European Journal of Nutrition最新文献

Purpose: Plant-based diets are increasingly recognized for cancer prevention, yet their specific impact on lung cancer (LC) risk remains insufficiently examined. This study aims to assess the relationship between plant-based diets adherence and the incidence of LC.

Methods: Data from the Prostate, Lung, Colorectal, and Ovarian cancer screening trial were analyzed. The plant-based diet index (PDI) was developed to assess adherence to plant-based diets. Multivariable Cox regression model was performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Restricted cubic spline (RCS) model was performed to examine risk across the PDI spectrum. Prespecified subgroup analyses identified potential modifiers, and sensitivity analyses tested the association's robustness.

Results: Of the 98,459 participants included, 1,642 developed LC over an average follow-up of 8.83 years. Higher PDI scores were associated with a lower LC risk (HR _{quartile 4 vs. 1}: 0.75, 95% CI: 0.65-0.87, P _trend < 0.001), evident in both non-small cell lung cancer (HR _{quartile 4 vs. 1}: 0.76, 95% CI: 0.65-0.88, P _trend < 0.001) and small cell lung cancer (HR _{quartile 4 vs. 1}: 0.73, 95% CI: 0.49-1.09, P _trend = 0.046). RCS analyses further confirmed these relationships. The association was stronger among participants with lower BMI, smokers, those without a history of emphysema or diabetes, those without a family history of LC, and those with lower physical activity (all P _trend < 0.001). Sensitivity analyses consistently supported these findings.

Conclusion: Our findings reveal an inverse correlation between PDI and LC risk, supporting the potential benefits of plant-based diets in LC prevention.

Clinical trial registry number: ClinicalTrials.gov ID: NCT00339495 (URL: https://www.

Clinicaltrials: gov/study/NCT00339495 ).

Purpose: Vitamin-mineral and dietary supplements (VMDS) are taken by a large fraction of the population. Whether their long-term consumption impacts mortality and cardiovascular disease (CVD) has seldom been studied.

Methods: Prospective study from a population-based cohort from Lausanne, Switzerland. Participants were categorized as non-users (no consumption at baseline and first follow-up), persistent users (consumption at baseline and follow-up), and occasional users (consumption either at baseline or follow-up). Incidence of CVD and of total mortality was assessed after the first follow-up.

Results: Data from 4261 participants (57.4 ± 10.4 years, 55% females) was used. Median follow-up was 9 years (interquartile range 7.0-9.2) After multivariable analysis, no association was found between VMDS use and total mortality: hazard ratio and (95% confidence interval) 0.95 (0.71-1.28) and 0.83 (0.55-1.26) for occasional and persistent consumers, respectively, CVD mortality: 1.00 (0.47-2.11) and 1.30 (0.53-3.18), or CVD events: 0.96 (0.72-1.27) and 0.95 (0.64-1.42). Similar findings were obtained after inverse probability weighting, using only vitamin-mineral supplement users, or considering only participants at baseline. When CVD events were split into coronary heart disease (CHD) or stroke, persistent use of VMDS was associated with a higher risk of CHD in females: 3.12 (1.52-6.41), p = 0.002, but not in males, 0.25 (0.03-1.82), p = 0.171, p for interaction < 0.05. No association was found between VMDS use and incidence of stroke in both sexes.

Conclusion: We found no association between vitamin and dietary supplement use and total or CVD mortality, or CVD events. The higher risk of CHD for persistent use in females should be further explored.

Background: Though the Planetary Health Diet (PHD) is designed to enhance both human and environmental health, there is limited understanding of how adherence to PHD influences the risk of mortality in the general US adult population. This study aimed to evaluate the relationship between the Planetary Health Diet Index for the United States (PHDI-US) and mortality among adults in the overall population of the United States.

Methods: The PHDI-US comprises 16 components, assigned scores ranging from 0 to 150, with higher scores signifying a greater level of adherence to the PHD. Data were obtained from the National Health and Nutrition Examination Survey spanning 2005 to 2018, with mortality data linked through December 2019.

Results: This study encompassed 30,521 participants (mean [SD] age, 47.02 [17.01] years; 14,817 males [48.0%]). Over an average follow-up period of 8.50 years, there were 3,706 recorded deaths. In the adjusted multivariable model, individuals in the highest quintile of PHDI-US exhibited a reduced risk of all-cause mortality (hazard ratio [HR], 0.64; 95% CI, 0.54-0.75), cardiovascular disease mortality (HR, 0.73; 95% CI, 0.55-0.97), cancer mortality (HR, 0.68; 95% CI, 0.52-0.89), and other-cause mortality (HR, 0.58; 95% CI, 0.46-0.72) compared to those in the lowest quintile.

Conclusion: Adherence to a PHD pattern was associated with lower mortality risk in the general US adult population.

Background: Breakfast is vital for young children's health. In Australia, breakfast is often provided in government-approved Early Childhood Education and Care (ECEC) services. However, research on breakfast provision in Australian ECEC services is limited. This study aimed to evaluate breakfast quality and enablers and barriers of breakfast provision in these settings.

Methods: A multi-method, sequential explanatory design was employed, including survey, on-site visits, and semi-structured interviews. ECEC services offering breakfast in Victoria, Australia, participated in an online survey to assess breakfast provision quality based on Victorian Health Eating Advisory Service (HEAS) guidelines. Multivariate logistic regression was utilised to identify the relationship between breakfast quality and service characteristics. A subset of services participated in 1-day observational visits and 30-min semi-structured interviews. The on-site visits observed breakfast foods and environments, while interviews explored enablers or barriers of breakfast provision.

Results: Fifty ECEC services participated in the online survey, with common breakfast items such as cereal, bread, and milk being frequently provided, while fruits and vegetables were among the least common items offered. Only 10-16% of services met the HEAS definitions of high-quality standards, and these centres were mostly located in socioeconomically advantaged areas. Of these, four services participated in the on-site observation phase, where the use of full-cream milk and multigrain bread was commonly noted. Additionally, eight interviews (two from each centre) were conducted to explore enablers and barriers to healthy breakfast provision. Key enablers included government funding and the use of nutritional guidelines, while barriers involved time constraints, budget limitations, staffing shortages, and insufficient confidence in applying and utilising nutrition guidance.

Conclusion: Fruits and vegetables are rarely provided at breakfast in ECEC settings, and only a small number of ECEC services met high-quality breakfast standards, with those in socio-economically advantaged areas more likely to achieve these standards. Targeted interventions, particularly in disadvantaged areas, are essential to improve the quality of breakfast provision, with a focus on including fruits and vegetables in line with guidelines. While the findings of this study had jurisdictional limitations, this study highlighted the importance of addressing issues such as time constraints, budget limitations, and staffing shortages, along with establishing practical and clear breakfast guidelines to enhance the quality of breakfast provision in ECEC settings. Further research is needed to explore specific and actionable strategies for implementing these improvements.

Purpose: A vegan diet is associated with health benefits but may also lead to inadequate intake of essential nutrients. Due to the lower selenium content in plant-based compared to animal-based foods, many vegans do not reach the recommended selenium intake in Europe. The only plant-based food with high selenium content is the Brazil nut, even though there is also a high variability. Therefore, we investigated the effectiveness of Brazil nut butter compared to a dietary supplement as selenium source to improve the selenium status of vegans and omnivores.

Methods: 44 vegans and 42 omnivores were randomly assigned to one of three intervention groups, either receiving placebo or consuming additional 55 µg of selenium daily as Brazil nut butter or supplement for two weeks. Serum selenium concentrations, glutathione peroxidase 3 (GPX3), and selenoprotein P (SELENOP) were measured at baseline and after intervention. Additionally, dietary selenium intake was estimated using a five-day dietary protocol.

Results: The estimated selenium intake was significantly lower in vegans compared to omnivores and correlated with all three selenium biomarkers. Independent of the dietary pattern (vegan or omnivore), Brazil nut butter as well as supplement significantly increased serum selenium and SELENOP concentrations, while there were no changes in the placebo groups. Both interventions were equally effective in increasing selenium levels, but the upregulation of SELENOP was more pronounced in vegans than in omnivores.

Conclusion: Brazil nuts are a plant-based source of selenium suitable for vegans and omnivores to improve their selenium status when consumed once in a while.

Trial registration number and date of registration: Clinical trials registration number: NCT05814874, April 18 2023.

Purpose: Evidence suggests bovine dairy products may have neutral or beneficial effects on cardiometabolic health, despite being a source of saturated fat. The dairy matrix, the structure and combination of protein, fat, and other nutrients, and how they interact with each other, is purported to be responsible for these beneficial health effects. Whether this relationship extends to endothelial function, as assessed by flow mediated dilation (FMD), remains to be elucidated.

Methods: Three electronic databases (PubMed, Embase and Cochrane Central) were searched from inception until 5th September 2024. This review included randomised controlled trials (RCT) investigating any bovine dairy intervention which considered endothelial function using FMD in humans with a non-dairy or alternative dairy control.

Results: Of 4,220 records identified, 18 reports from 11 RCT including 508 (53.3% male) participants, examined endothelial function by FMD and were eligible for evidence synthesis. Eight papers reported an improvement, nine reported no effect and one reported a decrease in FMD. The greatest effects were found in those with impaired health at baseline, with whey protein and high dairy intakes observed to be most beneficial.

Conclusion: Bovine dairy intake has neutral or beneficial effects on cardiometabolic health. This review demonstrates that this relationship extends to endothelial function as assessed by FMD. Whey protein and high dairy intakes may be most effective, although further high quality RCT in this area are warranted.

Purpose: This study aimed to evaluate the acute effects of beetroot extract and resveratrol supplementation (isolated and combined) on cardiac autonomic modulation and cardiovascular parameters recovery after exercise in individuals with coronary artery disease (CAD).

Methods: 14 males with CAD were submitted to 4 protocols consisting of 30 min (min) of rest, 30 min of aerobic exercise on a treadmill (60% of the heart rate reserve HRR), followed by 30 min of recovery. Before each protocol, the subjects consumed 500 mg of starch (placebo protocol), 500 mg of beetroot (beetroot protocol), or 500 mg of resveratrol (resveratrol protocol), or 500 mg of beetroot and 500 mg of resveratrol (combined protocol). Heart rate variability (HRV) indices and cardiorespiratory parameters were determined at different times during the protocols.

Results: Regarding HR, significantly higher values about rest in the placebo protocol at all recovery moments (1st to 30th min) were observed. Significant differences were observed in the other protocols (beetroot, resveratrol and combined) from the first to the 20th min recovery. For SBP, significantly higher values concerning rest were observed at the first minute of recovery for all protocols. No differences were found for the HRV index between time and protocols.

Conclusions: The single supplementation of beetroot and resveratrol (isolated and combined) did not alter HRV and cardiovascular parameter responses between protocols. The consumption of beetroot extract and resveratrol enhanced vagal modulation and heart rate recovery compared to rest.

Purpose: To examine the associations and substitutions of dietary sugars [extrinsic (free) or intrinsic (non-free)] as well as dietary starch and fiber intakes for indices of body fat and cardiometabolic health.

Methods: Dietary intake was assessed at multiple times using multi-day 24-hour recalls over 18-months for indices of body fat (body fat %, waist circumference, BMI, and weight change) (n = 1066) and at baseline and 12 months for cardiometabolic outcomes (LDL, HDL, HbA1c) (n = 736). Bayesian modeling was applied to analyze the probabilistic impact of dietary carbohydrate components using credible intervals for association and substitution analyses with repeated measures random effects modeling.

Results: A higher starch intake significantly associated with higher body fat %, BMI and waist circumference (WC) (all CrI > 0). Conversely, intrinsic sugar and fiber intakes were significantly linked to lower body fat indices, while free sugar showed no association. A 20 g substitution of free sugars with intrinsic sugars significantly associated with lower body fat (CrI: -4.2; -1.0%), BMI (CrI: -1.8; -0.4) and WC (CrI: -4.2; -1.0 cm), while substituting intrinsic sugars with starch resulted in significantly higher body fat, BMI, WC and weight change. Replacing starch with fiber associated with higher HDL-C (CrI: -0.0; 0.3) and lower LDL-C (CrI: -0.6; 0.1). Replacing free sugars with starch associated with a higher HbA1c level (CrI: 0.0;0.2).

Conclusion: These results underscore the importance of distinguishing between intrinsic versus extrinsic sugars and highlight the potential benefits of increasing intrinsic sugars and fiber while reducing starch for better body fat management and cardiometabolic health.

Purpose: With ageing, older adults (≥ 65 years) may experience decreased appetite, contributing to declines in body weight and muscle mass, potentially affecting physical capabilities. Physical activity (PA) has been suggested as a potential strategy to enhance appetite in older adults, but evidence supporting this is insufficient. This study aimed to investigate the relationship between PA levels, total energy expenditure (TEE), body composition, energy intake (EI) and appetite in older adults.

Methods: One hundred and eight healthy older adults (age 70 ± 4 years; BMI 24.3 ± 2.6 kg/m²) were categorised into three groups (low, medium, high) based on accelerometer-measured PA level (AMPA) and TEE from 7-day PA diaries. Body composition was measured using bioelectrical impedance. Energy and nutrient intakes were assessed using 3-day weighed food diaries. Appetite was assessed using the visual analogue scales at 30-min intervals throughout 1 day.

Results: TEE was positively correlated with EI and % muscle mass (p < 0.05), with higher % muscle mass and TEE associated with higher EI. Energy and protein intake were significantly higher in the high TEE group than the low group (p = 0.03, p = 0.01; respectively). No significant differences in energy and macronutrient intake were observed across AMPA groups, and appetite components (hunger, fullness, desire to eat, prospective consumption) did not differ significantly in either the AMPA or TEE groups.

Conclusions: Higher TEE is associated with higher energy and protein intake, with body composition playing a crucial role. These findings highlight the importance of considering PA, TEE, and body composition in interventions aimed at improving EI in older adults.

Clinical trail registration: clinicaltrials.gov as NCT05067036. Registered 2 October 2021, https://classic.

Clinicaltrials: gov/ct2/show/NCT05067036.