Journal of the American Nutrition Association最新文献

Objective: This study sought to clarify the relationship between triglyceride-glucose (TyG)-related obesity indices and all-cause and cardiovascular mortality in patients with hyperuricemia (HUA).

Method: A total of 4207 patients with HUA from the National Health and Nutrition Examination Survey (NHANES) database were included in this study. Various methods were employed, including weighted multivariate-adjusted Cox regression models, Kaplan-Meier curves, restricted cubic spline, and receiver operating curves.

Results: A nonlinear relationship was identified between TyG-related obesity indices and all-cause mortality, while a linear positive relationship was observed for cardiovascular mortality. Among the indices, TyG-ABSI (a body shape index) demonstrated the strongest predictive ability, with areas under the curve for all-cause mortality at 3, 5, and 10 years being 0.638, 0.632, and 0.650, respectively, and for cardiovascular mortality at 3, 5, and 10 years being 0.699, 0.673, and 0.671, respectively. Threshold analysis revealed the potential inflection point (k) of the nonlinear relationship. Subgroup analyses indicated interactions with age, diabetes, or cardiovascular disease. Additionally, serum uric acid was found to partially mediate the association between TyG-derived indices and follow-up time. The results of the sensitivity analysis were consistent with those of the original analysis.

Conclusions: TyG-ABSI, which exhibited the best predictive ability, may serve as a valuable biomarker for the long-term follow-up of individuals with HUA.

Objective: Selenium, an essential mineral with antioxidant properties, can potentially prevent atherosclerosis and maintain cardiovascular health. However, the association between selenium and ischemic heart disease (IHD) remains unclear. This study aimed to determine the impact of selenium on global IHD incidence (IHDi) and mortality (IHDd) over a 28-year period from 1990 to 2018, using open data for global comparisons.

Method: IHDi and IHDd per 100,000 people were obtained from the Global Burden of Disease Study (GBD) 2019 database and estimated selenium intake from the Global Dietary Database. Covariates were obtained from the World Bank and GBD databases. The associations of selenium intake with IHDi and IHDd in the 28 years from 1990 onward were analyzed for 149 countries with populations >1 million, using a Bayesian generalized additive mixed model, controlling for covariates.

Results: A nonlinear relationship existed between selenium intake and IHDi and IHDd. The selenium intake levels with the lowest risk for IHDi and IHDd were 93.3 and 78.5 µg/d, respectively. The risk ratios (RRs) for IHDi were 2.30 (95% CI, 1.82-2.84) and 1.40 (95% CI, 1.13-1.73) for selenium intakes of 10.0 µg/d and 200.0 µg/d, respectively. For IHDd, the RRs were 3.40 (95% CI, 2.62-4.40) for intakes of 10.0 µg/d and 1.72 (95% CI, 1.31-2.20) for 200.0 µg/d. The risk was higher for selenium underintake than for overintake.

Conclusions: This study revealed a nonlinear relationship between selenium intake and IHDi and IHDd, aiding in establishing a selenium target intake for the primary prevention of IHD and addressing public health problems.

Background: As the global population ages, extending not only the life expectancy (LE) but also the healthy life expectancy (HALE) has become a critical public health objective. Dietary choices, especially the intake of various fatty acids, may play a role in achieving good health.

Objective: The aim of this study was to describe the intake of fatty acid (FA) fractions across different countries and explore its associations with HALE and LE from 2010 to 2019 according to publicly available international data.

Methods: Data on FA intake in 2010 were obtained from the Global Dietary Database. HALE and LE data were sourced from the Global Burden of Disease Study 2019. A total of 151 countries with populations exceeding 1 million people were included in the analysis. Associations of the intake of each FA with HALE and LE were assessed using linear mixed models adjusted for various covariates.

Results: High national omega-3 fatty acid (n-3 PUFA) intake was positively associated with both HALE (β: 2.63, SE: 0.73, p < 0.001) and LE (β: 2.32, SE: 0.63, p < 0.001). These associations remained unchanged when n-3 PUFAs were separated into plant-derived and seafood-derived n-3 PUFAs. No significant associations were observed for the other FAs.

Conclusion: Higher intake of n-3 PUFAs is positively associated with longer HALE and LE at the national level. These findings underscore the importance of dietary fat composition in promoting healthy aging. Further research is needed to develop public health strategies adapted to each country.

Background: Consumption of mangos has been associated with improved diet quality, with reported reductions in systolic blood pressure and inflammatory biomarkers when consumed daily in robust amounts for six to eight weeks. Whether these changes could occur with a shorter intake period is unknown.

Methods: This study explored the effect of two weeks of mango intake (330 g/d) on microvascular function and cardiometabolic markers in a group of relatively healthy postmenopausal women with an overweight or obese body mass index. Outcomes were compared to two weeks of baseline measures without mango intake.

Results: The primary outcome measure, microvascular function did not significantly change, while supine systolic blood pressure, mean arterial pressure, mean pulse pressure, and fasting cholesterol were significantly reduced. No significant changes in platelet aggregation or adhesion markers were noted. To explore the results further, a small probe study was conducted comparing the intake of mango to a calorically-equivalent amount of white bread. Blood glucose rose in both groups one hour after consumption, but significantly less after mango intake. Insulin levels also rose one hour after intake of both foods, but remained elevated in response to white bread, suggesting a moderating effect of mangos on glucose absorption and metabolism.

Conclusions: Further research using amounts of mango typically consumed, over an extended period of time, are warranted.

Objective: The confluence of cardiovascular-kidney-metabolic (CKM) risk factors and chronic kidney disease (CKD) elevates the risk for adverse cardiovascular and kidney outcomes. Mounting evidence has emerged on the benefits of plant-based diets for CKD management. However, whether the benefits are mediated by improved CKM health are unclear. In addition, there remain concerns about the risk of malnutrition and hyperkalemia associated with plant-based diets. The objective of this study was to assess the relationship between adherence to healthy plant-based diets and CKM syndrome, nutritional status, and serum potassium levels in patients with nondialysis CKD stages 3-5.

Method: A total of 147 patients (median age 66 years) with CKD (median eGFR 23.1 mL/min/1.73 m²) were included. Responses to a food frequency questionnaire developed for the Asian population with CKD were used to calculate a healthy plant-based diet score (HPDS), which reflects higher consumption of plant foods and reduced intake of animal products and sugar. CKM risk factors included overweight/obesity, central obesity, high blood pressure, high triglycerides, and high blood glucose. Nutritional status was assessed using serum albumin and dietary energy and protein intake.

Results: In logistic regression analyses, a higher HPDS was significantly associated with lower odds of all CKM risk factors and malnutrition. After adjusting for age, sex, comorbidities, lifestyle factors, and medications, a higher HPDS remained significantly linked to lower odds of overweight/obesity and central obesity, as well as higher odds of having a normal serum albumin level (≥ 3.8 g/dL), dietary protein intake (≥ 0.6 g/kg/day), and dietary energy intake (≥ 25 g/kg/day). No significant association was observed between HPDS and hyperkalemia.

Conclusions: In patients with moderate to advanced CKD, healthy plant-based diets were associated with a lower risk of CKM syndrome. Adherence to a healthy plant-based diet was more likely to achieve a better nutritional status and was not associated with risk of hyperkalemia.

Objective: To determine whether tea consumption is associated with risk of type 2 diabetes (T2D), to elucidate potential effect modification by genetic susceptibility, and to examine metabolic biomarkers as potential mediators for the association.

Methods: We conducted a cohort analysis of 382,946 participants in the UK Biobank. Multivariable-adjusted age-stratified Cox proportional hazards regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between tea consumption and T2D risk.

Results: During a median follow-up of 14.0 years, 16,100 incident cases of T2D were documented. Greater tea consumption was associated with a modestly reduced risk of T2D. Compared with no tea consumption, the HR (95% CI) of T2D was 0.93 (0.89, 0.98), 0.86 (95% CI: 0.81, 0.90) and 0.87 (95% CI: 0.82, 0.92) for tea consumption of 2 to 3, 4 to 5, or 6+ cups per day, respectively (P for trend < 0.0001). The observed inverse association between tea consumption and T2D risk was generally consistent across cohort subgroups, including groups with different genetic susceptibility to T2D (P for interaction = 0.64). Mediation analyses estimated that 49.7% (95% CI: 37.1%, 62.4%), 11.2% (95% CI: 4.2%, 26.3%), 3.6% (95% CI: 1.5%, 8.5%), 5.3% (95% CI: 2.6%, 10.4%), and 2.8% (95% CI: 0.8%, 9.6%) of the inverse tea association may be effected through BMI, waist-hip ratio, non-high-density lipoprotein cholesterol, blood pressure, and C-reactive protein, respectively. On the other hand, consumption of artificially sweetened tea was positively related to risk of T2D.

Conclusions: Greater tea consumption was associated with decreased risk of T2D, independent of other risk factors and genetic predisposition. In contrast, consumption of artificially sweetened tea was positively associated with risk of T2D. Our findings provide evidence relevant to the primary prevention of T2D, supporting the potential of tea consumption as a component of a healthy diet.

Objective: This study aimed to estimate the dietary total antioxidant capacity (DTAC) of Brazilian adults and elderly and to identify the foods that contributed the most to antioxidant intake and their degree of processing.

Methods: Data were collected from the National Dietary Survey of the 2017-2018 Household Budget Survey. DTAC was estimated using a database based on the Ferric-Reducing Ability Power (FRAP) assay, evaluating 1,335 food items consumed by Brazilians, and the degree of processing was identified according to the NOVA Classification.

Results: The estimated average DTAC/1000Kcal was 4.27 mmol, and women (4.36mmol), elderly individuals (4.65mmol), black, mixed-race, and indigenous individuals (4.15mmol), residents in rural areas (4.61mmol), and those living in the South region (4.98mmol) had significantly higher DTAC when compared to other groups. DTAC decreased with the increase in income and education levels. Non-alcoholic beverages accounted for 58.84% of DTAC, followed by legumes (16.38%) and fruits (8.17%). Regarding the degree of processing, in natura and minimally processed foods contributed 92% of DTAC (3.93mmol), while ultra-processed foods accounted for 5.5% (0.235mmol).

Conclusions: The findings of this study reinforce the importance of consuming in natura and minimally processed foods, in the line with the Dietary Guidelines for the Brazilian Population, particularly with respect to antioxidant intake.

Objective: To investigate the effects of an 8-week supplementation with varying doses of creatine hydrochloride, administered alone or in combination with creatine ethyl ester, on cognitive function, clinical outcomes, brain creatine concentrations, and biochemical markers in perimenopausal and postmenopausal women. This study specifically aimed to evaluate the potential of low-dose creatine formulations with enhanced solubility as a targeted intervention for menopause-related neurocognitive and metabolic changes.

Methods: A total of 36 apparently healthy perimenopausal and menopausal women (mean age 50.1 ± 5.7 years) were randomly allocated to one of four groups: low-dose creatine hydrochloride (750 mg/day), medium-dose creatine hydrochloride (1,500 mg/day), creatine hydrochloride plus creatine ethyl ester (800 mg/day), or placebo, in this randomized controlled double-blind trial. Menopausal women were defined as having no menstrual cycle for 12 consecutive months without other causes, while perimenopausal women were still menstruating but reported at least one symptom such as hot flashes, sleep disturbances, mood swings, or concentration difficulties.

Results: Supplementation with medium-dose creatine hydrochloride was found to be superior to placebo in enhancing reaction time (1.2 vs. 6.6%; p < 0.01), increasing frontal brain creatine levels (0.9 vs. 16.4%; p < 0.01), and favorably modulating serum lipid profiles (p < 0.05). Moreover, medium-dose creatine hydrochloride demonstrated a potential advantage over other treatments in reducing the severity of mood swings (p = 0.06). All interventions were well tolerated, with no severe adverse effects reported.

Conclusion: Our findings suggest that this supplementation protocol may be a promising, safe, effective, and practical dietary strategy for improving clinical outcomes and elevating brain creatine concentrations in perimenopausal and menopausal women. The trial was registered at ClinicalTrials.gov (NCT06660004).

Factors like health concerns, environmental issues, and ethics have driven the rapid rise in veganism's popularity over the last decade. While studies confirm that veganism reduces the risk of chronic diseases, such as diabetes, obesity, and heart disease, significant challenges persist in meeting nutritional needs. This review identifies critical dietary deficiencies common in vegan diets, including inadequacies in vitamin B12, iron, calcium, vitamin D, Iodine, zinc, and omega-3 fatty acids, and explores strategies to mitigate these risks. These deficiencies result in chronic diseases like anemia, osteoporosis, and neurological disorders. Hence, this review observes the clinical literature to establish causes and will discuss a supplement strategy to enhance these deficiencies. Economic accessibility to fortified foods and supplements poses additional challenges, particularly for low-income individuals or regions with limited access to vegan-friendly products. Addressing these barriers is essential to make vegan diets viable for all. Many of these nutrients, predominantly found in animal products, are difficult to obtain in sufficient amounts through plant-based diets alone, leading to potential health risks like anemia, osteoporosis, and neurological disorders. This study evaluates clinical literature to pinpoint the causes of these deficiencies and examines effective supplementation strategies to address them. Beyond highlighting the challenges, it discusses the environmental benefits of veganism, showing how plant-based diets significantly reduce water usage, land pressure, and greenhouse gas emissions. The study concludes that while a poorly planned vegan diet can lead to nutritional inadequacies, with proper dietary planning and personalized supplementation, vegan diets can support long-term health and promote environmental sustainability. Recommendations from experts are also included for tailoring vegan diets to meet individual health needs effectively.

Objective: Low Glycemic Index (GI) diets improve cardiometabolic risk (CMR) specifically in those with insulin resistance. However, the prospective association between pasta (a low GI staple) consumption and CMR is unclear. We evaluated the longitudinal association of pasta consumption with CMR (after 2 y: body weight, body mass index (BMI), waist circumference (WC), blood pressure (BP); after 1 y: fasting blood glucose, HbA1c, HDL-cholesterol and triglycerides) in ∼6000 older adults (50% women) at high CMR.

Methods: Consumption of pasta and other staples were determined as the cumulative average of reported intakes at baseline and annual follow-up visits from food frequency questionnaires and defined as energy-adjusted (residuals) and the number of daily servings. Longitudinal association between pasta consumption and CMR was assessed in PREDIMED-Plus participants (Trail registry number: ISRCTN89898870).

Results: Mean (SD) dry pasta intake was 9(7) g/d at Year 1 and 8(6) g/d at Year 2. In linear regression models, higher pasta intake was associated with greater 2 y decreases in body weight, BMI and WC. When fully adjusted, every additional serving of pasta was associated with significantly greater 2 y decreases in body weight (-2.23(-3.47, -0.98 kg), BMI (-0.86(-1.27, -0.34 kg/m²) and WC (-1.92 (-3.46, -0.38 cm). There was no evidence of association with other outcomes. Additionally, substituting equivalent servings of pasta for white bread or white rice or potato was significantly associated with greater 2 y decreases in body weight and BMI. Replacing white bread with pasta was associated with higher 2 y reductions in WC. Replacing potato with pasta was associated with improvements in diastolic BP and HDL-cholesterol. Conclusions: Equivalent serving substitutions of white bread/white rice/potato with pasta may help reduce CMR in older Mediterranean adults with overweight/obesity. While such substitutions are feasible where pasta consumption aligns with the local gastronomic culture, the feasibility and potential CMR benefit of such interventions should be confirmed in other populations.