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A perspective on intermittent fasting and cardiovascular risk in the era of obesity pharmacotherapy.
IF 4 2区 农林科学 Q2 NUTRITION & DIETETICS Pub Date : 2025-01-17 eCollection Date: 2025-01-01 DOI: 10.3389/fnut.2025.1524125
Aristides G Eliopoulos, Kalliopi K Gkouskou, Konstantinos Tsioufis, Despina Sanoudou

Intermittent fasting has been linked to metabolic health by improving lipid profiles, reducing body weight, and increasing insulin sensitivity. However, several randomized clinical trials have shown that intermittent fasting is not more effective than standard daily caloric restriction for short-term weight loss or cardiometabolic improvements in patients with obesity. Observational studies also suggest cardiovascular benefits from extended rather than reduced eating windows, and indicate that long-term intermittent fasting regimens may increase the risk of cardiovascular disease mortality. In this perspective, we discuss evidence that may support potential adverse effects of intermittent fasting on cardiovascular health through the loss of lean mass, circadian misalignment and poor dietary choices associated with reward-based eating. Given the ongoing revolution in obesity pharmacotherapy, we argue that future research should integrate anti-obesity medications with dietary strategies that confer robust benefits to cardiometabolic health, combine exercise regimens, and consider genetic factors to personalize obesity treatment. Comprehensive approaches combining diet, pharmacotherapy, and lifestyle modifications will become crucial for managing obesity and minimizing long-term cardiovascular risk.

{"title":"A perspective on intermittent fasting and cardiovascular risk in the era of obesity pharmacotherapy.","authors":"Aristides G Eliopoulos, Kalliopi K Gkouskou, Konstantinos Tsioufis, Despina Sanoudou","doi":"10.3389/fnut.2025.1524125","DOIUrl":"10.3389/fnut.2025.1524125","url":null,"abstract":"<p><p>Intermittent fasting has been linked to metabolic health by improving lipid profiles, reducing body weight, and increasing insulin sensitivity. However, several randomized clinical trials have shown that intermittent fasting is not more effective than standard daily caloric restriction for short-term weight loss or cardiometabolic improvements in patients with obesity. Observational studies also suggest cardiovascular benefits from extended rather than reduced eating windows, and indicate that long-term intermittent fasting regimens may increase the risk of cardiovascular disease mortality. In this perspective, we discuss evidence that may support potential adverse effects of intermittent fasting on cardiovascular health through the loss of lean mass, circadian misalignment and poor dietary choices associated with reward-based eating. Given the ongoing revolution in obesity pharmacotherapy, we argue that future research should integrate anti-obesity medications with dietary strategies that confer robust benefits to cardiometabolic health, combine exercise regimens, and consider genetic factors to personalize obesity treatment. Comprehensive approaches combining diet, pharmacotherapy, and lifestyle modifications will become crucial for managing obesity and minimizing long-term cardiovascular risk.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"12 ","pages":"1524125"},"PeriodicalIF":4.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Increased intake of marine fish contributed to a decreased odds of comorbid depressive symptoms and coronary heart disease in Chinese adults.
IF 4 2区 农林科学 Q2 NUTRITION & DIETETICS Pub Date : 2025-01-17 eCollection Date: 2024-01-01 DOI: 10.3389/fnut.2024.1521124
Yuncao Fan, Wei Chen, Wenhui Lin, Jungu Jin, Enyu Lou, Jiaying Lao, Yu-Hsin Chen, Jianzhi Shao, Qizeng Wang, Qingxi Jiang, Fan Wang, Jinzhong Xu, Yanlong Liu, Bo Yang

Backgrounds: Increased consumption of fish has beneficial impacts upon emotional health; however, this benefit for comorbid depressive symptoms and coronary heart disease (DCHD) is not fully clear. We aimed to investigate the relationship between consumption of marine fish and DCHD in Chinese adults.

Methods: A cross-sectional study was conducted in 1,106 participants aged 25-95 years living in Taizhou, China. Fish intakes were assessed by using a validated food frequency questionnaire, with their tertiles as category levels of ≤1 time/week, 2-6 times/week, and ≥7 times/week. Coronary heart disease (CHD) was diagnosed using the coronary angiography, while the concurrent depressive symptoms was indicated using ≥8 scores from hospital anxiety and depression scales (HADS). Primary measurements were the prevalent DCHD, presented as multivariate-adjusted odds ratios (ORs) with 95% confidence intervals (CIs).

Results: A total of 932 participants were included, 88 (9.44%) participants with depressive symptoms, 477 (51.18%) CHD, and 106 (11.37%) DCHD, respectively. Participants at the highest tertile of fish intake have a lower odds of DCHD compared with those at the lowest (OR: 0.34, 95% CI: 0.20, 0.58), with 42% reductions in odds of DCHD for per one-tertile (3 times/week) increase (OR: 0.58, 95% CI: 0.45, 0.76). The beneficial associations were pronounced with decreased odds of depressive symptom (OR: 0.31, 95% CI: 0.20, 0.47), but not with CHD (OR: 0.87, 95% CI: 0.59, 1.29).

Conclusions: Increased consumption of marine fish is associated with decreased severity of depressive symptoms, which might have great benefits toward comorbid depressive symptom and with coronary heart diseases.

{"title":"Increased intake of marine fish contributed to a decreased odds of comorbid depressive symptoms and coronary heart disease in Chinese adults.","authors":"Yuncao Fan, Wei Chen, Wenhui Lin, Jungu Jin, Enyu Lou, Jiaying Lao, Yu-Hsin Chen, Jianzhi Shao, Qizeng Wang, Qingxi Jiang, Fan Wang, Jinzhong Xu, Yanlong Liu, Bo Yang","doi":"10.3389/fnut.2024.1521124","DOIUrl":"10.3389/fnut.2024.1521124","url":null,"abstract":"<p><strong>Backgrounds: </strong>Increased consumption of fish has beneficial impacts upon emotional health; however, this benefit for comorbid depressive symptoms and coronary heart disease (DCHD) is not fully clear. We aimed to investigate the relationship between consumption of marine fish and DCHD in Chinese adults.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in 1,106 participants aged 25-95 years living in Taizhou, China. Fish intakes were assessed by using a validated food frequency questionnaire, with their tertiles as category levels of ≤1 time/week, 2-6 times/week, and ≥7 times/week. Coronary heart disease (CHD) was diagnosed using the coronary angiography, while the concurrent depressive symptoms was indicated using ≥8 scores from hospital anxiety and depression scales (HADS). Primary measurements were the prevalent DCHD, presented as multivariate-adjusted odds ratios (ORs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>A total of 932 participants were included, 88 (9.44%) participants with depressive symptoms, 477 (51.18%) CHD, and 106 (11.37%) DCHD, respectively. Participants at the highest tertile of fish intake have a lower odds of DCHD compared with those at the lowest (OR: 0.34, 95% CI: 0.20, 0.58), with 42% reductions in odds of DCHD for per one-tertile (3 times/week) increase (OR: 0.58, 95% CI: 0.45, 0.76). The beneficial associations were pronounced with decreased odds of depressive symptom (OR: 0.31, 95% CI: 0.20, 0.47), but not with CHD (OR: 0.87, 95% CI: 0.59, 1.29).</p><p><strong>Conclusions: </strong>Increased consumption of marine fish is associated with decreased severity of depressive symptoms, which might have great benefits toward comorbid depressive symptom and with coronary heart diseases.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"11 ","pages":"1521124"},"PeriodicalIF":4.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between oxidative balance scores and peripheral artery disease in US adults: a cross-sectional study.
IF 4 2区 农林科学 Q2 NUTRITION & DIETETICS Pub Date : 2025-01-17 eCollection Date: 2024-01-01 DOI: 10.3389/fnut.2024.1497784
Min Zhou, Peng-Fei He, Keren Zhang, Li-Juan Deng, Ning Wang, Gang Wang, Guang-Yao Yang, Shang Ju

Background: The Oxidative Balance Score (OBS) quantifies the overall oxidative stress burden, with higher scores indicating greater antioxidant (relative to prooxidant) activity. This study aimed to examine the association between peripheral arterial disease (PAD) and OBS.

Methods and materials: Data from the National Health and Nutrition Examination Survey (NHANES, 1999-2004) were analyzed for participants with ankle-brachial index (ABI) measurements. The total Oxidative Balance Score (OBS) comprised a lifestyle OBS (four lifestyle categories) and a dietary OBS (16 dietary factors). Logistic regression analyses evaluated associations between PAD and total OBS, lifestyle OBS, and dietary OBS. Restricted cubic spline (RCS) analyses assessed dose-response relationships between ABI, PAD, and OBS. Mediation analyses investigated the roles of glucolipid metabolism and renal function in the OBS-PAD association. Sensitivity and stratification analyses were conducted to ensure robustness.

Results: This study included 2,437 eligible adult participants. Logistic regression analysis, adjusted for multiple potential confounders, revealed negative associations between lifestyle OBS (OR = 0.88; 95% CI: 0.79, 1.00), total OBS (OR = 0.97; 95% CI: 0.94, 0.99), and the likelihood of PAD (all p < 0.05). Restricted cubic spline (RCS) analysis demonstrated a linear relationship between total OBS and PAD, with the likelihood of PAD decreasing as total OBS increased p for nonlinearity = 0.736. Dietary OBS, lifestyle OBS, and total OBS all showed positive linear correlations with ABI levels (all p < 0.05). Mediation analysis indicated that fasting plasma glucose (FPG) and creatinine (CREA) mediated 5.9 and 0.8% of the association between total OBS and PAD, respectively (all p < 0.05). Sensitivity analyses confirmed the negative association between total OBS and PAD p < 0.05, supporting the stability of the results. Stratified analyses highlighted the significant influence of Age, particularly in the younger population aged 20-44 years, a group warranting greater attention.

Conclusion: Our study demonstrated that higher total OBS is associated with a lower likelihood of PAD. Adopting an antioxidant-rich diet alongside a healthy lifestyle may help mitigate PAD risk. Additionally, modulating FPG and CREA levels could offer potential value in addressing the link between low OBS and PAD.

{"title":"Association between oxidative balance scores and peripheral artery disease in US adults: a cross-sectional study.","authors":"Min Zhou, Peng-Fei He, Keren Zhang, Li-Juan Deng, Ning Wang, Gang Wang, Guang-Yao Yang, Shang Ju","doi":"10.3389/fnut.2024.1497784","DOIUrl":"10.3389/fnut.2024.1497784","url":null,"abstract":"<p><strong>Background: </strong>The Oxidative Balance Score (OBS) quantifies the overall oxidative stress burden, with higher scores indicating greater antioxidant (relative to prooxidant) activity. This study aimed to examine the association between peripheral arterial disease (PAD) and OBS.</p><p><strong>Methods and materials: </strong>Data from the National Health and Nutrition Examination Survey (NHANES, 1999-2004) were analyzed for participants with ankle-brachial index (ABI) measurements. The total Oxidative Balance Score (OBS) comprised a lifestyle OBS (four lifestyle categories) and a dietary OBS (16 dietary factors). Logistic regression analyses evaluated associations between PAD and total OBS, lifestyle OBS, and dietary OBS. Restricted cubic spline (RCS) analyses assessed dose-response relationships between ABI, PAD, and OBS. Mediation analyses investigated the roles of glucolipid metabolism and renal function in the OBS-PAD association. Sensitivity and stratification analyses were conducted to ensure robustness.</p><p><strong>Results: </strong>This study included 2,437 eligible adult participants. Logistic regression analysis, adjusted for multiple potential confounders, revealed negative associations between lifestyle OBS (OR = 0.88; 95% CI: 0.79, 1.00), total OBS (OR = 0.97; 95% CI: 0.94, 0.99), and the likelihood of PAD (all <i>p</i> < 0.05). Restricted cubic spline (RCS) analysis demonstrated a linear relationship between total OBS and PAD, with the likelihood of PAD decreasing as total OBS increased <i>p</i> for nonlinearity = 0.736. Dietary OBS, lifestyle OBS, and total OBS all showed positive linear correlations with ABI levels (all <i>p</i> < 0.05). Mediation analysis indicated that fasting plasma glucose (FPG) and creatinine (CREA) mediated 5.9 and 0.8% of the association between total OBS and PAD, respectively (all <i>p</i> < 0.05). Sensitivity analyses confirmed the negative association between total OBS and PAD <i>p</i> < 0.05, supporting the stability of the results. Stratified analyses highlighted the significant influence of Age, particularly in the younger population aged 20-44 years, a group warranting greater attention.</p><p><strong>Conclusion: </strong>Our study demonstrated that higher total OBS is associated with a lower likelihood of PAD. Adopting an antioxidant-rich diet alongside a healthy lifestyle may help mitigate PAD risk. Additionally, modulating FPG and CREA levels could offer potential value in addressing the link between low OBS and PAD.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"11 ","pages":"1497784"},"PeriodicalIF":4.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring the application of dietary antioxidant index for disease risk assessment: a comprehensive review.
IF 4 2区 农林科学 Q2 NUTRITION & DIETETICS Pub Date : 2025-01-16 eCollection Date: 2024-01-01 DOI: 10.3389/fnut.2024.1497364
Hossein Pourmontaseri, Sina Bazmi, Matin Sepehrinia, Ayda Mostafavi, Reza Arefnezhad, Reza Homayounfar, Farhad Vahid

Oxidative stress contributes to the development of cardiometabolic diseases and cancers. Numerous studies have highlighted the adverse effects of high reactive oxygen species (ROS) levels in the progression of chronic noncommunicable diseases and also during infections. On the other hand, antioxidants play a crucial role in preventing oxidative stress or postponing cell damage via the direct scavenging of free radicals or indirectly via the Keap1/Nrf2/ARE pathway, among others. Dietary antioxidants can be obtained from various sources, mainly through a plant-based diet, including fruits and vegetables. The dietary antioxidant index (DAI) has been developed to assess total antioxidant intake from diet. This review delineated the performance of DAI in the risk assessment of different diseases. It is suggested that a high DAI score prevents obesity-related diseases, including diabetes mellitus, hyperuricemia, dyslipidemia, and metabolic (dysfunction)-associated steatotic liver disease (MASLD). Additionally, DAI is negatively associated with Helicobacter pylori and Human papillomavirus infection, thus reducing the risk of gastric and cervical cancer. Also, a high intake of antioxidants prevents the development of osteoporosis, miscarriage, infertility, and mental illnesses. However, further prospective observations and clinical trials are warranted to confirm the application of DAI in preventing diseases that have been studied.

{"title":"Exploring the application of dietary antioxidant index for disease risk assessment: a comprehensive review.","authors":"Hossein Pourmontaseri, Sina Bazmi, Matin Sepehrinia, Ayda Mostafavi, Reza Arefnezhad, Reza Homayounfar, Farhad Vahid","doi":"10.3389/fnut.2024.1497364","DOIUrl":"10.3389/fnut.2024.1497364","url":null,"abstract":"<p><p>Oxidative stress contributes to the development of cardiometabolic diseases and cancers. Numerous studies have highlighted the adverse effects of high reactive oxygen species (ROS) levels in the progression of chronic noncommunicable diseases and also during infections. On the other hand, antioxidants play a crucial role in preventing oxidative stress or postponing cell damage via the direct scavenging of free radicals or indirectly via the Keap1/Nrf2/ARE pathway, among others. Dietary antioxidants can be obtained from various sources, mainly through a plant-based diet, including fruits and vegetables. The dietary antioxidant index (DAI) has been developed to assess total antioxidant intake from diet. This review delineated the performance of DAI in the risk assessment of different diseases. It is suggested that a high DAI score prevents obesity-related diseases, including diabetes mellitus, hyperuricemia, dyslipidemia, and metabolic (dysfunction)-associated steatotic liver disease (MASLD). Additionally, DAI is negatively associated with <i>Helicobacter pylori</i> and Human papillomavirus infection, thus reducing the risk of gastric and cervical cancer. Also, a high intake of antioxidants prevents the development of osteoporosis, miscarriage, infertility, and mental illnesses. However, further prospective observations and clinical trials are warranted to confirm the application of DAI in preventing diseases that have been studied.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"11 ","pages":"1497364"},"PeriodicalIF":4.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Associations between systemic immune-inflammatory index and visceral adipose tissue area: results of a national survey.
IF 4 2区 农林科学 Q2 NUTRITION & DIETETICS Pub Date : 2025-01-16 eCollection Date: 2024-01-01 DOI: 10.3389/fnut.2024.1517186
Yayun Liao, Kejian Zhou, Baoquan Lin, Shan Deng, Baohui Weng, Liya Pan

Background: Global health issues related to obesity are growing. Visceral adipose tissue (VAT) significantly contributes to complications associated with obesity. Reducing adipose tissue accumulation can improves inflammation. However, it is still unknown how the systemic immune-inflammation index (SII) and VAT area are related.

Methods: With the help of multivariate linear regression and smooth curve fitting, the relationship between SII and VAT area was explored with data from the 2013 and 2014 National Health and Nutrition Examination Survey (NHANES). Analyzing subgroups and testing for interaction were used to investigate whether the relationship was accurate across demographics.

Results: From 20 to 59 years of age, 3,290 individuals were observed to have a positive correlation between SII and VAT area. In accordance with the fully adjusted model, the VAT area increased by 9.34 cm2 for every unit increase in log SII [β = 9.34, 95% CI (4.02, 14.67)]. In the highest quartile of SII, the VAT area was 5.46 cm2 [β = 5.46, 95% CI (2.21, 8.71)] higher than that in the lowest quartile. Additionally, the population that was overweight or obese showed a stronger positive correlation.

Conclusion: SII has a positive correlation with VAT area in US adults. SII may be valuable in clinical applications to evaluate the severity of VAT area.

{"title":"Associations between systemic immune-inflammatory index and visceral adipose tissue area: results of a national survey.","authors":"Yayun Liao, Kejian Zhou, Baoquan Lin, Shan Deng, Baohui Weng, Liya Pan","doi":"10.3389/fnut.2024.1517186","DOIUrl":"10.3389/fnut.2024.1517186","url":null,"abstract":"<p><strong>Background: </strong>Global health issues related to obesity are growing. Visceral adipose tissue (VAT) significantly contributes to complications associated with obesity. Reducing adipose tissue accumulation can improves inflammation. However, it is still unknown how the systemic immune-inflammation index (SII) and VAT area are related.</p><p><strong>Methods: </strong>With the help of multivariate linear regression and smooth curve fitting, the relationship between SII and VAT area was explored with data from the 2013 and 2014 National Health and Nutrition Examination Survey (NHANES). Analyzing subgroups and testing for interaction were used to investigate whether the relationship was accurate across demographics.</p><p><strong>Results: </strong>From 20 to 59 years of age, 3,290 individuals were observed to have a positive correlation between SII and VAT area. In accordance with the fully adjusted model, the VAT area increased by 9.34 cm<sup>2</sup> for every unit increase in log SII [<i>β</i> = 9.34, 95% CI (4.02, 14.67)]. In the highest quartile of SII, the VAT area was 5.46 cm<sup>2</sup> [<i>β</i> = 5.46, 95% CI (2.21, 8.71)] higher than that in the lowest quartile. Additionally, the population that was overweight or obese showed a stronger positive correlation.</p><p><strong>Conclusion: </strong>SII has a positive correlation with VAT area in US adults. SII may be valuable in clinical applications to evaluate the severity of VAT area.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"11 ","pages":"1517186"},"PeriodicalIF":4.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fasting for male fertility-a mixed methods study.
IF 4 2区 农林科学 Q2 NUTRITION & DIETETICS Pub Date : 2025-01-16 eCollection Date: 2024-01-01 DOI: 10.3389/fnut.2024.1529466
Katharina T May, Jocelyn Behling, Katharina Sochiera-Plegniere, Katharina Batschari, Christian S Kessler, Andreas Michalsen, Farid I Kandil, Sarah B Blakeslee, Michael Jeitler, Wiebke Stritter, Daniela A Koppold

Purpose: Approximately 10-20% of couples in Germany are unable to conceive. About 50% of this subfertility can be attributed to the male partner. Preclinical studies suggest that fasting could potentially influence central mechanisms of spermatogenesis. This study aimed at investigating feasibility and effects of a Fasting Mimicking Diet (FMD) in the context of male subfertility.

Materials and methods: In this two-arm, randomized, controlled, exploratory mixed methods study men with impaired sperm quality were randomized into a fasting and a waiting-list control group. The fasting group followed an FMD (500 kcal/d for 5 days) thrice within 4 months, while the control group was instructed to maintain their lifestyle and diet. We assessed sperm quality according to WHO criteria (total and progressive sperm motility, concentration, total sperm count, ejaculation volume and sperm morphology) from baseline to 6 months later. Semi-structured interviews were conducted in a subgroup and evaluated by structured content analysis.

Results: Recruitment proved difficult, with 18 out of only 22 recruited participants completing all visits. There were no marked group differences between fasters (n = 10, 36.9 ± 5.17 years) and controls (n = 8, 36.1 ± 2.8 years) regarding sperm parameters. Effect sizes suggest slight positive trends regarding between group changes in the ANCOVA for total sperm motility (eta2 = 0.030) progressive sperm motility (eta2 = 0.059), total sperm count (eta2 = 0.001), concentration (eta2 = 0.050), normal sperm morphology (eta2 = 0.019) and the percentage of round cells (eta2 = 0.462) in the fasting group and a general decrease of sperm quality in the control group. This decrease of sperm quality concerned all parameters but the ejaculation volume, which increased in the CG but decreased in the FG (eta2 = 0.254). The decline of sperm quality in the CG is not explicable by the study setting. We also saw positive trends concerning the intragroup changes (e.g., within group change for progressive sperm motility: d = 0.36), Qualitative analysis (10 interviews) showed FMD feasibility, and its compatibility with full-time work. Motivation toward a healthier lifestyle after the FMD and a feeling of self-empowerment concerning one's fertility were reported.

Conclusion: This limited exploratory study showed FMD feasibility but found no notable differences between groups regarding all parameters. Yet, we saw positive trends regarding the between and within group changes in favour of the fasting group. Possible beneficial effects of the FMD on sperm quality should be investigated in larger studies. Interview results suggest that fasting could be a useful supportive intervention in male subfertility regarding self-efficacy and positive lifestyle changes.

{"title":"Fasting for male fertility-a mixed methods study.","authors":"Katharina T May, Jocelyn Behling, Katharina Sochiera-Plegniere, Katharina Batschari, Christian S Kessler, Andreas Michalsen, Farid I Kandil, Sarah B Blakeslee, Michael Jeitler, Wiebke Stritter, Daniela A Koppold","doi":"10.3389/fnut.2024.1529466","DOIUrl":"10.3389/fnut.2024.1529466","url":null,"abstract":"<p><strong>Purpose: </strong>Approximately 10-20% of couples in Germany are unable to conceive. About 50% of this subfertility can be attributed to the male partner. Preclinical studies suggest that fasting could potentially influence central mechanisms of spermatogenesis. This study aimed at investigating feasibility and effects of a Fasting Mimicking Diet (FMD) in the context of male subfertility.</p><p><strong>Materials and methods: </strong>In this two-arm, randomized, controlled, exploratory mixed methods study men with impaired sperm quality were randomized into a fasting and a waiting-list control group. The fasting group followed an FMD (500 kcal/d for 5 days) thrice within 4 months, while the control group was instructed to maintain their lifestyle and diet. We assessed sperm quality according to WHO criteria (total and progressive sperm motility, concentration, total sperm count, ejaculation volume and sperm morphology) from baseline to 6 months later. Semi-structured interviews were conducted in a subgroup and evaluated by structured content analysis.</p><p><strong>Results: </strong>Recruitment proved difficult, with 18 out of only 22 recruited participants completing all visits. There were no marked group differences between fasters (<i>n</i> = 10, 36.9 ± 5.17 years) and controls (<i>n</i> = 8, 36.1 ± 2.8 years) regarding sperm parameters. Effect sizes suggest slight positive trends regarding between group changes in the ANCOVA for total sperm motility (eta<sup>2</sup> = 0.030) progressive sperm motility (eta<sup>2</sup> = 0.059), total sperm count (eta<sup>2</sup> = 0.001), concentration (eta<sup>2</sup> = 0.050), normal sperm morphology (eta<sup>2</sup> = 0.019) and the percentage of round cells (eta<sup>2</sup> = 0.462) in the fasting group and a general decrease of sperm quality in the control group. This decrease of sperm quality concerned all parameters but the ejaculation volume, which increased in the CG but decreased in the FG (eta<sup>2</sup> = 0.254). The decline of sperm quality in the CG is not explicable by the study setting. We also saw positive trends concerning the intragroup changes (e.g., within group change for progressive sperm motility: d = 0.36), Qualitative analysis (10 interviews) showed FMD feasibility, and its compatibility with full-time work. Motivation toward a healthier lifestyle after the FMD and a feeling of self-empowerment concerning one's fertility were reported.</p><p><strong>Conclusion: </strong>This limited exploratory study showed FMD feasibility but found no notable differences between groups regarding all parameters. Yet, we saw positive trends regarding the between and within group changes in favour of the fasting group. Possible beneficial effects of the FMD on sperm quality should be investigated in larger studies. Interview results suggest that fasting could be a useful supportive intervention in male subfertility regarding self-efficacy and positive lifestyle changes.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"11 ","pages":"1529466"},"PeriodicalIF":4.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genetically predicted causal link between the plasma lipidome and pancreatic diseases: a bidirectional Mendelian randomization study.
IF 4 2区 农林科学 Q2 NUTRITION & DIETETICS Pub Date : 2025-01-15 eCollection Date: 2024-01-01 DOI: 10.3389/fnut.2024.1466509
Liaoyi Lin, Yingbao Huang, Songzan Qian, Lifang Chen, Houzhang Sun

Background: Recent studies have increasingly emphasized the strong correlation between the lipidome and the risk of pancreatic diseases. To determine causality, a Mendelian randomization (MR) analysis was performed to identify connections between the lipidome and pancreatic diseases.

Methods: Statistics from a genome-wide association study of the plasma lipidome, which included a diverse array of 179 lipid species, were obtained from the GeneRISK cohort study with 7,174 participants. Genetic associations with four types of pancreatitis and pancreatic cancer were sourced from the R11 release of the FinnGen consortium. Two pancreatitis datasets from UK Biobank were employed as the validation cohort. MR analysis was conducted to assess the relationship between the genetically predicted plasma lipidome and these pancreatic diseases. Inverse variance weighted was adopted as the main statistical method. Bayesian weighted MR was employed for further verification. The MR-Egger intercept test for pleiotropy and Cochrane's Q statistics test for heterogeneity were performed to ensure the robustness.

Results: MR analysis yielded significant evidence that 26, 25, 2, and 19 lipid species were correlated with diverse outcomes of pancreatitis, and 8 lipid species were correlated with pancreatic cancer. Notably, sterol ester (27:1/20:2) levels (OR: 0.84, 95% CI: 0.78-0.90, P = 5.79 × 10-7) were significantly associated with acute pancreatitis, and phosphatidylcholine (17:0_20:4) levels (OR: 0.89, 95% CI: 0.84-0.94, P = 1.78 × 10-4) and sterol ester (27:1/20:4) levels (OR: 0.90, 95% CI: 0.86-0.95, P = 2.71 × 10-4) levels were significantly associated with chronic pancreatitis after the Bonferroni-corrected test. As for validation, 14 and 9 lipid species were correlated with acute and chronic pancreatitis of UK Biobank. Some lipid classes showed significant effects both in the FinnGen consortium and UK Biobank datasets.

Conclusions: The findings of this study indicate a potential genetic predisposition linking the plasma lipidome to pancreatic diseases and good prospects for future pancreatic disease clinical trials.

{"title":"Genetically predicted causal link between the plasma lipidome and pancreatic diseases: a bidirectional Mendelian randomization study.","authors":"Liaoyi Lin, Yingbao Huang, Songzan Qian, Lifang Chen, Houzhang Sun","doi":"10.3389/fnut.2024.1466509","DOIUrl":"https://doi.org/10.3389/fnut.2024.1466509","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have increasingly emphasized the strong correlation between the lipidome and the risk of pancreatic diseases. To determine causality, a Mendelian randomization (MR) analysis was performed to identify connections between the lipidome and pancreatic diseases.</p><p><strong>Methods: </strong>Statistics from a genome-wide association study of the plasma lipidome, which included a diverse array of 179 lipid species, were obtained from the GeneRISK cohort study with 7,174 participants. Genetic associations with four types of pancreatitis and pancreatic cancer were sourced from the R11 release of the FinnGen consortium. Two pancreatitis datasets from UK Biobank were employed as the validation cohort. MR analysis was conducted to assess the relationship between the genetically predicted plasma lipidome and these pancreatic diseases. Inverse variance weighted was adopted as the main statistical method. Bayesian weighted MR was employed for further verification. The MR-Egger intercept test for pleiotropy and Cochrane's Q statistics test for heterogeneity were performed to ensure the robustness.</p><p><strong>Results: </strong>MR analysis yielded significant evidence that 26, 25, 2, and 19 lipid species were correlated with diverse outcomes of pancreatitis, and 8 lipid species were correlated with pancreatic cancer. Notably, sterol ester (27:1/20:2) levels (OR: 0.84, 95% CI: 0.78-0.90, <i>P</i> = 5.79 × 10<sup>-7</sup>) were significantly associated with acute pancreatitis, and phosphatidylcholine (17:0_20:4) levels (OR: 0.89, 95% CI: 0.84-0.94, <i>P</i> = 1.78 × 10<sup>-4</sup>) and sterol ester (27:1/20:4) levels (OR: 0.90, 95% CI: 0.86-0.95, <i>P</i> = 2.71 × 10<sup>-4</sup>) levels were significantly associated with chronic pancreatitis after the Bonferroni-corrected test. As for validation, 14 and 9 lipid species were correlated with acute and chronic pancreatitis of UK Biobank. Some lipid classes showed significant effects both in the FinnGen consortium and UK Biobank datasets.</p><p><strong>Conclusions: </strong>The findings of this study indicate a potential genetic predisposition linking the plasma lipidome to pancreatic diseases and good prospects for future pancreatic disease clinical trials.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"11 ","pages":"1466509"},"PeriodicalIF":4.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The burden of chronic kidney disease attributable to high sodium intake: a longitudinal study in 1990-2019 in China.
IF 4 2区 农林科学 Q2 NUTRITION & DIETETICS Pub Date : 2025-01-15 eCollection Date: 2024-01-01 DOI: 10.3389/fnut.2024.1531358
Yongyao Shen, Liying Jiang, Jin Yu, Bo Chen, Aidong Liu, Yongjin Guo

Objective: Elevated sodium consumption is associated with increased risk for chronic kidney disease (CKD) and data for this disease burden attributable to high sodium intake in China from 1990 to 2019 are scarce in China. Our study aims to estimate and present the national burden of CKD attributable to high sodium intake, as well as its profile.

Methods: The regional disease burden data from the China Center for Food Safety Risk Assessment (CFSA) from 1990 to 2019 were compiled based on the methodology of GBD 2019. CKD burden [deaths and disability-adjusted life years (DALYs)] was quantified according to population group (age, gender) and regions categories (province, SDI). The estimated annual percentage change (EAPC) in age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) were calculated to describe long-term trends.

Results: Totally, the number of deaths of CKD attributable to high sodium intake reached 95,000, with DALYs amounting to 2.59 million person-years in 2019, while the trends of ASMR (EAPC: -0.31, 95%CI: -0.46, -0.17%) and ASDR (-0.33, 95%CI: -0.48, -0.18%) were down during the observation period. The age-specific numbers and rates of deaths, as well as DALYs increase with age are higher in males than in females. Significant disparities in CKD burden attributable to high sodium intake were observed across provinces and SDI regions. In both 1990 and 2019, the number of deaths and DALYs were higher in middle SDI regions, while low-middle SDI regions had highest ASMR and ASDR. The EAPC of ASDR was found to be significantly negatively correlated with the 1990 ASDR (ρ = -0.393, p = 0.024), and the EAPC of ASMR and ASDR were also significantly negatively correlated with the 2019 SDI (ASMR:ρ = -0.571, p < 0.001; ASDR:ρ = -0.368, p = 0.035).

Conclusion: High sodium intake accounted for a sizeable burden of disease from 1990 to 2019 in China, also presents sexual and geographic variations. Despite a slight decreasing trend exists, the absolute number increased as much as twofold, particularly among males and seniors. Targeting to reduce sodium intake remains a priority, and progress requires systematic monitoring and evaluation, particularly in middle SDI regions that are experiencing rising trends and low-middle SDI regions being susceptible to approaches.

{"title":"The burden of chronic kidney disease attributable to high sodium intake: a longitudinal study in 1990-2019 in China.","authors":"Yongyao Shen, Liying Jiang, Jin Yu, Bo Chen, Aidong Liu, Yongjin Guo","doi":"10.3389/fnut.2024.1531358","DOIUrl":"10.3389/fnut.2024.1531358","url":null,"abstract":"<p><strong>Objective: </strong>Elevated sodium consumption is associated with increased risk for chronic kidney disease (CKD) and data for this disease burden attributable to high sodium intake in China from 1990 to 2019 are scarce in China. Our study aims to estimate and present the national burden of CKD attributable to high sodium intake, as well as its profile.</p><p><strong>Methods: </strong>The regional disease burden data from the China Center for Food Safety Risk Assessment (CFSA) from 1990 to 2019 were compiled based on the methodology of GBD 2019. CKD burden [deaths and disability-adjusted life years (DALYs)] was quantified according to population group (age, gender) and regions categories (province, SDI). The estimated annual percentage change (EAPC) in age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) were calculated to describe long-term trends.</p><p><strong>Results: </strong>Totally, the number of deaths of CKD attributable to high sodium intake reached 95,000, with DALYs amounting to 2.59 million person-years in 2019, while the trends of ASMR (EAPC: -0.31, 95%CI: -0.46, -0.17%) and ASDR (-0.33, 95%CI: -0.48, -0.18%) were down during the observation period. The age-specific numbers and rates of deaths, as well as DALYs increase with age are higher in males than in females. Significant disparities in CKD burden attributable to high sodium intake were observed across provinces and SDI regions. In both 1990 and 2019, the number of deaths and DALYs were higher in middle SDI regions, while low-middle SDI regions had highest ASMR and ASDR. The EAPC of ASDR was found to be significantly negatively correlated with the 1990 ASDR (<i>ρ</i> = -0.393, <i>p</i> = 0.024), and the EAPC of ASMR and ASDR were also significantly negatively correlated with the 2019 SDI (ASMR:ρ = -0.571, <i>p</i> < 0.001; ASDR:ρ = -0.368, <i>p</i> = 0.035).</p><p><strong>Conclusion: </strong>High sodium intake accounted for a sizeable burden of disease from 1990 to 2019 in China, also presents sexual and geographic variations. Despite a slight decreasing trend exists, the absolute number increased as much as twofold, particularly among males and seniors. Targeting to reduce sodium intake remains a priority, and progress requires systematic monitoring and evaluation, particularly in middle SDI regions that are experiencing rising trends and low-middle SDI regions being susceptible to approaches.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"11 ","pages":"1531358"},"PeriodicalIF":4.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Global burden of chronic kidney disease due to dietary factors.
IF 4 2区 农林科学 Q2 NUTRITION & DIETETICS Pub Date : 2025-01-15 eCollection Date: 2024-01-01 DOI: 10.3389/fnut.2024.1522555
Lingtao Yin, Mengni Kuai, Zhuo Liu, Binbin Zou, Ping Wu

Background: We aimed to assess the global impact of chronic kidney disease (CKD) attributable to dietary risk factors.

Methods: The research utilized data from the Global Burden of Disease Study 2021 to evaluate age-standardized mortality rates (ASMR), disability-adjusted life years (DALYs), and estimated annual percentage changes (EAPCs) linked to CKD resulting from dietary risk factors.

Results: From 1990 to 2021, both the ASMR and age-standardized DALY rate (ASDR) for CKD attributable to dietary risk factors exhibited an overall increasing trend globally. The mortality EAPC was 0.65, while the EAPC for DALYs stood at 0.39. Among dietary risk factors examined, a diet high in sugar-sweetened beverages was associated with the most substantial increase in CKD burden. Notably, Central sub-Saharan Africa bore the highest burden of CKD due to dietary risk factors, with an ASMR of 10.24 and an ASDR of 229.23. The increases in ASMR and ASDR were more pronounced in high-income regions, particularly in Latin America and the Caribbean, where the EAPC values for ASMR were 1.45 and 1.05, respectively, and for ASDR were 1.08 and 0.96. Furthermore, the burden of CKD was notably higher among middle-aged and elderly individuals, especially men aged 65 and above.

Conclusion: The global disease burden attributed to dietary risk factors for CKD is increasing. A diet high in sugar-sweetened beverages exerted the most significant impact on CKD. There is a high incidence in Central sub-Saharan Africa, as well as in high-income regions and Latin America and the Caribbean.

{"title":"Global burden of chronic kidney disease due to dietary factors.","authors":"Lingtao Yin, Mengni Kuai, Zhuo Liu, Binbin Zou, Ping Wu","doi":"10.3389/fnut.2024.1522555","DOIUrl":"https://doi.org/10.3389/fnut.2024.1522555","url":null,"abstract":"<p><strong>Background: </strong>We aimed to assess the global impact of chronic kidney disease (CKD) attributable to dietary risk factors.</p><p><strong>Methods: </strong>The research utilized data from the Global Burden of Disease Study 2021 to evaluate age-standardized mortality rates (ASMR), disability-adjusted life years (DALYs), and estimated annual percentage changes (EAPCs) linked to CKD resulting from dietary risk factors.</p><p><strong>Results: </strong>From 1990 to 2021, both the ASMR and age-standardized DALY rate (ASDR) for CKD attributable to dietary risk factors exhibited an overall increasing trend globally. The mortality EAPC was 0.65, while the EAPC for DALYs stood at 0.39. Among dietary risk factors examined, a diet high in sugar-sweetened beverages was associated with the most substantial increase in CKD burden. Notably, Central sub-Saharan Africa bore the highest burden of CKD due to dietary risk factors, with an ASMR of 10.24 and an ASDR of 229.23. The increases in ASMR and ASDR were more pronounced in high-income regions, particularly in Latin America and the Caribbean, where the EAPC values for ASMR were 1.45 and 1.05, respectively, and for ASDR were 1.08 and 0.96. Furthermore, the burden of CKD was notably higher among middle-aged and elderly individuals, especially men aged 65 and above.</p><p><strong>Conclusion: </strong>The global disease burden attributed to dietary risk factors for CKD is increasing. A diet high in sugar-sweetened beverages exerted the most significant impact on CKD. There is a high incidence in Central sub-Saharan Africa, as well as in high-income regions and Latin America and the Caribbean.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"11 ","pages":"1522555"},"PeriodicalIF":4.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of study Global Burden of Disease in 2021: global, regional, and national burden of nutritional deficiency from 1990 to 2021.
IF 4 2区 农林科学 Q2 NUTRITION & DIETETICS Pub Date : 2025-01-15 eCollection Date: 2024-01-01 DOI: 10.3389/fnut.2024.1540485
Jing Chen, Zedong Li, Hong Liu

Background: Nutrient deficiency disorders (NDs) harm growth, causing economic losses. Addressing NDs is a global priority, yet recent data is limited. This study examines latest NDs data across 204 countries and 21 regions from 1990 to 2021.

Methods: Data from the 2021 Global Burden of Disease (GBD) study were used to analyze NDs-related incidence, prevalence, deaths, and disability-adjusted life years (DALYs) at global, national, and regional levels. Joinpoint regression analysis was applied to evaluate temporal trends, with Estimated Annual Percentage Change (EAPC) assessing long-term patterns.

Results: In 2021, the global burden of NDs remained substantial, with a total of 1,845,246,558 cases with an ASPR of 23,858.99 cases per 100,000 individuals (95% UI: 23,445.77-24,320.82). The ASIR was 7,725.1 per 100,000 people (95% UI: 7,404.01-8,109.01), while the ASMR was 3.03 per 100,000 persons (95% UI: 2.69-3.4). Additionally, age-standardized DALYs rate was 657.62 per 100,000 individuals (95% UI: 489.93-869.58). Regionally, areas with low SDI exhibited the greatest ASPR, ASIR, ASDR, and age-standardized DALYs rates, whereas high SDI regions had the lowest rates.

Conclusions: Although global NDs burden has declined from 1990 to 2021, regional and demographic disparities remain. Enhanced healthcare access in high-risk SDI regions is essential to further mitigate NDs's global impact.

{"title":"Analysis of study Global Burden of Disease in 2021: global, regional, and national burden of nutritional deficiency from 1990 to 2021.","authors":"Jing Chen, Zedong Li, Hong Liu","doi":"10.3389/fnut.2024.1540485","DOIUrl":"https://doi.org/10.3389/fnut.2024.1540485","url":null,"abstract":"<p><strong>Background: </strong>Nutrient deficiency disorders (NDs) harm growth, causing economic losses. Addressing NDs is a global priority, yet recent data is limited. This study examines latest NDs data across 204 countries and 21 regions from 1990 to 2021.</p><p><strong>Methods: </strong>Data from the 2021 Global Burden of Disease (GBD) study were used to analyze NDs-related incidence, prevalence, deaths, and disability-adjusted life years (DALYs) at global, national, and regional levels. Joinpoint regression analysis was applied to evaluate temporal trends, with Estimated Annual Percentage Change (EAPC) assessing long-term patterns.</p><p><strong>Results: </strong>In 2021, the global burden of NDs remained substantial, with a total of 1,845,246,558 cases with an ASPR of 23,858.99 cases per 100,000 individuals (95% UI: 23,445.77-24,320.82). The ASIR was 7,725.1 per 100,000 people (95% UI: 7,404.01-8,109.01), while the ASMR was 3.03 per 100,000 persons (95% UI: 2.69-3.4). Additionally, age-standardized DALYs rate was 657.62 per 100,000 individuals (95% UI: 489.93-869.58). Regionally, areas with low SDI exhibited the greatest ASPR, ASIR, ASDR, and age-standardized DALYs rates, whereas high SDI regions had the lowest rates.</p><p><strong>Conclusions: </strong>Although global NDs burden has declined from 1990 to 2021, regional and demographic disparities remain. Enhanced healthcare access in high-risk SDI regions is essential to further mitigate NDs's global impact.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"11 ","pages":"1540485"},"PeriodicalIF":4.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Frontiers in Nutrition
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