Journal of Nutrition最新文献

Background: Pistachios are a bioavailable source of the xanthophyll lutein. Along with zeaxanthin, these plant pigments are major components of macular pigment (MP) in the human retina. MP can be non-invasively measured and is referred to as MP optical density (MPOD). MPOD is modifiable with dietary interventions that include lutein and zeaxanthin (L/Z). Higher MPOD protects the eye from light damage and is positively associated with eye health.

Objectives: This dietary intervention study aimed to evaluate the effect of pistachio consumption on MPOD.

Methods: This single-blinded, randomized controlled trial compared a 12-week pistachio intervention (2 oz/d) with usual diet (UD) on MPOD and serum L/Z in middle-aged to older healthy adults (n = 36) in a 1:1 randomization scheme. Participants were selected for habitually low L/Z intake and low baseline MPOD. MPOD was measured using heterochromatic flicker photometry at 4 retinal eccentricities during baseline, week 6, and week 12 study visits. Serum L/Z was analyzed using high-performance liquid chromatography. Primary statistical analysis was conducted on an intent-to-treat basis using repeated-measure analysis of variance.

Results: Compared with UD, MPOD of the participants in the pistachio intervention group (PIS) had significantly increased (P < 0.001) at all eccentricities over the initial 6-wk period. This increase was maintained at week 12. MPOD in the UD participants did not change during the 12-week period. Serum lutein concentration followed a similar pattern to MPOD; serum cis-lutein and zeaxanthin did not change in either group over the 12-wk intervention.

Conclusions: The results of our study demonstrate that a dietary intervention with pistachios is efficacious in increasing MPOD in healthy adults selected for habitually low intake of L/Z and low baseline MPOD. This suggests that pistachio consumption could be an effective dietary strategy for preserving eye health. Future studies need to evaluate the generalizability of our findings to other populations. This trial was registered at clinicaltrials.gov as NCT05283941.

Background: Human milk oligosaccharides (HMOs) and other milk-derived metabolites are crucial for infant health, influencing gut microbiota and overall development.

Objective: This study aimed to uncover insights into the variations of HMOs and non-HMO metabolites based on secretor (Se) status, lactation time, mode of delivery, and infant sex.

Methods: An exploratory cross-sectional study was designed to compare the concentrations of HMOs and non-HMOs metabolites in milk samples from 129 lactating Chinese women within 1 y postpartum. Nuclear magnetic resonance analysis was employed for the identification and quantification of the metabolites. The metabolites measured were grouped into sugars, free amino acids, fatty acids, and metabolites related to energy metabolism. The influences of delivery mode and infant sex on milk metabolite composition were explored.

Results: Uniform Manifold Approximation and Projection analysis of HMOs profiles revealed distinct clustering based on Se status, with significant differences in 2'-fucosyllactose (2'-FL) and 3-fucosyllactose (3-FL) concentrations observed between Se+ and Se- groups. A decreasing trend for 2'-FL and 6'-sialyllactose concentrations, along with an increase in 3-FL concentrations, was observed with increasing lactating period within 12 mo postpartum. Non-HMOs metabolite analysis indicated that Se status only affected glutamate concentrations. An increase in glutamine concentrations was observed 3-9 mo postpartum. A continuous increase in o-phosphocholine concentrations was noted in 12 mo postpartum, along with reductions in citrate and sn-glycero-phosphocholine concentrations. Delivery mode and infant sex did not affect both HMOs and non-HMOs concentrations.

Conclusions: Metabolomic analysis of human milk reveals significant variation of HMOs, but not in non-HMOs, based on Se status. Changes in certain HMOs and non-HMOs concentrations were also observed over the 1 y of lactation. Understanding how these metabolites change over time may influence recommendations for maternal diet, supplementation, and the timing of breastfeeding to ensure optimal nutrient delivery to the infant.

Background: Food insecurity (FI) continues to be a significant public health concern and is associated with myriad physical and mental health consequences. Increased understanding of conditions around its occurrence throughout the life course are needed. However, research has been limited due to inadequate measurement tools and study length.

Objectives: This study examined the intragenerational and intergenerational dynamics of FI over time by assessing the transmission of FI from childhood to adulthood and from mother to offspring using population-specific FI measures and the influence of sociodemographic factors.

Methods: Women in early midlife (n = 624) and their children (n = 331) participated in a prospective cohort study between 1987 and 2019 in Richmond, California. Three validated FI measures were assessed, representing 1) past childhood FI and 2) current adult household FI, reported by the women, and 3) current child FI, reported by the women's children. Associations between measures were examined using adjusted modified Poisson regression models. Mediation by current adult household FI between past childhood FI and their offspring's current child FI was assessed. Moderation by sociodemographic factors, including poverty level, parental education, marital status, and race was also assessed.

Results: Among women, 32.4% reported FI in childhood and 34.5% reported current adult household FI. Among their offspring, 53.2% reported current child FI. Past childhood FI increased the likelihood of current adult FI (RR: 2.18; 95% CI: 1.64, 2.90) and current adult FI increased the likelihood of current child FI (RR: 1.49; 95% CI: 1.08, 2.07). Current adult FI partially mediated past childhood FI and their offspring's current child FI (natural indirect effect OR: 1.42; 95% CI: 1.03, 2.24). There was no evidence of moderation by sociodemographic factors.

Conclusions: FI measures reported by adults and children capture differing experiences, highlighting the need to use FI measures that are appropriate for their target population. FI may be perpetuated intragenerationally and intergenerationally.

Background: Periconceptional folic acid supplementation (FAS) is widely recommended. However, the role of periconceptional FAS on neonatal birth weight remains unclear.

Objectives: This study aimed to explore the independent effects of periconceptional FAS on risks of small for gestational age (SGA) and large for gestational age (LGA) and to test the potential mediation role of maternal homocysteine (Hcy) during pregnancy on the above significant associations.

Methods: A large-scale prospective birth cohort was conducted in the Tongzhou Maternal and Child Health Hospital, Beijing, China, from June 2018 to August 2019. Periconceptional FAS was evaluated by a self-administered questionnaire on the day of recruitment in early pregnancy (<14th wk of gestation). FAS was defined as participants who had taken folic acid (FA) supplements, FA-containing multivitamins, or other FA-containing nutritional supplements. Neonatal birth weight was measured at delivery. Maternal serum Hcy concentrations were measured in early and late pregnancy, respectively. Logistic regression analyses were performed to assess the associations between FAS during preconception and/or early pregnancy and the occurrence of SGA or LGA. Mediation models were constructed to determine the role of maternal Hcy concentrations on the above associations.

Results: FAS before pregnancy [risk ratios (RR), 0.814; 95% confidence interval (CI): 0.667, 0.993], during early pregnancy (RR, 0.625; 95% CI: 0.453, 0.862), and from prepregnancy to early pregnancy (RR, 0.565; 95% CI: 0.371, 0.859) were associated with a lower risk of LGA. However, no significant association was found between periconceptional FAS and SGA birth. Maternal Hcy concentration in late pregnancy mediated the independent effects of maternal FAS during preconception, early pregnancy, and both pre- and early pregnancy stages on risks of LGA birth (P < 0.05).

Conclusions: Periconceptional FAS was associated with a lower risk of LGA, which may be mediated by the reduced serum Hcy concentration in late pregnancy. The current recommendation of periconceptional FAS should be complied with to reduce risks of LGA.

Background: Nonalcoholic fatty liver disease (NAFLD) is a chronic and progressive condition that afflicts patients of all ages, including neonates. Previously, we reported that neonatal pigs fed formulas rich in medium-chain (MCFA), compared with those fed formulas rich in long-chain fatty acid (LCFA) for 21 d, developed panacinar steatosis with no changes in whole-body adiposity.

Objectives: The objective of this study was to examine the temporal onset and development of NAFLD in neonatal pigs in response to MCFA feeding.

Methods: Neonatal pigs (n = 18) were fed isocaloric MCFA or LCFA formulas. Six pigs from each group were killed following 7, 14 or 21 d of feeding. Body composition was assessed before initiation and at the end of the feeding period using dual-energy X-ray absorptiometry. Liver fat content and liver morphologic features were determined from photomicrographs and evaluated for NAFLD by a pathologist.

Results: Lean mass and fat mass as a percentage of body weight were not different between formulas. However, liver weight (P = 0.001) and liver fat mass (P < 0.001) were greater for pigs in the MCFA than those for pigs in the LCFA group. Steatosis developed as early as 7 d in the MCFA compared with the LCFA fed pigs (P < 0.001). In addition, steatosis progressed in a portal-to-venous direction as MCFA feeding duration increased (P = 0.02). Pigs diagnosed with NASH (P < 0.001) and greater nonalcoholic fatty liver disease scores were those in the MCFA group (P < 0.001).

Conclusions: These results suggest that the onset and progression of NAFLD from steatosis to nonalcoholic steatohepatitis occurs rapidly in response to MCFA feeding. Moreover, periportal steatosis is the initial feature in the development of NAFLD before its progression to nonalcoholic steatohepatitis. The development of NAFLD in neonates seems to occur independently of whole-body adiposity.

Background: Human milk macronutrient (protein, fat, and carbohydrate) and energy concentrations vary based on maternal and infant factors and time postpartum.

Objectives: This study aimed to determine the change in milk macronutrient and energy concentrations from ∼2 to 5 mo postpartum and identify factors associated with this variation among a lactation cohort in Bangladesh.

Methods: In this prospective observational lactation cohort in rural Sylhet, Bangladesh, we collected hand-expressed mid-feed human milk samples and analyzed macronutrient concentrations using mid-infrared spectroscopy. We used the Wilcoxon rank-sum test to compare macronutrient and energy concentrations between time points and mixed linear regression to determine associations between predictors [maternal body mass index (BMI), maternal mid-upper arm circumference, infant gestational age, and infant small for gestational age status] and repeated measures of milk macronutrient and energy concentrations in models adjusted for parity, nicotine, and wealth index.

Results: We enrolled 99 participants. From visit 1 (∼2 mo) to visit 2 (∼5 mo), median milk protein concentration decreased from 1.4 g/dL [interquartile range (IQR): 1.1-1.6 g/dL] to 0.8 g/dL (IQR: 0.6-1.1 g/dL), median fat concentration decreased from 4.6 g/dL (IQR: 3.8-5.5 g/dL) to 2.8 g/dL (IQR: 2.1-3.7 g/dL), and median energy concentration decreased from 22.7 kcal/oz (IQR: 20.6, 25.1 kcal/oz) to 17.5 kcal/oz (IQR: 15.6-19.9 kcal/oz). Maternal overweight status was associated with a lower carbohydrate concentration (2 mo-mean difference: -0.16 g/dL; 95% CI: -0.28, -0.03 g/dL; 5 mo-mean difference: -0.14 g/dL; 95% CI: -0.26, -0.02; reference = normal BMI).

Conclusions: The decline of protein, fat, and energy concentrations over time is a potential concern for Bangladesh's vulnerable population of human milk-fed infants, as these nutrients have implications for infant growth and neurodevelopment.

Background: We previously reported that the intake of fruits and vegetables (FV) known to have high-pesticide contamination in the United States food supply is related to lower sperm counts. Whether the same is true for ovarian reserve is unknown.

Objective: We evaluated the relation between FV intake, overall and when taking into consideration pesticide residue status, with the markers of ovarian reserve among reproductive-aged females.

Methods: Participants were 633 females, 21-45 y, presenting to an academic fertility center. We combined surveillance data from the United States Department of Agriculture and self-reported food intake data to characterize exposure to pesticide residues through FV intake. Poisson and linear regression were used to evaluate associations of high-pesticide residue, low-pesticide residue, and total FV intake with markers of ovarian reserve (antral follicle count [AFC], follicle-stimulating hormone [FSH], anti-Müllerian hormone [AMH]) adjusting for potential confounders.

Results: There was no association of FV intake, overall or according to pesticide residue status, with day 3 FSH or AMH concentrations in multivariable-adjusted models. Regardless of pesticide residue status, FV intake was inversely related to AFC in these models. This pattern was magnified among females who had had a fertility evaluation before joining the study (n = 508). Among females who had not had a fertility evaluation before joining the study (n = 103), however, there were diverging patterns of association for high- and low-pesticide residue FV intake and markers of ovarian reserve. In this group, day 3 FSH was 71.6% (95% confidence interval: 39.5%, 111.2%) higher among females in the highest quintile of high-pesticide residue FV intake than among females in the lowest quintile (P-trend <0.001). Low-pesticide residue and total FV intake were unrelated to day 3 FSH in this group, with differences between top and bottom quintile of intake of -8.3% (-25.8%, 13.3%) and 7.5% (-13.8%, 34.0%), respectively.

Conclusions: High-pesticide residue FV intake may be related to lower ovarian reserve among females without a history of infertility treatment. Replication in populations with larger sample sizes and less susceptible to reverse causation is important.

Background: An unhealthy diet is a major contributor to several noncommunicable diseases, including cardiovascular diseases, the leading cause of death worldwide. Additionally, our food system has significant impacts on the environment. The EAT-Lancet Commission has recommended a healthy diet that preserves global environmental resources.

Objectives: This prospective study aimed to evaluate the associations between adherence to the EAT-Lancet diet and the incidence of cardiovascular events and all-cause mortality in a Swiss cohort.

Methods: We analyzed data from the CoLaus/PsyCoLaus cohort study (N = 3866). Dietary intake was assessed using a semiquantitative food frequency questionnaire. The EAT-Lancet adherence score was calculated based on the recommended intake and reference intervals of 12 food components, ranging from 0 to 39 points. Participants were categorized into low-, medium-, and high-adherence groups according to score tertiles. We used Cox Proportional Hazards regressions to assess the association among diet adherence, incident cardiovascular events, and all-cause mortality.

Results: During a mean follow-up of 7.9 y (SD: ±2.0 y), 294 individuals (7.6%) from our initial sample experienced a first cardiovascular event, and 264 (6.8%) died. Compared with the low-adherence group, the adjusted hazard ratios for all-cause mortality were 0.88 (95% CI: 0.66, 1.17) and 0.70 (95% CI: 0.49, 0.98) for the medium-adherence and high-adherence groups, respectively (P-trend = 0.04). We observed no association between adherence groups and cardiovascular events.

Conclusions: In a Swiss cohort, high adherence to the EAT-Lancet diet is associated with a potential 30% lower risk of overall mortality. However, it is not associated with cardiovascular events.

Background: Pregnancies complicated by maternal obesity are characterized by metabolic differences affecting placental nutrient transport and fetal development. Docosahexaenoic acid (DHA) is critical for fetal brain development and is primarily incorporated into phosphatidylcholine (PC). Recent evidence suggests that choline may enhance PC-DHA synthesis; however, data on the impact of maternal plasma choline on placental phospholipid DHA content in females with obesity are limited.

Methods: We conducted a secondary analysis of a DHA supplementation trial (800 mg/d) in 38 pregnant females with obesity (body mass index ≥30 kg/m²). Blood samples at 36 wk gestation and term placentas were analyzed for phospholipids using mass spectrometry. Choline transporter-like (CTL) proteins in the syncytiotrophoblast microvillous (MVM) and basal plasma membranes were quantified by Western blot.

Results: Daily DHA supplementation from 25 wk gestation was associated with higher maternal plasma and placental PC- and lysophosphatidylcholine (LPC)-DHA. A significant interaction (P interaction <0.05) between DHA supplementation and choline indicated that higher choline enhanced the incorporation of DHA into plasma PC. MVM CTL-1 expression was correlated with placental total PC-DHA and LPC-DHA content, suggesting that CTL-1 has a predominate role in placental choline uptake and phospholipid synthesis.

Conclusions: These findings suggest that choline may influence maternal PC- and LPC-DHA synthesis and plasma levels, as well as the expression of placental choline transporters and the resulting PC- and LPC-DHA content in females with obesity. These relationships may have implications for DHA transport to the fetus and overall fetal development.

Background: Hemoglobin and hematocrit are the 2 most common biomarkers used to identify anemia in clinical settings, but their results do not always agree.

Objectives: To examine agreement between hemoglobin and hematocrit in identifying anemia among children aged 1 to <5 y and pregnant persons.

Methods: Pregnant persons and children aged 1 to <5 y with hemoglobin and hematocrit results from the same whole blood sample in National Health and Nutrition Examination Survey (1999-2020) were included. We used the Centers for Disease Control and Prevention anemia cutoff values for children, pregnancy status, trimester, and smoking adjustments. We examined concordance of anemia, sensitivity, and specificity among those with anemia based on ≥1 test overall and by race/ethnicity, sex, and income level. Cohen's kappa was used to measure concordance.

Results: Analytic samples included 7052 children and 1437 pregnant persons, of whom 1119 had trimester data. Among children, anemia prevalence was 3.7% [95% confidence interval (CI): 3.1, 4.3] based on hemoglobin and 5.5% (95% CI: 4.7, 6.3) based on hematocrit. Among pregnant persons, anemia prevalence was 7.7% (95% CI: 5.9, 9.5) based on hemoglobin and 12.4% (95% CI: 10.1, 14.6) based on hematocrit. Kappa scores overall and by sociodemographic characteristics ranged from 0.64 to 0.75 (moderate concordance) among children and from 0.53 to 0.78 (weak to moderate concordance) among pregnant persons. Among those with anemia on ≥1 test, 53.5% of children and 61.5% of pregnant persons had anemia based on both tests.

Conclusions: We found substantial discordance between the 2 biomarkers; ∼50% of children and 40% of pregnant women were identified by only 1 of the 2 biomarkers. Because hemoglobin and hematocrit may be used interchangeably in the clinical setting, individuals with anemia may be missed, not receive treatment, and therefore be at higher risk of adverse pregnancy, birth, and developmental outcomes.