Nutrition Journal最新文献

Purpose: Low-fat dietary (LFD) pattern refers to a dietary structure with reduced fat intake. The aim was to investigate the association between LFD pattern and risk of head and neck cancer (HNC).

Methods: Data were derived from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. LFD score was used to assess adherence to an LFD pattern, with higher scores indicating greater adherence. Cox regression was used to evaluate the association between LFD score and risk of HNC and its subtypes. To visualize the trend in risk of HNC and its subtypes with changing LFD score, restricted cubic spline plots were utilized. A series of subgroup analyses were conducted to identify potential confounders. Sensitivity analyses were performed to assess the robustness of the results.

Results: Among 98,459 participants of PLCO trial, 268 cases with HNC were identified during an average of 8.8 years of follow-up. In the fully adjusted model, participants in the highest compared with the lowest quartiles of LFD score had a lower risk of HNC (HR _{Q4 vs. Q1}: 0.60; 95% CI: 0.40-0.90; P for trend = 0.026) and larynx cancer (HR_{Q4 vs. Q1}: 0.46; 95% CI: 0.22-0.96; P for trend = 0.039). The restricted cubic spline plots demonstrated a linear dose-response relationship between the LFD score and the risk of HNC and its subtypes (all P for nonlinearity > 0.05). The primary association remained robust in the sensitivity analysis.

Conclusion: Our findings suggest that adherence to an LFD pattern may lower the risk of HNC in the US population.

Background: The effect of supplements on mortality risk in patients with cancer remains uncertain and has scarcely been investigated in subgroups of patients with varying characteristics. This study aimed to investigate the association between two popular supplements, fish oil and glucosamine, and mortality risk in a large population-based cohort and determine whether cardiovascular health and clinical prognosis influence these associations.

Methods: This prospective cohort study analyzed the data of UK Biobank participants who were diagnosed with cancer. The associations of fish oil and glucosamine consumption with mortality were analyzed using Cox proportional hazards models. Subgroup analyses were performed to assess the effects of Life Essential 8 [LE8] scores (a measure of cardiovascular health) and cancer prognosis (grouped according to the survival rates of specific cancer types) on the associations between supplement use and mortality.

Results: This analysis included 14,920 participants (mean age = 59.9 years; 60.2% female). One third (34.1%) of the participants reported using fish oil, and one fifth (20.5%) reported using glucosamine. Over a median follow-up of 12.0 years, 2,708 all-cause deaths were registered. The use of fish oil was associated with reduced risks of all-cause mortality (adjusted hazard ratio [aHR] = 0.89, 95% Confidence Interval [CI] = 0.81-0.97) and cancer mortality (aHR = 0.89, 95% CI = 0.81-0.98). Similarly, glucosamine use was associated with reduced risks of all-cause mortality (aHR = 0.83, 95% CI = 0.74-0.92) and cancer mortality (aHR = 0.83, 95% CI = 0.74-0.93) in the fully adjusted model. Subgroup analyses revealed that the protective effects of fish oil and glucosamine against mortality risk were only observed in patients with LE8 scores lower than the mean score or a poor cancer prognosis. Additionally, the association between glucosamine use and a reduced risk of CVD-related mortality was only observed in patients with lower LE8 scores.

Conclusions: This large cohort study identified the potential differential impact of LE8 scores and cancer prognosis on the associations of fish oil and glucosamine supplementation with survival in patients with cancer. This suggests the importance of considering these factors in future research on supplements and in the provision of personalized integrative cancer care.

Background: Cardiovascular disease (CVD) poses a significant challenge to global public health. Dietary intervention therapy offers high cost-effectiveness for treating CVD. Currently, there is limited research on the dietary niacin intake and survival of CVD patients. This study aims to examine the association of dietary niacin intake with long-term survival in people with CVD.

Methods: A nationally representative sample of 4,377 diabetes subjects was drawn from the NHANES (National Health and Nutrition Examination Survey) data collected between 2003 and 2018. Dietary niacin intake in this study represents either the average of the two recalls or the value from one recall (if only one recall was available for a participant). Weighted Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% CIs to examine the associations between dietary niacin intake and the risk of all-cause and CVD mortality.

Results: After adjustment for multiple covariates, HRs and 95% CIs in model 3 indicated that participants in the highest quartile (Quartile 4) of dietary niacin intake were at lower risk for all-cause mortality (HR = 0.74, 95% CI: 0.60-0.90, P for trend = 0.010) and CVD mortality (HR = 0.67, 95% CI:0.51-0.89, P for trend = 0.020).

Conclusion: Higher dietary niacin intake may be associated with a reduced risk of all-cause and cardiovascular disease mortality among CVD patients. Additionally, significant interactions were found between dietary niacin intake and BMI as well as vitamin B12 subgroups.

Background: Hypertensive disorders of pregnancy (HDPs) are common complications encountered in pregnancy that affect between 5% and 15% of pregnancies worldwide. Some studies have associated adherence to a diet with a high acid load with an increased risk of HDPs. This study investigates the association between Dietary Acid Load (DAL) and the incidence of preeclampsia, chronic hypertension (HTN), and gestational hypertension (GHTN).

Methods: Pregnant women aged 18 to 45 in the first trimester of pregnancy were selected and followed up until delivery. Diet was evaluated using a 168-question semi-quantitative food frequency questionnaire (FFQ). After calculating the DAL score, the inverse probability weight of the propensity scores, estimated from augmented generalized models, was used to obtain a causal risk ratio (RR) adjusted for potential confounders.

Results: Out of 1,856 women, 92 (4.95%) developed preeclampsia. The potential renal acid load (PRAL) score ranged from - 16.14 to 0.58, while the net endogenous acid production (NEAP) score ranged from 34.61 to 50.15. Multivariable analysis revealed a significant association between PRAL and preeclampsia in the first (aRR: 1.87, 95% CI: 1.01, 3.49, p = 0.048) and third (aRR: 2.01, 95% CI: 1.07, 3.81, p = 0.030) quartiles compared to the reference group (Q2). No significant linear association was found in continuous analyses. For chronic HTN, significant associations were observed in the first (aRR: 2.56, 95% CI: 1.21, 5.42, p = 0.014) and fourth (aRR: 4.79, 95% CI: 2.37, 9.71, p < 0.001) PRAL quartiles, with similar findings for NEAP. Continuous analysis showed a significant linear association between both PRAL and NEAP scores and chronic HTN. Regarding GHTN, significant associations were found in the first (aRR: 1.48, 95% CI: 1.02, 2.16, p = 0.041) and fourth (aRR: 1.88, 95% CI: 1.31, 2.70, p = 0.001) PRAL quartiles, and in Q4 for NEAP (aRR: 1.56, 95% CI: 1.10, 2.21, p = 0.012), with no significant linear association in continuous analysis.

Conclusion: Extremes in DAL, as indicated by PRAL and NEAP, are associated with an increased risk of preeclampsia, chronic HTN, and GHTN, particularly in the highest and lowest quartiles. These findings highlight the potential impact of DAL on HDPs.

Background: In recent years, there has been a lot of discussion over the impact of ultra-processed foods (UPFs) intake on overall health of subjects. However, the association between UPFs intake and metabolic unhealthy (MU) status is still in a state of ambiguity. The current study assessed the relationship between UPFs intake and MU status with regard to brain-derived neurotrophic factor (BDNF) and adropin levels.

Methods: A sample of Iranian adults (aged 20-65 years) was selected to participate in this cross-sectional study using a multistage cluster random-sampling method. UPFs intake was assessed by a validated food frequency questionnaire and NOVA classification. Concentrations of metabolic parameters, BDNF and adropin were determined through fasting blood samples. MU status was assessed according to the criteria proposed by Wildman.

Results: The overall prevalence of MU phenotype among study participants (n = 527) was 42.5%. Higher intake of UPFs was associated with elevated odds of MU status in multivariable-adjusted model (OR_{T3 vs. T1}=1.88; 95%CI: 1.02-3.45). Moreover, a positive association was observed between UPFs intake and hypertriglyceridemia after controlling all confounders (OR_{T3 vs. T1}=2.07; 95%CI: 1.15-3.73). However, each tertile increase in UPFs intake was not significantly associated with serum BDNF ([Formula: see text]=0.15; 95%CI: -0.05, 0.34; P = 0.14) and adropin ([Formula: see text]=-1.37; 95%CI: -6.16, 3.42; P = 0.58) levels in multivariable-adjusted linear regression models.

Conclusion: Our findings suggested that higher consumption of UPFs was related to increased likelihood of MU status among a sample of Iranian adults. Further longitudinal studies are needed to verify the directionality and generalizability of the results to all adult populations.

Background: The sustainability of diets consumed by African populations under socio-economic transition remains to be determined. This study developed and characterized a multi-dimensional Sustainable Diet Index (SDI) reflecting healthfulness, climate-friendliness, sociocultural benefits, and financial affordability using individual-level data of adults in rural and urban Ghana and Ghanaian migrants in Europe to identify the role of living environment in dietary sustainability.

Methods: We used cross-sectional data from the multi-centre Research on Obesity and Diabetes among African Migrants Study (N = 3169; age range: 25-70 years). For the SDI construct (0-16 score points), we used the Diet Quality Index-International, food-related greenhouse gas emission, the ratio of natural to processed foods, and the proportion of food expenditure from income. In linear regression analyses, we estimated the adjusted ß-coefficients and 95% confidence intervals (CIs) for the differences in mean SDI across study sites (using rural Ghana as a reference), accounting for sociodemographic and lifestyle factors.

Results: The overall mean SDI was 8.0 (95% CI: 7.9, 8.1). Participants in the highest SDI-quintile compared to lower quintiles were older, more often women, non-smokers, and alcohol abstainers. The highest mean SDI was seen in London (9.1; 95% CI: 8.9, 9.3), followed by rural Ghana (8.2; 95% CI: 8.0, 8.3), Amsterdam (7.9; 95% CI: 7.7, 8.1), Berlin (7.8; 95% CI: 7.6, 8.0), and urban Ghana (7.7; 95% CI: 7.5, 7.8). Compared to rural Ghana, the differences between study sites were attenuated after accounting for age, gender and energy intake. No further changes were observed after adjustment for lifestyle factors.

Conclusion: The multi-dimensional SDI describes four dimensions of dietary sustainability in this Ghanaian population. Our findings suggest that living in Europe improved dietary sustainability, but the opposite seems true for urbanization in Ghana.

Background: Nuts consumption is related to cardioprotective effects on primary cardiovascular prevention, but studies conducted in secondary prevention are small, scarce and controversial. The objective of this trial was to evaluate the effects of a regional and sustainable cardioprotective diet added or not with an affordable mixed nuts on cardiometabolic features in patients with previous myocardial infarction.

Methods: DICA-NUTS study is a national, multi-center, and superiority-parallel randomized clinical trial. Males and females over 40 years old diagnosed with previous myocardial infarction in the last 2 to 6 months were included. Patients were allocated into two groups: the Brazilian Cardioprotective diet (DICA Br) supplemented with 30 g/day of mixed nuts (10 g of peanuts; 10 g of cashew; 10 g of Brazil nuts) (intervention group, n = 193); or only DICA Br prescription (control group, n = 195). The primary outcome was low-density lipoprotein cholesterol means (in mg/dL) after 16 weeks. Secondary outcomes were other lipid biomarkers, glycemic and anthropometric data and diet quality.

Results: After adjustment for baseline values, participating study site, time since myocardial infarction and statin treatment regimen (high potency, moderate and low potency/no statins), no significant difference was found between the groups in low-density lipoprotein cholesterol concentrations (intervention-control difference: 3.48 mg/dL [-3.45 to 10.41], P = 0.32). Both groups improved their overall diet quality at the end of the study without differences between them after 16 weeks (intervention-control difference: 1.05 (-0.9 to 2.99); P = 0.29). Other lipids, glycemic profile and anthropometrics were also not different between study groups at the end of the study.

Conclusion: Adding 30 g/day of mixed nuts to the DICA Br for 16 weeks did not change lipid, glycemic and anthropometric features in the post-myocardial infarction setting.

Trial registration: This study is registered on ClinicalTrials.gov website under number NCT03728127 and its World Health Organization Universal Trial Number (WHO-UTN) is U1111-1259-8105.

Background: The EAT-Lancet diet is a diet aimed at promoting population and planetary health from the perspective of sustainable diets in terms of environmental and health aspects. This study aimed to assess the association between adherence to the EAT-Lancet diet and cardiometabolic risk factors among adults and elderly individuals in a capital city in the northeastern region of Brazil.

Methods: This is an analytical cross-sectional observational study from a population-based sample conducted between 2019 and 2020, involving 398 non-institutionalized adults and elderly people, of both sexes from "Brazilian Usual Consumption Assessment" study (Brazuca-Natal). There was a 38% response rate due to the suspension of data collection due to the covid-19 pandemic, but According to the comparative analysis of socioeconomic and demographic variables between the surveyed and non-surveyed sectors, losses were found to be random (p = 0.135, Little's MCAR test). Socioeconomic and lifestyle data, anthropometric measurements, and dietary consumption were collected. We used the Planetary Health Diet Index (PHDI) and the Cardiovascular Health Diet Index (CHDI) for cardiovascular health to assess adherence to the diet's sustainability. The evaluated cardiometabolic parameters included fasting blood glucose, triglycerides, total cholesterol, HDL-C, LDL-C, and systolic and diastolic blood pressure measurements. We also assessed the presence of type 2 diabetes mellitus, arterial hypertension, and dyslipidemia. For the data analyses, sample weights and the effect of the study design were taken into account. Pearson's chi-square test was used to evaluate the statistical significance of frequencies. Multiple linear regression models assessed the associations between PHDI and CHDI and its components and the cardiometabolic parameters.

Results: The mean PHDI was 29.4 (95% CI 28.04:30.81), on a total score ranging from 0 to 150 points and the mean CHDI was 32.63 (95% CI 31.50:33.78), on a total score ranging from 0 to 110 points. PHDI showed a significant positive association with the final CHDI score and components of fruits, vegetables, and legumes, and a negative association with Ultra-processed Food (UPF) (p < 0.05). Notably, among the most consumed UPF, the following stand out: "packaged snacks, shoestring potatoes, and crackers" (16.94%), followed by margarine (14.14%). The PHDI exhibited a significant association with diabetes and dyslipidemia, as well as with systolic blood pressure, total cholesterol, and LDL-C.

Conclusions: The results suggest that adopting the EAT-Lancet diet is associated with the improvement of key cardiovascular health indicators.

Background: Type 2 diabetes mellitus (T2DM) is a chronic condition characterized by insulin resistance and impaired insulin production, leading to elevated blood glucose levels. Curcumin, a polyphenolic compound from Curcuma longa, has shown potential in improving insulin sensitivity and reducing blood glucose levels, which may help mitigate type 2 diabetes progression.

Objective: To assess the efficacy of improving type 2 diabetes (T2DM).

Study design: This randomized, double-blind, placebo-controlled trial included subjects (n = 272) with criteria for type 2 diabetes.

Methods: All subjects were randomly assigned to receive curcumin (1500 mg/day) or placebo with blind labels for 12 months. To assess the improvement of T2DM after curcumin treatments body weight and body mass index, fasting plasma glucose, glycosylated hemoglobin A_1c, β-cell function (homeostasis model assessment [HOMA-β]), insulin resistance (HOMA-IR), insulin, adiponectin, and leptin were monitored at the baseline and at 3-, 6-, 9-, and 12-month visits during the course of intervention.

Results: After 12 months of treatment, the curcumin-treated group showed a significant decrease in fasting blood glucose (115.49 vs.130.71; P < 0.05), HbA_1c (6.12 vs. 6.47; P < 0.05). In addition, the curcumin-treated group showed a better overall function of β-cells, with higher HOMA-β (136.20 vs. 105.19; P < 0.01) The curcumin-treated group showed a lower level of HOMA-IR (4.86 vs. 6.04; P < 0.001) and higher adiponectin (14.51 vs. 10.36; P < 0.001) when compared to the placebo group. The curcumin-treated group also showed a lower level of leptin (9.42 vs. 20.66; P < 0.001). Additionally, body mass index was lowered (25.9 4 vs.29.34), with a P value of 0.001.

Conclusions: A 12-month curcumin intervention in type 2 diabetes patients shows a significant glucose-lowering effect. Curcumin treatment appeared to improve the overall function of β-cells and reduce both insulin resistance and body weight, with very minor adverse effects. Curcumin intervention in obese patients with type 2 diabetes may be beneficial.

Trial registration: Thai clinical trials regentrify no.20140303003.