Pub Date : 2024-12-12DOI: 10.1007/s00394-024-03558-w
Dingyuan Tu, Qiang Xu, Jie Sun, Xiaoli Zuo, Chaoqun Ma
Purpose: Balanced dietary patterns, sufficient physical activity, and other healthy lifestyle behaviors are increasingly recognized as a complimentary strategy for the prevention of cardiovascular disease (CVD). We aim to explore the joint association of anti-inflammatory diet and vigorous leisure-time physical activity (LTPA) on all-cause and CVD mortality.
Methods: This retrospective cohort study included 16,068 adults from the National Health and Nutrition Examination Survey (2007-2014). Participants were categorized into four lifestyle patterns based on the inflammatory properties of the diet and the degree of vigorous LTPA: pro-inflammatory diet and insufficient vigorous LTPA (pattern 1), anti-inflammatory diet and insufficient vigorous LTPA (pattern 2), pro-inflammatory diet and sufficient vigorous LTPA (pattern 3), anti-inflammatory diet and sufficient vigorous LTPA (pattern 4). Multivariable Cox proportional hazards models were used to estimate the hazards ratio (HR) and 95% confidence intervals (CI).
Results: Compared to pattern 1, pattern 4 showed an obvious lower risk of all-cause (HR, 0.51; 95% CI 0.32-0.81) and CVD mortality (HR, 0.31; 95% CI 0.12-0.80). In addition, pattern 2 also had a significantly decreased all-cause (0.80; 0.69-0.92) and CVD mortality risk (0.71; 0.53-0.95). However, t there was no significant reduction in all-cause mortality (0.75; 0.54-1.06) and CVD mortality (0.60; 0.32-1.13) among pattern 3. Consistent results were obtained in subgroup and sensitivity analyses.
Conclusion: Adhering to the anti-inflammatory diet and sufficient vigorous LTPA was associated with lowest all-cause and CVD mortality. Anti-inflammatory diet can counteract the hazards caused by insufficient vigorous LTPA, while sufficient vigorous LTPA fails to offset the detrimental effect of pro-inflammatory diet.
{"title":"Joint association of anti-inflammatory diet and vigorous leisure-time physical activity on all-cause and cardiovascular disease mortality in U.S. adults: findings from NHANES, 2007-2014.","authors":"Dingyuan Tu, Qiang Xu, Jie Sun, Xiaoli Zuo, Chaoqun Ma","doi":"10.1007/s00394-024-03558-w","DOIUrl":"https://doi.org/10.1007/s00394-024-03558-w","url":null,"abstract":"<p><strong>Purpose: </strong>Balanced dietary patterns, sufficient physical activity, and other healthy lifestyle behaviors are increasingly recognized as a complimentary strategy for the prevention of cardiovascular disease (CVD). We aim to explore the joint association of anti-inflammatory diet and vigorous leisure-time physical activity (LTPA) on all-cause and CVD mortality.</p><p><strong>Methods: </strong>This retrospective cohort study included 16,068 adults from the National Health and Nutrition Examination Survey (2007-2014). Participants were categorized into four lifestyle patterns based on the inflammatory properties of the diet and the degree of vigorous LTPA: pro-inflammatory diet and insufficient vigorous LTPA (pattern 1), anti-inflammatory diet and insufficient vigorous LTPA (pattern 2), pro-inflammatory diet and sufficient vigorous LTPA (pattern 3), anti-inflammatory diet and sufficient vigorous LTPA (pattern 4). Multivariable Cox proportional hazards models were used to estimate the hazards ratio (HR) and 95% confidence intervals (CI).</p><p><strong>Results: </strong>Compared to pattern 1, pattern 4 showed an obvious lower risk of all-cause (HR, 0.51; 95% CI 0.32-0.81) and CVD mortality (HR, 0.31; 95% CI 0.12-0.80). In addition, pattern 2 also had a significantly decreased all-cause (0.80; 0.69-0.92) and CVD mortality risk (0.71; 0.53-0.95). However, t there was no significant reduction in all-cause mortality (0.75; 0.54-1.06) and CVD mortality (0.60; 0.32-1.13) among pattern 3. Consistent results were obtained in subgroup and sensitivity analyses.</p><p><strong>Conclusion: </strong>Adhering to the anti-inflammatory diet and sufficient vigorous LTPA was associated with lowest all-cause and CVD mortality. Anti-inflammatory diet can counteract the hazards caused by insufficient vigorous LTPA, while sufficient vigorous LTPA fails to offset the detrimental effect of pro-inflammatory diet.</p>","PeriodicalId":12030,"journal":{"name":"European Journal of Nutrition","volume":"64 1","pages":"45"},"PeriodicalIF":4.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-12DOI: 10.1007/s00394-024-03545-1
Bahareh Nikooyeh, Delaram Ghodsi, Zahra Yari, Hamid Rasekhi, Maryam Amini, Samira Rabiei, Samira Ebrahimof, Zahra Abdollahi, Mina Minaie, Mohammad Esmaeil Motlagh, Tirang R Neyestani
Purpose: This study examined the status and determinants of key micronutrients among 24-60 month children in underprivileged provinces of Iran, highlighting ongoing challenges despite intervention efforts.
Methods: This study analyzed data from the National Food and Nutrition Surveillance program. A multistage cluster sampling method was used, recruiting 280 children per province from Khuzestan, Kerman, Ilam, Bushehr, Hormozgan, Kohgiluyeh va Boyerahmad, Sistan va Baluchestan and South Khorasan. Demographic, dietary, and anthropometric data were collected, and micronutrient status was assessed through hemoglobin, serum ferritin, zinc, retinol and 25-hydroxycalciferol assays.
Results: This study included 2,247 children (42.2 ± 0.3 months). About 40% of children had low dietary diversity, and 48.4% were from low socioeconomic status (SES) families. Anemia was found in 24% of the children. Vitamin D and A deficiency affected 74%, and 22.3% of children, respectively. Notably, 39.1% had multiple micronutrient deficiencies. Father's occupation (odds ratio [OR] (95% confidence interval [CI]; freelance vs. employed: 1.86 (1.13, 3.06), worker vs. employed: 2.3 (1.43, 3.69)) and SES (middle vs. high: 2.15 (1.09, 4.2)) were significant predictors of anemia. Urban living and higher paternal education were protective against low ferritin. Children in lower SES categories and those with poor vitamin D status were more likely to have iron (1.53 (1.12, 2.09), p = 0.007) and zinc deficiencies (2.19 (1.46, 3.29) p < 0.001). Vitamin A and D statuses were mainly influenced by SES, food security, and supplement intake, respectively.
Conclusion: Our findings revealed high prevalence of micronutrient deficiencies among 24-60 month children residing in eight underprivileged provinces of Iran. Parental education, household SES and food security were the main determinants of micronutrient deficiencies among the studied children. Improvement of the households' food access through betterment of economic condition seems inevitable which in turn necessitates an inter-sectorial collaboration.
{"title":"Multifaceted determinants of micronutrient status in early childhood in Iran : National food and nutrition surveillance.","authors":"Bahareh Nikooyeh, Delaram Ghodsi, Zahra Yari, Hamid Rasekhi, Maryam Amini, Samira Rabiei, Samira Ebrahimof, Zahra Abdollahi, Mina Minaie, Mohammad Esmaeil Motlagh, Tirang R Neyestani","doi":"10.1007/s00394-024-03545-1","DOIUrl":"https://doi.org/10.1007/s00394-024-03545-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined the status and determinants of key micronutrients among 24-60 month children in underprivileged provinces of Iran, highlighting ongoing challenges despite intervention efforts.</p><p><strong>Methods: </strong>This study analyzed data from the National Food and Nutrition Surveillance program. A multistage cluster sampling method was used, recruiting 280 children per province from Khuzestan, Kerman, Ilam, Bushehr, Hormozgan, Kohgiluyeh va Boyerahmad, Sistan va Baluchestan and South Khorasan. Demographic, dietary, and anthropometric data were collected, and micronutrient status was assessed through hemoglobin, serum ferritin, zinc, retinol and 25-hydroxycalciferol assays.</p><p><strong>Results: </strong>This study included 2,247 children (42.2 ± 0.3 months). About 40% of children had low dietary diversity, and 48.4% were from low socioeconomic status (SES) families. Anemia was found in 24% of the children. Vitamin D and A deficiency affected 74%, and 22.3% of children, respectively. Notably, 39.1% had multiple micronutrient deficiencies. Father's occupation (odds ratio [OR] (95% confidence interval [CI]; freelance vs. employed: 1.86 (1.13, 3.06), worker vs. employed: 2.3 (1.43, 3.69)) and SES (middle vs. high: 2.15 (1.09, 4.2)) were significant predictors of anemia. Urban living and higher paternal education were protective against low ferritin. Children in lower SES categories and those with poor vitamin D status were more likely to have iron (1.53 (1.12, 2.09), p = 0.007) and zinc deficiencies (2.19 (1.46, 3.29) p < 0.001). Vitamin A and D statuses were mainly influenced by SES, food security, and supplement intake, respectively.</p><p><strong>Conclusion: </strong>Our findings revealed high prevalence of micronutrient deficiencies among 24-60 month children residing in eight underprivileged provinces of Iran. Parental education, household SES and food security were the main determinants of micronutrient deficiencies among the studied children. Improvement of the households' food access through betterment of economic condition seems inevitable which in turn necessitates an inter-sectorial collaboration.</p>","PeriodicalId":12030,"journal":{"name":"European Journal of Nutrition","volume":"64 1","pages":"43"},"PeriodicalIF":4.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-12DOI: 10.1007/s00394-024-03557-x
Yu-Ting Shen, Qi Li, Yu-Xiang Xu, Yan Huang, Yu-Hui Wan, Pu-Yu Su, Fang-Biao Tao, Ying Sun
Purpose: To investigate the potential associations between unhealthy chrononutrition behaviors (meal timing, frequency, and regularity) and their combined impact on cardiometabolic risk in adolescence.
Methods: Chrononutrition behaviors were assessed using a 7-day ecological momentary assessment (EMA). The unhealthy chrononutrition score (ranging from 0 to 8) was determined based on late meal timing, low meal frequency, and meal irregularity. The cardiometabolic (CM)-risk z score was calculated utilizing age- and sex-specific reference values for waist circumference (WC), mean arterial pressure (MAP), homeostatic model assessment of insulin resistance (HOMA-IR), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C). Restricted cubic splines were employed to estimate the dose-response relationships between the unhealthy chrononutrition score and outcomes.
Results: Among 458 participants [mean (SD) age, 17.9 (0.7) years; 340 (74.2%) Female], 14.3% had an unhealthy chrononutrition score ≥ 6, who exhibited higher MAP (β = 3.86; 95% CI 1.24, 6.47), higher CM-risk scores (β = 1.80; 95% CI 0.70, 2.90), and lower HDL-C (β = 0.18; 95% CI - 0.30, - 0.06), as opposed to those with a healthy score ≤ 2 (n = 136, 31.4%). Moreover, late breakfast (later than 9AM compared to earlier than 8AM), low meal frequency (eating two or fewer meals versus three meals a day), and meal irregularity (score of 3-5 compared to a good score of 6-9) were associated with an increased risk of CM-risk outcomes.
Conclusion: The findings suggest a clustering of unhealthy chrononutrition behaviors that collectively impact cardiometabolic health in adolescence. Further prospective and interventional investigations is necessary to validate these findings and explore the underlying mechanisms.
{"title":"Chrononutrition behaviors and cardiometabolic risk in adolescence: an ecological momentary assessment study.","authors":"Yu-Ting Shen, Qi Li, Yu-Xiang Xu, Yan Huang, Yu-Hui Wan, Pu-Yu Su, Fang-Biao Tao, Ying Sun","doi":"10.1007/s00394-024-03557-x","DOIUrl":"https://doi.org/10.1007/s00394-024-03557-x","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the potential associations between unhealthy chrononutrition behaviors (meal timing, frequency, and regularity) and their combined impact on cardiometabolic risk in adolescence.</p><p><strong>Methods: </strong>Chrononutrition behaviors were assessed using a 7-day ecological momentary assessment (EMA). The unhealthy chrononutrition score (ranging from 0 to 8) was determined based on late meal timing, low meal frequency, and meal irregularity. The cardiometabolic (CM)-risk z score was calculated utilizing age- and sex-specific reference values for waist circumference (WC), mean arterial pressure (MAP), homeostatic model assessment of insulin resistance (HOMA-IR), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C). Restricted cubic splines were employed to estimate the dose-response relationships between the unhealthy chrononutrition score and outcomes.</p><p><strong>Results: </strong>Among 458 participants [mean (SD) age, 17.9 (0.7) years; 340 (74.2%) Female], 14.3% had an unhealthy chrononutrition score ≥ 6, who exhibited higher MAP (β = 3.86; 95% CI 1.24, 6.47), higher CM-risk scores (β = 1.80; 95% CI 0.70, 2.90), and lower HDL-C (β = 0.18; 95% CI - 0.30, - 0.06), as opposed to those with a healthy score ≤ 2 (n = 136, 31.4%). Moreover, late breakfast (later than 9AM compared to earlier than 8AM), low meal frequency (eating two or fewer meals versus three meals a day), and meal irregularity (score of 3-5 compared to a good score of 6-9) were associated with an increased risk of CM-risk outcomes.</p><p><strong>Conclusion: </strong>The findings suggest a clustering of unhealthy chrononutrition behaviors that collectively impact cardiometabolic health in adolescence. Further prospective and interventional investigations is necessary to validate these findings and explore the underlying mechanisms.</p>","PeriodicalId":12030,"journal":{"name":"European Journal of Nutrition","volume":"64 1","pages":"44"},"PeriodicalIF":4.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-11DOI: 10.1007/s00394-024-03538-0
Hannah Jilani, Timm Intemann, Gabriele Eiben, Fabio Lauria, Lauren Lissner, Nathalie Michels, Dénes Molnár, Luis A Moreno, Valeria Pala, Michael Tornaritis, Toomas Veidebaum, Wolfgang Ahrens, Antje Hebestreit
Purpose: It is assumed that sensory taste perception shapes food choices and impacts dietary intake. However, this has rarely been studied in free living subjects of different age-groups with standardised methods. The present study investigated the association of the ability to rank sweet and fat taste intensities with consumption frequency of sweet and fatty foods in children, adolescents and adults from eight European countries.
Methods: In total, 461 children, 421 adolescents and 612 adults from the IDEFICS/I.Family cohort participated in sensory sweet and fat intensity rating tests. Sweet and fatty food consumption frequencies were assessed using a food frequency questionnaire. The association between the ability to rank sweet and fat intensity with sweet and fatty food consumption frequencies was estimated using linear mixed regression models adjusting for weight status, country, sex, age and family affiliation.
Results: Across all age groups, the largest proportion of participants had medium sweet and fat taste intensity ranking abilities. The next largest proportion had low sweet and fat taste intensity rating abilities, while the smallest proportion had high intensity rating abilities to sweet and fat taste. A negative association of sweet and fat taste intensity ranking ability with sweet and fatty food consumption frequencies was found for children. In adolescents, the association was positive. In adults, there was no association.
Conclusion: It seems that the association of taste intensity ratings with food consumption frequencies during adolescence differs from the associations in children and adults. This could be due to hormonal changes during puberty, growth and maturation. Thus, further research focussing on maturation processes in association with taste perception during adolescence may be required.
{"title":"Association of ability to rank sweet and fat taste intensities with sweet and fat food propensity ratios of children, adolescents and adults: the I.Family study.","authors":"Hannah Jilani, Timm Intemann, Gabriele Eiben, Fabio Lauria, Lauren Lissner, Nathalie Michels, Dénes Molnár, Luis A Moreno, Valeria Pala, Michael Tornaritis, Toomas Veidebaum, Wolfgang Ahrens, Antje Hebestreit","doi":"10.1007/s00394-024-03538-0","DOIUrl":"10.1007/s00394-024-03538-0","url":null,"abstract":"<p><strong>Purpose: </strong>It is assumed that sensory taste perception shapes food choices and impacts dietary intake. However, this has rarely been studied in free living subjects of different age-groups with standardised methods. The present study investigated the association of the ability to rank sweet and fat taste intensities with consumption frequency of sweet and fatty foods in children, adolescents and adults from eight European countries.</p><p><strong>Methods: </strong>In total, 461 children, 421 adolescents and 612 adults from the IDEFICS/I.Family cohort participated in sensory sweet and fat intensity rating tests. Sweet and fatty food consumption frequencies were assessed using a food frequency questionnaire. The association between the ability to rank sweet and fat intensity with sweet and fatty food consumption frequencies was estimated using linear mixed regression models adjusting for weight status, country, sex, age and family affiliation.</p><p><strong>Results: </strong>Across all age groups, the largest proportion of participants had medium sweet and fat taste intensity ranking abilities. The next largest proportion had low sweet and fat taste intensity rating abilities, while the smallest proportion had high intensity rating abilities to sweet and fat taste. A negative association of sweet and fat taste intensity ranking ability with sweet and fatty food consumption frequencies was found for children. In adolescents, the association was positive. In adults, there was no association.</p><p><strong>Conclusion: </strong>It seems that the association of taste intensity ratings with food consumption frequencies during adolescence differs from the associations in children and adults. This could be due to hormonal changes during puberty, growth and maturation. Thus, further research focussing on maturation processes in association with taste perception during adolescence may be required.</p>","PeriodicalId":12030,"journal":{"name":"European Journal of Nutrition","volume":"64 1","pages":"42"},"PeriodicalIF":4.1,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-07DOI: 10.1007/s00394-024-03523-7
Nicholas A Koemel, Alistair M Senior, Nasser Laouali, David S Celermajer, Amanda Grech, Helen M Parker, Stephen J Simpson, David Raubenheimer, Timothy P Gill, Michael R Skilton
Purpose: Dietary macronutrients significantly impact cardiometabolic health, yet research often focuses on individual macronutrient relationships. This study aimed to explore the associations between dietary macronutrient composition and cardiometabolic health.
Methods: This study included 33,681 US adults (49.7 ± 18.3 years; 52.5% female) from the National Health and Nutrition Examination Survey during 1999-2014. Dietary data was derived from 1 to 2 separate 24-hour recalls and cardiometabolic health included lipid profile, glycemic control, blood pressure, and adiposity collected in a mobile examination center. Associations between dietary macronutrient composition and cardiometabolic health were examined using generalized additive models adjusted for age, socio-demographics, lifestyle, and diet quality.
Results: In females, triglycerides (P < 0.01) and HDL cholesterol (P < 0.01) were the least optimal in diets containing lower fat (10%) and higher carbohydrate (75%). In males, HDL cholesterol was positively associated with fat (P < 0.01) and no association with triglycerides was detected. Total-C associations were male specific (P = 0.01) and highest in diets composed of 25% protein, 30% carbohydrate, and 45% fat. In both sexes, systolic blood pressure (P ≤ 0.02) was highest in diets containing lower fat (10%) coupled with moderate protein (25%). Diastolic blood pressure associations were female specific (P < 0.01) with higher values in those consuming the upper range of fat (55%). There were no associations of macronutrient composition with glycemic control or adiposity.
Conclusion: This study revealed sex-specific relationships between macronutrient composition and cardiometabolic health. Future research is needed to explore these relationships across age groups.
{"title":"Associations between dietary macronutrient composition and cardiometabolic health: data from NHANES 1999-2014.","authors":"Nicholas A Koemel, Alistair M Senior, Nasser Laouali, David S Celermajer, Amanda Grech, Helen M Parker, Stephen J Simpson, David Raubenheimer, Timothy P Gill, Michael R Skilton","doi":"10.1007/s00394-024-03523-7","DOIUrl":"10.1007/s00394-024-03523-7","url":null,"abstract":"<p><strong>Purpose: </strong>Dietary macronutrients significantly impact cardiometabolic health, yet research often focuses on individual macronutrient relationships. This study aimed to explore the associations between dietary macronutrient composition and cardiometabolic health.</p><p><strong>Methods: </strong>This study included 33,681 US adults (49.7 ± 18.3 years; 52.5% female) from the National Health and Nutrition Examination Survey during 1999-2014. Dietary data was derived from 1 to 2 separate 24-hour recalls and cardiometabolic health included lipid profile, glycemic control, blood pressure, and adiposity collected in a mobile examination center. Associations between dietary macronutrient composition and cardiometabolic health were examined using generalized additive models adjusted for age, socio-demographics, lifestyle, and diet quality.</p><p><strong>Results: </strong>In females, triglycerides (P < 0.01) and HDL cholesterol (P < 0.01) were the least optimal in diets containing lower fat (10%) and higher carbohydrate (75%). In males, HDL cholesterol was positively associated with fat (P < 0.01) and no association with triglycerides was detected. Total-C associations were male specific (P = 0.01) and highest in diets composed of 25% protein, 30% carbohydrate, and 45% fat. In both sexes, systolic blood pressure (P ≤ 0.02) was highest in diets containing lower fat (10%) coupled with moderate protein (25%). Diastolic blood pressure associations were female specific (P < 0.01) with higher values in those consuming the upper range of fat (55%). There were no associations of macronutrient composition with glycemic control or adiposity.</p><p><strong>Conclusion: </strong>This study revealed sex-specific relationships between macronutrient composition and cardiometabolic health. Future research is needed to explore these relationships across age groups.</p>","PeriodicalId":12030,"journal":{"name":"European Journal of Nutrition","volume":"64 1","pages":"41"},"PeriodicalIF":4.1,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-02DOI: 10.1007/s00394-024-03555-z
Shiyu Li, Haowen Chen, Ruxun Zhao, Tingyu Wang, Jufeng Ye
Purpose: Examine cross-sectional and longitudinal relationships between organic food consumption and cognitive function among older adults.
Methods: In this study, 6077 participants were selected from the 2012 Health and Retirement Study (HRS) and the Health Care and Nutrition Study (HCNS) for cross-sectional analyses, and retaining 4882 individuals for longitudinal analyses. Organic food consumption was assessed using a Food Frequency Questionnaire and participants were categorized based on their organic dietary diversity score. Cognitive function was evaluated using the Langa-Weir classification. A multivariable linear analysis was used to investigate the associations between organic food consumption and cognitive function. Cox proportional hazards model examined the association between mild cognitive impairment (MCI) and organic food consumption.
Results: Our findings revealed a positive association between the organic food consumption and cognitive function among older adults. However, the consumption of organic food was found to significantly reduce the risk of MCI only among females, with a hazard ratio of 0.80 (95% CI 0.65-0.98). Furthermore, both organic animal and plant food consumption were independently linked to a 27% and 20% reduction in the risk of incident MCI, respectively.
Conclusion: This research results underscores the cognitive benefits of organic diets, particularly in mitigating the risk of MCI among females. Recognizing the sex-specific nature of this association suggests the importance of considering gender perspectives in the formulation of dietary interventions aimed at cognitive health.
{"title":"Organic food consumption is positively associated with cognitive function among middle-aged and older adults: cross-sectional and longitudinal analyses.","authors":"Shiyu Li, Haowen Chen, Ruxun Zhao, Tingyu Wang, Jufeng Ye","doi":"10.1007/s00394-024-03555-z","DOIUrl":"https://doi.org/10.1007/s00394-024-03555-z","url":null,"abstract":"<p><strong>Purpose: </strong>Examine cross-sectional and longitudinal relationships between organic food consumption and cognitive function among older adults.</p><p><strong>Methods: </strong>In this study, 6077 participants were selected from the 2012 Health and Retirement Study (HRS) and the Health Care and Nutrition Study (HCNS) for cross-sectional analyses, and retaining 4882 individuals for longitudinal analyses. Organic food consumption was assessed using a Food Frequency Questionnaire and participants were categorized based on their organic dietary diversity score. Cognitive function was evaluated using the Langa-Weir classification. A multivariable linear analysis was used to investigate the associations between organic food consumption and cognitive function. Cox proportional hazards model examined the association between mild cognitive impairment (MCI) and organic food consumption.</p><p><strong>Results: </strong>Our findings revealed a positive association between the organic food consumption and cognitive function among older adults. However, the consumption of organic food was found to significantly reduce the risk of MCI only among females, with a hazard ratio of 0.80 (95% CI 0.65-0.98). Furthermore, both organic animal and plant food consumption were independently linked to a 27% and 20% reduction in the risk of incident MCI, respectively.</p><p><strong>Conclusion: </strong>This research results underscores the cognitive benefits of organic diets, particularly in mitigating the risk of MCI among females. Recognizing the sex-specific nature of this association suggests the importance of considering gender perspectives in the formulation of dietary interventions aimed at cognitive health.</p>","PeriodicalId":12030,"journal":{"name":"European Journal of Nutrition","volume":"64 1","pages":"40"},"PeriodicalIF":4.1,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-09-06DOI: 10.1007/s00394-024-03491-y
Xingwu Liu, Han Yu, Guanyu Yan, Mingjun Sun
Background: Growing studies have indicated an association between dietary factors and gastroesophageal reflux disease (GERD). However, whether these associations refer to a causal relationship and the potential mechanism by which dietary factors affect GERD is still unclear.
Methods: A two-step mendelian randomization analysis was performed to obtain causal estimates of dietary factors, blood lipids on GERD. Independent genetic variants associated with 13 kinds of dietary factors and 5 kinds of blood lipids at the genome-wide significance level were selected as instrumental variables. The summary statistics for GERD were obtained from European Bioinformatics Institute, including 129,080 cases and 473,524 controls. Inverse variance weighted was utilized as the main statistical method. MR-Egger intercept test, Cochran's Q test, and leave-one-out analysis were performed to evaluate possible heterogeneity and pleiotropy. And the potential reverse causality was assessed using Steiger filtering.
Results: The results of the inverse variance weighted method indicated that genetically predicted total pork intake (OR = 2.60, 95% CI: 1.21-5.58, p = 0.0143), total bread intake (OR = 0.68, 95% CI: 0.46-0.99, p = 0.0497), total cereal intake (OR = 0.42, 95% CI: 0.31-0.56, p = 2.98E-06), and total cheese intake (OR = 0.41, 95% CI: 0.27-0.61, p = 1.06E-05) were associated with the risk of GERD. Multivariable Mendelian randomization analysis also revealed a negative association between total cereal intake, total cheese intake and the risk of GERD, but the effect of total pork intake and total bread intake on GERD disappeared after adjustment of smoking, alcohol consumption, use of calcium channel blockers, BMI, physical activity levels, and biological sex (age adjusted). Furthermore, the concentration of low-density lipoprotein cholesterol (LDL-C) is negatively correlated with total cheese intake, which mediates the impact of total cheese intake on GERD. The proportion mediated by LDL-C is 2.27% (95%CI: 1.57%, 4.09%).
Conclusions: This study provides evidence that an increase in total cereal intake and total cheese intake will decrease the risk of GERD. Additionally, LDL-C mediates the causal effect of total cheese intake on GERD. These results provide new insights into the role of dietary factors and blood lipids in GERD, which is beneficial for disease prevention.
{"title":"Role of blood lipids in mediating the effect of dietary factors on gastroesophageal reflux disease: a two-step mendelian randomization study.","authors":"Xingwu Liu, Han Yu, Guanyu Yan, Mingjun Sun","doi":"10.1007/s00394-024-03491-y","DOIUrl":"10.1007/s00394-024-03491-y","url":null,"abstract":"<p><strong>Background: </strong>Growing studies have indicated an association between dietary factors and gastroesophageal reflux disease (GERD). However, whether these associations refer to a causal relationship and the potential mechanism by which dietary factors affect GERD is still unclear.</p><p><strong>Methods: </strong>A two-step mendelian randomization analysis was performed to obtain causal estimates of dietary factors, blood lipids on GERD. Independent genetic variants associated with 13 kinds of dietary factors and 5 kinds of blood lipids at the genome-wide significance level were selected as instrumental variables. The summary statistics for GERD were obtained from European Bioinformatics Institute, including 129,080 cases and 473,524 controls. Inverse variance weighted was utilized as the main statistical method. MR-Egger intercept test, Cochran's Q test, and leave-one-out analysis were performed to evaluate possible heterogeneity and pleiotropy. And the potential reverse causality was assessed using Steiger filtering.</p><p><strong>Results: </strong>The results of the inverse variance weighted method indicated that genetically predicted total pork intake (OR = 2.60, 95% CI: 1.21-5.58, p = 0.0143), total bread intake (OR = 0.68, 95% CI: 0.46-0.99, p = 0.0497), total cereal intake (OR = 0.42, 95% CI: 0.31-0.56, p = 2.98E-06), and total cheese intake (OR = 0.41, 95% CI: 0.27-0.61, p = 1.06E-05) were associated with the risk of GERD. Multivariable Mendelian randomization analysis also revealed a negative association between total cereal intake, total cheese intake and the risk of GERD, but the effect of total pork intake and total bread intake on GERD disappeared after adjustment of smoking, alcohol consumption, use of calcium channel blockers, BMI, physical activity levels, and biological sex (age adjusted). Furthermore, the concentration of low-density lipoprotein cholesterol (LDL-C) is negatively correlated with total cheese intake, which mediates the impact of total cheese intake on GERD. The proportion mediated by LDL-C is 2.27% (95%CI: 1.57%, 4.09%).</p><p><strong>Conclusions: </strong>This study provides evidence that an increase in total cereal intake and total cheese intake will decrease the risk of GERD. Additionally, LDL-C mediates the causal effect of total cheese intake on GERD. These results provide new insights into the role of dietary factors and blood lipids in GERD, which is beneficial for disease prevention.</p>","PeriodicalId":12030,"journal":{"name":"European Journal of Nutrition","volume":" ","pages":"3075-3091"},"PeriodicalIF":4.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-09-04DOI: 10.1007/s00394-024-03467-y
Javier T Gonzalez, Lorenzo Lolli, Rachel C Veasey, Penny L S Rumbold, James A Betts, Greg Atkinson, Emma J Stevenson
Background: Following consumption of a meal, circulating glucose concentrations can rise and then fall briefly below the basal/fasting concentrations. This phenomenon is known as reactive hypoglycaemia but to date no researcher has explored potential inter-individual differences in response to meal consumption.
Objective: We conducted a secondary analysis of existing data to examine inter-individual variability of reactive hypoglycaemia in response to breakfast consumption.
Methods: Using a replicate crossover design, 12 healthy, physically active men (age: 18-30 y, body mass index: 22.1 to 28.0 kg⋅m- 2) completed two identical control (continued overnight fasting) and two breakfast (444 kcal; 60% carbohydrate, 17% protein, 23% fat) conditions in randomised sequences. Blood glucose and lactate concentrations, serum insulin and non-esterified fatty acid concentrations, whole-body energy expenditure, carbohydrate and fat oxidation rates, and appetite ratings were determined before and 2 h after the interventions. Inter-individual differences were explored using Pearson's product-moment correlations between the first and second replicates of the fasting-adjusted breakfast response. Within-participant covariate-adjusted linear mixed models and a random-effects meta-analytical approach were used to quantify participant-by-condition interactions.
Results: Breakfast consumption lowered 2-h blood glucose by 0.44 mmol/L (95%CI: 0.76 to 0.12 mmol/L) and serum NEFA concentrations, whilst increasing blood lactate and serum insulin concentrations (all p < 0.01). Large, positive correlations were observed between the first and second replicates of the fasting-adjusted insulin, lactate, hunger, and satisfaction responses to breakfast consumption (all r > 0.5, 90%CI ranged from 0.03 to 0.91). The participant-by-condition interaction response variability (SD) for serum insulin concentration was 11 pmol/L (95%CI: 5 to 16 pmol/L), which was consistent with the τ-statistic from the random-effects meta-analysis (11.7 pmol/L, 95%CI 7.0 to 22.2 pmol/L) whereas effects were unclear for other outcome variables (e.g., τ-statistic value for glucose: 0 mmol/L, 95%CI 0.0 to 0.5 mmol/L).
Conclusions: Despite observing reactive hypoglycaemia at the group level, we were unable to detect any meaningful inter-individual variability of the reactive hypoglycaemia response to breakfast. There was, however, evidence that 2-h insulin responses to breakfast display meaningful inter-individual variability, which may be explained by relative carbohydrate dose ingested and variation in insulin sensitivity of participants.
{"title":"Are there interindividual differences in the reactive hypoglycaemia response to breakfast? A replicate crossover trial.","authors":"Javier T Gonzalez, Lorenzo Lolli, Rachel C Veasey, Penny L S Rumbold, James A Betts, Greg Atkinson, Emma J Stevenson","doi":"10.1007/s00394-024-03467-y","DOIUrl":"10.1007/s00394-024-03467-y","url":null,"abstract":"<p><strong>Background: </strong>Following consumption of a meal, circulating glucose concentrations can rise and then fall briefly below the basal/fasting concentrations. This phenomenon is known as reactive hypoglycaemia but to date no researcher has explored potential inter-individual differences in response to meal consumption.</p><p><strong>Objective: </strong>We conducted a secondary analysis of existing data to examine inter-individual variability of reactive hypoglycaemia in response to breakfast consumption.</p><p><strong>Methods: </strong>Using a replicate crossover design, 12 healthy, physically active men (age: 18-30 y, body mass index: 22.1 to 28.0 kg⋅m<sup>- 2</sup>) completed two identical control (continued overnight fasting) and two breakfast (444 kcal; 60% carbohydrate, 17% protein, 23% fat) conditions in randomised sequences. Blood glucose and lactate concentrations, serum insulin and non-esterified fatty acid concentrations, whole-body energy expenditure, carbohydrate and fat oxidation rates, and appetite ratings were determined before and 2 h after the interventions. Inter-individual differences were explored using Pearson's product-moment correlations between the first and second replicates of the fasting-adjusted breakfast response. Within-participant covariate-adjusted linear mixed models and a random-effects meta-analytical approach were used to quantify participant-by-condition interactions.</p><p><strong>Results: </strong>Breakfast consumption lowered 2-h blood glucose by 0.44 mmol/L (95%CI: 0.76 to 0.12 mmol/L) and serum NEFA concentrations, whilst increasing blood lactate and serum insulin concentrations (all p < 0.01). Large, positive correlations were observed between the first and second replicates of the fasting-adjusted insulin, lactate, hunger, and satisfaction responses to breakfast consumption (all r > 0.5, 90%CI ranged from 0.03 to 0.91). The participant-by-condition interaction response variability (SD) for serum insulin concentration was 11 pmol/L (95%CI: 5 to 16 pmol/L), which was consistent with the τ-statistic from the random-effects meta-analysis (11.7 pmol/L, 95%CI 7.0 to 22.2 pmol/L) whereas effects were unclear for other outcome variables (e.g., τ-statistic value for glucose: 0 mmol/L, 95%CI 0.0 to 0.5 mmol/L).</p><p><strong>Conclusions: </strong>Despite observing reactive hypoglycaemia at the group level, we were unable to detect any meaningful inter-individual variability of the reactive hypoglycaemia response to breakfast. There was, however, evidence that 2-h insulin responses to breakfast display meaningful inter-individual variability, which may be explained by relative carbohydrate dose ingested and variation in insulin sensitivity of participants.</p>","PeriodicalId":12030,"journal":{"name":"European Journal of Nutrition","volume":" ","pages":"2897-2909"},"PeriodicalIF":4.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-08-21DOI: 10.1007/s00394-024-03473-0
Dana El Masri, Mulubirhan Assefa Alemayohu, Federica Loperfido, Irene Bianco, Chiara Ferrara, Rosa Maria Cerbo, Stefano Ghirardello, Maria Cristina Monti, Beatrice Maccarini, Francesca Sottotetti, Elisa Civardi, Francesca Garofoli, Micol Angelini, Hellas Cena, Rachele De Giuseppe
Background/objectives: Gestational Weight Gain (GWG) impacts maternal and fetal health; deviations from optimal ranges pose health risks. Maternal lifestyle before and during pregnancy strongly influences GWG. This study explores factors linked to inadequate GWG, focusing on Mediterranean Diet (MD) adherence and specific food consumption.
Subjects/methods: 178 pregnant women were enrolled at Fondazione IRCCS Policlinico San Matteo (Pavia) during pre-hospital care before birth meeting inclusion/exclusion criteria. Sociodemographic data, pre-pregnancy BMI, GWG, MD adherence, physical activity (PA) levels, and smoking habits were retrospectively collected. Validated questionnaires adapted for the target group, assessed MD adherence and PA level. Participants were classified into adequate (AGWG) and inadequate GWG groups following IOM guidelines.
Results: Among 200 pregnant women (aged 30-36), 37.1% experienced low GWG and 24.1% excessive GWG. Our study revealed a significant association between inadequate GWG and educational level (P = 0.011); pre-pregnancy BMI (P = 0.005); MD adherence (P = 0.008), and daily average consumption of vegetables (P < 0.001). Our results also showed that a lower risk of EGWG vs. AGWG was associated with daily average consumption of vegetables (RRR = 0.279, P = 0.004), while a higher risk of EGWG vs. AGWG was associated with high daily meat product consumption (> 1.5 portions/day) (RRR = 7.83, P = 0.03).
Conclusion: These findings emphasize the importance of promoting lifestyle changes before and during pregnancy to tackle the increasing incidence of inadequate GWG and improve the health outcomes of both mother and child.
{"title":"Associations of maternal lifestyle factors with inadequate pregnancy weight gain: findings from the baseline data of the LIMIT prospective cohort study.","authors":"Dana El Masri, Mulubirhan Assefa Alemayohu, Federica Loperfido, Irene Bianco, Chiara Ferrara, Rosa Maria Cerbo, Stefano Ghirardello, Maria Cristina Monti, Beatrice Maccarini, Francesca Sottotetti, Elisa Civardi, Francesca Garofoli, Micol Angelini, Hellas Cena, Rachele De Giuseppe","doi":"10.1007/s00394-024-03473-0","DOIUrl":"10.1007/s00394-024-03473-0","url":null,"abstract":"<p><strong>Background/objectives: </strong>Gestational Weight Gain (GWG) impacts maternal and fetal health; deviations from optimal ranges pose health risks. Maternal lifestyle before and during pregnancy strongly influences GWG. This study explores factors linked to inadequate GWG, focusing on Mediterranean Diet (MD) adherence and specific food consumption.</p><p><strong>Subjects/methods: </strong>178 pregnant women were enrolled at Fondazione IRCCS Policlinico San Matteo (Pavia) during pre-hospital care before birth meeting inclusion/exclusion criteria. Sociodemographic data, pre-pregnancy BMI, GWG, MD adherence, physical activity (PA) levels, and smoking habits were retrospectively collected. Validated questionnaires adapted for the target group, assessed MD adherence and PA level. Participants were classified into adequate (AGWG) and inadequate GWG groups following IOM guidelines.</p><p><strong>Results: </strong>Among 200 pregnant women (aged 30-36), 37.1% experienced low GWG and 24.1% excessive GWG. Our study revealed a significant association between inadequate GWG and educational level (P = 0.011); pre-pregnancy BMI (P = 0.005); MD adherence (P = 0.008), and daily average consumption of vegetables (P < 0.001). Our results also showed that a lower risk of EGWG vs. AGWG was associated with daily average consumption of vegetables (RRR = 0.279, P = 0.004), while a higher risk of EGWG vs. AGWG was associated with high daily meat product consumption (> 1.5 portions/day) (RRR = 7.83, P = 0.03).</p><p><strong>Conclusion: </strong>These findings emphasize the importance of promoting lifestyle changes before and during pregnancy to tackle the increasing incidence of inadequate GWG and improve the health outcomes of both mother and child.</p>","PeriodicalId":12030,"journal":{"name":"European Journal of Nutrition","volume":" ","pages":"2911-2920"},"PeriodicalIF":4.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-09-04DOI: 10.1007/s00394-024-03481-0
Zhiyao Chang, Sander Biesbroek, Hongyi Cai, Shenggen Fan, Yuanying Ni, Xin Wen, Pieter Van 't Veer, Elise F Talsma
Purpose: Sub-optimal food choices contribute to the risk of multiple non-communicable diseases (NCDs) which can be mitigated by improving diet quality. Food consumption patterns may partly account for variation of NCD risks in population subgroups in China. This study aimed to evaluate the risk of diet-related NCDs of observed Chinese diets, and to assess the potential reduction in NCD risks by adhering to certain diet recommendations.
Methods: Dose-response meta-analyses were used to derive relative risks between three diet-related NCDs and consumption of 15 food groups. 24-h dietary recall data of 12,809 adults from the 2011 China Health and Nutrition Survey were used to estimate the diet-related summed risks (SRs) of NCDs. Twelve Chinese provinces were aggregated into five regions, and stratified by age, gender, overweight status, education, income, and urbanicity. The Chinese Dietary Guideline-2016 (CDG-2016) and the EAT-Lancet diet were used as recommended diets.
Results: Associations between SRs and gender, age, educational level, income level, and urbanicity were observed. No association was found between SRs and overweight status. Both diet recommendations have lower SRs compared to observed diets among all regions. The food groups that contributed most to the variation of the SRs of diet-related NCDs in China were high consumption of red meat and refined grains, and low consumption of whole grains, fruits, and legumes.
Conclusion: To address the heterogeneity in diet-related NCD risks, focusing on region-specific dietary practical is imperative for Chinese population, in order to propose tailored guidance to adhere to diet recommendations.
{"title":"Heterogeneity in diet-related non-communicable disease risks in a Chinese population.","authors":"Zhiyao Chang, Sander Biesbroek, Hongyi Cai, Shenggen Fan, Yuanying Ni, Xin Wen, Pieter Van 't Veer, Elise F Talsma","doi":"10.1007/s00394-024-03481-0","DOIUrl":"10.1007/s00394-024-03481-0","url":null,"abstract":"<p><strong>Purpose: </strong>Sub-optimal food choices contribute to the risk of multiple non-communicable diseases (NCDs) which can be mitigated by improving diet quality. Food consumption patterns may partly account for variation of NCD risks in population subgroups in China. This study aimed to evaluate the risk of diet-related NCDs of observed Chinese diets, and to assess the potential reduction in NCD risks by adhering to certain diet recommendations.</p><p><strong>Methods: </strong>Dose-response meta-analyses were used to derive relative risks between three diet-related NCDs and consumption of 15 food groups. 24-h dietary recall data of 12,809 adults from the 2011 China Health and Nutrition Survey were used to estimate the diet-related summed risks (SRs) of NCDs. Twelve Chinese provinces were aggregated into five regions, and stratified by age, gender, overweight status, education, income, and urbanicity. The Chinese Dietary Guideline-2016 (CDG-2016) and the EAT-Lancet diet were used as recommended diets.</p><p><strong>Results: </strong>Associations between SRs and gender, age, educational level, income level, and urbanicity were observed. No association was found between SRs and overweight status. Both diet recommendations have lower SRs compared to observed diets among all regions. The food groups that contributed most to the variation of the SRs of diet-related NCDs in China were high consumption of red meat and refined grains, and low consumption of whole grains, fruits, and legumes.</p><p><strong>Conclusion: </strong>To address the heterogeneity in diet-related NCD risks, focusing on region-specific dietary practical is imperative for Chinese population, in order to propose tailored guidance to adhere to diet recommendations.</p>","PeriodicalId":12030,"journal":{"name":"European Journal of Nutrition","volume":" ","pages":"2975-2986"},"PeriodicalIF":4.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}