Pub Date : 2025-12-24DOI: 10.1016/j.ajcnut.2025.101174
Zach Conrad , Matthias Leu , Songze Wu , Eli Fulcher , Brenna Keam , Min Kim , Dakota Kinsel , Sarah Lozina , Chloe DiStaso , Julia Kun , Juan Boston , Tomalita Peterson , Beth Roach , Tommy Tupponce , Jessica Phillips , Troy Wiipongwii
Background
The historical disruption of Indigenous food systems in the United States has been a leading driver of contemporary nutrition-related health disparities. More information is needed to understand how climate change may impact the capacity of Indigenous food systems to support diet quality in the future.
Objectives
The objective of this study was to model the impact of climate change (global climate models GFDL 370, GISSG 245, GISSG 370, GISSH 245, and GISSH 370) on the agricultural capacity of all 24 tribal nations in Virginia, Maryland, and North Carolina to support recommended dietary intakes using prime agricultural land, and by expanding agricultural production onto subprime agricultural land.
Methods
A biophysical simulation model was used to evaluate the agricultural capacity of tribal lands to support a diet pattern that is consistent with the 2020-2025 United States Dietary Guidelines for Americans. The model represented a regional Indigenous food system as a series of integrated biological processes that transform user-inputted diet patterns into the agricultural resources needed to produce them. The model was parameterized for local conditions using primary data collected from partnering Indigenous tribes, data from a previously published geoclimatic model, and publicly available secondary data.
Results
Under near-future (2021–2040) climate conditions, prime agricultural land was not able to support all dietary recommendations for the population. By expanding agricultural production onto low/moderate-suitability land, and by importing red/orange vegetables (tomatoes, sweet potatoes, and winter squash), 18% to 59% of the population was estimated to meet their dietary recommendations. Further expansion onto marginal agricultural land was estimated to support 213% of the population’s dietary needs without any imports.
Conclusions
Under modeled conditions, we estimated that Indigenous agriculture in the eastern United States can support some, but not all, of the population’s dietary needs. Greater efforts are needed to foster agricultural initiatives that promote food sovereignty and reduce nutrition-related health disparities, but their viability in this region will depend on future supply-demand dynamics that are influenced by changing political landscapes.
{"title":"First-contact tribal nations in the eastern United States can produce some, but not all, of their food needs in a changing climate: a modeling study","authors":"Zach Conrad , Matthias Leu , Songze Wu , Eli Fulcher , Brenna Keam , Min Kim , Dakota Kinsel , Sarah Lozina , Chloe DiStaso , Julia Kun , Juan Boston , Tomalita Peterson , Beth Roach , Tommy Tupponce , Jessica Phillips , Troy Wiipongwii","doi":"10.1016/j.ajcnut.2025.101174","DOIUrl":"10.1016/j.ajcnut.2025.101174","url":null,"abstract":"<div><h3>Background</h3><div>The historical disruption of Indigenous food systems in the United States has been a leading driver of contemporary nutrition-related health disparities. More information is needed to understand how climate change may impact the capacity of Indigenous food systems to support diet quality in the future.</div></div><div><h3>Objectives</h3><div>The objective of this study was to model the impact of climate change (global climate models GFDL 370, GISSG 245, GISSG 370, GISSH 245, and GISSH 370) on the agricultural capacity of all 24 tribal nations in Virginia, Maryland, and North Carolina to support recommended dietary intakes using prime agricultural land, and by expanding agricultural production onto subprime agricultural land.</div></div><div><h3>Methods</h3><div>A biophysical simulation model was used to evaluate the agricultural capacity of tribal lands to support a diet pattern that is consistent with the 2020-2025 United States Dietary Guidelines for Americans. The model represented a regional Indigenous food system as a series of integrated biological processes that transform user-inputted diet patterns into the agricultural resources needed to produce them. The model was parameterized for local conditions using primary data collected from partnering Indigenous tribes, data from a previously published geoclimatic model, and publicly available secondary data.</div></div><div><h3>Results</h3><div>Under near-future (2021–2040) climate conditions, prime agricultural land was not able to support all dietary recommendations for the population. By expanding agricultural production onto low/moderate-suitability land, and by importing red/orange vegetables (tomatoes, sweet potatoes, and winter squash), 18% to 59% of the population was estimated to meet their dietary recommendations. Further expansion onto marginal agricultural land was estimated to support 213% of the population’s dietary needs without any imports.</div></div><div><h3>Conclusions</h3><div>Under modeled conditions, we estimated that Indigenous agriculture in the eastern United States can support some, but not all, of the population’s dietary needs. Greater efforts are needed to foster agricultural initiatives that promote food sovereignty and reduce nutrition-related health disparities, but their viability in this region will depend on future supply-demand dynamics that are influenced by changing political landscapes.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 2","pages":"Article 101174"},"PeriodicalIF":6.9,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844525","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}
Pub Date : 2025-12-20DOI: 10.1016/j.ajcnut.2025.101142
Dong Liu , Yunnan Zhang , Zhi Chen , Yan Hong , Tong Liu , Li-Hua Chen
Background
In iodine-replete populations, hypothyroidism is mainly caused by autoimmune thyroiditis, which disproportionately affects females. Ultra-processed foods (UPFs) are linked to metabolic disturbances and chronic inflammation that may contribute to autoimmune-related hypothyroidism; however, evidence remains limited, particularly regarding sex-specific differences.
Objectives
To examine the association between UPF intake and incident autoimmune-related hypothyroidism, and quantify mediation by circulating biomarkers, with emphasis on sex-specific effects.
Methods
We included 123,812 UK Biobank participants (68,456 females; 55,356 males) without thyroid disease at baseline who completed ≥2 24-h dietary recalls (2009–2012). UPF intake (percentage energy) was defined according to NOVA and modeled in sex-specific quintiles. Incident hypothyroidism was identified via linked health records to 2020. Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for demographic, lifestyle, clinical, and dietary factors. Mediation analyses assessed the proportion of mediation via biomarkers involving renal, liver function, lipid, glucose metabolism, and immune-inflammatory status. Effect modification was evaluated by including cross-product interaction terms between UPF intake and potential modifiers.
Results
During a median of 11.2 y of follow-up, 2907 hypothyroidism cases occurred (2303 females; 604 males). Compared with the lowest UPF quintile, the highest quintile showed a higher risk of hypothyroidism (HR: 1.31; 95% confidence interval: 1.16, 1.49; P-trend < 0.001), consistent in females [1.28 (1.11, 1.48)] and males [1.36 (1.04, 1.79)]. Renal function biomarker cystatin C mediated the largest proportion of the association (35.5% in females; 26.3% in males), followed by cholesterol efflux–related biomarkers (apolipoprotein A and high-density lipoprotein cholesterol). Among females, associations were stronger with hormone replacement therapy (interaction HR: 1.06, P-interaction = 0.021).
Conclusions
Higher UPF intake was associated with an increased risk of autoimmune-related hypothyroidism in both sexes, partly mediated by renal and lipid biomarkers. Risk may be amplified in females using hormone replacement therapy.
{"title":"Ultra-processed food consumption and incident autoimmune-related hypothyroidism: a sex-stratified prospective analysis from the UK Biobank","authors":"Dong Liu , Yunnan Zhang , Zhi Chen , Yan Hong , Tong Liu , Li-Hua Chen","doi":"10.1016/j.ajcnut.2025.101142","DOIUrl":"10.1016/j.ajcnut.2025.101142","url":null,"abstract":"<div><h3>Background</h3><div>In iodine-replete populations, hypothyroidism is mainly caused by autoimmune thyroiditis, which disproportionately affects females. Ultra-processed foods (UPFs) are linked to metabolic disturbances and chronic inflammation that may contribute to autoimmune-related hypothyroidism; however, evidence remains limited, particularly regarding sex-specific differences.</div></div><div><h3>Objectives</h3><div>To examine the association between UPF intake and incident autoimmune-related hypothyroidism, and quantify mediation by circulating biomarkers, with emphasis on sex-specific effects.</div></div><div><h3>Methods</h3><div>We included 123,812 UK Biobank participants (68,456 females; 55,356 males) without thyroid disease at baseline who completed ≥2 24-h dietary recalls (2009–2012). UPF intake (percentage energy) was defined according to NOVA and modeled in sex-specific quintiles. Incident hypothyroidism was identified via linked health records to 2020. Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for demographic, lifestyle, clinical, and dietary factors. Mediation analyses assessed the proportion of mediation via biomarkers involving renal, liver function, lipid, glucose metabolism, and immune-inflammatory status. Effect modification was evaluated by including cross-product interaction terms between UPF intake and potential modifiers.</div></div><div><h3>Results</h3><div>During a median of 11.2 y of follow-up, 2907 hypothyroidism cases occurred (2303 females; 604 males). Compared with the lowest UPF quintile, the highest quintile showed a higher risk of hypothyroidism (HR: 1.31; 95% confidence interval: 1.16, 1.49; <em>P</em>-trend < 0.001), consistent in females [1.28 (1.11, 1.48)] and males [1.36 (1.04, 1.79)]. Renal function biomarker cystatin C mediated the largest proportion of the association (35.5% in females; 26.3% in males), followed by cholesterol efflux–related biomarkers (apolipoprotein A and high-density lipoprotein cholesterol). Among females, associations were stronger with hormone replacement therapy (interaction HR: 1.06, <em>P</em>-interaction = 0.021).</div></div><div><h3>Conclusions</h3><div>Higher UPF intake was associated with an increased risk of autoimmune-related hypothyroidism in both sexes, partly mediated by renal and lipid biomarkers. Risk may be amplified in females using hormone replacement therapy.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 2","pages":"Article 101142"},"PeriodicalIF":6.9,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812254","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}
Pub Date : 2025-12-20DOI: 10.1016/j.ajcnut.2025.101141
Elise Sheinberg , Anna C Tucker , Alessandra Uriarte , Christine M Weston , Cerra C Antonacci , Melissa N Laska , Julia A Wolfson , Cindy W Leung
Background
Food insecurity is associated with poor diet quality. However, nutrition security may better predict diet quality as it specifically measures healthy food access.
Objectives
This study aims to examine the associations between food security, nutrition security, and joint food and nutrition security status with diet quality.
Methods
Data came from 2 cross-sectional surveys of United States adults (n = 4554) and Supplemental Nutrition Assistance Program (SNAP) participants (n = 1463). For United States adults, food security was measured with the 18-item Household Food Security Survey Module, and diet quality was measured with the Prime Diet Quality Score (PDQS). For SNAP adults, food security was measured with the USDA’s 6-item Food Security Survey, and diet quality was measured with the rapid PDQS (rPDQS). Nutrition security was measured with the Center for Nutrition and Health Impact’s Household Nutrition Security (HNS) in both samples. Linear regression models analyzed the relationship between food and nutrition security and diet quality separately and jointly, adjusting for sociodemographic covariates.
Results
In the United States adult sample, 52.8% were food and nutrition secure (FS/NS), 16.4% were food insecure and nutrition secure (FI/NS), 4.2% were food secure and nutrition insecure (FS/NI), and 26.6% were food and nutrition insecurity (FI/NI). In the SNAP sample, 24.1% were FS/NS, 27.5% were FI/NS, 1.4% were FS/NI, and 46.9% were FI/NI. After multivariate adjustment, food insecurity was associated with lower diet quality in both samples [United States adults: = −1.2 PDQS points; 95% confidence interval (CI): = −1.9, −0.54; SNAP sample: 0.92 rPDQS points; 95% CI: −1.7, −0.14]. Nutrition insecurity was not associated with lower diet quality for either sample. In both samples, joint food and nutrition insecurity was associated with the lowest diet quality compared with other groups.
Conclusions
Further research is needed to understand the utility of the HNS because food insecurity was more strongly associated with lower diet quality than nutrition insecurity.
{"title":"Understanding the association of food insecurity and nutrition insecurity with diet quality: a cross-sectional analysis of 2 national samples","authors":"Elise Sheinberg , Anna C Tucker , Alessandra Uriarte , Christine M Weston , Cerra C Antonacci , Melissa N Laska , Julia A Wolfson , Cindy W Leung","doi":"10.1016/j.ajcnut.2025.101141","DOIUrl":"10.1016/j.ajcnut.2025.101141","url":null,"abstract":"<div><h3>Background</h3><div>Food insecurity is associated with poor diet quality. However, nutrition security may better predict diet quality as it specifically measures healthy food access.</div></div><div><h3>Objectives</h3><div>This study aims to examine the associations between food security, nutrition security, and joint food and nutrition security status with diet quality.</div></div><div><h3>Methods</h3><div>Data came from 2 cross-sectional surveys of United States adults (<em>n =</em> 4554) and Supplemental Nutrition Assistance Program (SNAP) participants (<em>n =</em> 1463). For United States adults, food security was measured with the 18-item Household Food Security Survey Module, and diet quality was measured with the Prime Diet Quality Score (PDQS). For SNAP adults, food security was measured with the USDA’s 6-item Food Security Survey, and diet quality was measured with the rapid PDQS (rPDQS). Nutrition security was measured with the Center for Nutrition and Health Impact’s Household Nutrition Security (HNS) in both samples. Linear regression models analyzed the relationship between food and nutrition security and diet quality separately and jointly, adjusting for sociodemographic covariates.</div></div><div><h3>Results</h3><div>In the United States adult sample, 52.8% were food and nutrition secure (FS/NS), 16.4% were food insecure and nutrition secure (FI/NS), 4.2% were food secure and nutrition insecure (FS/NI), and 26.6% were food and nutrition insecurity (FI/NI). In the SNAP sample, 24.1% were FS/NS, 27.5% were FI/NS, 1.4% were FS/NI, and 46.9% were FI/NI. After multivariate adjustment, food insecurity was associated with lower diet quality in both samples [United States adults: <span><math><mrow><mi>β</mi></mrow></math></span> = −1.2 PDQS points; 95% confidence interval (CI): = −1.9, −0.54; SNAP sample: <span><math><mrow><mi>β</mi><mo>=</mo><mo>−</mo></mrow></math></span>0.92 rPDQS points; 95% CI: −1.7, −0.14]. Nutrition insecurity was not associated with lower diet quality for either sample. In both samples, joint food and nutrition insecurity was associated with the lowest diet quality compared with other groups.</div></div><div><h3>Conclusions</h3><div>Further research is needed to understand the utility of the HNS because food insecurity was more strongly associated with lower diet quality than nutrition insecurity.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 2","pages":"Article 101141"},"PeriodicalIF":6.9,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812236","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}
Pub Date : 2025-12-20DOI: 10.1016/j.ajcnut.2025.101144
Jie Chen , Hongjuan Cao , Yangxin Xu , Yu Chang , Xinsheng Qin , Zhuang Zhang , Wanshui Yang
Background
The association between light-to-moderate alcohol drinking (≤14 g/d for females; ≤28 g/d for males) and the risk of steatotic liver disease (SLD), including its metabolic dysfunction-associated subtype (MASLD), remains unclear, as does the role of related gut microbiota.
Objectives
We investigated the association between light-to-moderate alcohol drinking and incident SLD/MASLD, identified gut microbial species associated with such drinking, and evaluated their associations with disease risk.
Methods
Among 1297 adults from a Chinese community-based cohort, alcohol intake was assessed by a validated questionnaire, and SLD was diagnosed by vibration-controlled transient elastography. In a subset with fecal samples at follow-up (n = 665), gut microbiota was profiled using shotgun metagenomic sequencing. We used the mean alcohol intake from baseline and follow-up to represent long-term drinking habits. Species differentially associated with alcohol intake were identified using zero-inflated Gaussian models with false discovery rate (FDR) correction. Cox and logistic regression were used to estimate hazard ratio (HR) and odds ratio (OR) with 95% confidence interval (CI), respectively.
Results
During follow-up (2020–2025), 513 incident SLD cases were identified. Light-to-moderate drinkers showed higher risks of SLD (HR = 1.27, 95% CI: 1.03, 1.58) and MASLD (HR = 1.27, 95% CI: 1.01, 1.59) compared with abstainers. For the same comparison, liquor consumption was positively associated with SLD (HR = 1.29, 95% CI: 1.01, 1.65). We identified 89 microbial species associated with alcohol intake and constructed a microbial score, which was positively associated with SLD (ORT3 vs T1 = 1.54, 95% CI: 1.03, 2.31, Ptrend = 0.05) and MASLD (ORT3 vs T1 = 1.50, 95% CI: 1.00, 2.26, Ptrend = 0.05). Among these species, Stenotrophomonas maltophilia AQ, Olsenella E timonensis, and Firm 11 sp., which were less abundant in drinkers, showed inverse associations with both conditions after FDR correction.
Conclusions
Light-to-moderate alcohol consumption was associated with increased risks of SLD and MASLD. A gut microbial score based on alcohol-associated species also predicted higher disease risk.
{"title":"Is light-to-moderate alcohol drinking associated with the onset of metabolic dysfunction-associated steatotic liver disease in a Chinese cohort?","authors":"Jie Chen , Hongjuan Cao , Yangxin Xu , Yu Chang , Xinsheng Qin , Zhuang Zhang , Wanshui Yang","doi":"10.1016/j.ajcnut.2025.101144","DOIUrl":"10.1016/j.ajcnut.2025.101144","url":null,"abstract":"<div><h3>Background</h3><div>The association between light-to-moderate alcohol drinking (≤14 g/d for females; ≤28 g/d for males) and the risk of steatotic liver disease (SLD), including its metabolic dysfunction-associated subtype (MASLD), remains unclear, as does the role of related gut microbiota.</div></div><div><h3>Objectives</h3><div>We investigated the association between light-to-moderate alcohol drinking and incident SLD/MASLD, identified gut microbial species associated with such drinking, and evaluated their associations with disease risk.</div></div><div><h3>Methods</h3><div>Among 1297 adults from a Chinese community-based cohort, alcohol intake was assessed by a validated questionnaire, and SLD was diagnosed by vibration-controlled transient elastography. In a subset with fecal samples at follow-up (<em>n =</em> 665), gut microbiota was profiled using shotgun metagenomic sequencing. We used the mean alcohol intake from baseline and follow-up to represent long-term drinking habits. Species differentially associated with alcohol intake were identified using zero-inflated Gaussian models with false discovery rate (FDR) correction. Cox and logistic regression were used to estimate hazard ratio (HR) and odds ratio (OR) with 95% confidence interval (CI), respectively.</div></div><div><h3>Results</h3><div>During follow-up (2020–2025), 513 incident SLD cases were identified. Light-to-moderate drinkers showed higher risks of SLD (HR = 1.27, 95% CI: 1.03, 1.58) and MASLD (HR = 1.27, 95% CI: 1.01, 1.59) compared with abstainers. For the same comparison, liquor consumption was positively associated with SLD (HR = 1.29, 95% CI: 1.01, 1.65). We identified 89 microbial species associated with alcohol intake and constructed a microbial score, which was positively associated with SLD (OR<sub>T3 vs T1</sub> = 1.54, 95% CI: 1.03, 2.31, <em>P</em><sub>trend</sub> = 0.05) and MASLD (OR<sub>T3 vs T1</sub> = 1.50, 95% CI: 1.00, 2.26, <em>P</em><sub>trend</sub> = 0.05). Among these species, <em>Stenotrophomonas maltophilia AQ</em>, <em>Olsenella E timonensis</em>, and <em>Firm 11 sp.</em>, which were less abundant in drinkers, showed inverse associations with both conditions after FDR correction.</div></div><div><h3>Conclusions</h3><div>Light-to-moderate alcohol consumption was associated with increased risks of SLD and MASLD. A gut microbial score based on alcohol-associated species also predicted higher disease risk.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 2","pages":"Article 101144"},"PeriodicalIF":6.9,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812215","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}
Pub Date : 2025-12-19DOI: 10.1016/j.ajcnut.2025.101143
Julien O Tremblay , Samuel L Swift , Tatjana Rundek , Daniela Sotres-Alvarez , Leopoldo Raij , Linda Van Horn , Martha Daviglus , Sheila Castaneda , Christina Cordero , Nora Franceschini , Sylvia Wassertheil-Smoller , Tali Elfassy
Background
Associations between dietary sodium and potassium with cardiovascular disease (CVD) remain controversial.
Objectives
This study aimed to evaluate the relationship of dietary sodium and potassium with incident cardiovascular disease among diverse Hispanic/Latino adults.
Methods
The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a prospective cohort of 16,415 self-identifying Hispanic/Latino adults aged 18 to 74 y. At baseline (2008–2011), participants underwent a comprehensive examination by bilingual interviewers. Dietary sodium (mg/d) and potassium (mg/d) intake were assessed from the average of two 24-h dietary recall surveys. CVD events (heart failure, myocardial infarction, or stroke) occurring from baseline through 2021 were adjudicated by an expert panel of clinicians. Cox proportional hazards models were used to determine the associations between sodium, potassium, and the sodium-to-potassium ratio, with CVD, after adjusting for demographic, socioeconomic, behavioral, and clinical factors. All analyses accounted for the HCHS/SOL complex survey design.
Results
Among 14,947 participants without a self-reported history of CVD, mean age was 40 y, with 53% female. Over 11.5 y, there were 481 CVD events [2.7 per 1000 person years, 95% confidence interval (CI): 2.3, 3.2]. Nutrient intakes were associated with increased risk of CVD: by 19% for each 1 g/d increment of sodium [hazard ratio (HR): 1.19, 95% CI: 1.05, 1.34]; by 40% for each 1 g/d decrement of potassium (HR: 1.40, 95% CI: 1.13, 1.73); and by 146% for each 0.5 molar increment of sodium-to-potassium ratio (HR: 2.46, 95% CI: 1.71, 3.56).
Conclusions
In a large and diverse sample of Hispanic/Latino adults, high dietary sodium and low dietary potassium were independently associated with an increased risk of CVD. Results underscore the importance of investing in public health interventions to improve dietary quality and reduce incident CVD.
{"title":"High sodium and low potassium are associated with incident cardiovascular disease among United States Hispanic/Latino adults: prospective results from the Hispanic Community Health Study/Study of Latinos","authors":"Julien O Tremblay , Samuel L Swift , Tatjana Rundek , Daniela Sotres-Alvarez , Leopoldo Raij , Linda Van Horn , Martha Daviglus , Sheila Castaneda , Christina Cordero , Nora Franceschini , Sylvia Wassertheil-Smoller , Tali Elfassy","doi":"10.1016/j.ajcnut.2025.101143","DOIUrl":"10.1016/j.ajcnut.2025.101143","url":null,"abstract":"<div><h3>Background</h3><div>Associations between dietary sodium and potassium with cardiovascular disease (CVD) remain controversial.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the relationship of dietary sodium and potassium with incident cardiovascular disease among diverse Hispanic/Latino adults.</div></div><div><h3>Methods</h3><div>The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a prospective cohort of 16,415 self-identifying Hispanic/Latino adults aged 18 to 74 y. At baseline (2008–2011), participants underwent a comprehensive examination by bilingual interviewers. Dietary sodium (mg/d) and potassium (mg/d) intake were assessed from the average of two 24-h dietary recall surveys. CVD events (heart failure, myocardial infarction, or stroke) occurring from baseline through 2021 were adjudicated by an expert panel of clinicians. Cox proportional hazards models were used to determine the associations between sodium, potassium, and the sodium-to-potassium ratio, with CVD, after adjusting for demographic, socioeconomic, behavioral, and clinical factors. All analyses accounted for the HCHS/SOL complex survey design.</div></div><div><h3>Results</h3><div>Among 14,947 participants without a self-reported history of CVD, mean age was 40 y, with 53% female. Over 11.5 y, there were 481 CVD events [2.7 per 1000 person years, 95% confidence interval (CI): 2.3, 3.2]. Nutrient intakes were associated with increased risk of CVD: by 19% for each 1 g/d increment of sodium [hazard ratio (HR): 1.19, 95% CI: 1.05, 1.34]; by 40% for each 1 g/d decrement of potassium (HR: 1.40, 95% CI: 1.13, 1.73); and by 146% for each 0.5 molar increment of sodium-to-potassium ratio (HR: 2.46, 95% CI: 1.71, 3.56).</div></div><div><h3>Conclusions</h3><div>In a large and diverse sample of Hispanic/Latino adults, high dietary sodium and low dietary potassium were independently associated with an increased risk of CVD. Results underscore the importance of investing in public health interventions to improve dietary quality and reduce incident CVD.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 2","pages":"Article 101143"},"PeriodicalIF":6.9,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806416","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}
Pub Date : 2025-12-19DOI: 10.1016/j.ajcnut.2025.101139
Yanhe Li , Janet A Novotny , David Baer , Yang Hu , Qi Sun , Shuwei Zhang , Shengmin Sang
Background
Betainized compounds are bioactive metabolites involved in 1-carbon metabolism and cellular osmoprotection. Whole grains (WGs) are important dietary sources of these compounds, but their postprandial and daily metabolic responses in humans remain understudied.
Objectives
To characterize the pharmacokinetic (PK) profiles and short-term accumulation of 16 betainized metabolites following WG wheat and oat intake and to identify WG intake-specific biomarkers.
Methods
Two randomized, controlled crossover trials were conducted. The first was a 2-period PK study involving 12 healthy adults, who consumed WG wheat and oat in a crossover design, with serial plasma and urine collection ≤24 h and 48 h, respectively. The second was a study with five 15-d controlled feeding periods separated by washout phases (∼8 mo total), in which 54 participants consumed wheat- or oat-based diets. Plasma and urine were collected on day 1 (baseline), day 8, and day 15 of each period. All samples were analyzed using liquid chromatography–mass spectrometry (LC-MS). PK parameters were calculated, and statistical analyses evaluated interindividual variability, temporal trends, and grain-specific effects.
Results
Valine betaine, isoleucine betaine, and glutamine betaine exhibited distinct PK profiles, peaking at 5 to 6 h after WG wheat consumption and coinciding with their major urinary excretion window. In the daily grain intake study, valine betaine increased from 1.2 ± 0.4 to 22.2 ± 1.8 nM in plasma and from 39.5 ± 2.2 to 218.5 ± 8.6 μmol/mmol creatinine in urine by day 15 (P < 0.05). Isoleucine betaine showed a similar trend, whereas glutamine betaine was only detected in urine, increasing from 5.7 ± 0.9 to 10.7 ± 0.6 μmol/mmol creatinine. These results demonstrate clear dose- and time-dependent accumulation consistent with their kinetic behavior.
Conclusions
Valine betaine, isoleucine betaine, and glutamine betaine are specific biomarkers of WG wheat intake, not WG oat. Their distinct responses highlight the need for precision nutrition when evaluating the health benefits of WGs.
This trial was registered at clinicaltrials.gov as NCT03783637 and NCT04104581.
{"title":"Betainized metabolites as biomarkers of whole grain wheat, not oat: insights from controlled crossover pharmacokinetic and daily feeding studies","authors":"Yanhe Li , Janet A Novotny , David Baer , Yang Hu , Qi Sun , Shuwei Zhang , Shengmin Sang","doi":"10.1016/j.ajcnut.2025.101139","DOIUrl":"10.1016/j.ajcnut.2025.101139","url":null,"abstract":"<div><h3>Background</h3><div>Betainized compounds are bioactive metabolites involved in 1-carbon metabolism and cellular osmoprotection. Whole grains (WGs) are important dietary sources of these compounds, but their postprandial and daily metabolic responses in humans remain understudied.</div></div><div><h3>Objectives</h3><div>To characterize the pharmacokinetic (PK) profiles and short-term accumulation of 16 betainized metabolites following WG wheat and oat intake and to identify WG intake-specific biomarkers.</div></div><div><h3>Methods</h3><div>Two randomized, controlled crossover trials were conducted. The first was a 2-period PK study involving 12 healthy adults, who consumed WG wheat and oat in a crossover design, with serial plasma and urine collection ≤24 h and 48 h, respectively. The second was a study with five 15-d controlled feeding periods separated by washout phases (∼8 mo total), in which 54 participants consumed wheat- or oat-based diets. Plasma and urine were collected on day 1 (baseline), day 8, and day 15 of each period. All samples were analyzed using liquid chromatography–mass spectrometry (LC-MS). PK parameters were calculated, and statistical analyses evaluated interindividual variability, temporal trends, and grain-specific effects.</div></div><div><h3>Results</h3><div>Valine betaine, isoleucine betaine, and glutamine betaine exhibited distinct PK profiles, peaking at 5 to 6 h after WG wheat consumption and coinciding with their major urinary excretion window. In the daily grain intake study, valine betaine increased from 1.2 ± 0.4 to 22.2 ± 1.8 nM in plasma and from 39.5 ± 2.2 to 218.5 ± 8.6 <em>μ</em>mol/mmol creatinine in urine by day 15 (<em>P</em> < 0.05). Isoleucine betaine showed a similar trend, whereas glutamine betaine was only detected in urine, increasing from 5.7 ± 0.9 to 10.7 ± 0.6 <em>μ</em>mol/mmol creatinine. These results demonstrate clear dose- and time-dependent accumulation consistent with their kinetic behavior.</div></div><div><h3>Conclusions</h3><div>Valine betaine, isoleucine betaine, and glutamine betaine are specific biomarkers of WG wheat intake, not WG oat. Their distinct responses highlight the need for precision nutrition when evaluating the health benefits of WGs.</div><div>This trial was registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> as NCT03783637 and NCT04104581.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 2","pages":"Article 101139"},"PeriodicalIF":6.9,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806419","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}
Pub Date : 2025-12-13DOI: 10.1016/j.ajcnut.2025.101137
Nana Gletsu-Miller , Meredith L Wilcox , Lisa A Spence , Amy J Wright , Liana L Guarneiri , Muhammad M Nadeem , Mark J Hutter , Karen L Sprague , Andrew W Brown , Allon N Friedman , Carol F Kirkpatrick , Kevin C Maki
Background
Limited high-quality evidence exists from controlled trials on the impact of avocado-containing diets on cardiometabolic risk factors.
Objectives
The purpose of this randomized, double-blind, free-living, controlled feeding, crossover study in adults with increased cardiometabolic risk was to assess the effects of replacing energy from solid fats and added sugars with equivalent energy from 1 avocado daily on cardiometabolic risk factors.
Methods
For two 3-wk periods, separated by a 2-wk washout, healthy adults with elevated triglycerides (TG, 135–499 mg/dL) consumed an average American diet or a diet in which 1 avocado (∼180 g/d, ∼300 kcal/d) replaced energy from saturated fatty acids and added sugars. The same study products (muffins, granola bites, dressing, salsa, marinade, and pesto) delivered the avocado or control ingredients. Green food dye was added to the control study products to facilitate double blinding. Non–high-density lipoprotein (non-HDL) cholesterol (primary outcome), other lipoprotein lipids, fasting glucose and insulin, and fasting and postprandial blood pressures were measured at baseline and end of condition. Linear mixed models were used to generate estimates for percentage changes.
Results
Of 42 randomly assigned participants, 37 completed the avocado condition and 39 completed the control condition. An intention-to-treat analysis showed significantly larger percentage changes, 95% confidence intervals (CIs), from baseline after the avocado condition, compared with after the control condition, for non-HDL cholesterol (−4.65%; 95% CI: −9.01%, −0.08%; P = 0.047), very-low-density lipoprotein cholesterol (−9.30%; 95% CI: −15.3%, −2.82%; P = 0.007); TG (−17.4%; 95% CI: −25.0%, −8.99%; P < 0.001), small low-density lipoprotein subfraction cholesterol (−13.9%; 95% CI: −23.2%, −3.49%; P = 0.012), and total cholesterol:HDL cholesterol ratio (−6.56%; 95% CI: −12.0%, −0.79%; P = 0.028). Percentage changes for other lipoprotein lipids, glucose, insulin, and blood pressures did not significantly differ (P > 0.05) between conditions.
Conclusions
Replacing solid fats and added sugars with avocado in a typical American diet improves the lipoprotein lipid profile in adults with elevated TG.
This trial was registered at clinicaltrials.gov as NCT04990817 (https://clinicaltrials.gov/study/NCT04990817).
{"title":"Effects of replacing solid fats and added sugars with avocado in adults with elevated cardiometabolic risk: a randomized, double-blind, controlled feeding, crossover trial","authors":"Nana Gletsu-Miller , Meredith L Wilcox , Lisa A Spence , Amy J Wright , Liana L Guarneiri , Muhammad M Nadeem , Mark J Hutter , Karen L Sprague , Andrew W Brown , Allon N Friedman , Carol F Kirkpatrick , Kevin C Maki","doi":"10.1016/j.ajcnut.2025.101137","DOIUrl":"10.1016/j.ajcnut.2025.101137","url":null,"abstract":"<div><h3>Background</h3><div>Limited high-quality evidence exists from controlled trials on the impact of avocado-containing diets on cardiometabolic risk factors.</div></div><div><h3>Objectives</h3><div>The purpose of this randomized, double-blind, free-living, controlled feeding, crossover study in adults with increased cardiometabolic risk was to assess the effects of replacing energy from solid fats and added sugars with equivalent energy from 1 avocado daily on cardiometabolic risk factors.</div></div><div><h3>Methods</h3><div>For two 3-wk periods, separated by a 2-wk washout, healthy adults with elevated triglycerides (TG, 135–499 mg/dL) consumed an average American diet or a diet in which 1 avocado (∼180 g/d, ∼300 kcal/d) replaced energy from saturated fatty acids and added sugars. The same study products (muffins, granola bites, dressing, salsa, marinade, and pesto) delivered the avocado or control ingredients. Green food dye was added to the control study products to facilitate double blinding. Non–high-density lipoprotein (non-HDL) cholesterol (primary outcome), other lipoprotein lipids, fasting glucose and insulin, and fasting and postprandial blood pressures were measured at baseline and end of condition. Linear mixed models were used to generate estimates for percentage changes.</div></div><div><h3>Results</h3><div>Of 42 randomly assigned participants, 37 completed the avocado condition and 39 completed the control condition. An intention-to-treat analysis showed significantly larger percentage changes, 95% confidence intervals (CIs), from baseline after the avocado condition, compared with after the control condition, for non-HDL cholesterol (−4.65%; 95% CI: −9.01%, −0.08%; <em>P</em> = 0.047), very-low-density lipoprotein cholesterol (−9.30%; 95% CI: −15.3%, −2.82%; <em>P</em> = 0.007); TG (−17.4%; 95% CI: −25.0%, −8.99%; <em>P</em> < 0.001), small low-density lipoprotein subfraction cholesterol (−13.9%; 95% CI: −23.2%, −3.49%; <em>P</em> = 0.012), and total cholesterol:HDL cholesterol ratio (−6.56%; 95% CI: −12.0%, −0.79%; <em>P</em> = 0.028). Percentage changes for other lipoprotein lipids, glucose, insulin, and blood pressures did not significantly differ (<em>P</em> > 0.05) between conditions.</div></div><div><h3>Conclusions</h3><div>Replacing solid fats and added sugars with avocado in a typical American diet improves the lipoprotein lipid profile in adults with elevated TG.</div><div>This trial was registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> as NCT04990817 (<span><span>https://clinicaltrials.gov/study/NCT04990817</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 2","pages":"Article 101137"},"PeriodicalIF":6.9,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764333","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}
Pub Date : 2025-12-12DOI: 10.1016/j.ajcnut.2025.101135
Fangcheng Yuan, Lei Wang, Sang M Nguyen, Xiao-Ou Shu, Martha J Shrubsole, Wanqing Wen, Qiuyin Cai, Danxia Yu, Wei Zheng
Background
Plant-based diets have been advertised for environmental and health benefits. Their effects on cancer risk, gut microbial, and blood metabolomic profiles remain unclear.
Objectives
We investigated plant-based diets in relation to cancer incidence as well as gut microbial composition and blood metabolites in the Southern Community Cohort Study.
Methods
Included in the analysis were 71,533 participants. Habitual dietary intake assessed at baseline (2002–2009) was used to derive the overall plant-based diet index (PDI), healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI). Incident cancer cases were ascertained via linkage to state cancer registries and the National Death Index. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from Cox proportional hazards models after adjusting for potential confounders. We examined associations of the 3 indices with gut microbiota and blood metabolites using fecal metagenomic and blood metabolomic data from 2 subsets of 417 and 1581 participants, respectively.
Results
During a median follow-up time of 11.6 y, 783, 316, and 295 incident colorectal, liver, and pancreatic cancer cases were identified. High hPDI was related to a lower liver cancer risk (HR: 0.67, 95% CI: 0.45, 0.99 comparing extreme quartiles, P-trend = 0.03). No apparent association was observed for colorectal cancer (CRC) in the whole cohort. However, among 49,132 CRC screening-naïve participants at baseline, PDI was inversely associated (HR: 0.74, 95% CI: 0.58, 0.96, P-trend = 0.01), whereas uPDI was positively associated (HR: 1.39, 95% CI: 1.06, 1.82, P-trend = 0.02) with CRC risk. No index was associated with pancreatic cancer. These diet indices were associated with microbial taxa and blood metabolites that have been implicated in the tumorigenesis of the colorectum and liver.
Conclusions
A diet high in healthy plant foods and low in animal foods was inversely associated with liver cancer risk and with CRC risk among screening-naïve participants. These associations may be partly mediated through gut microbiota and systemic metabolism.
{"title":"Plant-based diets, gut microbiota, blood metabolome, and risk of colorectal, liver, and pancreatic cancers: results from a large prospective cohort study of predominantly low-income Americans","authors":"Fangcheng Yuan, Lei Wang, Sang M Nguyen, Xiao-Ou Shu, Martha J Shrubsole, Wanqing Wen, Qiuyin Cai, Danxia Yu, Wei Zheng","doi":"10.1016/j.ajcnut.2025.101135","DOIUrl":"10.1016/j.ajcnut.2025.101135","url":null,"abstract":"<div><h3>Background</h3><div>Plant-based diets have been advertised for environmental and health benefits. Their effects on cancer risk, gut microbial, and blood metabolomic profiles remain unclear.</div></div><div><h3>Objectives</h3><div>We investigated plant-based diets in relation to cancer incidence as well as gut microbial composition and blood metabolites in the Southern Community Cohort Study.</div></div><div><h3>Methods</h3><div>Included in the analysis were 71,533 participants. Habitual dietary intake assessed at baseline (2002–2009) was used to derive the overall plant-based diet index (PDI), healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI). Incident cancer cases were ascertained via linkage to state cancer registries and the National Death Index. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from Cox proportional hazards models after adjusting for potential confounders. We examined associations of the 3 indices with gut microbiota and blood metabolites using fecal metagenomic and blood metabolomic data from 2 subsets of 417 and 1581 participants, respectively.</div></div><div><h3>Results</h3><div>During a median follow-up time of 11.6 y, 783, 316, and 295 incident colorectal, liver, and pancreatic cancer cases were identified. High hPDI was related to a lower liver cancer risk (HR: 0.67, 95% CI: 0.45, 0.99 comparing extreme quartiles, <em>P</em>-trend = 0.03). No apparent association was observed for colorectal cancer (CRC) in the whole cohort. However, among 49,132 CRC screening-naïve participants at baseline, PDI was inversely associated (HR: 0.74, 95% CI: 0.58, 0.96, <em>P</em>-trend = 0.01), whereas uPDI was positively associated (HR: 1.39, 95% CI: 1.06, 1.82, <em>P</em>-trend = 0.02) with CRC risk. No index was associated with pancreatic cancer. These diet indices were associated with microbial taxa and blood metabolites that have been implicated in the tumorigenesis of the colorectum and liver.</div></div><div><h3>Conclusions</h3><div>A diet high in healthy plant foods and low in animal foods was inversely associated with liver cancer risk and with CRC risk among screening-naïve participants. These associations may be partly mediated through gut microbiota and systemic metabolism.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 2","pages":"Article 101135"},"PeriodicalIF":6.9,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758280","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}
Pub Date : 2025-12-04DOI: 10.1016/j.ajcnut.2025.101132
Zeina Jamaluddine , Oona MR Campbell , Miho Sato , Akihiro Seita , Eric O Ohuma , Edward A Frongillo , Hala Ghattas
Background
Evidence on the association of birth size and rapid weight gain with overweight/obesity is inconsistent. Refugees face unique nutritional challenges that influence weight patterns, yet data remain limited.
Objectives
We examined the association between size at birth, infant feeding, and rapid weight gain in the first year of life, and subsequent overweight/obesity in childhood among Palestinian refugees.
Methods
This retrospective cohort study used data from 388,347 live births from 1 January, 2010 to 31 December, 2020, linked to child growth monitoring data using United Nations Relief and Works Agency electronic-health records. The cohort included children aged 0 to 60 mo from 5 regions: Gaza, Jordan, Lebanon, Syria, and the West Bank. Size at birth was categorized into 9 phenotypes, and rapid weight gain was defined as an increase of 0.67 in weight-for-age z-score from birth until age 12 mo. Overweight/obesity occurrence was defined as a weight-for-height z-score >+2 at any time point after 24 to 60 mo of age. Multilevel mixed-effects models and structural equation modeling were used to analyze associations.
Results
Small for gestational age children had lower odds of exclusive human milk feeding [adjusted odds ratio (aOR): 0.83; 95% confidence interval (CI): 0.81, 0.85], higher odds of rapid weight gain (aOR: 2.39; 95% CI: 2.32, 2.45), and lower odds of overweight/obesity (aOR: 0.50; 95% CI: 0.46, 0.56) compared with appropriate for gestational age children. Large for gestational age children showed lower odds of rapid weight gain (aOR: 0.35; 95% CI: 0.33, 0.36) but higher odds of overweight/obesity (aOR: 2.76; 95% CI: 2.59, 2.95) compared with appropriate for gestational age. Between 22.2% and 34.4% of children experienced rapid weight gain. Rapid weight gain was strongly associated with overweight/obesity at 24 to 60 mo (aOR: 6.53; 95% CI: 6.15, 6.94). Exclusive human milk feeding was associated with lower odds of rapid weight gain (aOR: 0.66; 95% CI: 0.65, 0.67).
Conclusions
Rapid weight gain in infancy, regardless of birth size, is a predictor of childhood overweight/obesity. Exclusive human milk feeding mitigates the risk of rapid weight gain and subsequent overweight/obesity.
{"title":"Association between size at birth, rapid weight gain in infancy, and overweight status among Palestinian refugees under 5 years old: a retrospective cohort study","authors":"Zeina Jamaluddine , Oona MR Campbell , Miho Sato , Akihiro Seita , Eric O Ohuma , Edward A Frongillo , Hala Ghattas","doi":"10.1016/j.ajcnut.2025.101132","DOIUrl":"10.1016/j.ajcnut.2025.101132","url":null,"abstract":"<div><h3>Background</h3><div>Evidence on the association of birth size and rapid weight gain with overweight/obesity is inconsistent. Refugees face unique nutritional challenges that influence weight patterns, yet data remain limited.</div></div><div><h3>Objectives</h3><div>We examined the association between size at birth, infant feeding, and rapid weight gain in the first year of life, and subsequent overweight/obesity in childhood among Palestinian refugees.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used data from 388,347 live births from 1 January, 2010 to 31 December, 2020, linked to child growth monitoring data using United Nations Relief and Works Agency electronic-health records. The cohort included children aged 0 to 60 mo from 5 regions: Gaza, Jordan, Lebanon, Syria, and the West Bank. Size at birth was categorized into 9 phenotypes, and rapid weight gain was defined as an increase of 0.67 in weight-for-age <em>z</em>-score from birth until age 12 mo. Overweight/obesity occurrence was defined as a weight-for-height <em>z</em>-score >+2 at any time point after 24 to 60 mo of age. Multilevel mixed-effects models and structural equation modeling were used to analyze associations.</div></div><div><h3>Results</h3><div>Small for gestational age children had lower odds of exclusive human milk feeding [adjusted odds ratio (aOR): 0.83; 95% confidence interval (CI): 0.81, 0.85], higher odds of rapid weight gain (aOR: 2.39; 95% CI: 2.32, 2.45), and lower odds of overweight/obesity (aOR: 0.50; 95% CI: 0.46, 0.56) compared with appropriate for gestational age children. Large for gestational age children showed lower odds of rapid weight gain (aOR: 0.35; 95% CI: 0.33, 0.36) but higher odds of overweight/obesity (aOR: 2.76; 95% CI: 2.59, 2.95) compared with appropriate for gestational age. Between 22.2% and 34.4% of children experienced rapid weight gain. Rapid weight gain was strongly associated with overweight/obesity at 24 to 60 mo (aOR: 6.53; 95% CI: 6.15, 6.94). Exclusive human milk feeding was associated with lower odds of rapid weight gain (aOR: 0.66; 95% CI: 0.65, 0.67).</div></div><div><h3>Conclusions</h3><div>Rapid weight gain in infancy, regardless of birth size, is a predictor of childhood overweight/obesity. Exclusive human milk feeding mitigates the risk of rapid weight gain and subsequent overweight/obesity.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"123 2","pages":"Article 101132"},"PeriodicalIF":6.9,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696451","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}
Pub Date : 2025-12-01DOI: 10.1016/j.ajcnut.2025.10.001
Niels Klaassen-Dekker , Erwin G Zoetendal , Edoardo Capuano , Renate M Winkels , Fränzel JB van Duijnhoven , N Tjarda van Heek , Flip M Kruyt , Arve Ulvik , Adrian McCann , Per Magne Ueland , Johannes HW de Wilt , Ellen Kampman , Dieuwertje E Kok
Background
Emerging evidence suggests that nutritional prehabilitation reduces risk of complications after colorectal cancer (CRC) surgery. The gut microbiota and its metabolic activity potentially link preoperative diet to postoperative outcomes.
Objective
To investigate associations between preoperative plasma levels of microbial-derived metabolites and postoperative complications in patients with CRC.
Methods
We used data from a prospective cohort study among 1220 patients with nonmetastatic CRC. The short-chain fatty acids (SCFAs) acetate, propionate, butyrate, and valerate, as well as the branched-chain fatty acids (BCFAs) isovalerate, isobutyrate, and α-methylbutyrate, were measured in plasma collected at diagnosis. Prevalence ratios (PR) were calculated using regression models adjusted for age, sex, tumor location, smoking status, and physical health status.
Results
Acetate levels of 40.0 μmol/L were associated with a lower risk of any postoperative complications compared with the reference of 20.0 μmol/L [PR: 0.76; 95% confidence interval (CI): 0.62, 0.93]. Higher levels of propionate (per 1 μmol/L) were associated with a lower risk of any complications (PR: 0.84; 95% CI: 0.73, 0.96). Similar associations were found for acetate (per 20 μmol/L) and propionate (per 1 μmol/L) in relation to surgical complications (PR: 0.75; 95% CI: 0.60, 0.93; and PR: 0.83; 95% CI: 0.69, 1.00; respectively). No associations were found for BCFAs in relation to complications. Low (below median) total SCFA levels combined with high (above median) total BCFA levels were least favorable in terms of complication risk (PR: 1.35; 95% CI: 1.02, 1.80) when compared with a low SCFA/low BCFA profile.
Conclusions
Our findings suggest that microbial fermentation processes, mainly those resulting in higher SCFA levels, may be linked to postoperative recovery. These findings provide leads for future studies investigating the role of preoperative diet, especially the balance between fiber and protein intake, and microbial metabolism in relation to postoperative recovery of patients with CRC.
This study was registered at clinicaltrials.gov with registration number NCT03191110.
{"title":"Preoperative plasma short- and branched-chain fatty acids in relation to risk of complications after colorectal cancer surgery: a prospective cohort study","authors":"Niels Klaassen-Dekker , Erwin G Zoetendal , Edoardo Capuano , Renate M Winkels , Fränzel JB van Duijnhoven , N Tjarda van Heek , Flip M Kruyt , Arve Ulvik , Adrian McCann , Per Magne Ueland , Johannes HW de Wilt , Ellen Kampman , Dieuwertje E Kok","doi":"10.1016/j.ajcnut.2025.10.001","DOIUrl":"10.1016/j.ajcnut.2025.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Emerging evidence suggests that nutritional prehabilitation reduces risk of complications after colorectal cancer (CRC) surgery. The gut microbiota and its metabolic activity potentially link preoperative diet to postoperative outcomes.</div></div><div><h3>Objective</h3><div>To investigate associations between preoperative plasma levels of microbial-derived metabolites and postoperative complications in patients with CRC.</div></div><div><h3>Methods</h3><div>We used data from a prospective cohort study among 1220 patients with nonmetastatic CRC. The short-chain fatty acids (SCFAs) acetate, propionate, butyrate, and valerate, as well as the branched-chain fatty acids (BCFAs) isovalerate, isobutyrate, and α-methylbutyrate, were measured in plasma collected at diagnosis. Prevalence ratios (PR) were calculated using regression models adjusted for age, sex, tumor location, smoking status, and physical health status.</div></div><div><h3>Results</h3><div>Acetate levels of 40.0 μmol/L were associated with a lower risk of any postoperative complications compared with the reference of 20.0 μmol/L [PR: 0.76; 95% confidence interval (CI): 0.62, 0.93]. Higher levels of propionate (per 1 μmol/L) were associated with a lower risk of any complications (PR: 0.84; 95% CI: 0.73, 0.96). Similar associations were found for acetate (per 20 μmol/L) and propionate (per 1 μmol/L) in relation to surgical complications (PR: 0.75; 95% CI: 0.60, 0.93; and PR: 0.83; 95% CI: 0.69, 1.00; respectively). No associations were found for BCFAs in relation to complications. Low (below median) total SCFA levels combined with high (above median) total BCFA levels were least favorable in terms of complication risk (PR: 1.35; 95% CI: 1.02, 1.80) when compared with a low SCFA/low BCFA profile.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that microbial fermentation processes, mainly those resulting in higher SCFA levels, may be linked to postoperative recovery. These findings provide leads for future studies investigating the role of preoperative diet, especially the balance between fiber and protein intake, and microbial metabolism in relation to postoperative recovery of patients with CRC.</div><div>This study was registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> with registration number NCT03191110.</div></div>","PeriodicalId":50813,"journal":{"name":"American Journal of Clinical Nutrition","volume":"122 6","pages":"Pages 1579-1590"},"PeriodicalIF":6.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276548","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}
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