Maroua Jalouli, Abdel Halim Harrath, Mohammed Al-Zharani, Md Ataur Rahman
Autophagy is an evolutionarily preserved intracellular degradation process pivotal in maintaining proteostasis, mitochondrial homeostasis, and metabolic equilibrium, all of which are dysregulated with aging. Aberrant autophagy has been recognized as a hallmark of human aging and age-related diseases, including neurodegeneration, metabolic dysfunction, cardiovascular diseases, and cancer. Bioactive natural compounds derived from plants, foods, and marine organisms have emerged as potent modulators of autophagy, offering a promising strategy to counteract aging and promote healthy lifespan. Mechanistically, these compounds regulate autophagy by modulating key signaling pathways, such as AMPK, PI3K/AKT/mTOR, SIRT1, and FOXO, while also alleviating oxidative stress, inflammation, and mitochondrial dysfunction. Natural compounds like polyphenols, flavonoids, alkaloids, terpenoids, and carotenoids exhibit dual roles by restoring age-related suppressed autophagic flux and inhibiting excessive autophagy-induced cell death. In this review, we provide a comprehensive overview of the molecular mechanisms through which bioactive natural compounds modulate autophagy and impact human aging and longevity. We discuss both experimental and clinical evidence supporting their geroprotective effects, limitations regarding bioavailability and dose-dependent effects, and prospects for the utilization of autophagy-targeting natural products in aging intervention strategies.
{"title":"Mechanistic Modulation of Autophagy by Bioactive Natural Products: Implications for Human Aging and Longevity.","authors":"Maroua Jalouli, Abdel Halim Harrath, Mohammed Al-Zharani, Md Ataur Rahman","doi":"10.3390/nu18050863","DOIUrl":"10.3390/nu18050863","url":null,"abstract":"<p><p>Autophagy is an evolutionarily preserved intracellular degradation process pivotal in maintaining proteostasis, mitochondrial homeostasis, and metabolic equilibrium, all of which are dysregulated with aging. Aberrant autophagy has been recognized as a hallmark of human aging and age-related diseases, including neurodegeneration, metabolic dysfunction, cardiovascular diseases, and cancer. Bioactive natural compounds derived from plants, foods, and marine organisms have emerged as potent modulators of autophagy, offering a promising strategy to counteract aging and promote healthy lifespan. Mechanistically, these compounds regulate autophagy by modulating key signaling pathways, such as AMPK, PI3K/AKT/mTOR, SIRT1, and FOXO, while also alleviating oxidative stress, inflammation, and mitochondrial dysfunction. Natural compounds like polyphenols, flavonoids, alkaloids, terpenoids, and carotenoids exhibit dual roles by restoring age-related suppressed autophagic flux and inhibiting excessive autophagy-induced cell death. In this review, we provide a comprehensive overview of the molecular mechanisms through which bioactive natural compounds modulate autophagy and impact human aging and longevity. We discuss both experimental and clinical evidence supporting their geroprotective effects, limitations regarding bioavailability and dose-dependent effects, and prospects for the utilization of autophagy-targeting natural products in aging intervention strategies.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 5","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12986615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antonella Rosa, Alessandra Piras, Silva Porcedda, Paolo Solari, Ilenia Pinna, Carla Masala
Background: Aging is characterized by a decrease in olfactory, attentional, memory, language, and visuospatial/executive abilities. In this context, our study aimed to evaluate the potential effects of Rosmarinus officinalis L. (rosemary) and Carum carvi L. (caraway) essential oils (EOs) on aging. First, we assessed, in 402 participants, the age-related changes in olfactory functions (odor threshold, discrimination, and identification), gustatory perceptions (sweet, sour, salty, and bitter taste), cognitive functions (focusing on attention, memory, language, and visuospatial/executive functions), and their possible correlations with aging. To achieve this, olfactory function, gustatory perception, and cognitive abilities were evaluated in healthy participants across different age groups. Then, to evaluate the age-related decrease in trigeminal function (59 participants), we used rosemary and caraway EOs that contain carvone, limonene, and 1,8-cineole, all of which are considered typical trigeminal stimuli.
Methods: Olfactory function was assessed with the Sniffin' Sticks test, gustatory function by the Taste Strips test, and rosemary and caraway EOs by the ratings of odor pleasantness, intensity, and familiarity using a labeled hedonic Likert-type scale.
Results: Olfactory function could be a potential early indicator of attentional, memory, language, and visuospatial/executive dysfunctions. Our data indicated that rosemary and caraway EOs were perceived without any significant decrease in odor pleasantness, intensity, and familiarity ratings in relation to aging.
Conclusion: Our results suggest the potential bioactive effects of rosemary and caraway natural EOs as a new strategy to promote healthy aging.
{"title":"Age-Related Olfactory and Cognitive Decline: Potential Effects of <i>Rosmarinus officinalis</i> and <i>Carum carvi</i> Essential Oils.","authors":"Antonella Rosa, Alessandra Piras, Silva Porcedda, Paolo Solari, Ilenia Pinna, Carla Masala","doi":"10.3390/nu18050862","DOIUrl":"10.3390/nu18050862","url":null,"abstract":"<p><strong>Background: </strong>Aging is characterized by a decrease in olfactory, attentional, memory, language, and visuospatial/executive abilities. In this context, our study aimed to evaluate the potential effects of <i>Rosmarinus officinalis</i> L. (rosemary) and <i>Carum carvi</i> L. (caraway) essential oils (EOs) on aging. First, we assessed, in 402 participants, the age-related changes in olfactory functions (odor threshold, discrimination, and identification), gustatory perceptions (sweet, sour, salty, and bitter taste), cognitive functions (focusing on attention, memory, language, and visuospatial/executive functions), and their possible correlations with aging. To achieve this, olfactory function, gustatory perception, and cognitive abilities were evaluated in healthy participants across different age groups. Then, to evaluate the age-related decrease in trigeminal function (59 participants), we used rosemary and caraway EOs that contain carvone, limonene, and 1,8-cineole, all of which are considered typical trigeminal stimuli.</p><p><strong>Methods: </strong>Olfactory function was assessed with the Sniffin' Sticks test, gustatory function by the Taste Strips test, and rosemary and caraway EOs by the ratings of odor pleasantness, intensity, and familiarity using a labeled hedonic Likert-type scale.</p><p><strong>Results: </strong>Olfactory function could be a potential early indicator of attentional, memory, language, and visuospatial/executive dysfunctions. Our data indicated that rosemary and caraway EOs were perceived without any significant decrease in odor pleasantness, intensity, and familiarity ratings in relation to aging.</p><p><strong>Conclusion: </strong>Our results suggest the potential bioactive effects of rosemary and caraway natural EOs as a new strategy to promote healthy aging.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 5","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12987288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ye Jin Kim, Chaerin Kim, Jihyun Park, Miok Choi, Won Suk An, Oh Yoen Kim
Background/Objectives: This study examined the association between dietary acid load (DAL) and metabolic syndrome (MetS)-related parameters in Korean adults undergoing eating habit modification. Methods: Forty-eight Korean adults (≥19 years) with at least one MetS risk factor were recruited via public advertisement. Anthropometric and biochemical parameters, Nutrition Quotient (NQ) scores, and nutrient intake were assessed. The DAL was calculated and expressed as the potential renal acid load (PRAL) and the net endogenous acid production (NEAP). Results: Forty participants completed the 8-week intervention. Overall improvements were observed in total and domain-specific NQ scores, along with improvements in body composition, blood pressure, and glycemic parameters. Among all participants, the mean DAL scores did not change significantly after FDR correction, although the NEAP showed a modest non-significant decrease. Baseline PRAL and NEAP values did not differ between participants with and without MetS risk improvement. At weeks 4 and 8, DAL indices tended to decrease in the improved group and increase in the non-improved group, with a significant between-group difference observed only for the 8-week change in NEAP after FDR correction. While no significant associations were detected at baseline after FDR adjustment, cross-sectional associations between DAL indices and adiposity-related parameters were observed at week 8, particularly when DAL was expressed as NEAP. However, change-to-change analyses did not remain significant after FDR correction. Conclusions: In this exploratory study, DAL levels, especially NEAP, were associated with anthropometric and metabolic status at week 8; however, the absence of significant change-to-change correlations limits causal interpretation. Larger randomized controlled trials are needed to determine whether modification of DAL independently contributes to metabolic improvement (Trial registration number: KCT0011528).
{"title":"Association of Dietary Acid Load with Metabolic Syndrome-Related Parameters Following Eating Habit Modification in Korean Adults.","authors":"Ye Jin Kim, Chaerin Kim, Jihyun Park, Miok Choi, Won Suk An, Oh Yoen Kim","doi":"10.3390/nu18050864","DOIUrl":"10.3390/nu18050864","url":null,"abstract":"<p><p><b>Background/Objectives:</b> This study examined the association between dietary acid load (DAL) and metabolic syndrome (MetS)-related parameters in Korean adults undergoing eating habit modification. <b>Methods:</b> Forty-eight Korean adults (≥19 years) with at least one MetS risk factor were recruited via public advertisement. Anthropometric and biochemical parameters, Nutrition Quotient (NQ) scores, and nutrient intake were assessed. The DAL was calculated and expressed as the potential renal acid load (PRAL) and the net endogenous acid production (NEAP). <b>Results:</b> Forty participants completed the 8-week intervention. Overall improvements were observed in total and domain-specific NQ scores, along with improvements in body composition, blood pressure, and glycemic parameters. Among all participants, the mean DAL scores did not change significantly after FDR correction, although the NEAP showed a modest non-significant decrease. Baseline PRAL and NEAP values did not differ between participants with and without MetS risk improvement. At weeks 4 and 8, DAL indices tended to decrease in the improved group and increase in the non-improved group, with a significant between-group difference observed only for the 8-week change in NEAP after FDR correction. While no significant associations were detected at baseline after FDR adjustment, cross-sectional associations between DAL indices and adiposity-related parameters were observed at week 8, particularly when DAL was expressed as NEAP. However, change-to-change analyses did not remain significant after FDR correction. <b>Conclusions:</b> In this exploratory study, DAL levels, especially NEAP, were associated with anthropometric and metabolic status at week 8; however, the absence of significant change-to-change correlations limits causal interpretation. Larger randomized controlled trials are needed to determine whether modification of DAL independently contributes to metabolic improvement (Trial registration number: KCT0011528).</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 5","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12987368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Objectives: Vitamin D plays a central role in calcium and bone homeostasis; however, evidence linking serum 25-hydroxyvitamin D (25(OH)D) to bone mineral density (BMD) in postmenopausal women remains inconsistent. Because body weight and lean mass strongly influence skeletal loading and may also affect circulating 25(OH)D, we aimed to evaluate the association between serum 25(OH)D and bone outcomes in early postmenopausal women and to determine whether body composition attenuates this relationship. Methods: In this cross-sectional study, 120 women within 10 years after natural menopause (59.5 ± 6.3 years) were assessed. Serum 25(OH)D was measured by chemiluminescent immunoassay. Total body areal bone mineral density (total body aBMD, g/cm2) was assessed by DXA, and trabecular volumetric BMD and cortical thickness were obtained using 3D modeling. Associations were examined using Spearman correlations and multivariable linear and logistic regression models adjusted for age, body weight, lean mass, and years since menopause. Results: Median serum 25(OH)D was 23.7 ng/mL [16.7-30.4]. A modest correlation was observed between 25(OH)D and total body aBMD (ρ = 0.22, p = 0.016), but not with trabecular volumetric BMD or cortical thickness. After adjustment, 25(OH)D was not independently associated with total body aBMD (p = 0.144), whereas body weight remained significantly associated (β = 0.27, p = 0.002). In logistic models, body weight (OR = 0.93, 95% CI 0.90-0.96) and lean mass (OR = 0.97, 95% CI 0.95-0.99) were protective against low BMD, while the association with 25(OH)D was modest. Conclusions: In early postmenopause, the association between serum 25(OH)D and BMD is modest and largely attenuated after accounting for body composition. Body weight and lean mass appear to be stronger determinants of bone outcomes than vitamin D status.
背景/目的:维生素D在钙和骨稳态中起核心作用;然而,绝经后妇女血清25-羟基维生素D (25(OH)D)与骨密度(BMD)之间的关联证据仍不一致。由于体重和瘦质量强烈影响骨骼负荷,也可能影响循环25(OH)D,我们的目的是评估早期绝经后妇女血清25(OH)D与骨骼结局之间的关系,并确定身体成分是否减弱了这种关系。方法:对120名自然绝经后10年内(59.5±6.3年)的女性进行横断面研究。采用化学发光免疫法测定血清25(OH)D。通过DXA评估全身面积骨密度(Total body aBMD, g/cm2),通过3D建模获得小梁体积骨密度和皮质厚度。使用Spearman相关性和多变量线性和逻辑回归模型对年龄、体重、瘦质量和绝经后年数进行校正。结果:血清25(OH)D中位数为23.7 ng/mL[16.7 ~ 30.4]。25(OH)D与全身骨密度有一定的相关性(ρ = 0.22, p = 0.016),但与小梁体积骨密度或皮质厚度无相关性。调整后,25(OH)D与全身aBMD无独立相关性(p = 0.144),而体重与aBMD仍有显著相关性(β = 0.27, p = 0.002)。在logistic模型中,体重(OR = 0.93, 95% CI 0.90-0.96)和瘦质量(OR = 0.97, 95% CI 0.95-0.99)对低骨密度有保护作用,而与25(OH)D的关联不大。结论:在绝经后早期,血清25(OH)D与BMD之间的关系是适度的,在考虑了身体成分后,这种关系在很大程度上减弱了。体重和瘦质量似乎比维生素D水平更能决定骨骼发育。
{"title":"Body Composition Attenuates the Association Between Serum 25-Hydroxyvitamin D and Bone Mineral Density in Early Postmenopausal Women.","authors":"Raquel Domingo-Molina, Borja Sañudo, Sergio Tejero, Gonzalo Reverte-Pagola, Mª Ángeles Martínez-Maestre","doi":"10.3390/nu18050865","DOIUrl":"10.3390/nu18050865","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Vitamin D plays a central role in calcium and bone homeostasis; however, evidence linking serum 25-hydroxyvitamin D (25(OH)D) to bone mineral density (BMD) in postmenopausal women remains inconsistent. Because body weight and lean mass strongly influence skeletal loading and may also affect circulating 25(OH)D, we aimed to evaluate the association between serum 25(OH)D and bone outcomes in early postmenopausal women and to determine whether body composition attenuates this relationship. <b>Methods</b>: In this cross-sectional study, 120 women within 10 years after natural menopause (59.5 ± 6.3 years) were assessed. Serum 25(OH)D was measured by chemiluminescent immunoassay. Total body areal bone mineral density (total body aBMD, g/cm<sup>2</sup>) was assessed by DXA, and trabecular volumetric BMD and cortical thickness were obtained using 3D modeling. Associations were examined using Spearman correlations and multivariable linear and logistic regression models adjusted for age, body weight, lean mass, and years since menopause. <b>Results</b>: Median serum 25(OH)D was 23.7 ng/mL [16.7-30.4]. A modest correlation was observed between 25(OH)D and total body aBMD (ρ = 0.22, <i>p</i> = 0.016), but not with trabecular volumetric BMD or cortical thickness. After adjustment, 25(OH)D was not independently associated with total body aBMD (<i>p</i> = 0.144), whereas body weight remained significantly associated (β = 0.27, <i>p</i> = 0.002). In logistic models, body weight (OR = 0.93, 95% CI 0.90-0.96) and lean mass (OR = 0.97, 95% CI 0.95-0.99) were protective against low BMD, while the association with 25(OH)D was modest. <b>Conclusions</b>: In early postmenopause, the association between serum 25(OH)D and BMD is modest and largely attenuated after accounting for body composition. Body weight and lean mass appear to be stronger determinants of bone outcomes than vitamin D status.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 5","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12986650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peiqi Huang, Boyan Zeng, Sicheng Li, Ke Zhang, Chunhao Li, Yingru Liang, Bingyu Liuzhang, Xiaoli Wu, Shaohua Xie, Yan Li, Bo Zhang
Objectives: Disruptions in circadian-related behaviors are emerging as potential risk factors for gastrointestinal cancers. This study investigated the independent and joint associations of nightly fasting duration and sleep duration with the risk of colorectal cancer (CRC) among community-dwelling Chinese older adults. Methods: Participants were drawn from the Guangzhou CRC Screening Program, which used a questionnaire-based investigation, two separate fecal occult blood tests (FOBTs) for risk evaluation, and colonoscopy for high-risk individuals. Of the 347,297 people initially screened, 197,507 individuals were finally included after excluding 100,930 cases with missing eating/sleeping data or unknown/benign lesions via colonoscopy. Among the final sample, 351 CRC cases and 1384 precancerous lesions were diagnosed, while 195,772 individuals had negative results. Habitual times for dinner, breakfast, bedtime, and wake-up were used to define nightly fasting duration (dinner-to-breakfast) and nightly sleep duration (bedtime-to-wake). Multivariable logistic regression, subgroup analyses, and sensitivity analyses were performed to evaluate the associations. Results: In the fully adjusted models, each 1-h increment in nightly fasting duration was associated with a 9.5% (95% CI 1.039-1.153) higher risk of CRC, and the direct association was limited to individuals over 60 years (OR = 1.147, 95% CI 1.073-1.226), while each 1-h increment in nightly sleep duration was associated with a 15.2% (95% CI 0.806-0.893) lower risk of CRC. Consistently, earlier dinner, later breakfast and later bedtime were also associated with a higher CRC risk. Conclusions: In Guangzhou older residents, long nightly fasting duration was a risk factor for CRC, especially among individuals over 60 years old; while long nightly sleep duration was protective. These findings suggest that maintaining adequate sleep and optimizing the nightly fasting window may be viable lifestyle strategies for CRC prevention, emphasizing the need for tailored preventive measures for different age groups.
目的:昼夜节律相关行为的紊乱正成为胃肠道癌症的潜在危险因素。本研究调查了中国社区老年人夜间禁食时间和睡眠时间与结直肠癌(CRC)风险的独立和联合关系。方法:参与者来自广州结直肠癌筛查项目,该项目采用问卷调查,两次单独的粪便潜血检查(FOBTs)进行风险评估,并对高危人群进行结肠镜检查。在最初筛选的347,297人中,通过结肠镜检查排除了100,930例缺少饮食/睡眠数据或未知/良性病变的病例后,最终纳入了197,507人。在最终的样本中,351例结直肠癌病例和1384例癌前病变被诊断出来,195772例结果为阴性。晚餐、早餐、就寝和起床的习惯时间被用来定义夜间禁食时间(从晚餐到早餐)和夜间睡眠时间(从就寝到醒来)。采用多变量logistic回归、亚组分析和敏感性分析来评估相关性。结果:在完全调整的模型中,夜间禁食时间每增加1小时与CRC风险增加9.5% (95% CI 1.039-1.153)相关,直接关联仅限于60岁以上的个体(OR = 1.147, 95% CI 1.073-1.226),而夜间睡眠时间每增加1小时与CRC风险降低15.2% (95% CI 0.806-0.893)相关。一直以来,早吃晚餐、晚吃早餐和晚睡觉也与更高的结直肠癌风险有关。结论:在广州老年居民中,夜间禁食时间过长是结直肠癌的危险因素,特别是在60岁以上的人群中;而长时间的夜间睡眠则有保护作用。这些发现表明,保持充足的睡眠和优化夜间禁食窗口可能是预防结直肠癌的可行生活方式策略,强调需要针对不同年龄组制定量身定制的预防措施。
{"title":"Exploratory Analysis of Association of Nightly Fasting and Sleep Durations with Colorectal Cancer Risk in Chinese Community-Dwelling Older Adults: A Cross-Sectional Study.","authors":"Peiqi Huang, Boyan Zeng, Sicheng Li, Ke Zhang, Chunhao Li, Yingru Liang, Bingyu Liuzhang, Xiaoli Wu, Shaohua Xie, Yan Li, Bo Zhang","doi":"10.3390/nu18050861","DOIUrl":"10.3390/nu18050861","url":null,"abstract":"<p><p><b>Objectives:</b> Disruptions in circadian-related behaviors are emerging as potential risk factors for gastrointestinal cancers. This study investigated the independent and joint associations of nightly fasting duration and sleep duration with the risk of colorectal cancer (CRC) among community-dwelling Chinese older adults. <b>Methods:</b> Participants were drawn from the Guangzhou CRC Screening Program, which used a questionnaire-based investigation, two separate fecal occult blood tests (FOBTs) for risk evaluation, and colonoscopy for high-risk individuals. Of the 347,297 people initially screened, 197,507 individuals were finally included after excluding 100,930 cases with missing eating/sleeping data or unknown/benign lesions via colonoscopy. Among the final sample, 351 CRC cases and 1384 precancerous lesions were diagnosed, while 195,772 individuals had negative results. Habitual times for dinner, breakfast, bedtime, and wake-up were used to define nightly fasting duration (dinner-to-breakfast) and nightly sleep duration (bedtime-to-wake). Multivariable logistic regression, subgroup analyses, and sensitivity analyses were performed to evaluate the associations. <b>Results:</b> In the fully adjusted models, each 1-h increment in nightly fasting duration was associated with a 9.5% (95% CI 1.039-1.153) higher risk of CRC, and the direct association was limited to individuals over 60 years (OR = 1.147, 95% CI 1.073-1.226), while each 1-h increment in nightly sleep duration was associated with a 15.2% (95% CI 0.806-0.893) lower risk of CRC. Consistently, earlier dinner, later breakfast and later bedtime were also associated with a higher CRC risk. <b>Conclusions:</b> In Guangzhou older residents, long nightly fasting duration was a risk factor for CRC, especially among individuals over 60 years old; while long nightly sleep duration was protective. These findings suggest that maintaining adequate sleep and optimizing the nightly fasting window may be viable lifestyle strategies for CRC prevention, emphasizing the need for tailored preventive measures for different age groups.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 5","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12987043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147459020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Dimitriou, Natalia Chatzaki, Dimitra Kostara, Maria-Eleni Tsialta, Alexandra Miliou, Sofia Mpanti, Lydia Stalidi, Maria G Grammatikopoulou, Dimitrios Poulimeneas
Background/Objectives: Internalized weight bias has been linked to adverse mental health outcomes and maladaptive eating-related behaviors. However, its relationship with habitual dietary intake and overall diet quality remains insufficiently explored. The objective of this study was to examine associations between internalized weight bias and habitual energy intake, macronutrient composition, and adherence to the Mediterranean diet among adults with a history of overweight or obesity. Methods: In this web-based cross-sectional study, 484 adults with a history of excess body mass index completed validated assessments of internalized weight bias (Weight Bias Internalization Scale-Modified; WBIS-M) and usual dietary intake (69-item Food Frequency Questionnaire). Adherence to the Mediterranean diet (MeDi) was assessed via the MedDietScore. Multivariable analyses adjusted for several covariates were performed. Results: Higher levels of internalized weight bias were associated with lower adherence to the MeDi (Badj = -0.670, p = 0.025). Higher adherence to the MeDi was associated with reduced odds of being classified in the medium or the highest WBIS-M tertile, corresponding to an approximately 5% reduction per 1-unit increment in the MedDietScore. No associations were observed between internalized weight bias and total energy intake. At the macronutrient level, higher internalized weight bias was associated with higher saturated fat intake, independent of total energy intake. Conclusions: Internalized weight bias was associated with poorer habitual diet quality and unfavorable macronutrient profiles, independent of total energy intake. These findings suggest that internalized weight bias relates to qualitative differences in habitual food choices, highlighting the potential importance of addressing weight bias in efforts to improve diet quality among adults with overweight or obesity.
背景/目的:内化的体重偏见与不良的心理健康结果和饮食相关的不适应行为有关。然而,其与习惯性饮食摄入和整体饮食质量的关系仍未得到充分探讨。本研究的目的是在有超重或肥胖史的成年人中检查内化体重偏差与习惯性能量摄入、常量营养素组成和坚持地中海饮食之间的关系。方法:在这项基于网络的横断面研究中,484名体重指数过高的成年人完成了内化体重偏倚(体重偏倚内化量表-修正版;WBIS-M)和日常饮食摄入(69项食物频率问卷)的有效评估。通过MedDietScore评估地中海饮食(MeDi)的依从性。对多个协变量进行调整后的多变量分析。结果:较高水平的内化体重偏倚与较低的MeDi依从性相关(Badj = -0.670, p = 0.025)。较高的medii依从性与被分类为中等或最高WBIS-M分值的几率降低相关,相当于MedDietScore每增加1个单位就减少约5%。内化体重偏差和总能量摄入之间没有关联。在常量营养素水平上,较高的内化体重偏差与较高的饱和脂肪摄入量相关,与总能量摄入无关。结论:内化体重偏差与较差的习惯饮食质量和不利的宏量营养素相关,与总能量摄入无关。这些发现表明,内化的体重偏见与习惯性食物选择的质量差异有关,强调了解决体重偏见在改善超重或肥胖成年人饮食质量方面的潜在重要性。
{"title":"Weight Bias Internalization Is Inversely Associated with Adherence to the Mediterranean Diet: The Greek Lifestyle and Obesity-Related Bias Survey.","authors":"Maria Dimitriou, Natalia Chatzaki, Dimitra Kostara, Maria-Eleni Tsialta, Alexandra Miliou, Sofia Mpanti, Lydia Stalidi, Maria G Grammatikopoulou, Dimitrios Poulimeneas","doi":"10.3390/nu18050866","DOIUrl":"10.3390/nu18050866","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Internalized weight bias has been linked to adverse mental health outcomes and maladaptive eating-related behaviors. However, its relationship with habitual dietary intake and overall diet quality remains insufficiently explored. The objective of this study was to examine associations between internalized weight bias and habitual energy intake, macronutrient composition, and adherence to the Mediterranean diet among adults with a history of overweight or obesity. <b>Methods</b>: In this web-based cross-sectional study, 484 adults with a history of excess body mass index completed validated assessments of internalized weight bias (Weight Bias Internalization Scale-Modified; WBIS-M) and usual dietary intake (69-item Food Frequency Questionnaire). Adherence to the Mediterranean diet (MeDi) was assessed via the MedDietScore. Multivariable analyses adjusted for several covariates were performed. <b>Results</b>: Higher levels of internalized weight bias were associated with lower adherence to the MeDi (B<sub>adj</sub> = -0.670, <i>p</i> = 0.025). Higher adherence to the MeDi was associated with reduced odds of being classified in the medium or the highest WBIS-M tertile, corresponding to an approximately 5% reduction per 1-unit increment in the MedDietScore. No associations were observed between internalized weight bias and total energy intake. At the macronutrient level, higher internalized weight bias was associated with higher saturated fat intake, independent of total energy intake. <b>Conclusions</b>: Internalized weight bias was associated with poorer habitual diet quality and unfavorable macronutrient profiles, independent of total energy intake. These findings suggest that internalized weight bias relates to qualitative differences in habitual food choices, highlighting the potential importance of addressing weight bias in efforts to improve diet quality among adults with overweight or obesity.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 5","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12986805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olavo João Frederico Ramos Junior, Carlos Alberto de Souza Filho, Shaheen Majeed, Thiago Silveira Alvares
Background: Low estrogen levels during menopause reduce nitric oxide (NO) production, contributing to decline in skeletal muscle quality and function. Although acute and short-term dietary nitrate supplementation has demonstrated promising effects, long-term benefits, particularly on muscle quality in postmenopausal women, are not well established. Objectives: The objective was to investigate the effects of long-term (12-week) nitrate-rich beetroot extract supplementation on morphological and functional muscle quality, rate of force development (RFD), maximal strength, and circulating nitrate/nitrite concentrations in postmenopausal women. Methods: In a randomized, double-blind, placebo-controlled design, 20 postmenopausal women (21 years ± 7 since menopause) consumed 20 g/day of a nitrate-rich beetroot extract (BET; 548 mg nitrate/day) or a nitrate-depleted beetroot extract (PLA; 43 mg nitrate/day) for 12 weeks. Outcome measures, including muscle quality (functional via muscle strength/thickness ratio; morphological via ultrasound echo intensity), RFD, maximal voluntary isometric contraction (MVIC), and serum nitrate/nitrite levels, were evaluated at baseline, 8 weeks, and 12 weeks. Results: BET significantly increased serum nitrate (0.005) and nitrite (0.022) levels compared to PLA at both week 8 and week 12. Morphological muscle quality also improved significantly in the BET group (interaction effect, p = 0.014). Early-phase rate of force development (RFD) increased between 30 and 100 ms, whereas late-phase RFD increased between 100 and 200 ms. RFDpeak also improved by week 8, and these gains were maintained through week 12 (interaction effect, p < 0.05). Although there was no significant difference between groups for functional muscle quality, MVIC increased at week 12 in the BET group, but no significant Time × Group interaction was observed. Conclusions: Twelve weeks of nitrate-rich beetroot extract supplementation improved morphological muscle quality and RFD, suggesting potential clinical relevance for preventing structural and neuromuscular function decline in postmenopausal women. This study was registered with ReBEC (RBR-87qh649) and approved on 8 October 2024.
{"title":"Long-Term Beetroot Extract Supplementation Improves Morphological Muscle Quality and Rate of Force Development in Postmenopausal Women: A Randomized Clinical Trial.","authors":"Olavo João Frederico Ramos Junior, Carlos Alberto de Souza Filho, Shaheen Majeed, Thiago Silveira Alvares","doi":"10.3390/nu18050860","DOIUrl":"10.3390/nu18050860","url":null,"abstract":"<p><p><b>Background:</b> Low estrogen levels during menopause reduce nitric oxide (NO) production, contributing to decline in skeletal muscle quality and function. Although acute and short-term dietary nitrate supplementation has demonstrated promising effects, long-term benefits, particularly on muscle quality in postmenopausal women, are not well established. <b>Objectives:</b> The objective was to investigate the effects of long-term (12-week) nitrate-rich beetroot extract supplementation on morphological and functional muscle quality, rate of force development (RFD), maximal strength, and circulating nitrate/nitrite concentrations in postmenopausal women. <b>Methods:</b> In a randomized, double-blind, placebo-controlled design, 20 postmenopausal women (21 years ± 7 since menopause) consumed 20 g/day of a nitrate-rich beetroot extract (BET; 548 mg nitrate/day) or a nitrate-depleted beetroot extract (PLA; 43 mg nitrate/day) for 12 weeks. Outcome measures, including muscle quality (functional via muscle strength/thickness ratio; morphological via ultrasound echo intensity), RFD, maximal voluntary isometric contraction (MVIC), and serum nitrate/nitrite levels, were evaluated at baseline, 8 weeks, and 12 weeks. <b>Results:</b> BET significantly increased serum nitrate (0.005) and nitrite (0.022) levels compared to PLA at both week 8 and week 12. Morphological muscle quality also improved significantly in the BET group (interaction effect, <i>p</i> = 0.014). Early-phase rate of force development (RFD) increased between 30 and 100 ms, whereas late-phase RFD increased between 100 and 200 ms. RFD<sub>peak</sub> also improved by week 8, and these gains were maintained through week 12 (interaction effect, <i>p</i> < 0.05). Although there was no significant difference between groups for functional muscle quality, MVIC increased at week 12 in the BET group, but no significant Time × Group interaction was observed. <b>Conclusions:</b> Twelve weeks of nitrate-rich beetroot extract supplementation improved morphological muscle quality and RFD, suggesting potential clinical relevance for preventing structural and neuromuscular function decline in postmenopausal women. This study was registered with ReBEC (RBR-87qh649) and approved on 8 October 2024.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 5","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12986568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aidan M Cavanah, Laura A Robinson, Madison M Aguilar, Elaine F Molaison, Michael W Greene, Michael D Roberts, Andrew D Fruge
Background/Objectives: Mood disorders like depression, anxiety, and stress have increased steadily among adults, with growing interest in non-pharmaceutical treatments to improve symptomology. Epigallocatechin-3-gallate (EGCG) and curcumin are polyphenols with evidence to support their positive impacts on mood disorder symptomology and potential mood-associated biomarkers like brain-derived neurotrophic factor (BDNF). This study examined the effects of combined EGCG and curcumin supplementation on mood disturbance symptomology and serum brain-derived neurotrophic factor in adults. Methods: An 8-week randomized double-blinded placebo-controlled trial was conducted in adults (n = 64, 18-50 years old). Participants were randomized to a supplement group (n = 32; 350 mg EGCG and 1330 mg curcumin daily) or a matched placebo group (n = 32). Mood disturbance (DASS-21, GAD-7), sleep disturbance (GSAQ), and physical activity (IPAQ) were assessed at baseline, Week 4, and Week 8. Anthropometric measures, 24 h diet recalls, and fasted blood samples for serum BDNF were collected at baseline and Week 8. A multivariate ANOVA evaluated primary outcomes (DASS-21 composite score and BDNF), followed by repeated measures ANOVA for secondary outcomes (p < 0.05). Results: Significant improvements were observed across all participants for mood (DASS-21 composite and subscales, GAD-7, p < 0.001 for all), sleep (p < 0.001), and physical activity (p < 0.01), with no significant difference between supplement and placebo groups. Mean serum BDNF increased in both groups, but neither were statistically significant with no group-by-time interactions. Sugar intake (g/kg body weight) was positively correlated with mood symptoms at Week 8 in the supplement group. Baseline fruit and vegetable intake was associated with mood symptom severity at select time points; however, dietary changes during the intervention were not significantly related to changes in mood outcomes. Conclusions: Combined EGCG and curcumin supplementation did not show additional benefits beyond placebo for mood disturbance or serum BDNF over eight weeks. Observed improvements across both groups suggest that behavioral or lifestyle factors may play a larger role in short-term mood improvements than supplementation alone.
{"title":"A Randomized Controlled Trial to Determine the Effects of Curcumin and Epigallocatechin-3-Gallate Supplementation on Serum Brain-Derived Neurotrophic Factor and Mood Disturbance in Adults.","authors":"Aidan M Cavanah, Laura A Robinson, Madison M Aguilar, Elaine F Molaison, Michael W Greene, Michael D Roberts, Andrew D Fruge","doi":"10.3390/nu18050855","DOIUrl":"10.3390/nu18050855","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Mood disorders like depression, anxiety, and stress have increased steadily among adults, with growing interest in non-pharmaceutical treatments to improve symptomology. Epigallocatechin-3-gallate (EGCG) and curcumin are polyphenols with evidence to support their positive impacts on mood disorder symptomology and potential mood-associated biomarkers like brain-derived neurotrophic factor (BDNF). This study examined the effects of combined EGCG and curcumin supplementation on mood disturbance symptomology and serum brain-derived neurotrophic factor in adults. <b>Methods</b>: An 8-week randomized double-blinded placebo-controlled trial was conducted in adults (<i>n</i> = 64, 18-50 years old). Participants were randomized to a supplement group (<i>n</i> = 32; 350 mg EGCG and 1330 mg curcumin daily) or a matched placebo group (<i>n</i> = 32). Mood disturbance (DASS-21, GAD-7), sleep disturbance (GSAQ), and physical activity (IPAQ) were assessed at baseline, Week 4, and Week 8. Anthropometric measures, 24 h diet recalls, and fasted blood samples for serum BDNF were collected at baseline and Week 8. A multivariate ANOVA evaluated primary outcomes (DASS-21 composite score and BDNF), followed by repeated measures ANOVA for secondary outcomes (<i>p</i> < 0.05). <b>Results</b>: Significant improvements were observed across all participants for mood (DASS-21 composite and subscales, GAD-7, <i>p</i> < 0.001 for all), sleep (<i>p</i> < 0.001), and physical activity (<i>p</i> < 0.01), with no significant difference between supplement and placebo groups. Mean serum BDNF increased in both groups, but neither were statistically significant with no group-by-time interactions. Sugar intake (g/kg body weight) was positively correlated with mood symptoms at Week 8 in the supplement group. Baseline fruit and vegetable intake was associated with mood symptom severity at select time points; however, dietary changes during the intervention were not significantly related to changes in mood outcomes. <b>Conclusions</b>: Combined EGCG and curcumin supplementation did not show additional benefits beyond placebo for mood disturbance or serum BDNF over eight weeks. Observed improvements across both groups suggest that behavioral or lifestyle factors may play a larger role in short-term mood improvements than supplementation alone.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 5","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12986582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147459168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Noncommunicable diseases (NCDs) are a major global public health challenge and can be prevented and managed through a balanced, nutrient-rich diet. Food nutrition labels play an important role in guiding healthier choices, particularly for individuals at risk of chronic health conditions. This study assessed awareness, understanding and use of nutrition labels among adults in Shanghai, China, and explored their associations with NCDs. Methods: A face-to-face structured questionnaire survey was conducted among 1503 adults in 2024. Data were collected on sociodemographic characteristics, self-reported chronic conditions (obesity, diabetes, hypertension, hyperlipidemia, hypercholesterolemia, cardiovascular and cerebrovascular diseases (CCVDs), and fatty liver disease), and awareness, understanding, and use of nutrition labels. Generalized linear regression models were applied to assess associations between label-related behaviors and chronic conditions. Results: Overall, 81.6% of participants were aware of labels, 15.0% reported understanding them, and 35.5% reported using them. Participants who were underweight or obese were less likely to be aware of labels compared to those with normal weight (73.8% and 72.9% vs. 83.5%). Individuals with fatty liver disease were less likely to understand labels compared to those without the condition (7.2% vs. 16.1%). Conversely, participants with three or more chronic conditions were more likely to use labels than those without any chronic conditions (46.1% vs. 34.4%). Conclusions: Among adults in Shanghai, nutrition label awareness was relatively high, while understanding and use of labels remained insufficient. Targeted nutrition education and the integration of nutrition labeling into chronic disease management strategies are needed to improve public health outcomes.
背景:非传染性疾病(NCDs)是一项重大的全球公共卫生挑战,可以通过均衡、营养丰富的饮食来预防和管理。食品营养标签在指导更健康的选择方面发挥着重要作用,特别是对有慢性健康状况风险的个人而言。本研究评估了中国上海成年人对营养标签的认识、理解和使用情况,并探讨了其与非传染性疾病的关系。方法:于2024年对1503名成人进行面对面结构化问卷调查。收集有关社会人口统计学特征、自我报告的慢性疾病(肥胖、糖尿病、高血压、高脂血症、高胆固醇血症、心脑血管疾病(ccvd)和脂肪肝疾病)以及对营养标签的认识、理解和使用的数据。应用广义线性回归模型评估标签相关行为与慢性疾病之间的关联。结果:总体而言,81.6%的参与者知道标签,15.0%的受访者表示理解标签,35.5%的受访者表示使用标签。与正常体重的参与者相比,体重过轻或肥胖的参与者不太可能意识到标签(73.8%和72.9% vs. 83.5%)。与没有脂肪肝的人相比,脂肪肝患者理解标签的可能性更低(7.2%对16.1%)。相反,患有三种或更多慢性疾病的参与者比没有任何慢性疾病的参与者更有可能使用标签(46.1%对34.4%)。结论:上海市成年人对营养标签的认知度较高,但对营养标签的理解和使用仍然不足。需要有针对性的营养教育和将营养标签纳入慢性病管理战略,以改善公共卫生结果。
{"title":"Awareness, Understanding, and Use of Nutrition Labels on Pre-Packaged Foods and Their Associations with Noncommunicable Diseases Among Adults in Shanghai, China.","authors":"Wei Zhou, Jingyi Si, Yifan Gao, Weiwei Zheng, Ruifen Li, Changfeng Zhu, Xue Han, Jiajie Zang, Zhengyuan Wang","doi":"10.3390/nu18050854","DOIUrl":"10.3390/nu18050854","url":null,"abstract":"<p><p><b>Background</b>: Noncommunicable diseases (NCDs) are a major global public health challenge and can be prevented and managed through a balanced, nutrient-rich diet. Food nutrition labels play an important role in guiding healthier choices, particularly for individuals at risk of chronic health conditions. This study assessed awareness, understanding and use of nutrition labels among adults in Shanghai, China, and explored their associations with NCDs. <b>Methods</b>: A face-to-face structured questionnaire survey was conducted among 1503 adults in 2024. Data were collected on sociodemographic characteristics, self-reported chronic conditions (obesity, diabetes, hypertension, hyperlipidemia, hypercholesterolemia, cardiovascular and cerebrovascular diseases (CCVDs), and fatty liver disease), and awareness, understanding, and use of nutrition labels. Generalized linear regression models were applied to assess associations between label-related behaviors and chronic conditions. <b>Results</b>: Overall, 81.6% of participants were aware of labels, 15.0% reported understanding them, and 35.5% reported using them. Participants who were underweight or obese were less likely to be aware of labels compared to those with normal weight (73.8% and 72.9% vs. 83.5%). Individuals with fatty liver disease were less likely to understand labels compared to those without the condition (7.2% vs. 16.1%). Conversely, participants with three or more chronic conditions were more likely to use labels than those without any chronic conditions (46.1% vs. 34.4%). <b>Conclusions</b>: Among adults in Shanghai, nutrition label awareness was relatively high, while understanding and use of labels remained insufficient. Targeted nutrition education and the integration of nutrition labeling into chronic disease management strategies are needed to improve public health outcomes.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 5","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12987300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/objectives: Comprehensive management of lifestyle factors is important for long-term survival. This study aims to examine whether a comprehensive healthy lifestyle score (HLS) incorporating overall diet assessment predicts all-cause, cancer, and cardiovascular mortality in Korean population.
Methods: This prospective cohort study was conducted among men and women (n = 111,633, 64.6% women) aged 40 to 85 years who participated in the Korean Genome and Epidemiology Study_Health Examinees (Mean age = 55.2, SD = 8.8). Participants completed a baseline questionnaire between 2004 and 2013 and were followed until December 2023. The HLS consisted of five components classified as healthy behaviors: never or former smoking; engaging in ≥30 min/day of moderate-to-vigorous physical activity on ≥5 days/week; alcohol intake ≤40 g/day for men and ≤20 g/day for women; a BMI of 18.5-24.9 kg/m2; and an unhealthful plant-based diet index (uPDI) in the bottom 40th percentile, which reflects overall diet quality and aligns with the traditional plant-rich dietary pattern of Koreans. Diet was assessed using data from baseline and the first follow-up, while the remaining components were measured at baseline only. Cox proportional hazards models were applied to evaluate multivariable-adjusted associations between the HLS and all-cause, cancer, and cardiovascular mortality.
Results: During 1,538,490 person-years of follow-up, 5246 all-cause deaths, 2362 cancer deaths, and 815 cardiovascular deaths were documented. Compared with the lowest HLS category, men with the highest HLS had lower risks of all-cause (HR: 0.65, 95% CI: 0.53-0.80), cancer (HR: 0.62, 95% CI: 0.46-0.85), and cardiovascular mortality (HR: 0.34, 95% CI: 0.17-0.66). Among women, the corresponding HRs were 0.38 (95% CI: 0.26-0.55), 0.52 (95% CI: 0.29-0.90), and 0.30 (95% CI: 0.11-0.84), respectively. The inverse association was stronger in older adults (≥55 years) than in younger adults. All five individual lifestyle components, including diet (quintile 5 vs. quintile 1 of uPDI: HR 0.74, 95% CI: 0.66-0.83 in men; HR 0.67, 95% CI: 0.58-0.76 in women), were significantly associated with a lower risk of all-cause mortality. However, when smoking was excluded from the HLS, the inverse association was attenuated, particularly among men.
Conclusions: Greater adherence to a healthy lifestyle score was strongly associated with reduced risks of all-cause, cancer, and cardiovascular mortality. These findings underscore the importance of promoting integrated, multi-behavior lifestyle interventions, especially smoking cessation, to reduce premature mortality.
{"title":"Association of a Comprehensive Healthy Lifestyle Score with Risk of All-Cause, Cancer, and Cardiovascular Mortality: Evidence from an 18-Year Cohort Study.","authors":"Dongmin Kim, Daeyun Kim, Hyunju Kim, Jihye Kim","doi":"10.3390/nu18050856","DOIUrl":"10.3390/nu18050856","url":null,"abstract":"<p><strong>Background/objectives: </strong>Comprehensive management of lifestyle factors is important for long-term survival. This study aims to examine whether a comprehensive healthy lifestyle score (HLS) incorporating overall diet assessment predicts all-cause, cancer, and cardiovascular mortality in Korean population.</p><p><strong>Methods: </strong>This prospective cohort study was conducted among men and women (n = 111,633, 64.6% women) aged 40 to 85 years who participated in the Korean Genome and Epidemiology Study_Health Examinees (Mean age = 55.2, SD = 8.8). Participants completed a baseline questionnaire between 2004 and 2013 and were followed until December 2023. The HLS consisted of five components classified as healthy behaviors: never or former smoking; engaging in ≥30 min/day of moderate-to-vigorous physical activity on ≥5 days/week; alcohol intake ≤40 g/day for men and ≤20 g/day for women; a BMI of 18.5-24.9 kg/m<sup>2</sup>; and an unhealthful plant-based diet index (uPDI) in the bottom 40th percentile, which reflects overall diet quality and aligns with the traditional plant-rich dietary pattern of Koreans. Diet was assessed using data from baseline and the first follow-up, while the remaining components were measured at baseline only. Cox proportional hazards models were applied to evaluate multivariable-adjusted associations between the HLS and all-cause, cancer, and cardiovascular mortality.</p><p><strong>Results: </strong>During 1,538,490 person-years of follow-up, 5246 all-cause deaths, 2362 cancer deaths, and 815 cardiovascular deaths were documented. Compared with the lowest HLS category, men with the highest HLS had lower risks of all-cause (HR: 0.65, 95% CI: 0.53-0.80), cancer (HR: 0.62, 95% CI: 0.46-0.85), and cardiovascular mortality (HR: 0.34, 95% CI: 0.17-0.66). Among women, the corresponding HRs were 0.38 (95% CI: 0.26-0.55), 0.52 (95% CI: 0.29-0.90), and 0.30 (95% CI: 0.11-0.84), respectively. The inverse association was stronger in older adults (≥55 years) than in younger adults. All five individual lifestyle components, including diet (quintile 5 vs. quintile 1 of uPDI: HR 0.74, 95% CI: 0.66-0.83 in men; HR 0.67, 95% CI: 0.58-0.76 in women), were significantly associated with a lower risk of all-cause mortality. However, when smoking was excluded from the HLS, the inverse association was attenuated, particularly among men.</p><p><strong>Conclusions: </strong>Greater adherence to a healthy lifestyle score was strongly associated with reduced risks of all-cause, cancer, and cardiovascular mortality. These findings underscore the importance of promoting integrated, multi-behavior lifestyle interventions, especially smoking cessation, to reduce premature mortality.</p>","PeriodicalId":19486,"journal":{"name":"Nutrients","volume":"18 5","pages":""},"PeriodicalIF":5.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12986665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}