European Journal of Nutrition最新文献

Purpose: To reduce the risk of recurrent cardiovascular events in patients with established cardiovascular disease (CVD), guidelines recommend adopting a more plant-based diet. The EAT-Lancet diet, which focuses on plant-based foods, is associated with a lower risk of CVD in apparently healthy people. However, the relationship in patients with established CVD is unclear. Therefore, the aim of this research was to quantify the relationship between the EAT-Lancet Healthy Reference Diet (HRD) and risk of recurrent CVD in patients with established CVD.

Methods: Patients with established CVD from the Utrecht Cardiovascular Cohort-Second Manifestations of ARTerial disease were studied. Dietary intake was measured using a food frequency questionnaire and the relationship between the EAT-Lancet HRD (score from 0 to 140 points) and non-fatal myocardial infarction and stroke was assessed using Cox regression adjusted for age, sex, educational background, lifestyle factors, and energy intake.

Results: During a follow-up of 24,212 person-years 209 non-fatal vascular events occurred. The median score for the EAT-Lancet HRD was 57 out of 140 points (IQR: 41-68). After adjustment for confounders, a diet more in line with the EAT-Lancet HRD was associated with a lower risk of non-fatal vascular events (HR 0.87 (95% CI 0.79-0.96) per 10-point increase); stroke (HR 0.76 (95% CI 0.63-0.91) per 10-point increase); and a trend towards lower risk of myocardial infarction (HR 0.90 (95% CI 0.81-1.02) per 10-point increase).

Conclusion: In patients with established CVD, a dietary pattern more in line with the EAT-Lancet HRD is associated with a lower risk of non-fatal stroke and myocardial infarction.

Purpose: Maternal nutrition during pregnancy is key for offspring neurodevelopment. Given the role of glucose in brain function, assessing carbohydrate quantity and quality, including glycemic index (GI), glycemic load (GL) and carbohydrate quality index (CQI), may provide insights into early brain development. This study examined the associations between maternal dietary carbohydrate intake and neurodevelopmental outcomes in early childhood.

Methods: The prospective cohort study included 1080 mother-child pairs from the Barcelona Life Study Cohort. Maternal dietary carbohydrate intake, GI, GL and CQI were assessed during mid-pregnancy using a food frequency questionnaire. Child neurodevelopment was evaluated at 8 and 28 months using the Developmental Profile 3 (DP-3) and at 18 months using the Bayley Scales of Infant and Toddler Development (BSID-III). Associations were analyzed using multivariable linear regression models adjusted for relevant maternal and child covariates.

Results: Increased maternal carbohydrate intake, GI, and GL were inversely associated with language development (β (95% CI): - 2.67 (- 5.13, - 0.21), - 2.73 (- 5.21, - 0.26), - 3.51 (- 5.96, - 1.07) respectively) and receptive language (β (95% CI): - 0.58 (- 1.07, - 0.08), - 0.54 (- 1.04, - 0.04), - 0.70 (- 1.20, - 0.21) respectively) at 18 months, as measured by the BSID-III, although these associations were attenuated after adjustment for maternal and child covariates. Increased GI and lower CQI were associated with lower gross motor scores (β (95% CI): - 0.49 (- 0.84, - 0.15), 0.39 (0.06, 0.71) respectively) at 18 months (BSID-III), as well as reduced motor development (β (95% CI): - 3.2 (- 5.50, - 0.76), 2.22 (- 0.1, 4.54) respectively) at 8 and 28 months (DP-3).

Conclusions: Maternal carbohydrate quality during pregnancy may influence early neurodevelopment, particularly motor outcomes. Emphasizing low-GI, low-GL and high-CQI carbohydrate sources during pregnancy could support favorable developmental trajectories in offspring.

Background: Odd-chain saturated fatty acids (SFAs) have shown potential metabolic benefits, may exert protective metabolic effects. However, their association with MetS and the potential role of insulin resistance remains unclear.

Methods: In a cross-sectional study of 746 adults, we assessed associations between erythrocyte odd-chain SFAs and MetS using logistic regression Mediation and interaction analyses were performed to explore the role of insulin resistance (HOMA-IR) in these associations. We also examined the correlations between odd-chain SFAs and dietary factors.

Results: Higher erythrocyte C17:0 levels were associated with lower MetS risk (OR = 0.36, 95% CI 0.21-0.60), partially mediated by HOMA-IR (33.8%). Joint analysis revealed the lowest MetS risk among participants with both high C17:0 and low HOMA-IR (OR = 0.14, 95% CI 0.07-0.26). Additive interaction between C17:0 and HOMA-IR was significant. Dietary fiber intake was positively associated with C17:0 levels. No significant association was observed for C15:0.

Conclusions: Elevated erythrocyte C17:0 is inversely associated with the risk of metabolic syndrome, partially through improved insulin sensitivity. Targeting the elevation of C17:0 levels and enhancing insulin sensitivity may offer a promising strategy for early MetS prevention. Dietary fiber may play a potential role in modulating C17:0 levels.

Purpose: This study aimed to establish trends in overweight and obesity prevalence among adults living in Ireland (18-64 years) and older adults (> 65 years) over three decades, from 1990 to 2024.

Methods: Anthropometric data pertaining to n4357 adults were collated from four nationally representative, cross-sectional nutrition surveys published in Ireland between 1990 and 2024. These anthropometric data were measured by researchers in three of the four datasets, and self-measured in the fourth. X² tests and one-way analysis of variance (ANOVA) were used to test for significant differences. Binary logistic regression explored the association between sociodemographic variables and the presence of overweight and obesity.

Results: Significant increases in mean height and weight were observed between 1990 and 2011, across both age groups (18-64 years and > 65 years) and sexes (p ≤ 0.001). A decrease was observed in mean weight and BMI among the more recent 2024 cross-sectional sample (p < 0.001). A similar pattern was noted in the prevalence of those living with obesity with 11.5% presenting with obesity in 1990, increasing to 23.7% 2011, and declining to 17.3% in 2024 among the adults aged 18-64 years. The proportion of older adults living with obesity between 1990 and 2024 followed a similar trajectory. Social class was associated with the presence of overweight and obesity, with the greatest association noted among the 2011 cross-sectional sample (p = 0.003).

Conclusion: Weight status increased during the period 1990-2024, with the more recent data indicating a possible plateau emerging, methodological differences between the studies included hinder certainty. Consistent associations between social class and the presence of overweight and obesity are noted. Continuous monitoring of weight status is required to confirm the trends noted in the present study and to guide population wide public health measures related to weight status.

Background: In the UK, more than half of the food supply is composed of ultra-processed foods (UPF). However, the association between UPF intake and osteoporosis risk remains unclear. This study aimed to investigate this association and explore potential mediating biomarkers.

Methods: This prospective cohort study enrolled 141,577 eligible participants from the UK Biobank. UPF intake was defined based on the NOVA classification, and dietary data were obtained via 24-h recall. Osteoporosis incidence was identified through linkage with primary care records. To assess the relationship between UPF consumption and osteoporosis risk, Cox proportional hazards models and restricted cubic spline analyses were applied. Mediation analyses examined the potential mediating roles of inflammatory and bone-related biomarkers. We also assessed the interaction between UPF intake and osteoporosis-related polygenic risk scores (PRS).

Results: During a median follow-up period of 13.3 years, 3562 individuals developed osteoporosis. The highest tertile of UPF intake was associated with a fully adjusted hazard ratio (HR) of 1.09 (95% CI 1.01-1.19) versus the reference group. Each standard deviation increase in UPF intake was associated with a 5% higher risk of osteoporosis. Mediation analysis indicated that inflammatory markers accounted for 2.76-3.30% of this association. No significant interaction was detected between UPF and genetic factors. Sensitivity analyses yielded results consistent with the main findings.

Conclusion: Higher intake of UPF is associated with an elevated risk of osteoporosis, with inflammation playing a partially mediating role. Reducing UPF consumption may help mitigate osteoporosis risk.

Purpose: Plate-clearing behavior (PCB), a maladaptive behavior in a food environment characterized by large, energy-dense portions of food, may contribute to weight gain over time. If a portion size is selected that causes overeating, a trade-off exists between food waste and weight gain due to PCB. However, patterns between PCBs and pre-meal portion planning to prevent overeating (PPP-O) remain overlooked. This study aimed to identify these patterns in various meal situations and describe the demographic, anthropometric, psychological, and lifestyle-related characteristics of those following each pattern.

Methods: Overall, 1,707 Japanese participants responded to a web-based anonymous questionnaire in February 2023. Cluster analysis was performed to identify patterns in PPP-O and PCB. Multiple logistic regression analysis was used on clusters of participant characteristic variables.

Results: The median age of the participants was 40 (25th and 75th percentile: 30, 50) years (female =  865, 50.7%). Four clusters with independent predictors were identified: low PPP-O and high PCB, moderate PPP-O and high PCB, moderate PPP-O and low PCB, and high PPP-O and low PCB. Low BMI and a higher positive attitude toward food waste were independent predictors in high PPP-O and low PCB, while high BMI was an independent predictor in moderate PPP-O and high PCBs and low attitude toward food waste were independent predictors in moderate PPP-O and low PCB. Psychological factors were described as independent predictors of several clusters.

Conclusion: The results support the possibility of a trade-off between food waste and weight gain if PPP-O is not implemented.

Purpose: The Paleolithic Diet Fraction (PDF) estimates the proportion of absolute dietary intake derived from food groups included in the Paleolithic diet. In the Malmö Diet and Cancer Study (MDCS), higher PDF and lower systemic low-grade chronic inflammation (SLGCI) have been associated with lower cardiometabolic morbidity and mortality. We examined associations between PDF and SLGCI in the MDCS.

Methods: The study population (n = 23,250; 63% women; ages 44-74 years) excluded participants with prior coronary events, diabetes, stroke, high-grade inflammation, or missing baseline covariate data. PDF was calculated from baseline dietary data collected via food frequency questionnaires, seven-day food records, and interviews. Biomarkers of SLGCI included total leukocyte count (TLC) and neutrophil-to-lymphocyte ratio (NLR) measured at baseline, and C-reactive protein (CRP) measured ~ 4 months later in a subpopulation (n = 4196).

Results: PDF was significantly and inversely associated with all three biomarkers of SLGCI in both simple and fully adjusted models (adjusted for age, sex, physical activity level, BMI, smoking status, education level, living alone, born in Sweden, season of dietary data collection, and dietary method version): TLC (B = -0.008), NLR (B = -0.003), and lnCRP (B =  -0.005), respectively (p < 0.001). Inflammatory biomarkers were weakly but significantly correlated: TLC with NLR (r_s = 0.263), TLC with CRP (r_s = 0.262), and NLR with CRP (r_s = 0.062) (p < 0.001).

Conclusion: PDF was inversely associated with SLGCI biomarkers, suggesting that SLGCI may mediate its relationship with cardiometabolic outcomes. Given the cross-sectional design and CRP measurement lag, these findings should be interpreted with caution.

Purpose: Legumes are promoted as climate-friendly and healthy protein sources. This study evaluated the association between replacing red and processed meat, poultry, or fish with equal amounts of legumes and the risk of gallbladder disease.

Methods: Participants from the UK Biobank Cohort who completed two or more 24 h dietary assessments and had complete information on covariates were included. Information on age, sex, and socioeconomic and lifestyle factors were collected at recruitment, while information on dietary intake was collected using multiple 24 h dietary assessments. Information on incident gallbladder disease (defined as cholelithiasis, cholecystectomy, or cholecystitis) was collected from health registries based on ICD10-diagnosis or operation codes. The rate of developing gallbladder diseases when replacing red and processed meat, poultry, or fish with legumes was estimated using multivariable-adjusted Cox Proportional Hazards regression analyses adjusted for potential confounders.

Results: Over a median follow-up time of 10.5 (interquartile range: 10.4-10.9) years, 121,593 eligible participants provided 1,246,913 person-years of follow-up during which 3772 individuals developed gallbladder disease. Replacing 80 g/week of red and processed meat with legumes was associated with a lower rate of gallbladder disease (HR: 0.97, 95% CI 0.95; 0.98, p < 0.001). No association was found when replacing poultry or fish with legumes. Adjusting for BMI did not change the magnitude or direction of associations.

Conclusions: Replacing red and processed meat with legumes was associated with lower rates of gallbladder disease. Further research in populations with higher legume intake is warranted to confirm these findings.

Purpose: A ketogenic diet (KD), high in fat and low in carbohydrates, induces ketosis characterized by elevated circulating ketone bodies. While both KD and ketone bodies have demonstrated therapeutic potential in various pathophysiological conditions, their effect on inflammatory bowel diseases remains controversial. This study aimed to investigate the impact of a KD and ketone ester (KE), an ingestible form of ketone bodies, on intestinal inflammation.

Methods: Acute dextran sodium sulfate (DSS)- and 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced murine colitis models were used to evaluate and compare the effects of KD feeding and KE supplementation on intestinal inflammation, the mucus barrier and gut microbiota composition.

Results: KD feeding did not significantly affect colitis activity, whereas KE supplementation alleviated colitis in both models investigated. KE-induced mitigation of colitis was associated with increased mucin2 expression, indicating enhanced colonic mucus barrier integrity. KE supplementation also improved goblet cell function and differentiation, as evidenced by increased goblet cell numbers and the upregulation of goblet cell differentiation markers. Furthermore, 16S rRNA sequencing analysis revealed that KE supplementation resulted in higher abundances of mucus-degrading Akkermansia, a genus believed to play a key role in maintaining intestinal homeostasis.

Conclusion: The present study suggests that KE represent an effective anti-inflammatory dietary supplement in the context of acute colitis, potentially by modulating mucin2 expression, goblet cell differentiation, and the abundance of Akkermansia. Although promising, these findings remain preliminary, and further investigations are needed to explore the therapeutic potential of KE as a dietary supplement in patients with inflammatory bowel disease.