Journal of the American Nutrition Association最新文献

We systematically evaluated effects of Mediterranean diets (MED) on cardiovascular (CV) disease and risk factors in overweight or obese adults. Five engines and two registries were searched until October 2023 for randomized controlled trials (RCTs) evaluating any type of MED compared to other diets or advice in adults. Outcomes of interest were clinical outcomes and CV risk factors (anthropometric, lipids, blood pressure, glucose metabolism, liver function). Inverse variance random effects models were used for meta-analyses; effects of MED were described as mean differences (MDs) and their 95% confidence intervals (CIs). Quality of evidence (QoE) per outcome was evaluated using GRADE methodology. Twenty-six RCTs (n = 10,352) were included. Four RCTs evaluated only obese patients and 22 evaluated overweight and obese patients. Clinical outcomes were only described in the revised 2018 PREDIMED trial where MED was associated with 35% lower risk of myocardial infarction, stroke, or CV death vs advice (hazard ratio, 0.65; 95% CI, 0.50-0.85). MED significantly reduced the values of body mass index (MD, -0.61 kg/m²; 95% CI, -1.14 to -0.09; 17 RCTs), waist circumference (MD, -2.48 cm; 95% CI, -3.99 to -0.96; 17 RCTs), triglycerides (MD, -7.93 mg/dL; 95% CI, -13.48 to -2.39; 19 RCTs), and fatty liver index (MD, -12.26; 95% CI, -23.96 to -0.56; 3 RCTs) compared with controls. MED did not significantly change any other CV risk factors. QoE was very low for most of the outcomes; 85% of RCTs had some concerns or high risk of bias. In overweight or obese adults, MED significantly decreased body mass index, waist circumference, triglycerides, and fatty liver index score but no other CV risk factors when compared with other diets or advice. There was paucity of data on effects of MED on clinical outcomes.

Breast cancer (BC) is one of the leading causes of death and morbidity among women worldwide. Epidemiologic evidence shows that the risk of BC and other chronic diseases decreases as the proportion of whole plant foods increases, while the proportion of animal foods (fish, meat, poultry, eggs, seafood, and dairy products) and non-whole plant foods (e.g., refined grains, added sugars, French fries) in the diet decreases. Whole plant foods include fruits, vegetables, roots, tubers, whole grains, legumes, nuts, and seeds from which no edible part has been removed and to which no non-whole food been added. A whole plant foods diet lowers insulin resistance, inflammation, excess body fat, cholesterol, and insulin-like growth factor 1 and sex hormone bioavailability; it also increases estrogen excretion, induces favorable changes in the gut microbiota, and may also favorably affect mammary microbiota composition and decrease the risk of early menarche, all contributing to reduced BC incidence, recurrence, and mortality. This review explores the connection between a whole plant foods diet and BC risk and mortality as well as the potential mechanisms involved. Additionally, this diet is compared with other dietary approaches recommended for BC. A whole plant foods diet seems the optimal dietary pattern for BC and overall disease prevention as it exclusively consists of whole plant foods which, based on existing evidence, lead to the best health outcomes.

A high-fat meal can cause postprandial hyperlipemia, initiating an acute inflammatory response. New structured lipids (SLs) free from trans and palm fatty acids are emerging as food structurants.

Objective: We evaluated the postprandial response and inflammatory profiles in Swiss mice after oral administration of SLs in high-fat meals.

Methods: SLs with different contents of long-chain saturated fatty acids were synthesized through an interesterification process involving soybean, peanut oils and crambe hard fat.

Results: SLs containing 23.79% (SL1), 32.01% (SL2), and 43.87% (SL3) of total saturated fatty acids reduced the absorption of serum triglycerides and appeared to mitigate postprandial inflammation by interleukin-6. A faster gastric emptying rate after consuming SL3 was corroborated by the fecal presence of behenic acid.

Conclusions: Our results suggest that SLs, free from palm and trans fats, may have the potential to mitigate inflammation, reduce the postprandial response, and lower absorption upon acute consumption.

Objective: Obesity has become one of the major public health issues and is associated with various comorbidities, including type 2 diabetes mellitus, dyslipidemia, and hypertension. Lychee seeds are considered promising ingredients for developing functional foods owing to their nutraceutical properties and phytochemical composition. This study aimed to induce obesity in zebrafish (Danio rerio) through a hyperlipidic diet supplemented with different concentrations of lychee seed flour and to evaluate its effects on adipose tissue, biochemical parameters, oxidative stress, and caudal fin regeneration.

Methods: A total of 200 adult zebrafish were u anded and divided into five experimental groups: control, hyperlipidic diet (HFD), and HFD supplemented with 2%, 4%, and 6% lychee seed flour. After 12 wk of feeding, biochemical parameters (glycemia, triglycerides, total cholesterol, high-density lipoprotein-HDL, aspartate aminotransferase-AST, alanine aminotransferase-ALT, and cortisol) and oxidative stress biomarkers, such as Catalase (CAT), Superoxide Dismutase (SOD), Glutathione-S-Transferase (GST), Glutathione (GSH), and Reactive Oxygen Species (ROS), were evaluated.

Results: The results showed that the HFD4% group exhibited a significant reduction in the diameter of visceral adipocytes compared with the control, HFD, and HFD2% groups. There was a higher prevalence of severe steatosis in the control and HFD groups and mild steatosis in the HFD6% group. The HFD4% and HFD6% groups had the lowest glycemic levels, whereas the HFD6% group had the highest HDL levels. Supplementation with lychee seed flour also positively modulated oxidative stress biomarkers, with increased CAT and GST activity in the HFD6% group and reduced ROS in the HFD4% and HFD6% groups compared with the HFD group.

Conclusion: It was concluded that adding 4 to 6% lychee seed flour may have beneficial effects on biochemical parameters and oxidative stress markers in HFD-fed zebrafish. The results indicate that lychee seed flour shows promise for use in foods and supplements targeting obesity prevention and management.

Objective: The potential adverse effects of dietary creatine on kidney health are rarely addressed at the population level, particularly in individuals with preexisting kidney disease. This study aimed to evaluate the association between dietary creatine intake and serum cystatin C levels in participants with and without kidney failure, utilizing data from the 1999-2001 National Health and Nutrition Examination Survey (NHANES) round.

Method: A total of 4969 individuals (50.0% female; mean age 51.2 ± 23.9 years) who provided information on dietary creatine intake and had serum cystatin C levels measured were included in the final analysis.

Results: Linear regression across the entire sample revealed a significant inverse association between daily creatine intake and cystatin C concentrations (unstandardized B = -0.003; ß = -0.067; p < 0.001), indicating that for each additional milligram of creatine intake, the expected reduction in cystatin C levels was 0.003 mg/dL. In a subsample of respondents with kidney dysfunction, a significant negative association was found between creatine intake and cystatin C levels (unstandardized B = -0.024; ß = -0.165; p = 0.046).

Conclusions: Findings suggest that food-derived creatine does not pose a risk of kidney stress, even for individuals with kidney failure, and might be considered a renoprotective nutrient.

Background: Common gastrointestinal (GI) symptoms such as abdominal pain, indigestion, and constipation affect a significant portion of the global population and can substantially impair quality of life. Despite these widespread issues, research specifically investigating the effects of walnuts on gut function and GI symptoms remain limited.

Objective: This study investigates the effects of walnuts on gastrointestinal symptoms in healthy adults.

Design: An experimental baseline-end study with an equivalent group design was employed.

Setting: The experimental group consumed 42 grams of walnuts daily, and their gastrointestinal symptoms were compared with those of a control group that did not consume walnuts over a 3-week period.

Participants: Sixty university students were recruited as volunteer subjects, consisting of 30 males and 30 females.

Intervention(s): Participants were randomly assigned to either an experimental group or a control group.

Main outcome measure(s): The independent variable was walnut consumption, and the dependent variable was gastrointestinal health, assessed using the Gastrointestinal Symptom Rating Scale (GSRS) and a qualitative questionnaire to collect participants' perceived changes in GI symptoms.

Analysis: A t-test with a p-value of less than 0.05 and verbatim analysis were utilized.

Results: This mixed-methods study provides evidence for the beneficial effects of walnuts in promoting normal digestive function.

Conclusions and implications: The study provides alternative evidence for the beneficial effects of walnuts in promoting normal digestive function.

Objective: We explored potential relationships between dietary live microbe intake and chronic diarrhea (CD) and fecal incontinence (FI).

Methods: We conducted a cross-sectional retrospective study based on the National Health and Nutrition Examination Survey (NHANES) database. Participants were categorized into three groups according to the Sanders classification system (low, medium, and high dietary live microbe groups). CD and FI were defined using a bowel health questionnaire. Logistic regression and restricted cubic spline (RCS) analyses were performed on weighted data to explore potential relationships.

Results: In univariate logistic regression analyses, participants in the high dietary live microbe group exhibited a lower CD prevalence when compared to those in the low group (odds ratio (OR) = 0.58, 95% confidence interval (CI): 0.43-0.79). After adjusting for covariates, model 2 (OR = 0.69 95% CI: 0.49-0.96) and model 3 (OR = 0.66 95% CI: 0.45-0.96) data were consistent with model 1 data. No significant association was identified between dietary live microbe intake and FI. Withal, subgroup analyses revealed significant associations between high dietary live microbes and CD in males or participants without abdominal obesity, hypertension, diabetes, and sleep disorder (p < 0.05).

Conclusions: In this cross-sectional study, consuming foods rich in live microbes may exert positive effects on CD risk. This finding may facilitate new management strategies for CD.

Objective: Alcoholic hepatitis (AH) represents a severe manifestation of alcoholic liver disease (ALD) associated with a wide severity spectrum. ALD is linked to nutritional deficiencies, with the gravity of malnutrition escalating as alcohol abuse and ALD progress. This study aims to delve into the impact of malnutrition on the clinical trajectory of AH.

Methods: We identified adult patients admitted with AH using the National Readmission Database (NRD) 2016-2020. We further classified AH patients based on the severity of malnutrition. We compared the outcomes of AH hospitalizations using a multivariate regression model.

Results: We included 82,367 AH patients, of whom 15,693 (19.00%) had malnutrition. 4,243 (5.15%) patients exhibited mild to moderate malnutrition, 5,862 (7.07%) patients had severe malnutrition, and 5,588 (6.78%) patients had unspecified severity of malnutrition. We found that adjusted in-hospital mortality due to AH was higher in patients with malnutrition, corresponding to the severity of malnutrition (adjusted odds ratio [aOR] 1.62 and 3.14 in mild-moderate malnutrition and severe malnutrition, respectively; p < .01). Additionally, patients with malnutrition had progressively elevated odds of septic shock, vasopressor requirement, mechanical ventilation, and intensive care unit (ICU) admission with escalating intensity of malnutrition. Liver-related complications, such as spontaneous bacterial peritonitis, coagulopathy, hepatorenal syndrome, and hepatic encephalopathy, were also found to have an increased likelihood in the presence of malnutrition. Furthermore, resource utilization showed a progressive increase with increasing severity of malnutrition.

Conclusion: Our findings indicate that malnutrition is a common comorbidity in AH patients, with varying degrees of severity, which correlates with higher mortality rates, emphasizing the critical role of nutritional status in the prognosis of AH. These findings underscore the importance of addressing and managing malnutrition in patients with AH, not only for its potential contribution to mortality but also because of its association with a spectrum of complications and increased healthcare resource utilization.

Objective: The EAT-Lancet Commission has proposed an EAT-Lancet diet (ELD), also known as a planetary health diet (PHD), which is environmentally sustainable and promotes human health. However, the association between this diet and the risk of hypertension remains unclear. This study aimed to determine whether adherence to ELD was associated with a lower risk of hypertension.

Methods: 11,402 adults without hypertension at baseline from the China Health and Nutrition Survey were included. The PHD score was used to evaluate ELD adherence, with higher scores reflecting better compliance. Cox proportional hazards regression analysis was utilized to estimate the hazard ratio (HR) with a 95% confidence interval (CI). Additionally, a subgroup analysis was performed to identify the possible effect modifiers, and a mediation analysis was conducted to explore the mediation effects of anthropometric measurements on the association between ELD and hypertension.

Results: A total of 3993 participants (35%) developed hypertension during 93,058 person-years of follow-up. In the covariate-adjusted model, hypertension risk was reduced in the highest quartile participants compared to the lowest quartile of the PHD score (adjusted HR: 0.79, 95%CI: 0.71-0.87; P-trend < 0.001), which remained significant after sensitivity analysis. Notably, the association was also observed in isolated systolic hypertension, isolated diastolic hypertension, and systolic-diastolic hypertension. Subgroup analysis revealed that the inverse association between the PHD score and hypertension risk was more pronounced in nonsmokers and high-sodium intake consumers than in smokers and low-sodium consumers (P-interaction < 0.05). Additionally, mediation analysis revealed that 23.3% of the association between the PHD score and hypertension risk was mediated by the waist-to-height ratio.

Conclusion: Our findings suggest that a higher adherence to ELD is associated with a lower risk of hypertension. These results emphasize that ELD may serve as a potential strategy to prevent hypertension.

Objective: This study aimed to examine the complex associations between Internet addiction, sleep disturbances, and disordered eating behaviors.

Methods: This cross-sectional study included 646 students from 17 high schools in Edirne, Türkiye between December 2023 and May 2024. A face-to-face questionnaire was administered to assess demographic characteristics, Internet addiction (YIAT), sleep quality (PSQI), and eating behavior (TFEQ-R21).

Results: In total, 644 students completed the study. The prevalence of Internet addiction among adolescents was 16.3%, with a similar prevalence among male and female adolescents. The prevalence of poor sleep quality among adolescents was 6.4%, and this trend was more pronounced in male adolescents, with an incidence of 13.0%. A weak positive correlation was observed between Internet addiction and disordered eating behavior. Additionally, a moderate positive correlation was observed between poor sleep quality and disordered eating behavior. Gender, maternal education level, Internet addiction, and poor sleep quality were significant predictors of eating disorders in adolescents.

Conclusion: The findings of our study are of significant value in providing insights into the development of programs designed to prevent undesired eating behaviors.