Journal of the American Nutrition Association最新文献

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.

Menatetrenone (MK-4), a potent form of vitamin K2, has gained significant attention for its diverse therapeutic potential, particularly in bone health, cardiovascular protection, and metabolic disorders. This manuscript explores the origins and chemical structure of menatetrenone, highlighting its synthesis from dietary sources and its enzymatic conversion in the body. The review examines the extensive therapeutic applications of MK-4, focusing on its role in treating osteoporosis, diabetes, and cardiovascular diseases, along with emerging evidence of its anticancer and neuroprotective effects. Furthermore, the manuscript discusses innovative delivery systems, such as nanostructured lipid carriers and other advanced formulations, designed to enhance the bioavailability and therapeutic efficacy of menatetrenone. By addressing the challenges associated with its pharmacokinetics and exploring novel drug delivery strategies, this review provides a comprehensive overview of menatetrenone's therapeutic promise and outlines future directions for its clinical use.

Objective: This study aims to: (i) describe the results of recruitment into the eFfEct of an Anti-inflammatory diet for knee oSTeoarthritis (FEAST) randomized controlled trial (RCT); (ii) report baseline characteristics of randomized participants and compare these with four large international cohorts; and (iii) explore cross-sectional associations between dietary inflammatory index (DII^®) scores and baseline clinical characteristics.

Methods: The FEAST RCT compares an anti-inflammatory dietary programme and standard care low-fat dietary programme for adults aged 45-85 years with knee osteoarthritis (OA). At baseline, participants provided medical history (medical comorbidities, symptomatic musculoskeletal sites), completed questionnaires (demographic characteristics, Knee injury and OA Outcome Score (KOOS)) and a 3-day food diary. Both DII^® and energy-adjusted DII (E-DII^TM) scores were calculated based on 3-day food diary data and was used to quantify the effect of diet on systemic inflammation. Associations between DII/E-DII and KOOS subscales, symptomatic musculoskeletal sites, and comorbidities was assessed using linear and negative binomial regression.

Results: 1121 individuals were screened to identify 182 eligible individuals, from which 144 participants (64% female, 36% male) enrolled, with a mean ± SD age 65 ± 8 years and body mass index 30.3 ± 6.2 kg/m². Overweight (41%) and obesity (45%) was common. Two-thirds (62%) had ≥1 medical comorbidity, most commonly hypertension (26%). Musculoskeletal pain in sites other than the index knee was reported in 79%, most commonly in the lower back (42%). Mean DII and E-DII scores were 0.58 ± 1.49 and -0.31 ± 1.41, respectively. No associations were found between DII/E-DII and KOOS subscales except for activities of daily living (ADL), number of medical comorbidities and symptomatic MSK sites, and BMI.

Conclusion: The FEAST cohort is comparable to other knee OA cohorts, supporting generalizability of the results. Despite a relatively pro-inflammatory diet at baseline, DII/E-DII was not associated with KOOS subscales, number of comorbidities or symptomatic musculoskeletal sites.

Objective: β-carotene, a vitamin A precursor is reported to inhibit molecular pathways cardinal to pathogenesis of fibrotic tissue alterations and in this study, the effectiveness of 14 days oral administration of β-carotene (10, 20, and 40 mg/kg/day) in the cardiac fibrosis (CF) in rats was studied and explored the mechanisms through network pharmacology.

Methods: CF was induced by isoproterenol (ISO) 6 mg/kg/SC from day 1 to day 7. Losartan (LOS) 10 mg/kg/day/p.o. served as the standard. Both β-carotene and LOS were administered from day 1 to 14. On the 15^th day, ECG and blood pressure (systolic, diastolic and mean) were recorded in the anesthetized rats followed by their euthanasia. The extent of cardiac fibrosis in the isolated hearts was determined using heart coefficient, tissue levels of hydroxyproline, histological examination. The oxidative stress in cardiac tissue was estimated, as GSH, SOD, catalase, MDA and NO. β-carotene targeted proteins pathway, process, and functional enrichment analysis were explored through network pharmacology.

Results: β-carotene dose-dependently mitigated the biochemical and histological changes induced by ISO in heart tissues. In ECG, it restored ST height, QT, and QRS intervals. Additionally, it normalized systolic, diastolic, and mean arterial pressures. The reduction in heart coefficient suggests β-carotene's potential to inhibit collagen deposition in heart tissue. β-carotene normalized oxidative stress markers, and hydroxyproline levels. All other biochemical parameters were restored to normal levels with β-carotene treatment. β-carotene 40 mg/kg dose showed comparable effect to that of LOS 10 mg/kg. β-carotene modulated IL-17, TNF, NF-kappa B, HIF-1, Sphingolipid, Relaxin, Adipocytokine, cAMP, Toll-like receptor, MAPK, PI3K-Akt, cGMP-PKG, VEGF, Ras, and PPAR signaling pathways.

Conclusions: β-carotene dose-dependently protects against ISO-induced CF in rats, with 40 mg/kg as an effective antifibrotic dose.

Background: Diabetes is closely related to hypertension, and insulin resistance-related indices are novel metrics used to evaluate the risk of diabetes and cardiovascular diseases. This study aims to explore the relationships between the TyG index, METS-IR, TG/HDL-C, and HOMA-IR with hypertension.

Methods: Data from the NHANES spanning ten consecutive survey cycles from 1998 to 2018 were utilized, focusing on adults with complete blood pressure data and comprehensive information for calculating the TyG index, METS-IR, TG/HDL-C, and HOMA-IR. A multivariable logistic regression model was employed to examine the relationship between insulin resistance indices and hypertension as well as blood pressure levels, while subgroup analyses were conducted to explore potential influencing factors. RCS curves were used to describe both linear and non-linear relationships.

Results: This NHANES-based study included 16,062 adults. Regardless of the adjustment for covariates, significant associations were found between the TyG index, METS-IR, TG/HDL-C, HOMA-IR and hypertension risk. The ROC curve demonstrated the stability of the TyG index, METS-IR, TG/HDL-C, and HOMA-IR in predicting hypertension risk. The RCS curves uncovered a linear relationship between the TyG index, METS-IR, and hypertension, whereas TG/HDL-C and HOMA-IR exhibited a non-linear association with hypertension. Subgroup analyses indicated that smoking and diabetes may influence the relationship between insulin resistance-related indices and hypertension.

Conclusion: Elevated levels of the insulin resistance indices TyG index, METS-IR, TG/HDL-C, and HOMA-IR are closely associated with hypertension risk. These indices can serve as effective markers for monitoring hypertension risk in clinical practice. However, larger-scale prospective cohort studies are needed to validate these findings and further explore the clinical application potential of the TyG index, METS-IR, TG/HDL-C, and HOMA-IR as tools for cardiovascular risk assessment. Such studies will help elucidate the specific causal relationships between these insulin resistance-related indices and hypertension and advance their practical application in clinical settings.

Objective: This study aimed to investigate the association between zinc deficiency (ZD) and the risks of all-cause mortality, major adverse cardiovascular events (MACEs), major adverse kidney events (MAKEs), and all-cause hospitalization in diabetic patients.

Methods: This retrospective cohort study utilized the TriNetX research network to identify adult patients with diabetes mellitus (DM) between January 1, 2010, and August 31, 2024. Propensity score matching was used to match patients with serum zinc levels below 70 µg/dL (ZD group) to those with serum zinc levels between 70 and 120 µg/dL (control group).

Results: Each group comprised 11,698 matched patients with balanced baseline characteristics. During the 1-year follow-up period, the ZD group exhibited significantly higher risks of all-cause mortality (hazard ratio [HR]: 1.788, 95% confidence interval [CI]: 1.591-2.009), MACEs (HR: 1.641, 95% CI: 1.278-2.105), and MAKEs (HR: 1.534, 95% CI: 1.293-1.821), as well as a higher risk of hospitalization (HR: 1.272, 95% CI: 1.216-1.330).

Conclusion: Zinc deficiency in diabetic patients is associated with increased risks of all-cause mortality, MACEs, MAKEs, and all-cause hospitalization. These findings underscore the importance of assessing zinc status in the clinical management of patients with DM.

Objective: Compared with other diseases with similar global burdens, little is known about how lifestyle factors other than smoking affect respiratory health, and few studies have systematically investigated the combined associations between diet and respiratory health. The aim of this research was to examine the Dietary Inflammation Index (DII), Healthy Eating Index (HEI)-2015, and individual food and nutrient associations with multiple respiratory outcomes.

Methods: This study combined a cross-sectional study with a prospective cohort study to systematically evaluate data from adults aged 40 years or older (N = 13,227) from 4 National Health and Nutrition Examination Survey cycles (2005-2006 through 2011-2012) with lung function measures in a subset (n = 6337). DII, HEI-2015, and individual foods and nutrients were evaluated for their associations with respiratory symptoms (cough, phlegm problem, wheezing, and exertional dyspnea), chronic lung disease (asthma, chronic bronchitis, and emphysema), lung function (percentage of predicted forced expiratory volume in 1 second [FEV1pp], percentage of predicted forced vital capacity [FVCpp], forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC), obstructive or restrictive spirometry patterns), respiratory cancer, all-cause mortality, and respiratory disease mortality.

Results: For each point increase in DII, the odds of cough (adjusted odds ratio [aOR], 1.036; 95% CI, 1.002-1.071), wheezing (aOR, 1.044; 95% CI, 1.013-1.075), exertional dyspnea (aOR, 1.042; 95% CI, 1.019-1.066), emphysema (aOR, 1.096; 95% CI, 1.030-1.166), and restrictive spirometry patterns (aOR, 1.066; 95% CI, 1.007-1.128) increased and FEV1pp (adjusted mean difference [aMD], -0.525%; 95% CI, -0.747% to -0.303%) and FVCpp (aMD, -0.566%; 95% CI, -0.762% to -0.371%) decreased. HEI-2015 scores were similarly associated with these respiratory outcomes. Each point increase in the DII was associated with an increased risk of all-cause mortality (adjusted hazard ratio [aHR], 1.048; 95% CI, 1.025-1.071) and respiratory disease mortality (aHR, 1.097; 95% CI, 1.013-1.189); each increase in the HEI-2015 score was associated with a decreased risk of all-cause mortality (aHR, 0.994; 95% CI, 0.991-0.997). The multiple adequacy components recommended in the HEI (fruits, vegetables, whole grains, seafood and plant proteins, and monounsaturated fatty acids) were associated with better respiratory outcomes; the moderation components of restricting refined grains, sugars, and saturated fats were associated with better respiratory outcomes, but restricting sodium intake was associated with increased respiratory symptoms.

Conclusions: The results of this study suggest that a low-inflammatory diet and a healthy diet are consistently associated with better respiratory outcomes. These findings support the potential benefits of a "Food Is M

Background and objectives: Patients with locally advanced head and neck squamous cell carcinoma (HNSCC) typically undergo surgery followed by postoperative radiotherapy/chemoradiotherpy. Nutritional issues often arise during treatment, potentially affecting outcomes. This study aimed to investigate whether early initiation of oral nutritional supplements (ONS) would prevent weight loss in HNSCC patients undergoing postoperative radiotherapy/chemoradiotherapy compared to conventional nutritional intervention.

Subjects and methods: Sixty-five surgically treated HNSCC patients were randomized to early nutritional intervention (ENI) or conventional nutritional intervention (CNI) groups. The ENI group started ONS two weeks before radiotherapy, while the CNI group initiated ONS based on dietitian's advice when dietary intake was insufficient. Primary endpoint was body weight change from baseline to two weeks post-radiotherapy. Secondary endpoints included nutritional status, body composition, adverse events, quality of life, and survival.

Results: Patients in the ENI group experienced less pronounced weight loss compared to those in the CNI group. Lower serum prealbumin levels were observed in the CNI group during radiotherapy, while no significant between-group differences existed in other nutritional parameters, QoL, or survival.

Conclusion: Early ONS intervention effectively prevented significant weight loss in HNSCC patients undergoing postoperative radiotherapy/chemoradiotherapy. Our findings strongly support prioritizing and integrating early nutritional support with ONS into routine care for this patient population, given its clear benefits in improving nutritional outcomes during treatment.

Clinical trial registration: www.ClinicalTrials.gov. NCT03545490.

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.

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.