British Journal of Nutrition最新文献

Increased ultra-processed food (UPF) intake is associated with adverse health outcomes. However, with limitations in UPF evidence, and partial overlap between UK front of package labelling (FOPL) and degree of food processing, the value of food processing within dietary guidance is unclear. This study compared food and drink from the UK National Diet and Nutrition Survey (NDNS) database based on micronutrient content, Nova classification and FOPL. The aim was to examine the micronutrient contributions of UK food and drink to UK government dietary micronutrient recommendations for adult females and males, aged 19-64 years, based on the degree of food processing and FOPL. NDNS items were coded into minimally processed food (MPF), processed culinary ingredients (PCI), processed food (PF) and UPF, and FOPL traffic lights. MPF, PF and UPF provided similar average contributions per 100g to micronutrient recommendations. Per 100kcal, MPF provided the greatest average contribution to micronutrient recommendations (14.4% [interquartile range (IQR):8.2-28.1]), followed by PF (7.7% [IQR:4.6-10.9], then UPF (5.8% [IQR:3.1-9.7]). After adjusting for healthy/unhealthy items (presence of 1+ red FOPL), MPF had higher odds of an above average micronutrient contribution per 100kcal than UPF (odds ratio (OR): 5.9x (95%CI:4.9, 7.2)), and PF (OR:3.2 (95%CI:2.4, 4.2)). MPFs were more likely to provide greater contributions to dietary micronutrient recommendations than PF or UPF per 100kcal. These findings suggest that UPF or PF diets are less likely to meet micronutrient recommendations than an energy-matched MPF diet. The results are important for understanding how consumers perceive the healthiness of products based on FOPL.

This interventional single-center prospective open-label study aims to evaluate the effects of a vegan diet, compared to a vegetarian and omnivorous diet, on metabolic parameters, insulin sensitivity, and liver and kidney steatosis in healthy adults. The study included 53 omnivorous participants aged 18-40 years, body-mass index 18-30 kg/m2, without any chronic disease, chronic medication use, active smoking, or significant alcohol consumption. All participants were omnivorous at baseline and selected to continue an omnivorous diet or transition to a vegetarian or vegan diet, with follow-up over six months. Anthropometric measurements, biochemical parameters, and liver and kidney steatosis were assessed at baseline and after six months using magnetic resonance imaging-proton density fat fraction (MRI-PDFF). Primary outcomes included changes in liver and kidney steatosis, while secondary outcomes were alterations in anthropometric and biochemical markers. Among 53 participants, 18 followed an omnivorous diet, 21 adopted a vegetarian diet, and 14 transitioned to a vegan diet. Dietary interventions did not result in statistically significant changes in body mass index, fat mass, fat percentage, or muscle mass over six months. However, statistically significant improvements in systolic and diastolic blood pressure, favoring the vegan diet, were observed. We aimed to control for potentially confounding variables to ensure the reliability of these findings. We have demonstrated a better decline in steatosis at the lower kidney pole, the total hilus and the Liver 6 index in vegans. We demonstrated that a plant-based diet is associated with improvements in several metabolic parameters and may reduce liver and kidney steatosis.

Low vegetable consumption among school-age children and adolescents put them at risk of micronutrient malnutrition and non-communicable diseases. There is a dearth of synthesized literature on vegetable intake and interventions to promote increased consumption among this age-group in West-Africa. This study pooled evidence on vegetable consumption and interventions to promote vegetable consumption among school- age children and adolescents (6-19 years) in West-Africa. Quantitative and qualitative studies from year 2002 to 2023 were electronically searched in PubMed, African Journals Online (AJOL), and Google Scholar databases. PRISMA system was adhered to in reporting this review (PROSPERO ID: CRD42023444444). Joanna Briggs Institute (JBI) critical evaluation tool was used to appraise quality of studies. Forty (40) studies met the search criteria out of N= 5,080 non-duplicated records. Meta-analysis was not possible due to high heterogeneity. Low vegetable consumption expressed in frequency or amounts was recorded among the school-age children and adolescents in the reviewed studies.Intervention studies were mostly among adolescents; the most common type of intervention was the use of nutrition education. Insufficient evidence and high heterogeneity of studies reflect the need for more high-quality interventions using globally identified standards but applied contextually. School-age children appear to be an under-served population in West-Africa with regards to nutrition interventions to promote vegetable consumption.There is a need for multi-component intervention studies that encourage vegetable consumption as a food group. Gardening, parental involvement, gamification and goal setting are promising components that could improve availability, accessibility and consumption of vegetables.

An assessment of systemic inflammation and nutritional status may form the basis of a framework to examine the prognostic value of cachexia in patients with advanced cancer. The objective of the study was to examine the prognostic value of GLIM criteria, including body mass index (BMI), weight loss (WL) and systemic inflammation (mGPS), in advanced cancer patients. Three criteria were examined in a combined cohort of patients with advanced cancer and their relationship with survival was examined using Cox regression methods. Data were available on 1303 patients. Considering BMI and the mGPS, the 3-month survival rate varied from 74% (BMI>28 kg/m²) to 61% (BMI <20 kg/m²) and from 84% (mGPS 0) to 60% (mGPS 2). Considering WL and the mGPS, the 3-month survival rate varied from 81% (WL ±2.4%) to 47% (WL≥15%) and from 93% (mGPS 0) to 60% (mGPS 2). Considering BMI/WL grade and mGPS, the 3-month survival rate varied from 86% (BMI/WL grade 0) to 59% (BMI/WL grade 4) and from 93% (mGPS 0) to 63% (mGPS 2). When these criteria were combined, they better predicted survival. On multivariate survival analysis, the most highly predictive factors were BMI/WL grade 3 (HR 1.454, P=0.004), BMI/WL grade 4 (HR 2.285, P<0.001) and mGPS 1 and 2 (HR 1.889, HR 2.545, all P < 0.001). In summary, a high BMI/WL grade and a high mGPS as outlined in the BMI/WL grade/mGPS framework were consistently associated with poorer survival of patients with advanced cancer. It can be readily incorporated into the routine assessment of patients.

Rheumatoid arthritis (RA) is characterized by chronic inflammation in joints. Obesity, stress, being women, and dietary pattern are important in pathogenesis. The joint damage in RA is accelerated by oxidative stress. The aim of this study was to examine the serum total antioxidant level, nutritional status, and Mediterranean diet adherence of adult women with RA. 35 adult women RA patients and 35 healthy control subjects participated in this study (45.4 ± 11.61 and 42.5 ± 8.50 years, respectively). Nutritional status, physical activity levels, and adherence to the Mediterranean diet were questioned. Physicians assessed the disease activity score of patients with RA. Serum total antioxidant (TAS) and oxidant status (TOS) were analysed. The serum TAS of the control group was higher, whereas the oxidative stress index (OSI) and TOS were lower than that of RA group. Dietary protein, fiber, eicosapentaenoic acid (EPA), retinol, iron, zinc, and total antioxidant intake in the RA group were lower than the control group (p < 0.05). Individuals with higher fiber intake showed a significantly lower risk for RA after adjusted for potential confounding factors (OR = 0.845, 95% CI = 0.773-0.923, p < 0.001). The mean physical activity level of the control group was higher than that of the RA group (1.59 ± 0.10 and 1.53 ± 0.13, respectively) (p = 0.01). In conclusion, serum antioxidant parameters and dietary antioxidant intake are decreased in patients with RA. Therefore, medical treatment for these patients should be supplemented with medical nutrition therapy to achieve optimal nutritional status.

Oxidative stress is present in chronic obstructive pulmonary disease (COPD); however, the effect of increased dietary antioxidants on reducing COPD risk remains unclear. The aim of this study was to investigate the association of the Composite Dietary Antioxidant Index (CDAI) with COPD in adults. This study conducted a cross-sectional investigation using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2015 to March 2020 to explore the association between CDAI and COPD in adults. This study included 9295 participants. Three logistic regression models (crude model, partially adjusted model, and fully adjusted model) and restricted cubic spline (RCS) curves were utilized to assess the association between CDAI levels and COPD risk. Subsequently, a two-sample Mendelian Randomization (MR) was employed to analyze the causal impact of antioxidant levels within CDAI on the occurrence of COPD. CDAI levels were inversely associated with COPD after adjusting for confounders (OR=0.97, 95%CI:0.95-1.00), and the association was linear (p<0.001), and the results of the RCS showed that CDAI was linearly correlated with COPD occurrence (p<0.001). MR analysis revealed a causal relationship between vitamin C and COPD occurrence (OR=0.99, 95%CI:0.98-1.00, p<0.05). Our study indicates that dietary sources of antioxidants may reduce the risk of COPD occurrence, and the results of the MR analysis further show that vitamin C is causally associated with a reduced risk of COPD occurrence. However, further exploration is needed to understand how antioxidants prevent COPD.

Colorectal cancer, the third most common cancer globally, causes over 900,000 deaths annually. Although vitamin D is observed to have potential anti-carcinogenic properties, research findings on its preventable effect against colorectal cancer remain inconclusive. Notably, different subsites within the colon and rectum may be associated with distinct risk factors. While some studies have explored this relationship with circulating 25-hydroxyvitamin D (25(OH)D), the results remain contradictory. Our study employed a nested case-control design, involving 775 colorectal cancer cases matched with 775 cancer-free controls based on age, region of living, and the time of blood sampling. The study was conducted within the Norwegian Women and Cancer post-genome cohort, which comprises approximately 50,000 women. We measured pre-diagnostic circulating plasma 25(OH)D status 5 to 13 years before diagnosis. Adjustment variables were based on self-administered questionnaires and included: Body mass index, physical activity level, smoking, intake of processed meat, calcium, alcohol, and fibre. An increase of 5 nmol/L in 25(OH)D reduced the risk of proximal colon cancer by 6% (OR=0.94, 95% confidence interval (CI): 0.89-0.99). Furthermore, a sensitivity analysis revealed a 62% increased risk among the women with 25(OH)D levels below 50 nmol/L compared to sufficient levels, ≥50 to <75 nmol/L (OR=1.62, 95% CI: 1.01-2.61). No association was found with colorectal cancer, colon, or distal colon cancer. We observed a subsite-specific association between 25(OH)D and colorectal cancer, highlighting the need for further investigation to elucidate the potential underlying mechanisms and clinical implications.

Indigenous peoples are often not routinely included in iodine programs because of language barriers and remote access, and may thus be at higher risk of iodine deficiency disorders, which could adversely impact their quality of life. We conducted this cross-sectional study in the remote Pwo Karen community of Thailand to determine the urinary iodine concentration (UIC) of school-aged children (SAC) and women of reproductive age (WRA) and investigate the iodine content in household salt. We measured UIC in spot urine samples from healthy SAC and WRA, administered a questionnaire, estimated daily iodine intake and collected household salt samples to determine salt iodine concentration. The median UIC (range) of SAC (n=170) was 192 (136 - 263) µg/L, which was significantly higher than WRA (n=306) [147 (89 - 233) µg/L] (P < 0.001). The estimated daily iodine intake in the SAC and WRA were 135 and 195 μg/day, respectively. The median (range) iodine concentration in rock and granulated salts consumed in the households were 2.32 (0.52 - 3.19) and 26.64 (20.86 - 31.01) ppm, respectively. Surprisingly, use of iodized salt and frequency of seafood consumption were not significant predictors of UIC in these two groups. Our data suggest that school children and women of the Pwo Karen community have sufficient iodine intake, indicating the Thai salt iodization program is effectively reaching even this isolated indigenous community. Sentinel surveys of remote vulnerable populations can be a useful tool in national iodine programs to ensure that program coverage is truly universal.

Low iron stores at birth may adversely influence child cognitive and motor development. The aims of this study were to assess cord blood iron levels and explore maternal and neonatal factors associated with iron status. Cord blood specimens (n=46) were obtained from the BC Children's Hospital BioBank in Vancouver, Canada. The primary outcome was cord plasma ferritin, measured using sandwich-ELISA. Predictors of interest included maternal age, gestational age, gravidity, infant sex, birth weight, and delivery method. Median (IQR) maternal age and gestational age at delivery was 33.5 (29.3-35.8) years and 36.5 (30.0-39.0) weeks, respectively, and 44% of infants were female. Median (IQR) cord ferritin was 100.4 (75.7-128.9) µg/L, and 26% had low iron status (ferritin <76 µg/L). Among preterm deliveries, a 1-week increase in gestational age was associated with a 6.22 (95% CI [1.10, 9.52]) µg/L increase in median cord ferritin. However, among term deliveries, a negative trend was observed (-2.38 µg/L per week of gestation [95% CI: -34.8, 0.78]), indicating a potential non-linear relationship between gestational age and cord ferritin. Female term infants had higher cord ferritin compared to males (β [95% CI]: 30.3 [18.4, 57.9] µg/L), suggesting sex-specific differences in iron transfer, acquisition and utilization. Cord ferritin was higher with vaginal deliveries compared to cesarean sections (β [95% CI]: 39.1 [29.0, 51.5] µg/L). Low iron status may be a concern among infants in Canada; however, further research is needed to inform appropriate thresholds to define optimal iron status in cord blood.

We aimed to evaluate the association of coffee consumption with different additives, including milk and/or sweetener (sugar and/or artificial sweetener), and different coffee types, with new-onset acute kidney injury (AKI), and examine the modifying effects of genetic variation in caffeine metabolism. 194 324 participants without AKI at baseline in the UK Biobank were included. The study outcome was new-onset AKI. During a median follow-up of 11·6 years, 5864 participants developed new-onset AKI. Compared with coffee non-consumers, a significantly lower risk of new-onset AKI was found in coffee consumers adding neither milk nor sugar to coffee (hazard ratio (HR), 0·86; 95 % CI, 0·78, 0·94) and adding only milk to coffee (HR,0·83; 95 % CI, 0·78, 0·89), but not in coffee consumers adding only sweetener (HR,1·14; 95 % CI, 0·99, 1·31) and both milk and sweetener to coffee (HR,0·96; 95 % CI, 0·89, 1·03). Moreover, there was a U-shaped association of coffee consumption with new-onset AKI, with the lowest risk at 2-3 drinks/d, in unsweetened coffee (no additives or milk only to coffee), but no association was found in sweetened coffee (sweetener only or both milk and sweetener to coffee). Genetic variation in caffeine metabolism did not significantly modify the association. A similar U-shaped association was found for instant, ground and decaffeinated coffee consumption in unsweetened coffee consumers, but not in sweetened coffee consumers. In conclusion, moderate consumption (2-3 drinks/d) of unsweetened coffee with or without milk was associated with a lower risk of new-onset AKI, irrespective of coffee type and genetic variation in caffeine metabolism.