PMID: 39195148 DOI: 10.3390/jcdd11080240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND AND AIM To study the relationships of cardiovascular risk factors with cancer and cardiovascular mortality in a cohort of middle-aged men followed-up for 61 years. MATERIALS AND METHODS A rural cohort of 1611 cancer- and cardiovascular disease-free men aged 40-59 years was examined in 1960 within the Italian Section of the Seven Countries Study, and 28 risk factors measured at baseline were used to predict cancer (n = 459) and cardiovascular deaths (n = 678) that occurred during 61 years of follow-up until the extinction of the cohort with Cox proportional hazard models. RESULTS A model with 28 risk factors and cancer deaths as the end-point produced eight statistically significant coefficients for age, smoking habits, mother early death, corneal arcus, xanthelasma and diabetes directly related to events, and arm circumference and healthy diet inversely related. In the corresponding models for major cardiovascular diseases and their subgroups, only the coefficients of age and smoking habits were significant among those found for cancer deaths, to which healthy diet can be added if considering coronary heart disease alone. Following a competing risks analysis by the Fine-Gray method, risk factors significantly common to both conditions were only age, smoking, and xanthelasma. CONCLUSIONS A sizeable number of traditional cardiovascular risk factors were not predictors of cancer death in a middle-aged male cohort followed-up until extinction.
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Affiliation(s)
| | - Paolo Emilio Puddu
- Association for Cardiac Research, 00182 Rome, Italy
- EA 4650, Signalisation, Électrophysiologie et Imagerie des Lésions D'ischémie Reperfusion Myocardique, Normandie Université, UNICAEN, 14000 Caen, France
| | - Paolo Piras
- Department of Structural Engineering, Sapienza University of Rome, 00185 Rome, Italy
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9
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Gołąbek KD, Chmielewska A, Karoluk E, Kujawa K, Regulska-Ilow B. Assessment of Diet Quality Based on Selected Dietary Quality Indices and Consumption of Specific Food Items of Midwives Working on a Shift Schedule in Wroclaw, Poland. Nutrients 2024; 16:2409. [PMID: 39125290 PMCID: PMC11314451 DOI: 10.3390/nu16152409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/23/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
The aim of this study was to assess the quality of diets among midwives working in a shift system and to analyze variations in their dietary habits according to their working hours. In a group of fifty midwives employed in four public hospitals in Wrocław, the HDI-2015, HEI-2015, AHEI-2010, and Mellen's DASH diet index were calculated. The significance of differences in terms of the prevalence of selected dietary habits, meal frequency, average content of selected food items, and the percentage of energy obtained from them was assessed. Over half of the diets of the participants exhibited low adherence to the selected dietary indices. Only the scores on Mellen's DASH diet index were significantly associated with other components of the diet. Diets scoring ≥ 4.5 points were characterized by significantly lower processed meat content, meal frequency, and energy value, as well as lower sugar content and lower dietary energy value, compared to diets scoring < 4.5 points. Regardless of their working hours, the diets of midwives are characterized by low quality. Therefore, it appears essential to introduce targeted educational programs and provide guidance on appropriate dietary models, such as the DASH diet.
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Affiliation(s)
- Katarzyna Daria Gołąbek
- Department of Dietetics and Bromatology, Pharmacy Faculty, Wroclaw Medical University, ul. Borowska 211, 50-556 Wrocław, Poland; (A.C.); (B.R.-I.)
| | - Anna Chmielewska
- Department of Dietetics and Bromatology, Pharmacy Faculty, Wroclaw Medical University, ul. Borowska 211, 50-556 Wrocław, Poland; (A.C.); (B.R.-I.)
| | - Ewa Karoluk
- Department of Obstetrics and Gynecological and Obstetric Nursing, Health Sciences Faculty, Wroclaw Medical University, 51-618 Wrocław, Poland;
| | - Krzysztof Kujawa
- Statistical Analysis Centre, Wroclaw Medical University, 50-368 Wrocław, Poland;
| | - Bożena Regulska-Ilow
- Department of Dietetics and Bromatology, Pharmacy Faculty, Wroclaw Medical University, ul. Borowska 211, 50-556 Wrocław, Poland; (A.C.); (B.R.-I.)
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Ghasemi-Tehrani H, Askari G, Allameh FZ, Vajdi M, Amiri Khosroshahi R, Talebi S, Ziaei R, Ghavami A, Askari F. Healthy eating index and risk of diminished ovarian reserve: a case-control study. Sci Rep 2024; 14:16861. [PMID: 39043733 PMCID: PMC11266691 DOI: 10.1038/s41598-024-67734-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 07/15/2024] [Indexed: 07/25/2024] Open
Abstract
Diminished ovarian reserve (DOR) is associated with reduced fertility and poor reproductive outcomes. The association between dietary patterns and DOR was not well studied. The purpose of this study was to evaluate the relationship between adhering to the healthy eating index (HEI-2015) and the risk of DOR. In this case-control study, 370 Iranian women (120 with DOR and 250 age- and BMI-matched controls) were examined. A reliable semi-quantitative food frequency questionnaire was used to collect diet-related data. We analyzed the HEI-2015 and their dietary intake data to determine major dietary patterns. The multivariable logistic regression was used in order to analyze the association between HEI-2015 and risk of DOR. We found no significant association between HEI-2015 score and risk of DOR in the unadjusted model (OR 0.78; 95%CI 0.59, 1.03). After controlling for physical activity and energy intake, we observed that women in the highest quartile of the HEI-2015 score had 31% decreased odds of DOR (OR 0.69; 95%CI 0.46, 0.93). This association remained significant even after adjusting for all potential confounders. Overall, increased adherence to HEI may lead to a significant reduction in the odds ratio of DOR. Clinical trials and prospective studies are needed to confirm this association.
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Affiliation(s)
- Hatav Ghasemi-Tehrani
- Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Zahra Allameh
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahdi Vajdi
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan, Iran
| | - Reza Amiri Khosroshahi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepide Talebi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Rahele Ziaei
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Abed Ghavami
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Farzaneh Askari
- Department of Applied Human Nutrition, The Mount Saint Vincent University, Halifax, Canada
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11
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Zhao W, Gao L, Wu Z, Qin M. Association between dietary patterns and the risk of all-cause mortality among old adults with obstructive sleep apnea. BMC Geriatr 2024; 24:569. [PMID: 38956519 PMCID: PMC11218104 DOI: 10.1186/s12877-024-05126-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 06/03/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) was associated with the increased cardiovascular events and all-cause mortality. And anti-inflammatory dietary has potential to improve the prognosis of OSA. This study aimed to investigate the association of anti-inflammatory dietary patterns with all-cause mortality among individuals with OSA. METHODS This retrospective cohort study involved 1522 older adults with OSA from 2005 to 2008 in the National Health and Nutrition Examinations Survey (NHANES). Mortality status was determined by routine follow-up through December 31, 2019, using the National Death Index. Anti-inflammatory dietary patterns included Alternate Mediterranean Diet Score (aMED), Healthy Eating Index-2015 (HEI-2015), and Alternate Healthy Eating Index-2010 (AHEI-2010). Weighted Cox proportional hazard regression models were performed to investigate the association between anti-inflammatory dietary pattern and all-cause mortality. RESULTS After a median follow-up of 131 months, 604 participants were recorded all-cause mortality. The mean age of OSA patients was 68.99 years old, of whom 859 were male (52.34%). Higher adherence of aMED (HR = 0.61, 95%CI: 0.48 to 0.78) and HEI-2015 (HR = 0.75, 95%CI: 0.60 to 0.95) were associated with lower all-cause mortality risk in the elderly with OSA. Conversely, no association was found between AHEI-2010 dietary pattern and all-cause mortality in individuals with OSA. In the component analysis of aMED, it was found that a higher intake of vegetables and olive oil potentially contributes to the reduction all-cause mortality risk in the elderly with OSA (HR = 0.60, 95%CI: 0.48 to 0.76; HR = 0.67, 95%CI: 0.63 to 0.71). CONCLUSION Higher adherence to the aMED and the HEI-2015 was associated with a lower risk of all-cause mortality in OSA. Future interventions in the elderly with OSA should considering adopting anti-inflammatory dietary patterns.
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Affiliation(s)
- Wei Zhao
- Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People's Republic of China.
| | - Lu Gao
- Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People's Republic of China
| | - Zhiyuan Wu
- Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA, 02115, United States
| | - Mingzhao Qin
- Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People's Republic of China
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12
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Kang M, Wilkens LR, Wirth MD, Shivappa N, Hébert JR, Haiman CA, Le Marchand L, Park SY. Diet Quality and Risk of Bladder Cancer in the Multiethnic Cohort Study. Nutrients 2024; 16:1965. [PMID: 38931318 PMCID: PMC11206544 DOI: 10.3390/nu16121965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/05/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
This study analyzed the overall quality of the diet using predefined indices, including the Healthy Eating Index-2015 (HEI-2015), the Alternative Healthy Eating Index-2010 (AHEI-2010), the alternate Mediterranean Diet (aMED) score, the Dietary Approaches to Stop Hypertension (DASH) score, and the Dietary Inflammatory Index (DII®), to explore their association with the risk of bladder cancer in the Multiethnic Cohort Study. Data were taken from 186,979 African American, Japanese American, Latino, Native Hawaiian, and non-Hispanic White participants aged 45-75 years, with 1152 incident cases of invasive bladder cancer during a mean follow-up period of 19.2 ± 6.6 years. Cox models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) with comprehensive adjustment for smoking. Comparing the highest vs. lowest diet quality score quintile, HRs (95% CIs) in men was 1.08 (0.86-1.36) for HEI-2015, 1.05 (0.84-1.30) for AHEI-2010, 1.01 (0.80-1.27) for aMED, 1.13 (0.90-1.41) for DASH, and 0.96 (0.76-1.21) for DII®, whereas the corresponding HRs for women were 0.75 (0.53-1.07), 0.64 (0.45-0.92), 0.60 (0.40-0.88), 0.66 (0.46-0.95), and 0.63 (0.43-0.90) with all p values for trend <0.05. The inverse association found in women did not vary by smoking status or race and ethnicity. Our findings suggest that adopting high-quality diets may reduce the risk of invasive bladder cancer among women in a multiethnic population.
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Affiliation(s)
- Minji Kang
- Department of Food and Nutrition, Duksung Women’s University, Seoul 01369, Republic of Korea
| | - Lynne R. Wilkens
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (L.R.W.); (L.L.M.); (S.-Y.P.)
| | - Michael D. Wirth
- College of Nursing, University of South Carolina, Columbia, SC 29208, USA;
- Department of Epidemiology and Biostatistics, Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - James R. Hébert
- Department of Epidemiology and Biostatistics, Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - Christopher A. Haiman
- Department of Population and Public Health Sciences, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA;
| | - Loïc Le Marchand
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (L.R.W.); (L.L.M.); (S.-Y.P.)
| | - Song-Yi Park
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (L.R.W.); (L.L.M.); (S.-Y.P.)
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13
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Donofry SD, Jouppi RJ, Call CC, Kolko Conlon RP, Levine MD. Improvements in Maternal Cardiovascular Health Over the Perinatal Period Longitudinally Predict Lower Postpartum Psychological Distress Among Individuals Who Began Their Pregnancies With Overweight or Obesity. J Am Heart Assoc 2024; 13:e034153. [PMID: 38874183 PMCID: PMC11255758 DOI: 10.1161/jaha.123.034153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/15/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Adverse cardiovascular events during pregnancy (eg, preeclampsia) occur at higher rates among individuals with overweight or obesity (body mass index ≥25 kg/m2) and have been associated with postpartum depression. The present study examined whether changes in cardiovascular health (CVH) during the perinatal period, as defined by the American Heart Association's Life's Essential 8 framework, predicted postpartum psychological functioning among individuals with prepregnancy body mass index ≥25 kg/m2. METHODS AND RESULTS Pregnant individuals (N = 226; mean ± SD age = 28.43 ± 5.4 years; mean body mass index = 34.17 ± 7.15 kg/m2) were recruited at 12 to 20 weeks of gestation (mean, 15.64 ± 2.45 weeks) for a longitudinal study of health and well-being. Participants completed ratings of depression and perceived stress and reported on CVH behaviors (dietary intake, physical activity, nicotine exposure, and sleep) at baseline and at 6 months postpartum. Body mass index and CVH behaviors were used to calculate a composite CVH score at both time points. Linear regression analyses were performed to examine whether change in CVH related to postpartum symptom scores. Because sleep was measured in only a subset of participants (n = 114), analyses were conducted with and without sleep. Improved CVH was associated with lower postpartum depression (β = -0.18, P<0.01) and perceived stress (β = -0.13, P=0.02) scores. However, when including sleep, these relationships were no longer significant (all P>0.4). CONCLUSIONS Improvements in CVH from early pregnancy to 6 months postpartum were associated with lower postpartum depressive symptoms and perceived stress but not when including sleep in the CVH metric, potentially due to the large reduction in sample size. These data suggest that intervening during pregnancy to promote CVH may improve postpartum psychological functioning among high-risk individuals.
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Affiliation(s)
- Shannon D. Donofry
- RANDPittsburghPA
- Department of PsychologyUniversity of PittsburghPittsburghPA
| | - Riley J. Jouppi
- Department of PsychologyUniversity of PittsburghPittsburghPA
| | - Christine C. Call
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPA
| | | | - Michele D. Levine
- Department of PsychologyUniversity of PittsburghPittsburghPA
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPA
- Department of Obstetrics, Gynecology, and Reproductive SciencesUniversity of PittsburghPittsburghPA
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14
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Kadam I, Dalloul M, Hausser J, Vaday D, Gilboa E, Wang L, Hittelman J, Hoepner L, Fordjour L, Chitamanni P, Saxena A, Jiang X. Role of one-carbon nutrient intake and diabetes during pregnancy in children's growth and neurodevelopment: A 2-year follow-up study of a prospective cohort. Clin Nutr 2024; 43:1216-1223. [PMID: 38636347 DOI: 10.1016/j.clnu.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/21/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND & AIMS Both maternal metabolic dysregulation, e.g., gestational diabetes mellitus (GDM), and maternal supply of nutrients that participate in one-carbon (1C) metabolism, e.g., folate, choline, betaine, and vitamin B12, have been demonstrated to influence epigenetic modification such as DNA methylation, thereby exerting long-lasting impacts on growth and development of offspring. This study aimed to determine how maternal 1C nutrient intake was associated with DNA methylation and further, development of children, as well as whether maternal GDM status modified the association in a prospective cohort. METHODS In this study, women with (n = 18) and without (n = 20) GDM were recruited at 25-33 weeks gestation. Detailed dietary intake data was collected by 3-day 24-h dietary recall and nutrient levels in maternal blood were also assessed at enrollment. The maternal-child dyads were invited to participate in a 2-year follow-up during which anthropometric measurement and the Bayley Scales of Infant and Toddler Development™ Screening Test (Third Edition) were conducted on children. The association between maternal 1C nutrients and children's developmental outcomes was analyzed with a generalized linear model controlling for maternal GDM status. RESULTS We found that children born to mothers with GDM had lower scores in the language domain of the Bayley test (p = 0.049). Higher maternal food folate and choline intakes were associated with better language scores in children (p = 0.01 and 0.025, respectively). Higher maternal food folate intakes were also associated with better cognitive scores in children (p = 0.002). Higher 1C nutrient intakes during pregnancy were associated with lower body weight of children at 2 years of age (p < 0.05). However, global DNA methylation of children's buccal cells was not associated with any maternal 1C nutrients. CONCLUSIONS In conclusion, higher 1C nutrient intake during pregnancy was associated with lower body weight and better neurodevelopmental outcomes of children. This may help overcome the lower language scores seen in GDM-affected children in this cohort. Studies in larger cohorts and with a longer follow-up duration are needed to further delineate the relationship between prenatal 1C nutrient exposure, especially in GDM-affected pregnancies, and offspring health outcomes.
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Affiliation(s)
- Isma'il Kadam
- Departments of Health and Nutrition Sciences, Brooklyn College of City University of New York, Brooklyn, NY 11210, USA; PhD Program in Biochemistry, Graduate Center of the City University of New York, New York, NY 10016, USA
| | - Mudar Dalloul
- Department of Obstetrics and Gynecology, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Jeanette Hausser
- Departments of Health and Nutrition Sciences, Brooklyn College of City University of New York, Brooklyn, NY 11210, USA
| | - Doron Vaday
- Departments of Health and Nutrition Sciences, Brooklyn College of City University of New York, Brooklyn, NY 11210, USA
| | - Ella Gilboa
- Departments of Health and Nutrition Sciences, Brooklyn College of City University of New York, Brooklyn, NY 11210, USA
| | - Liang Wang
- Department of Public Health, Robbins College of Human Health and Sciences, Baylor University, Waco, TX 76711, USA
| | - Joan Hittelman
- Department of Psychology, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Lori Hoepner
- Department of Environmental and Occupational Health Sciences, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Lawrence Fordjour
- Department of Pediatrics, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Pavani Chitamanni
- Department of Pediatrics, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Anjana Saxena
- Department of Biology, Brooklyn College of City University of New York, Brooklyn, NY 11210, USA
| | - Xinyin Jiang
- Departments of Health and Nutrition Sciences, Brooklyn College of City University of New York, Brooklyn, NY 11210, USA; PhD Program in Biochemistry, Graduate Center of the City University of New York, New York, NY 10016, USA.
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15
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Murakami K, Shinozaki N, Okuhara T, McCaffrey TA, Livingstone MBE. Self-perceived food literacy in relation to the quality of overall diet and main meals: A cross-sectional study in Japanese adults. Appetite 2024; 196:107281. [PMID: 38373536 DOI: 10.1016/j.appet.2024.107281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/14/2024] [Accepted: 02/16/2024] [Indexed: 02/21/2024]
Abstract
This cross-sectional study aimed to assess the relationship between self-perceived food literacy (SPFL) and quality of overall diet and main meals in Japanese adults. In total, 5998 adults aged 20-79 years were included in this analysis. The SPFL was assessed using the Japanese version of the 29-item Dutch SPFL scale (score range 1-5). Using validated dietary information, the Healthy Eating Index-2015 (HEI-2015) was calculated (score range 0-100). The mean SPFL was 3.18; the internal consistency of the overall scale was considered good (Cronbach's alpha: 0.80). The mean HEI-2015 for overall diet was 50.4. The SPFL was significantly and positively associated with the HEI-2015. Using multiple linear regression, one point increase of SPFL corresponded to an increase in HEI-2015 by a point of 4.8 for overall diet, 6.2 for breakfast, 4.6 for lunch, and 3.6 for dinner (all P < 0.0001). Six of the eight domains of SPFL (i.e., food preparation skills, resilience and resistance, healthy snack styles, examining food labels, healthy budgeting, and healthy food stockpiling) were significantly associated with the HEI-2015 for overall diet. When the HEI-2015 for each meal was examined, the domains showing significant associations with all three meals included food preparation skills, healthy snack styles, and healthy budgeting. The healthy food stockpiling was associated with the HEI-2015 for breakfast and lunch, but not dinner. The social and conscious eating and daily food planning were associated with the breakfast HEI-2015 only, with the resilience and resistance associated with the dinner HEI-2015 only. In conclusion, the SPFL was cross-sectionally associated with the quality of overall diet and main meals in Japanese adults. Further observation and intervention studies are needed to confirm the associations observed here.
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Affiliation(s)
- Kentaro Murakami
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Nana Shinozaki
- Department of Nutritional Epidemiology and Behavioural Nutrition, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Tracy A McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Melbourne, Australia
| | - M Barbara E Livingstone
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, UK
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16
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Cheng J, Costacou T, Rockette-Wagner B, Sereika SM, Conroy MB, Kriska AM, Kariuki JK, Klem ML, Parmanto B, Burke LE. Perceived and calculated diet quality improvements in a randomized mHealth weight loss trial. Behav Med 2024; 50:164-169. [PMID: 36789848 PMCID: PMC10425562 DOI: 10.1080/08964289.2023.2178374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/15/2022] [Accepted: 01/31/2023] [Indexed: 02/16/2023]
Abstract
The diet quality of US adults is poor and cross-sectional analyses suggest self-perception of healthful dietary intake may be overestimated. This analysis assessed the concordance between calculated and perceived diet quality and changes in diet quality among adults seeking weight loss and enrolled in a 12-month randomized behavioral trial. Healthy Eating Index-2015 diet quality (HEI) was calculated from self-administered 24-hour recalls. Perceived diet quality (PDQ) was measured on a 100-point scale. Higher scores indicate better diet quality. Concordance was assessed using the concordance correlation coefficient and Bland-Altman plots. The one hundred and five participants with complete dietary data were mostly female and white. There was good agreement between HEI and PDQ scores at 12 months for less than a third of participants. Most of the disagreement arose from PDQ scores being higher than HEI scores. Even fewer participants had good agreement between HEI changes and PDQ changes. Participants perceived greater improvement in diet quality than indicated by HEI score changes. Concordance was low at 12 months and for change in diet quality. Despite the diet quality of adults seeking weight loss being suboptimal and not improving, many perceived their diet quality and diet quality improvements as better than calculated. Future studies might explore the effect of misperceptions on weight loss outcomes.
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Affiliation(s)
- Jessica Cheng
- Department of Epidemiology, School of Public Health, University of Pittsburgh
| | - Tina Costacou
- Department of Epidemiology, School of Public Health, University of Pittsburgh
| | | | - Susan M Sereika
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh
| | - Molly B Conroy
- Division of General Internal Medicine, University of Utah School of Medicine
| | - Andrea M Kriska
- Department of Epidemiology, School of Public Health, University of Pittsburgh
| | - Jacob K Kariuki
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh
| | - Mary Lou Klem
- Health Sciences Library System, University of Pittsburgh
| | - Bambang Parmanto
- Department of Health Information Management, School of Rehabilitation Science, University of Pittsburgh
| | - Lora E Burke
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh
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17
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Bullock SL, Winthrop HM, Hales D, Lin FC, Yang Y, Ammerman AS, Viera AJ. Who chooses "healthy" meals? An analysis of lunchtime meal quality in a workplace cafeteria. BMC Public Health 2024; 24:921. [PMID: 38553694 PMCID: PMC10979548 DOI: 10.1186/s12889-024-18284-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/05/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND The workplace can play an important role in shaping the eating behaviors of U.S. adults. Unfortunately, foods obtained in the workplace tend to be low in nutritional quality. Questions remain about the best way to approach the promotion of healthy food purchases among employees and to what extent health promotion activities should be tailored to the demographic characteristics of the employees. The purpose of this study was to (1) assess the nutritional quality of lunchtime meal purchases by employees in cafeterias of a large organization, (2) examine associations between lunchtime meal quality selection and the demographic characteristics of employees, and (3) determine the healthfulness of foods and beverages offered in the cafeterias of this organization. METHODS A cross-sectional analysis was conducted using secondary data from a food labeling study implemented in three worksite cafeterias. Demographic data was collected via surveys and meal data was collected using a photo capture system for 378 participants. The Healthy Eating Index 2015 (HEI-2015) was used to determine meal quality and a total score for the menu of options available in the cafeterias during the study period. Summary statistics were generated, and the analysis of variance (ANOVA) was used to compare the HEI-2015 scores between groups. RESULTS The mean HEI-2015 total score for the menu items offered (n = 1,229) in the cafeteria during the study period was 63.1 (SD = 1.83). The mean HEI-2015 score for individual lunchtime meal observations (n = 378) was 47.1 (SD = 6.8). In general, HEI-2015 total scores were higher for non-smokers, individuals who self-identified as Asian, had higher physical activity levels, scored higher on numeracy and literacy assessments, and reported higher education levels, incomes, and health status. CONCLUSIONS The overall HEI-2015 scores indicate that the menu of options offered in the cafeterias and individual meal selections did not align with the Dietary Guidelines for Americans, and there were significant associations between average lunchtime meal quality scores and several demographic characteristics. These results suggest that healthy eating promotion activities in workplaces may need to be tailored to the demographic characteristics of the employees, and efforts to improve the food environment in the workplace could improve meal quality for all employees.
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Affiliation(s)
- Sally L Bullock
- Davidson College, PO Box 5000, 209 Ridge Road, Davidson, NC, 28035, USA.
| | - Hilary M Winthrop
- Duke University School of Medicine, 2200 W Main St, Durham, NC, 27705, USA
| | - Derek Hales
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 MLK Jr. Blvd, CB#7426,, Chapel Hill, NC, 27599, USA
| | - Feng-Chang Lin
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 3101 McGavran-Greenberg Hall, CB #7420,, Chapel Hill, NC, 27599, USA
| | - Yumei Yang
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 3101 McGavran-Greenberg Hall, CB #7420,, Chapel Hill, NC, 27599, USA
| | - Alice S Ammerman
- Department of Nutrition, Gillings School of Global Public Health, Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, CB# 7426, 1700 MLK Jr. Blvd, Room 239,, Chapel Hill, 27599, USA
| | - Anthony J Viera
- Department of Family Medicine and Community Health, Duke University School of Medicine, 2200 W Main St, Suite 400, Durham, NC, 27705, USA
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18
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Zhu Y, Wang Z. Association between joint physical activity and healthy dietary patterns and hypertension in US adults: cross-sectional NHANES study. BMC Public Health 2024; 24:855. [PMID: 38504199 PMCID: PMC10953194 DOI: 10.1186/s12889-024-18346-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/12/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Lack of physical activity (PA), poor dietary habits, or other unhealthy lifestyle behaviors are potential modifiable risk factors for hypertension. It has been sufficiently demonstrated in previous studies that physical activity or healthy dietary patterns can reduce the risk of hypertension. However, no research focused on the joint effects of PA and healthy dietary patterns on hypertension in a representative sample of adults. METHODS We used data collected from the 2007-2018 National Health and Nutrition Examination Survey. Healthy dietary patterns were assessed with the Healthy Eating Index 2015 (HEI-2015), and PA was measured using the metabolic equivalent minutes per week reported in questionnaires. We created four lifestyle categories based on the HEI-2015 and PA: (1) unhealthy diet and physically inactive (less than recommended PA), (2) healthy diet but physically inactive, (3) unhealthy diet but physically active (recommended PA), (4) healthy diet and physically active. Logistic regression was used to evaluate the association between joint PA and HEI-2015 and hypertension. RESULTS A total of 24,453 participants were enrolled in the study. Compared with unhealthy diet and physically inactive individuals, only healthy diet and physically active participants (adjusted odds ratio [AOR]: 0.77, 95% CI 0.65-0.9) were negatively associated with hypertension, while healthy diet but physically inactive participants (AOR: 0.89, 95% CI 0.76-1.03) and unhealthy diet but physically active participants (AOR: 0.9, 95% CI 0.76-1.06) were not associated with hypertension. CONCLUSION In a representative sample of US adults, our findings suggest that individuals with recommended PA and healthy dietary patterns have a lower risk of hypertension than those with an unhealthy diet or less than recommended PA. Healthy eating habits and regular PA are potential preventive precautions against hypertension.
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Affiliation(s)
- Yanzhou Zhu
- Department of Geriatrics, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, 355000, China
| | - Zhigang Wang
- Department of Geriatrics, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, 355000, China.
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19
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Hao X, Li D. The Healthy Eating Index-2015 and All-Cause/Cause-Specific Mortality: A Systematic Review and Dose-Response Meta-Analysis. Adv Nutr 2024; 15:100166. [PMID: 38461130 PMCID: PMC10980904 DOI: 10.1016/j.advnut.2023.100166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/30/2023] [Accepted: 12/21/2023] [Indexed: 03/11/2024] Open
Abstract
This meta-analysis was undertaken to determine the predictive value of Healthy Eating Index (HEI)-2015 in all-cause, cancer-cause, and cardiovascular disease (CVD)-cause mortality. This review was registered with PROSPERO as CRD42023421585. PubMed and Web of Science were searched for articles published by September 15, 2023. The hazard ratio (HR) was calculated with exact confidence intervals (CIs) of 95%. Statistical heterogeneity among studies was measured by Cochran's Q test (χ2) and the I2 statistic. Eighteen published studies were finally identified in this meta-analysis. The results showed that the HEI-2015 was associated with all-cause mortality either as a categorical variable (HR: 0.80; 95% CI: 0.79, 0.82) or continuous variable (HR: 0.90; 95% CI: 0.88, 0.92). The HEI-2015 was also associated with cancer-cause mortality as categorical variable (HR: 0.81; 95% CI: 0.78, 0.83) or continuous variable (HR: 0.90; 95% CI: 0.81, 0.99). The categorical HEI-2015 was also independently correlated with decreasing CVD-cause mortality (HR: 0.81; 95% CI: 0.75, 0.87). A nonlinear dose-response relation between the HEI-2015 and all-cause mortality was found. In the linear dose-response analysis, the risk of mortality from cancer decreased by 0.42% per 1 score increment of the HEI-2015 and the risk of CVD-cause mortality decreased by 0.51% with the increment of the HEI-2015 per 1 score. Our analysis indicated a significant relationship between the HEI-2015 and all-cause, cancer-cause, and CVD-cause mortality.
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Affiliation(s)
- Xuanyu Hao
- The Department of Gastroenterology at Shengjing Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Dongyang Li
- The Department of Urology at Shengjing Hospital of China Medical University, Shenyang, Liaoning, P.R. China.
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20
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Reeder NK, Reneker JC, Beech BM, Bruce MA, Heitman E, Norris KC, Talegawkar SA, Thorpe RJ. Adherence to the healthy eating index-2010 and alternative healthy eating index-2010 in relation to metabolic syndrome among African Americans in the Jackson heart study. Public Health Nutr 2024; 27:e74. [PMID: 38361460 PMCID: PMC10966834 DOI: 10.1017/s1368980024000016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 11/11/2023] [Accepted: 12/21/2023] [Indexed: 02/17/2024]
Abstract
OBJECTIVE The primary objective of this study was to determine whether Healthy Eating Index (HEI) and Alternative Healthy Eating Index (AHEI) scores were associated with incident metabolic syndrome. DESIGN This study is a secondary analysis of data from the Jackson Heart Study. HEI and AHEI scores were divided into quintiles and Cox proportional hazards regression models were analysed for 1864 African American adults free from metabolic syndrome at Exam 1 to examine the incidence of metabolic syndrome by quintile of dietary quality score. SETTING Hinds, Madison and Rankin counties, Mississippi, USA. PARTICIPANTS African American adults, ages 21-94 years, 60·9 % female. RESULTS Over a mean follow-up time of 6·7 years, we observed 932 incident cases of metabolic syndrome. After adjusting for multiple covariates, a higher HEI score at Exam 1 was not associated with the risk of incident metabolic syndrome, except when looking at the trend analysis for the subgroup of adults with two metabolic syndrome components at Exam 1 (P-trend = 0·03). A higher AHEI score at Exam 1 was associated with the risk of incident metabolic syndrome (hazard ratio for those in the highest quintile compared to the lowest: 0·80 (95 % CI: 0·65, 0·99), P-trend = 0·03). CONCLUSION These findings suggest that a dietary pattern that scores higher on the AHEI may help reduce the risk of metabolic syndrome, even for adults who already have two of the minimum of three components required for a diagnosis of metabolic syndrome.
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Affiliation(s)
- Nicole K Reeder
- Department of Food Science, Nutrition, and Health Promotion, Mississippi State University, Mississippi State, MS, USA
| | - Jennifer C Reneker
- Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, MS, USA
| | - Bettina M Beech
- UH Population Health, University of Houston, Houston, TX, USA
| | - Marino A Bruce
- UH Population Health, University of Houston, Houston, TX, USA
- Department of Behavioral and Social Sciences, University of Houston, Tilman J. Fertitta Family College of Medicine, Houston, TX, USA
| | - Elizabeth Heitman
- Program in Ethics in Science and Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Keith C Norris
- Department of Medicine, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Sameera A Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Roland J Thorpe
- Hopkins Center for Health Disparities Solutions, Johns Hopkins School of Public Health, 624 N. Broadway, Ste 708, Baltimore, MD, USA
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21
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Park SY, Setiawan VW, Crimmins EM, White LR, Wu AH, Cheng I, Darst BF, Haiman CA, Wilkens LR, Le Marchand L, Lim U. Racial and Ethnic Differences in the Population-Attributable Fractions of Alzheimer Disease and Related Dementias. Neurology 2024; 102:e208116. [PMID: 38232335 PMCID: PMC11097758 DOI: 10.1212/wnl.0000000000208116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/22/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Previous studies estimated that modifiable risk factors explain up to 40% of the dementia cases in the United States and that this population-attributable fraction (PAF) differs by race and ethnicity-estimates of future impact based on the risk factor prevalence in contemporary surveys. The aim of this study was to determine the race-specific and ethnicity-specific PAF of late-onset Alzheimer disease and related dementias (ADRDs) based on the risk factor prevalence and associations observed on the same individuals within a prospective cohort. METHODS Data were from Multiethnic Cohort Study participants (African American, Japanese American, Latino, Native Hawaiian, and White) enrolled in Medicare Fee-for-Service. We estimated the PAF based on the prevalence of risk factors at cohort baseline and their mutually adjusted association with subsequent ADRD incidence. Risk factors included low educational attainment and midlife exposures to low neighborhood socioeconomic status, unmarried status, history of hypertension, stroke, diabetes or heart disease, smoking, physical inactivity, short or long sleep duration, obesity, and low-quality diet, as well as APOE ε4 for a subset. RESULTS Among 91,881 participants (mean age 59.3 at baseline, 55.0% female participants), 16,507 incident ADRD cases were identified from Medicare claims (1999-2016, mean follow-up 9.3 years). The PAF for nongenetic factors combined was similar in men (24.0% [95% CI 21.3-26.6]) and women (22.8% [20.3-25.2]) but varied across Japanese American (14.2% [11.1-17.2]), White (21.9% [19.0-24.7]), African American (27.8% [22.3-33.0]), Native Hawaiian (29.3% [21.0-36.7]), and Latino (33.3% [27.5-38.5]) groups. The combined PAF was attenuated when accounting for competing risk of death, in both men (10.4%) and women (13.9%) and across racial and ethnic groups (4.7%-25.5%). The combined PAF was also different by age at diagnosis and ADRD subtypes, higher for younger (65-74 years: 43.2%) than older (75-84 years: 32.4%; ≥85 years: 11.3%) diagnoses and higher for vascular or unspecified ADRD than for AD or Lewy body dementia. An additional PAF of 11.8% (9.9-13.6) was associated with APOE ε4, which together with nongenetic risk factors accounted for 30.6% (25.8-35.1) of ADRD. DISCUSSION Known risk factors explained about a third of the ADRD cases but with unequal distributions across racial and ethnic groups.
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Affiliation(s)
- Song-Yi Park
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Veronica Wendy Setiawan
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Eileen M Crimmins
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Lon R White
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Anna H Wu
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Iona Cheng
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Burcu F Darst
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Christopher A Haiman
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Lynne R Wilkens
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Loїc Le Marchand
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Unhee Lim
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
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22
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Tsuzaki J, Maskarinec G, Mapa V, Shvetsov YB, Park SY, Monroe KR, Lim U, Le Marchand L, Boushey CJ. Diet Quality and Body Mass Index Over 20 Years in the Multiethnic Cohort. J Acad Nutr Diet 2024; 124:194-204. [PMID: 36758897 PMCID: PMC10404631 DOI: 10.1016/j.jand.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 01/15/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND With increasing rates of overweight and obesity and disparities by ethnicity, it is important to understand the role of diet in ameliorating this health problem. OBJECTIVE This study examined the relation of diet quality as measured by the Healthy Eating Index 2015 with body mass index (BMI; calculated as kg/m2) and obesity among participants of the Multiethnic Cohort (MEC) in cross-sectional analyses at 3 time points (T-1, T-2, and T-3) over 20 years. DESIGN In a subset of 1,860 MEC participants, 3 cross-sectional analyses at cohort entry (1993 to 1996, T-1) and follow-ups in 2003 to 2008 (T-2) and 2013 to 2016 (T-3) were performed. PARTICIPANTS/SETTING The cohort consists of African American, Native Hawaiian, Japanese American, Latino, and White adults in Hawaii and California; mean age was 48 years at T-1. MAIN OUTCOME MEASURE BMI and weight status in relation to diet quality were measured. STATISTICAL ANALYSIS Linear and multinomial logistic regressions were applied to analyze the relation of diet quality with BMI and obesity, while adjusting for known confounders. RESULTS Healthy Eating Index 2015 increased by 6.1 and 5.1 units for men and women, respectively, from T-1 to T-3; the respective values for BMI were 1.5 and 2.4. Diet quality was inversely associated with BMI across time: BMI was lower by -0.47, -0.72, and -0.92 units for every 10-point increase in Healthy Eating Index 2015 scores at T-1, T-2, and T-3, respectively (P < .0001 for all). During the 20 years, the association was consistently high among Japanese American participants (-0.79, -0.87, and -1.02) and weakest in African American cohort members (-0.34, -0.37, and -0.40). Higher diet quality was related to lower odds of having obesity at all 3 time points; prevalence odds ratios were 0.72, 0.57, and 0.60. CONCLUSIONS These findings suggest that consuming a high-quality diet is related to lower BMI and rates of overweight and obesity but with the strongest association at an older age. To understand the ethnic differences, investigations of dietary habits and behaviors and/or fat distribution patterns will be needed in the future.
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Affiliation(s)
- Jenna Tsuzaki
- University of Hawaii Cancer Center, Honolulu, Hawaii
| | | | | | | | - Song-Yi Park
- University of Hawaii Cancer Center, Honolulu, Hawaii
| | | | - Unhee Lim
- University of Hawaii Cancer Center, Honolulu, Hawaii
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23
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Kadam I, Nebie C, Dalloul M, Hittelman J, Fordjour L, Hoepner L, Futterman ID, Minkoff H, Jiang X. Maternal Lutein Intake during Pregnancies with or without Gestational Diabetes Mellitus and Cognitive Development of Children at 2 Years of Age: A Prospective Observational Study. Nutrients 2024; 16:328. [PMID: 38276566 PMCID: PMC10819807 DOI: 10.3390/nu16020328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/14/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
Lutein and its isomer zeaxanthin serve as antioxidants and preserve cognitive function during aging. However, whether lutein/zeaxanthin (L + Z) exposure early in life improves cognitive development of children is rarely explored. It is also unknown whether gestational diabetes mellitus (GDM), characterized by heightened oxidative stress, affects lutein metabolism. This prospective longitudinal cohort study examined the differences in L + Z intake and metabolism, as well as the association between maternal L + Z intake and children's cognitive development in GDM versus non-GDM pregnancies. Seventy-six pregnant women (n = 40 with GDM) were recruited between 25 and 33 weeks of gestation and dietary intakes were recorded. At delivery, cord blood was collected, and 2 years later, the Bayley III developmental test was conducted on a subset of children (n = 38). The results suggest that GDM reduced cord blood lutein levels at birth; L + Z intake during pregnancy was associated with better cognitive (β = 0.003, p = 0.001) and language (β = 0.002, p = 0.038) scoring of children at 2 years regardless of GDM status. In conclusion, maternal L + Z intake was positively associated with children's developmental scores, regardless of GDM. More studies are needed to confirm such associations.
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Affiliation(s)
- Isma’il Kadam
- PhD Program in Biochemistry, Graduate Center of the City University of New York, New York, NY 10016, USA;
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York, Brooklyn, NY 11210, USA;
| | - Chauntelle Nebie
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York, Brooklyn, NY 11210, USA;
| | - Mudar Dalloul
- Department of Obstetrics and Gynecology, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (M.D.); (H.M.)
| | - Joan Hittelman
- Department of Psychology, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA;
| | - Lawrence Fordjour
- Department of Pediatrics, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA;
| | - Lori Hoepner
- Department of Environmental and Occupational Health Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA;
| | - Itamar D. Futterman
- Departments of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA;
| | - Howard Minkoff
- Department of Obstetrics and Gynecology, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA; (M.D.); (H.M.)
- Departments of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA;
| | - Xinyin Jiang
- PhD Program in Biochemistry, Graduate Center of the City University of New York, New York, NY 10016, USA;
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York, Brooklyn, NY 11210, USA;
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24
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Zhao Y, Araki T. Diet quality and its associated factors among adults with overweight and obesity: findings from the 2015-2018 National Health and Nutrition Examination Survey. Br J Nutr 2024; 131:134-142. [PMID: 37462503 DOI: 10.1017/s0007114523001587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
The rate of adult severe obesity has been continually rising in the USA. While improving diet quality has been shown to reduce the risk of obesity, few studies have explored the differences in diet quality among adults with overweight and obesity by different weight statuses along with socio-demographic factors and physical activity using data from a nationally representative survey in the USA. The main goal of the study is to assess the diet quality of adults with overweight and obesity by examining differences in the Healthy Eating Index-2015 (HEI-2015) scores, using data from the 2015-2018 National Health and Nutrition Survey. Among 6746 adults with overweight and obesity (aged ≥ 20 years), severe obesity was prevalent (27 %), particularly among females, non-Hispanic Blacks and those with lower education and income. Compared to adults with overweight, adults with severe obesity had lower HEI-2015 total scores as well as component scores for total fruits, whole fruits, greens and beans, refined grains, sodium and saturated fats. Among adults with overweight and obesity, non-Hispanic Blacks had lower diet quality than non-Hispanic Asians; females had better diet quality than males; older adults had better diet quality than younger adults; adults with a college degree and above had better diet quality than those with less than a high school degree. Socio-demographic differences in diet quality and weight status should be considered in future obesity interventions to reduce adult severe obesity in the USA.
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Affiliation(s)
- Yajie Zhao
- International Agro-Informatics Laboratory, Department of Global Agricultural Sciences, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Bunkyo-ku, Japan
| | - Tetsuya Araki
- International Agro-Informatics Laboratory, Department of Global Agricultural Sciences, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Bunkyo-ku, Japan
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25
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Kang J, Moser DK, Lennie TA, Chung ML, Thomas DT, Biddle MJ. Diet Quality Mediates the Relationship Between Chronic Stress and Inflammation in Patients With Metabolic Syndrome. J Cardiovasc Nurs 2024:00005082-990000000-00159. [PMID: 38192030 PMCID: PMC11231055 DOI: 10.1097/jcn.0000000000001072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
BACKGROUND Chronic stress is associated with promotion of inflammation and development of metabolic syndrome, as well as deterioration of diet quality. Inflammation can be modified by changes in dietary intake. OBJECTIVE The aim of this study was to test the hypothesis that diet quality mediates the relationship of chronic stress with inflammation in patients with metabolic syndrome. METHODS Participants with metabolic syndrome (n = 73, 62 ± 12 years old, 71% female) completed questionnaires on chronic stress (Perceived Stress Scale-10) and diet quality (Healthy Eating Index-2020). The Perceived Stress Scale-10 was dichotomized. The Healthy Eating Index-2020 score was used as a continuous variable, and higher scores indicate better diet quality. Inflammation was assessed using plasma high-sensitivity C-reactive protein (log-transformed). We used PROCESS in SPSS to test the hypothesis. RESULTS Patients in the higher stress group had lower Healthy Eating Index-2020 scores (worse diet quality) than those in the lower stress group (57 ± 13 vs 64 ± 10, P = .01). Diet quality mediated the relationship between chronic stress and inflammation (indirect effect, 0.211; 95% bootstrap confidence interval, 0.006-0.496). Higher stress was associated with lower diet quality (effect, -7.152; 95% confidence interval, -13.168 to -1.137) that was associated with increased inflammation (effect, -0.030; 95% confidence interval, -0.052 to -0.007). CONCLUSIONS Our findings show the important role of diet quality in the relationship of chronic stress with inflammation in patients with metabolic syndrome. Healthcare providers should encourage patients with higher stress to improve diet quality, which can decrease inflammation.
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Affiliation(s)
- JungHee Kang
- College of Nursing, University of Kentucky, 2201 Regency Rd, Suite 403, Lexington, KY 40503, USA
| | - Debra K. Moser
- College of Nursing, University of Kentucky, 2201 Regency Rd, Suite 403, Lexington, KY 40503, USA
| | - Terry A. Lennie
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY 40536, USA
| | - Misook L. Chung
- College of Nursing, University of Kentucky, 2201 Regency Rd, Suite 403, Lexington, KY 40503, USA
| | - D. Travis Thomas
- Department of Athletic Training and Clinical Nutrition, College of Health Sciences, University of Kentucky, 214D, Wethington Building, Lexington, KY 40536, USA
| | - Martha J. Biddle
- College of Nursing, University of Kentucky, 2201 Regency Rd, Suite 403, Lexington, KY 40503, USA
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26
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Peterson LL, Ligibel JA. Dietary and serum advanced glycation end-products and clinical outcomes in breast cancer. Biochim Biophys Acta Rev Cancer 2024; 1879:188995. [PMID: 37806640 DOI: 10.1016/j.bbcan.2023.188995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/31/2023] [Accepted: 09/27/2023] [Indexed: 10/10/2023]
Abstract
One in five women with breast cancer will relapse despite ideal treatment. Body weight and physical activity are strongly associated with recurrence risk, thus lifestyle modification is an attractive strategy to improve prognosis. Trials of dietary modification in breast cancer are promising but the role of specific diets is unclear, as is whether high-quality diet without weight loss can impact prognosis. Advanced glycation end-products (AGEs) are compounds produced in the body during sugar metabolism. Exogenous AGEs, such as those found in food, combined with endogenous AGEs, make up the total body AGE load. AGEs deposit in tissues over time impacting cell signaling pathways and altering protein functions. AGEs can be measured or estimated in the diet and measured in blood through their metabolites. Studies demonstrate an association between AGEs and breast cancer risk and prognosis. Here, we review the clinical data on dietary and serum AGEs in breast cancer.
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Affiliation(s)
- Lindsay L Peterson
- Washington University School of Medicine, Division of Medical Oncology, Siteman Cancer Center, 660 S. Euclid Avenue, Campus Box 8056, St. Louis, MO 63110, United States of America.
| | - Jennifer A Ligibel
- Dana-Farber Cancer Institute, Department of Medical Oncology, Harvard Medical School, Boston, MA, United States of America
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Wang S, Xia BX, Luo T, Wang P. Association between physical activity and diet quality of obese and non-obese MAFLD. Nutr Metab Cardiovasc Dis 2024; 34:75-89. [PMID: 37949716 DOI: 10.1016/j.numecd.2023.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 07/04/2023] [Accepted: 07/15/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND AND AIM Clinical data on the prevalence of metabolic-associated fatty liver disease (MAFLD) in obese and non-obese individuals within a diverse US population is scarce. Furthermore, the influence of physical activity (PA) and dietary quality (DQ) on MAFLD risk remains unclear. This study aims to assess the prevalence and clinical features of MAFLD and examine the relationship between PA and DQ with the risk of developing MAFLD. METHODS AND RESULTS A cross-sectional analysis of data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) was conducted. The overall MAFLD prevalence was 41.9%, with 28.6% of participants being obese and 13.4% non-obese. Among those with MAFLD, 67.1% (95% confidence interval (CI): 59.1%-75.1%) were obese, and 32.9% (95% CI: 29.1%-36.7%) were non-obese. Non-obese MAFLD was more frequent in Asians (27.2%), while obese MAFLD was more prevalent in Blacks (66.3%). Metabolic comorbidities were more common in individuals with obese MAFLD, who also exhibited more advanced fibrosis. A high-quality diet (HQD) and increased PA were linked to reduced odds of both obese and non-obese MAFLD (odds ratio (OR) and 95% CI: 0.67 [0.51-0.88] and 0.57 [0.47-0.69]; 0.62 [0.43-0.90] and 0.63 [0.46-0.87], respectively). PA and HQD significantly decreased the risk of obese and non-obese MAFLD (OR and 95% CI: 0.46 [0.33-0.64] and 0.42 [0.31-0.57]). CONCLUSION A substantial proportion of the US population is affected by both obese and non-obese MAFLD. A strong association exists between a lower risk of both types of MAFLD and adherence to an HQD and engagement in PA.
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Affiliation(s)
- Shuang Wang
- Department of Geriatrics, The People's Hospital of Changshou, Chongqing, China
| | - Bing Xin Xia
- Department of Geriatrics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tingting Luo
- Department of Gynaecology, Three Gorges Hospital, Chongqing, China
| | - Peng Wang
- Department of Geriatrics, The People's Hospital of Changshou, Chongqing, China.
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Donofry SD, Jouppi RJ, Call CC, Conlon RPK, Levine MD. Improvements in cardiovascular health over the perinatal period predicts lower postpartum psychological distress. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.22.23300475. [PMID: 38234856 PMCID: PMC10793538 DOI: 10.1101/2023.12.22.23300475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Background Adverse cardiovascular events during pregnancy (e.g., pre-eclampsia) occur at higher rates among individuals with pre-pregnancy overweight or obesity (body mass index [BMI]≥25kg/m2) and have been associated with postpartum depression. However, it is unclear whether cardiovascular health (CVH), defined more holistically than the absence of cardiovascular conditions in pregnancy, relates to postpartum psychological functioning. The present study examined whether changes in CVH during the perinatal period predicted postpartum psychological functioning among individuals with pre-pregnancy BMI≥25kg/m2. Methods Individuals (N=226; Mage=28.43±5.4 years; MBMI=34.17±7.15kg/m2) were recruited when their pregnancies were 12-20 weeks gestation (M=15.64±2.45 weeks) for a longitudinal study of health and well-being. Participants completed the Center for Epidemiological Studies Depression Scale (CES-D) and Perceived Stress Scale (PSS) and reported on CVH behaviors (dietary intake, physical activity, nicotine exposure, and sleep) at baseline and at 6-months postpartum. BMI and CVH behaviors were coded according to the American Heart Association's Life's Essential 8 to create a CVH score at both timepoints. Linear regression analyses were performed to examine whether change in CVH related to postpartum CES-D and PSS scores. Because sleep was only measured in a subset of participants (n=114), analyses were conducted with and without sleep included. Baseline CVH, CES-D and PSS scores, and demographic factors were included as covariates in all models. Results Improved CVH was associated with lower postpartum CES-D (β=-0.18, p<0.01) and PSS (β=-0.13, p=0.02) scores when excluding sleep. Compared to those whose CVH improved by >1SD from pregnancy to 6-months postpartum, individuals whose CVH worsened by >1SD scored 6.42 points higher on the CESD (MCESD=15.25±10.92 vs. 8.52±6.90) and 6.12 points higher on the PSS (MPSS=24.45±8.29 vs. 17.83±8.70). However, when including sleep, these relationships were no longer significant (ps>0.4). Conclusions Improvements in CVH from early pregnancy to 6-months postpartum were associated with lower postpartum depressive symptoms and perceived stress. However, these relationships were no longer significant when including sleep in the CVH metric, potentially due to the large reduction in sample size. These data suggest that intervening during pregnancy to promote CVH may improve postpartum psychological functioning among high-risk individuals.
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Affiliation(s)
- Shannon D. Donofry
- RAND Corporation, Pittsburgh, PA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Riley J. Jouppi
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Christine C. Call
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Michele D. Levine
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA
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Murakami K, Shinozaki N, Livingstone MBE, Yuan X, Tajima R, Matsumoto M, Masayasu S, Sasaki S. Associations of food choice values and food literacy with overall diet quality: a nationwide cross-sectional study in Japanese adults. Br J Nutr 2023; 130:1795-1805. [PMID: 37017207 PMCID: PMC10587391 DOI: 10.1017/s000711452300082x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/28/2023] [Accepted: 03/22/2023] [Indexed: 04/06/2023]
Abstract
To date, a limited number of studies have examined aspects of food choice values and food literacy in relation to some aspects of dietary behaviours. The aim of this cross-sectional study was to comprehensively examine the associations of food choice values and food literacy with diet quality. In total, 2231 Japanese adults aged 19-80 years completed questionnaires asking about food choice values (accessibility, convenience, health/weight control, tradition, sensory appeal, organic, comfort and safety) and food literacy characterised by nutrition knowledge, cooking skills, food skills and eating behaviours (hunger, food responsiveness, emotional overeating, enjoyment of food, satiety responsiveness, emotional undereating, food fussiness and slowness in eating). As a measure of diet quality, the Healthy Eating Index-2015 (HEI-2015) was calculated using a brief-type diet history questionnaire (BDHQ) or a food combination questionnaire (FCQ). In males, after adjustment for potential confounding factors (including age, BMI and the ratio of reported energy intake to estimated energy requirement), the HEI-2015 derived from BDHQ and that derived from FCQ were associated significantly (P ≤ 0·02) and positively with the food choice values of organic and inversely with food fussiness. In females, the HEI-2015 showed positive associations with the food choice values of health/weight control, nutrition knowledge and cooking skills and an inverse association with food fussiness, irrespective of the dietary assessment questionnaire (P ≤ 0·03). In conclusion, this study suggests that several aspects of food choice values and food literacy were associated with diet quality, and the aspects related differed between males and females.
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Affiliation(s)
- Kentaro Murakami
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo113-0033, Japan
| | - Nana Shinozaki
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo113-0033, Japan
| | - M. Barbara E. Livingstone
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, ColeraineBT52 1SA, UK
| | - Xiaoyi Yuan
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Biomedical Innovation, Health and Nutrition, Tokyo162-8636, Japan
| | - Ryoko Tajima
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Biomedical Innovation, Health and Nutrition, Tokyo162-8636, Japan
| | - Mai Matsumoto
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Biomedical Innovation, Health and Nutrition, Tokyo162-8636, Japan
| | | | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo113-0033, Japan
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Kamari N, Fateh HL, Pasdar Y, Rezaeian S, Shakiba E, Najafi F. Bone mineral density and muscle mass associated with healthy eating index in postmenopausal women; results from RaNCD cohort study. BMC Womens Health 2023; 23:615. [PMID: 37978520 PMCID: PMC10657131 DOI: 10.1186/s12905-023-02774-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The Healthy Eating Index 2015 (HEI-2015) is a tool for checking the quality of diet. This index is used to examine how well people's dietary behavior fits certain criteria for achieving a healthy diet in Dietary Guidelines for Americans 2015-2020. We look at the possible association between the HEI-2015 and bone mineral density (BMD) and muscle strength in postmenopausal women. METHODS This research included 1012 postmenopausal women from the recruitment phase of the Ravansar Noncommunicable Diseases (RaNCD) cohort study in Kermanshah-Iran. A standardized and repeatable food-frequency questionnaire (FFQ) that contains 118 items was used to quantify dietary consumption. Anthropometric indices measured via Bio-Impedance Analyzer BIA (Inbody 770, Inbody Co, Seoul, Korea). RESULT The mean age of postmenopausal women was (56.41 ± 5.31) years. Participants in the highest quartile had a more daily energy intake compared to the lowest quartile (2329.89 ± 837.59), (P < 0.001). Women in the upper quartiles had greater Skeletal Muscle Mass (SMM) than those in the lower quartiles (21.61 ± 2.80 vs 20.52 ± 3.13; p = 0.0002). The linear model didn't show a significant relationship between HEI score and greater BMD (β = 0.0014, P = 0.169). CONCLUSION A diet of high quality followed by a high HEL-2015 score was shown to be strongly connected to increased BMD and muscle mass in Kurdish postmenopausal women.
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Affiliation(s)
- Negin Kamari
- School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hawal Lateef Fateh
- Nursing Department, Kalar Technical College, Garmian Polytechnic University, Kalar, Kurdistan region, Iraq
| | - Yahya Pasdar
- School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahab Rezaeian
- Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ebrahim Shakiba
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Grummon AH, Lee CJY, Robinson TN, Rimm EB, Rose D. Simple dietary substitutions can reduce carbon footprints and improve dietary quality across diverse segments of the US population. NATURE FOOD 2023; 4:966-977. [PMID: 37884673 PMCID: PMC10725296 DOI: 10.1038/s43016-023-00864-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 09/19/2023] [Indexed: 10/28/2023]
Abstract
Changing what foods we eat could reduce environmental harms and improve human health, but sweeping dietary change is challenging. We used dietary intake data from a nationally representative sample of 7,753 US children and adults to identify simple, actionable dietary substitutions from higher- to lower-carbon foods (for example, substituting chicken for beef in mixed dishes such as burritos, but making no other changes to the diet). We simulated the potential impact of these substitutions on dietary carbon emissions and dietary quality. If all consumers who ate the high-carbon foods instead consumed a lower-carbon substitute, the total dietary carbon footprint in the United States would be reduced by more than 35%. Moreover, if adopted, these substitutions would improve consumers' overall dietary quality by 4-10%, with benefits projected for all age, gender, and racial and ethnic groups. These results suggest that a 'small changes' approach could be a valuable starting point for addressing diet's impact on climate and health.
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Affiliation(s)
- Anna H Grummon
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
- Department of Health Policy, Stanford University School of Medicine, Stanford, CA, USA.
| | - Cristina J Y Lee
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Thomas N Robinson
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Eric B Rimm
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Donald Rose
- Tulane Nutrition, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
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Melo Herrera Y, Tovar A, Oaks BM, Quashie NT, Vadiveloo M. Associations between Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Maternal Diet Quality. J Nutr 2023; 153:3317-3326. [PMID: 37604386 DOI: 10.1016/j.tjnut.2023.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/25/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND An objective of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is to improve maternal diet quality, but its effectiveness remains unclear. Better understanding how WIC participation shapes women's diet quality is crucial given that maternal diet plays a critical role in determining mothers' and children's short- and long-term overall health. OBJECTIVES This study aimed to compare the diet quality of WIC-participating women to WIC-eligible nonparticipating women and higher-income pregnant and postpartum women using a nationally representative sample. METHODS This was a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) 2011-2018 cycles. Women aged 20 to 44 with at least one 24-h recall and complete data on pregnancy and postpartum status and WIC participation were included (n = 626). Diet quality was evaluated using the Healthy Eating Index-2015 (HEI-2015). Multivariable Tukey-adjusted linear models were used to compare HEI-2015 total and component scores between groups. Models were adjusted for age, pregnancy and postpartum status, breastfeeding status, race and ethnicity, and food security. RESULTS Most women were postpartum and not pregnant (75%), nonbreastfeeding (60%), identified as non-Hispanic White (58%), and food secure (64%). WIC participants, WIC-eligible nonparticipants, and income-ineligible women had mean Total HEI-2015 scores of 52.7 (95% confidence interval [CI]: 50.6, 54.8), 54.2 (95% CI: 51.6, 56.7), and 55.0 (95% CI: 51.8, 58.2), respectively. There were no differences between groups for total and most component scores. Income-ineligible women had better Fatty Acids scores (5.7; 95% CI: 5.0, 6.4) than WIC participants (4.7; 95% CI: 4.1, 5.3; P < 0.05). WIC-eligible nonparticipants had better Refined Grains scores (6.0; 95% CI: 5.3, 6.6) than WIC participants (5.0; 95% CI: 4.4, 5.6; P < 0.05). CONCLUSIONS Overall diet quality was similar across WIC and income groups. Lower HEI-2015 component scores for WIC participants compared with WIC-eligible nonparticipants warrant further exploration. Research evaluating WIC's impact on maternal diet quality is needed to ensure continued support for low-income women's health.
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Affiliation(s)
- Yarisbel Melo Herrera
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, United States
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Brietta M Oaks
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, United States
| | - Nekehia T Quashie
- Department of Health Studies, University of Rhode Island, Kingston, RI, United States
| | - Maya Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, United States.
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Wang YB, Page AJ, Gill TK, Melaku YA. The association between diet quality, plant-based diets, systemic inflammation, and mortality risk: findings from NHANES. Eur J Nutr 2023; 62:2723-2737. [PMID: 37347305 PMCID: PMC10468921 DOI: 10.1007/s00394-023-03191-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/02/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE To our knowledge, no studies have examined the association of diet quality and plant-based diets (PBD) with inflammatory-related mortality in obesity. Therefore, this study aimed to determine the joint associations of Healthy Eating Index-2015 (HEI-2015), plant-based dietary index (PDI), healthy PDI (hPDI), unhealthy PDI (uPDI), pro-vegetarian dietary index (PVD), and systemic inflammation with all-cause, cardiovascular disease (CVD), and cancer mortality risks by obesity status. METHODS Participants from NHANES were included in cross-sectional (N = 27,915, cycle 1999-2010, 2015-2018) and longitudinal analysis (N = 11,939, cycle 1999-2008). HEI-2015, PDI, hPDI, uPDI, and PVD were constructed based on the 24-h recall dietary interview. The grade of inflammation (low, moderate, and high) was determined based on C-reactive protein (CRP) values and multivariable ordinal logistic regression was used to determine the association. Cox proportional hazard models were used to determine the joint associations of diet and inflammation with mortality. RESULTS In the fully adjusted model, HEI-2015 (ORT3vsT1 = 0.76, 95% CI 0.69-0.84; p-trend = < 0.001), PDI (ORT3vsT1 = 0.83, 95% CI 0.75-0.91; p trend = < 0.001), hPDI (ORT3vsT1 = 0.79, 95% CI 0.71-0.88; p trend = < 0.001), and PVD (ORT3vsT1 = 0.85, 95% CI 0.75-0.97; p trend = 0.02) were associated with lower systemic inflammation. In contrast, uPDI was associated with higher systemic inflammation (ORT3vsT1 = 1.18, 95% CI 1.06-1.31; p-trend = 0.03). Severe inflammation was associated with a 25% increase in all-cause mortality (ORT3vsT1 = 1.25, 95% CI 1.03-1.53, p trend = 0.02). No association was found between PDI, hPDI, uPDI, and PVD with mortality. The joint association, between HEI-2015, levels of systemic inflammation, and all-cause, CVD and cancer mortality, was not significant. However, a greater reduction in mortality risk with an increase in HEI-2015 scores was observed in individuals with low and moderate inflammation, especially those with obesity. CONCLUSION Higher scores of HEI-2015 and increased intake of a healthy plant-based diet were associated with lower inflammation, while an unhealthy plant-based diet was associated with higher inflammation. A greater adherence to the 2015 dietary guidelines may reduce the risk of mortality associated with inflammation and may also benefit individuals with obesity who had low and moderate inflammation.
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Affiliation(s)
- Yoko Brigitte Wang
- Vagal Afferent Research Group, School of Biomedicine, University of Adelaide, Adelaide, SA, Australia.
- Nutrition, Diabetes & Gut Health, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.
- Department of Cellular and Integrative Physiology, Long School of Medicine, UT Health Science Center at San Antonio, San Antonio, TX, 78229, USA.
| | - Amanda J Page
- Vagal Afferent Research Group, School of Biomedicine, University of Adelaide, Adelaide, SA, Australia
- Nutrition, Diabetes & Gut Health, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Tiffany K Gill
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Yohannes Adama Melaku
- Nutrition, Diabetes & Gut Health, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- FHMRI Sleep Health, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
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Deierlein AL, Litvak J, Liu C, Stein CR. Diet quality, diet-related factors and disability status among male adults of reproductive age in the USA. Public Health Nutr 2023; 26:1976-1985. [PMID: 37395178 PMCID: PMC10564594 DOI: 10.1017/s1368980023001222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 05/19/2023] [Accepted: 06/09/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To examine diet quality and diet-related factors among male adults of reproductive age with and without disabilities. DESIGN Cross-sectional data from the National Health and Nutrition Examination Surveys, 2013-2018. SETTING Disability was reported as serious difficulty hearing, seeing, concentrating, walking, dressing and/or running errands due to physical, mental or emotional conditions. Diet quality was assessed by the Healthy Eating Index (HEI)-2015 and diet-related factors included self-rated diet healthfulness, food security and food assistance programmes. Multivariable linear regression estimated differences in HEI-2015 scores. Multivariable Poisson regression estimated adjusted prevalence ratios (aPR) and 95 % CI for diet-related factors. PARTICIPANTS In total, 3249 males, 18-44 years; of whom, 441 (13·4 %) reported having disabilities. RESULTS Compared with males without disabilities, those with disabilities had a 2·69-point (95 % CI: -4·18, -1·20) lower mean total HEI-2015 score and approximately one-third to half of a point lower HEI-2015 component scores for greens and beans, total protein foods, seafood and plant proteins, fatty acids and added sugars. Males with any disabilities were more likely to have low food security (aPR = 1·57; 95 % CI: 1·28, 2·92); household participation in food assistance programmes (aPR = 1·61; 95 % CI: 1·34, 1·93) and consume fast food meals during the previous week (1-3 meals: aPR = 1·11; 95 % CI: 1·01-1·21 and 4 or more meals: aPR = 1·18; 95 % CI: 1·01-1·38) compared with males with no disabilities. CONCLUSIONS Factors affecting diet and other modifiable health behaviours among male adults of reproductive age with disabilities require further investigation. Health promotion strategies that are adaptive to diverse populations within the disability community are needed.
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Affiliation(s)
| | - Jaqueline Litvak
- School of Global Public Health, New York University, New York, NY, USA
| | - Chang Liu
- School of Global Public Health, New York University, New York, NY, USA
| | - Cheryl R Stein
- Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
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Kadam I, Dalloul M, Hausser J, Huntley M, Hoepner L, Fordjour L, Hittelman J, Saxena A, Liu J, Futterman ID, Minkoff H, Jiang X. Associations between nutrients in one-carbon metabolism and fetal DNA methylation in pregnancies with or without gestational diabetes mellitus. Clin Epigenetics 2023; 15:137. [PMID: 37633918 PMCID: PMC10464204 DOI: 10.1186/s13148-023-01554-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/14/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM), characterized by hyperglycemia that develops during pregnancy, increases the risk of fetal macrosomia, childhood obesity and cardiometabolic disorders later in life. This process has been attributed partly to DNA methylation modifications in growth and stress-related pathways. Nutrients involved with one-carbon metabolism (OCM), such as folate, choline, betaine, and vitamin B12, provide methyl groups for DNA methylation of these pathways. Therefore, this study aimed to determine whether maternal OCM nutrient intakes and levels modified fetal DNA methylation and in turn altered fetal growth patterns in pregnancies with and without GDM. RESULTS In this prospective study at a single academic institution from September 2016 to June 2019, we recruited 76 pregnant women with and without GDM at 25-33 weeks gestational age and assessed their OCM nutrient intake by diet recalls and measured maternal blood OCM nutrient levels. We also collected placenta and cord blood samples at delivery to examine fetal tissue DNA methylation of the genes that modify fetal growth and stress response such as insulin-like growth factor 2 (IGF2) and corticotropin-releasing hormone (CRH). We analyzed the association between maternal OCM nutrients and fetal DNA methylation using a generalized linear mixed model. Our results demonstrated that maternal choline intake was positively correlated with cord blood CRH methylation levels in both GDM and non-GDM pregnancies (r = 0.13, p = 0.007). Further, the downstream stress hormone cortisol regulated by CRH was inversely associated with maternal choline intake (r = - 0.36, p = 0.021). Higher maternal betaine intake and serum folate levels were associated with lower cord blood and placental IGF2 DNA methylation (r = - 0.13, p = 0.049 and r = - 0.065, p = 0.034, respectively) in both GDM and non-GDM pregnancies. Further, there was an inverse association between maternal betaine intake and birthweight of infants (r = - 0.28, p = 0.015). CONCLUSIONS In conclusion, we observed a complex interrelationship between maternal OCM nutrients and fetal DNA methylation levels regardless of GDM status, which may, epigenetically, program molecular pathways related to fetal growth and stress response.
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Affiliation(s)
- Isma'il Kadam
- Departments of Health and Nutrition Sciences, Brooklyn College of City University of New York, 2900 Bedford Ave, Brooklyn, NY, 11210, USA
| | - Mudar Dalloul
- Department of Obstetrics and Gynecology, State University of New York Downstate Health Sciences University, Brooklyn, NY, 11203, USA
| | - Jeanette Hausser
- Departments of Health and Nutrition Sciences, Brooklyn College of City University of New York, 2900 Bedford Ave, Brooklyn, NY, 11210, USA
| | - Monique Huntley
- Departments of Health and Nutrition Sciences, Brooklyn College of City University of New York, 2900 Bedford Ave, Brooklyn, NY, 11210, USA
| | - Lori Hoepner
- Department of Environmental and Occupational Health Sciences, State University of New York Downstate Health Sciences University, Brooklyn, NY, 11203, USA
| | - Lawrence Fordjour
- Department of Pediatrics, State University of New York Downstate Health Sciences University, Brooklyn, NY, 11203, USA
| | - Joan Hittelman
- Department of Psychology, State University of New York Downstate Health Sciences University, Brooklyn, NY, 11203, USA
| | - Anjana Saxena
- Departments of Biology, Brooklyn College of City University of New York, Brooklyn, USA
| | - Jia Liu
- Neuroscience Initiative, Advanced Science Research Center at the Graduate Center of the CUNY, New York, NY, 10031, USA
| | - Itamar D Futterman
- Division of Maternal Fetal Medicine, Departments of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, USA
| | - Howard Minkoff
- Department of Obstetrics and Gynecology, State University of New York Downstate Health Sciences University, Brooklyn, NY, 11203, USA
- Division of Maternal Fetal Medicine, Departments of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, USA
| | - Xinyin Jiang
- Departments of Health and Nutrition Sciences, Brooklyn College of City University of New York, 2900 Bedford Ave, Brooklyn, NY, 11210, USA.
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Kang M, Boushey CJ, Shvetsov YB, Setiawan VW, Paik HY, Wilkens LR, Le Marchand L, Park SY. Changes in Diet Quality over 10 Years and Subsequent Mortality from Cardiovascular Disease in the Multiethnic Cohort Study. Nutrients 2023; 15:3482. [PMID: 37571419 PMCID: PMC10421371 DOI: 10.3390/nu15153482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023] Open
Abstract
This study investigated how diet quality changes over a ten-year period, assessed using the following four diet quality indexes, the Healthy Eating Index-2015 (HEI-2015), Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH), were related to mortality from cardiovascular disease (CVD) in the Multiethnic Cohort Study. The analysis included 61,361 participants who completed both the 1993-1996 baseline survey and the 2003-2008 10-year follow-up surveys. Over the mean follow-up period of 13 years after the 10-year survey, 4174 deaths from CVD were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox models. Increases in diet quality scores were associated with a reduced risk of CVD mortality for all indexes: HRs per one SD increment of 0.94 to 0.99 (HR (95% CI), 0.96 (0.92-1.01) for HEI-2015, 0.96 (0.91-1.01) for AHEI-2010, 0.99 (0.94-1.04) for aMED, and 0.94 (0.89-0.99) for DASH) in men and 0.88 to 0.92 (0.88 (0.84-0.92) for HEI-2015, 0.90 (0.85-0.95) for AHEI-2010, 0.89 (0.84-0.95) for aMED, and 0.92 (0.87-0.96) for DASH) in women. The inverse association generally did not vary by race and ethnicity, age, body mass index, smoking, and hypertension in each sex. Our findings suggest that improving diet quality and maintaining a high-quality diet over time may help reduce the risk of CVD mortality and could also be beneficial for those at higher risk of CVD.
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Affiliation(s)
- Minji Kang
- Department of Food and Nutrition, Duksung Women’s University, Seoul 01369, Republic of Korea
| | - Carol J. Boushey
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (C.J.B.); (Y.B.S.); (L.R.W.); (L.L.M.); (S.-Y.P.)
| | - Yurii B. Shvetsov
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (C.J.B.); (Y.B.S.); (L.R.W.); (L.L.M.); (S.-Y.P.)
| | - Veronica W. Setiawan
- Department of Population and Public Health Sciences, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089, USA;
| | - Hee-Young Paik
- Department of Food and Nutrition, Seoul National University, Seoul 08826, Republic of Korea;
- Center for Gendered Innovations for Science and Technology Research (GISTeR), Korea Federation of Women’s Science & Technology Associations, Seoul 06130, Republic of Korea
| | - Lynne R. Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (C.J.B.); (Y.B.S.); (L.R.W.); (L.L.M.); (S.-Y.P.)
| | - Loïc Le Marchand
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (C.J.B.); (Y.B.S.); (L.R.W.); (L.L.M.); (S.-Y.P.)
| | - Song-Yi Park
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (C.J.B.); (Y.B.S.); (L.R.W.); (L.L.M.); (S.-Y.P.)
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Amini Kahrizsangi M, Jafari F, Najam W, Safarpour AR, Fattahi MR, Nouri M, Ghalandari H, Askarpour M, Hamidian Shirazi M, Amini MR, Akbarzadeh M. Adherence to a healthy diet and odds of metabolic syndrome: A cross-sectional study. Clin Nutr ESPEN 2023; 56:180-186. [PMID: 37344071 DOI: 10.1016/j.clnesp.2023.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 05/12/2023] [Accepted: 05/23/2023] [Indexed: 06/23/2023]
Abstract
INTRODUCTION Metabolic syndrome (MetS) is a major health concern around the world. Dietary factors, including diet quality, play a significant role in its pathophysiology. Healthy Eating Index (HEI) is a tool used as a valid measurement of the individual's diet quality. We aimed at investigating the relationship between diet quality as assessed by HEI-2015 and the risk of MetS and its components in a cross-sectional sample of suburban individuals from PERSIAN Kavar cohort study (PKCS), Fars province, Iran. METHODS 2225 individuals meeting the eligibility criteria participated in the study. The relevant data were obtained from the baseline phase of PKCS. MetS was defined according to cut-offs presented by the National Cholesterol Education Program Adult Treatment Panel III (ATP III). HEI-2015 was calculated for the included individuals. Odds ratios were estimated. P-values <0.05 were considered as significant. RESULTS The overall prevalence of MetS was 27.3%. Individuals with lower HEI-2015 scores had higher odds for MetS and its components. We observed that those who were categorized as the top HEI-2015 tertile had 42% (OR: 0.58; 95% CI: 0.38-0.90) lower odds of high blood pressure in the overall population. Also, the odds of high serum triacylglycerol was lower (OR: 0.72; 95% CI: 0.57-0.90) in those with the highest HEI-2015 scores. CONCLUSION We found that higher dietary quality measured by HEI will decrease the risk of developing MetS, hypertension, and hypertriglyceridemia among Iranian adults. However, future interventional studies are required to further elucidate the issue.
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Affiliation(s)
- Masoud Amini Kahrizsangi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Jafari
- Department of Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, TX, United States
| | - Wasiuddin Najam
- Department of Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, TX, United States
| | - Ali Reza Safarpour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Fattahi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehran Nouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Ghalandari
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Moein Askarpour
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Hamidian Shirazi
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Amini
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Akbarzadeh
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Mohammadi A, Darbandi M, Pasdar Y, Mohebi M, Kamari N, Ziaei N, Najafi F. The Healthy Eating Index and oral health among adults: a cross-sectional study from an Iranian RaNCD cohort data. Sci Rep 2023; 13:11706. [PMID: 37474607 PMCID: PMC10359248 DOI: 10.1038/s41598-023-37168-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/17/2023] [Indexed: 07/22/2023] Open
Abstract
This study was conducted to investigate the association between decayed, missing, and filled teeth (DMFT) index and nutritional status measured by Healthy Eating Index 2015 (HEI-2015), in Iranian adults. In this cross-sectional study, data from the Ravansar non-communicable diseases cohort study were analyzed. DMFT index was employed as a measurement of oral health. The HEI-2015 score was calculated based on data obtained from Food Frequency Questionnaire and categorized into quartiles. Linear regression models were used to assess the association between HEI-2015 and DMFT. From total of 7549 participants with the mean age of 45.65 ± 7.70, 3741 of them were female (49.56%). The mean of DMFT in the highest quartile of HEI-2015 was lower than the lowest quartile (12.64 ± 7.04 vs. 14.29 ± 7.54, P < 0.001). The mean of DMFT in subject who had higher socioeconomic status (SES (was significantly lower than those with low SES (P < 0.001). The mean of DMFT in the lowest quartile of HEI-2015 was significantly lower than in the highest quartile, after adjusting for confounding variables (ß = - 0.11, 95% CI - 0.54, - 0.30). The increasing dairy intake (β = - 0.08, 95% CI - 0.13, - 0.03) was associated with decreasing DMFT score and increasing refined grains (β = 0.20, 95% CI 0.02, 0.35) and sodium (β = 0.07, 95% CI 0.02, 0.12) intake was significantly associated with increasing DMFT score. A healthy diet was associated with a decrease in DMFT score in the studied population. Following a healthy diet is recommended for oral health.
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Affiliation(s)
- Arash Mohammadi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Darbandi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahsa Mohebi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Negin Kamari
- Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Narges Ziaei
- Periodontology Department, Dental School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Petrone BL, Aqeel A, Jiang S, Durand HK, Dallow EP, McCann JR, Dressman HK, Hu Z, Tenekjian CB, Yancy WS, Lin PH, Scialla JJ, Seed PC, Rawls JF, Armstrong SC, Stevens J, David LA. Diversity of plant DNA in stool is linked to dietary quality, age, and household income. Proc Natl Acad Sci U S A 2023; 120:e2304441120. [PMID: 37368926 PMCID: PMC10319039 DOI: 10.1073/pnas.2304441120] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/10/2023] [Indexed: 06/29/2023] Open
Abstract
Eating a varied diet is a central tenet of good nutrition. Here, we develop a molecular tool to quantify human dietary plant diversity by applying DNA metabarcoding with the chloroplast trnL-P6 marker to 1,029 fecal samples from 324 participants across two interventional feeding studies and three observational cohorts. The number of plant taxa per sample (plant metabarcoding richness or pMR) correlated with recorded intakes in interventional diets and with indices calculated from a food frequency questionnaire in typical diets (ρ = 0.40 to 0.63). In adolescents unable to collect validated dietary survey data, trnL metabarcoding detected 111 plant taxa, with 86 consumed by more than one individual and four (wheat, chocolate, corn, and potato family) consumed by >70% of individuals. Adolescent pMR was associated with age and household income, replicating prior epidemiologic findings. Overall, trnL metabarcoding promises an objective and accurate measure of the number and types of plants consumed that is applicable to diverse human populations.
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Affiliation(s)
- Brianna L. Petrone
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
- Medical Scientist Training Program, Duke University School of Medicine, Durham, NC27710
| | - Ammara Aqeel
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Sharon Jiang
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Heather K. Durand
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Eric P. Dallow
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Jessica R. McCann
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
| | - Holly K. Dressman
- Duke Microbiome Core Facility, Center for Genomic and Computational Biology, Duke University, Durham, NC27710
| | - Zhengzheng Hu
- Duke Microbiome Core Facility, Center for Genomic and Computational Biology, Duke University, Durham, NC27710
| | | | - William S. Yancy
- Duke Lifestyle and Weight Management Center, Durham, NC27710
- Department of Medicine, Duke University School of Medicine, Durham, NC27710
| | - Pao-Hwa Lin
- Department of Medicine, Nephrology Division, Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, NC27705
| | - Julia J. Scialla
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA22903
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA22903
| | - Patrick C. Seed
- Division of Pediatric Infectious Diseases, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL60611
| | - John F. Rawls
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
- Duke Microbiome Center, Duke University School of Medicine, Durham, NC27710
| | - Sarah C. Armstrong
- Department of Pediatrics, Duke University School of Medicine, Durham, NC27710
| | - June Stevens
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC27599
| | - Lawrence A. David
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC27710
- Duke Microbiome Center, Duke University School of Medicine, Durham, NC27710
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Haslam DE, John EM, Knight JA, Li Z, Buys SS, Andrulis IL, Daly MB, Genkinger JM, Terry MB, Zhang FF. Diet Quality and All-Cause Mortality in Women with Breast Cancer from the Breast Cancer Family Registry. Cancer Epidemiol Biomarkers Prev 2023; 32:678-686. [PMID: 36857773 PMCID: PMC10066732 DOI: 10.1158/1055-9965.epi-22-1198] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND The impact of diet on breast cancer survival remains inconclusive. We assessed associations of all-cause mortality with adherence to the four diet quality indices: Healthy Eating Index-2015 (HEI-2015), Alternative Healthy Eating Index (AHEI), Alternative Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH). METHODS Dietary intake data were evaluated for 6,157 North American women enrolled in the Breast Cancer Family Registry who had been diagnosed with invasive breast cancer from 1993 to 2011 and were followed through 2018. Pre-diagnosis (n = 4,557) or post-diagnosis (n = 1,600) dietary intake was estimated through a food frequency questionnaire. During a median follow-up time of 11.3 years, 1,265 deaths occurred. Cox proportional hazards models were used to estimate multivariable-adjusted HR and 95% confidence intervals (CI). RESULTS Women in the highest versus lowest quartile of adherence to the HEI-2015, AHEI, aMED, and DASH indices had a lower risk of all-cause mortality. HR (95% CI) were 0.88 (0.74-1.04; Ptrend = 0.12) for HEI-2015; 0.82 (0.69-0.97; Ptrend = 0.02) for AHEI; 0.73 (0.59-0.92; Ptrend = 0.02) for aMED; and 0.78 (0.65-0.94; Ptrend = 0.006) for DASH. In subgroup analyses, the associations with higher adherence to the four indices were similar for pre- or post-diagnosis dietary intake and were confined to women with a body mass index <25 kg/m2 and women with hormone receptor positive tumors. CONCLUSIONS Higher adherence to the HEI-2015, AHEI, aMED, and DASH indices was associated with lower mortality among women with breast cancer. IMPACT Adherence to a healthy diet may improve survival of women with breast cancer.
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Affiliation(s)
- Danielle E. Haslam
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Esther M. John
- Departments of Epidemiology & Population Health and Medicine (Oncology), Stanford University of School of Medicine, Stanford, California
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Julia A. Knight
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Zhongyu Li
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Saundra S. Buys
- Huntsman Cancer Institute at the University of Utah Health Sciences Center
| | - Irene L. Andrulis
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
- Deparment of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Mary B. Daly
- Clinical Genetics, Fox Chase Cancer Center, Philadelphia, Pennsylvania, Salt Lake City, Utah
| | - Jeanine M. Genkinger
- Mailman School of Public Health, Columbia University
- Herbert Irving Comprehensive Cancer Center, New York City, New York
| | - Mary Beth Terry
- Mailman School of Public Health, Columbia University
- Herbert Irving Comprehensive Cancer Center, New York City, New York
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
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Croskey O, Clark MK. Individualized diet conversation in primary care: A pilot intervention. Nurse Pract 2023; 48:38-46. [PMID: 36975749 DOI: 10.1097/01.npr.0000000000000026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
BACKGROUND Most primary care providers do not routinely discuss nutrition and diet with their patients, largely due to lack of time, inadequate resources, and perceived complexity of the topic. This article describes development and implementation of a brief protocol for systematically assessing and discussing diet during routine primary care visits to increase the frequency of these conversations and improve patient health outcomes. METHODS The authors developed a protocol for assessing both nutrition and stage of change as well as a guide for engaging in patient-led conversations about nutrition. The protocol was modeled after Screening, Brief Intervention, and Referral to Treatment and informed by the Dietary Guidelines for Americans, the Transtheoretical Model of Behavior Change, and principles of motivational interviewing. It was implemented over three months at a rural health clinic staffed by one NP. RESULTS The protocol and conversation guide were easy to use with minimal training and seamlessly incorporated into clinic workflow. The likelihood of making diet changes increased significantly following the diet conversation, with persons who initially scored lower in readiness to change ultimately reporting significantly greater increases. CONCLUSION A protocol for assessing diet and engaging patients in a stage of change-appropriate diet conversation can be efficiently integrated into a single primary care visit and increase patients' intent to change their diet. Further investigation is needed to evaluate the protocol more completely and in multiple clinics.
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Lee E, Kim JM. The association of the Korean Healthy Eating Index with chronic conditions in middle-aged single-person households. Nutr Res Pract 2023; 17:316-329. [PMID: 37009143 PMCID: PMC10042713 DOI: 10.4162/nrp.2023.17.2.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/30/2022] [Accepted: 11/25/2022] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND/OBJECTIVES This study investigated the association between dietary quality based on the Korean Healthy Eating Index (KHEI), and the prevalence of chronic conditions among middle-aged individuals (40-60 ys of age) living alone. MATERIALS/METHODS The participants were selected (1,517 men and 2,596 women) from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016-2018 and classified into single-person households (SPH) and multi-person households (MPH). Nutrient intake, KHEI, and the prevalence of chronic conditions were compared according to household size. The odds ratios (ORs) of chronic conditions were analyzed according to the tertile levels of KHEI by gender within each household size category. RESULTS Men in SPH had a significantly lower total KHEI score (P < 0.0001) and a lower prevalence of obesity (OR, 0.576) than those in MPH. For men, the adjusted ORs for obesity, hypertension, and hypertriglyceridemia in the first tertile (T1) of KHEI scores within SPH compared with the third tertile (T3) were 4.625, 3.790, and 4.333, respectively. Moreover, the adjusted OR for hypertriglyceridemia in the T1 group compared to the T3 group within the MPH was 1.556. For women, the adjusted ORs for obesity and hypertriglyceridemia in T1 compared to T3 within the SPH were 3.223 and 7.134, respectively, and 1.573 and 1.373 for obesity and hypertension, respectively, within MPH. CONCLUSIONS A healthy eating index was associated with a reduced risk of chronic conditions in middle-aged adults. Greater adherence to a healthy eating index could lower the risk of chronic conditions in middle-aged adults living alone.
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Affiliation(s)
- EunJung Lee
- Food and Nutrition Major, School of Wellness Industry Convergence, Hankyong National University, Anseong 17579, Korea
| | - Ji-Myung Kim
- Food and Nutrition Major, Division of Food Science & Culinary Arts, Shinhan University, Uijeongbu 11644, Korea
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Chen ZF, Kusuma JD, Shiao SYPK. Validating Healthy Eating Index, Glycemic Index, and Glycemic Load with Modern Diets for E-Health Era. Nutrients 2023; 15:nu15051263. [PMID: 36904261 PMCID: PMC10005628 DOI: 10.3390/nu15051263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Predictors of healthy eating parameters, including the Healthy Eating Index (HEI), Glycemic Index (GI), and Glycemic Load (GL), were examined using various modern diets (n = 131) in preparation for personalized nutrition in the e-health era. Using Nutrition Data Systems for Research computerized software and artificial intelligence machine-learning-based predictive validation analyses, we included domains of HEI, caloric source, and various diets as the potentially modifiable factors. HEI predictors included whole fruits and whole grains, and empty calories. Carbohydrates were the common predictor for both GI and GL, with total fruits and Mexican diets being additional predictors for GI. The median amount of carbohydrates to reach an acceptable GL < 20 was predicted as 33.95 g per meal (median: 3.59 meals daily) with a regression coefficient of 37.33 across all daily diets. Diets with greater carbohydrates and more meals needed to reach acceptable GL < 20 included smoothies, convenient diets, and liquids. Mexican diets were the common predictor for GI and carbohydrates per meal to reach acceptable GL < 20; with smoothies (12.04), high-school (5.75), fast-food (4.48), Korean (4.30), Chinese (3.93), and liquid diets (3.71) presenting a higher median number of meals. These findings could be used to manage diets for various populations in the precision-based e-health era.
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Affiliation(s)
- Zhao-Feng Chen
- Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Correspondence: (Z.-F.C.); (S.-Y.P.K.S.); Tel.: +1-(818)-233-6112 (S.-Y.P.K.S.)
| | | | - Shyang-Yun Pamela K. Shiao
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Correspondence: (Z.-F.C.); (S.-Y.P.K.S.); Tel.: +1-(818)-233-6112 (S.-Y.P.K.S.)
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Park SY, Setiawan VW, White LR, Wu AH, Cheng I, Haiman CA, Wilkens LR, Le Marchand L, Lim U. Modifying effects of race and ethnicity and APOE on the association of physical activity with risk of Alzheimer's disease and related dementias. Alzheimers Dement 2023; 19:507-517. [PMID: 35476309 PMCID: PMC9810117 DOI: 10.1002/alz.12677] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION We investigated whether the protective association of physical activity with risk of Alzheimer's disease and related dementias (ADRD) has genetic or behavioral variations. METHODS In the Multiethnic Cohort, we analyzed moderate or vigorous physical activity (MVPA) reported at ages 45 to 75 among 88,047 participants in relation to 13,039 incident diagnoses of late-onset ADRD identified in Medicare claims (1999 to 2014), by five racial and ethnic groups, hours sitting, and in a subset (16%), apolipoprotein E (APOE) genotype. RESULTS MVPA was inversely associated with ADRD (hazard ratio for ≥14 vs <2.5 hours/week: 0.83, 95% confidence interval [CI]: 0.76 to 0.90 in men; 0.88, 5% CI: 0.81 to 0.95 in women). The association was inverse in all racial and ethnic groups except Black participants (P-heterogeneity = 0.52), but stronger in individuals with lower levels of sitting duration or those who do not carry the APOE e4 risk allele. DISCUSSION The different effects of physical activity by sitting duration and APOE genotype warrant further research.
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Affiliation(s)
- Song-Yi Park
- Cancer Epidemiology Program, University of Hawaii Cancer Center, University of Hawaii, Honolulu, Hawaii, USA
| | - Veronica Wendy Setiawan
- Department of Population and Public Health Sciences, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| | - Lon R. White
- Pacific Health Research and Education Institute, Honolulu, Hawaii, USA
- Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA
| | - Anna H. Wu
- Department of Population and Public Health Sciences, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Christopher A. Haiman
- Department of Population and Public Health Sciences, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| | - Lynne R. Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, University of Hawaii, Honolulu, Hawaii, USA
| | - Loїc Le Marchand
- Cancer Epidemiology Program, University of Hawaii Cancer Center, University of Hawaii, Honolulu, Hawaii, USA
| | - Unhee Lim
- Cancer Epidemiology Program, University of Hawaii Cancer Center, University of Hawaii, Honolulu, Hawaii, USA
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Dietary Quality and Diet-Related Factors Among Female Adults of Reproductive Age With and Without Disabilities Participating in the National Health and Nutrition Examination Surveys, 2013-2018. J Acad Nutr Diet 2023; 123:263-275. [PMID: 35872244 DOI: 10.1016/j.jand.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 07/04/2022] [Accepted: 07/18/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Female adults of reproductive age (18 to 44 years) with disabilities have higher rates of health-risk behaviors and chronic conditions compared with their counterparts without disabilities; however, there is limited examination of diet. OBJECTIVE Our aim was to examine associations of self-reported disability status with diet quality and diet-related factors. DESIGN Cross-sectional data were from the National Health and Nutrition Examination Surveys, 2013-2018. PARTICIPANTS/SETTING Female adults aged 18 through 44 years were included. Disability was defined as serious difficulty hearing, seeing, concentrating, walking, dressing, and/or running errands due to physical, mental, or emotional conditions. MAIN OUTCOME MEASURES The Healthy Eating Index-2015 assessed diet quality. Diet-related factors included self-rated diet healthfulness, meal characteristics, food security, and food assistance programs. STATISTICAL ANALYSIS Multivariable linear regression estimated differences in Healthy Eating Index-2015 scores for a given day and multivariable Poisson regression estimated adjusted prevalence ratios and 95% CI of diet-related factors by disability status. RESULTS Of 3,579 female adults, 557 (16%) reported any disabilities, 207 (6%) of whom reported having 2 or more types of disabilities. Differences in mean Healthy Eating Index-2015 scores for a given day were one-third to one-half a point lower for fruits, total protein foods, and seafood and plant proteins among female adults with 2 or more types of disabilities compared with those without disabilities. Female adults with any disabilities were more likely to rate their diet as poor, have low food security, participate in food-assistance programs, and consume frozen foods or pizza, compared with those without disabilities (adjusted prevalence ratio ranged from 1.35 to 1.93); they were less likely to be the main food planner or preparer or shopper for their households. CONCLUSIONS Some indicators of diet quality and diet-related factors differed between female adults with and without disabilities. Additional investigation of dietary intakes and behaviors, as well as access to and availability of healthy foods, among female adults with disabilities is necessary.
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Laouali N, Benmarhnia T, Lanphear BP, Oulhote Y. Associations with Blood Lead and Urinary Cadmium Concentrations in Relation to Mortality in the US Population: A Causal Survival Analysis with G-Computation. TOXICS 2023; 11:toxics11020133. [PMID: 36851008 PMCID: PMC9966985 DOI: 10.3390/toxics11020133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 05/19/2023]
Abstract
Using the parametric g-formula, we estimated the 27-year risk of all-cause and specific causes of mortality under different potential interventions for blood lead (BLLs) and urinary cadmium (UCd) levels. We used data on 14,311 adults aged ≥20 years enrolled in the NHANES-III between 1988 and 1994 and followed up through 31 Dec 31 2015. Time and cause of death were determined from the National Death Index records. We used the parametric g-formula with pooled logistic regression models to estimate the relative and absolute risk of all-cause, cardiovascular, and cancer mortality under different potential threshold interventions for BLLs and UCd concentrations. Median follow-up was 22.5 years. A total of 5167 (36%) participants died by the end of the study, including 1550 from cardiovascular diseases and 1135 from cancer. Increases in BLLs and creatinine-corrected UCd levels from the 5th to the 95th percentiles were associated with risk differences of 4.17% (1.54 to 8.77) and 6.22% (4.51 to 12.00) for all-cause mortality, 1.52% (0.09 to 3.74) and 1.06% (-0.57 to 3.50) for cardiovascular disease mortality, and 1.32% (-0.09 to 3.67) and 0.64% (-0.98 to 2.80) for cancer mortality, respectively. Interventions to reduce historical exposures to lead and cadmium may have prevented premature deaths, especially from cardiovascular disease.
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Affiliation(s)
- Nasser Laouali
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, Amherst, MA 01003, USA
- Scripps Institution of Oceanography, University of California, San Diego, CA 95616, USA
- CESP UMR1018, Université Paris-Saclay, UVSQ, Inserm, Gustave Roussy, 94800 Villejuif, France
- Correspondence:
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, CA 95616, USA
| | - Bruce P. Lanphear
- Child and Family Research Institute, BC Children’s Hospital, Vancouver, BC V6H 3N1, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Youssef Oulhote
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, Amherst, MA 01003, USA
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Food combination questionnaire for Japanese: relative validity regarding food and nutrient intake and overall diet quality against the 4-day weighed dietary record. J Nutr Sci 2023; 12:e22. [PMID: 36843967 PMCID: PMC9947634 DOI: 10.1017/jns.2023.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 02/17/2023] Open
Abstract
The aim of this cross-sectional study was to examine the relative validity of food and nutrient intakes and overall diet quality scores derived using a newly developed dietary assessment questionnaire (food combination questionnaire, FCQ). Dietary data were collected from 222 Japanese adults (111 for each sex) aged 30-76 years using the online FCQ and then the 4-non-consective-day weighed dietary record (DR). The median of Spearman correlation coefficients for sixteen food groups was 0⋅32 among women and 0⋅38 among men. The median of Pearson correlation coefficients for forty-six nutrients was 0⋅34 among women and 0⋅31 among men. The Pearson correlation coefficient between the total scores of Healthy Eating Index-2015 (HEI-2015) derived from the DR and FCQ was 0⋅37 among women and 0⋅39 among men. The corresponding value for the Nutrient-Rich Food Index 9.3 (NRF9.3) total scores was 0⋅39 among women and 0⋅46 among men. Bland-Altman plots for these diet quality scores showed poor agreement at the individual level, although mean difference was small for the HEI-2015 (but not NRF9.3). Similar results were obtained using the paper version of FCQ, which was answered after conducting the DR, except for somewhat high Pearson correlation coefficients for the total scores of HEI-2015 (0⋅50 among both women and men) and NRF9.3 (0⋅37 among women and 0⋅53 among men). In conclusion, this analysis may lend support to the possible use of the FCQ as a rapid dietary assessment tool in large-scale epidemiologic studies in Japan, but further refinement of this tool should be pursued.
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Milliron BJ, Klobodu C, Deutsch J, Martyn K, Dychtwald D, Riahi E, Carro S, Hisek T, Darcy N, Klassen AC. "Keep Your Chin Up, and Keep Eating": Perceptions of Barriers and Facilitators to Healthful Dietary Behaviors Among Individuals With Gastrointestinal Cancer and Caregivers. Cancer Control 2023; 30:10732748231208316. [PMID: 37914716 PMCID: PMC10623986 DOI: 10.1177/10732748231208316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 09/12/2023] [Accepted: 09/26/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND This study explored perceptions of barriers and facilitators to healthful dietary behaviors among patients with gastrointestinal (GI) cancer and their caregivers, including caregiver preparedness, patient and caregiver self-efficacy for symptom management, and other environmental, social, and familial factors that may serve as barriers and facilitators to healthful eating. METHODS Using a concurrent mixed methods cross-sectional study design, individuals with GI cancer receiving outpatient chemotherapy and their caregivers completed surveys, dietary assessments, and interviews. Caregiving preparedness, self-efficacy for symptom management, and dietary intake were assessed using validated instruments. Dietary quality was measured using the Healthy Eating Index (HEI)-2020. In-depth interviews explored barriers and facilitators to healthful eating, symptom management, and caregiver preparedness. RESULTS Twenty-seven patient-caregiver dyads completed study activities (N = 54). Dietary quality scores ranged from 26 to 81, with a median score of 43 for patients and 42 for caregivers. Thematic analysis identified three barriers to healthful eating: caregiver self-efficacy and preparedness, caregiver needs are neglected, and nutrition as a source of conflict. Overall self-efficacy scores (Mdn, [IQR]) were 69.1 (45.0) for caregivers and 75.6 (34.1) for patients. Caregiver preparedness score was 2.99 ± .87; problem areas were identified, including addressing emotional needs, fluctuating eating habits, advanced disease progression and making care activities pleasant. Despite the challenges, three main facilitators were identified: increased awareness and value of nutrition, influential others, and positive coping. CONCLUSION Our findings suggest the importance of developing interventions that increase nutrition-related preparedness among caregivers and self-efficacy for managing treatment side effects. Future research should continue to explore the relationship between positive coping and dietary behaviors. While engaging patients and caregivers together during dietary interventions is a promising modality, strategies for maintaining personal nutrition-related goals when facing contrasting priorities between patients and caregivers should be addressed.
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Affiliation(s)
- Brandy-Joe Milliron
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Cynthia Klobodu
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Jonathan Deutsch
- Department of Food and Hospitality Management, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Karon Martyn
- Asplundh Cancer Pavilion, Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA, USA
| | - Dan Dychtwald
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Emily Riahi
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Shawn Carro
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Taylor Hisek
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Natalie Darcy
- Asplundh Cancer Pavilion, Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA, USA
| | - Ann C Klassen
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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Shah UA, Maclachlan KH, Derkach A, Salcedo M, Barnett K, Caple J, Blaslov J, Tran L, Ciardiello A, Burge M, Shekarkhand T, Adintori P, Cross J, Pianko MJ, Hosszu K, McAvoy D, Mailankody S, Korde N, Hultcrantz M, Hassoun H, Tan CR, Lu SX, Patel D, Diamond B, Shah G, Scordo M, Lahoud O, Chung DJ, Landau H, Usmani SZ, Giralt S, Taur Y, Landgren CO, Block G, Block T, Peled JU, van den Brink MRM, Lesokhin AM. Sustained Minimal Residual Disease Negativity in Multiple Myeloma is Associated with Stool Butyrate and Healthier Plant-Based Diets. Clin Cancer Res 2022; 28:5149-5155. [PMID: 36170461 PMCID: PMC9722533 DOI: 10.1158/1078-0432.ccr-22-0723] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/23/2022] [Accepted: 09/26/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE Sustained minimal residual disease (MRD) negativity is associated with long-term survival in multiple myeloma. The gut microbiome is affected by diet, and in turn can modulate host immunity, for example through production of short-chain fatty acids including butyrate. We hypothesized that dietary factors affect the microbiome (abundance of butyrate-producing bacteria or stool butyrate concentration) and may be associated with multiple myeloma outcomes. EXPERIMENTAL DESIGN We examined the relationship of dietary factors (via a food frequency questionnaire), stool metabolites (via gas chromatography-mass spectrometry), and the stool microbiome (via 16S sequencing - α-diversity and relative abundance of butyrate-producing bacteria) with sustained MRD negativity (via flow cytometry at two timepoints 1 year apart) in myeloma patients on lenalidomide maintenance. The Healthy Eating Index 2015 score and flavonoid nutrient values were calculated from the food frequency questionnaire. The Wilcoxon rank sum test was used to evaluate associations with two-sided P < 0.05 considered significant. RESULTS At 3 months, higher stool butyrate concentration (P = 0.037), butyrate producers (P = 0.025), and α-diversity (P = 0.0035) were associated with sustained MRD negativity. Healthier dietary proteins, (from seafood and plants), correlated with butyrate at 3 months (P = 0.009) and sustained MRD negativity (P = 0.05). Consumption of dietary flavonoids, plant nutrients with antioxidant effects, correlated with stool butyrate concentration (anthocyanidins P = 0.01, flavones P = 0.01, and flavanols P = 0.02). CONCLUSIONS This is the first study to demonstrate an association between a plant-based dietary pattern, stool butyrate production, and sustained MRD negativity in multiple myeloma, providing rationale to evaluate a prospective dietary intervention.
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Affiliation(s)
- Urvi A. Shah
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Kylee H. Maclachlan
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Andriy Derkach
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Meghan Salcedo
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kelly Barnett
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Julia Caple
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jenna Blaslov
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Linh Tran
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Amanda Ciardiello
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Miranda Burge
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Tala Shekarkhand
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Peter Adintori
- Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Justin Cross
- Donald B. and Catherine C. Marron Cancer Metabolism Center, Sloan Kettering Institute, New York, NY
| | | | - Kinga Hosszu
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Devin McAvoy
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sham Mailankody
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Neha Korde
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Malin Hultcrantz
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Hani Hassoun
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Carlyn R. Tan
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Sydney X. Lu
- Department of Medicine, Division of Hematology, Stanford University School of Medicine, Palo Alto, CA
| | - Dhwani Patel
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Benjamin Diamond
- Myeloma Program, Department of Medicine, University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL
| | - Gunjan Shah
- Department of Medicine, Weill Cornell Medical College, New York, New York
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michael Scordo
- Department of Medicine, Weill Cornell Medical College, New York, New York
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Oscar Lahoud
- Department of Medicine, Weill Cornell Medical College, New York, New York
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - David J. Chung
- Department of Medicine, Weill Cornell Medical College, New York, New York
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Heather Landau
- Department of Medicine, Weill Cornell Medical College, New York, New York
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Saad Z. Usmani
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Sergio Giralt
- Department of Medicine, Weill Cornell Medical College, New York, New York
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ying Taur
- Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - C. Ola Landgren
- Myeloma Program, Department of Medicine, University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL
| | | | | | - Jonathan U. Peled
- Department of Medicine, Weill Cornell Medical College, New York, New York
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Marcel RM van den Brink
- Department of Medicine, Weill Cornell Medical College, New York, New York
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Alexander M. Lesokhin
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, New York
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O'Hearn M, Erndt-Marino J, Gerber S, Lauren BN, Economos C, Wong JB, Blumberg JB, Mozaffarian D. Validation of Food Compass with a healthy diet, cardiometabolic health, and mortality among U.S. adults, 1999-2018. Nat Commun 2022; 13:7066. [PMID: 36414619 PMCID: PMC9681774 DOI: 10.1038/s41467-022-34195-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 10/14/2022] [Indexed: 11/23/2022] Open
Abstract
The Food Compass is a nutrient profiling system (NPS) to characterize the healthfulness of diverse foods, beverages and meals. In a nationally representative cohort of 47,999 U.S. adults, we validated a person's individual Food Compass Score (i.FCS), ranging from 1 (least healthful) to 100 (most healthful) based on cumulative scores of items consumed, against: (a) the Healthy Eating Index (HEI) 2015; (b) clinical risk factors and health conditions; and (c) all-cause mortality. Nationally, the mean (SD) of i.FCS was 35.5 (10.9). i.FCS correlated highly with HEI-2015 (R = 0.81). After multivariable-adjustment, each one SD (10.9 point) higher i.FCS associated with more favorable BMI (-0.60 kg/m2 [-0.70,-0.51]), systolic blood pressure (-0.69 mmHg [-0.91,-0.48]), diastolic blood pressure (-0.49 mmHg [-0.66,-0.32]), LDL-C (-2.01 mg/dl [-2.63,-1.40]), HDL-C (1.65 mg/d [1.44,1.85]), HbA1c (-0.02% [-0.03,-0.01]), and fasting plasma glucose (-0.44 mg/dL [-0.74,-0.15]); lower prevalence of metabolic syndrome (OR = 0.85 [0.82,0.88]), CVD (0.92 [0.88,0.96]), cancer (0.95 [0.91,0.99]), and lung disease (0.92 [0.88,0.96]); and higher prevalence of optimal cardiometabolic health (1.24 [1.16,1.32]). i.FCS also associated with lower all-cause mortality (HR = 0.93 [0.89,0.96]). Findings were similar by age, sex, race/ethnicity, education, income, and BMI. These findings support validity of Food Compass as a tool to guide public health and private sector strategies to identify and encourage healthier eating.
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Affiliation(s)
- Meghan O'Hearn
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
| | | | - Suzannah Gerber
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Brianna N Lauren
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Christina Economos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - John B Wong
- Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
- Tufts Medical Center, Institute for Clinical Research and Health Policy Studies, Boston, MA, USA
| | - Jeffrey B Blumberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
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