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Gut microbiota may modify the association between dietary polyphenol intake and serum concentrations of hippuric acid: results from a 1-year longitudinal study in China 肠道菌群可能改变膳食多酚摄入量和循环马尿酸水平之间的关系:来自中国一项为期一年的纵向研究的结果。
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-03-01 DOI: 10.1016/j.ajcnut.2025.01.018
Yutong Pan , Yang Yang , Zhaohong Peng , Wuqi Wang , Junyi Zhang , Guobing Sun , Fuyu Wang , Zixuan Zhu , Hongjuan Cao , Young Lyu , Zhuang Zhang , Wanshui Yang

Background

Hippuric acid (HA), a host-microbe cometabolite, normally derives from gut microbial catabolism of dietary polyphenols.

Objectives

We investigated the potential interplay between dietary polyphenols and gut microbiota on circulating HA concentrations and examined the associations between serum concentrations of HA and cardiometabolic risk markers.

Methods

In a 1-y cohort of 754 community-dwelling adults, serum HA and its precursor [benzoic acid (BA)], and fecal microbiota were assayed using liquid chromatography-tandem mass spectrometry and 16S ribosomal RNA sequencing, respectively. Diet, blood pressure, blood glucose, and lipid concentrations were measured twice, 1 y apart. Arterial stiffness [indicated by brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index] and liver fat accumulation [indicated by controlled attenuation parameter (CAP)] were measured after 1 y.

Results

We identified 27 microbial genera whose relative abundance was positively associated with serum HA concentrations (PFDR < 0.05) and constructed a microbial score to reflect the overall HA-producing potential. In multivariate-adjusted linear models, dietary intake of catechins and chlorogenic acids was positively associated with serum HA concentrations among participants with a higher microbial score (β = 0.26, P = 0.03) but not among those with a lower score (β = −0.13, P = 0.30, Pinteraction = 0.03). Participants with higher intake of dietary catechins and chlorogenic acids had lower triglyceride concentrations (Percentage change = −5.9%, P < 0.05). Each 1 μmol/L increase in serum HA, but not in BA, was associated with 5.7%, 1.5%, 1.7%, 1.7%, and 1.7% decrease in triglyceride, systolic blood pressure, diastolic blood pressure, baPWV, and CAP, respectively (all P < 0.05).

Conclusions

The gut microbial genera that predicted circulating HA concentrations might modify the association between dietary polyphenol intake and circulating HA concentrations, and elevated serum HA concentrations are favorably associated with multiple cardiometabolic risk markers.
背景:马尿酸(HA)是一种宿主-微生物共代谢产物,通常来源于肠道微生物对食物多酚的分解代谢。目的:我们研究了膳食多酚和肠道微生物群对循环HA水平的潜在相互作用,并研究了血清HA浓度与心脏代谢危险标志物之间的关系。方法:采用液相色谱-串联质谱法和16S核糖体RNA测序,对754名社区居民进行为期1年的血清HA及其前体[苯甲酸(BA)]和粪便微生物群测定。饮食、血压、血糖、血脂测量2次,间隔1年。1年后测量动脉硬度[以肱-踝脉搏波速度(baPWV)和踝-肱指数表示]和肝脏脂肪堆积[以控制衰减参数(CAP)表示]。结果:我们鉴定出27个微生物属,其相对丰度与血清HA浓度呈正相关(pfdr相互作用=0.03)。饮食中摄入较多儿茶素和绿原酸的参与者甘油三酯较低(百分比变化= -5.9%)。结论:预测循环HA水平的肠道微生物属可能改变了饮食多酚摄入量与循环HA水平之间的关系,血清HA浓度升高与多种心脏代谢危险标志物有利相关。
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引用次数: 0
Characterization of gene–environment interactions for vitamin D through variance quantitative trait loci: a UK Biobank-based genetic epidemiology study
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-03-01 DOI: 10.1016/j.ajcnut.2025.01.021
Tianyuan Lu , Wenmin Zhang , Cassianne Robinson-Cohen , Corinne D Engelman , Qiongshi Lu , Ian H de Boer , Lei Sun , Andrew D Paterson

Background

Understanding gene–environment interactions associated with vitamin D status may refine nutrition and public health strategies for vitamin D deficiency. Recent methodological advances have enabled the identification of variance quantitative trait loci (vQTLs) where gene–environment interactions are enriched.

Objectives

The study aims to identify vQTLs for serum 25-hydroxy vitamin D (25OHD) concentrations and characterize potential gene–environment interactions of vQTLs.

Methods

We conducted vQTL discovery for 25OHD using a newly developed quantile integral linear model in the UK Biobank individuals of European (N = 313,514), African (N = 7800), East Asian (N = 2146), and South Asian (N = 8771) ancestries, respectively. We tested for interactions between the identified vQTL lead variants and 18 environmental, biological, or lifestyle factors, followed by multiple sensitivity analyses.

Results

We identified 19 independent vQTL lead variants (P < 5 × 10–8) in the European ancestry population. No vQTLs were identified in the non-European ancestry populations, likely because of limited sample sizes. A total of 32 interactions were detected with a false discovery rate <0.05. Although known gene-season of measurement interactions were confirmed, additional interactions were identified involving modifiable risk factors, including time spent outdoors and body mass index. The magnitudes of these interactions were consistent within each locus upon adjusting for the season of measurement and other covariates. We also identified a gene–sex interaction at a vQTL that implicates DHCR7. Integrating transcript- and protein-level evidence, we found that the sex-differentiated genetic associations may act through sex-biased expression of DHCR7 isoforms in skin tissues because of alternative splicing.

Conclusions

Through the lens of vQTLs, we identified additional gene–environment interactions affecting vitamin D status in addition to the season of measurement. These findings may provide new insights into the etiology of vitamin D deficiency and encourage personalized prevention and management of associated diseases for at-risk individuals.
{"title":"Characterization of gene–environment interactions for vitamin D through variance quantitative trait loci: a UK Biobank-based genetic epidemiology study","authors":"Tianyuan Lu ,&nbsp;Wenmin Zhang ,&nbsp;Cassianne Robinson-Cohen ,&nbsp;Corinne D Engelman ,&nbsp;Qiongshi Lu ,&nbsp;Ian H de Boer ,&nbsp;Lei Sun ,&nbsp;Andrew D Paterson","doi":"10.1016/j.ajcnut.2025.01.021","DOIUrl":"10.1016/j.ajcnut.2025.01.021","url":null,"abstract":"<div><h3>Background</h3><div>Understanding gene–environment interactions associated with vitamin D status may refine nutrition and public health strategies for vitamin D deficiency. Recent methodological advances have enabled the identification of variance quantitative trait loci (vQTLs) where gene–environment interactions are enriched.</div></div><div><h3>Objectives</h3><div>The study aims to identify vQTLs for serum 25-hydroxy vitamin D (25OHD) concentrations and characterize potential gene–environment interactions of vQTLs.</div></div><div><h3>Methods</h3><div>We conducted vQTL discovery for 25OHD using a newly developed quantile integral linear model in the UK Biobank individuals of European (<em>N</em> = 313,514), African (<em>N</em> = 7800), East Asian (<em>N</em> = 2146), and South Asian (<em>N</em> = 8771) ancestries, respectively. We tested for interactions between the identified vQTL lead variants and 18 environmental, biological, or lifestyle factors, followed by multiple sensitivity analyses.</div></div><div><h3>Results</h3><div>We identified 19 independent vQTL lead variants (<em>P</em> &lt; 5 × 10<sup>–8</sup>) in the European ancestry population. No vQTLs were identified in the non-European ancestry populations, likely because of limited sample sizes. A total of 32 interactions were detected with a false discovery rate &lt;0.05. Although known gene-season of measurement interactions were confirmed, additional interactions were identified involving modifiable risk factors, including time spent outdoors and body mass index. The magnitudes of these interactions were consistent within each locus upon adjusting for the season of measurement and other covariates. We also identified a gene–sex interaction at a vQTL that implicates <em>DHCR7</em>. Integrating transcript- and protein-level evidence, we found that the sex-differentiated genetic associations may act through sex-biased expression of DHCR7 isoforms in skin tissues because of alternative splicing.</div></div><div><h3>Conclusions</h3><div>Through the lens of vQTLs, we identified additional gene–environment interactions affecting vitamin D status in addition to the season of measurement. These findings may provide new insights into the etiology of vitamin D deficiency and encourage personalized prevention and management of associated diseases for at-risk individuals.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"121 3","pages":"Pages 731-740"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Planetary Health Diet Index in relation to mortality in a prospective cohort study of United States Black females
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-03-01 DOI: 10.1016/j.ajcnut.2025.01.023
Yifei Shan , Kimberly A Bertrand , Jessica L Petrick , Shanshan Sheehy , Julie R Palmer

Background

To improve both human health and the health of our planet, the EAT-Lancet Commission proposed the planetary health diet (PHD).

Objectives

We aimed to evaluate associations of PHD with all-cause, cardiovascular disease (CVD), and cancer-specific mortality among United States Black females.

Methods

The Black Women’s Health Study is a prospective study of self-identified United States Black females. In 2001, 33,824 participants free of cancer and CVD completed a validated food frequency questionnaire. PHD Index (PHDI) was calculated based on reported consumption of 15 food groups, such as whole grains, nonstarchy vegetables, legumes, soy foods, added fat and trans fat, and red/processed meats. Deaths were identified through linkage to the National Death Index. Cox proportional hazards regression, stratified by age and adjusted for smoking status, body mass index, and other CVD risk factors, was used to calculate hazard ratios (HRs) for quintiles of PHDI in relation to all-cause, CVD-, and cancer-specific mortality.

Results

During 18 years of follow-up, we identified 3537 deaths, including 779 from CVD and 1625 from cancer. Females in the quintile representing the highest adherence to PHD were estimated to have an 18% reduction in risk of all-cause mortality [HR = 0.82, 95% confidence interval (CI): 0.71, 0.94] and 26% reduction in CVD-specific mortality (HR = 0.74, 95% CI: 0.55, 0.98), compared with those in the lowest quintile, with similar reductions observed for quintiles 2, 3, and 4. Among individuals under age 55, there was a significant trend of lower CVD mortality risk with a higher level of adherence to PHD (Ptrend = 0.004), and the HR for the highest compared with the lowest quintile was 0.43 (95% CI: 0.21, 0.87). PHDI was not associated with cancer-specific mortality.

Conclusions

Adherence to a diet that has been shown to benefit the planet was associated with a lower risk of mortality among Black females, primarily driven by a reduction in CVD-specific mortality risk.
{"title":"Planetary Health Diet Index in relation to mortality in a prospective cohort study of United States Black females","authors":"Yifei Shan ,&nbsp;Kimberly A Bertrand ,&nbsp;Jessica L Petrick ,&nbsp;Shanshan Sheehy ,&nbsp;Julie R Palmer","doi":"10.1016/j.ajcnut.2025.01.023","DOIUrl":"10.1016/j.ajcnut.2025.01.023","url":null,"abstract":"<div><h3>Background</h3><div>To improve both human health and the health of our planet, the EAT-Lancet Commission proposed the planetary health diet (PHD).</div></div><div><h3>Objectives</h3><div>We aimed to evaluate associations of PHD with all-cause, cardiovascular disease (CVD), and cancer-specific mortality among United States Black females.</div></div><div><h3>Methods</h3><div>The Black Women’s Health Study is a prospective study of self-identified United States Black females. In 2001, 33,824 participants free of cancer and CVD completed a validated food frequency questionnaire. PHD Index (PHDI) was calculated based on reported consumption of 15 food groups, such as whole grains, nonstarchy vegetables, legumes, soy foods, added fat and trans fat, and red/processed meats. Deaths were identified through linkage to the National Death Index. Cox proportional hazards regression, stratified by age and adjusted for smoking status, body mass index, and other CVD risk factors, was used to calculate hazard ratios (HRs) for quintiles of PHDI in relation to all-cause, CVD-, and cancer-specific mortality.</div></div><div><h3>Results</h3><div>During 18 years of follow-up, we identified 3537 deaths, including 779 from CVD and 1625 from cancer. Females in the quintile representing the highest adherence to PHD were estimated to have an 18% reduction in risk of all-cause mortality [HR = 0.82, 95% confidence interval (CI): 0.71, 0.94] and 26% reduction in CVD-specific mortality (HR = 0.74, 95% CI: 0.55, 0.98), compared with those in the lowest quintile, with similar reductions observed for quintiles 2, 3, and 4. Among individuals under age 55, there was a significant trend of lower CVD mortality risk with a higher level of adherence to PHD (<em>P</em><sub>trend</sub> = 0.004), and the HR for the highest compared with the lowest quintile was 0.43 (95% CI: 0.21, 0.87). PHDI was not associated with cancer-specific mortality.</div></div><div><h3>Conclusions</h3><div>Adherence to a diet that has been shown to benefit the planet was associated with a lower risk of mortality among Black females, primarily driven by a reduction in CVD-specific mortality risk.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"121 3","pages":"Pages 589-596"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reporting of nutritional screening, status, and intake in trials of nutritional and physical rehabilitation following critical illness: a systematic review 危重疾病后营养和身体康复试验中营养筛查、状态和摄入的报告:系统综述
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-03-01 DOI: 10.1016/j.ajcnut.2024.12.028
Reema Rabheru , Anne Langan , Judith Merriweather , Bronwen Connolly , Kevin Whelan , Danielle E Bear

Background

Surviving critical illness leads to prolonged physical and functional recovery with both nutritional and physical rehabilitation interventions for prevention and treatment being investigated. Nutritional status and adequacy may influence outcome, but no consensus on which nutritional-related variables should be measured and reported in clinical trials exists.

Objectives

This study aimed to undertake a systematic review investigating the reporting of nutritional screening, nutritional status, and nutritional intake/delivery in randomized controlled trials (RCTs) evaluating nutritional and/or physical rehabilitation on physical and functional recovery during and following critical illness.

Methods

Five electronic databases (MEDLINE, Web of Science, EMBASE, CINAHL, and Cochrane) were searched (last update 9 August, 2023). Search terms included both free text and standardized indexed terms. Studies included were RCTs assessing nutritional and/or physical interventions either during or following intensive care unit (ICU) admission in adults (18 y or older) with critical illness, and who required invasive mechanical ventilation for any duration during ICU admission. Study quality was assessed using the Cochrane Collaboration Risk of Bias tool for RCTs and descriptive data synthesis was performed and presented as counts (%). n t

Results

In total, 123 RCTs (30 nutritional, 87 physical function, and 6 combined) were included. Further, ≥1 nutritional variable was measured and/or reported in 99 (80%) of the studies including BMI (n = 69), body weight (n = 57), nutritional status (n = 11), nutritional risk (n = 10), energy delivery (n = 41), protein delivery (n = 35), handgrip strength (n = 40), and other nutritional-related muscle variables (n = 41). Only 3 studies were considered to have low risk of bias in all categories.

Conclusions

Few RCTs of physical rehabilitation measure and report nutritional or related variables. Future studies should measure and report specific nutritional factors that could impact physical and functional recovery to support interpretation where studies do not show benefit.
This protocol was preregistered at PROSPERO as CRD42022315122.
背景:生存的危重疾病导致长期的身体和功能恢复,营养和身体康复干预预防和治疗正在研究中。营养状况和充足性可能会影响结果,但在临床试验中应该测量和报告哪些营养相关变量,目前尚无共识。目的:开展一项系统综述,调查危重疾病期间和之后评估营养和/或身体康复对身体和功能恢复的随机对照试验(rct)中营养筛查、营养状况和营养摄入/输送的报告。方法:检索MEDLINE、Web of Science、EMBASE、CINAHL、Cochrane 5个电子数据库(最后更新日期:2023年8月9日)。搜索词包括自由文本和标准化索引词。纳入的研究为随机对照试验,评估重症监护病房(ICU)入住期间或之后的重症成人(≥18岁)的营养和/或物理干预,并在ICU入住期间的任何时间需要有创机械通气。使用Cochrane协作rct偏倚风险工具评估研究质量,进行描述性数据综合并以计数(%)表示。未进行meta分析,因为本系统综述调查的是测量和报告,而不是有效性终点。结果:纳入123项随机对照试验,其中营养组30项,体能组87项,综合组6项。在99项(80%)研究中,至少测量和/或报告了一项营养变量,包括BMI (n=69)、体重(n=57)、营养状况(n=11)、营养风险(n=10)、能量输送(n=41)、蛋白质输送(n=35)、握力(n=40)和其他与营养相关的肌肉变量(n=41)。在所有类别中,只有三项研究被认为具有低偏倚风险。结论:很少有随机对照试验测量和报告营养或相关变量。未来的研究应该测量和报告可能影响身体和功能恢复的特定营养因素,以支持研究未显示益处的解释。协议在PROSPERO上预注册(CRD42022315122)。
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引用次数: 0
The relationship between a high-fat diet, gut microbiome, and systemic chronic inflammation: insights from integrated multiomics analysis 高脂肪饮食、肠道微生物组和系统性慢性炎症之间的关系:来自综合多组学分析的见解。
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-03-01 DOI: 10.1016/j.ajcnut.2024.12.026
Zhiwei Du , Xuxu Liu , Zhihong Xie , Qiang Wang , Zhenyi Lv , Lianghao Li , Heming Wang , Dongbo Xue , Yingmei Zhang

Background

The detrimental effects of a high-fat diet (HFD) extend beyond metabolic consequences and include systemic chronic inflammation (SCI), immune dysregulation, and gut health disruption.

Objectives

In this study, we used Mendelian randomization (MR) to investigate the relationship between HFD, gut microbiota, and SCI.

Methods

Genetic variants associated with dietary fat were utilized to explore causal relationships. Genome-wide association study data for the analyses of the gut microbiota, inflammatory cytokines, immune cell characteristics, and serum metabolites were obtained from European individuals. Mediation analysis was used to reveal potential mediating factors. The GMrepo database was used to analyze the bacterial composition in different groups. Transcriptomic and single-cell sequencing analyses explored inflammation and barrier function in colonic tissue.

Results

HFD consumption was linked to changes in the abundance of 3 bacterial families and 11 bacterial genera. Combined with the GMrepo database, the increased abundance of the genus Lachnospiraceae_FCS020group and the decreased abundance of genus Bacteroides and genus Barnesiella are consistent with the MR results. Transcriptomic and single-cell sequencing analyses revealed intestinal inflammation and mucosal barrier dysfunction in HFD-fed mice. MR revealed a link between HFD consumption and increased levels of interleukin (IL)-18 [odds ratio (OR): 3.64, 95%CI: 1.24, 10.69, P = 0.02], MIG (OR = 3.14, 95%CI: 1.17, 8.47, P = 0.02), IL-13 [OR = 3.21, 95% confidence interval (CI): 1.08, -9.52, P = 0.04], and IL-2RA (OR = 2.93, 95%CI: 1.01, 8.53, P = 0.049). Twenty-nine immune cell signatures, including altered monocyte and T-cell subsets, were affected by HFD consumption. Twenty-six serum metabolites that are linked to HFD consumption, particularly lipid and amino acid metabolites, were identified. The positive gut microbiota exhibit extensive associations with inflammatory cytokines. In particular, Lachnospiraceae_FCS020 group (OR: 1.93, 95% CI: 1.11, 3.37, P = 0.02) may play a mediating role in HFD-induced increases in IL-2RA concentrations.

Conclusions

Microbial dysbiosis appears to be an important mechanism for HFD-induced SCI. The Lachnospiraceae_FCS020 group may act as a key genus in HFD-mediated elevation of IL-2RA.
背景:高脂肪饮食(HFD)的有害影响超出了代谢后果,包括全身性慢性炎症(SCI)、免疫失调和肠道健康破坏。目的:在这项研究中,我们使用孟德尔随机化(MR)来研究HFD和肠道微生物群以及SCI之间的关系。方法:利用与膳食脂肪相关的遗传变异来探索因果关系。用于分析肠道微生物群、炎症细胞因子、免疫细胞特征和血清代谢物的GWAS数据来自欧洲个体。采用中介分析揭示潜在的中介因素。使用GMrepo数据库分析不同组的细菌组成。转录组学和单细胞测序分析用于探索结肠组织中的炎症和屏障功能。结果:食用HFD与3个细菌科和11个细菌属的丰度变化有关。结合GMrepo数据库,增加了属的丰度。lachnospirace_fcs020类群及属丰度下降。拟杆菌和属。巴内氏菌与核磁共振结果一致。转录组学和单细胞测序分析显示,饲喂hfd的小鼠出现肠道炎症和粘膜屏障功能障碍。MR显示高脂肪摄入与白细胞介素(IL)-18 (OR=3.64, 95%CI: 1.24-10.69, P=0.02)、米格(OR=3.14, 95%CI: 1.17-8.47, P=0.02)、IL-13 (OR=3.21, 95%CI:1.08-9.52, P=0.04)和IL- 2ra (OR=2.93, 95%CI: 1.01-8.53, P=0.049)水平升高有关。29种免疫细胞特征,包括单核细胞和t细胞亚群的改变,受到HFD消耗的影响。鉴定了26种与HFD消耗有关的血清代谢物,特别是脂质和氨基酸代谢物。阳性肠道菌群表现出与炎症细胞因子的广泛关联。特别是Lachnospiraceae_FCS020组(OR=1.93, 95% CI: 1.11-3.37, P=0.02)可能在hfd诱导的IL-2RA水平升高中起中介作用。结论:微生物生态失调可能是hfd诱导的脊髓损伤的重要机制。Lachnospiraceae_FCS020群可能是hfd介导IL-2RA升高的关键属。
{"title":"The relationship between a high-fat diet, gut microbiome, and systemic chronic inflammation: insights from integrated multiomics analysis","authors":"Zhiwei Du ,&nbsp;Xuxu Liu ,&nbsp;Zhihong Xie ,&nbsp;Qiang Wang ,&nbsp;Zhenyi Lv ,&nbsp;Lianghao Li ,&nbsp;Heming Wang ,&nbsp;Dongbo Xue ,&nbsp;Yingmei Zhang","doi":"10.1016/j.ajcnut.2024.12.026","DOIUrl":"10.1016/j.ajcnut.2024.12.026","url":null,"abstract":"<div><h3>Background</h3><div>The detrimental effects of a high-fat diet (HFD) extend beyond metabolic consequences and include systemic chronic inflammation (SCI), immune dysregulation, and gut health disruption.</div></div><div><h3>Objectives</h3><div>In this study, we used Mendelian randomization (MR) to investigate the relationship between HFD, gut microbiota, and SCI.</div></div><div><h3>Methods</h3><div>Genetic variants associated with dietary fat were utilized to explore causal relationships. Genome-wide association study data for the analyses of the gut microbiota, inflammatory cytokines, immune cell characteristics, and serum metabolites were obtained from European individuals. Mediation analysis was used to reveal potential mediating factors. The GMrepo database was used to analyze the bacterial composition in different groups. Transcriptomic and single-cell sequencing analyses explored inflammation and barrier function in colonic tissue.</div></div><div><h3>Results</h3><div>HFD consumption was linked to changes in the abundance of 3 bacterial families and 11 bacterial genera. Combined with the GMrepo database, the increased abundance of the genus Lachnospiraceae_FCS020group and the decreased abundance of genus <em>Bacteroides</em> and genus <em>Barnesiella</em> are consistent with the MR results. Transcriptomic and single-cell sequencing analyses revealed intestinal inflammation and mucosal barrier dysfunction in HFD-fed mice. MR revealed a link between HFD consumption and increased levels of interleukin (IL)-18 [odds ratio (OR): 3.64, 95%CI: 1.24, 10.69, <em>P</em> = 0.02], MIG (OR = 3.14, 95%CI: 1.17, 8.47, <em>P</em> = 0.02), IL-13 [OR = 3.21, 95% confidence interval (CI): 1.08, -9.52, <em>P</em> = 0.04], and IL-2RA (OR = 2.93, 95%CI: 1.01, 8.53, <em>P</em> = 0.049). Twenty-nine immune cell signatures, including altered monocyte and T-cell subsets, were affected by HFD consumption. Twenty-six serum metabolites that are linked to HFD consumption, particularly lipid and amino acid metabolites, were identified. The positive gut microbiota exhibit extensive associations with inflammatory cytokines. In particular, Lachnospiraceae_FCS020 group (OR: 1.93, 95% CI: 1.11, 3.37, <em>P</em> = 0.02) may play a mediating role in HFD-induced increases in IL-2RA concentrations.</div></div><div><h3>Conclusions</h3><div>Microbial dysbiosis appears to be an important mechanism for HFD-induced SCI. The Lachnospiraceae_FCS020 group may act as a key genus in HFD-mediated elevation of IL-2RA.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"121 3","pages":"Pages 643-653"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Planetary Health Diet Index Trends and Associations with Dietary Greenhouse Gas Emissions, Disease Biomarkers, Obesity, and Mortality in the United States (2005–2018) 全球健康饮食指数趋势及其与美国饮食温室气体排放、疾病生物标志物、肥胖和死亡率的关系(2005-2018)。
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-03-01 DOI: 10.1016/j.ajcnut.2025.01.007
Jiada Zhan , Linh Bui , Rebecca A Hodge , Meghan Zimmer , Tung Pham , Donald Rose , Amelia Willits-Smith , Walter C Willett

Background

Diet plays a vital role in human health and environmental effects. Monitoring diet quality and its relationship to both health and environment are essential for policy making.

Objectives

This study aimed to analyze trends in the Planetary Health Diet Index (PHDI) and its associations with daily greenhouse gas (GHG) emissions from food, disease-related biomarkers, anthropometric measurements, obesity, and all-cause mortality in the United States population.

Methods

We analyzed 27,181 adults in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018, except for the mortality analysis. 23,599 adults were analyzed as the 2017–2018 NHANES dietary data were removed due to the potential for reverse causation. We calculated PHDI scores by using 2 24-h dietary recalls and GHG by linking the consumption of individual foods to dataFRIENDS, a food-environmental impact database. To assess associations with the PHDI, we used generalized linear regression models for GHG, disease-related biomarkers, and obesity and used the Cox proportional hazards model for all-cause mortality.

Results

The energy-adjusted mean of the PHDI (140 possible points) increased from 68.6 in 2005–2006 to 71.7 in 2017–2018 (P-trend < 0.001). Compared with the lowest quintile (Q1), the highest PHDI quintile (Q5) was associated with 25% lower GHG emissions, a better cardiometabolic profile, lower prevalence ratios of obesity [0.59; 95% confidence interval (CI): 0.50, 0.69] and abdominal obesity (0.74; 95% CI: 0.66, 0.82), and a lower risk of all-cause death [hazard ratio (HR): 0.65; 95% CI: 0.54, 0.78].

Conclusions

These results underscore the potential health and GHG emission benefits aligned with the planetary health diet.
背景:饮食在人类健康和环境影响中起着至关重要的作用。监测饮食质量及其与健康和环境的关系对制定政策至关重要。目的:本研究旨在分析地球健康饮食指数(PHDI)的趋势及其与美国人口每日食物温室气体排放(GHG)、疾病相关生物标志物、人体测量、肥胖和全因死亡率的关系。方法:除死亡率分析外,我们分析了2005年至2018年国家健康与营养调查(NHANES)中的27181名成年人。由于可能存在反向因果关系,研究人员删除了2017-2018年NHANES饮食数据,对23,599名成年人进行了分析。我们通过使用两次24小时饮食召回和通过将单个食物的消费与dataffriends(一个食品-环境影响数据库)联系起来计算PHDI分数。为了评估与PHDI的相关性,我们对温室气体、疾病相关生物标志物和肥胖使用了广义线性回归模型,并对全因死亡率使用了Cox比例风险模型。结果:能量调整后的PHDI平均值(140可能点)从2005-2006年的68.6上升到2017-2018年的71.7 (p < 0.001)。与最低五分位数(Q1)相比,最高PHDI五分位数(Q5)与降低25%的温室气体排放量、更好的心脏代谢谱、较低的肥胖患病率(0.59,95% CI: 0.50-0.69)和腹部肥胖患病率(0.74,95% CI: 0.66-0.82)以及较低的全因死亡风险(HR: 0.65, 95% CI: 0.54-0.78)相关。结论:这些结果强调了与地球健康饮食相一致的潜在健康和温室气体排放益处。
{"title":"Planetary Health Diet Index Trends and Associations with Dietary Greenhouse Gas Emissions, Disease Biomarkers, Obesity, and Mortality in the United States (2005–2018)","authors":"Jiada Zhan ,&nbsp;Linh Bui ,&nbsp;Rebecca A Hodge ,&nbsp;Meghan Zimmer ,&nbsp;Tung Pham ,&nbsp;Donald Rose ,&nbsp;Amelia Willits-Smith ,&nbsp;Walter C Willett","doi":"10.1016/j.ajcnut.2025.01.007","DOIUrl":"10.1016/j.ajcnut.2025.01.007","url":null,"abstract":"<div><h3>Background</h3><div>Diet plays a vital role in human health and environmental effects. Monitoring diet quality and its relationship to both health and environment are essential for policy making.</div></div><div><h3>Objectives</h3><div>This study aimed to analyze trends in the Planetary Health Diet Index (PHDI) and its associations with daily greenhouse gas (GHG) emissions from food, disease-related biomarkers, anthropometric measurements, obesity, and all-cause mortality in the United States population.</div></div><div><h3>Methods</h3><div>We analyzed 27,181 adults in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018, except for the mortality analysis. 23,599 adults were analyzed as the 2017–2018 NHANES dietary data were removed due to the potential for reverse causation. We calculated PHDI scores by using 2 24-h dietary recalls and GHG by linking the consumption of individual foods to dataFRIENDS, a food-environmental impact database. To assess associations with the PHDI, we used generalized linear regression models for GHG, disease-related biomarkers, and obesity and used the Cox proportional hazards model for all-cause mortality.</div></div><div><h3>Results</h3><div>The energy-adjusted mean of the PHDI (140 possible points) increased from 68.6 in 2005–2006 to 71.7 in 2017–2018 (<em>P</em>-trend &lt; 0.001). Compared with the lowest quintile (Q1), the highest PHDI quintile (Q5) was associated with 25% lower GHG emissions, a better cardiometabolic profile, lower prevalence ratios of obesity [0.59; 95% confidence interval (CI): 0.50, 0.69] and abdominal obesity (0.74; 95% CI: 0.66, 0.82), and a lower risk of all-cause death [hazard ratio (HR): 0.65; 95% CI: 0.54, 0.78].</div></div><div><h3>Conclusions</h3><div>These results underscore the potential health and GHG emission benefits aligned with the planetary health diet.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"121 3","pages":"Pages 580-588"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Urinary creatinine excretion—a standard that requires further calibration 尿肌酐排泄--需要进一步校准的标准
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-03-01 DOI: 10.1016/j.ajcnut.2025.01.010
Talat A Ikizler
{"title":"Urinary creatinine excretion—a standard that requires further calibration","authors":"Talat A Ikizler","doi":"10.1016/j.ajcnut.2025.01.010","DOIUrl":"10.1016/j.ajcnut.2025.01.010","url":null,"abstract":"","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"121 3","pages":"Pages 509-510"},"PeriodicalIF":6.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Continuous glucose monitor overestimates glycemia, with the magnitude of bias varying by postprandial test and individual - a randomized crossover trial.
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-26 DOI: 10.1016/j.ajcnut.2025.02.024
Katie M Hutchins, James A Betts, Dylan Thompson, Aaron Hengist, Javier T Gonzalez

Background: Continuous glucose monitors (CGM) are used to characterize postprandial glycemia, yet no study has directly tested how different test foods/beverages alter CGM accuracy.

Objectives: Assess glycemic responses to test foods/drinks using CGM compared with capillary sampling (criterion).

Methods: Fifteen healthy females (n = 9) and males (n = 6) completed 7 laboratory visits in a randomized crossover design with ≥48 h washout between visits. During each visit, participants consumed an oral carbohydrate challenge comprising either 50 g glucose or equivalent 50 g carbohydrate as whole fruits, 50 g carbohydrate as blended fruit, 50 g carbohydrate as commercially available fruit smoothie, 50 g carbohydrate as commercially available fruit smoothie ingested over 30 ± 4 min, 50 g carbohydrate as commercially available fruit smoothie with 5 g inulin, 30 g carbohydrate as commercially available fruit smoothie. The glycemia was recorded from both CGM and capillary samples every 15 min for 120 min and expressed as incremental areas under the curve. The glycemic index (GI) was calculated relative to 50 g glucose where appropriate. Exploratory analyses examined 1) interindividual heterogeneity of CGM bias compared with criterion and 2) whether CGM bias could be improved with adjustment for baseline differences.

Results: CGM-estimated fasting and postprandial glucose concentrations were (mean ± standard deviation) 0.9 ± 0.6 and 0.9 ± 0.5 mmol/L higher than capillary estimates, respectively(both, P < 0.001). CGM bias varied by postprandial test such that GI for 50 g carbohydrate as commercially available fruit smoothie was higher with CGM (69; 95% confidence interval: 48, 99) compared with capillary (53; 95% confidence interval: 40, 69; P = 0.05). Furthermore, differences in CGM compared with capillary fasting glucose concentrations varied by participant (P = 0.001). Unadjusted, CGM overestimated time >7.8 mmol/L by ∼4-fold, and adjustment for baseline differences reduced this overestimate to ∼2-fold (both P < 0.01).

Conclusions: CGM overestimated glycemic responses in numerous contexts. At times, this can mischaracterize the GI. In addition, there is interindividual heterogeneity in the accuracy of CGM in estimating fasting glucose concentrations. Correction for this difference reduces, but does not eliminate, postprandial overestimate of glycemia by CGM. Caution should be applied when inferring absolute or relative glycemic responses to foods using CGM, and capillary sampling should be prioritized for accurate quantification of glycemic response. This trial was registered at clinicaltrials.gov as NCT06333184.

{"title":"Continuous glucose monitor overestimates glycemia, with the magnitude of bias varying by postprandial test and individual - a randomized crossover trial.","authors":"Katie M Hutchins, James A Betts, Dylan Thompson, Aaron Hengist, Javier T Gonzalez","doi":"10.1016/j.ajcnut.2025.02.024","DOIUrl":"10.1016/j.ajcnut.2025.02.024","url":null,"abstract":"<p><strong>Background: </strong>Continuous glucose monitors (CGM) are used to characterize postprandial glycemia, yet no study has directly tested how different test foods/beverages alter CGM accuracy.</p><p><strong>Objectives: </strong>Assess glycemic responses to test foods/drinks using CGM compared with capillary sampling (criterion).</p><p><strong>Methods: </strong>Fifteen healthy females (n = 9) and males (n = 6) completed 7 laboratory visits in a randomized crossover design with ≥48 h washout between visits. During each visit, participants consumed an oral carbohydrate challenge comprising either 50 g glucose or equivalent 50 g carbohydrate as whole fruits, 50 g carbohydrate as blended fruit, 50 g carbohydrate as commercially available fruit smoothie, 50 g carbohydrate as commercially available fruit smoothie ingested over 30 ± 4 min, 50 g carbohydrate as commercially available fruit smoothie with 5 g inulin, 30 g carbohydrate as commercially available fruit smoothie. The glycemia was recorded from both CGM and capillary samples every 15 min for 120 min and expressed as incremental areas under the curve. The glycemic index (GI) was calculated relative to 50 g glucose where appropriate. Exploratory analyses examined 1) interindividual heterogeneity of CGM bias compared with criterion and 2) whether CGM bias could be improved with adjustment for baseline differences.</p><p><strong>Results: </strong>CGM-estimated fasting and postprandial glucose concentrations were (mean ± standard deviation) 0.9 ± 0.6 and 0.9 ± 0.5 mmol/L higher than capillary estimates, respectively(both, P < 0.001). CGM bias varied by postprandial test such that GI for 50 g carbohydrate as commercially available fruit smoothie was higher with CGM (69; 95% confidence interval: 48, 99) compared with capillary (53; 95% confidence interval: 40, 69; P = 0.05). Furthermore, differences in CGM compared with capillary fasting glucose concentrations varied by participant (P = 0.001). Unadjusted, CGM overestimated time >7.8 mmol/L by ∼4-fold, and adjustment for baseline differences reduced this overestimate to ∼2-fold (both P < 0.01).</p><p><strong>Conclusions: </strong>CGM overestimated glycemic responses in numerous contexts. At times, this can mischaracterize the GI. In addition, there is interindividual heterogeneity in the accuracy of CGM in estimating fasting glucose concentrations. Correction for this difference reduces, but does not eliminate, postprandial overestimate of glycemia by CGM. Caution should be applied when inferring absolute or relative glycemic responses to foods using CGM, and capillary sampling should be prioritized for accurate quantification of glycemic response. This trial was registered at clinicaltrials.gov as NCT06333184.</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reducing cardiometabolic disease risk dietary pattern in the Chinese population with dyslipidemia: a single-center, open-label, randomized, dietary intervention study.
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-25 DOI: 10.1016/j.ajcnut.2025.02.026
Qi Wu, Shanshan Bian, Cheng Cheng, Xukun Chen, Liyang Zhang, Li Huang, Tongtong Li, Ruiting Yan, Huilian Duan, Zehao Wang, Yuan Li, Tongyang Wu, Yue Wang, Yan Chen, Xiping Deng, Yongjie Chen, Meilin Zhang, Fei Ma, Wen Li, Guowei Huang

Background: There is no specific dietary pattern for cardiometabolic health based on Chinese food culture.

Objectives: The study aimed to develop and assess the efficacy of the reducing cardiometabolic disease risk (RCMDR) dietary pattern on cardiometabolic disease risk in the Chinese population with dyslipidemia.

Methods: In this single-center, open-label, randomized, 12-wk dietary intervention study, 100 adults aged 35-45 y with dyslipidemia were randomly assigned (1:1) to the RCMDR dietary pattern intervention or general health education control group.

Results: Compared with the control group, the RCMDR dietary pattern intervention resulted in a significantly lower clustered cardiometabolic risk score (primary outcome) (β: -0.17; 95% CI: -0.29, -0.05); diastolic blood pressure (β: -0.23; 95% CI: -0.40, -0.07); total cholesterol, LDL cholesterol, triglyceride (β: -0.27; 95% CI: -0.49, -0.04; β: -0.24; 95% CI: -0.41, -0.07; and β: -0.19; 95% CI: -0.35, -0.04, respectively); homocysteine (β: -0.19; 95% CI: -0.28, -0.09); waist circumference, waist-to-hip ratio, body fat percentage, body fat mass, visceral adipose tissue, visceral fat area, and a significantly higher lean body mass (β: -1.12; 95% CI: -1.65, -0.59; β: -1.01; 95% CI: -1.66, -0.36; β: -1.43; 95% CI: -1.87, -0.98; β: -0.98; 95% CI: -1.35, -0.60; β: -1.93; 95% CI: -2.75, -1.11; β: -6.52; 95% CI: -9.10, -3.95; and β: 1.24; 95% CI: 0.84, 1.65, respectively).

Conclusions: Compared with the control group, the RCMDR dietary pattern intervention lowers cardiometabolic risk, blood lipids, blood pressure, abdominal obesity, and circulating homocysteine concentration among Chinese population with dyslipidemia.

Clinical trial registry: This trial was registered at Chinese Clinical Trial Registry as ChiCTR2300072472 (https://www.chictr.org.cn/showproj.html?proj=198618).

{"title":"Reducing cardiometabolic disease risk dietary pattern in the Chinese population with dyslipidemia: a single-center, open-label, randomized, dietary intervention study.","authors":"Qi Wu, Shanshan Bian, Cheng Cheng, Xukun Chen, Liyang Zhang, Li Huang, Tongtong Li, Ruiting Yan, Huilian Duan, Zehao Wang, Yuan Li, Tongyang Wu, Yue Wang, Yan Chen, Xiping Deng, Yongjie Chen, Meilin Zhang, Fei Ma, Wen Li, Guowei Huang","doi":"10.1016/j.ajcnut.2025.02.026","DOIUrl":"10.1016/j.ajcnut.2025.02.026","url":null,"abstract":"<p><strong>Background: </strong>There is no specific dietary pattern for cardiometabolic health based on Chinese food culture.</p><p><strong>Objectives: </strong>The study aimed to develop and assess the efficacy of the reducing cardiometabolic disease risk (RCMDR) dietary pattern on cardiometabolic disease risk in the Chinese population with dyslipidemia.</p><p><strong>Methods: </strong>In this single-center, open-label, randomized, 12-wk dietary intervention study, 100 adults aged 35-45 y with dyslipidemia were randomly assigned (1:1) to the RCMDR dietary pattern intervention or general health education control group.</p><p><strong>Results: </strong>Compared with the control group, the RCMDR dietary pattern intervention resulted in a significantly lower clustered cardiometabolic risk score (primary outcome) (β: -0.17; 95% CI: -0.29, -0.05); diastolic blood pressure (β: -0.23; 95% CI: -0.40, -0.07); total cholesterol, LDL cholesterol, triglyceride (β: -0.27; 95% CI: -0.49, -0.04; β: -0.24; 95% CI: -0.41, -0.07; and β: -0.19; 95% CI: -0.35, -0.04, respectively); homocysteine (β: -0.19; 95% CI: -0.28, -0.09); waist circumference, waist-to-hip ratio, body fat percentage, body fat mass, visceral adipose tissue, visceral fat area, and a significantly higher lean body mass (β: -1.12; 95% CI: -1.65, -0.59; β: -1.01; 95% CI: -1.66, -0.36; β: -1.43; 95% CI: -1.87, -0.98; β: -0.98; 95% CI: -1.35, -0.60; β: -1.93; 95% CI: -2.75, -1.11; β: -6.52; 95% CI: -9.10, -3.95; and β: 1.24; 95% CI: 0.84, 1.65, respectively).</p><p><strong>Conclusions: </strong>Compared with the control group, the RCMDR dietary pattern intervention lowers cardiometabolic risk, blood lipids, blood pressure, abdominal obesity, and circulating homocysteine concentration among Chinese population with dyslipidemia.</p><p><strong>Clinical trial registry: </strong>This trial was registered at Chinese Clinical Trial Registry as ChiCTR2300072472 (https://www.chictr.org.cn/showproj.html?proj=198618).</p>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dietary patterns and colorectal cancer risk: Global Cancer Update Programme (CUP Global) systematic literature review.
IF 6.5 1区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-25 DOI: 10.1016/j.ajcnut.2025.02.021
Anne Hy Chu, Kehuan Lin, Helen Croker, Sarah Kefyalew, Nerea Becerra-Tomás, Laure Dossus, Esther M González-Gil, Nahid Ahmadi, Yikyung Park, John Krebs, Matty P Weijenberg, Monica L Baskin, Ellen Copson, Sarah J Lewis, Jacob C Seidell, Rajiv Chowdhury, Lynette Hill, Doris Sm Chan, Dong Hoon Lee, Edward L Giovannucci

Background: The 2018 World Cancer Research Fund/American Institute for Cancer Research Third Expert Report, including studies up to 2015, determined limited-no conclusion evidence on dietary patterns and colorectal cancer (CRC) risk due to insufficient data and varying pattern definitions.

Objectives: This updated review synthesized literature on dietary patterns and CRC risk/mortality.

Methods: PubMed and Embase were searched through 31 March, 2023, for randomized controlled trials (RCTs) and prospective cohort studies on adulthood dietary patterns. Patterns were categorized by derivation method: a priori, a posteriori, or hybrid, and were then descriptively reviewed in relation to the primary outcomes: CRC risk or mortality. The Global Cancer Update Programme Expert Committee and Expert Panel independently graded the evidence on the likelihood of causality using predefined criteria.

Results: Thirty-two dietary scores from 53 observational studies and 3 RCTs were reviewed. Limited-suggestive evidence was concluded for higher alignment with a priori-derived patterns: Mediterranean, healthful plant-based index, Healthy Eating Index (HEI)/alternate HEI, and Dietary Approaches to Stop Hypertension (DASH), in relation to lower CRC risk. Common features across these diets included high plant-based food intake and limited red/processed meat. Hybrid-derived patterns: the empirical dietary pattern for hyperinsulinemia and empirical dietary inflammatory pattern (EDIP), showed strong-probable evidence for increased CRC risk. Evidence for a priori-derived low-fat dietary interventions and a posteriori-derived patterns was graded as limited-no conclusion. By cancer subsite, higher alignment with Mediterranean diet showed limited-suggestive evidence for lower rectal cancer risk, and that with HEI/alternate HEI and DASH showed limited-suggestive evidence for lower colon and rectal cancer risks. Empirical dietary pattern for hyperinsulinemia and EDIP showed strong-probable evidence for increased colon cancer risks. All exposure-mortality pairs and other pattern-outcome associations were graded as limited-no conclusion.

Conclusions: This review highlights the role of dietary patterns in CRC risk/mortality, providing insights for future research and public health strategies. This review was registered at PROSPERO as CRD42022324327 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324327).

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American Journal of Clinical Nutrition
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