British Journal of Nutrition最新文献

Ultra-processed foods (UPF) are often energy dense and low in nutrients. High consumption of UPF has been associated with non-communicable diseases, premature mortality and environmental impacts. The objective of this study was to assess UPF consumption in relation to diet quality and associated greenhouse gas (GHG) emissions, previously not examined in Iceland. Data from the Icelandic National Dietary Survey (2019–2021, n 822) were utilised. The NOVA classification system was used classifying all food and drinks reported. Dietary GHG emissions were quantified using an open-source life cycle assessment database. On average, 45 %±15 of the total calories consumed daily were derived from UPF, ranging from 24 % in the lowest quartile (UPFQ1) to 64 % in the highest quartile (UPFQ4). The energy contribution of UPF considered to fall within the Icelandic dietary guidelines was 4 %±4. UPFQ4 had significantly lower consumption of, e.g. red meat, fruits, vegetables and whole grains and higher consumption of, e.g. refined grains, sweets and soft drinks, compared with UPFQ1. UPFQ4 had a significantly higher energy intake, added sugar intake and lower intake of, e.g. proteins and iodine. The median (interquartile range (IQR)) share of dietary GHG emissions was 21 % (IQR: 11–34) of total kg CO₂-eq/d, while significantly lower in UPFQ4 compared with UPFQ1. Almost half of the daily energy intake of Icelandic diets was derived from UPF, reflecting relatively poor diet quality. However, dietary GHG emissions were relatively low in high consumers of UPF, reflecting higher meat consumption in low consumers of UPF. Findings underline the urgency of policy implementation, aligning food consumption with dietary guidelines.

Dietary patterns are key modifiable determinants in cardiovascular disease (CVD) prevention, accounting for over half of CVD-related deaths and disabilities. This study aimed to examine whether changes in diet quality and six predefined diet scores were associated with incident cardiovascular (CV) events over four years among secondary care cardiology patients. We conducted a secondary prospective analysis of participants aged ≥45 years from the Brazilian Cardioprotective Nutritional Program Trial, including 1,704, 1,629 and 1,286 individuals for the 12-, 24- and 36-month change analyses, respectively. The assessed diet scores included the Dietary Inflammatory Index (DII), Dietary Total Antioxidant Capacity (dTAC), overall, healthful and unhealthful Plant-Based Diet Index (PDI, hPDI, uPDI), and the modified Alternative Healthy Eating Index (mAHEI). The primary outcome was the incidence of new CV events in each follow-up period, adjudicated by the Clinical Endpoints Committee. Associations were estimated using Cox proportional hazards models, combining intervention and control groups. A total of 162 incident CVD cases occurred over a median follow-up of 3.25 years. After 36 months, improvements in mAHEI scores were inversely associated with CV event incidence in both crude (HR: 0.96; 95% CI: 0.92-0.99) and adjusted models (HR: 0.94; 95% CI: 0.89-1.00). No significant associations were found for changes in DII, dTAC, PDI, hPDI or uPDI across any time point. These findings suggest that, in individuals receiving secondary CV care, sustained improvements in diet quality, particularly those reflected by the mAHEI, may require longer periods to translate into measurable benefits for cardiovascular health.

Nutritional status has been compromised by ongoing war and restrictions on food deliveries in the Gaza Strip. We developed a mathematical model that outputs retrospective estimates and scenario-based projections of acute malnutrition prevalence among children given caloric intake and other factors. We present here the model and its application to the crisis in Gaza. We extended an existing mechanistic model for weight change as a function of energy balance, calibrating it to represent variability in growth curves observed in pre-war Gaza. We simulated open cohorts of children exposed to time-varying caloric intake, infant exclusive breast-feeding prevalence, incidence of infectious disease and coverage of malnutrition treatment, while allowing for adult caloric sacrifice to supplement child intake in times of food scarcity. The model accurately replicates growth standards, pre-war growth patterns and expected parameter dependencies. It suggests that a considerable increase in acute malnutrition occurred in northern Gaza during early 2024. Projections for late 2024 include a serious nutritional emergency if relatively pessimistic assumptions are made about food availability. The model may hold considerable promise for informing decisions in humanitarian response but requires further validation and development.

Although metabolic syndrome (MetSyn) patients are frequently reported to experience alterations in ghrelin levels, appetite regulation and mood, these issues have been largely overlooked. Thus, the present randomised controlled trial (RCT) examined the effects of incorporating brown rice bran powder (BRBP) into a standard diet on ghrelin levels, appetite control, depression, insulin resistance and atherogenicity indices. This secondary analysis used data from our 8-week RCT involving forty-three MetSyn patients, with nineteen on a standard diet and twenty-four receiving an additional 15 g/d of BRBP. Serum ghrelin levels were measured using an ELISA kit, and seven atherosclerosis-related indicators were assessed before and after the intervention. Appetite rating and depression status were evaluated using a four-component visual analogue scale (VAS) and the Beck Depression Inventory (BDI) questionnaires. The ANCOVA model adjusted for baseline values (and BMI for ghrelin) indicated that patients receiving BRBP plus the standard diet experienced significant increases in ghrelin levels and feelings of satiety and fullness compared with those on the standard diet alone (P-value < 0·008; effect sizes (ES) of 0·95, 1·14, and 1·34, respectively). BRBP intake led to significant reductions in atherogenic coefficient, Castelli risk index-II, cholesterol index, metabolic score for insulin resistance, BDI scores, and hunger sensations (P-value ≤ 0·05; ES of -0·94, -0·96, -0·81, -1·74, -0·98 and -0·71, respectively) compared with the standard diet alone. Overall, this secondary analysis of the RCT supports the efficacy of BRBP administration in enhancing ghrelin levels while reducing appetite-related indices, depression scores, as well as markers of atherogenicity and insulin resistance. Nevertheless, given the study's limitations, namely small sample size and lack of a placebo, further research is needed.

There is growing evidence that optimising dietary quality and engaging in physical activity (PA) can reduce dementia and cognitive decline risk and improve psychosocial health and quality of life (QoL). Multimodal interventions focusing on diet and PA are recognised as significant strategies to tackle these behavioural risk factors; however, the cost-effectiveness of such interventions is seldom reported. A limited cost consequence based on a 12-month cluster-randomised Mediterranean diet (MedDiet) and walking controlled trial (MedWalk) was undertaken. In addition, QoL data were analysed. Programme costs ($AUD2024) covered staff to deliver the MedWalk programme and foods to support dietary behaviour change. The primary outcome measure of this study was change in QoL utility score, measured using the Assessment of Quality of Life (AQoL-8D). Change scores were compared for the groups using general linear models while controlling for demographic factors associated with baseline group differences and attrition. Change in QoL (decreased, maintained or improved) was determined using a cross-tabulation test. MedWalk programme costs were estimated at $2695 AUD per participant and control group cost at $165 per person - a differential cost of $2530. Mean change in utility scores from baseline to 12 months was not statistically significant between groups. Nevertheless, the MedWalk group was significantly less likely to experience a reduction in their QoL (20·3 % MedWalk v. 42·6 % control group) (P = 0·020). A MedDiet and walking intervention may have a role in preventing decline in QoL of older Australians; however, longer-term follow-up would be beneficial to see if this is maintained.

Menopausal age represents the endpoint of the entire reproductive cycle of women, and it is a biological marker that indicates the overall health and ageing status of women. Flavonoids are the most common polyphenolic compounds in the daily diet, and their intake is related to reduced risks of certain diseases. Our study aimed to analyse the relationships between the intake of flavonoids and menopausal age. We selected 29 940 participants from National Health and Nutrition Examination Survey database from 2007-2008, 2009-2010 to 2017-2018. A total of 680 participants were included in our analysis after screening. Multiple logistic regression was used to explore the association between dietary flavonoid subclasses intake and menopausal delay (≥ 55 years old). Restricted cubic splines plots were generated to reveal the nonlinear relationships between the subclasses of flavonoids intake and menopausal age. According to the adjusted multiple factor logistic regression analysis, the top quartile intake (compared with bottom intake) of anthocyanidins was positively associated with delayed menopause (OR = 4·123; 95 % CI: 1·130, 15·041; P_trend = 0·036), whereas the moderate intake of flavonols was negatively associated with delayed menopause (Q2 v. Q1, OR = 0·081 (95 % CI: 0·025, 0·261), P_trend = 0·001; Q3 v. Q1, OR = 0·271 (95 % CI: 0·093, 0·791), P_trend = 0·023). The restricted cubic splines revealed that non-linear association was observed between the intake of isoflavones, flavan-3-ols, flavonols and later menopause (P value for non-linearity < 0·05). Our findings suggest that specific dietary flavonoids intake may have potential roles in regulating menopausal timing.

Due to the high prevalence of depression among young adults, identifying prevention strategies during young adulthood are crucial. Dietary polyphenols have been associated with depression in older cohorts; however, the association remains unclear, particularly in young adults. This study aimed to assess the prospective association between the intake of total polyphenols, polyphenol classes, and polyphenol subclasses with depressive symptoms in young adults. Data from 1,484 Raine Study Generation 2 participants [52.7% female; baseline mean age (SD): 20 (0.5)] at the -20, -22, and -27 year follow-ups (N = 964, 979, and 1,094, respectively), with overlap across follow-ups, were used. Energy-adjusted polyphenol intake was estimated from food frequency questionnaire data using our expansion of the AUSNUT 2011-13 and Phenol-Explorer to include polyphenol content data and categorised into quartiles. The primary outcome was self-reported depressive symptoms assessed via the 21-item Depression, Anxiety, and Stress Scale averaged across the three timepoints. Linear mixed-effects models were used to assess the association between the polyphenol intake exposures and depressive symptoms. Sociodemographic characteristics and lifestyle- and health-related behaviours were adjusted for. Participants in the highest quartiles for flavonol and hydroxybenzoic acid intake had lower depressive symptoms across time than participants in the lowest quartiles [flavonols (Q4 v Q1 mean difference: -1.41, 95%CIs: -2.51, -0.31); hydroxybenzoic acids (Q4 v Q1: -1.42, 95%CIs: -2.54, -0.29)]. We found no evidence of a highest versus lowest association for all other polyphenol categories. Future studies are required to investigate whether increasing polyphenol intake could protect against depression in young adults.

This study systematically evaluates the effects of probiotic interventions on gut microbiota and clinical outcomes in diabetic patients to determine the optimal target population and conditions for effective use, with an emphasis on precision treatment. A comprehensive search was performed across PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Internet (CNKI), and Wanfang databases until April 2024. Randomized controlled trials (RCTs) assessing probiotics as adjunctive therapy for diabetes were included. The control group received standard care, and the intervention group received probiotics alongside standard care. Data were managed with Endnote and Excel, and analyses were conducted using Revman 5.3 and Stata 16. Twelve RCTs involving 1113 participants were included. Probiotics significantly increased fecal Lactobacillus (standardized mean difference (SMD) 1.42, P < 0.0001, I² = 95 %) and Bifidobacterium levels (SMD 1.27, P < 0.0001, I²; = 90 %) and reduced fasting plasma glucose (SMD -0.35, P = 0.004). Subgroup analysis showed that shorter intervention durations (≤ 3 months) improved FPG, HbA1c, and Bifidobacterium levels, while younger patients (≤ 60 years) experienced the most significant improvements in Bifidobacterium levels. In conclusion, probiotics improve gut microbiota and clinical outcomes in diabetic patients, with intervention duration and patient age as key factors influencing treatment effectiveness.

Total energy expenditure (TEE) is estimated as the product of BMR and a spinal cord injury (SCI)-specific factor. The agreement between TEE and total energy intake (TEI) was just established. The findings suggested the existence of positive and negative energy balance distributions. Forty-two males with chronic SCI underwent BMR followed by a detailed metabolic profile after an overnight fast. TEI and macronutrients of 3-d dietary logs were analysed using the Nutrition Data System for Research software. Energy surplus was calculated as TEE minus TEI. Body composition assessment was conducted using dual-energy X-ray absorptiometry. 57 % of SCI participants were classified as negative energy surplus with an average TEI of 1284 (sd 422) compared with 2197 (sd 553) kcal/d in the positive energy group (P = 0·0002). Negative energy group had a higher BMR (9 %; P = 0·02), greater body weight (P = 0·03) and greater total body lean mass (P = 0·03) and consumed a greater percentage of protein compared with the positive energy group. Percentage macronutrients of protein explained 27 % of the variance of energy surplus in a multivariate regression model (r² 0·27; P = 0·008). TEI adjusted to fat-free mass explained 87 % of the variance in energy surplus, and an intake of 34·7 kcal/kg per d was recommended to balance TEI with TEE. Persons with SCI are either classified into negative or positive energy surplus groups. Larger body weight and greater protein intakes are among the major characteristics of the negative energy group. Clinicians may need to consider the spectrum of energy balance before starting a dietary regimen after SCI.

This study aimed to investigate (1) the longitudinal associations between food patterns and body weight in young adulthood and (2) how food patterns of young adults relate to food consumption in early, middle and late childhood. The study sample includes 700 participants of the Québec Longitudinal Study of Child Development. During childhood, frequency of consumption of various foods was reported on ten occasions between 1·5 and 13 years. At age 22 years, food frequency questions (with quantities) were used to derive four food patterns (labelled healthy, beverage rich, protein rich and high energy density) through exploratory factor analysis. Self-reported height and weight were collected at 22 and 23 years. Regression analyses were performed to assess the associations between (1) food patterns and weight outcomes a year later (BMI, BMI change and overweight status) and (2) frequency of consumption of eight food groups in childhood and food patterns in adulthood. Dietary habits characterised by the consumption of vegetables, fruit, plant-based sources of protein and whole-grain cereal products were related to a lower risk of obesity a year later. Conversely, dietary habits characterised by a high consumption of energy-dense foods, of animal sources of proteins and, among women, of high quantities of liquids were associated with higher risk of excess weight a year later. Healthier food choices in childhood were associated with healthier food patterns in young adulthood. These findings reinforce the value of preventive dietary interventions in the early years to foster eating environments that favour healthy eating and healthy weights in adulthood.