Nutrition Journal最新文献

Background: The global burden of early-onset chronic diseases, especially early-onset type 2 diabetes, is increasing, particularly in China. Diet is a key factor and emerging evidence highlights substantial inter-individual variability in metabolic responses to diets, highlighting the need for precision nutrition.

Methods: The China Precision Nutrition Biobank (CPNB) is a prospective, longitudinal, cohort study designed to investigate diet-phenotype/genotype interactions and develop precision dietary strategies for early prevention and intervention of chronic diseases, with a particular focus on early-onset diseases. CPNB consists of three phases: the alpha (pilot cohort), beta (transition cohort), and gamma (main cohort) phases. Approximately 200, 1450, and 20,000 adults aged 18-40 years from urban and rural areas in China including Beijing, one city each in Heilongjiang, Shandong, Zhejiang, Guangxi, and Hainan provinces, and one or more villages each in Henan, Gansu, Sichuan, Zhejiang, and Hunan provinces will be recruited during the alpha, beta, and gamma phases, respectively, between 2025 and 2035. Sociodemographic information, medical records, read-time weighed food records and corresponding continuous glucose monitor (CGM) readings, objective physical activity, food challenges, genes, gut and oral microbiota, metabolites from blood, stool, urine, saliva, and hair, and questionnaires will be collected at baseline survey. The follow-up survey will be conducted every five years to repeat these assessments until participants' death (the follow-up period may extend up to 80 years). Outcomes of interest are common early- and late-onset chronic diseases and their preclinical stages.

Discussion: The CPNB data can be used to develop prediction models for personalized metabolic responses and risks of early-onset chronic diseases among Chinese people. It will also provide new evidence on interactions of diet with human phenotypes/genotypes during preclinical stage, onset, and progression of early-onset diseases. CPNB aims to inform the development of precision nutrition strategies aligned with the principles of predictive, personalized, preventive, and participatory medicine in the Chinese population.

Trial registration: CPNB was registered at Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ) on June 3rd, 2025, under the registration number ChiCTR2500103621.

Background: Although Western studies have suggested that dietary carotenoids and flavonoids may reduce the risk of ageing-related physical frailty, evidence from prospective Asian studies is limited. We examined the association between midlife intake of these phytochemicals and risk of physical frailty among Chinese adults in Singapore.

Methods: This study included 10,738 participants from the population-based prospective cohort of the Singapore Chinese Health Study. Dietary information was collected using a validated 165-item semi-quantitative food frequency questionnaire at recruitment from 1993 to 1998 (mean age 51 years, range 45-60 years). During follow-up 3 interviews from 2014 to 2017, physical frailty was assessed using a modified version of the Cardiovascular Health Study phenotype (mean age 72 years, range 63-84 years). Multivariable logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for the associations between nutrient intake and physical frailty.

Results: Among the 10,738 participants in the current study, 58.3% were female. Over a mean (SD) follow-up period of 20 (1.9) years, 1,220 participants (11.4%) were identified as being physically frail. Higher baseline consumption of carotenoids and flavonoids were associated with lower odds of physical frailty at follow-up 3. Compared to those in the lowest quintiles, the ORs (95% CIs) for the association with physical frailty for those in the highest quintiles were 0.69 (0.55-0.85) for total carotenoids (p-trend = 0.001) and 0.80 (0.64-0.99) for total flavonoids (p-trend = 0.019). Specifically, total carotenoid intake showed significant inverse association with weakness defined by weak handgrip; the OR (95% CI) comparing extreme quintiles was 0.60 (0.49-0.72) (p-trend = 0.001). Conversely, flavonoid intake was inversely associated with slow timed-up-and-go test, with an OR (95% CI) of 0.83 (0.67-1.03) for the extreme quintiles (p-trend = 0.021). For individual nutrients, significant inverse associations between consumption and odds of physical frailty were found for alpha-carotene, beta-carotene and lutein among carotenoids, and for flavan-3-ols, flavonese and flavonols among flavonoids.

Conclusion: Higher dietary intake of carotenoids and flavonoids during midlife may be beneficial in reducing physical frailty in later life.

Background: Processed meat (PM) consumption is an established risk factor for colorectal cancer (CRC). It has been hypothesized that nitrosyl-heme, formed by the addition of nitrites during meat processing, may enhance the carcinogenic effects of PMs. This study aims to investigate the association between nitrosyl-heme intake and CRC risk within the European Prospective Investigation into Cancer and Nutrition(EPIC) study.

Methods: This prospective study included 367,463 participants(70.3% women) from seven countries from the EPIC-study. Dietary data were collected via baseline questionnaires, and nitrosyl-heme exposure was estimated using biochemical data from 52 Spanish PMs, extrapolated to country-specific items. Sex-specific multivariable-adjusted hazard ratios(HRs) and 95% confidence intervals(CIs) were calculated using Cox proportional hazards models.

Results: Over a 15-year median follow-up, 5,115 incident CRC cases were identified. Comparing the highest vs. the lowest sex-specific tertile of nitrosyl-heme intake we found no significant association with CRC risk (HR_T3vsT1:1.01;95%CI:0.93-1.09). Subgroup analyses by tumor subtype and interactions with lifestyle factors also showed no associations.

Conclusions: This study offers insights into nitrosyl-heme exposure in European populations but found no link to CRC risk. Further research is needed to understand nitrosyl-heme's role in CRC.

Aims: This study aimed to investigate the association between the weight-adjusted waist circumference index (WWI) and cardiovascular outcomes in patients with T2DM.

Methods: Using Cox proportional hazards regression models to determine the impact of WWI on cardiovascular event. Nonlinear associations were explored through restricted cubic splines (RCS) and smooth curve fitting (SCF), and the integrity of these findings was supported by subgroup and sensitivity analyses.

Results: An elevation in WWI was linked to a significant rise in the likelihood of major adverse cardiovascular events (MACEs), composite cardiovascular outcomes MSD, including myocardial infarction, stroke, and any death, congestive heart failure (CHF), and total mortality (TM). An increase of per 1 standard deviations (SD) in WWI corresponded to a 7% heightened risk of MACEs (HR: 1.07, 95% CI: 1.02, 1.13), a 9% greater risk of MSD (HR: 1.09, 95% CI: 1.04, 1.13), a 20% greater risk of CHF (HR: 1.20, 95% CI: 1.10, 1.30), and a 11% increase in TM (HR: 1.11, 95% CI: 1.06, 1.17). RCS and SCF analysis revealed a nonlinear correlation between WWI and the risks of CHF and TM. Subgroup analyses demonstrated that WWI more accurately predicted CHF risk in patients whose duration of diabetes was under 10 years. Sensitivity analyses reinforced the reliability of these results.The integration of WWI into conventional predictive models improved the accuracy of these outcomes.

Conclusions: WWI is closely associated with future cardiovascular outcomes and TM in patients with T2DM.WWI serves as an autonomous predictor of both future cardiovascular events and TM among patients with T2DM, outperforming traditional obesity indices in predictive ability. CLINICAL TRIAL URLS: https://clinicaltrials.gov/ct2/show/NCT00000620.

Objective: This study aimed to investigate the effects of low-carbohydrate diets (LCD) and low-fat diets (LFD) on sarcopenia, as well as the source and quality of nutrients, to provide strong support for the development of a more scientifically based dietary guidance scheme.

Methods: The data of this study came from the National Health and Nutrition Examination Survey (NHANES). LCD and LFD scores were calculated based on macronutrient energy proportions. Logistic regression, isoenergetic substitution models were used to evaluate associations with sarcopenia, defined by dual-energy X-ray absorptiometry (DXA).

Results: A total of 1,745 participants were included in this study, with a mean age of 38.71 ± 0.46 years and a mean body mass index (BMI) of 28.87 ± 0.26 kg/m². After adjusting for covariates, the highest tertiles of overall LCD and healthful LCD scores were associated with a significantly lower risk of sarcopenia, with odds ratios (OR) of 0.48 (95% CI: 0.24-0.96) and 0.51 (95% CI: 0.32-0.81), respectively, compared with the lowest tertiles. In comparison, the highest tertile of the total LFD was associated with a 78% higher risk of sarcopenia (OR = 1.78; 95% CI: 1.03-3.11). Furthermore, replacing 5% of energy from carbohydrates with protein or fat, and with plant protein or unsaturated fat, was associated with reduced sarcopenia risk, with OR of 0.86 (95% CI: 0.74-0.99) and 0.80 (95% CI: 0.65-0.99), respectively.

Conclusion: In this cross-sectional study, higher overall and healthful LCD scores are associated with a lower risk of sarcopenia, whereas higher overall and unhealthful LFD scores are associated with an increased risk. These findings suggest that the relationships between LCD, LFD, and sarcopenia may depend not only on the quantity of macronutrients but also on their dietary sources.

Background: Low muscle mass exhibits a high prevalence in population, with its incidence increasing with age. Body mass index (BMI) has been identified as an independent predictor of poor muscle quality, and people with higher BMI have higher risk of low muscle mass. Nutrition interventions have been demonstrated efficacy in mitigating its effects. The Healthy Eating Index-2020 (HEI-2020) assesses overall diet quality but lacks studies on its association with low muscle mass. This study aims to investigate the association between the HEI-2020 and low muscle mass and to explore the mediating role of BMI among middle-aged individuals.

Methods: Participants aged 40-59 were recruited from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. Muscle mass was quantified using the ratio of appendicular lean mass (ALM) to BMI, with low muscle mass criteria defined at 0.789 kg/kg/m² for men and 0.512 kg/kg/m² for women. The HEI-2020 score was constructed based on two days of 24-hour dietary recalls and consists of 13 components. Logistic regression models analyzed the associations between HEI-2020, its components, and low muscle mass. Mediation analysis assessed the role of BMI in the association between HEI-2020 and low muscle mass.

Results: The sample comprised 4,355 individuals with a median age of 50 (45, 55) years, of whom 9.7% had low muscle mass. The HEI-2020 scores ranged from 22.85 to 91.33, with an average score of 52.10 ± 11.78. Participants in the highest HEI-2020 score quartile had a 65% lower risk of low muscle mass compared to those in the lowest quartile. Adequate intake of vegetables, fruits, beans, proteins and fatty acids, along with restricted intake of added sugars, was associated with lower risk of low muscle mass. BMI was identified as a mediator, accounting for 33.1% of the association between HEI-2020 and low muscle mass.

Conclusions: HEI-2020 was inversely associated with low muscle mass among middle-aged individuals. The impact of a healthy diet on muscle mass is partially mediated by BMI. Adhering to the healthy eating patterns and keeping a healthy weight is conducive to the maintenance of muscle mass and the prevention of low muscle mass.

Background: The association between relative fat mass (RFM), a sex-specific adiposity index derived from waist circumference and height, and incident cardiovascular diseases (CVDs) remains underexplored in Chinese populations. This study aimed to evaluate the predictive value of RFM for CVD risk in Chinese adults, addressing a gap in evidence for Asian cohorts with unique adiposity patterns.

Methods: We analyzed 7,027 adults aged≥45 years without baseline CVD from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2020). RFM was calculated using validated sex-specific equations. Cox regression models assessed RFM-CVD associations, with comprehensive subgroup analyses conducted to evaluate effect modification. The incremental predictive value of RFM beyond conventional Framingham risk factors was evaluated using area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI).

Results: Over a median 9-year follow-up, 24.6% participants developed CVDs. Each 1-unit RFM increase conferred a 3% higher CVD risk (adjusted HR=1.03, 95% CI: 1.02-1.05). Participants in the highest RFM quartile had 46% greater CVD risk versus the lowest quartile (adjusted HR=1.46, 95% CI: 1.05-2.03; P-trend=0.004). Sex-stratified analyses revealed consistent associations in both genders, though stronger effects were observed in males. Subgroup analyses confirmed robust associations across age groups and those without comorbidities. RFM significantly improved CVD prediction when added to Framingham risk factors (AUC 0.640 vs. 0.634; NRI=0.140, IDI=0.004; P<0.001).

Conclusions: Higher RFM independently predicts incident CVDs in Chinese adults and enhances conventional risk stratification. RFM represents a practical anthropometric index for CVD prevention in clinical and public health settings, particularly valuable for resource-limited environments.

Background: Sarcopenia, a prevalent complication of cirrhosis, is strongly linked to adverse clinical outcomes including hepatic encephalopathy and increased mortality which underscoring the urgent need for effective prevention and treatment strategies. This study investigates the effects of a diet based on vegetable and dairy protein on sarcopenia-related parameters in patients with cirrhosis.

Methods: This randomized, controlled clinical trial was carried out on 42 patients with cirrhosis aged 30 to 60 years. Patients were randomly assigned to either the diet based on vegetable and dairy protein (n = 21) or the standard omnivorous isocaloric and isonitrogenous diet (n = 21). Fasting blood samples, anthropometric measurements, handgrip strength, five times sit to stand (5STS) test, four meters gate speed (4MGS) as well as dietary intake and physical activity data were collected for all patients at the baseline and after 12 weeks of the intervention.

Results: Following 12 weeks of intervention, functional indicators of sarcopenia including handgrip strength, 4MGS, and the 5STS improved in vegetable and dairy protein-based diet group; however, no significant differences were found between the intervention and control groups (P > 0.05). Blood ammonia and myostatin levels remained stable in the vegetable and dairy protein-based diet group, whereas these biomarkers significantly increased in the standard diet group (P = 0.03). Moreover, a significant between-group difference was observed in blood ammonia levels (P = 0.02). Anthropometric indices including weight, BMI, mid-arm circumference (MAC), triceps skinfold (TSF), and mid-arm muscle circumference (MAMC) did not show significant differences between two groups (P > 0.05).

Conclusions: In conclusion, a vegetable and dairy protein-based diet effectively inhibited significant elevations in ammonia levels compared to the standard diet in persons with liver cirrhosis; however, anthropometric parameters and muscle function did not differ between two groups.

Background: The consumption of a healthy diet may play an important role in the prevention of noncommunicable diseases (NCDs). Although associations between nutrient patterns and cardiometabolic risk factors or NCDs have been examined, the associations between nutrient patterns and mortality remain unknown. The present study examined the relationships between nutrient patterns and all-cause and cause-specific mortalities in a large Japanese population.

Methods: A prospective cohort analysis was performed on the data of 72,939 participants aged 35-69 years with a mean follow-up of 11.7 years in the Japan Multi-Institutional Collaborative Cohort Study. A factor analysis was applied to the energy-adjusted intakes of 21 nutrients, and 4 nutrient patterns were extracted: Factor 1 (folate, carotene, fiber, vitamin C, potassium, iron, and retinol patterns); Factor 2 (unsaturated fatty acid and vitamin E patterns); Factor 3 (saturated fatty acid, calcium, vitamin B2 and low carbohydrate patterns); and Factor 4 (sodium, protein and vitamin D patterns). A multivariable Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortalities according to the quartiles of nutrient patterns adjusted for potential confounders including age, sex, research site, drinking and smoking habits.

Results: During the follow-up period, 3,488 deaths were identified. A higher Factor 1 (folate, carotene, fiber, vitamin C, potassium, iron, and retinol) score was associated with lower all-cause (HR 0.81, 95% CI 0.73-0.90), CVD (HR 0.65, 95% CI 0.49-0.85) and cerebrovascular disease (HR 0.60, 95% CI 0.38-0.96) mortalities. The second lowest quartile group of the Factor 2 (unsaturated fatty acid and vitamin E) score was associated with lower all-cause (HR 0.86, 95% CI 0.79-0.94) and cancer (HR 0.85, 95% CI 0.76-0.95) mortalities. On the other hand, a higher Factor 2 score was associated with greater cerebrovascular disease mortality (HR 1.57, 95% CI 1.03-2.40).

Conclusions: The results of the present study suggest that increased adherence to nutrient patterns rich in folate, carotene, fiber, vitamin C, potassium, iron, and retinol or moderate adherence to unsaturated fatty acids and vitamin E are associated with a decreased risk of mortality in Japanese adults.