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Luo X, Tang M, Wei X, Peng Y. Magnesium depletion score and sleep quality in U.S. adults, NHANES 2005-2014. J Affect Disord 2024:S0165-0327(24)00718-3. [PMID: 38703902 DOI: 10.1016/j.jad.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/26/2024] [Accepted: 05/01/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND The association between magnesium status and sleep quality is unclear. The aim of this study was to determine the relationship between renal reabsorption-related magnesium depletion score (MDS) and sleep quality. METHODS This study was conducted through a cross-sectional survey of adults aged ≥20 years who participated in NHANES 2005-2014. We used weighted logistic regression to examine the association between MDS and sleep quality and performed trend tests to analyze for the presence of a dose-response relationship. Subgroup analyses were performed based on various sleep outcomes and covariates. RESULTS A total of 20,585 participants were included in the study, with a mean age of 48.8 years and 50.7 % female. After adjusting for all covariates, we found a graded dose-response relationship between MDS and sleep trouble as well as sleep disorder. Further analyses revealed a significant positive association between MDS and sleep apnea (OR = 3.01; 95 % CI 1.37-6.62), but no association with restless legs, insomnia or insufficient sleep. In addition, subgroup analyses revealed that middle-aged, male, obese, low magnesium intake, and depressed patients were more prone to sleep trouble and sleep disorder; interestingly, MDS was positively associated with excessive sleep in subjects ≥60 years and without depression. CONCLUSIONS Our study found a significant association between MDS and sleep quality, particularly sleep apnea, but adequate magnesium intake may be beneficial in mitigating this association. MDS may be associated with excessive sleep in older adults, but not with insufficient sleep or insomnia.
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Affiliation(s)
- Xiaomin Luo
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Tang
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaohui Wei
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongde Peng
- Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China..
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Maino Vieytes CA, Zhu R, Gany F, Koester BD, Arthur AE. Dietary patterns among U.S. food insecure cancer survivors and the risk of mortality: NHANES 1999-2018. Cancer Causes Control 2024:10.1007/s10552-024-01868-2. [PMID: 38532045 DOI: 10.1007/s10552-024-01868-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE Food insecurity-the lack of unabated access to nutritious foods-is a consequence many cancer survivors face. Food insecurity is associated with adverse health outcomes and lower diet quality in the general public. The goal of this analysis was to extract major and prevailing dietary patterns among food insecure cancer survivors from observed 24-h recall data and evaluate their relationship to survival after a cancer diagnosis. METHODS We implemented two dietary patterns analysis approaches: penalized logistic regression and principal components analysis. Using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) study, we extracted three dietary patterns. Additionally, we evaluated the HEI-2015 for comparison. Cox proportional hazards models assessed the relationship between the diet quality indices and survival after a cancer diagnosis. RESULTS There were 981 deaths from all causes and 343 cancer-related deaths. After multivariable adjustment, we found higher risks of all-cause mortality associated with higher adherence to Pattern #1 (HR 1.25; 95% CI 1.09-1.43) and Pattern #2 (HR 1.15; 95% CI 1.01-1.31) among cancer survivors. CONCLUSION Among all cancer survivors, higher adherence to major and prevailing dietary patterns from the U.S. food insecure cancer survivor population may lead to worse survival outcomes.
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Affiliation(s)
- Christian A Maino Vieytes
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, 386 Bevier Hall, 905 S Goodwin Ave, Urbana, IL, 61801, USA.
| | - Ruoqing Zhu
- Department of Statistics, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
| | - Francesca Gany
- Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Brenda D Koester
- Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
| | - Anna E Arthur
- Department of Dietetics and Nutrition, Medical Center, University of Kansas, Kansas City, KS, 66160, USA
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Martínez-González MÁ, Hernández Hernández A. Effect of the Mediterranean diet in cardiovascular prevention. Rev Esp Cardiol (Engl Ed) 2024:S1885-5857(24)00043-4. [PMID: 38336153 DOI: 10.1016/j.rec.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
The Mediterranean diet is the best evidence-based model for cardiovascular prevention. In addition to 2 major randomized secondary prevention trials (Lyon Heart and CORDIOPREV) and 1 primary prevention trial (PREDIMED) that have demonstrated these benefits, there is an unprecedented body of high-quality prospective epidemiological evidence supporting these beneficial effects. The key elements of this traditional pattern are the abundant use of extra-virgin olive oil and high consumption of foods of natural plant-based origin (fruits, vegetables, nuts, and legumes) and fish, along with a reduction in processed meats, red meats, and ultraprocessed products. Moderate consumption of wine, preferably red wine, with meals is an essential element of this traditional pattern. Although removing wine consumption from the Mediterranean diet has been associated with a reduction in its preventive efficacy, doubts have recently arisen about the possible adverse effect of even low or moderate intake of any alcoholic beverages. A new large Spanish trial, UNATI, which will begin in June 2024, will randomize 10 000 drinkers aged 50 to 75 years to abstention or moderate consumption. UNATI aims to answer these doubts with the best possible evidence.
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Affiliation(s)
- Miguel Á Martínez-González
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, United States.
| | - Aitor Hernández Hernández
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Departamento de Cardiología, Clínica Universidad de Navarra, Madrid, Spain
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Barboza BP, Bricarello LP, Alves MDA, Tureck C, Retondario A, Longo GZ, Souza ADM, de Vasconcelos FDAG. Dietary patterns and biochemical markers related to diabetes mellitus: an association analysis based on data from the Study of Cardiovascular Risk in Adolescents (ERICA). Nutrition 2024; 118:112283. [PMID: 38071935 DOI: 10.1016/j.nut.2023.112283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 09/04/2023] [Accepted: 10/25/2023] [Indexed: 01/07/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the association between dietary patterns and biochemical markers related to diabetes mellitus (DM): glucose, insulin, glycated hemoglobin (HbA1c), and homeostasis model assessment of insulin resistance index from 35 454 Brazilian adolescents 12 to 17 y of age. METHODS Dietary patterns were derived using factor analysis by the principal components method. The data originated from the school-based study ERICA (Study of Cardiovascular Risk in Adolescents) carried out between 2013 and 2014. Linear regression models analyzed the associations. RESULTS Three dietary patterns were found: traditional Brazilian, bread and coffee, and Western. An inverse association was found in young girls between the traditional Brazilian pattern and fasting glucose (β = -0.76; P = 0.005) and HbA1c in the second and third tertiles (β = -0.04; P = 0.002; β = -0 .06; P < 0.001), and the Western pattern with HbA1c (β = -0.02; P = 0.035). In boys, a positive association was found between the second tertile of the dietary pattern and insulin (β = 0.48; P = 0.009) and homeostasis model assessment of insulin resistance index (β = 0.11; P = 0.012). CONCLUSIONS This study showed that the traditional Brazilian pattern was inversely associated with blood glucose and HbA1c values in girls. Furthermore, the data suggest that there is an important difference between boys and girls in the association of dietary patterns and the markers used.
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Affiliation(s)
- Bernardo Paz Barboza
- Postgraduate Program in Nutrition, Federal University of Santa Catarina (UFSC), Santa Catarina, Brazil.
| | - Liliana Paula Bricarello
- Postgraduate Program in Nutrition, Federal University of Santa Catarina (UFSC), Santa Catarina, Brazil
| | - Mariane de Almeida Alves
- Postgraduate Program in Nutrition in Public Health, School of Public Health, University of São Paulo (USP), São Paulo, Brazil
| | - Camila Tureck
- Postgraduate Program in Nutrition, Federal University of Santa Catarina (UFSC), Santa Catarina, Brazil
| | | | - Giana Zarbato Longo
- Postgraduate Program in Nutrition, Federal University of Santa Catarina (UFSC), Santa Catarina, Brazil
| | - Amanda de Moura Souza
- Institute of Studies on Collective Health, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Tong TYN, Clarke R, Schmidt JA, Huybrechts I, Noor U, Forouhi NG, Imamura F, Travis RC, Weiderpass E, Aleksandrova K, Dahm CC, van der Schouw YT, Overvad K, Kyrø C, Tjønneland A, Kaaks R, Katzke V, Schiborn C, Schulze MB, Mayen-Chacon AL, Masala G, Sieri S, de Magistris MS, Tumino R, Sacerdote C, Boer JMA, Verschuren WMM, Brustad M, Nøst TH, Crous-Bou M, Petrova D, Amiano P, Huerta JM, Moreno-Iribas C, Engström G, Melander O, Johansson K, Lindvall K, Aglago EK, Heath AK, Butterworth AS, Danesh J, Key TJ. Dietary amino acids and risk of stroke subtypes: a prospective analysis of 356,000 participants in seven European countries. Eur J Nutr 2024; 63:209-220. [PMID: 37804448 PMCID: PMC10799144 DOI: 10.1007/s00394-023-03251-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/08/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE Previously reported associations of protein-rich foods with stroke subtypes have prompted interest in the assessment of individual amino acids. We examined the associations of dietary amino acids with risks of ischaemic and haemorrhagic stroke in the EPIC study. METHODS We analysed data from 356,142 participants from seven European countries. Dietary intakes of 19 individual amino acids were assessed using validated country-specific dietary questionnaires, calibrated using additional 24-h dietary recalls. Multivariable-adjusted Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of ischaemic and haemorrhagic stroke in relation to the intake of each amino acid. The role of blood pressure as a potential mechanism was assessed in 267,642 (75%) participants. RESULTS After a median follow-up of 12.9 years, 4295 participants had an ischaemic stroke and 1375 participants had a haemorrhagic stroke. After correction for multiple testing, a higher intake of proline (as a percent of total protein) was associated with a 12% lower risk of ischaemic stroke (HR per 1 SD higher intake 0.88; 95% CI 0.82, 0.94). The association persisted after mutual adjustment for all other amino acids, systolic and diastolic blood pressure. The inverse associations of isoleucine, leucine, valine, phenylalanine, threonine, tryptophan, glutamic acid, serine and tyrosine with ischaemic stroke were each attenuated with adjustment for proline intake. For haemorrhagic stroke, no statistically significant associations were observed in the continuous analyses after correcting for multiple testing. CONCLUSION Higher proline intake may be associated with a lower risk of ischaemic stroke, independent of other dietary amino acids and blood pressure.
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Affiliation(s)
- Tammy Y N Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Julie A Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
- Departments of Clinical Epidemiology, Clinical Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Inge Huybrechts
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France
| | - Urwah Noor
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Elisabete Weiderpass
- International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France
| | - Krasimira Aleksandrova
- Department Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
- Faculty of Human and Health Sciences, University of Bremen, Grazer Straße 2, 28359, Bremen, Germany
| | | | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Cecilie Kyrø
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Catarina Schiborn
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute for Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Ana-Lucia Mayen-Chacon
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, Milan, Italy
| | | | - Rosario Tumino
- Hyblean Association for Epidemiological Research AIRE-ONLUS, Ragusa, Italy
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Turin, Italy
| | - Jolanda M A Boer
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - W M Monique Verschuren
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Magritt Brustad
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
- The Public Dental Service Competence Centre of Northern Norway (TkNN), Tromsø, Norway
| | - Therese Haugdahl Nøst
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
- K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marta Crous-Bou
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)-Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Dafina Petrova
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C. de Melchor Fernández Almagro, Madrid, Spain
| | - Pilar Amiano
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C. de Melchor Fernández Almagro, Madrid, Spain
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain
- Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain
| | - José María Huerta
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C. de Melchor Fernández Almagro, Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
| | - Conchi Moreno-Iribas
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C. de Melchor Fernández Almagro, Madrid, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, SpainInstituto de Salud Pu´Blica de Navarra, IdiSNA, Navarre Institute for Health Research, Pamplona, Spain
| | - Gunnar Engström
- Department of Clinical Science in Malmö, Lund University, Clinical Research Center, Malmö, Sweden
| | - Olle Melander
- Department of Clinical Science in Malmö, Lund University, Clinical Research Center, Malmö, Sweden
- Department of Emergency and Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Kristina Johansson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Kristina Lindvall
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Elom K Aglago
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Adam S Butterworth
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Hills Road, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - John Danesh
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Hills Road, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- Department of Human Genetics, Wellcome Sanger Institute, Hinxton, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
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da Cruz GL, da Costa Louzada ML, da Silva JT, Maria Fellegger Garzillo J, Rauber F, Schmidt Rivera X, Reynolds C, Levy RB. The environmental impact of beef and ultra-processed food consumption in Brazil. Public Health Nutr 2024; 27:e34. [PMID: 38173129 PMCID: PMC10897569 DOI: 10.1017/s1368980023002975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/30/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE This study evaluated the independent and combined environmental impacts of the consumption of beef and ultra-processed foods in Brazil. DESIGN Cross-sectional study. SETTING Brazil. PARTICIPANTS We used food purchases data from a national household budget survey conducted between July 2017 and July 2018, representing all Brazilian households. Food purchases were converted into energy, carbon footprints and water footprints. Multiple linear regression models were used to assess the association between quintiles of beef and ultra-processed foods in total energy purchases and the environmental footprints, controlling for sociodemographic variables. RESULTS Both beef and ultra-processed foods had a significant linear association with carbon and water footprints (P < 0·01) in crude and adjusted models. In the crude upper quintile of beef purchases, carbon and water footprints were 47·7 % and 30·8 % higher, respectively, compared to the lower quintile. The upper quintile of ultra-processed food purchases showed carbon and water footprints 14·4 % and 22·8 % higher, respectively, than the lower quintile. The greatest reduction in environmental footprints would occur when both beef and ultra-processed food purchases are decreased, resulting in a 21·1 % reduction in carbon footprint and a 20·0 % reduction in water footprint. CONCLUSIONS Although the environmental footprints associated with beef consumption are higher, dietary patterns with lower consumption of beef and ultra-processed foods combined showed the greatest reduction in carbon and water footprints in Brazil. The high consumption of beef and ultra-processed foods is harmful to human health, as well as to the environment; thus, their reduction is beneficial to both.
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Affiliation(s)
- Gabriela Lopes da Cruz
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, São Paulo, Brazil
| | - Maria Laura da Costa Louzada
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, São Paulo, Brazil
| | - Jacqueline Tereza da Silva
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, São Paulo, Brazil
- Global Academy of Agriculture and Food Systems, The University of Edinburgh, Edinburgh, UK
| | - Josefa Maria Fellegger Garzillo
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, São Paulo, Brazil
| | - Fernanda Rauber
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, São Paulo, Brazil
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Ximena Schmidt Rivera
- Equitable Development and Resilience Research Group, Department of Chemical Engineering, College of Engineering, Design and Physical Science, Brunel University London, London, UK
| | - Christian Reynolds
- Centre for Food Policy, City University, London, UK
- Department of Geography, University of Sheffield, Sheffield, UK
| | - Renata Bertazzi Levy
- Center for Epidemiological Research in Nutrition and Health (NUPENS), University of São Paulo, São Paulo, Brazil
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
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Åkesson A, Donat-Vargas C, Hallström E, Sonesson U, Widenfalk A, Wolk A. Associations between dietary pesticide residue mixture exposure and mortality in a population-based prospective cohort of men and women. Environ Int 2023; 182:108346. [PMID: 38008011 DOI: 10.1016/j.envint.2023.108346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 10/31/2023] [Accepted: 11/21/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND There is a concern that pesticide residues, regularly detected in foods, might pose a health risk to the consumer, but epidemiological evidence is limited. We assessed the associations between dietary exposure to a mixture of pesticide residues and mortality. METHODS Food consumption was assessed in 68,844 participants from the Swedish Mammography Cohort and the Cohort of Swedish Men, 45-83 years at baseline (1997). Concentrations of pesticide residues detected in foods on the Swedish market (1996-1998), mainly fruits and vegetables, were obtained via monitoring programs. To assess mixture effects, we summed per food item the ratios of each single pesticide mean residue concentration divided by its acceptable daily intake to create for each participant a Dietary Pesticide Hazard Index (adjusted for energy intake and expressed per kilogram of body weight). Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95 % confidence intervals (95 %CI). RESULTS During 15 years of follow-up (1998-2014), a total of 16,527 deaths occurred, of which 6,238 were caused by cardiovascular disease (CVD) and 5,364 by cancer. Comparing extreme quintiles of Dietary Pesticide Hazard Index, the highest category was inversely associated with CVD mortality HR, 0.82 (95 % CI, 0.75-0.90) and with cancer mortality HR 0.82 (95 % CI 0.75-0.91). In analyses stratified by high/low Dietary Pesticide Hazard Index, similar inverse associations were observed by increasing fruit and vegetable consumption. CONCLUSIONS We observed no indications that dietary exposure to pesticide residue mixtures was associated with increased mortality, nor any clear indications that the benefits of fruit and vegetable consumption on mortality was compromised. Yet, our results need to be interpreted with caution.
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Affiliation(s)
- Agneta Åkesson
- Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
| | - Carolina Donat-Vargas
- Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden; ISGlobal, Campus Mar, Barcelona, Spain; Center for Networked Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Elinor Hallström
- RISE - Research Institutes of Sweden, Dep of Agriculture and Food, Box 5401, SE-402 29 Gothenburg, Sweden
| | - Ulf Sonesson
- RISE - Research Institutes of Sweden, Dep of Agriculture and Food, Box 5401, SE-402 29 Gothenburg, Sweden
| | | | - Alicja Wolk
- Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden
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8
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Andersen JLM, Frederiksen K, Kyrø C, Hansen J, Raaschou-Nielsen O, Overvad K, Tjønneland A, Olsen A. Organic food consumption and the incidence of type 2 diabetes mellitus in the Danish Diet, Cancer and Health cohort. Diabetes Res Clin Pract 2023; 205:110972. [PMID: 37884066 DOI: 10.1016/j.diabres.2023.110972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/26/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
AIM To investigate the association between organic food consumption and the incidence of type 2 diabetes mellitus. METHODS Among 41,286 cohort participants, aged 50-65 years, organic food consumption of vegetables, fruits, dairy products, eggs, meat, and cereal products, was summarized into an organic food score evaluated as never, low, medium and high consumption and as continuous intake. During follow-up, 4,843 cases were identified in the National Diabetes Register. Organic food consumption was associated to the disease incidence in Cox regression models. RESULTS Organic food consumption was linearly associated with a lower incidence of type 2 diabetes mellitus (Women, HR: 0.94, 95% CI: 0.89-1.00, Men, HR: 0.95, 95% CI: 0.90-1.00). Organic food consumption frequency, compared to never consumption, showed HRs below 1.00 for both women (medium intake HR: 0.96, 95% CI: 0.84-1.10, high intake HR: 0.88, 95% CI: 0.74-1.05) and men (low intake, HR: 0.95, 95% CI: 0.85-1.05, medium intake, HR: 0.92, 95% CI: 0.83-1.03, high intake, HR: 0.89, 95% CI: 0.75-1.05) but were not statistically significant. Similar patterns were observed with consumption of the specific organic food groups for women, but not for men. CONCLUSIONS Organic food consumption was associated with a suggested lower incidence of type 2 diabetes mellitus.
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Affiliation(s)
| | | | - Cecilie Kyrø
- Danish Cancer Institute, Diet, Cancer and Health, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Johnni Hansen
- Danish Cancer Institute, Work, Environment and Cancer, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
| | - Ole Raaschou-Nielsen
- Danish Cancer Institute, Work, Environment and Cancer, Strandboulevarden 49, DK-2100 Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Anne Tjønneland
- Danish Cancer Institute, Diet, Cancer and Health, Strandboulevarden 49, DK-2100 Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anja Olsen
- Danish Cancer Institute, Diet, Cancer and Health, Strandboulevarden 49, DK-2100 Copenhagen, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark
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Martínez-González MA, Montero P, Ruiz-Canela M, Toledo E, Estruch R, Gómez-Gracia E, Li J, Ros E, Arós F, Hernáez A, Corella D, Fiol M, Lapetra J, Serra-Majem L, Pintó X, Cofán M, Sorlí JV, Babio N, Márquez-Sandoval YF, Castañer O, Salas-Salvadó J. Yearly attained adherence to Mediterranean diet and incidence of diabetes in a large randomized trial. Cardiovasc Diabetol 2023; 22:262. [PMID: 37775736 PMCID: PMC10542699 DOI: 10.1186/s12933-023-01994-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/15/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Several large observational prospective studies have reported a protection by the traditional Mediterranean diet against type 2 diabetes, but none of them used yearly repeated measures of dietary intake. Repeated measurements of dietary intake are able to improve subject classification and to increase the quality of the assessed relationships in nutritional epidemiology. Beyond observational studies, randomized trials provide stronger causal evidence. In the context of a randomized trial of primary cardiovascular prevention, we assessed type 2 diabetes incidence according to yearly repeated measures of compliance with a nutritional intervention based on the traditional Mediterranean diet. METHODS PREDIMED (''PREvención con DIeta MEDiterránea'') was a Spanish trial including 7447 men and women at high cardiovascular risk. We assessed 3541 participants initially free of diabetes and originally randomized to 1 of 3 diets: low-fat diet (n = 1147, control group), Mediterranean diet supplemented with extra virgin olive (n = 1154) or Mediterranean diet supplemented with mixed nuts (n = 1240). As exposure we used actual adherence to Mediterranean diet (cumulative average), yearly assessed with the Mediterranean Diet Adherence Screener (scoring 0 to 14 points), and repeated up to 8 times (baseline and 7 consecutive follow-up years). This score was categorized into four groups: < 8, 8-< 10, 10- < 12, and 12-14 points. The outcome was new-onset type 2 diabetes. RESULTS Multivariable-adjusted hazard ratios from time-varying Cox models were 0.80 (95% confidence interval, 0.70-0.92) per + 2 points in Mediterranean Diet Adherence Screener (linear trend p = .001), and 0.46 (0.25-0.83) for the highest (12-14 points) versus the lowest (< 8) adherence. This inverse association was maintained after additionally adjusting for the randomized arm. Age- and sex-adjusted analysis of a validated plasma metabolomic signature of the Mediterranean Diet Adherence Screener (constituted of 67 metabolites) in a subset of 889 participants also supported these results. CONCLUSIONS Dietary intervention trials should quantify actual dietary adherence throughout the trial period to enhance the benefits and to assist results interpretation. A rapid dietary assessment tool, yearly repeated as a screener, was able to capture a strong inverse linear relationship between Mediterranean diet and type 2 diabetes. Trial registration ISRCTN35739639.
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Affiliation(s)
- Miguel A Martínez-González
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain.
- IdiSNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain.
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Pedro Montero
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - Miguel Ruiz-Canela
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- IdiSNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - Estefanía Toledo
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- IdiSNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - Ramón Estruch
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Enrique Gómez-Gracia
- Department of Preventive Medicine, University of Malaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Jun Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Deparment of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Emilio Ros
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic,, University of Barcelona, Barcelona, Spain
| | - Fernando Arós
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Osakidetza Basque Health Service, Bioaraba Health Research Institute, Araba University Hospital, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Alvaro Hernáez
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Blanquerna School of Health Sciences, Universitat Ramon Llull, Barcelona, Spain
| | - Dolores Corella
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Miquel Fiol
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Platform for Clinical Trials, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - José Lapetra
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Lluis Serra-Majem
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Xavier Pintó
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Montse Cofán
- Lipid Clinic, Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic,, University of Barcelona, Barcelona, Spain
| | - José V Sorlí
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Nancy Babio
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana (Grup ANUT-DSM). Institut d'Investigació Sanitària Pere Virgili, Reus, Spain
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Universitat Rovira i Virgili, Reus, Spain
| | - Yolanda F Márquez-Sandoval
- Cuerpo Académico UDG-CA-454 Alimentación y Nutrición en el Proceso de Salud-enfermedad, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Olga Castañer
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
- Centro de Investigacion Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Salas-Salvadó
- Instituto de Salud Carlos III, Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Universitat Rovira i Virgili, Reus, Spain
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Titcomb TJ, Liu B, Wahls TL, Snetselaar LG, Shadyab AH, Tabung FK, Saquib N, Arcan C, Tinker LF, Wallace RB, Bao W. Comparison of the Ketogenic Ratio of Macronutrients With the Low-Carbohydrate Diet Score and Their Association With Risk of Type 2 Diabetes in Postmenopausal Women: A Secondary Analysis of the Women's Health Initiative. J Acad Nutr Diet 2023; 123:1152-1161.e4. [PMID: 36549565 PMCID: PMC10279805 DOI: 10.1016/j.jand.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 10/27/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Previous attempts to identify low-carbohydrate diets (LCDs) in epidemiological studies relied on the LCD Score, which is unable to identify ketogenic dieters. Ketogenic ratios of macronutrients are clinical equations proposed to predict ketogenic diets; however, their utility in epidemiological studies is unknown. OBJECTIVE To determine the number of participants consuming a ketogenic diet, compare ketogenic ratios to the LCD Score, and evaluate their association with type 2 diabetes mellitus (T2DM). DESIGN Secondary analysis of the Women's Health Initiative with 17.9 ± 6.03 years of follow-up. Baseline food frequency questionnaires were used to calculate the ketogenic ratio as follows: (0.9 × grams fat + 0.46 × grams protein) / (0.1 × grams fat + 0.58 × grams protein + grams net carbohydrate), a value ≥1.5 is the minimum threshold for a ketogenic diet. PARTICIPANTS/SETTING One hundred twenty-five nine hundred eighty-two postmenopausal women without diabetes (aged 50 to 79 years) enrolled in the multicenter Women's Health Initiative observational study and clinical trials were included. MAIN OUTCOME MEASURES Risk of self-reported incident T2DM. STATISTICAL ANALYSES PERFORMED Cox proportional hazards models, adjusted for age, race, ethnicity, education, income, health insurance, relationship status, geographic region, Women's Health Initiative study component, female hormone use, smoking status, alcohol use, recreational physical activity, total energy intake, diet quality, body mass index, hyperlipidemia, and hypertension, were used to compare hazard ratios and 95% CIs for T2DM among quintiles of the ketogenic ratio. RESULTS A total of 18,775 incident cases of T2DM occurred. The median ketogenic ratio was 0.35 (interquartile range 0.28 to 0.42) and 15 individuals (0.01%) exceeded the threshold for a ketogenic diet. Higher ketogenic ratio quintiles were associated with increased risk of T2DM in a dose-dependent manner. Comparing extreme quintiles of the ketogenic ratio, the hazard ratio for diabetes was 1.24 (95% CI 1.18 to 1.31; Ptrend < 0.001) in fully adjusted models. Similarly, comparing extreme quintiles, the hazard ratio for diabetes was 1.36 (95% CI 1.29 to 1.43; Ptrend < 0.001) for the LCD Score and 1.13 (95% CI 1.07 to 1.19; Ptrend < 0.001) for the simplified ketogenic ratio in fully adjusted models. CONCLUSIONS Increasing ketogenic ratio values are associated with increased risk of T2DM and align well with LCD Scores; however, too few participants consumed a ketogenic diet to determine its association with T2DM.
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Affiliation(s)
- Tyler J Titcomb
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa; Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa; Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa.
| | - Buyun Liu
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa; Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Terry L Wahls
- Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Linda G Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California
| | - Fred K Tabung
- Department of Internal Medicine, College of Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Nazmus Saquib
- Department of Research, Sulaiman AlRajhi University, Al Bukayriah, Saudi Arabia
| | - Chrisa Arcan
- Department of Family Medicine & Population Health, Virginia Commonwealth University, Richmond, Virginia
| | - Lesley F Tinker
- Department of Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Robert B Wallace
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa; Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa; Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa; Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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11
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MacDonald CJ, Madkia AL, Mounier-Vehier C, Severi G, Boutron-Ruault MC. Associations between saturated fat intake and other dietary macronutrients and incident hypertension in a prospective study of French women. Eur J Nutr 2023; 62:1207-1215. [PMID: 36482209 DOI: 10.1007/s00394-022-03053-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 11/09/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Saturated fat has long been associated with cardiovascular disease in multiple prospective studies, and randomized controlled trials. Few studies have assessed the relative associations between saturated fat and other macronutrients with hypertension, a major risk factor for cardiovascular disease. The aim of this study was to assess the relative associations between saturated fat, other macronutrients such as monounsaturated and polyunsaturated fat, proteins, and carbohydrates, and incident hypertension in a large prospective cohort of French women. METHODS This study used data from the E3N cohort study, including participants free of hypertension at baseline. A food frequency questionnaire was used to determine dietary intakes of saturated fat (SFA), monounsaturated fat (MUFA), polyunsaturated fat (PUFA), animal protein (AP), vegetable protein (VP), carbohydrates (CH) and various foods. Cases of hypertension were based on self-report, validated by drug reimbursement data. Covariates were based on self-report. Cox proportional hazard models were used to estimate the relative associations between different macronutrients and hypertension risk, using the 'substitution' framework. Bootstrapping was used to generate 95% confidence intervals. RESULTS This study included 45,854 women free of hypertension at baseline. During 708,887 person-years of follow-up, 12,338 incident cases of hypertension were identified. Compared to saturated fat, higher consumption of all other macronutrients was associated with a lower risk of hypertension (HRMUFA = 0.74 [0.67: 0.81], HRPUFA = 0.84 [0.77: 0.92], HRCH = 0.83 [0.77: 0.88], HRAP = 0.91 [0.85: 0.97], HRVP = 0.93 [0.83: 1.03]). CONCLUSION This study finds that relative to other macronutrients such as monounsaturated or polyunsaturated fat, higher intake of saturated fat is associated with a higher risk of hypertension among women.
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Affiliation(s)
- Conor James MacDonald
- University Paris-Saclay, UVSQ, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), "Exposome and Heredity" Team, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anne-Laure Madkia
- University Paris-Saclay, UVSQ, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), "Exposome and Heredity" Team, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
- Université de Lille, CHU Lille, EA 2694-Santé Publique: Epidémiologie et Qualité des Soins, 59000, Lille, France
| | - Claire Mounier-Vehier
- Université de Lille, CHU Lille, EA 2694-Santé Publique: Epidémiologie et Qualité des Soins, 59000, Lille, France
- CHU Lille, Institut Cœur-Poumon, Médecine Vasculaire et HTA, Lille, France
| | - Gianluca Severi
- University Paris-Saclay, UVSQ, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), "Exposome and Heredity" Team, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France
- Department of Statistics, Computer Science and Applications (DISIA), University of Florence, Firenze, Italy
| | - Marie-Christine Boutron-Ruault
- University Paris-Saclay, UVSQ, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), "Exposome and Heredity" Team, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France.
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12
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Kelly RK, Tong TYN, Watling CZ, Reynolds A, Piernas C, Schmidt JA, Papier K, Carter JL, Key TJ, Perez-Cornago A. Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants. BMC Med 2023; 21:34. [PMID: 36782209 PMCID: PMC9926727 DOI: 10.1186/s12916-022-02712-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/14/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Recent studies have reported that the associations between dietary carbohydrates and cardiovascular disease (CVD) may depend on the quality, rather than the quantity, of carbohydrates consumed. This study aimed to assess the associations between types and sources of dietary carbohydrates and CVD incidence. A secondary aim was to examine the associations of carbohydrate intakes with triglycerides within lipoprotein subclasses. METHODS A total of 110,497 UK Biobank participants with ≥ two (maximum five) 24-h dietary assessments who were free from CVD and diabetes at baseline were included. Multivariable-adjusted Cox regressions were used to estimate risks of incident total CVD (4188 cases), ischaemic heart disease (IHD; 3138) and stroke (1124) by carbohydrate intakes over a median follow-up time of 9.4 years, and the effect of modelled dietary substitutions. The associations of carbohydrate intakes with plasma triglycerides within lipoprotein subclasses as measured by nuclear magnetic resonance (NMR) spectroscopy were examined in 26,095 participants with baseline NMR spectroscopy measurements. RESULTS Total carbohydrate intake was not associated with CVD outcomes. Free sugar intake was positively associated with total CVD (HR; 95% CI per 5% of energy, 1.07;1.03-1.10), IHD (1.06;1.02-1.10), and stroke (1.10;1.04-1.17). Fibre intake was inversely associated with total CVD (HR; 95% CI per 5 g/d, 0.96;0.93-0.99). Modelled isoenergetic substitution of 5% of energy from refined grain starch with wholegrain starch was inversely associated with total CVD (0.94;0.91-0.98) and IHD (0.94;0.90-0.98), and substitution of free sugars with non-free sugars was inversely associated with total CVD (0.95;0.92-0.98) and stroke (0.91;0.86-0.97). Free sugar intake was positively associated with triglycerides within all lipoproteins. CONCLUSIONS Higher free sugar intake was associated with higher CVD incidence and higher triglyceride concentrations within all lipoproteins. Higher fibre intake and replacement of refined grain starch and free sugars with wholegrain starch and non-free sugars, respectively, may be protective for incident CVD.
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Affiliation(s)
- Rebecca K. Kelly
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
| | - Tammy Y. N. Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
| | - Cody Z. Watling
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
| | - Andrew Reynolds
- Department of Medicine, University of Otago, Dunedin, 9016 New Zealand
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX3 7LF UK
| | - Julie A. Schmidt
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Olof Palmes Allé 43-45, 8200 Aarhus N, Denmark
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
| | - Jennifer L. Carter
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, OX3 7LF UK
| | - Timothy J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF UK
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Ottaviani JI, Schroeter H, Kuhnle GGC. Measuring the intake of dietary bioactives: Pitfalls and how to avoid them. Mol Aspects Med 2023; 89:101139. [PMID: 36031430 DOI: 10.1016/j.mam.2022.101139] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 02/04/2023]
Abstract
Bioactives are food constituents that, while not essential to human life, can affect health. Thus, there is increased interest in developing dietary recommendations for bioactives. Such recommendations require detailed information about the long-term association between habitual intake and health at population scale, and these can only be provided by large-scale observational studies. Nutritional epidemiology relies on the accurate estimation of intake, but currently used methods, commonly based on a 2-step process involving self-reports and food composition tables, are fraught with significant challenges and are unable to estimate the systemic presence of bioactives. Intake assessments based on nutritional biomarkers can provide an advanced alternative, but there are a number of pitfalls that need to be addressed in order to obtain reliable data on intake. Using flavan-3-ols as a case study, we highlight here key challenges and how they may be avoided. Taken together, we believe that the approaches outlined in this review can be applied to a wide range of food constituents, and doing so will improve assessments of the dietary intake of bioactives.
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Affiliation(s)
| | | | - Gunter G C Kuhnle
- Department of Food & Nutritional Sciences, University of Reading, Reading RG56 6DX, UK.
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Jones-Antwi RE, Cunningham SA. Weight patterns among mother-child pairs in the Middle East and North African Region. Ann Epidemiol 2023; 77:67-74. [PMID: 36519722 PMCID: PMC9807028 DOI: 10.1016/j.annepidem.2022.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 11/07/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022]
Abstract
AIM We aim to evaluate weight status in mother-child household pairs and patterns specific to over-nutrition households and double burden households. METHODS We used nationally representative data from the most recent Demographic and Health Survey (2001-2014) in the Middle East & North African (MENA) Region (n = 45,104) to examine weight status of mother-child dyads. Under-nutrition households were defined as mothers with underweight and children with wasting; over-nutrition households as mothers with overweight/obesity and children with overweight; and double burden households as mothers with underweight and children with overweight or mothers with overweight/obesity mother and children with wasting. Survey-adjusted multinomial logistic regression were used to quantify predictors of weight patterns. RESULTS Across the MENA region, 8.6% of households were experiencing double burden malnutrition, 11% were experiencing over-nutrition and 0.2% were experiencing under-nutrition. Wealthier households with older mothers, higher birth-order children, more educated parents and private water access were more likely to be over-nutrition or double burden households. Compared to over-nutrition households, double burden households were poorer and more likely to have a child with low birthweight. CONCLUSIONS Over-nutrition is the most common unhealthy weight pattern, followed by double-burden; socioeconomic status and birth weight are consistent predictors of unhealthy mother-child pairs.
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Affiliation(s)
| | - Solveig A Cunningham
- Hubert Department of Global Health, Emory University, Atlanta, GA; Department of Sociology, Emory University, Atlanta, GA
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15
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Pitre T, Jassal T, Park L, Coello PA, de Souza R, Zeraatkar D. Reporting and interpretation of effects in non-randomized nutritional and environmental epidemiology: a methods study. Ann Epidemiol 2023; 77:37-43. [PMID: 36375709 DOI: 10.1016/j.annepidem.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/19/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE The presentation of absolute effects, in addition to relative effects, is critical to the optimal interpretation of effect estimates. Failure to present and interpret absolute effects may obscure the magnitude of the effect of an intervention or exposure and mislead evidence users. OBJECTIVE In this study, we estimate the proportion of systematic reviews and meta-analyses (SRMAs) addressing the health effects of nutritional and environmental exposures that report absolute effects. METHODS We searched MEDLINE and EMBASE from 2019 through 2021 for SRMAs addressing the health effects of nutritional and environmental exposures and patient-important health outcomes. We included a sample of 200 SRMAs. Pairs of reviewers, working independently and in duplicate, reviewed search records for eligibility and collected data from SRMAs. RESULTS More than two-thirds (153/200; 76.5%) of eligible systematic reviews reported on one or more dichotomous outcomes that could be translated to absolute effects. Only eight (8/153, 5.2%)5.2%), however, reported absolute effects. A similar proportion of reviews published in high-impact journals and in other journals reported absolute effects (4/131; 3.1% vs. 4/69; 5.9%). Among reviews that reported absolute effects, six reviews (6/8; 75%) reported absolute risk differences as fractions (e.g., 2 fewer cases per 1000 people) and two reviews (2/8; 25%) presented the number of cases prevented by modifying the exposure (e.g., 2000 cases prevented in United States annually). CONCLUSIONS Reviews addressing the effects of nutritional and environmental exposures on health outcomes rarely report absolute effects, which precludes effective interpretation of magnitudes of effects and their importance. We present guidance for review authors, editors, peer reviewers, and evidence users to calculate and interpret absolute effects.
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Affiliation(s)
- Tyler Pitre
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Tanvir Jassal
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - Louis Park
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Pablo Alonso Coello
- Iberoamerican Cochrane Centre, Biomedical Research Institute (IIB Sant Pau-CIBERESP), Barcelona, Spain, Barcelona GRADE Centre, Biomedical Research Institute (IIB Sant Pau-CIBERESP), Barcelona, Spain
| | - Russell de Souza
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Dena Zeraatkar
- Department of Biomedical Informatics, Harvard Medical School, Cambridge, MA, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
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16
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de Almeida Alves M, Molina MDCB, da Fonseca MJM, Lotufo PA, Benseñor IM, Marchioni DML. Different statistical methods identify similar population-specific dietary patterns: an analysis of Longitudinal Study of Adult Health (ELSA-Brasil). Br J Nutr 2022; 128:2249-57. [PMID: 35086581 DOI: 10.1017/S0007114522000253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In recent decades, different data-driven approaches have emerged to identify dietary patterns (DP) and little is discussed about how these methods are able to capture diet complexity within the same population. This study aimed to apply three statistical methods to identify the DP of the Longitudinal Study of Adult Health (ELSA-Brasil) population and evaluate the similarities and differences between them. Dietary data were assessed at baseline in the ELSA-Brasil study using a FFQ. DP were identified by applying three statistical methods: (1) factor analysis (FA), (2) treelet transform (TT) and (3) reduced rank regression (RRR). The characteristics of individuals classified in the last tertile of each DP were compared. Cross-classification and Pearson's correlation coefficients were assessed to evaluate the agreement between individuals' adherence to DP of the three methods. A similar convenience DP was identified for all three methods. FA and TT also identified a similar prudent DP and a DP highly loaded for the food groups rice and beans. Individuals classified in the third tertile of similar DP of each method presented similar socio-demographic and nutrient intake characteristics. Regarding the cross-classification, prudent DP from FA and TT presented a higher level of agreement (75 %), while convenience DP from TT and RRR presented the lowest agreement (44·8 %). The different statistical methods were able to capture the populations' DP in a similar way while highlighting the particularities of each method.
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Mattar JB, Domingos ALG, Hermsdorff HHM, Juvanhol LL, de Oliveira FLP, Pimenta AM, Bressan J. Ultra-processed food consumption and dietary, lifestyle and social determinants: a path analysis in Brazilian graduates (CUME project). Public Health Nutr 2022; 25:1-9. [PMID: 36146891 PMCID: PMC9991755 DOI: 10.1017/s1368980022002087] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 06/30/2022] [Accepted: 08/30/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore the relationship between ultra-processed foods (UPF) consumption and dietary, lifestyle and social determinants using pathway analysis in the baseline of the Cohort of Universities of Minas Gerais (CUME project). DESIGN Cross-sectional study, in which path analysis was used to estimate direct and indirect effects of dietary practices, sleep, time on the computer and professional status on UPF consumption. SETTING Data were collected in 2016, through an online questionnaire composed of sociodemographic, anthropometric, lifestyle and dietary practices questions, and a FFQ. PARTICIPANTS Baseline participants from the CUME Project (n 2826), adults who graduated from Universidade Federal de Viçosa or Universidade Federal de Minas Gerais, Brazil. RESULTS Being employed (P = 0·024), the time spent on the computer (P = 0·031) and the frequency of fried food intake (P < 0·001) were positively and directly associated with UPF consumption, whereas the sleep duration (P = 0·007) and the number of meals per d (P < 0·001) were negatively and directly associated with UPF consumption. Indirect effects were observed between being employed, mediated by the sleep duration (P = 0·032) and fried food intake (P = 0·005), whereas being a student is mediated by the time on the computer (P = 0·048). CONCLUSION The time spent on the computer, sleep duration and fried food consumption showed direct effects on UPF consumption. They also acted as mediators on the relationship between professional status and UPF consumption. Besides, the number of meals eaten each day also was directly associated with UPF consumption.
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Affiliation(s)
- Jéssica Bevenuto Mattar
- Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), PH Rolfs Avenue W/N, University Campus, Viçosa, MG36571-000, Brazil
| | - Ana Luiza Gomes Domingos
- Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), PH Rolfs Avenue W/N, University Campus, Viçosa, MG36571-000, Brazil
| | - Helen Hermana Miranda Hermsdorff
- Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), PH Rolfs Avenue W/N, University Campus, Viçosa, MG36571-000, Brazil
| | - Leidjaira Lopes Juvanhol
- Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), PH Rolfs Avenue W/N, University Campus, Viçosa, MG36571-000, Brazil
| | | | | | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), PH Rolfs Avenue W/N, University Campus, Viçosa, MG36571-000, Brazil
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18
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Mulcahy MC, Tellez-Rojo MM, Cantoral A, Solano-González M, Baylin A, Bridges D, Peterson KE, Perng W. Maternal carbohydrate intake during pregnancy is associated with child peripubertal markers of metabolic health but not adiposity. Public Health Nutr 2022; 25:2541-2553. [PMID: 34814962 PMCID: PMC9991622 DOI: 10.1017/s1368980021004614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/15/2021] [Accepted: 11/15/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine the associations of trimester-specific maternal prenatal carbohydrate (CHO) intake with offspring adiposity and metabolic health during peripuberty. DESIGN Prospective cohort study in which maternal dietary intake was collected via validated FFQ during each trimester. Offspring adiposity and metabolic biomarkers were evaluated at age 8-14 years. We used multivariable linear regression to examine associations between total energy-adjusted maternal CHO intake and offspring BMI z-score, skinfold thickness and metabolic syndrome risk z-score calculated as the average of waist circumference, fasting glucose, fasting C-peptide, TAG:HDL and systolic blood pressure + diastolic blood pressure/2. SETTING Mexico City, Mexico. PARTICIPANTS 237 mother-child pairs in the Early Life Exposure in Mexico to Environmental Toxicants cohort. RESULTS We found non-linear associations of maternal CHO intake during pregnancy with offspring metabolic health during peripuberty. After adjusting for maternal age, and child age, sex and pubertal status, children whose mothers were in the fourth v. first quartile of total CHO intake during the third trimester had 0·42 (95 % CI -0·01, 0·08) ng/ml lower C-peptide and 0·10 (95 % CI -0·02, 0·22) units lower C-peptide insulin resistance (CP-IR). We found similar magnitude and direction of association with respect to net CHO intake during the first trimester and offspring C-peptide and CP-IR. Maternal CHO intake during pregnancy was not associated with offspring adiposity. CONCLUSIONS In this study of mother-child pairs in Mexico City, children born to women in the highest quartile of CHO intake during pregnancy had lowest C-peptide and CP-IR during peripuberty. Additional research is warranted to replicate and identify mechanisms.
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Affiliation(s)
- Molly C Mulcahy
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Martha Maria Tellez-Rojo
- Center for Nutrition and Health Research, Instituto de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Alejandra Cantoral
- Department of Health, Universidad Iberoamericana, Prolongación Paseo de Reforma 880, Lomas de Santa Fe, Ciudad de México, C.P. 01219, Mexico
| | - Maritsa Solano-González
- Center for Nutrition and Health Research, Instituto de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Ana Baylin
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Dave Bridges
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Wei Perng
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Epidemiology, Colorado School of Public Health, Anschutz Medical Campus, Aurora, CO, USA
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Brown RB. Low dietary sodium potentially mediates COVID-19 prevention associated with whole-food plant-based diets. Br J Nutr 2022; 129:1-6. [PMID: 35912674 PMCID: PMC10011594 DOI: 10.1017/s0007114522002252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/11/2022] [Accepted: 07/12/2022] [Indexed: 11/07/2022]
Abstract
Compared with an omnivorous Western diet, plant-based diets containing mostly fruits, vegetables, grains, legumes, nuts and seeds, with restricted amounts of foods of animal origin, are associated with reduced risk and severity of COVID-19. Additionally, inflammatory immune responses and severe acute respiratory symptoms of COVID-19, including pulmonary oedema, shortness of breath, fever and nasopharyngeal infections, are associated with Na toxicity from excessive dietary Na. High dietary Na is also associated with increased risks of diseases and conditions that are co-morbid with COVID-19, including chronic kidney disease, hypertension, stroke, diabetes and obesity. This article presents evidence that low dietary Na potentially mediates the association of plant-based diets with COVID-19 prevention. Processed meats and poultry injected with sodium chloride contribute considerable amounts of dietary Na in the Western diet, and the avoidance or reduction of these and other processed foods in whole-food plant-based (WFPB) diets could help lower overall dietary Na intake. Moreover, high amounts of K in plant-based diets increase urinary Na excretion, and preagricultural diets high in plant-based foods were estimated to contain much lower ratios of dietary Na to K compared with modern diets. Further research should investigate low Na in WFPB diets for protection against COVID-19 and co-morbid conditions.
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Affiliation(s)
- Ronald B. Brown
- School of Public Health Sciences, University of Waterloo, Waterloo, ONN2L3G1, Canada
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20
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Zhu B, Li Y, Shi Y, Song N, Fang Y, Ding X. Long-term drinking behavior change patterns and its association with hyperuricemia in chinese adults: evidence from China Health and Nutrition Survey. BMC Public Health 2022; 22:1230. [PMID: 35725435 PMCID: PMC9210654 DOI: 10.1186/s12889-022-13637-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 06/08/2022] [Indexed: 11/27/2022] Open
Abstract
Background We aimed to explore the association between long-term drinking behavior change patterns with hyperuricemia (HUA) in Chinese community adults. Methods This study was designed as a community-based unbalanced cohort study involving 4127 adults aged between 18 ~ 75 years, derived from the China Health and Nutrition Survey (CHNS) in 1997 and 2009. Drinking behavior change patterns were categorized into: never drinking, change to drinking, quitting drinking, and continued drinking. The alcoholism, type, and frequency of drinking were further categorized. We applied logistic regression models to explore the associations between drinking behavior change patterns and HUA. Results The average age of the participants was 54.6 (± 11.3) years and 47.8% were male. The overall prevalence of HUA was 15.5%. Drinking behavior change patterns of quitting (aOR 1.8; 95% CI 1.1 ~ 2.8) and continued drinking (aOR 2.0; 95% CI 1.3 ~ 3.0) were positively associated with high risks of HUA in the male participants. Early drinking behaviors such as liquor intake (aOR 1.8; 95% CI 1.4 ~ 2.5) and high consumption or frequency showed a positive correlation with HUA. Of note, heavy alcoholism (aOR 2.0; 95% CI 1.4 ~ 2.8) and daily drinking (aOR 2.5; 95% CI 1.7 ~ 3.6) had the highest risks of HUA. Furthermore, in the male participants, the association between early total alcohol intake and HUA was more pronounced at 18 standard drinks intake, with a stable increasing trend. In contrast, no statistical correlation was observed between the drinking behaviors and HUA in the female participants. Conclusions Drinking behavior change patterns of quitting and continued drinking are strongly associated with increased risks of HUA in males. The risks emanated from early drinking behaviors such as liquor drinking, high drinking frequency, and alcohol consumption. Although quitting drinking was associated with lower HUA risks compared to continued drinking, it still presented an undeniable risk for HUA. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13637-4.
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Affiliation(s)
- Bowen Zhu
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yang Li
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yiqin Shi
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Nana Song
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yi Fang
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China.,Shanghai Medical Center of Kidney, Shanghai, China.,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, 200032, Shanghai, Shanghai, China. .,Shanghai Medical Center of Kidney, Shanghai, China. .,Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China.
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21
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Maugeri A, Barchitta M, Magnano San Lio R, Scalisi A, Agodi A. Antioxidant and inflammatory potential of diet among women at risk of cervical cancer: findings from a cross-sectional study in Italy. Public Health Nutr 2022; 25:1577-85. [PMID: 33958013 DOI: 10.1017/S1368980021001944] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
OBJECTIVE To evaluate the association of Composite Dietary Antioxidant Index (CDAI) and Dietary Inflammatory Index (DII) with the prevalence of high-grade cervical intraepithelial neoplasia (CIN). DESIGN A cross-sectional study was conducted on women with abnormal Papanicolaou test, who underwent high-risk human papillomavirus (HPV) screening and histological test through colposcopy. Dietary data were collected using a FFQ and used to assess both CDAI and DII. SETTING Women were recruited from 2012 to 2015 at the Cervical Cancer Screening Unit of the 'Azienda Sanitaria Provinciale' of Catania (Italy). PARTICIPANTS The study included 539 women with a mean age of 40·2 years, who were classified as cases (n 127 with CIN2 or more severe lesions) and controls (n 412 with normal cervical epithelium or CIN1). RESULTS Although we observed a lower proportion of HPV-positive women among those with higher CDAI (P < 0·001), the index was not associated with the diagnosis of CIN2 or more severe lesions. By contrast, women with medium or high DII showed higher odds to be diagnosed with CIN2 or more severe lesions than those with low DII (OR = 2·15; 95 % CI 1·11, 4·17; P = 0·024 and OR = 3·14; 95 % CI 1·50, 6·56; P = 0·002, respectively), after adjusting for age, HPV status, educational level, BMI, smoking status, parity, use of oral contraceptives and supplements. CONCLUSIONS Our findings suggested that a pro-inflammatory diet might be associated with an increased risk of CIN2 and more severe lesions. However, further prospective studies should be encouraged to support this evidence.
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Abstract
PURPOSE OF REVIEW The number of published studies on the health effects of plant-based diets has increased dramatically in the last decade. The purpose of this narrative review is to update the most recent evidence from large prospective cohort studies and meta-analyses on the effects of plant-based dietary patterns on cardiovascular outcomes and risk factors and total mortality. RECENT FINDINGS Most new data from large prospective cohort studies carried out in the USA, Europe, and Asia continue to show inverse associations between plant-based diets and the incidence of ischemic heart disease and stroke, while less data exist for heart failure incidence. New analyses suggest that only some components of plant-based diets are associated with cardiovascular benefit. Recent meta-analyses show inverse associations between plant-protein intake and all-cause mortality, although heterogeneity exists, and small mortality risks from some animal proteins, notably processed meats. New studies continue to demonstrate small but favorable effects of plant-based diets on traditional risk factors and suggest other emerging mechanisms by which plant-based diets exert cardiovascular benefits. The recommendation to consume a plant-based diet to reduce cardiovascular risk remains an evidence-based strategy based on observational studies. New data highlight the importance of ensuring that these diets are nutrient-rich and low in plant foods associated with signals of harm. For this reason, assessment of diet quality is important even in patients who report adherence to plant-based diets. Large randomized trials with hard cardiovascular endpoints might strengthen this evidence-base, but feasibility is limited.
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23
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Legay C, Krasniqi T, Bourdet A, Bonny O, Bochud M. Methods for the dietary assessment of adult kidney stone formers: a scoping review. J Nephrol 2022; 35:821-830. [PMID: 35167058 PMCID: PMC8995246 DOI: 10.1007/s40620-022-01259-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/15/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Kidney stones are a frequent and potentially severe condition, affecting 5-10% of the European population. Causes are multifactorial, diet in particular plays a major role in the formation and management of kidney stones. The aim of this scoping review is to assess the methods used to study the diet of adult kidney stone formers. METHODS We conducted a systematic search in Medline Ovid SP, Embase, Cinahl, Cochrane (CENTRAL), Web of Sciences databases on June 10th, 2020. Self-report methods (such as food frequency questionnaires or 24-h dietary recalls), objective nutritional biomarkers and controlled diets were considered. We analyzed the selected publications based on the origin of participants, study design and dietary assessment methods used. RESULTS We screened 871 publications and included 162 of them. Most studies included participants from North America and Europe and were observational. Short and cost-effective tools such as food frequency questionnaires and other questionnaires were the most frequently used. Moreover, food diary was a frequently selected method to study the diet of kidney stone formers. New technologies (e.g. online questionnaires, phone applications, connected tools) were rarely used. CONCLUSION Accurate reporting of the methods used in nutritional studies is of key importance to interpret results and build evidence. Assessing long-term dietary intake is still a challenge for nutritional epidemiology. A combination of self-report methods with objective dietary biomarkers and new technologies probably represents the best way forward.
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Affiliation(s)
- Constance Legay
- Department of Biomedical Sciences, University of Lausanne, Switzer Rue du Bugnon 27, 1011, Lausanne, Switzerland.,Department of Epidemiology and Health Systems, Unisanté, Lausanne, Switzerland.,NCCR Kidney.CH, Zürich, Switzerland
| | - Tropoja Krasniqi
- Department of Biomedical Sciences, University of Lausanne, Switzer Rue du Bugnon 27, 1011, Lausanne, Switzerland.,Service of Nephrology, Lausanne University Hospital, Lausanne, Switzerland
| | - Alice Bourdet
- Department of Epidemiology and Health Systems, Unisanté, Lausanne, Switzerland
| | - Olivier Bonny
- Department of Biomedical Sciences, University of Lausanne, Switzer Rue du Bugnon 27, 1011, Lausanne, Switzerland. .,Service of Nephrology, Lausanne University Hospital, Lausanne, Switzerland. .,NCCR Kidney.CH, Zürich, Switzerland.
| | - Murielle Bochud
- Department of Epidemiology and Health Systems, Unisanté, Lausanne, Switzerland.,NCCR Kidney.CH, Zürich, Switzerland
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Abstract
Estimating the marginal and joint densities of the long-term average intakes of different dietary components is an important problem in nutritional epidemiology. Since these variables cannot be directly measured, data are usually collected in the form of 24-hour recalls of the intakes, which show marked patterns of conditional heteroscedasticity. Significantly compounding the challenges, the recalls for episodically consumed dietary components also include exact zeros. The problem of estimating the density of the latent long-time intakes from their observed measurement error contaminated proxies is then a problem of deconvolution of densities with zero-inflated data. We propose a Bayesian semiparametric solution to the problem, building on a novel hierarchical latent variable framework that translates the problem to one involving continuous surrogates only. Crucial to accommodating important aspects of the problem, we then design a copula based approach to model the involved joint distributions, adopting different modeling strategies for the marginals of the different dietary components. We design efficient Markov chain Monte Carlo algorithms for posterior inference and illustrate the efficacy of the proposed method through simulation experiments. Applied to our motivating nutritional epidemiology problems, compared to other approaches, our method provides more realistic estimates of the consumption patterns of episodically consumed dietary components.
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Affiliation(s)
- Abhra Sarkar
- Department of Statistics and Data Sciences, The University of Texas at Austin, 2317 Speedway D9800, Austin, TX 78712-1823, USA
| | - Debdeep Pati
- Department of Statistics, Texas A&M University, 3143 TAMU, College Station, TX 77843-3143, USA
| | - Bani K Mallick
- Department of Statistics, Texas A&M University, 3143 TAMU, College Station, TX 77843-3143, USA
| | - Raymond J Carroll
- Department of Statistics, Texas A&M University, 3143 TAMU, College Station, TX 77843-3143, USA, School of Mathematical and Physical Sciences, University of Technology, Sydney, Broadway NSW 2007, Australia
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25
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Black LJ, Dunlop E, Lucas RM, Pearson G, Farrant B, Shepherd CCJ. Prevalence and predictors of vitamin D deficiency in a nationally representative sample of Australian Aboriginal and Torres Strait Islander adults. Br J Nutr 2021; 126:101-9. [PMID: 33028435 DOI: 10.1017/S0007114520003931] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) concentration <50 nmol/l) is recognised as a public health problem globally. The present study details the prevalence and predictors of vitamin D deficiency in a nationally representative sample (n 3250) of Australian Aboriginal and Torres Strait Islander adults aged ≥18 years. We used data from the 2012-2013 Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS). Serum 25(OH)D concentrations were measured by liquid chromatography-tandem MS. Survey-weighted logistic regression models were used to determine the independent predictors of vitamin D deficiency. Approximately 27 % of adult AATSIHS participants were vitamin D deficient. Vitamin D deficiency was more prevalent in remote areas (39 %) than in non-remote areas (23 %). Independent predictors of vitamin D deficiency included assessment during winter (men, adjusted OR (aOR) 5·7; 95 % CI 2·2, 14·6; women, aOR 2·2; 95 % CI 1·3, 3·8) and spring (men, aOR 3·3; 95 % CI 1·4, 7·5; women, aOR 2·6; 95 % CI 1·5, 4·5) compared with summer, and obesity (men, aOR 2·6; 95 % CI 1·2, 5·4; women, aOR 4·3; 95 % CI 2·8, 6·8) compared with healthy weight. Statistically significant associations were evident for current smokers (men only, aOR 2·0; 95 % CI 1·2, 3·4), remote-dwelling women (aOR 2·0; 95 % CI 1·4, 2·9) and university-educated women (aOR 2·4; 95 % CI 1·2, 4·8). Given the high prevalence of vitamin D deficiency in this population, strategies to maintain adequate vitamin D status through safe sun exposure and dietary approaches are needed.
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Cao Z, Wong MY. Moment estimation method of parameters in additive measurement error model. Comput Methods Programs Biomed 2021; 206:106090. [PMID: 33964801 DOI: 10.1016/j.cmpb.2021.106090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In nutritional epidemiology, covariates in some studies such as the EPIC are prone to measurement error. Estimation of unknown parameters in most measurement error models for food frequency questionnaire (FFQ) and nutrient biomarkers requires replicated measurements. But, the EPIC-InterAct Study did not collect replicated measurements for FFQ or 24-hour dietary recalls (24HR). The method of correcting measurement error in this case is worth studying. METHODS A moment method is applied to estimate unknown parameters of the proposed error model with correlated errors between biased measurements of FFQ and 24HR. Then, correction factor and reliability ratio of each error-prone nutrient can be obtained correspondingly. Afterwards, regression calibration (RC) under a Cox model is used to correct measurement error of nutrients of interest in the EPIC-InterAct data. RESULTS Compared to the naive estimation, estimation results for dietary intakes could be very different when we take measurement error into consideration. Using RC as the correction method, hazard ratios (HR) of vegetable plus fruit, fat and energy for males become 1.01 (95% CI 0.75-1.35), 1.30 (95% CI 1.12-1.51) and 1.16 (95% CI 1.04-1.28), respectively, and HR of energy for females becomes 0.99 (95% CI 0.91-1.08). These HRs are greatly different from those by naive estimation. CONCLUSIONS Although there is no repeated measurement for FFQ and 24HR, we can still estimate all unknown parameters in our proposed error model under four assumptions and then correct measurement error in nutrients of interest in EPIC-InterAct Study by RC for avoiding some misleading results from naive estimation.
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Affiliation(s)
- Zhiqiang Cao
- College of Big Data and Internet, Shenzhen Technology University, Shenzhen, PR China.
| | - Man Yu Wong
- Department of Mathematics, The Hong Kong University of Science and Technology, Hong Kong SAR, PR China
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Marakis G, Katsioulis A, Kontopoulou L, Ehlers A, Heimberg K, Hirsch-Ernst KI, Langerholc T, Adamska H, Matyjaszczyk E, Silva KDR, Madumali KAC, Yeh TS, Chiou LJ, Lin MJ, Karpetas G, Weissenborn A. Knowledge, attitude and behaviour of university students regarding salt and iodine: a multicentre cross-sectional study in six countries in Europe and Asia. ACTA ACUST UNITED AC 2021; 79:68. [PMID: 33947465 PMCID: PMC8097851 DOI: 10.1186/s13690-021-00593-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/21/2021] [Indexed: 11/25/2022]
Abstract
Background Strategies to reduce salt intake are encouraged to be implemented in parallel with those that aim to ensure iodine adequacy at the population level. The aim of the present study was to assess and compare knowledge, attitudes and behaviours related to salt and iodine among students in Europe and Asia. Methods A multicentre cross-sectional study was conducted with 2459 university students in total (42.7% males, median age 21 years) from four countries in Europe and two countries in Asia. Data were collected with the use of a self-administered questionnaire, and univariate and multivariate statistical analyses were performed to explore any association between variables. Results Only 6.5% of all participants knew the correct salt recommendations. Nearly a quarter of them (24.4%) found salt recommendations confusing and/or contradictory. There were significant differences between European and Asian participants, with those from Europe being better informed about salt recommendations, but significantly less knowledgeable about iodine. The reported frequency of use of salt and salt-containing sauces either at the table or for cooking, as well as knowledge about ways to reduce salt intake among those who indicated to make conscious efforts to do so, differed significantly between countries. Significant differences between countries were also observed with respect to the type of salt used, with about one third of all participants (34%) not being aware of the kind of salt they used. Conclusion The results of this survey highlight serious salt- and iodine-related knowledge gaps among university students in Europe and Asia. Raising awareness and conducting information campaigns is needed to promote changes in behaviour that would result in a reduction of salt intake and conscious use of iodised salt at the individual level. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00593-5.
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Affiliation(s)
- Georgios Marakis
- Nutrition and Food Standards Unit, Directorate of Risk Assessment and Nutrition, Hellenic Food Authority, Athens, Greece
| | | | | | - Anke Ehlers
- Department of Food Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Katharina Heimberg
- Department of Food Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | | | - Tomaž Langerholc
- Department of Microbiology, Biochemistry, Molecular Biology and Biotechnology, University of Maribor, Maribor, Slovenia
| | - Hanna Adamska
- Institute of Economic Sciences, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
| | - Ewa Matyjaszczyk
- Institute of Plant Protection-National Research Institute, Poznan, Poland
| | - K D Renuka Silva
- Department of Applied Nutrition, Wayamba University of Sri Lanka, Gonawila, Kuliyapitiya, Sri Lanka
| | - K A Chathurika Madumali
- Department of Applied Nutrition, Wayamba University of Sri Lanka, Gonawila, Kuliyapitiya, Sri Lanka
| | - Tai-Sheng Yeh
- Department of Food Science and Nutrition, Meiho University, Neipu, Pingtung, Taiwan
| | - Ling-Jan Chiou
- Department of Health Business Administration, Meiho University, Neipu, Pingtung, Taiwan
| | - Mei-Jen Lin
- Department of Animal Science, National Pingtung University of Science and Technology, Neipu, Pingtung, Taiwan
| | | | - Anke Weissenborn
- Department of Food Safety, German Federal Institute for Risk Assessment, Berlin, Germany.
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Sakurai M, Ishizaki M, Morikawa Y, Kido T, Naruse Y, Nakashima Y, Okamoto C, Nogawa K, Watanabe Y, Suwazono Y, Hozawa A, Yoshita K, Nakagawa H. Frequency of consumption of balanced meals, bodyweight gain and incident risk of glucose intolerance in Japanese men and women: A cohort study. J Diabetes Investig 2021; 12:763-770. [PMID: 32869545 PMCID: PMC8089009 DOI: 10.1111/jdi.13392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/17/2020] [Accepted: 08/20/2020] [Indexed: 12/14/2022] Open
Abstract
AIMS/INTRODUCTION This cohort study assessed the risk for bodyweight gain and development of glucose intolerance based on the frequency of consumption of balanced meals including grain, fish or meat and vegetables. MATERIALS AND METHODS The participants (8,573 men, 3,327 women) were employees of a company in Japan. A self-administered questionnaire was used to evaluate the frequency of balanced meal consumption. Bodyweight changes and the incidence of glucose intolerance (glycated hemoglobin >6.0%) during the 3-year follow-up period were determined through annual health examinations. RESULTS The mean bodyweight change over a period of 3 years was 0.78 kg for men and 0.84 kg for women. A lower frequency of balanced meals was associated with a higher bodyweight gain for men (P for trend = 0.004), but not for women. During the study, 464 men and 115 women developed glucose intolerance. Overall, the frequency of balanced meals was not associated with the risk of glucose intolerance in either sex. However, the interaction between the frequency of balanced meals and degree of obesity had a significant effect on the incidence of glucose intolerance in men (P = 0.005), with less frequent consumption of balanced meals being associated with a higher risk for glucose intolerance among men with a BMI ≥25.0 kg/m2 (P for trend = 0.007). CONCLUSIONS A higher frequency of balanced meals, including grain, fish or meat and vegetable dishes - important components of healthy Japanese food - was associated with a lower risk of glucose intolerance in obese men, but not in non-obese men and women.
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Affiliation(s)
- Masaru Sakurai
- Department of Social and Environmental MedicineKanazawa Medical UniversityUchinadaJapan
- Health Evaluation CenterKanazawa Medical UniversityUchinadaJapan
| | - Masao Ishizaki
- Department of Social and Environmental MedicineKanazawa Medical UniversityUchinadaJapan
- Health Evaluation CenterKanazawa Medical UniversityUchinadaJapan
| | - Yuko Morikawa
- School of NursingKanazawa Medical UniversityUchinadaJapan
| | - Teruhiko Kido
- School of Health SciencesCollege of Medical, Pharmaceutical and Health SciencesKanazawa UniversityKanazawaJapan
| | | | | | | | - Kazuhiro Nogawa
- Department of Occupation and Environmental MedicineGraduate School of MedicineChiba UniversityChibaJapan
| | - Yuuka Watanabe
- Department of Occupation and Environmental MedicineGraduate School of MedicineChiba UniversityChibaJapan
| | - Yasushi Suwazono
- Department of Occupation and Environmental MedicineGraduate School of MedicineChiba UniversityChibaJapan
| | - Atsushi Hozawa
- Department of Preventive Medicine and EpidemiologyTohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Katsushi Yoshita
- Department of Food Science and NutritionGraduate School of Human Life ScienceOsaka City UniversityOsakaJapan
| | - Hideaki Nakagawa
- Department of Social and Environmental MedicineKanazawa Medical UniversityUchinadaJapan
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Suhett LG, Vieira Ribeiro SA, Hermsdorff HHM, Silva MA, Shivappa N, Hébert JR, Novaes JF. Dietary inflammatory index scores are associated with atherogenic risk in Brazilian schoolchildren. Public Health Nutr 2021;:1-10. [PMID: 33902777 DOI: 10.1017/S1368980021001816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the association between the Children's Dietary Inflammatory Index (C-DIITM) scores and atherogenic risk in Brazilian schoolchildren. DESIGN A cross-sectional representative study. Three 24-h dietary recalls were performed to evaluate food consumption and to calculate C-DII scores. Blood samples were collected for the lipid profile analysis (serum total cholesterol (TC), HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol and triglycerides (TAG)) and to determine atherogenic indexes (Castelli risk indexes I and II, lipoprotein combined index (LCI), and atherogenic index of plasma and atherogenic coefficient (AC)). A semi-structured questionnaire was used to obtain sociodemographic characteristics and screen time. Body fat was assessed by dual-energy X-ray absorptiometry. We compared the distributions of outcomes by C-DII categories using multivariable linear regression. SETTING Viçosa, Minas Gerais, Brazil. PARTICIPANTS Three hundred seventy-eight children between the ages of 8 and 9 years. RESULTS The mean C-DII score was 0·60 ± 0·94, and the prevalence of dyslipidaemia was 70 %. Children with hypercholesterolaemia and hypertriglyceridaemia had higher C-DII scores. The C-DII was directly associated with atherogenic risk. Every 1 sd of C-DII was associated with a 0·07 (0·01, 0·13), 1·94 (0·20, 3·67), 0·06 (0·002, 0·12) and 0·12 (0·02, 0·22) units higher TC:HDL cholesterol ratio, LCI, AC and accumulation of altered dyslipidaemia markers (high TC + high LDL-cholesterol + high TAG + low HDL-cholesterol), respectively. CONCLUSIONS Dietary inflammatory potential, as estimated by the C-DII, is directly associated with atherogenic risk in Brazilian schoolchildren. This results reinforce the importance of effective nutritional policies to promote healthy eating habits and improve children's lipid profiles.
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Hodge AM, Karim MN, Hébert JR, Shivappa N, Milne RL, de Courten B. Diet scores and prediction of general and abdominal obesity in the Melbourne collaborative cohort study. Public Health Nutr 2021;:1-12. [PMID: 33875030 DOI: 10.1017/S1368980021001713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To ascertain which of the Alternative Healthy Eating Index (AHEI) 2010, Dietary Inflammatory Index (DII®) and Mediterranean Diet Score (MDS) best predicted BMI and waist-to-hip circumference ratio (WHR). DESIGN Body size was measured at baseline (1990-1994) and in 2003-2007. Diet was assessed at baseline using a FFQ, along with age, sex, socio-economic status, smoking, alcohol drinking, physical activity and country of birth. Regression coefficients and 95 % CI for the association of baseline dietary scores with follow-up BMI and WHR were generated using multivariable linear regression, adjusting for baseline body size, confounders and energy intake. SETTING Population-based cohort in Melbourne, Australia. PARTICIPANTS Included were data from 11 030 men and 16 774 women aged 40-69 years at baseline. RESULTS Median (IQR) follow-up was 11·6 (10·7-12·8) years. BMI and WHR at follow-up were associated with baseline DII® (Q5 v. Q1 (BMI 0·41, 95 % CI 0·21, 0·61) and WHR 0·009, 95 % CI 0·006, 0·013)) and AHEI (Q5 v. Q1 (BMI -0·51, 95 % CI -0·68, -0·35) and WHR -0·011, 95 % CI -0·013, -0·008)). WHR, but not BMI, at follow-up was associated with baseline MDS (Group 3 most Mediterranean v. G1 (BMI -0·05, 95 % CI -0·23, 0·13) and WHR -0·004, 95 % CI -0·007, -0·001)). Based on Akaike's Information Criterion and Bayesian Information Criterion statistics, AHEI was a stronger predictor of body size than the other diet scores. CONCLUSIONS Poor quality or pro-inflammatory diets predicted overall and central obesity. The AHEI may provide the best way to assess the obesogenic potential of diet.
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van Meijeren-van Lunteren AW, Voortman T, Elfrink MEC, Wolvius EB, Kragt L. Breastfeeding and Childhood Dental Caries: Results from a Socially Diverse Birth Cohort Study. Caries Res 2021; 55:153-161. [PMID: 33706311 DOI: 10.1159/000514502] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/13/2020] [Indexed: 12/29/2022] Open
Abstract
Previous studies showed that prolonged breastfeeding increases the risk of caries. However, the observed associations were mainly based on non-European populations, and important confounding and mediating factors like socioeconomic position (SEP) and diet were often neglected. The aim of this study was to investigate the role of breastfeeding and bottle-feeding practices on dental caries during childhood while accounting for SEP, ethnic background, and sugar intake. This study was part of the Generation R Study, a prospective multiethnic cohort study conducted in Rotterdam, The Netherlands. In total, 4,146 children were included in the analyses. Information about feeding practices was derived from delivery reports and questionnaires during infancy. Caries was measured via intraoral photographs at the age of 6 years and defined as decayed, missing, and filled teeth (dmft). Negative binomial hurdle regression analyses were used to study the associations between several infant feeding practices and childhood caries. The prevalence of dental caries at the age of 6 years was 27.9% (n = 1,158). Prolonged breastfeeding (for >12 months) was associated with dental caries (OR 1.35, 95% CI 1.04-1.74) and the number of teeth affected by dental caries (RR 1.27, 95% CI 1.03-1.56). Furthermore, nocturnal bottle-feeding was associated with dental caries (OR 1.52, 95% CI 1.20-1.93). All associations were independent of family SEP, ethnic background, and sugar intake. Results from this Dutch cohort study confirmed the previously observed associations between prolonged breastfeeding and nocturnal bottle-feeding and the increased risk of childhood dental caries, even after proper adjustments for indicators of SEP, ethnic background, and sugar intake. Future studies are encouraged to elaborate further on possible explanations for the observed relationships. Healthcare professionals should be aware and advise caregivers about the potential risk of prolonged breastfeeding on caries development by applying the current recommendations on breastfeeding, oral hygiene, and feeding frequency.
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Affiliation(s)
- Agatha W van Meijeren-van Lunteren
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands, .,Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands,
| | - Trudy Voortman
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Marlies E C Elfrink
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Mondzorgcentrum Nijverdal, Nijverdal, The Netherlands
| | - Eppo B Wolvius
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Lea Kragt
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands
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Couch CA, Gray MS, Shikany JM, Howard VJ, Howard G, Long DL, McClure LA, Manly JJ, Cushman M, Zakai NA, Pearson KE, Levitan EB, Judd SE. Correlates of a southern diet pattern in a national cohort study of blacks and whites: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Br J Nutr 2021;:1-7. [PMID: 33632366 DOI: 10.1017/S0007114521000696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Southern dietary pattern, derived within the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort, is characterised by high consumption of added fats, fried food, organ meats, processed meats and sugar-sweetened beverages and is associated with increased risk of several chronic diseases. The aim of the present study was to identify characteristics of individuals with high adherence to this dietary pattern. We analysed data from REGARDS, a national cohort of 30 239 black and white adults ≥45 years of age living in the USA. Dietary data were collected using the Block 98 FFQ. Multivariable linear regression was used to calculate standardised beta coefficients across all covariates for the entire sample and stratified by race and region. We included 16 781 participants with complete dietary data. Among these, 34·6 % were black, 45·6 % male, 55·2 % resided in stroke belt region and the average age was 65 years. Black race was the factor with the largest magnitude of association with the Southern dietary pattern (Δ = 0·76 sd, P < 0·0001). Large differences in Southern dietary pattern adherence were observed between black participants and white participants in the stroke belt and non-belt (stroke belt Δ = 0·75 sd, non-belt Δ = 0·77 sd). There was a high consumption of the Southern dietary pattern in the US black population, regardless of other factors, underlying our previous findings showing the substantial contribution of this dietary pattern to racial disparities in incident hypertension and stroke.
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Suhett LG, Hermsdorff HHM, Ribeiro SAV, Filgueiras MDS, Shivappa N, Hébert JR, de Novaes JF. The dietary inflammatory index is associated with anti- and pro-inflammatory adipokines in Brazilian schoolchildren. Eur J Nutr 2021; 60:2841-2849. [PMID: 33575861 DOI: 10.1007/s00394-021-02500-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 01/22/2021] [Indexed: 01/02/2023]
Abstract
PURPOSE To investigate the relationship of Children's Dietary Inflammatory Index (C-DII™) scores with body fat distribution and serum adipokines in Brazilian schoolchildren. METHODS This population-based cross-sectional study enrolled 378 schoolchildren aged 8 and 9 years from Viçosa, Minas Gerais, Brazil. Food consumption was assessed using three 24-h dietary recalls from which C-DII scores were calculated. Serum adipokines [adiponectin, leptin, retinal-binding protein 4 (RBP4), and chemerin] were analyzed in blood samples. Sociodemographic characteristics and sedentary behavior were assessed using a semi-structured questionnaire. Total, truncal, android and gynoid body fat were evaluated by dual-energy X-ray absorptiometry (DXA). We compared the distributions of adiposity measures and serum adipokines by C-DII categories with linear regression, adjusting for potential confounders. RESULTS The mean sample C-DII was 0.59 ± 0.94 and ranged from - 2.16 to + 2.75. The C-DII was not associated with central and total body fat. However, the C-DII was modestly inversely associated with adiponectin and RBP4, and modestly directly associated with chemerin. These results remained significant after adjusting for body fat. Every 1 SD of C-DII was related, respectively, to a - 0.8 (- 1.5, - 0.03) and to a - 0.1 (- 0.2, - 0.05) units lower mean of adiponectin and RBP4, and to 7.2 (0.3, 14.1) units higher of chemerin. CONCLUSION Higher C-DII score was modestly inversely and directly associated with anti- and pro-inflammatory adipokines, respectively, in Brazilian children. The development of public health policies is needed to promote healthy eating habits during childhood to prevent the early onset of systemic inflammation and ill health effects later in life.
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Affiliation(s)
- Lara Gomes Suhett
- Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Av. P.H. Rolfs s/n, Campus Universitário, Viçosa, Minas Gerais, 36570-000, Brazil.
| | - H H M Hermsdorff
- Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Av. P.H. Rolfs s/n, Campus Universitário, Viçosa, Minas Gerais, 36570-000, Brazil
| | - Sarah Aparecida Vieira Ribeiro
- Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Av. P.H. Rolfs s/n, Campus Universitário, Viçosa, Minas Gerais, 36570-000, Brazil
| | - Mariana De Santis Filgueiras
- Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Av. P.H. Rolfs s/n, Campus Universitário, Viçosa, Minas Gerais, 36570-000, Brazil
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Statewide Cancer Prevention and Control Program (CPCP), Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA.,Department of Nutrition, Connecting Health Innovations (CHI), 1417 Gregg Street, Columbia, SC, 29201, USA
| | - James R Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Statewide Cancer Prevention and Control Program (CPCP), Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA.,Department of Nutrition, Connecting Health Innovations (CHI), 1417 Gregg Street, Columbia, SC, 29201, USA
| | - Juliana Farias de Novaes
- Department of Nutrition and Health, Universidade Federal de Viçosa (UFV), Av. P.H. Rolfs s/n, Campus Universitário, Viçosa, Minas Gerais, 36570-000, Brazil
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Zhang X, Liu Y, Li S, Lichtenstein AH, Chen S, Na M, Veldheer S, Xing A, Wang Y, Wu S, Gao X. Alcohol consumption and risk of cardiovascular disease, cancer and mortality: a prospective cohort study. Nutr J 2021; 20:13. [PMID: 33522924 PMCID: PMC7852289 DOI: 10.1186/s12937-021-00671-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 01/27/2021] [Indexed: 12/24/2022] Open
Abstract
Background Studies regarding whether light to moderate alcohol consumption is associated with a lower risk of cardiovascular diseases (CVD) have generated mixed results. Further, few studies have examined the potential impact of alcohol consumption on diverse disease outcomes simultaneously. We aimed to prospectively study the dose-response association between alcohol consumption and risk of CVD, cancer, and mortality. Methods This study included 83,732 adult Chinese participants, free of CVD and cancer at baseline. Participants were categorized into 6 groups based on self-report alcohol consumption: 0, 1–25, 26–150, 151–350, 351–750, and > 750 g alcohol/wk. Incident cases of CVD, cancers, and mortality were confirmed by medical records. Hazard ratios (HRs) for the composite risk of these three outcomes, and each individual outcome, were calculated using Cox proportional hazard model. Results During a median follow-up of 10.0 years, there were 6411 incident cases of CVD, 2947 cancers and 6646 deaths. We observed a J-shaped relation between alcohol intake and risk of CVD, cancer, and mortality, with the lowest risk at 25 g/wk., which is equivalent to ~ 2 servings/wk. Compared to consuming 1–25 g/wk., the adjusted HR for composite outcomes was 1.38 (95% confidence interval (CI):1.29–1.49) for non-drinker, 1.15 (95% CI: 1.04–1.27) for 26–150 g/wk., 1.22 (95% CI: 1.10–1.34) for 151–350 g/wk., 1.33 (95% CI: 1.21–1.46) for 351–750 g/wk., and 1.57 (95% CI: 1.30–1.90) for > 750 g/wk., after adjusting for age, sex, lifestyle, social economic status, and medication use. Conclusions Light alcohol consumption at ~ 25 g/wk was associated with lower risk of CVD, cancer, and mortality than none or higher consumption in Chinese adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00671-y.
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Affiliation(s)
- Xinyuan Zhang
- Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, PA, 16802, USA
| | - Yan Liu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China
| | - Shanshan Li
- Slone Epidemiology Center, Boston University School of Medicine, Boston, USA
| | - Alice H Lichtenstein
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, USA
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China
| | - Muzi Na
- Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, PA, 16802, USA
| | - Susan Veldheer
- Department of Family and Community Medicine and Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, USA
| | - Aijun Xing
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China
| | - Yanxiu Wang
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China.
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, PA, 16802, USA.
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Fujii R, Kondo T, Tsukamoto M, Kawai S, Sasakabe T, Naito M, Kubo Y, Okada R, Tamura T, Hishida A, Ueyama J, Hayashi Y, Ohnishi J, Hamajima N, Takeuchi K, Wakai K. Association of self-reported moderate vegetable juice intake with small decline in kidney function in a five-year prospective study. Nutrition 2020; 84:111114. [PMID: 33454529 DOI: 10.1016/j.nut.2020.111114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 11/24/2020] [Accepted: 12/04/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Although consumption of vegetable and 100% fruit juices are an acceptable alternative for vegetable and fruit intake, information about their actual effects on kidney function is sparse. The aim of this study was to determine the association between the consumption of vegetable and fruit juices and changes in kidney function in a Japanese population over a 5-y period. METHODS In this prospective study, we analyzed 2755 Japanese (742 men and 2013 women) individuals who participated in both the baseline and follow-up surveys in the Daiko study (a study within the Japan Multi-Institutional Collaborative Cohort study). Estimated glomerular filtration rate (eGFR) was calculated by age, sex, and serum creatinine level. For each beverage, we categorized all participants into four groups-rare (rarely consumed), low (≤2 cups/wk), moderate (3-4 cups/wk), or frequent (≥5 cups/wk) consumers of the beverage-based on a food frequency questionnaire. RESULTS The mean baseline and follow-up eGFR (SD) were 82.4 (14.6) and 72.2 (12.6), respectively. In fully adjusted regression analyses, moderate consumption of vegetable juice was associated a lower decline in eGFR compared with the rare consumption group (β = -1.30; P = 0.01). Moreover, stratified analyses revealed that this significant association remained in those who were young, female, non-obese, normotensive, smoked cigarettes, consumed alcohol, or exercised. However, no significant association was found in analyses for fruit juices. CONCLUSIONS This 5-y prospective study suggested an association between self-reported moderate consumption of vegetable juice and changes (possibly smaller decline) in kidney function in a relatively healthy Japanese population.
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Affiliation(s)
- Ryosuke Fujii
- Department of Preventive Medical Sciences, Fujita Health University School of Medical Sciences, Toyoake, Japan; Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Takaaki Kondo
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mineko Tsukamoto
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sayo Kawai
- Department of Public Health, Aichi Medical University, Nagakute, Japan
| | - Tae Sasakabe
- Department of Public Health, Aichi Medical University, Nagakute, Japan
| | - Mariko Naito
- Department of Oral Epidemiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yoko Kubo
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Rieko Okada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Jun Ueyama
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yumi Hayashi
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Joji Ohnishi
- Department of Community Healthcare & Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Gu YQ, Xia Y, Zhang SM, Bao X, Wu HM, Bian SS, Huang LY, Meng G, Niu KJ. [Method of dietary nutritional status assessment and its application in cohort study of nutritional epidemiology]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:1145-1150. [PMID: 32741185 DOI: 10.3760/cma.j.cn112338-20200110-00027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Minimizing the burden on study subjects and assessing the general dietary nutritional status as accurately as possible are the basis of a nutritional epidemiological cohort study in the general population. While introducing the main dietary nutrition assessment methods, this paper manly describes the basic contents and principles for the development of food frequency questionnaire, and briefly illustrates the problems and solutions for the development of area specific food frequency questionnaires by taking the example of Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort study. Finally, discusses preliminarily the necessity and possibility of developing a national food frequency questionnaire.
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Affiliation(s)
- Y Q Gu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300192, China; Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Y Xia
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - S M Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - X Bao
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - H M Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - S S Bian
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - L Y Huang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - G Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - K J Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
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Montero-Salazar H, Donat-Vargas C, Moreno-Franco B, Sandoval-Insausti H, Civeira F, Laclaustra M, Guallar-Castillón P. High consumption of ultra-processed food may double the risk of subclinical coronary atherosclerosis: the Aragon Workers' Health Study (AWHS). BMC Med 2020; 18:235. [PMID: 32787915 PMCID: PMC7425006 DOI: 10.1186/s12916-020-01678-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/23/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Ultra-processed food (UPF) consumption, which is increasing worldwide, has recently been associated with an increased risk of death and cardiovascular disease. We aimed to assess whether consumption of UPF is directly associated with subclinical coronary atherosclerosis in middle-aged men. METHODS A computed tomography scan was performed on 1876 men from the Aragon Workers' Health Study, recruited from January 2011 to December 2014, to assess coronary calcium. All participants were free of coronary heart disease. Dietary intake was collected by a validated 136-item semi-quantitative food frequency questionnaire. UPF was defined according to the NOVA classification. Associations between consumption of total energy-adjusted UPF and Coronary Calcium Agatston Score (CACS)-categorized into CACS of 0, > 0 and < 100, and ≥ 100-were cross-sectionally assessed by generalized ordered logistic regression adjusted for main confounders. RESULTS No coronary calcium was detected in 60.2% of the participants, whereas 10.2% had a CACS ≥ 100. A significant dose-response association was observed between energy-adjusted UPF consumption and the risk of having a CACS ≥ 100, when compared with those in the lowest CACS categories (CACS of 0 together with CACS > 0 and < 100). The fully adjusted ORs (95% CI) of having a CACS ≥ 100 across quartiles of energy-adjusted UPF consumption (approximately 100 g/day in the lowest quartile (ref.) and 500 g/day in the highest) were 1.00 (ref.), 1.50 (0.93, 2.42), 1.56 (0.96, 2.52), and 2.00 (1.26, 3.16), p trend .005. CONCLUSION In this middle-aged worker's sample, approximately 500 g/day of UPF consumption was associated with a 2-fold greater prevalence of subclinical coronary atherosclerosis than consuming only 100 g/day, independently of total energy intake and other well-established cardiovascular risk factors.
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Affiliation(s)
- Henry Montero-Salazar
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CEI UAM+CSIC, Avda. Arzobispo Morcillo, n 4, 28029, Madrid, Spain
| | - Carolina Donat-Vargas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CEI UAM+CSIC, Avda. Arzobispo Morcillo, n 4, 28029, Madrid, Spain. .,Unit of Nutritional and Cardiovascular Epidemiology, Environmental Medicine Institute (IMM), Karolinska Institutet, Stockholm, Sweden. .,CIBERESP (CIBER of Epidemiology and Public Health) Instituto de Salud Carlos III, Madrid, Spain. .,Instituto de Investigación IdiPaz, Madrid, Spain. .,IMDEA-Food Institute CEI UAM+CSIC, Madrid, Spain.
| | - Belén Moreno-Franco
- IIS Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.,CIBERCV Instituto de Salud Carlos III, Madrid, Spain.,Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
| | - Helena Sandoval-Insausti
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CEI UAM+CSIC, Avda. Arzobispo Morcillo, n 4, 28029, Madrid, Spain.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fernando Civeira
- IIS Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.,CIBERCV Instituto de Salud Carlos III, Madrid, Spain.,Agencia Aragonesa para la Investigación y el Desarrollo (ARAID), Zaragoza, Spain
| | - Martín Laclaustra
- IIS Aragón, Hospital Universitario Miguel Servet, Universidad de Zaragoza, Zaragoza, Spain.,CIBERCV Instituto de Salud Carlos III, Madrid, Spain.,Agencia Aragonesa para la Investigación y el Desarrollo (ARAID), Zaragoza, Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CEI UAM+CSIC, Avda. Arzobispo Morcillo, n 4, 28029, Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health) Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación IdiPaz, Madrid, Spain.,IMDEA-Food Institute CEI UAM+CSIC, Madrid, Spain
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Harmouche-Karaki M, Mahfouz M, Obeyd J, Salameh P, Mahfouz Y, Helou K. Development and validation of a quantitative food frequency questionnaire to assess dietary intake among Lebanese adults. Nutr J 2020; 19:65. [PMID: 32631430 PMCID: PMC7339409 DOI: 10.1186/s12937-020-00581-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 06/24/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The food frequency questionnaire (FFQ) is the most frequently used method to assess dietary intake in epidemiological studies evaluating diet-disease association. The objective of this study was to validate a FFQ for use among Lebanese adults by evaluating various facets of validity and reproducibility. METHODS The quantitative 164-items FFQ was validated against the average of six 24-h dietary recalls (DRs) in a sample of 238 Lebanese adults. Reproducibility of the FFQ was assessed by administering it twice within 1 month' time interval. RESULTS Positive statistically significant Pearson correlations were observed in most macro and micronutrients between the FFQ and the six 24-h DRs, ranging from 0.16 to 0.65, with two thirds of the correlation coefficients exceeding 0.3. Energy, gender, and age-adjusted statistically significant Pearson correlation coefficients ranged from 0.14 to 0.64, with two thirds of the coefficients exceeding 0.2. Intakes from the FFQ were mostly higher than those of the 24-h DRs. Mean percent difference between nutrient intakes from both dietary methods decreased remarkably after using energy-adjusted mean intakes. Values were acceptable to good for all macronutrients and several micronutrients. Cross-classification analysis revealed that around 64.3 to 83.9% of participants were classified into the same and adjacent quartile whereas grossly misclassified proportions ranged from 3.7 to 12.2%. Weighted kappa values ranged from 0.02 to 0.36 with most of them exceeding 0.2. In indirect validity analysis, key nutrient mean intakes estimated from the six 24-h DRs were significantly positively associated with tertiles of food groups derived from the FFQ. Bland Altman plots showed that the majority of data points fell within the limits of agreement (LOA) for all nutrients. As for reproducibility analysis, ICC values were all statistically significant ranging from 0.645 to 0.959 and Bland Altman plots confirmed these results. CONCLUSIONS Based on various aspects of validity and reproducibility, and an extensive range of statistical tests, the present FFQ developed for a Lebanese community is an acceptable tool for dietary assessment and is useful for evaluating diet-disease associations in future studies.
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Affiliation(s)
- Mireille Harmouche-Karaki
- Department of Nutrition, Faculty of Pharmacy, Saint Joseph University of Beirut, Lebanon B.P. 11-5076 – Riad el Solh, Beirut, 1107 2180 Lebanon
| | - Maya Mahfouz
- Department of Nutrition, Faculty of Pharmacy, Saint Joseph University of Beirut, Lebanon B.P. 11-5076 – Riad el Solh, Beirut, 1107 2180 Lebanon
| | - Jawaher Obeyd
- Department of Nutrition, Faculty of Pharmacy, Saint Joseph University of Beirut, Lebanon B.P. 11-5076 – Riad el Solh, Beirut, 1107 2180 Lebanon
| | - Pascale Salameh
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
| | - Yara Mahfouz
- Department of Nutrition, Faculty of Pharmacy, Saint Joseph University of Beirut, Lebanon B.P. 11-5076 – Riad el Solh, Beirut, 1107 2180 Lebanon
| | - Khalil Helou
- Department of Nutrition, Faculty of Pharmacy, Saint Joseph University of Beirut, Lebanon B.P. 11-5076 – Riad el Solh, Beirut, 1107 2180 Lebanon
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Zanini B, Simonetto A, Bertolotti P, Marullo M, Marconi S, Becchetti C, Gilioli G, Valerio A, Donato F, Ricci C, Castellano M. A new self-administered semi-quantitative food frequency questionnaire to estimate nutrient intake among Italian adults: development design and validation process. Nutr Res 2020; 80:18-27. [PMID: 32673962 DOI: 10.1016/j.nutres.2020.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 05/04/2020] [Accepted: 05/13/2020] [Indexed: 01/21/2023]
Abstract
Food Frequency Questionnaires (FFQs) are valuable research tools in nutritional epidemiology. This study aimed to develop and validate a new semi-quantitative FFQ, specifically designed for the Italian population and best fitted for self-administration. During the development process, we adapted to Italian needs the validated FFQ proposed by the Fred Hutchinson Cancer Research Center, revising food items, food frequency scale, portion sizes, and time frame. To assess the validity of the proposed FFQ, we compared the estimated daily intake using FFQ with the mean of 3-day food diaries and one 24-hour recall (considered as reference method). The validation process was conducted among a cohort of 51 healthy subjects enrolled in a clinical trial. Four statistical tests were applied on 23 estimated nutrient intakes. Spearman's coefficients ranged from 0.223 (sodium) to 0.748 (alcohol) and were good (≥0.50) and acceptable (0.20-0.49) for 7 and 16 nutrients, respectively. Cross classification showed a good agreement (≥50% in the same tertile or ≤10% in the opposite tertile) for 7 nutrients. The weighted Cohen's kappa values indicated an acceptable outcome (0.20-0.60) for 13 nutrients. Bland Altman plots did not show heteroscedasticity in the error terms, despite the presence of a bias. Our study provided a new Italian semi-quantitative FFQ for self-administration with an acceptable validation level. Its definitive release requires additional refinements and efforts.
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Affiliation(s)
- Barbara Zanini
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, Brescia, Italy.
| | - Anna Simonetto
- AgroFood Lab, Department of Molecular and Translational Medicine; University of Brescia, Viale Europa 11, Brescia, Italy.
| | - Paola Bertolotti
- AgroFood Lab, Department of Molecular and Translational Medicine; University of Brescia, Viale Europa 11, Brescia, Italy.
| | - Monica Marullo
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Viale Europa 11, Brescia, Italy.
| | - Silvia Marconi
- AgroFood Lab, Department of Molecular and Translational Medicine; University of Brescia, Viale Europa 11, Brescia, Italy.
| | - Chiara Becchetti
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, Brescia, Italy.
| | - Gianni Gilioli
- AgroFood Lab, Department of Molecular and Translational Medicine; University of Brescia, Viale Europa 11, Brescia, Italy.
| | - Alessandra Valerio
- AgroFood Lab, Department of Molecular and Translational Medicine; University of Brescia, Viale Europa 11, Brescia, Italy.
| | - Francesco Donato
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Viale Europa 11, Brescia, Italy.
| | - Chiara Ricci
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, Brescia, Italy; Department of Medicine, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, Brescia, Italy.
| | - Maurizio Castellano
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, Brescia, Italy; Department of Medicine, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, Brescia, Italy.
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Xu F, Chong BQ, Cai T, Zhang JL, Lv J. Associations between major dietary patterns and anxiety in middle-aged adults in eastern China. Public Health Nutr 2021; 24:1716-24. [PMID: 32408927 DOI: 10.1017/S1368980020000221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The current study aimed to evaluate the association of major dietary patterns with anxiety in middle-aged adults in eastern China. DESIGN Dietary intake was assessed using a semi-quantitative FFQ. Binary logistic regression analysis was used to estimate OR and 95 % CI for anxiety according to quartiles of each dietary pattern score. SETTING Evidence regarding the relationship between dietary patterns and anxiety in the Chinese population is scarce. PARTICIPANTS The study participants were 1360 Chinese adults aged 45-59 years, who participated in a health survey at the time of periodic check-up in the city of Linyi, Shandong Province, China. RESULTS Four major dietary patterns were identified by factor analysis: traditional Chinese, western, grains-vegetables and high-salt diets. After adjusting for potential confounders, participants in the highest quartile of the western pattern had greater odds for anxiety, compared with those in the lowest quartile (OR 1·35, 95 % CI 1·000, 3·086, P < 0·05). In contrast, participants in the highest quartile of the grains-vegetables pattern had lower odds for anxiety than did those in the lowest quartile (OR 0·78, 95 % CI 0·574, 1·000, P < 0·05). Moreover, no significant associations were observed between the traditional Chinese and high-salt patterns and the risk of anxiety. CONCLUSIONS Our findings indicate that the western pattern is associated with an increased risk, and the grains-vegetables pattern is associated with a decreased risk of anxiety.
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Mumu SJ, Merom D, Ali L, Fahey PP, Hossain I, Rahman AKMF, Allman-Farinelli M. Validation of a food frequency questionnaire as a tool for assessing dietary intake in cardiovascular disease research and surveillance in Bangladesh. Nutr J 2020; 19:42. [PMID: 32410632 PMCID: PMC7227307 DOI: 10.1186/s12937-020-00563-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) has emerged as a major public health concern in Bangladesh. Diet is an established risk factor for CVD but a tool to assess dietary intake in Bangladesh is lacking. This study aimed to validate a food frequency questionnaire (FFQ) using the 24-h dietary recall method and corresponding nutritional biological markers among rural and urban populations of Bangladesh. METHOD Participants of both genders aged 18-60 years were included in the analysis (total n = 146, rural n = 94 and urban n = 52). Two FFQs of 166 items were administered three-months apart, during which time three 24-h dietary recalls were also completed. Participants were asked to recall their frequency of consumption over the preceding 3 months. Urine and blood samples were collected for comparison between FFQ-estimates of nutrients and their corresponding biomarkers. Methods were compared using unadjusted, energy-adjusted, de-attenuated correlation coefficients, 95% limits of agreement (LOA) and quartile classification. RESULTS Fair to moderate agreement for ranking energy, macro and micronutrients into quartiles was observed (weighted k value ranged from 0.22 to 0.58; p < 0.001 for unadjusted data) except for vitamin D (weighted k - 0.05) and zinc (weighted k 0.09). Correlation coefficients of crude energy, macronutrients and common micronutrients including vitamin E, thiamine, riboflavin, niacin, pyridoxine, folate, iron, magnesium, phosphorus, potassium, and sodium were moderately good, ranging from 0.42 to 0.78; p < 0.001 but only fair for vitamin A, β carotene and calcium (0.31 to 0.38; p < 0.001) and poor for vitamin D and zinc (0.02 and 0.16; p = ns, respectively). Energy-adjusted correlations were generally lower except for fat and vitamin E, and in range of - 0.017 (for calcium) to 0.686 (for fat). De-attenuated correlations were higher than unadjusted and energy- adjusted, and significant for all nutrients except for vitamin D (0.017) to 0.801 (for carbohydrate). The Bland Altman tests demonstrated that most of the coefficients were positive which indicated that FFQ provided a greater overestimation at higher intakes. More than one in three participants appeared to overestimate their food consumption based on the ratio of energy intake to basal metabolic rate cut points suggested by Goldberg. Absolute intake of macronutrients was 1.5 times higher and for micronutrients it ranged from 1.07 (sodium) to 26 times (Zinc). FFQ estimates correlated well for sodium (0.32; p < 0.001), and vitamin D (0.20; p = 0.017) with their corresponding biomarkers and iron (0.25; p = 0.003) with serum ferritin for unadjusted data. Folate, iron (with haemoglobin) and total protein showed inverse association; and fat and potassium showed poor correlation with their corresponding biomarkers for unadjusted data. However, folate showed significant positive correlation (0.189; p = 0.025) with biomarker after energy adjustment. CONCLUSION Although FFQ showed overestimation for absolute intake in comparison with 24-h recalls, the validation study demonstrated acceptable agreement for ranking dietary intakes from FFQ with 24-h recall methods and some biomarkers and therefore could be considered as a tool to measure dietary intake for research and CVD risk factors surveillance in Bangladesh. The instrument may not be appropriate for monitoring population adherence to recommended intakes because of the overestimation.
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Affiliation(s)
- Shirin Jahan Mumu
- School of Health Science, Western Sydney University, Sydney, Australia. .,Dept of Epidemiology, Bangladesh University of Health Sciences (BUHS), Dhaka, 1216, Bangladesh.
| | - Dafna Merom
- School of Health Science, Western Sydney University, Sydney, Australia
| | - Liaquat Ali
- Pothikrit Centre for Health Studies, Dhaka, 1000, Bangladesh
| | - Paul P Fahey
- School of Health Science, Western Sydney University, Sydney, Australia
| | - Israt Hossain
- Dept of Biochemistry & Cell Biology, BUHS, Dhaka, 1216, Bangladesh
| | - A K M Fazlur Rahman
- Dept of Epidemiology, Bangladesh University of Health Sciences (BUHS), Dhaka, 1216, Bangladesh
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Davey Smith G, Holmes MV, Davies NM, Ebrahim S. Mendel's laws, Mendelian randomization and causal inference in observational data: substantive and nomenclatural issues. Eur J Epidemiol 2020; 35:99-111. [PMID: 32207040 PMCID: PMC7125255 DOI: 10.1007/s10654-020-00622-7] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 03/09/2020] [Indexed: 12/16/2022]
Abstract
We respond to criticisms of Mendelian randomization (MR) by Mukamal, Stampfer and Rimm (MSR). MSR consider that MR is receiving too much attention and should be renamed. We explain how MR links to Mendel's laws, the origin of the name and our lack of concern regarding nomenclature. We address MSR's substantive points regarding MR of alcohol and cardiovascular disease, an issue on which they dispute the MR findings. We demonstrate that their strictures with respect to population stratification, confounding, weak instrument bias, pleiotropy and confounding have been addressed, and summarise how the field has advanced in relation to the issues they raise. We agree with MSR that "the hard problem of conducting high-quality, reproducible epidemiology" should be addressed by epidemiologists. However we see more evidence of confrontation of this issue within MR, as opposed to conventional observational epidemiology, within which the same methods that have demonstrably failed in the past are simply rolled out into new areas, leaving their previous failures unexamined.
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Affiliation(s)
- George Davey Smith
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
| | - Michael V Holmes
- Medical Research Council Population Health Research Unit (MRC PHRU), Department of Population Health, University of Oxford, Nuffield, Oxford, UK
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Neil M Davies
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Shah Ebrahim
- London School of Hygiene and Tropical Medicine, London, UK
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Rippin HL, Hutchinson J, Jewell J, Breda JJ, Cade JE. Assessing diet in European populations using national dietary surveys. Proc Nutr Soc 2020; 79:1-11. [PMID: 31969200 DOI: 10.1017/s0029665119001174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The WHO encourages countries to conduct national dietary surveys (NDS) to inform preventative policies targeting malnutrition and noncommunicable diseases. Previous reviews have found inadequate nutrient intakes and survey provision across Europe. This research is the first to provide an updated review of NDS provision within the whole WHO European Region, across the lifecourse, with reference to disadvantaged groups, obesity and nutrients of concern. Over a third of WHO European countries, mainly Central and Eastern European countries (CEEC), had no identifiable NDS. Where countries reported nutrient intakes, poor WHO recommended nutrient intake attainment was Europe-wide across the lifecourse, particularly in CEEC. Lower educated individuals had poorer diet quality. However, heterogeneity in age group sampled, dietary assessment method, nutrient composition database and under-reporting hindered inter-country comparisons. Average population trans fatty acid intakes below WHO recommended limits may hide inequalities in disadvantaged groups; legislative bans may help alleviate this. There were few associations between NDS-derived consumed food portion size (FPS) and BMI. However, consumed FPS was greater than on-pack serving-size in the majority of foods studied. This review illustrates how NDS can generate information on diet, nutrient intakes and the food environment. However, to enable valid inter-country comparisons, countries should be encouraged to conduct and report harmonised NDS, particularly in the age groups sampled, dietary assessment methodology, nutrient range, underpinning food composition database and treatment of under-reporters. This will aid effective, coordinated policy development that can have a real impact on dietary improvement, on a population and subgroup level, throughout Europe.
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Affiliation(s)
- Holly L Rippin
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LeedsLS2 9JT, UK
| | - Jayne Hutchinson
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LeedsLS2 9JT, UK
| | - Jo Jewell
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, World Health Organization Regional Office for Europe, UN City, Marmorvej 51, 21000Copenhagen, Denmark
| | - Joao J Breda
- Division of Noncommunicable Diseases and Promoting Health through the Life-Course, World Health Organization Regional Office for Europe, UN City, Marmorvej 51, 21000Copenhagen, Denmark
| | - Janet E Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, LeedsLS2 9JT, UK
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García Rodríguez M, Romero Saldaña M, Alcaide Leyva JM, Moreno Rojas R, Molina Recio G. Design and validation of a food frequency questionnaire (FFQ) for the nutritional evaluation of food intake in the Peruvian Amazon. J Health Popul Nutr 2019; 38:47. [PMID: 31856919 PMCID: PMC6923861 DOI: 10.1186/s41043-019-0199-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 10/28/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Food frequency questionnaires (FFQs) are dietary surveys widely used in studies of nutritional epidemiology because they are inexpensive, easy to complete and provide significant information on dietary intake over a long period of time. FFQs should be written specifically for each study group since diet may be influenced by ethnicity, culture, economic status and environmental factors. The aim of the authors on this work was to design and validate a food frequency questionnaire for the Peruvian Amazon population. METHODS Three hundred three individuals were selected and completed three 24-h recalls (R24). Two FFQs were conducted on two different occasions (FFQ.1 and FFQ.2). The validity of the FFQ was evaluated by comparing the relationship between the average daily nutrient intake estimated by the FFQs and that obtained by the three R24. The reproducibility was measured by comparing the mean nutrient intake of the two FFQs carried out. The correlations were assessed using the Pearson correlation coefficient, the intraclass correlation coefficient (ICC), the Lin correlation coefficient (CCC) and the Bland-Altman plot. RESULTS The results obtained to establish the validity showed a high correlation, with an average Pearson's correlation coefficient of 0.70, a CCI of 0.65 and a CCC of 0.60. Approximately 60% of the nutrients had a CCC above 0.60. In terms of reproducibility, better results were obtained, with an average Pearson's correlation coefficient of 0.67, 0.64 for CCI and 0.58 for CCC. CONCLUSIONS The correlation coefficients show good validity and reproducibility, and therefore, the FFQ we have developed may be considered a useful and valid tool to estimate the dietary intake of the Peruvian Amazon population.
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Bhat S, Mocciaro G, Ray S. The association of dietary patterns and carotid intima-media thickness: A synthesis of current evidence. Nutr Metab Cardiovasc Dis 2019; 29:1273-1287. [PMID: 31669106 DOI: 10.1016/j.numecd.2019.08.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/15/2019] [Accepted: 08/20/2019] [Indexed: 02/06/2023]
Abstract
AIMS Dietary pattern (DP) analysis has emerged as a holistic method to understand the effects of food intake on health outcomes. Though dietary intake has been associated with cardiovascular disease, the association of DPs and carotid intima-media thickness (CIMT), a robust early marker of cardiovascular disease progression has not been comprehensively investigated. This study systematically explores the association of a posteriori and a priori DPs and CIMT. DATA SYNTHESIS Through a systematic search of MEDLINE, CINAHL, and Web of Science, twenty studies that derived DPs using a posteriori or a priori methods with CIMT as an outcome were included. Four cross-sectional studies and 1 cohort paper reported a statistically significant association between increased consumption of 'unhealthy' foods (i.e processed meat, soda drinks and refined grain) and increased CIMT. While four cross-sectional studies reported a statistically significant association of DPs characterized by increased consumption of 'healthy' foods (i.e fruit and vegetables, fish) and decreased CIMT. DPs derived from each study varied depending on derivation method, study design and use of dietary data collection method. CONCLUSION Findings from this review are generally supportive of a trend between DPs with higher consumption of 'healthy' foods and lower consumption of 'unhealthy' foods and decreased CIMT; however, the association was largely not statistically significant. Evidence was overwhelmingly heterogeneous due to differences seen in DPs based on location and culture, sample characteristics and adjustment for confounders. Long-term prospective observational and interventional studies with standardized sample selection and dietary data collection are needed to significantly establish the role of DPs on CIMT.
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Affiliation(s)
- S Bhat
- Division of Health and Social Care Research, Faculty of Life Sciences and Medicine, King's College London, London, SE1 1UL, UK; MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL, UK; NNEdPro Global Centre for Nutrition and Health, St John's Innovation Centre, Cambridge, CB4 0WS, UK.
| | - G Mocciaro
- MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL, UK; NNEdPro Global Centre for Nutrition and Health, St John's Innovation Centre, Cambridge, CB4 0WS, UK
| | - S Ray
- MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL, UK; NNEdPro Global Centre for Nutrition and Health, St John's Innovation Centre, Cambridge, CB4 0WS, UK
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Aumueller N, Gruszfeld D, Gradowska K, Escribano J, Ferré N, Rousseaux D, Hoyos J, Verduci E, ReDionigi A, Koletzko B, Grote V. Associations of sugar intake with anthropometrics in children from ages 2 until 8 years in the EU Childhood Obesity Project. Eur J Nutr 2020; 59:2593-601. [PMID: 31642983 DOI: 10.1007/s00394-019-02107-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/04/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE We determined the association of total sugar intake with body weight and fat mass in children on an energy-equivalent basis and potential changes in the association from 2 to 8 years of age. METHODS Data were available from the Childhood Obesity Project Trial initiated in 2002. Sugar intake was measured by 3-day weighed food protocols at 2, 3, 4, 5, 6, and 8 years of age. Body mass index (BMI) and fat mass index (FMI) were available at the same time points. To investigate the association of sugar intake with anthropometrics over time, linear mixed models were applied. Odds ratios for having a high BMI or FMI (above one standard deviation) were estimated by logistic random-effects models. To control for total energy intake, the residual method was chosen and models were additionally adjusted for total energy intake. RESULTS Data were available for 809 children with in total 2846 observations. In an isocaloric model, an increase of 100 kcal from sugar per day was significantly associated with lower zBMI (- 0.033; 95% CI -0.061, - 0.005) and zFMI (- 0.050; 95% CI - 0.089, - 0.011). In addition, a 100 kcal higher sugar intake was related to lower odds of having a high zBMI (OR 0.743; 95% CI 0.611, 0.903). CONCLUSION This study provides no indication that increased total sugar intake positively affects BMI on an energy-equivalent basis. Whether the negative association of sugar is due to physiological effects or points more to macronutrient preferences or a reporting bias (lower sugar intake) in children with higher BMI can be debated. CLINICAL TRIAL REGISTRY ClinicalTrials.gov Identifier: NCT00338689; Registered: June 19, 2006. URL: http://clinicaltrials.gov/ct2/show/NCT00338689?term=NCT00338689&rank=1 .
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Abstract
OBJECTIVE To explore the relationship between dietary patterns and risk of chronic kidney disease (CKD) in Chinese adults aged 45-59 years. DESIGN Dietary data were collected using a semi-quantitative FFQ. Factor analysis was used to identify the major dietary patterns. Logistic regression models were applied to clarify the association between dietary patterns and the risk of CKD. SETTING The present study population was a part of the population-based Nutrition and Health Study performed in the city of Hangzhou, Zhejiang Province, eastern China. PARTICIPANTS A total of 2437 eligible participants (45-59 years) were enrolled in the present cross-sectional study from June 2015 to December 2016. RESULTS Three major dietary patterns were identified: 'traditional southern Chinese', 'Western' and 'grains-vegetables' patterns, collectively accounting for 25·6 % of variance in the diet. After adjustment for potential confounders, participants in the highest quartile of the Western pattern had greater odds for CKD (OR = 1·83, 95 % CI 1·21, 2·81; P < 0·05) than those in the lowest quartile. Compared with the lowest quartile of the grains-vegetables pattern, the highest quartile had lower odds for CKD (OR = 0·84, 95 % CI 0·77, 0·93; P < 0·05). In addition, there was no significant association between the traditional southern Chinese pattern and risk of CKD (P > 0·05). CONCLUSIONS Our results suggest that the Western pattern is associated with an increased risk, whereas the grains-vegetables pattern is associated with a reduced risk for CKD. These findings can guide dietary interventions for the prevention of CKD in a middle-aged Chinese population.
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Bromage S, Enkhmaa D, Baatar T, Garmaa G, Bradwin G, Yondonsambuu B, Sengee T, Jamts E, Suldsuren N, McElrath TF, Cantonwine DE, Hoover RN, Troisi R, Ganmaa D. Comparison of seasonal serum 25-hydroxyvitamin D concentrations among pregnant women in Mongolia and Boston. J Steroid Biochem Mol Biol 2019; 193:105427. [PMID: 31323345 DOI: 10.1016/j.jsbmb.2019.105427] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 07/09/2019] [Accepted: 07/15/2019] [Indexed: 01/01/2023]
Abstract
Adequate vitamin D status during pregnancy is important for developing fetal bone strength and density and may play a role in preventing a range of skeletal and non-skeletal diseases in both mothers and children. We previously identified Mongolian women of reproductive age to have the lowest vitamin D levels yet observed in any population globally, which renders this population uniquely important in vitamin D research. In this study, we measured the seasonal distribution of 25-hydroxyvitamin D (25(OH)D) concentration in 390 healthy third trimester pregnant women living in urban and rural Mongolia using DiaSorin LIAISON and compared this distribution to that of 206 third trimester women living in Boston, USA. Also, we analyzed seasonally-independent associations between (25(OH)D) levels and selected predictors in both groups using quantile regression. Mean 25(OH)D levels were significantly higher and less seasonal in Boston (seasonal range: 27.1 ± 7.0-31.5 ± 7.7 ng/ml) than in Mongolia (seasonal range: 11.2 ± 3.9-19.2 ± 6.7 ng/ml). Adjusting for month of blood draw, higher 25(OH)D levels were significantly associated with older age, lower gravidity, lower BMI, and lack of a college or university degree among Boston participants, however, only gravidity was robust to multivariable adjustment. No assessed characteristics were independently predictive in Mongolia, likely due to universally low 25(OH)D levels and a resulting lack of between-person variation. In conclusion, vitamin D status among pregnant Mongolians is severely depressed throughout the year and should be addressed through fortification and supplementation, while in the U.S., deficiency is associated with specific characteristics targetable through supplementation.
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Affiliation(s)
- Sabri Bromage
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, SPH-2 Floor 3, Boston, MA, 02115, USA; Mongolian Health Initiative Non-Governmental Organization, Bayanzurkh District, Ulaanbaatar, Mongolia.
| | - Davaasambuu Enkhmaa
- National Center for Maternal and Child Health, Khuvisgalchdin Street, Bayangol District, Ulaanbaatar, Mongolia.
| | - Tsedmaa Baatar
- United Nations Population Fund Mongolia Country Office, 14 United Nations Street, Sukhbaatar District, Ulaanbaatar, Mongolia.
| | - Gantsetseg Garmaa
- Mongolian Health Initiative Non-Governmental Organization, Bayanzurkh District, Ulaanbaatar, Mongolia.
| | - Gary Bradwin
- Department of Laboratory Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
| | | | - Tuul Sengee
- Bayangol District Hospital, Bayangol District, Ulaanbaatar, Mongolia.
| | - Enkhtuya Jamts
- National Center for Maternal and Child Health, Khuvisgalchdin Street, Bayangol District, Ulaanbaatar, Mongolia.
| | - Narmandakh Suldsuren
- United Nations Population Fund Mongolia Country Office, 14 United Nations Street, Sukhbaatar District, Ulaanbaatar, Mongolia.
| | - Thomas F McElrath
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
| | - David E Cantonwine
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
| | - Robert N Hoover
- Division of Cancer Epidemiology and Genetics, National Institutes of Health, 9609 Medical Center Drive, MSC 9776, Bethesda, MD, 20892, USA.
| | - Rebecca Troisi
- Division of Cancer Epidemiology and Genetics, National Institutes of Health, 9609 Medical Center Drive, MSC 9776, Bethesda, MD, 20892, USA.
| | - Davaasambuu Ganmaa
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, SPH-2 Floor 3, Boston, MA, 02115, USA; Mongolian Health Initiative Non-Governmental Organization, Bayanzurkh District, Ulaanbaatar, Mongolia; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
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Abstract
Dietary fibre comprises many different, mainly plant-based, compounds that are not fully digested in the human gut. Insoluble fibres include cellulose, hemi-celluloses and lignin and soluble fibres include pectins, β-glucan and hydro-colloids. In the UK, the daily recommended amount has increased to 30 g but only 13 % of men and 4 % of women meet this recommendation. Currently the mean intake for adults is 21 g for men and 17 g for women. There is a wealth of epidemiological evidence based on systematic reviews of trials and cohorts to support the higher fibre recommendation. This includes evidence of reductions in the risk for CVD (both heart disease and stroke) and lower risk of type 2 diabetes, lower blood pressure, lower LDL-cholesterol, as well as some cancers. Beneficial effects of fibre operate via a diverse range of mechanisms throughout the digestive system including the mouth, stomach and small and large intestine; some of which are still not completely understood. The updated recommendation for fibre is a long way from a typical British diet and requires several daily portions of fruit and vegetables and wholegrain foods. Improving dietary fibre intakes will require a variety of actions and policies from stakeholders; however, there is currently more of a focus on reducing sugar than increasing fibre. In order to increase the number of adults meeting the fibre recommendation, social marketing and labelling of high-fibre foods are warranted as well as reformulation and wider availability of wholegrain versions of popular foods.
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Filippini T, Cilloni S, Malavolti M, Violi F, Malagoli C, Tesauro M, Bottecchi I, Ferrari A, Vescovi L, Vinceti M. Dietary intake of cadmium, chromium, copper, manganese, selenium and zinc in a Northern Italy community. J Trace Elem Med Biol 2018; 50:508-517. [PMID: 29548610 DOI: 10.1016/j.jtemb.2018.03.001] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/26/2018] [Accepted: 03/02/2018] [Indexed: 02/06/2023]
Abstract
This study provides the dietary intakes of six trace elements (cadmium, chromium, copper, manganese, selenium and zinc), generally characterized by both nutritional and toxicological features depending on their exposure. Being diet the most relevant source of exposure to trace elements in non-professionally exposed subjects, we measured content of these trace elements in foods composing the typical Italian diet using inductively coupled plasma-mass spectrometry, and assessing dietary habits using a validated semi-quantitative food frequency questionnaire we eventually estimated dietary daily intake of trace elements in a Northern Italian community. In the 890 analyzed food samples, the main contributors to cadmium intake are cereals, vegetables and sweets, while cereals, beverages and vegetable are to primary source of manganese. The primary contributors for copper are cereals, fresh fruits and vegetables, while for chromium are beverages, cereals and meat. The main source of selenium intake are cereals and meat, followed by fish, seafood and milk and dairy products, while of zinc intake are meat, cereals, milk and dairy products. In our Italian population sample, the estimated median (interquartile range) dietary daily intakes are 5.00 (3.17-7.65), 56.70 (36.08-86.70) and 66.53 (40.04-101.32) μg/day for cadmium, chromium and selenium, and corresponding figures are 0.98 (0.61-1.49), 2.34 (1.46-3.52) and 8.50 (5.21-12.48) mg/day for copper, manganese and zinc. The estimated intakes are generally within the average intake reported in other European populations, and in such cases well above the daily dietary intakes recommended by national international agencies, avoiding the risk of excess or deficiency. The present estimated intake data can be used to examine a specific trace element of interest and would afford enhanced health protection from those trace elements characterized by both nutritional and toxicological effects.
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Affiliation(s)
- Tommaso Filippini
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Silvia Cilloni
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Marcella Malavolti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Federica Violi
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Carlotta Malagoli
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Marina Tesauro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy
| | - Ilaria Bottecchi
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Angela Ferrari
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | | | - Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
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