American Journal of Clinical Nutrition最新文献

Background: Omega-3 long-chain-polyunsaturated fatty acids (LCPUFAs) are important dietary components for maternal and infant health during pregnancy and lactation.

Objectives: This study investigated determinants of maternal and infant LCPUFAs status at 3 mo postpartum and the relationship between maternal serum, maternal milk, and infant LCPUFAs.

Methods: This cross-sectional study included mothers (n = 1481) and their offspring (n = 526) at 3 mo postpartum from the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort. Maternal dietary intake (24-h recall), blood samples from mothers and infants, and maternal milk were collected. Fatty acid composition (relative % of total fatty acids) was determined by gas-liquid chromatography. Linear regression analyses explored associations between diet, sociodemographic factors, and fatty acid status.

Results: In a multivariable-adjusted analysis, maternal total dietary intake (supplement + food) was positively associated with the percentage of DHA (standardized ß [Sβ] = 0.158; ß = 0.394; 95% [confidence interval] CI: 0.192, 0.558; P < 0.001) in maternal serum phospholipids. Similar associations were found for DHA and eicosapentaenoic acid in maternal milk and plasma phospholipids of infants. Prepregnancy body mass index (BMI) was negatively associated with DHA (Sß = -0.073; ß = -0.003; 95% CI: -0.006, -0.001; P = 0.008) and positively associated with total saturated fatty acids (Sß = 0.086; ß = 0.111; 95% CI: 0.042, 0.180; P = 0.002) in maternal milk. Infants receiving formula combination with maternal milk had lower percentage of DHA (Sß = -0.177; ß = -0.390; 95% CI: -0.604, -0.175; P < 0.001) and arachidonic acid (Sß = -0.106; ß = -0.595; 95% CI: -1.122, -0.067; P = 0.027) in their plasma phospholipids compared with those who fed exclusively maternal milk.

Conclusions: Maternal total dietary intake and prepregnancy BMI are independently associated with their serum fatty acid status during lactation, whereas maternal diet, milk fatty acid composition, and lactation status are important determinants of infant n-3 LCPUFAs fatty acid status. Future research should investigate the impact of these differences in fatty acid status on infant health outcomes.

Background: The impact of direct and indirect drivers on linear growth and wasting in young children is of public health interest. Although the contributions of poverty, maternal education, empowerment, and birth weight to early childhood growth are well recognized, the contribution of environmental factors like heat, precipitation, agriculture outputs, and food security in comparable datasets is less well established.

Objectives: This study aims to investigate the association of length-for-age z-score (LAZ) and weight-for-length z-score (WLZ) with various indicators among children aged under 2 y in Pakistan using representative household-level nutrition surveys and ecological datasets.

Methods: Using geo-tagged metadata from Pakistan's 2011 and 2018 National Nutrition Surveys, anthropometric data from 29,887 children (9231 from 2011 and 20,656 from 2018) were analyzed. Dietary intake and food security data for 140 districts were linked to gridded data on temperature, precipitation and soil moisture, and district measures of agriculture production of edible crops. Multiple linear regressions assessed factors associated with LAZ and WLZ in index children.

Results: LAZ was positively associated with improved socioeconomic conditions (β = 0.06), food security (β = 0.10), birth size (β = 0.26), maternal age (β = 0.02), body mass index (β = 0.02), height (β = 0.02), and dietary score (β = 0.03). Negative associations with LAZ were found for increased temperature, precipitation, diarrhea, household crowding, and parity. Similar patterns were observed with WLZ for higher surface temperatures and precipitation was associated with declines in linear growth, alongside increased diarrhea prevalence and higher maternal parity.

Conclusions: Apart from recognized multifactorial drivers of stunting and wasting among children such as poverty, food insecurity, and maternal undernutrition, our analysis suggests the potential independent association with climatic factors such as heat and excess precipitation over time. These findings underscore the need for further research and the potential integration of climatic mitigation and adaptation with nutrition response strategies.

Background: An increasing body of evidence has linked fructose intake to colorectal cancer (CRC). African-American (AA) adults consume greater quantities of fructose and are more likely to develop right-side colon cancer than European American (EA) adults.

Objectives: We examined the hypothesis that fructose consumption leads to epigenomic and transcriptomic differences associated with CRC tumor biology.

Methods: Deoxyribonucleic acid methylation data from this cross-sectional study was obtained using the Illumina Infinium MethylationEPIC kit (GSE151732). Right and left colon differentially methylated regions (DMRs) were identified using DMRcate through analysis of Food Frequency Questionnaire data on fructose consumption in normal colon biopsies (n = 79) of AA adults undergoing screening colonoscopy. Secondary analysis of CRC tumors was carried out using data derived from The Cancer Genome Atlas Colon Adenocarcinoma, GSE101764, and GSE193535. Right colon organoids derived from AA (n = 5) and EA (n = 5) adults were exposed to 4.4 mM of fructose for 72 h. Differentially expressed genes (DEGs) were identified using DESeq2.

Results: We identified 4263 right colon fructose-associated DMRs [false-discovery rates (FDR) < 0.05]. In contrast, only 24 DMRs survived multiple testing corrections (FDR < 0.05) in matched, left colon. Almost 50% of right colon fructose-associated DMRs overlapped regions implicated in CRC in ≥1 of 3 data sets. Highly significant enrichment was also observed between genes corresponding to right colon fructose-associated DMRs and DEGs associated with fructose exposure in right colon organoids of AA individuals (P = 3.28E^-30). Overlapping and significant enrichments for fatty acid metabolism, glycolysis, and cell proliferation pathways were also found. Cross-referencing genes within these pathways to DEGs in CRC tumors reveal potential roles for ankyrin repeat domain containing protein 23 and phosphofructokinase, platelet in fructose-mediated CRC risk for AA individuals.

Conclusions: Our data support that dietary fructose exerts a greater CRC risk-related effect in the right than left colon among AA adults, alluding to its potential role in contributing to racial disparities in CRC.

Background: Diet affects the development of chronic diseases such as type 2 diabetes, but the underlying biological mechanisms are only partly understood.

Objectives: This study aimed to identify proteomic markers of the Alternative Healthy Eating Index (AHEI) and the Dietary Approaches to Stop Hypertension (DASH) diet and their association with type 2 diabetes risk.

Methods: We examined the associations between the AHEI and DASH diet quality scores and 1317 plasma proteins in African American participants of the Jackson Heart Study (JHS, n = 1878). These findings were validated in a Singapore Multi-Ethnic Cohort (n = 2395) and examined in relation to type 2 diabetes incidence (n = 539 cases). We adjusted for multiple testing by using false discovery rate-adjusted q values.

Results: We identified 13 proteins consistently associated with the AHEI or DASH scores with the strongest associations for the AHEI score and epidermal growth factor receptor (β:0.089; SE: 0.017; q < 0.001) and for the DASH score and tissue factor (β: -0.114; SE: 0.022; q < 0.001). Most of these proteins were related to inflammation, thrombosis, adipogenesis, and glucose metabolism. Concentrations of myeloperoxidase, epidermal growth factor receptor, hepatocyte growth factor receptor, coagulation factor Xa, contactin 4, kynureninase, neurogenic locus notch homolog protein 1, and vesicular integral-membrane protein VIP36 were associated with the risk of type 2 diabetes in the Asian cohort. The diabetes odds ratio for a 2-fold higher protein abundance concentration ranged from 0.03 (95% CI: 0.01, 0.08) for neurogenic locus notch homolog protein 1 to 3.04 (95% CI: 2.13, 4.33) for kynureninase. Furthermore, genetic markers for myeloperoxidase and hepatocyte growth factor receptor were significantly associated with diabetes risk.

Conclusions: Our study across geographically and ethnically diverse populations identified robust protein biomarkers for healthy dietary patterns. Furthermore, our findings suggest novel biological mechanisms linking dietary patterns with type 2 diabetes development.

Background: Diet has been hypothesized as a risk factor for the development of inflammatory bowel disease (IBD).

Objective: The objective of this study was to explore associations between maternal diet diversity and quality in pregnancy and the offspring's risk of IBD.

Methods: We used data from a nationwide cohort study on 85,129 Norwegian children followed from birth (1999-2009) with information on maternal diet in pregnancy from validated food frequency questionnaires. Hazard ratios (HRs) for IBD, Crohn disease (CD), and ulcerative colitis (UC) by maternal diet diversity, quality, and intake amounts of individual food groups were adjusted for maternal BMI, parental IBD, and sociodemographic factors. Sensitivity analyses were adjusted for the child's early-life diet quality and antibiotic treatment. Dietary exposures were classified into tertiles, comparing low (reference) with medium, and high levels.

Results: During a mean follow-up time of 16.1 y (1,367,837 person-years of follow-up), 268 children developed IBD (CD, n = 119; UC, n = 76; IBD-unclassified, n = 73). High compared with low diet diversity in pregnancy was associated with a lower risk of UC in the offspring [adjusted HR (aHR) 0.46, 95% confidence interval: 0.25, 0.87], with consistent findings after further adjustment for the child's early-life diet quality and antibiotic treatment. High compared with low diet diversity in pregnancy yielded aHRs of 0.81 for CD (0.51-1.28) and 0.75 for any IBD (0.55-1.02) in the offspring. A high compared with low diet quality in pregnancy or intakes of specific food groups were not associated with the offspring's risk of IBD or its subtypes.

Conclusions: Our findings suggest that a higher maternal diet diversity in pregnancy may be associated with a lower risk of UC in the offspring.

Background: Calorie restriction has been demonstrated to be effective in treating metabolic dysfunction-associated steatotic liver disease (MASLD). However, it has been limited by poor long-term adherence.

Objectives: This study aimed to compare intermittent calorie restriction (ICR) with traditional continuous calorie restriction (CCR) for the treatment of MASLD.

Methods: We conducted a 12-wk, parallel-arm, randomized controlled trial that included 60 adults with MASLD and abnormal glucose metabolism. The participants were randomly assigned to either the ICR group (2 successive days of fasting [∼500 kcal/d] and 5 d of recovery per week) or the CCR group. The primary outcome was liver fat content (LFC) measured by ¹H-proton magnetic resonance spectroscopy. The secondary and exploratory outcomes included weight, body composition, glucose, insulin, lipids, and liver stiffness.

Results: The mean reduction in LFC was -20.5% [95% confidence interval (CI): -25.0, -15.9%] in the ICR group and -15.5% (95% CI: -20.3, -10.8%) in the CCR group. Changes in LFC were not significantly different between the 2 groups (P = 0.15), and were homogeneous among different liver segments. The analysis of exploratory endpoints provided clues that the ICR was associated with greater reductions in fat mass and glycosylated hemoglobin. There were no significant differences in changes of weight, lean mass, insulin resistance, triglyceride, and liver stiffness between the 2 groups. Participants showed high adherence to both the ICR and CCR schemes.

Conclusions: The ICR and CCR schemes had similar effects on reducing LFC, suggesting that the ICR 5:2 diet can be an effective alternative for treating MASLD with high adherence.

Trial registration number: This trial was registered at clinicaltrials.gov as NCT04283942.

Background: Although interventions to change nutrition policies, systems, and environments (PSE) for children are generally cost effective for preventing childhood obesity, existing evidence suggests that nutrition education curricula, without accompanying PSE changes, are more commonly implemented.

Objectives: This study aimed to estimate the societal costs and potential for cost-effectiveness of 3 nutrition education curricula frequently implemented in United States public schools for childhood obesity prevention.

Methods: In 2021, we searched for nutrition education curricula in the Supplemental Nutrition Assistance Program (SNAP)-Ed Toolkit, a catalog of interventions for obesity prevention coordinated by the federal government. Standard costing methodologies estimated the societal costs from 2023 to 2032 of nationwide implementation of each identified curriculum. Using the Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) microsimulation model, which projects the costs, health care costs saved, and cases of obesity prevented for childhood obesity prevention interventions, we conducted threshold analyses for each curriculum, estimating the cost per quality-adjusted life-year for a range of hypothetical effects on child BMI to determine how large of an effect each curriculum would need to have to meet a cost-effectiveness threshold of $150,000 per quality-adjusted life-year.

Results: Three nutrition education curricula without PSE were identified from SNAP-Ed; none had evidence of an impact on obesity risk. From 2023 to 2032, the estimated implementation costs of the curricula nationwide ranged from $1.80 billion (95% upper interval: $1.79, $1.82 billion) to $3.48 billion (95% upper interval: $3.44, $3.51 billion). Each curriculum would have to reduce average child BMI by 0.10 kg/m² or more-an effect size that has not been reported by any of the 3 curricula, or by more comprehensive existing prevention programs-to be considered cost effective at this threshold.

Conclusions: SNAP-Ed-endorsed nutrition education curricula alone are unlikely to be cost effective for preventing childhood obesity. Continued efforts to implement interventions with strong evidence for effectiveness, including PSE approaches, are needed.