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Nutritional Studies and Diet

Works Count: 77871

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This cluster of papers explores the role of the Mediterranean Diet in influencing various health outcomes, including cardiovascular disease, chronic inflammation, cancer prevention, and metabolic syndrome. It also delves into the assessment of dietary patterns, chronic disease risk, and diet quality using methods such as the Healthy Eating Index and nutritional epidemiology. The research emphasizes the impact of dietary factors on overall health and the potential benefits of adhering to a Mediterranean-style diet.

Keywords

Mediterranean Diet; Cardiovascular Disease; Inflammation; Dietary Patterns; Chronic Disease Risk; Nutritional Epidemiology; Cancer Prevention; Metabolic Syndrome; Healthy Eating Index; Diet Quality

Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc : a report of the Panel on Micronutrients, Subcommittees on Upper Reference Levels of Nutrients and of Interpretation and Use of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine

2001-01-01

Nutrition Board. Panel on Micronutrients

This volume is the newest release in the authoritative series issued by the National Academy of Sciences on dietary reference intakes (DRIs). This series provides recommended intakes, such as Recommended … This volume is the newest release in the authoritative series issued by the National Academy of Sciences on dietary reference intakes (DRIs). This series provides recommended intakes, such as Recommended Dietary Allowances (RDAs), for use in planning nutritionally adequate diets for individuals based on age and gender. In addition, a new reference intake, the Tolerable Upper Intake Level (UL), has also been established to assist an individual in knowing how is too much of a nutrient. Based on the Institute of Medicine's review of the scientific literature regarding dietary micronutrients, recommendations have been formulated regarding vitamins A and K, iron, iodine, chromium, copper, manganese, molybdenum, zinc, and other potentially beneficial trace elements such as boron to determine the roles, if any, they play in health. The book also: * Reviews selected components of food that may influence the bioavailability of these compounds. * Develops estimates of dietary intake of these compounds that are compatible with good nutrition throughout the life span and that may decrease risk of chronic disease where data indicate they play a role. * Determines Tolerable Upper Intake levels for each nutrient reviewed where adequate scientific data are available in specific population subgroups. * Identifies research needed to improve knowledge of the role of these micronutrients in human health. This book will be important to professionals in nutrition research and education.

Treating Tobacco Use and Dependence: 2008 Update

2009-01-01

Tobacco Use and Dependence Guideline Panel

Dietary Reference Intakes for Calcium and Vitamin D

2018-05-01

A. Catharine Ross , Christine L. Taylor , Ann L. Yaktine +1 more

The charge to the committee (Institute of Medicine Committee to Review Dietary Reference Intakes for Vitamin D and Calcium) was to assess current relevant data and update, as appropriate, the … The charge to the committee (Institute of Medicine Committee to Review Dietary Reference Intakes for Vitamin D and Calcium) was to assess current relevant data and update, as appropriate, the DRIs (Dietary Reference Intakes) for vitamin D and calcium. The review was to include consideration of chronic disease indicators (e.g., reduction in risk of cancer) and other (non-chronic disease) indicators and health outcomes. The definitions of these terms are discussed below. Consistent with the framework for DRI development, the indicators to assess adequacy and excess intake were to be selected based on the strength and quality of the evidence and their demonstrated public health significance, taking into consideration sources of uncertainty in the evidence. Further, the committee deliberations were to incorporate, as appropriate, systematic evidence-based reviews of the literature.Specifically, in carrying out its work, the committee was to: Review evidence on indicators to assess adequacy and indicators to assess excess intake relevant to the general North American population, including groups whose needs for or sensitivity to the nutrient may be affected by particular conditions that are widespread in the population such as obesity or age-related chronic diseases. Special groups under medical care whose needs or sensitivities are affected by rare genetic disorders or diseases and their treatments were to be excluded; Consider systematic evidence-based reviews, including those made available by the sponsors as well as others, and carefully document the approach used by the committee to carry out any of its own literature reviews; Regarding selection of indicators upon which to base DRI values for adequate intake, give priority to selecting indicators relevant to the various age, gender, and life stage groups that will allow for the determination of an Estimated Average Requirement (EAR); Regarding selection of indicators upon which to base DRI values for upper levels of intake, give priority to examining whether a critical adverse effect can be selected that will allow for the determination of a so-called benchmark intake; Update DRI values, as appropriate, using a risk assessment approach that includes (1) identification of potential indicators to assess adequacy and excess intake, (2) selection of the indicators of adequacy and excess intake, (3) intake-response assessment, (4) dietary intake assessment, and (5) risk characterization. Identify research gaps to address the uncertainties identified in the process of deriving the reference values and evaluating their public health implications.

Use of the Danish Adoption Register for the study of obesity and thinness.

1983-01-01

Albert J. Stunkard , Thorkild I. A. Sørensen , Fini Schulsinger

Adjustment for total energy intake in epidemiologic studies

1997-04-01

WC Willett , GR Howe , Lawrence H. Kushi

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McCance and Widdowson's The Composition of Foods

2002-09-26

McCance and Widdowsons's The Composition of Foods, Seventh Summary Edition provides a timely, authoritative and comprehensive update of the nutrient data for the most commonly consumed foods in the UK. … McCance and Widdowsons's The Composition of Foods, Seventh Summary Edition provides a timely, authoritative and comprehensive update of the nutrient data for the most commonly consumed foods in the UK. Foods that are less commonly consumed but are important in the diets of sub-groups of the population are also included. This Seventh Summary Edition contains data which has been reviewed and updated since the last edition was published in 2002 and incorporates data from previously published supplements plus new analytical data and additional data from manufacturers. New data includes updates on key foods in the UK diet including flours and grains, bread, pasta, breakfast cereals, biscuits, cakes, eggs, fat spreads, fruits, vegetables, fish and fish products. Values for a wide range of nutrients (e.g. proximates, inorganics, vitamins, fibre and fatty acids) are provided and additional tables provide data for carotenoid fractions, vitamin E fractions and vitamin K for selected foods. Values for specific nutrients, including sodium, sugars, saturated and trans fatty acids in processed foods have been updated to reflect changes resulting from health policy and recent industry initiatives on reformulations. AOAC fibre values have been included for a wide range of foods to enable energy calculations, including fibre for food labelling purposes. Aimed at students and professionals in all food and health disciplines, this essential handbook should be on the bookshelf of everyone who needs to know the nutritional value of foods consumed in the UK.

Dietary Fiber, Glycemic Load, and Risk of Non—insulin-dependent Diabetes Mellitus in Women

1997-02-12

Jorge Salmerón

<h3>Objective.</h3> —To examine prospectively the relationship between glycemic diets, low fiber intake, and risk of non—insulin-dependent diabetes mellitus. <h3>Desing.</h3> —Cohort study. <h3>Setting.</h3> —In 1986, a total of 65173 US women … <h3>Objective.</h3> —To examine prospectively the relationship between glycemic diets, low fiber intake, and risk of non—insulin-dependent diabetes mellitus. <h3>Desing.</h3> —Cohort study. <h3>Setting.</h3> —In 1986, a total of 65173 US women 40 to 65 years of age and free from diagnosed cardiovascular disease, cancer, and diabetes completed a detailed dietary questionnaire from which we calculated usual intake of total and specific sources of dietary fiber, dietary glycemic index, and glycemic load. <h3>Main Outcome Measure.</h3> —Non—insulin-dependent diabetes mellitus. <h3>Results.</h3> —During 6 years of follow-up, 915 incident cases of diabetes were documented. The dietary glycemic index was positively associated with risk of diabetes after adjustment for age, body mass index, smoking, physical activity, family history of diabetes, alcohol and cereal fiber intake, and total energy intake. Comparing the highest with the lowest quintile, the relative risk (RR) of diabetes was 1.37 (95% confidence interval [CI], 1.09-1.71,<i>P</i>trend=.005). The glycemic load (an indicator of a global dietary insulin demand) was also positively associated with diabetes (RR=1.47; 95% CI, 1.16-1.86,<i>P</i>trend=.003). Cereal fiber intake was inversely associated with risk of diabetes when comparing the extreme quintiles (RR=0.72,95% CI, 0.58-0.90,<i>P</i>trend=.001). The combination of a high glycemic load and a low cereal fiber intake further increased the risk of diabetes (RR=2.50, 95% CI, 1.14-5.51) when compared with a low glycemic load and high cereal fiber intake. <h3>Conclusions.</h3> —Our results support the hypothesis that diets with a high glycemic load and a low cereal fiber content increase risk of diabetes in women. Further, they suggest that grains should be consumed in a minimally refined form to reduce the incidence of diabetes.

American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer With Healthy Food Choices and Physical Activity

2006-09-01

Lawrence H. Kushi , Tim Byers , Colleen Doyle +7 more

The American Cancer Society (ACS) publishes Nutrition and Physical Activity Guidelines to serve as a foundation for its communication, policy, and community strategies and ultimately, to affect dietary and physical … The American Cancer Society (ACS) publishes Nutrition and Physical Activity Guidelines to serve as a foundation for its communication, policy, and community strategies and ultimately, to affect dietary and physical activity patterns among Americans. These Guidelines, published every 5 years, are developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, and as such, they represent the most current scientific evidence related to dietary and activity patterns and cancer risk. The ACS Guidelines include recommendations for individual choices regarding diet and physical activity patterns, but those choices occur within a community context that either facilitates or interferes with healthy behaviors. Community efforts are essential to create a social environment that promotes healthy food choices and physical activity. Therefore, this committee presents one key recommendation for community action to accompany the four recommendations for individual choices to reduce cancer risk. This recommendation for community action recognizes that a supportive social environment is indispensable if individuals at all levels of society are to have genuine opportunities to choose healthy behaviors. The ACS Guidelines are consistent with guidelines from the American Heart Association and the American Diabetes Association forthe prevention of coronary heart disease and diabetes, as well as for general health promotion, as defined by the Department of Health and Human Services' 2005 Dietary Guidelinesfor Americans.

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Diet, Lifestyle, and the Risk of Type 2 Diabetes Mellitus in Women

2001-09-13

Frank B. Hu , JoAnn E. Manson , Meir J. Stampfer +4 more

Previous studies have examined individual dietary and lifestyle factors in relation to type 2 diabetes, but the combined effects of these factors are largely unknown. Previous studies have examined individual dietary and lifestyle factors in relation to type 2 diabetes, but the combined effects of these factors are largely unknown.

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Overweight, Obesity, and Mortality in a Large Prospective Cohort of Persons 50 to 71 Years Old

2006-08-22

Kenneth Adams , Arthur Schatzkin , Tamara B. Harris +5 more

Obesity, defined by a body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters) of 30.0 or more, is associated with an increased risk … Obesity, defined by a body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters) of 30.0 or more, is associated with an increased risk of death, but the relation between overweight (a BMI of 25.0 to 29.9) and the risk of death has been questioned.We prospectively examined BMI in relation to the risk of death from any cause in 527,265 U.S. men and women in the National Institutes of Health-AARP cohort who were 50 to 71 years old at enrollment in 1995-1996. BMI was calculated from self-reported weight and height. Relative risks and 95 percent confidence intervals were adjusted for age, race or ethnic group, level of education, smoking status, physical activity, and alcohol intake. We also conducted alternative analyses to address potential biases related to preexisting chronic disease and smoking status.During a maximum follow-up of 10 years through 2005, 61,317 participants (42,173 men and 19,144 women) died. Initial analyses showed an increased risk of death for the highest and lowest categories of BMI among both men and women, in all racial or ethnic groups, and at all ages. When the analysis was restricted to healthy people who had never smoked, the risk of death was associated with both overweight and obesity among men and women. In analyses of BMI during midlife (age of 50 years) among those who had never smoked, the associations became stronger, with the risk of death increasing by 20 to 40 percent among overweight persons and by two to at least three times among obese persons; the risk of death among underweight persons was attenuated.Excess body weight during midlife, including overweight, is associated with an increased risk of death.

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Dietary pattern analysis: a new direction in nutritional epidemiology

2002-02-01

Frank B. Hu

Recently, dietary pattern analysis has emerged as an alternative and complementary approach to examining the relationship between diet and the risk of chronic diseases. Instead of looking at individual nutrients … Recently, dietary pattern analysis has emerged as an alternative and complementary approach to examining the relationship between diet and the risk of chronic diseases. Instead of looking at individual nutrients or foods, pattern analysis examines the effects of overall diet. Conceptually, dietary patterns represent a broader picture of food and nutrient consumption, and may thus be more predictive of disease risk than individual foods or nutrients. Several studies have suggested that dietary patterns derived from factor or cluster analysis predict disease risk or mortality. In addition, there is growing interest in using dietary quality indices to evaluate whether adherence to a certain dietary pattern (e.g. Mediterranean pattern) or current dietary guidelines lowers the risk of disease. In this review, we describe the rationale for studying dietary patterns, and discuss quantitative methods for analysing dietary patterns and their reproducibility and validity, and the available evidence regarding the relationship between major dietary patterns and the risk of cardiovascular disease.

Dietary Reference Intakes

2001-03-01

Paula R. Trumbo , Allison A. Yates , Sandra A. Schlicker +1 more

Effect of a Mediterranean-Style Diet on Endothelial Dysfunction and Markers of Vascular Inflammation in the Metabolic Syndrome

2004-09-21

Katherine Esposito , Raffaele Marfella , Miryam Ciotola +6 more

The metabolic syndrome has been identified as a target for dietary therapies to reduce risk of cardiovascular disease; however, the role of diet in the etiology of the metabolic syndrome … The metabolic syndrome has been identified as a target for dietary therapies to reduce risk of cardiovascular disease; however, the role of diet in the etiology of the metabolic syndrome is poorly understood.To assess the effect of a Mediterranean-style diet on endothelial function and vascular inflammatory markers in patients with the metabolic syndrome.Randomized, single-blind trial conducted from June 2001 to January 2004 at a university hospital in Italy among 180 patients (99 men and 81 women) with the metabolic syndrome, as defined by the Adult Treatment Panel III.Patients in the intervention group (n = 90) were instructed to follow a Mediterranean-style diet and received detailed advice about how to increase daily consumption of whole grains, fruits, vegetables, nuts, and olive oil; patients in the control group (n = 90) followed a prudent diet (carbohydrates, 50%-60%; proteins, 15%-20%; total fat, <30%).Nutrient intake; endothelial function score as a measure of blood pressure and platelet aggregation response to l-arginine; lipid and glucose parameters; insulin sensitivity; and circulating levels of high-sensitivity C-reactive protein (hs-CRP) and interleukins 6 (IL-6), 7 (IL-7), and 18 (IL-18).After 2 years, patients following the Mediterranean-style diet consumed more foods rich in monounsaturated fat, polyunsaturated fat, and fiber and had a lower ratio of omega-6 to omega-3 fatty acids. Total fruit, vegetable, and nuts intake (274 g/d), whole grain intake (103 g/d), and olive oil consumption (8 g/d) were also significantly higher in the intervention group (P<.001). The level of physical activity increased in both groups by approximately 60%, without difference between groups (P =.22). Mean (SD) body weight decreased more in patients in the intervention group (-4.0 [1.1] kg) than in those in the control group (-1.2 [0.6] kg) (P<.001). Compared with patients consuming the control diet, patients consuming the intervention diet had significantly reduced serum concentrations of hs-CRP (P =.01), IL-6 (P =.04), IL-7 (P = 0.4), and IL-18 (P = 0.3), as well as decreased insulin resistance (P<.001). Endothelial function score improved in the intervention group (mean [SD] change, +1.9 [0.6]; P<.001) but remained stable in the control group (+0.2 [0.2]; P =.33). At 2 years of follow-up, 40 patients in the intervention group still had features of the metabolic syndrome, compared with 78 patients in the control group (P<.001).A Mediterranean-style diet might be effective in reducing the prevalence of the metabolic syndrome and its associated cardiovascular risk.

Fruit, vegetables, and cancer prevention: A review of the epidemiological evidence

1992-01-01

Gladys Block , Blossom H. Patterson , Amy F. Subar

Abstract Approximately 200 studies that examined the relationship between fruit and vegetable intake and cancers of the lung, colon, breast, cervix, esophagus, oral cavity, stomach, bladder, pancreas, and ovary are … Abstract Approximately 200 studies that examined the relationship between fruit and vegetable intake and cancers of the lung, colon, breast, cervix, esophagus, oral cavity, stomach, bladder, pancreas, and ovary are reviewed. A statistically significant protective effect of fruit and vegetable consumption was found in 128 of 156 dietary studies in which results were expressed in terms of relative risk. For most cancer sites, persons with low fruit and vegetable intake (at least the lower one‐fourth of the population) experience about twice the risk of cancer compared with those with high intake, even after control for potentially confounding factors. For lung cancer, significant protection was found in 24 of 25 studies after control for smoking in most instances. Fruits, in particular, were significantly protective in cancers of the esophagus, oral cavity, and larynx, for which 28 of 29 studies were significant. Strong evidence of a protective effect of fruit and vegetable consumption was seen in cancers of the pancreas and stomach (26 of 30 studies), as well as in colorectal and bladder cancers (23 of 38 studies). For cancers of the cervix, ovary, and endometrium, a significant protective effect was shown in 11 of 13 studies, and for breast cancer a protective effect was found to be strong and consistent in a meta analysis. It would appear that major public health benefits could be achieved by substantially increasing consumption of these foods.

Mediterranean Diet, Traditional Risk Factors, and the Rate of Cardiovascular Complications After Myocardial Infarction

1999-02-16

Michel de Lorgeril , Patricia Salen , Jean‐Louis Martin +3 more

Background —The Lyon Diet Heart Study is a randomized secondary prevention trial aimed at testing whether a Mediterranean-type diet may reduce the rate of recurrence after a first myocardial infarction. … Background —The Lyon Diet Heart Study is a randomized secondary prevention trial aimed at testing whether a Mediterranean-type diet may reduce the rate of recurrence after a first myocardial infarction. An intermediate analysis showed a striking protective effect after 27 months of follow-up. This report presents results of an extended follow-up (with a mean of 46 months per patient) and deals with the relationships of dietary patterns and traditional risk factors with recurrence. Methods and Results —Three composite outcomes (COs) combining either cardiac death and nonfatal myocardial infarction (CO 1), or the preceding plus major secondary end points (unstable angina, stroke, heart failure, pulmonary or peripheral embolism) (CO 2), or the preceding plus minor events requiring hospital admission (CO 3) were studied. In the Mediterranean diet group, CO 1 was reduced (14 events versus 44 in the prudent Western-type diet group, P =0.0001), as were CO 2 (27 events versus 90, P =0.0001) and CO 3 (95 events versus 180, P =0.0002). Adjusted risk ratios ranged from 0.28 to 0.53. Among the traditional risk factors, total cholesterol (1 mmol/L being associated with an increased risk of 18% to 28%), systolic blood pressure (1 mm Hg being associated with an increased risk of 1% to 2%), leukocyte count (adjusted risk ratios ranging from 1.64 to 2.86 with count >9×10 9 /L), female sex (adjusted risk ratios, 0.27 to 0.46), and aspirin use (adjusted risk ratios, 0.59 to 0.82) were each significantly and independently associated with recurrence. Conclusions —The protective effect of the Mediterranean dietary pattern was maintained up to 4 years after the first infarction, confirming previous intermediate analyses. Major traditional risk factors, such as high blood cholesterol and blood pressure, were shown to be independent and joint predictors of recurrence, indicating that the Mediterranean dietary pattern did not alter, at least qualitatively, the usual relationships between major risk factors and recurrence. Thus, a comprehensive strategy to decrease cardiovascular morbidity and mortality should include primarily a cardioprotective diet. It should be associated with other (pharmacological?) means aimed at reducing modifiable risk factors. Further trials combining the 2 approaches are warranted.

REPRODUCIBILITY AND VALIDITY OF A SEMIQUANTITATIVE FOOD FREQUENCY QUESTIONNAIRE

1985-07-01

Walter C. Willett , Laura Sampson , Meir J. Stampfer +5 more

Journal Article REPRODUCIBILITY AND VALIDITY OF A SEMIQUANTITATIVE FOOD FREQUENCY QUESTIONNAIRE Get access WALTER C. WILLETT, WALTER C. WILLETT 1The Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham … Journal Article REPRODUCIBILITY AND VALIDITY OF A SEMIQUANTITATIVE FOOD FREQUENCY QUESTIONNAIRE Get access WALTER C. WILLETT, WALTER C. WILLETT 1The Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's HospitalBoston, MA2Departments of Epidemiology and Nutrition, Harvard School of Public HealthBoston, MA Reprint requests to Dr. Walter C. Willett, Chan-ning Laboratory, 180 Longwood Avenue, Boston, MA 02115 Search for other works by this author on: Oxford Academic PubMed Google Scholar LAURA SAMPSON, LAURA SAMPSON 1The Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's HospitalBoston, MA Search for other works by this author on: Oxford Academic PubMed Google Scholar MEIR J. STAMPFER, MEIR J. STAMPFER 1The Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's HospitalBoston, MA2Departments of Epidemiology and Nutrition, Harvard School of Public HealthBoston, MA Search for other works by this author on: Oxford Academic PubMed Google Scholar BERNARD ROSNER, BERNARD ROSNER 1The Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's HospitalBoston, MA Search for other works by this author on: Oxford Academic PubMed Google Scholar CHRISTOPHER BAIN, CHRISTOPHER BAIN 3Department of Social and Preventive Medicine, University of QueenslandAustralia Search for other works by this author on: Oxford Academic PubMed Google Scholar JELIA WITSCHI, JELIA WITSCHI 2Departments of Epidemiology and Nutrition, Harvard School of Public HealthBoston, MA Search for other works by this author on: Oxford Academic PubMed Google Scholar CHARLES H. HENNEKENS, CHARLES H. HENNEKENS 1The Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's HospitalBoston, MA Search for other works by this author on: Oxford Academic PubMed Google Scholar FRANK E. SPEIZER FRANK E. SPEIZER 1The Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's HospitalBoston, MA Search for other works by this author on: Oxford Academic PubMed Google Scholar American Journal of Epidemiology, Volume 122, Issue 1, July 1985, Pages 51–65, https://doi.org/10.1093/oxfordjournals.aje.a114086 Published: 01 July 1985 Article history Received: 18 July 1984 Revision received: 13 November 1984 Published: 01 July 1985

A DATA-BASED APPROACH TO DIET QUESTIONNAIRE DESIGN AND TESTING

1986-09-01

Gladys Block , Anne M. Hartman , Connie Dresser +3 more

A self-administered diet history questionnaire has been developed for epidemiologic and clinical use. Both the food list and the nutrient values to be associated with it were developed using dietary … A self-administered diet history questionnaire has been developed for epidemiologic and clinical use. Both the food list and the nutrient values to be associated with it were developed using dietary data from 11,658 adult respondents to the Second National Health and Nutrition Examination Survey (NHANES II). Food items were selected on the basis of their contribution to total population intake of energy and each of 17 nutrients in the NHANES II data, and represent over 90% of each of those nutrients. Associated nutrient composition values were determined from the NHANES II database using frequency of consumption data in that survey. Portion sizes to be associated with each food item were derived from observed portion size distributions in NHANES II, based on three-dimensional models. The resulting food list and its corresponding brief data base, when used to calculate nutrients from a diet record, yielded correlations of r greater than 0.70 with the more detailed method. Field administration produced mean values comparable to national data.

THE DIET AND 15-YEAR DEATH RATE IN THE SEVEN COUNTRIES STUDY

1986-12-01

Ancel Keys , ALESSANDRO MIENOTTI , MARITI J. KARVONEN +7 more

Keys, A. (84060 Pioppi (SA), Italy), A. Menotti, M. J. Karvonen, C. Aravanis, H. Blackburn, R. Buzina, B. S. Djordjevlc, A. S. Dontas, F. Fldanza, M. H. Keys, D. Kromhout, … Keys, A. (84060 Pioppi (SA), Italy), A. Menotti, M. J. Karvonen, C. Aravanis, H. Blackburn, R. Buzina, B. S. Djordjevlc, A. S. Dontas, F. Fldanza, M. H. Keys, D. Kromhout, S. Nedeljkovic, S. Punsar, F. Seccareccia, and H. Toshima. The diet and 15-year death rate In the Seven Countries Study. Am J Epidemiol 1986; 124:903–15 In 15 cohorts of the Seven Countries Study, comprising 11,579 men aged 40-years and “healthy” at entry, 2,288 died In 15 years. Death rates differed among cohorts. Differences In mean age, blood pressure, serum cholesterol, and smoking habits “explained” 46% of variance in death rate from all causes, 80% from coronary heart dIsease, 35% from cancer, and 45% from stroke. Death rate differences were unrelated to cohort differences in mean relative body weIght. fatness, and physical activity. The cohorts differed in average dIets. Death rates were related positively to average percentage of dIetary energy from saturated fatty acids, negatively to dietary energy percentage from monounsaturated fatty acids, and were unrelated to dietary energy percentage from polyunsaturated fatty acids, proteins, carbohydrates, and alcohol. All death rates were negatively related to the ratio of monounsaturated to saturated fatty acids. Inclusion of that ratio with age, blood pressure, serum cholesterol, and smokIng habits as inde pendent variables accounted for 85% of variance In rates of deaths from all causes, 96% coronary heart dIsease, 55% cancer, and 66% stroke. Oleic acid accounted for almost all dIfferences In monounsaturates among cohorts. All- cause and coronary heart disease death rates were low In cohorts with olive oil the main fat Causal relationshIps are not claimed but consideration of characteristics of populations as well as of Individuals withIn populations is urged evaluating risks.

The Spread of Obesity in a Large Social Network over 32 Years

2007-07-25

Nicholas A. Christakis , James H. Fowler

The prevalence of obesity has increased substantially over the past 30 years. We performed a quantitative analysis of the nature and extent of the person-to-person spread of obesity as a … The prevalence of obesity has increased substantially over the past 30 years. We performed a quantitative analysis of the nature and extent of the person-to-person spread of obesity as a possible factor contributing to the obesity epidemic.We evaluated a densely interconnected social network of 12,067 people assessed repeatedly from 1971 to 2003 as part of the Framingham Heart Study. The body-mass index was available for all subjects. We used longitudinal statistical models to examine whether weight gain in one person was associated with weight gain in his or her friends, siblings, spouse, and neighbors.Discernible clusters of obese persons (body-mass index [the weight in kilograms divided by the square of the height in meters], > or =30) were present in the network at all time points, and the clusters extended to three degrees of separation. These clusters did not appear to be solely attributable to the selective formation of social ties among obese persons. A person's chances of becoming obese increased by 57% (95% confidence interval [CI], 6 to 123) if he or she had a friend who became obese in a given interval. Among pairs of adult siblings, if one sibling became obese, the chance that the other would become obese increased by 40% (95% CI, 21 to 60). If one spouse became obese, the likelihood that the other spouse would become obese increased by 37% (95% CI, 7 to 73). These effects were not seen among neighbors in the immediate geographic location. Persons of the same sex had relatively greater influence on each other than those of the opposite sex. The spread of smoking cessation did not account for the spread of obesity in the network.Network phenomena appear to be relevant to the biologic and behavioral trait of obesity, and obesity appears to spread through social ties. These findings have implications for clinical and public health interventions.

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Effects of Soft Drink Consumption on Nutrition and Health: A Systematic Review and Meta-Analysis

2007-03-01

Lenny R. Vartanian , Marlene B. Schwartz , Kelly D. Brownell

In a meta-analysis of 88 studies, we examined the association between soft drink consumption and nutrition and health outcomes. We found clear associations of soft drink intake with increased energy … In a meta-analysis of 88 studies, we examined the association between soft drink consumption and nutrition and health outcomes. We found clear associations of soft drink intake with increased energy intake and body weight. Soft drink intake also was associated with lower intakes of milk, calcium, and other nutrients and with an increased risk of several medical problems (e.g., diabetes). Study design significantly influenced results: larger effect sizes were observed in studies with stronger methods (longitudinal and experimental vs cross-sectional studies). Several other factors also moderated effect sizes (e.g., gender, age, beverage type). Finally, studies funded by the food industry reported significantly smaller effects than did non-industry-funded studies. Recommendations to reduce population soft drink consumption are strongly supported by the available science.

Reproducibility and Validity of an Expanded Self-Administered Semiquantitative Food Frequency Questionnaire among Male Health Professionals

1992-05-15

Eric B. Rimm , Edward L. Giovannucci , Meir J. Stampfer +3 more

The authors assessed the reproducibility and validity of an expanded 131-item semiquantitative food frequency questionnaire used in a prospective study among 51, 529 men. The form was administered by mail … The authors assessed the reproducibility and validity of an expanded 131-item semiquantitative food frequency questionnaire used in a prospective study among 51, 529 men. The form was administered by mail twice to a sample of 127 participants at a one-year interval. During this interval, men completed two one-week diet records spaced approximately 6 months apart. Mean values for intake of most nutrients assessed by the two methods were similar. Intraclass correlation coefficients for nutrient intakes assessed by questionnaires one year apart ranged from 0.47 for vitamin E without supplements to 0.80 for vitamin C with supplements. Correlation coefficients between the energy-adjusted nutrient intakes measured by diet records and the second questionnaire (which asked about diet during the year encompassing the diet records) ranged from 0.28 for iron without supplements to 0.86 for vitamin C with supplements (mean r = 0.59). These correlations were higher after adjusting for week-to-week variation in diet record intakes (mean r = 0.65). These data indicate that the expanded semiquantitative food frequency questionnaire is reproducible and provides a useful measure of intake for many nutrients over a one-year period. Am J Epidemiol 1992; 135: 1114–26

Designing and developing a literature-derived, population-based dietary inflammatory index

2013-08-14

Nitin Shivappa , Susan E. Steck , Thomas G. Hurley +2 more

Abstract Objective To design and develop a literature-derived, population-based dietary inflammatory index (DII) to compare diverse populations on the inflammatory potential of their diets. Design Peer-reviewed primary research articles published … Abstract Objective To design and develop a literature-derived, population-based dietary inflammatory index (DII) to compare diverse populations on the inflammatory potential of their diets. Design Peer-reviewed primary research articles published through December 2010 on the effect of diet on inflammation were screened for possible inclusion in the DII scoring algorithm. Qualifying articles were scored according to whether each dietary parameter increased (+1), decreased (−1) or had no (0) effect on six inflammatory biomarkers: IL-1β, IL-4, IL-6, IL-10, TNF-α and C-reactive protein. Setting The Dietary Inflammatory Index Development Study was conducted in the Cancer Prevention and Control Program of the University of South Carolina in Columbia, SC, USA from 2011 to 2012. Results A total of ≈6500 articles published through December 2010 on the effect of dietary parameters on the six inflammatory markers were screened for inclusion in the DII scoring algorithm. Eleven food consumption data sets from countries around the world were identified that allowed individuals’ intakes to be expressed relative to the range of intakes of the forty-five food parameters observed across these diverse populations. Qualifying articles ( n 1943) were read and scored based on the forty-five pro- and anti-inflammatory food parameters identified in the search. When fit to this composite global database, the DII score of the maximally pro-inflammatory diet was +7·98, the maximally anti-inflammatory DII score was −8·87 and the median was +0·23. Conclusions The DII reflects both a robust literature base and standardization of individual intakes to global referent values. The success of this first-of-a-kind attempt at relating intakes of inflammation-modulating foods relative to global norms sets the stage for use of the DII in a wide variety of epidemiological and clinical studies.

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Alternative Dietary Indices Both Strongly Predict Risk of Chronic Disease

2012-04-19

Stephanie E. Chiuve , Teresa T. Fung , Eric B. Rimm +5 more

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Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices

1975-04-15

Bruce K. Armstrong , Richard Doll

Abstract Incidence rates for 27 cancers in 23 countries and mortality rates for 14 cancers in 32 countries have been correlated with a wide range of dietary and other variables. … Abstract Incidence rates for 27 cancers in 23 countries and mortality rates for 14 cancers in 32 countries have been correlated with a wide range of dietary and other variables. Dietary variables were strongly correlated with several types of cancer, particularly meat consumption with cancer of the colon and fat consumption with cancers of the breast and corpus uteri. The data suggest a possible role for dietary factors in modifying the development of cancer at a number of other sites. The usefulness and limitations of the method are discussed.

Diet and Lifestyle Recommendations Revision 2006

2006-06-20

Alice H. Lichtenstein , Lawrence J. Appel , Michael W. Brands +7 more

Improving diet and lifestyle is a critical component of the American Heart Association’s strategy for cardiovascular disease risk reduction in the general population. This document presents recommendations designed to meet … Improving diet and lifestyle is a critical component of the American Heart Association’s strategy for cardiovascular disease risk reduction in the general population. This document presents recommendations designed to meet this objective. Specific goals are to consume an overall healthy diet; aim for a healthy body weight; aim for recommended levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides; aim for normal blood pressure; aim for a normal blood glucose level; be physically active; and avoid use of and exposure to tobacco products. The recommendations are to balance caloric intake and physical activity to achieve and maintain a healthy body weight; consume a diet rich in vegetables and fruits; choose whole-grain, high-fiber foods; consume fish, especially oily fish, at least twice a week; limit intake of saturated fat to <7% of energy, trans fat to <1% of energy, and cholesterol to <300 mg/day by choosing lean meats and vegetable alternatives, fat-free (skim) or low-fat (1% fat) dairy products and minimize intake of partially hydrogenated fats; minimize intake of beverages and foods with added sugars; choose and prepare foods with little or no salt; if you consume alcohol, do so in moderation; and when you eat food prepared outside of the home, follow these Diet and Lifestyle Recommendations. By adhering to these diet and lifestyle recommendations, Americans can substantially reduce their risk of developing cardiovascular disease, which remains the leading cause of morbidity and mortality in the United States.

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Methods for Trend Estimation from Summarized Dose-Response Data, with Applications to Meta-Analysis

1992-06-01

Sander Greenland , Matthew P. Longnecker

Meta-analysis often requires pooling of correlated estimates to compute regression slopes (trends) across different exposure or treatment levels. The authors propose two methods that account for the correlations but require … Meta-analysis often requires pooling of correlated estimates to compute regression slopes (trends) across different exposure or treatment levels. The authors propose two methods that account for the correlations but require only the summary estimates and marginal data from the studies. These methods provide more efficient estimates of regression slope, more accurate variance estimates, and more valid heterogeneity tests than those previously available. One method also allows estimation of nonlinear trend components, such as quadratic effects. The authors illustrate these methods in a meta-analysis of alcohol use and breast cancer. Am J Epidemiol 1992; 135: 1301–9

The projected effect of risk factor reduction on Alzheimer's disease prevalence

2011-07-23

Deborah E. Barnes , Kristine Yaffe

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Overweight, Obesity, and Mortality from Cancer in a Prospectively Studied Cohort of U.S. Adults

2003-04-23

Eugenia E. Calle , Carmen Rodríguez , Kimberly A Walker-Thurmond +1 more

The influence of excess body weight on the risk of death from cancer has not been fully characterized.In a prospectively studied population of more than 900,000 U.S. adults (404,576 men … The influence of excess body weight on the risk of death from cancer has not been fully characterized.In a prospectively studied population of more than 900,000 U.S. adults (404,576 men and 495,477 women) who were free of cancer at enrollment in 1982, there were 57,145 deaths from cancer during 16 years of follow-up. We examined the relation in men and women between the body-mass index in 1982 and the risk of death from all cancers and from cancers at individual sites, while controlling for other risk factors in multivariate proportional-hazards models. We calculated the proportion of all deaths from cancer that was attributable to overweight and obesity in the U.S. population on the basis of risk estimates from the current study and national estimates of the prevalence of overweight and obesity in the U.S. adult population.The heaviest members of this cohort (those with a body-mass index [the weight in kilograms divided by the square of the height in meters] of at least 40) had death rates from all cancers combined that were 52 percent higher (for men) and 62 percent higher (for women) than the rates in men and women of normal weight. For men, the relative risk of death was 1.52 (95 percent confidence interval, 1.13 to 2.05); for women, the relative risk was 1.62 (95 percent confidence interval, 1.40 to 1.87). In both men and women, body-mass index was also significantly associated with higher rates of death due to cancer of the esophagus, colon and rectum, liver, gallbladder, pancreas, and kidney; the same was true for death due to non-Hodgkin's lymphoma and multiple myeloma. Significant trends of increasing risk with higher body-mass-index values were observed for death from cancers of the stomach and prostate in men and for death from cancers of the breast, uterus, cervix, and ovary in women. On the basis of associations observed in this study, we estimate that current patterns of overweight and obesity in the United States could account for 14 percent of all deaths from cancer in men and 20 percent of those in women.Increased body weight was associated with increased death rates for all cancers combined and for cancers at multiple specific sites.

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The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes

2008-08-01

Alanna Moshfegh , Donna Rhodes , David J. Baer +7 more

Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies

2009-03-01

Gary Whitlock , Sarah Lewington , Paul Sherliker +6 more

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Potential for primary prevention of Alzheimer's disease: an analysis of population-based data

2014-07-13

Sam Norton , Fiona E. Matthews , Deborah E. Barnes +2 more

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Cancer is a Preventable Disease that Requires Major Lifestyle Changes

2008-07-14

Preetha Anand , Ajaikumar B. Kunnumakara , Chitra Sundaram +5 more

This year, more than 1 million Americans and more than 10 million people worldwide are expected to be diagnosed with cancer, a disease commonly believed to be preventable. Only 5-10% … This year, more than 1 million Americans and more than 10 million people worldwide are expected to be diagnosed with cancer, a disease commonly believed to be preventable. Only 5-10% of all cancer cases can be attributed to genetic defects, whereas the remaining 90-95% have their roots in the environment and lifestyle. The lifestyle factors include cigarette smoking, diet (fried foods, red meat), alcohol, sun exposure, environmental pollutants, infections, stress, obesity, and physical inactivity. The evidence indicates that of all cancer-related deaths, almost 25-30% are due to tobacco, as many as 30-35% are linked to diet, about 15-20% are due to infections, and the remaining percentage are due to other factors like radiation, stress, physical activity, environmental pollutants etc. Therefore, cancer prevention requires smoking cessation, increased ingestion of fruits and vegetables, moderate use of alcohol, caloric restriction, exercise, avoidance of direct exposure to sunlight, minimal meat consumption, use of whole grains, use of vaccinations, and regular check-ups. In this review, we present evidence that inflammation is the link between the agents/factors that cause cancer and the agents that prevent it. In addition, we provide evidence that cancer is a preventable disease that requires major lifestyle changes.

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Adherence to a Mediterranean Diet and Survival in a Greek Population

2003-06-25

Antonia Trichopoulou , Tina Costacou , Christina Bamia +1 more

Adherence to a Mediterranean diet may improve longevity, but relevant data are limited.We conducted a population-based, prospective investigation involving 22,043 adults in Greece who completed an extensive, validated, food-frequency questionnaire … Adherence to a Mediterranean diet may improve longevity, but relevant data are limited.We conducted a population-based, prospective investigation involving 22,043 adults in Greece who completed an extensive, validated, food-frequency questionnaire at base line. Adherence to the traditional Mediterranean diet was assessed by a 10-point Mediterranean-diet scale that incorporated the salient characteristics of this diet (range of scores, 0 to 9, with higher scores indicating greater adherence). We used proportional-hazards regression to assess the relation between adherence to the Mediterranean diet and total mortality, as well as mortality due to coronary heart disease and mortality due to cancer, with adjustment for age, sex, body-mass index, physical-activity level, and other potential confounders.During a median of 44 months of follow-up, there were 275 deaths. A higher degree of adherence to the Mediterranean diet was associated with a reduction in total mortality (adjusted hazard ratio for death associated with a two-point increment in the Mediterranean-diet score, 0.75 [95 percent confidence interval, 0.64 to 0.87]). An inverse association with greater adherence to this diet was evident for both death due to coronary heart disease (adjusted hazard ratio, 0.67 [95 percent confidence interval, 0.47 to 0.94]) and death due to cancer (adjusted hazard ratio, 0.76 [95 percent confidence interval, 0.59 to 0.98]). Associations between individual food groups contributing to the Mediterranean-diet score and total mortality were generally not significant.Greater adherence to the traditional Mediterranean diet is associated with a significant reduction in total mortality.

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The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors

2009-04-27

Goodarz Danaei , Eric L. Ding , Dariush Mozaffarian +4 more

Knowledge of the number of deaths caused by risk factors is needed for health policy and priority setting. Our aim was to estimate the mortality effects of the following 12 … Knowledge of the number of deaths caused by risk factors is needed for health policy and priority setting. Our aim was to estimate the mortality effects of the following 12 modifiable dietary, lifestyle, and metabolic risk factors in the United States (US) using consistent and comparable methods: high blood glucose, low-density lipoprotein (LDL) cholesterol, and blood pressure; overweight-obesity; high dietary trans fatty acids and salt; low dietary polyunsaturated fatty acids, omega-3 fatty acids (seafood), and fruits and vegetables; physical inactivity; alcohol use; and tobacco smoking.We used data on risk factor exposures in the US population from nationally representative health surveys and disease-specific mortality statistics from the National Center for Health Statistics. We obtained the etiological effects of risk factors on disease-specific mortality, by age, from systematic reviews and meta-analyses of epidemiological studies that had adjusted (i) for major potential confounders, and (ii) where possible for regression dilution bias. We estimated the number of disease-specific deaths attributable to all non-optimal levels of each risk factor exposure, by age and sex. In 2005, tobacco smoking and high blood pressure were responsible for an estimated 467,000 (95% confidence interval [CI] 436,000-500,000) and 395,000 (372,000-414,000) deaths, accounting for about one in five or six deaths in US adults. Overweight-obesity (216,000; 188,000-237,000) and physical inactivity (191,000; 164,000-222,000) were each responsible for nearly 1 in 10 deaths. High dietary salt (102,000; 97,000-107,000), low dietary omega-3 fatty acids (84,000; 72,000-96,000), and high dietary trans fatty acids (82,000; 63,000-97,000) were the dietary risks with the largest mortality effects. Although 26,000 (23,000-40,000) deaths from ischemic heart disease, ischemic stroke, and diabetes were averted by current alcohol use, they were outweighed by 90,000 (88,000-94,000) deaths from other cardiovascular diseases, cancers, liver cirrhosis, pancreatitis, alcohol use disorders, road traffic and other injuries, and violence.Smoking and high blood pressure, which both have effective interventions, are responsible for the largest number of deaths in the US. Other dietary, lifestyle, and metabolic risk factors for chronic diseases also cause a substantial number of deaths in the US.

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European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection

2002-12-01

Elio Ríboli , Kelly J. Hunt , Nadia Slimani +7 more

Abstract The European Prospective Investigation into Cancer and Nutrition (EPIC) is an ongoing multi-centre prospective cohort study designed to investigate the relationship between nutrition and cancer, with the potential for … Abstract The European Prospective Investigation into Cancer and Nutrition (EPIC) is an ongoing multi-centre prospective cohort study designed to investigate the relationship between nutrition and cancer, with the potential for studying other diseases as well. The study currently includes 519 978 participants (366 521 women and 153 457 men, mostly aged 35–70 years) in 23 centres located in 10 European countries, to be followed for cancer incidence and cause-specific mortality for several decades. At enrolment, which took place between 1992 and 2000 at each of the different centres, information was collected through a non-dietary questionnaire on lifestyle variables and through a dietary questionnaire addressing usual diet. Anthropometric measurements were performed and blood samples taken, from which plasma, serum, red cells and buffy coat fractions were separated and aliquoted for long-term storage, mostly in liquid nitrogen. To calibrate dietary measurements, a standardised, computer-assisted 24-hour dietary recall was implemented at each centre on stratified random samples of the participants, for a total of 36 900 subjects. EPIC represents the largest single resource available today world-wide for prospective investigations on the aetiology of cancers (and other diseases) that can integrate questionnaire data on lifestyle and diet, biomarkers of diet and of endogenous metabolism (e.g. hormones and growth factors) and genetic polymorphisms. First results of case–control studies nested within the cohort are expected early in 2003. The present paper provides a description of the EPIC study, with the aim of simplifying reference to it in future papers reporting substantive or methodological studies carried out in the EPIC cohort.

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National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants

2011-02-01

Mariel M. Finucane , Gretchen A Stevens , Melanie Cowan +7 more

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Principles of nutritional assessment

1990-07-01

PART 1: INTRODUCTION PART 2: FOOD CONSUMPTION AT THE NATIONAL AND HOUSEHOLD LEVELS PART 3: MEASURING FOOD CONSUMPTION OF INDIVIDUALS PART 4: ASSESSMENT OF NUTRIENT INTAKES FROM FOOD CONSUMPTION DATA … PART 1: INTRODUCTION PART 2: FOOD CONSUMPTION AT THE NATIONAL AND HOUSEHOLD LEVELS PART 3: MEASURING FOOD CONSUMPTION OF INDIVIDUALS PART 4: ASSESSMENT OF NUTRIENT INTAKES FROM FOOD CONSUMPTION DATA PART 5: MEASUREMENT ERRORS IN DIETARY ASSESSMENT PART 6: REPRODUCIBILITY IN DIETARY ASSESSMENT PART 7: VALIDITY IN DIETARY ASSESSMENT METHODS PART 8: EVALUATION OF NUTRIENT INTAKES AND DIETS PART 9: ANTHROPOMETRIC ASSESSMENT PART 10: ANTHROPOMETRIC ASSESSMENT OF BODY SIZE PART 11: ANTHROPOMETRIC ASSESSMENT OF BODY COMPOSITION PART 12: ANTHROPOMETRIC REFERENCE DATA PART 13: EVALUATION OF ANTHROPOMETRIC INDICES PART 14: LABORATORY ASSESSMENT OF BODY COMPOSITION PART 15: LABORATORY ASSESSMENT PART 16: ASSESSMENT OF PROTEIN STATUS PART 17: ASSESSMENT OF IRON STATUS PART 18: ASSESSMENT OF THE STATUS OF VITAMINS A, D AND E PART 19: ASSESSMENT OF VITAMIN C STATUS PART 20: ASSESSMENT OF THE STATUS OF THIAMIN, RIBOFLAVIN, AND NIACIN PART 21: ASSESSMENT OF VITAMIN B6 STATUS PART 22: ASSESSMENT OF FOLATE AND VITAMIN B12 STATUS PART 23: ASSESSMENT OF CALCIUM, PHOSPHORUS AND MAGNESIUM STATUS PART 24: ASSESSMENT OF CHRONIUM, COPPER AND ZINC STATUS PART 25: ASSESSMENT OF IODINE AND SELENIUM STATUS PART 26: CLINICAL ASSESSMENT PART 27: NUTRITIONAL ASSESSMENT OF HOSPITAL PATIENTS

Health Benefits of Fruits and Vegetables

2012-07-01

Joanne Slavin , Beate Lloyd

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Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity

2016-01-09

Dariush Mozaffarian

Suboptimal nutrition is a leading cause of poor health. Nutrition and policy science have advanced rapidly, creating confusion yet also providing powerful opportunities to reduce the adverse health and economic … Suboptimal nutrition is a leading cause of poor health. Nutrition and policy science have advanced rapidly, creating confusion yet also providing powerful opportunities to reduce the adverse health and economic impacts of poor diets. This review considers the history, new evidence, controversies, and corresponding lessons for modern dietary and policy priorities for cardiovascular diseases, obesity, and diabetes mellitus. Major identified themes include the importance of evaluating the full diversity of diet-related risk pathways, not only blood lipids or obesity; focusing on foods and overall diet patterns, rather than single isolated nutrients; recognizing the complex influences of different foods on long-term weight regulation, rather than simply counting calories; and characterizing and implementing evidence-based strategies, including policy approaches, for lifestyle change. Evidence-informed dietary priorities include increased fruits, nonstarchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and minimally processed whole grains; and fewer red meats, processed (eg, sodium-preserved) meats, and foods rich in refined grains, starch, added sugars, salt, and trans fat. More investigation is needed on the cardiometabolic effects of phenolics, dairy fat, probiotics, fermentation, coffee, tea, cocoa, eggs, specific vegetable and tropical oils, vitamin D, individual fatty acids, and diet-microbiome interactions. Little evidence to date supports the cardiometabolic relevance of other popular priorities: eg, local, organic, grass-fed, farmed/wild, or non-genetically modified. Evidence-based personalized nutrition appears to depend more on nongenetic characteristics (eg, physical activity, abdominal adiposity, gender, socioeconomic status, culture) than genetic factors. Food choices must be strongly supported by clinical behavior change efforts, health systems reforms, novel technologies, and robust policy strategies targeting economic incentives, schools and workplaces, neighborhood environments, and the food system. Scientific advances provide crucial new insights on optimal targets and best practices to reduce the burdens of diet-related cardiometabolic diseases.

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Dietary Fat Intake and the Risk of Coronary Heart Disease in Women

1997-11-20

Frank B. Hu , Meir J. Stampfer , JoAnn E. Manson +5 more

The relation between dietary intake of specific types of fat, particularly trans unsaturated fat, and the risk of coronary disease remains unclear. We therefore studied this relation in women enrolled … The relation between dietary intake of specific types of fat, particularly trans unsaturated fat, and the risk of coronary disease remains unclear. We therefore studied this relation in women enrolled in the Nurses' Health Study.

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Primary Prevention of Coronary Heart Disease in Women through Diet and Lifestyle

2000-07-06

Meir J. Stampfer , Frank B. Hu , JoAnn E. Manson +2 more

Many lifestyle-related risk factors for coronary heart disease have been identified, but little is known about their effect on the risk of disease when they are considered together. Many lifestyle-related risk factors for coronary heart disease have been identified, but little is known about their effect on the risk of disease when they are considered together.

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Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts

2018-06-13

Ramón Estruch , Emilio Ros , Jordi Salas‐Salvadó +7 more

Observational cohort studies and a secondary prevention trial have shown inverse associations between adherence to the Mediterranean diet and cardiovascular risk.In a multicenter trial in Spain, we assigned 7447 participants … Observational cohort studies and a secondary prevention trial have shown inverse associations between adherence to the Mediterranean diet and cardiovascular risk.In a multicenter trial in Spain, we assigned 7447 participants (55 to 80 years of age, 57% women) who were at high cardiovascular risk, but with no cardiovascular disease at enrollment, to one of three diets: a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). Participants received quarterly educational sessions and, depending on group assignment, free provision of extra-virgin olive oil, mixed nuts, or small nonfood gifts. The primary end point was a major cardiovascular event (myocardial infarction, stroke, or death from cardiovascular causes). After a median follow-up of 4.8 years, the trial was stopped on the basis of a prespecified interim analysis. In 2013, we reported the results for the primary end point in the Journal. We subsequently identified protocol deviations, including enrollment of household members without randomization, assignment to a study group without randomization of some participants at 1 of 11 study sites, and apparent inconsistent use of randomization tables at another site. We have withdrawn our previously published report and now report revised effect estimates based on analyses that do not rely exclusively on the assumption that all the participants were randomly assigned.A primary end-point event occurred in 288 participants; there were 96 events in the group assigned to a Mediterranean diet with extra-virgin olive oil (3.8%), 83 in the group assigned to a Mediterranean diet with nuts (3.4%), and 109 in the control group (4.4%). In the intention-to-treat analysis including all the participants and adjusting for baseline characteristics and propensity scores, the hazard ratio was 0.69 (95% confidence interval [CI], 0.53 to 0.91) for a Mediterranean diet with extra-virgin olive oil and 0.72 (95% CI, 0.54 to 0.95) for a Mediterranean diet with nuts, as compared with the control diet. Results were similar after the omission of 1588 participants whose study-group assignments were known or suspected to have departed from the protocol.In this study involving persons at high cardiovascular risk, the incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet. (Funded by Instituto de Salud Carlos III, Spanish Ministry of Health, and others; Current Controlled Trials number, ISRCTN35739639 .).

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Update of the Healthy Eating Index: HEI-2015

2018-08-23

Susan M. Krebs‐Smith , TusaRebecca E. Pannucci , Amy F. Subar +5 more

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Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

2019-04-04

Ashkan Afshin , Patrick J Sur , Kairsten Fay +7 more

<h2>Summary</h2><h3>Background</h3> Suboptimal diet is an important preventable risk factor for non-communicable diseases (NCDs); however, its impact on the burden of NCDs has not been systematically evaluated. This study aimed to … <h2>Summary</h2><h3>Background</h3> Suboptimal diet is an important preventable risk factor for non-communicable diseases (NCDs); however, its impact on the burden of NCDs has not been systematically evaluated. This study aimed to evaluate the consumption of major foods and nutrients across 195 countries and to quantify the impact of their suboptimal intake on NCD mortality and morbidity. <h3>Methods</h3> By use of a comparative risk assessment approach, we estimated the proportion of disease-specific burden attributable to each dietary risk factor (also referred to as population attributable fraction) among adults aged 25 years or older. The main inputs to this analysis included the intake of each dietary factor, the effect size of the dietary factor on disease endpoint, and the level of intake associated with the lowest risk of mortality. Then, by use of disease-specific population attributable fractions, mortality, and disability-adjusted life-years (DALYs), we calculated the number of deaths and DALYs attributable to diet for each disease outcome. <h3>Findings</h3> In 2017, 11 million (95% uncertainty interval [UI] 10–12) deaths and 255 million (234–274) DALYs were attributable to dietary risk factors. High intake of sodium (3 million [1–5] deaths and 70 million [34–118] DALYs), low intake of whole grains (3 million [2–4] deaths and 82 million [59–109] DALYs), and low intake of fruits (2 million [1–4] deaths and 65 million [41–92] DALYs) were the leading dietary risk factors for deaths and DALYs globally and in many countries. Dietary data were from mixed sources and were not available for all countries, increasing the statistical uncertainty of our estimates. <h3>Interpretation</h3> This study provides a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations. Our findings will inform implementation of evidence-based dietary interventions and provide a platform for evaluation of their impact on human health annually. <h3>Funding</h3> Bill & Melinda Gates Foundation.

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Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—a systematic review and dose-response meta-analysis of prospective studies

2016-10-26

Dagfinn Aune , Edward L. Giovannucci , Paolo Boffetta +7 more

Questions remain about the strength and shape of the dose-response relationship between fruit and vegetable intake and risk of cardiovascular disease, cancer and mortality, and the effects of specific types … Questions remain about the strength and shape of the dose-response relationship between fruit and vegetable intake and risk of cardiovascular disease, cancer and mortality, and the effects of specific types of fruit and vegetables. We conducted a systematic review and meta-analysis to clarify these associations.

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Report of the American Institute of Nutrition Ad Hoc Committee on Standards for Nutritional Studies

1977-07-01

Enablers and Challenges of Dietary Interventions and Change for Pacific Peoples Living in Aotearoa, New Zealand: A Scoping Review

2025-06-25

Tutangi Amataiti , Amber Parry‐Strong , Soana Muimuiheata +7 more | Nutrition Reviews

Abstract Background Pacific Peoples face increasing rates of metabolic diseases, yet interventions for healthy dietary change are rarely focused on Pacific communities or centered around the cultural values and socio-cultural … Abstract Background Pacific Peoples face increasing rates of metabolic diseases, yet interventions for healthy dietary change are rarely focused on Pacific communities or centered around the cultural values and socio-cultural environment of Pacific Peoples. Objective In this scoping review we aimed to systematically identify enablers and challenges of dietary change for Pacific Peoples in Aotearoa, New Zealand (AoNZ), and Australia. Data Sources Medline (OVID), Embase (OVID), Scopus, Indigenous health (informIT), CINAHL (EBSCO), NZ Research, and Web of Science databases were searched from inception until July 2021. Data Extraction We performed this review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist, Joanna Briggs Institute methodology. Of 10 963 articles identified, 19 were selected for review. Eight articles focused solely on Pacific Peoples and 11 included Pacific Peoples alongside other groups. Seventeen articles reported consultations with Pacific communities, utilized Pacific research methodology, or included authors of Pacific heritage. Data Synthesis The Pacific Health model “Kato Polopola” (food basket) was utilized to synthesize the findings. This model includes 12 domains reflecting values commonly shared across Pacific Island cultures: family, community, church, and concepts, impacting the relationship between Pacific Peoples and food. Results Key enablers to engaging in positive dietary change centered on cultural values of Pacific communities: inclusion of the whole family; use of a holistic approach to physical and spiritual health; the significance of food in preserving cultural traditions; and co-design and facilitation performed with the Pacific Community. Crucially, the main challenges identified were primarily related to the social determinants of health and well-being. Conclusion Despite alarming health outcomes for Pacific Peoples living in AoNZ, this scoping review highlights the paucity of research addressing healthy dietary change for Pacific communities. Pacific-led research, based on Pacific values, is essential to promote meaningful change, alongside addressing the social determinants of health. This review provides a valuable basis for future research.

Dietify - AI Based Diet & Nutrition Consultation Application

2025-06-24

Aastha Bhatt | International Journal for Research in Applied Science and Engineering Technology

This paper provides a detailed review of Dietify, an AI-based application designed to offer personalized diet and nutrition consultations. Utilizing machine learning and predictive analytics, Dietify provides real-time dietary recommendations, … This paper provides a detailed review of Dietify, an AI-based application designed to offer personalized diet and nutrition consultations. Utilizing machine learning and predictive analytics, Dietify provides real-time dietary recommendations, continuously adapting meal plans based on user feedback and health objectives. This review examines Dietify’s functional architecture, methodology, advantages, and limitations. Furthermore, it situates Dietify within the broader field of AI-driven diet management applications and discusses future opportunities, including expanded integration with wearable health data, advanced predictive modeling, and increased personalization for chronic disease management. Dietify represents a significant advancement in personalized diet consultation, enhancing accessibility, individualization, and data-driven adaptability in health management

Diabetes duration-specific association of dietary inflammatory index with the risk of mortality among individuals with diabetes

2025-06-24

Xi Chen , Lixia Lin , Yejun Tan +4 more | Diabetology & Metabolic Syndrome

The dietary inflammatory index (DII) is a literature-derived index to assess the inflammatory potential of diet. While numerous studies have linked a higher DII score to an increased risk of … The dietary inflammatory index (DII) is a literature-derived index to assess the inflammatory potential of diet. While numerous studies have linked a higher DII score to an increased risk of mortality, there are limited studies among individuals with diabetes. To investigate the association of the DII with all-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality among individuals with diabetes, and to explore whether diabetes duration could modify these associations. A total of 9942 participants with diabetes from the UK Biobank were included. The DII scores were calculated based on 24-h dietary data. Outcomes were ascertained from linked records. The hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality according to DII quartiles were estimated using Cox proportional hazards models. During the median follow-up period of 12.1 years, 1225 (12.3%) participants with diabetes died. The multivariable HRs (95% CIs) in the highest quartile compared with the lowest DII quartiles were 1.30 (1.06, 1.58) for mortality, 1.67 (1.13, 2.48) for CVD mortality, and 1.00 (0.73, 1.38) for cancer mortality. Spline regression analysis indicated significant nonlinear associations between DII and mortality, while the relationship with CVD mortality was linear. Moreover, diabetes duration significantly modified the association between DII and all-cause mortality (P-interaction = 0.002). In participants with diabetes duration of less than 5 years, the HR (95% CIs) for all-cause mortality in the highest versus lowest DII quartile was 1.73 (1.25, 2.39), while for those with diabetes duration of 5 years or more, the HR (95% CIs) was 1.08 (0.83, 1.39). A higher DII, indicating a pro-inflammation dietary pattern, is associated with an elevated risk of all-cause mortality and CVD mortality in individuals with diabetes. Notably, the association with mortality is more pronounced in those with diabetes duration less than 5 years.

Food classification using daily sugar intake among Indonesian school-aged children

2025-06-24

Wardina Humayrah , Megah Stefani , Athiya Fadlina | Malaysian Journal of Nutrition

Introduction: The increasing prevalence of diabetes and sugary snacking habits among schoolchildren in Indonesia is driving the need for a comprehensive food classification system, particularly based on sugar intake, with … Introduction: The increasing prevalence of diabetes and sugary snacking habits among schoolchildren in Indonesia is driving the need for a comprehensive food classification system, particularly based on sugar intake, with potential implications for sugar traffic light labelling. This study aimed to classify foods according to sugar intake in Indonesian children aged 5 to 9 years. Methods: Using cross-sectional design, the study used secondary data from the 2014 Individual Food Consumption Survey (IFCS), which included 24-hour recalls from 8007 school-aged children (5-9 years). The 1318 food items consumed were aggregated into 61 subgroups and Ward’s hierarchical clustering method (HCWM) was used for classification. Principal component analysis (PCA) and BiPlot visualisation were used to analyse the similarity of the characteristic variables in each food level. Results: Four levels of food groups based on daily sugar intake: Level 1 (low sugar), Level 2 (moderate sugar), Level 3 (high sugar), and Level 4 (very high sugar). Notable items included instant noodles (Level 1), tea/coffee/cocoa drinks (Level 2), soft drinks/fruit drinks (Level 3), and added sugars/sugary milk (Level 4). Level 4 foods had highest sugar content and were among the most frequently consumed items, significantly contributing to daily sugar intake. Conclusion: This classification system highlighted the significant contribution of specific foods to daily sugar intake of school-aged children. Targeted nutrition interventions and strong food labelling policies are essential to reduce consumption of foods high in sugar and promote healthier dietary choices among children.

Development of empirical anti-inflammatory diet index: a cross-sectional study

2025-06-23

Joanna Kałuża , Lisa Hellerström , Daniel Kaluza +4 more | Nutrition Journal

The mediating role of body mass index in the association between unprocessed or minimally processed foods and gallstones

2025-06-23

Chenyu Jiang , Li‐Hua Zhu , Xiaosheng Teng +4 more | Frontiers in Nutrition

Background The extent of food processing significantly impacts human health, with ultra-processed foods (UPFs) linked to numerous adverse health outcomes. In contrast, research on unprocessed or minimally processed foods (MPFs) … Background The extent of food processing significantly impacts human health, with ultra-processed foods (UPFs) linked to numerous adverse health outcomes. In contrast, research on unprocessed or minimally processed foods (MPFs) and their association with gallstones remains scarce. This study aimed to investigate the relationship between MPF intake and gallstones in U.S. adults. Methods We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES, 2017–2023). MPF intake was assessed according to the NOVA classification system. Survey-weighted logistic regression, restricted cubic spline models, and mediation analyses were employed to evaluate the association between MPF consumption and gallstones disease. Results Among 11,779 U.S. adults, 1,303 cases of gallstones disease were identified (weighted prevalence: 9.8%). Elevated percentage contribution of MPF was significantly associated with a reduced likelihood of gallstones [model 1, odds ratio (OR): 0.40, 95% confidence interval (CI): 0.21–0.78], and this inverse relationship persisted after full adjustment (model 3; OR: 0.28, 95% CI: 0.09–0.84). Compared to the lowest quartile (Q1), the highest quartile (Q4) of MPF consumption showed significantly lower odds of gallstones (OR: 0.72, 95% CI: 0.53–0.98). A non-linear, inverted U-shaped relationship was observed between MPF intake and gallstones (overall p &lt; 0.001; non-linear p = 0.031). Mediation analysis indicated that the body mass index (BMI) partially mediated this association. No significant associations were found between other NOVA food groups, including UPF, and gallstones disease. Conclusion Higher MPF consumption is associated with a lower risk of gallstones disease, with BMI partially mediating this relationship.

Fruit and Vegetable Intake in Relation to Lung Cancer Risk: A Systematic Review and Dose-response Meta-analysis of Prospective Cohort Studies

2025-06-23

Seyed Vahid Tabatabaei , Ali Akbar Haghdoost , Seyed Mohammad Alavi +3 more | Journal of Cancer Prevention

Human vs. AI: Assessing the Quality of Weight Loss Dietary Information Published on the Web

2025-06-23

Evangelia Fappa , Mary Micheli , Dimitris Panaretos +3 more | Information

Information availability through the web has been both a challenge and an asset for healthcare support, as evidence-based information coexists with unsupported claims. With the emergence of artificial intelligence (AI), … Information availability through the web has been both a challenge and an asset for healthcare support, as evidence-based information coexists with unsupported claims. With the emergence of artificial intelligence (AI), this situation may be enhanced or improved. The aim of the present study was to compare the quality assessment of online dietary weight loss information conducted by an AI assistant (ChatGPT 4.5) to that of health professionals. Thus, 177 webpages publishing dietary advice on weight loss were retrieved from the web and assessed by ChatGPT-4.5 and by dietitians through (1) a validated instrument (DISCERN) and (2) a self-made scale based on official guidelines for weight management. Also, webpages were assessed by a ChatGPT custom scoring system. Analysis revealed no significant differences in quantitative quality scores between human raters, ChatGPT-4.5, and the AI-derived system (p = 0.528). On the contrary, statistically significant differences were found between the three content accuracy scores (p < 0.001), with scores assigned by ChatGPT-4.5 being higher than those assigned by humans (all p < 0.001). Our findings suggest that ChatGPT-4.5 could complement human experts in evaluating online weight loss information, when using a validated instrument like DISCERN. However, more relevant research is needed before forming any suggestions.

The Impact of Egg Consumption on Gastrointestinal Health: A Systematic Literature Review and Meta-Analysis

2025-06-20

Nessmah Sultan , Caroline J. Tuck , T.C.E. Cheng +2 more | Nutrients

Objective: Eggs are a valuable source of nutrients and bioactive compounds that may influence the gastrointestinal tract by modulating the microbiome, promoting the production of gastrointestinal-related metabolites, and mediating inflammation. … Objective: Eggs are a valuable source of nutrients and bioactive compounds that may influence the gastrointestinal tract by modulating the microbiome, promoting the production of gastrointestinal-related metabolites, and mediating inflammation. Limited human studies have explored the effects of whole egg intake on indices of gastrointestinal health. This systematic literature review aimed to synthesise research investigating the impact of whole egg consumption on markers of gastrointestinal health. Methods: Five databases were searched from inception until July 2024. Studies were included if they examined the link between whole egg consumption and gastrointestinal markers, including symptoms, gut microbiome composition, inflammation, colonic fermentation, and egg-derived metabolites such as trimethylamine N-oxide (TMAO) in healthy adults. Two reviewers independently conducted title and abstract and full-text screening, with conflicts resolved by a third reviewer. Similarly, two authors conducted data extraction, which was verified by a third. A risk of bias assessment was conducted using validated tools. Random effects meta-analyses were performed to summarise the effect of egg consumption on TMAO, choline, and C-reactive protein (CRP). Results: Twenty-two studies were included in a narrative synthesis and ten in the meta-analyses. Nine were randomised controlled trials (RCTs), three were non-randomised intervention trials, eight were cross-sectional, and two were prospective cohort studies. Meta-analyses indicated that egg consumption did not impact plasma TMAO (n = 6, p = 0.22) or CRP (n = 3, p = 0.45) concentrations but did increase plasma choline (n = 5, p < 0.001) in the short term (≤4 weeks). Four studies found correlations between habitual egg consumption and specific gut bacteria, although results varied as egg consumption was both positively and negatively associated with butyrate-producing genera. Conclusions: This review found conflicting results regarding egg consumption and most gastrointestinal outcomes, highlighting that future studies are needed to explore links between habitual egg intake and plasma TMAO, microbial diversity, and inflammation (PROSPERO registration: 408532).

Trends in diet structural composition and quality among adults in Beijing, China (2010–2022)

2025-06-20

Ning Chen , Liyu Huang , Kai Zhao +7 more | Frontiers in Nutrition

Background Unbalanced dietary patterns are a major risk factor for chronic non-communicable diseases. Examining trends in population-level dietary structural composition and quality is essential for monitoring nutritional transitions, identifying key … Background Unbalanced dietary patterns are a major risk factor for chronic non-communicable diseases. Examining trends in population-level dietary structural composition and quality is essential for monitoring nutritional transitions, identifying key dietary risks, and developing targeted public health policies. Methods This study analyzed dietary trends among Beijing adults using three waves (2010–2022) of data from the China Nutrition and Health Surveillance (CNHS). Dietary intake was assessed through consecutive 3-day 24-h dietary recalls, supplemented by household weighing of cooking oils and condiments. Dietary structural composition was comprehensively analyzed, including the energy contribution of macronutrients and food sources of energy, protein, and fat intake. Population-level dietary quality was evaluated using the Chinese Diet Balance Index (DBI-22). Trend analyses were performed using the Jonckheere–Terpstra test, while group comparisons utilized chi-square and Mantel–Haenszel tests. Results A total of 4,520 participants were included. Between 2010 and 2022, carbohydrate contribution to energy intake decreased from 56.1 to 46.7%, whereas fat intake increased from 31.6 to 36.9%. A dietary shift from plant-based to animal-sourced foods was observed, with the latter demonstrating annual increases in their proportional contributions to total energy, protein, and fat intake ( p for trend &lt;0.001). DBI-22 assessments revealed persistent imbalances relative to dietary guidelines, with insufficient intake of vegetables, fruits, dairy, aquatic products, and soybeans (median scores: −1.5 to −6) and excessive intake of cereals, meat, eggs, oil, and salt (median scores: 1 to 4.7). Trend analyses indicated a worsening in excessive intake ( p = 0.001) alongside a modest improvement in intake deficiency ( p = 0.004) over the study period. However, the overall gap between the actual and recommended intake remains unchanged ( p = 0.868). Subgroup analyses revealed stable dietary transition trajectories across population strata, with significant interaction effects between area and time observed for both dietary composition and diet quality ( p for interaction &lt;0.05), indicating divergent trends between urban and rural residents over time. Conclusion Between 2010 and 2022, Beijing adults experienced substantial imbalances in dietary structure, characterized by decreasing energy intake from carbohydrates and increasing intake from fat, both diverging further from recommended levels. Dietary deficiencies and excesses coexist, contributing to suboptimal dietary quality compared with national dietary guidelines.

Association Between Health Literacy and Adherence to the Eat- <i>Lancet</i> Sustainable Reference Diet Among Cancer Survivors

2025-06-20

Luíza de Carvalho Almeida , Leandro Teixeira Cacau , Alberto Freitas +5 more | Nutrition and Cancer

This study aimed to investigate whether there is an association between the health literacy of breast and prostate cancer survivors and their feeding, considering the planetary diet recommendation. This cross-sectional … This study aimed to investigate whether there is an association between the health literacy of breast and prostate cancer survivors and their feeding, considering the planetary diet recommendation. This cross-sectional study utilized secondary data from 201 women with breast cancer and 106 men with prostate cancer. Health literacy was evaluated using the Brazilian version of the Health Literacy Questionnaire. The EAT-Lancet diet adherence was assessed using the Planetary Health Diet Index (PHDI). The mean PHDI score was 45.3 (9.0) points, without differences in consumption between men and women. The health literacy status and PHDI score were unassociated among cancer survivors. Adherence to a healthy and sustainable diet and health literacy were low among the studied population. Further studies should evaluate these conditions in other populations.

Regular consumption of fruits, vegetables, and whole grain foods is associated with fewer depressive symptoms in older adults: a cross-sectional analysis of EpiFloripa Aging cohort study, Brazil

2025-06-20

Karine Kahl , Gilciane Ceolin , Eleonora d’Orsi +1 more | Aging & Mental Health

Objectives: Diet has been postulated as a modifiable risk factor for the onset of depression. Here, we tested the hypothesis that weekly and daily consumption of healthy food decreases the … Objectives: Diet has been postulated as a modifiable risk factor for the onset of depression. Here, we tested the hypothesis that weekly and daily consumption of healthy food decreases the prevalence ratio (PR) of depressive symptoms in older adults. Method: Data from 1197 participants from the third wave of data collection of the EpiFloripa Aging cohort study (2017-2019) were used. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS-15); the frequency of consumption of healthy foods (fruits, vegetables, whole food, fish, and beans) were collected through a questionnaire to evaluate the regular consumption of the food groups (≥5 times/week for fruits, vegetables, beans and whole grain; ≥2 times/week for fish; ≥5 times/day for fruits and vegetables combined). Poisson regression was used to examine the associations between food intake and depressive symptoms. A Directed Acyclic Graph (DAG) was created to define the minimal adjustment model. Results: The prevalence of depressive symptoms was 14.6%. A statistically significant inverse association was found between regular consumption of healthy food and depressive symptoms: ≥5 times/week for fruits (PR = 0.71 [95%CI: 0.56, 0.90]), vegetables (0.81 [0.68, 0.96]), beans (0.84 [0.74, 0.96]), and whole grains (0.86 [0.74, 0.99]); once a week for fish consumption (0.82 [0.71, 0.95]); 2-4 times/day (0.80 [0.65, 0.97]) and ≥5 times/day (0.75 [0.58, 0.96]) for fruits and vegetables (FV). Conclusion: Our results suggest that older adults who regularly consume healthy food are less likely to experience depressive symptoms. Further longitudinal studies are necessary to understand the underlying mechanisms in the relationship between diet and depression.

Sex Specificities in the Association Between Diet, Physical Activity, and Body Composition Among the Elderly: A Cross-Sectional Study in Florence, Italy

2025-06-20

Nora De Bonfioli Cavalcabo’ , Luigi Facchini , Melania Assedi +7 more | International Journal of Environmental Research and Public Health

The rising prevalence of elderly obesity in developed countries poses a public health challenge, since body composition changes during aging are associated with higher risks of chronic diseases. We cross-sectionally … The rising prevalence of elderly obesity in developed countries poses a public health challenge, since body composition changes during aging are associated with higher risks of chronic diseases. We cross-sectionally explored the relationship between diet, physical activity, and sex-specific differences in body composition among 378 elderly previously enrolled in the Florence European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Information on dietary habits and lifestyle was collected through validated questionnaires. Adherence to the Italian Mediterranean Index (IMI), Dietary Approaches to Stop Hypertension (DASH), and Greek Modified Mediterranean Diet (GMMD) a priori dietary patterns was calculated. Anthropometric measures were taken by trained personnel, and body composition parameters were estimated via bioelectrical impedance. In age- and energy-intake-adjusted regression models, adherence to the DASH and IMI patterns was associated with healthier body composition among women, while no significant relationship emerged among men. Fitness activities and total recreational physical activity revealed positive associations with healthier body composition (lower % fat mass, higher % muscle mass, and reduced waist circumference) in both sexes. These findings highlight the synergistic effect of diet and physical activity on body composition in the elderly and underscore the need for sex-specific interventions for promoting healthy aging.

Low-burden metrics for monitoring healthy diets across contexts: A multi-country validation analysis using quantitative 24-hour dietary intake data

2025-06-20

Giles Hanley‐Cook , Edward A. Frongillo , Isabela Fleury Sattamini +3 more | medRxiv (Cold Spring Harbor Laboratory)

Summary Background Unhealthy diets are a major public health concern. However, a lack of available and up-to-date quantitative dietary intake data, accurate low-burden data collection methods, and valid and interpretable … Summary Background Unhealthy diets are a major public health concern. However, a lack of available and up-to-date quantitative dietary intake data, accurate low-burden data collection methods, and valid and interpretable metrics across contexts has hindered frequent monitoring of diets globally. Methods In this multi-country validation study, we compared the relationships between low-burden metrics of a healthy diet, identified by the FAO, UNICEF, and WHO Healthy Diets Monitoring Initiative, and a suite of reference metrics of dietary intake. To this end, we used harmonized open access quantitative 24-hour recall and food record data collected from 77,118 adolescent and adult females across 27 countries. Findings On any given day, non-consumption of sweet foods or sweet beverages was associated with greater population-level adherence to <10% energy from free sugars in available upper-middle income countries [odds ratio (95% CI): 5.35 (5.05, 5.66)]. Food group diversity score (FGDS) was positively associated with mean adequacy ratio of micronutrients [ β of 1-SD change (95% CI): ∼11 percentage points (9, 12)], while NCD-Protect score best predicted consumption of ≥400 g/day of fruits and vegetables [range odds ratio of 1-SD changes (95% CI): 2.56 to 3.01 (2.40 to 3.13) in lower-middle and high income countries, respectively]. FGDS and Global Diet Quality Score Positive were associated with achieving ≥25 g/day of fibre and ≥3,510 mg/day of potassium across contexts. No indicator accurately predicted adherence to WHO guidelines for sodium intake or energy intake ranges for carbohydrates, lipids, and proteins. Interpretation Accurate low-burden dietary assessment methods can provide valid metrics that enable timely monitoring of key characteristics of healthy diets globally. Specifically, avoiding sweet foods or sweet beverages serves as an indicator for population-level adherence to the WHO guideline for free sugar intake, while metrics reflecting nutritious food group diversity are strongly predictive of better micronutrient adequacy and adherence to WHO guidelines for fruits and vegetables, fibre, and potassium intakes across settings. Research in context Evidence before this study Unhealthy diets are a common cause of all forms of malnutrition and are the major risk factor for non-communicable diseases. However, a lack of up-to-date nationally representative quantitative dietary intake data, and a lack of consensus on fit-for-purpose lower-burden data collection methods and metrics, based on comparative epidemiological evidence, has hindered monitoring of healthy diets globally. Added value of this study Using open access quantitative 24-hour recall and food record data collected in 27 countries, our validation analyses compared the relationships between measures of a healthy diet, deemed most promising for global surveillance by the FAO, UNICEF, and WHO Healthy Diets Monitoring Initiative, and a suite of reference metrics of dietary intake, both within and across countries. Implications of all the available evidence Nationally representative quantitative dietary intake assessments remain the reference for nutrition. Nevertheless, complementary low-burden methods can yield metrics that are suitable for high-frequency monitoring of healthy diets. Specifically, on any given day, avoiding sweet foods or sweet beverages is an accurate population-level indicator for achieving the WHO guideline of <10% kcal/day from free sugars, while metrics capturing nutritious food group diversity are associated with better micronutrient adequacy, as well as, higher probabilities of reaching WHO guidelines of ≥400 and ≥25 g/day for fruits and vegetables and fibre, respectively, and ≥3,510 mg/day of potassium across contexts.

The association between Dietary Inflammatory Index and Latent Tuberculosis Infection in US participants :a cross-sectional study from NHANES

2025-06-20

Jun Jia , Yuanyuan Liu , Hua Zhang +5 more | medRxiv (Cold Spring Harbor Laboratory)

Abstract Background There is a growing recognition that inflammation related to diet could influence Latent Tuberculosis Infection(LTBI). However, the association between Dietary Inflammatory Index(DII) and LTBI remains unclear. Objective This … Abstract Background There is a growing recognition that inflammation related to diet could influence Latent Tuberculosis Infection(LTBI). However, the association between Dietary Inflammatory Index(DII) and LTBI remains unclear. Objective This study aimed to explore the relationship between DII and LTBI using a cross-sectional design, incorporating univariate and multivariate logistic regression analyses. Methods We conducted a cross-sectional analysis involving 3,892 participants from the National Health and Nutrition Examination Survey (NHANES). Demographic data, including age, sex, race, body mass index (BMI), education level, poverty income ratio (PIR), marital status, smoking, alcohol consumption, hypertension (HPT), and diabetes mellitus (DM), were collected from all participants. We used logistic regression, smooth curve fitting, and subgroup analys to achieve our research objectives. Results Among all eligible participants, the mean age was 48.4 ± 17.8 years, with males comprising 50.6% of the study population. After adjusting for confounding variables, we found a positive association between the DII and the risk of LTBI, with an odds ratio of 1.07 (95% CI, 1.01–1.13; P=0.023). Adjusted smoothed plots also suggest a straightforward linear relationship between DII and LTBI(P for non-linearity = 0.924),as the level of DII increases, the risk of LTBI shows an upward trend.Additionally, subgroup analysis within the defined gender, age, BMI, PIR, smoking, drinking, HPT, and DM groups indicated no significant interactions among the subgroups, as evidenced by all P values for interaction exceeding 0.05. Conclusions These results underscore that DII may serve as an important risk factor for LTBI, providing new insights for early screening and intervention strategies. However,further studies are needed to explore the underlying mechanisms.

Lifestyle Medicine as a Pathway to Longevity: The Impact of the Healthy Lifestyle Community Program (Cohort 2, HLCP-2) on Oxidative Stress Biomarkers in the Adult Rural German Population

2025-06-20

Sarah Husain , Corinna Anand , Ragna‐Marie Kranz +4 more | American Journal of Lifestyle Medicine

Aim: Oxidative stress (OS) is a major contributor to the development of non-communicable diseases (NCDs) diseases such as cardiovascular disease, diabetes, and cancer. The aim of this study was to … Aim: Oxidative stress (OS) is a major contributor to the development of non-communicable diseases (NCDs) diseases such as cardiovascular disease, diabetes, and cancer. The aim of this study was to investigate the effects of a 10-week community-based lifestyle intervention program on oxidative stress biomarkers in the adult German population. Methods: A total of 175 adults (aged 18-75 years) were assigned to the intervention group (n = 103) and the control group (n = 72). The intervention group participated in a 10-week healthy lifestyle community-based program (HLCP-2) that included empowering individuals with scientific based knowledge on the four important pillars of health: nutritional health (high plant-based), physical health (physical activity), mental health (stress management), and social health (community support and social interactions). The control group received no intervention. Biomarkers of oxidative stress-including total antioxidant capacity (TAC), superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), and lipid peroxidation (LPO)-were assessed via fasting blood samples at four timepoints: baseline (T0), post-intervention (T1), 6 months (T2), and 12 months (T3). Results: Our study shows significant improvements in the oxidative stress biomarkers among German adults, who participated in the healthy lifestyle community program (HLCP-2). Significant within-group improvements were observed in the IG from T0 to T1 across TAC, SOD, GSH, and LPO (all P < 0.01), with sustained effects through T2 and T3. CAT showed a significant group-by-time effect, though within-group changes were not consistently significant. By contrast, the CG demonstrated minimal improvement or worsening of biomarker levels over time, including a notable increase in LPO (T0 to T1: P < 0.01). Gender-based analysis revealed a significant increase in catalase activity in females (P = 0.009). Multivariate regression indicated that group assignment was the strongest predictor of improved oxidative stress status, independent of age, sex, and cardiometabolic risk. Conclusions: These findings suggest that the Healthy lifestyle community program-2 (HLCP-2) had a positive impact on improving oxidative stress and may be a promising tool for reducing the risk of chronic diseases and enhancing longevity. Our study highlights the importance of simple lifestyle choices in improving overall health, offering effective strategies to combat global health challenges in the form of NCDs and promoting healthy aging.

Mediterranean diet vs. the Australian guide to healthy eating (<scp>AGHE</scp>) on body composition and glucose metabolism: A randomized controlled trial

2025-06-20

Robel Hussen Kabthymer , Jessica Danaher , Barbora de Courten | Diabetes Obesity and Metabolism

Abstract Aims The Mediterranean diet has been extensively studied and shown to reduce chronic disease risk. The Australian Guide to Healthy Eating (AGHE) offers a balanced dietary framework tailored to … Abstract Aims The Mediterranean diet has been extensively studied and shown to reduce chronic disease risk. The Australian Guide to Healthy Eating (AGHE) offers a balanced dietary framework tailored to Australian habits, yet its comparative efficacy with the Mediterranean diet remains unexplored. Thus, this study aims to compare the efficacy of the Mediterranean diet with AGHE on body composition and glucose metabolism. Materials and Methods We conducted a randomised controlled trial including 57 participants (median age 31, IQR: 25–37 years; 71.9% female, BMI = 25.1 kg/m 2 ), with 23 participants randomised to the Mediterranean diet and 34 participants to the AGHE diet for eight weeks. Paired t‐tests were employed for within‐group comparisons, and analysis of covariance (ANOVA) was used for between‐group comparisons, adjusted for age and baseline observations. Results The Mediterranean diet intervention resulted in a significant decrease in waist circumference (−1.3 cm, p = 0.043), body fat percentage (−1.8%, p = 0.014), resting metabolic rate (RMR) (−17.9 kcal/day, p = 0.02) and fasting insulin concentration (−1.2 μIU/mL, p = 0.016), along with an increase in body lean mass percentage (1.7%, p = 0.015) compared to the AGHE group. Conclusion The Mediterranean diet demonstrated greater efficacy in improving body composition and maintaining metabolic variables than the AGHE. These findings may support the use of the Mediterranean diet in improving health outcomes related to obesity and metabolic disorders. However, larger, well‐designed clinical trials are needed to confirm these findings and explore underlying mechanisms.

586-P: Effects of Replacing Diet Beverages with Water on Sustained Weight Loss and Type 2 Diabetes Remission—An 18-Month Randomized Clinical Trial

2025-06-20

Mireille Nasr , Ameneh Madjd , Hamid R. Farshchi | Diabetes

Introduction and Objective: To evaluate the effects of replacing diet beverages (DBs) with water on the durability of weight loss and Type 2 Diabetes (T2D) remission over an 18-month weight … Introduction and Objective: To evaluate the effects of replacing diet beverages (DBs) with water on the durability of weight loss and Type 2 Diabetes (T2D) remission over an 18-month weight management follow-up, which included a 6-month weight loss intervention and a subsequent 12-month weight maintenance program. Methods: 81 adult women with obesity or overweight and T2D, who usually consumed DBs in their diet, were randomly assigned to either substitute with water or continue drinking DBs 5 times/week after their lunch for the 18-month follow-up. Results: The participants who were randomly assigned were included in the study by using an intention-to-treat analysis. After the 18-month follow-up period, significant weight change (mean ± SD) in the water group was observed compared with the DBs group (-6.82 ± 2.73 kg vs. -4.85 ± 2.07kg) (P&lt;0.001). Diabetes remission was achieved in 37/41 (90%) participants of the water group vs. 18/40 (45%) in the DBs group (P&lt;0·0001). There were also significant changes in BMI, fasting plasma glucose, insulin levels, the homeostasis model assessment of insulin resistance, 2h postprandial glucose and serum triglyceride in the water group compared with DBs over the 18 months. Conclusion: Sustained replacement of DBs with water after the main meals in women with T2D may promote further weight reduction during an 18-month weight management program. It may also offer benefits in glycemic control and diabetes remission during the long-term diet plan. Disclosure M. Farshchi Nasr: None. A. Madjd: None. H.R. Farshchi: None.

Association of dietary inflammatory index with dyslipidemia and atherogenic indices in Iranian adults: a cross-sectional study from the PERSIAN dena cohort

2025-06-20

Mehrdad Behzadi , Mohammad-Reza Jowshan , Shiva Shokri +5 more | Nutrition Journal

Dyslipidemia is a metabolic disorder that can lead to various chronic diseases. Anti-inflammatory diets may help prevent dyslipidemia; however, the evidence remains inconsistent. Therefore, the present study investigated the relationship … Dyslipidemia is a metabolic disorder that can lead to various chronic diseases. Anti-inflammatory diets may help prevent dyslipidemia; however, the evidence remains inconsistent. Therefore, the present study investigated the relationship between the Dietary Inflammatory Index (DII) and dyslipidemia, as well as the Atherogenic Index of Plasma (AIP). A cross-sectional study was done among 3,178 Iranian adults aged 35-70 years who had resided in Dena County, Iran, for a minimum of nine months each year. Demographic data were collected from all participants, and anthropometric and biochemical parameters were measured for each subject using standardized methods. Dietary intake was assessed using 113-item and 127-item Food Frequency Questionnaires (FFQs) to calculate the DII. A significant trend was observed indicating increasing serum levels of total cholesterol (TC) (P < 0.001) and low-density lipoprotein cholesterol (LDL-C) (P = 0.002), along with decreasing levels of high-density lipoprotein cholesterol (HDL-C) (P = 0.024), as the DII quartiles elevated. Similarly, a significant association was found between higher DII scores and increased ratios of LDL/HDL (P < 0.001), TC/HDL (P < 0.001), and triglycerides (TG)/HDL-C (P = 0.03) in the serum. Furthermore, higher DII scores were linked to increased odds of hypercholesterolemia (OR = 1.3, P = 0.032), high LDL-C (OR = 1.31, P = 0.036), low-HDL-C (OR = 1.31, P = 0.006), high-TC/HDL-C (OR = 1.15, P = 0.016) ratio, and high-AIP (OR = 1.35, P = 0.001) values after adjusting for confounders. Nonetheless, no significant association was found between the DII score and the serum levels of TG, nor with the odds of having hypertriglyceridemia or a high LDL-C/HDL-C ratio. Our findings revealed that higher DII scores are associated with higher AIP values and lipid biomarker levels, except for triglycerides. However, prospective cohorts and randomized controlled trials testing anti-inflammatory diets (e.g., Mediterranean adaptations for Iran) are needed to establish causality.

Reference intervals for urine creatinine-to-specific gravity ratio as an indicator of relative creatinine excretion rate: a cross-sectional study

2025-06-20

Shih‐Ping Hsu , Chiang-Ting Chien | Annals of Medicine and Surgery

Metabolite Profiles in Response to Dietary Interventions for Management of Blood Pressure: A Systematic Review

2025-06-20

María Gómez‐Martín , Floor Rikken , Erin D. Clarke +3 more | Current Nutrition Reports

Abstract Background Hypertension is a major global public health issue. The mechanisms through which diet influences blood pressure (BP) remain to be fully elucidated. Nutritional metabolomics offers an objective method … Abstract Background Hypertension is a major global public health issue. The mechanisms through which diet influences blood pressure (BP) remain to be fully elucidated. Nutritional metabolomics offers an objective method for examining diet-health outcomes, including the contribution of intermediate molecules and metabolic byproducts or metabolites to BP regulation. To date, no review has investigated the relationship between diet, metabolites and BP regulation. Objective This systematic review aim was to synthesise findings of human dietary intervention studies on BP, including feeding studies providing all foods and meals, as well as those that provided supplements. Methods Six databases were systematically searched (Scopus, Medline, Embase, CINAHL, PsycINFO, and Cochrane) for intervention studies examining the relationship between dietary metabolites and BP regulation. The Academy of Nutrition and Dietetics Quality Criteria were used to assess the risk of bias. Results Twelve articles (11 unique studies) met the inclusion criteria, reporting 11 significant associations between metabolites and BP, while one study found no significant associations. More than 100 metabolites were associated with BP, 40 associated with SBP, 29 with DBP, 31 with both, and 2 did not differentiate between SBP or DBP. Only two metabolites, proline-betaine and N-acetylneuraminate, had significant relationships with BP measurement in more than one study. Conclusions This review identified a shortlist of potential metabolite indicators of response to dietary interventions for BP regulation. Findings highlight nutritional metabolomics as a potential contributor to understanding diet-induced changes in BP and CVD risk reduction. However, variability in reported metabolites and limited replication across studies may affect specificity and limit generalizability. Further research is needed to better understand this relationship.

The association between the dietary index for gut microbiota and its components with cardiovascular disease risk: a cross-sectional study based on NHANES

2025-06-20

Na Lin , Jing Chang , Xinqi Li +4 more | Frontiers in Nutrition

Introduction Cardiovascular disease (CVD) is a leading cause of mortality worldwide, and its development and progression are closely associated with diet-induced changes in gut microbiota. This study aims to investigate … Introduction Cardiovascular disease (CVD) is a leading cause of mortality worldwide, and its development and progression are closely associated with diet-induced changes in gut microbiota. This study aims to investigate the relationship between the dietary index for gut microbiota (DI-GM) and its components, including the beneficial gut microbiota score (BGMS) and the unfavorable gut microbiota score (UGMS), in relation to cardiovascular disease. Methods We conducted a cross-sectional study using National Health and Nutrition Examination Survey (NHANES) data (1999–2020), collecting baseline sociodemographic and health-related data from 41,193 adults aged ≥20 years. We constructed multivariable weighted logistic regression models to evaluate associations between DI-GM, BGMS, UGMS, and CVD risk, generating weighted restricted cubic spline (RCS) plots to visualize dose–response relationships. Subgroup analyses assessed outcome robustness across sex, age, hypertension, and diabetes subgroups. Results After adjusting for confounders (age, sex, race, poverty-to-income ratio [PIR index], marital status, and education level, smoking status, alcohol consumption, body mass index [BMI], and comorbidities), significant associations emerged between DI-GM, BGMS, and CVD risk. Increasing DI-GM and BGMS levels showed gradually decreasing CVD risk trends (DI-GM: OR = 0.97, 95% CI: 0.94–1.00, p &lt; 0.05; BGMS: OR = 0.92, 95% CI: 0.88–0.96, p &lt; 0.05). No significant association was found between UGMS and CVD risk (OR = 1.04, 95% CI: 0.99–1.08, p &gt; 0.05). Subgroup analyses revealed more significant DI-GM and BGMS associations with CVD risk in female versus male participants ( p for interaction &lt; 0.05). Conclusion Among adults aged ≥20 years, DI-GM and BGMS showed significant inverse association with CVD risk. Compared to DI-GM, BGMS demonstrates a stronger inverse association with cardiovascular disease risk. These findings underscore the potential crucial role of favorable dietary patterns in cardiovascular disease prevention.

‘The wisdom of crowds’: a survey on the rating of nutritional values of meals in digital pictures

2025-06-20

Kathrin Gemesi , Sophie Laura Holzmann , Markus Böhm +7 more | BMJ Nutrition Prevention & Health

Background Photo-based nutrition diaries might be useful to assess dietary intake without much effort and maybe even without nutrition expertise. This proof-of-concept study aimed to investigate the principle of ‘the … Background Photo-based nutrition diaries might be useful to assess dietary intake without much effort and maybe even without nutrition expertise. This proof-of-concept study aimed to investigate the principle of ‘the wisdom of crowds’ by examining how accurately both nutrition experts and non-experts can rate nutritional values of meals presented in digital pictures. Methods An online survey was conducted among adults in Germany from 2016 to 2017. Participants rated a random selection of six meal pictures according to their nutritional values (energy, carbohydrates, sugar and fat content) and their healthiness. Rating results were compared with the nutritional value calculated by the German Nutrient Database or according to the manufacturer’s information (‘truth’). Descriptive statistical analysis, Mann-Whitney-U test and multiple linear regression analysis were performed using RStudio. Results In total, 110 (92.7 % women, mean age: 38.7±14.0 years) nutrition experts and 233 (31.3 % women, mean age: 21.2±2.6 years) non-experts participated. Overall meal pictures, experts overestimated the average content of all nutritional values (sugar: 3.8 %, energy: 4.9 %, carbohydrates: 4.9 % and fat: 10.4 %). Non-experts overestimated the average energy content by 10.4 %, fat content by 17.1 % and sugar content by 27.5%. The average carbohydrate content was underestimated by 9.0%. A statistically significant difference between the two crowds’ ratings was found for energy (p=0.03), carbohydrates (p<0.001) and sugar (p<0.001), but not for fat (p=0.44). An increasing deviation of nutritional value ratings from the truth towards overrating was associated with decreasing rating of healthiness (all p<0.001). Conclusion This study suggests that both experts and non-experts rate nutritional values of meals in digital pictures in an appropriate manner, although both crowds occasionally deviated significantly from the truth, especially over-rating occurred with decreasing rating of healthiness. Due to the proof-of-concept approach and the limited generalisability of the results, the principle of ‘the wisdom of crowds’ is not fully supported. Studies with a large representative population are necessary. However, findings suggest that crowd-based meal picture ratings could be a method of digital dietary self-monitoring in combination with gamification elements.

Cumulative behavioral and metabolic determinants of health are associated with higher inflammation-related indices: insights from a cross-sectional study (NHANES 2005–2018)

2025-06-19

Anzhi Wang , Yanxin Zeng , Xiaoyan Gao +4 more | Frontiers in Public Health

Objective This study innovatively investigates the cumulative associations between behavioral determinants of health (BDoH), metabolic determinants of health (MDoH), and systemic inflammation biomarkers in U.S. adults, using a novel cross-sectional … Objective This study innovatively investigates the cumulative associations between behavioral determinants of health (BDoH), metabolic determinants of health (MDoH), and systemic inflammation biomarkers in U.S. adults, using a novel cross-sectional framework to quantify their synergistic effects. Methods Utilizing cross-sectional data from 18,500 participants in the National Health and Nutrition Examination Survey (NHANES 2005–2018 cycle), we developed a composite exposure model integrating BDoH (smoking status, physical activity, dietary quality) and MDoH (obesity metrics, hypertension, diabetes) through standardized questionnaires and clinical measurements. Systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) were calculated from peripheral blood cell counts. Multivariable-adjusted logistic regression models examined dose–response relationships, with trend analysis explicitly testing cumulative BDoH-MDoH interactions. Results The cohort (mean age 44.3 ± 0.3 years; 52.4% male) demonstrated significant positive associations between adverse health determinants and inflammatory indices. Current tobacco use (OR = 1.32, 95%CI = 1.18–1.47), suboptimal diet (HEI &lt; 52: OR = 1.24, 95%CI = 1.11–1.38), obesity (BMI ≥ 30 kg/m 2 : OR = 1.41, 95%CI = 1.27–1.56), and central adipometry (OR = 1.39, 95%CI = 1.25–1.54) showed strongest correlations with elevated SII/SIRI. Metabolic disorders exhibited distinct patterns: hypertension and diabetes associated specifically with SIRI elevation (OR = 1.19, 95%CI = 1.06–1.33 and OR = 1.17, 95%CI = 1.03–1.32, respectively), while physical inactivity (&lt;600 MET-min/week) uniquely correlated with SII increase (OR = 1.26, 95%CI = 1.13–1.40). Notably, our cumulative model revealed synergistic effects: exposure to ≥3 adverse behavioral determinants amplified inflammation risks (SII: OR = 1.57, 95%CI = 1.42–1.73; SIRI: OR = 1.49, 95%CI = 1.35–1.64), with significant dose-dependent trends (P-trend&lt;0.001). Co-occurring metabolic abnormalities demonstrated additive inflammatory effects (P-trend&lt;0.001), exceeding individual risk factor impacts. Conclusion This cross-sectional study provides the first evidence that integrated BDoH-MDoH cumulative exposure models uncover distinct and synergistic inflammatory pathways. Both individual and combined behavioral-metabolic risk factors significantly associate with systemic inflammation biomarker elevation, highlighting the necessity of dual-target intervention strategies.

Effect of dietary fiber on trimethylamine-N-oxide production after beef consumption and on gut microbiota: MEATMARK – a randomized cross-over study

2025-06-19

Melanie Haas , Beate Brandl , Klaus Neuhaus +4 more | European Journal of Clinical Nutrition

Abstract Background/Objectives The gut-microbiota-dependent metabolite trimethylamine-N-oxide (TMAO) has been linked to cardiovascular disease (CVD) risk, while dietary fiber is associated with reduced CVD risk and improved gut health. Considering these … Abstract Background/Objectives The gut-microbiota-dependent metabolite trimethylamine-N-oxide (TMAO) has been linked to cardiovascular disease (CVD) risk, while dietary fiber is associated with reduced CVD risk and improved gut health. Considering these associations, we conducted a randomized, double-blind, pilot study to investigate the influence of fiber supplementation on intestinal TMAO formation after beef consumption. Subjects/Methods 13 volunteers underwent a two-week dietary fiber and placebo intervention. We assessed the effect of fiber supplementation on the gut microbiota and gene abundance of the enzyme cutC, a key enzyme for microbial TMA formation, a precursor for TMAO. We measured the TMAO response following beef consumption after the two-week intervention. We also examined the role of hepatic enzyme FMO3 on TMAO plasma levels. Results Although overall TMAO production did not change between the dietary fiber and placebo group ( p -value = 0.26, 95% CI), subgroup analysis revealed that fiber supplementation attenuated TMAO formation following beef intake in participants with lower habitual meat consumption ( <3 times/week, p -value = 0.029, 95% CI). Furthermore, fiber intervention significantly downregulated microbial cutC gene abundance ( p = 0.034, 95% CI), suggesting a mechanism by which fiber might reduce plasma TMAO levels. While dietary fiber intervention did not alter TMAO production across all participants, it showed a potential effect in individuals with lower habitual meat intake. The observed downregulation of cutC gene abundance suggests a mechanism for the beneficial impact of fiber on TMAO formation. Conclusion These findings support the role of a high-fiber, low-meat diet as a promising strategy to mitigate TMAO-related CVD risk.

Comparison of the association between different dietary pattern scoring indices and periodontitis and their population heterogeneity

2025-06-19

Rui Zhang , Z.J. Zhang , Shuming Ji +2 more | Frontiers in Nutrition

Objectives Association between different dietary indices and periodontitis remained unclear. This study aims to compare the associations of four commonly dietary indices (including Healthy Eating Index-2020, HEI-2020; alternative Mediterranean Diet … Objectives Association between different dietary indices and periodontitis remained unclear. This study aims to compare the associations of four commonly dietary indices (including Healthy Eating Index-2020, HEI-2020; alternative Mediterranean Diet Score, aMED; Dietary Approaches to Stop Hypertension, DASH; Dietary Inflammatory Index, DII) with the risk of periodontitis. Methods A cross-sectional study was designed using a publicly available data collected from the National Health and Nutrition Examination Survey (NHANES) between 2009 and 2014 ( N = 8,571 adults over 30 years). After adjusting for confounders, dietary indices were included in logistic regression models by single, double and overall forms to explore the association with periodontitis. Odds ratios (ORs) for the dietary indices were adjusted by one-fourth of their scoring range to compare the effect sizes; and diminishing marginal receiver operating characteristic (ROC) curves analysis with univariate exclusion in the overall model was used to compare the contribution of the dietary indices to periodontitis. Restricted cubic splines (RCS) was used to explore the non-linear association in both the total population and various sub-populations. Results Although all dietary indices exhibited a significant effect on periodontitis in single exposure model; only DASH and DII retained complete significance in the double exposure condition. In the overall model, aMED and DASH presented significantly positive associations, the corresponding OR were 1.147 (95%CI: 1.002–1.313) and 1.310 (95%CI: 1.139–1.507); but DII showed a negative association with OR of 0.675 (95%CI: 0.597–0.763). The ROC analyses showed that the contribution of dietary indices to periodontitis was second only to sex and ethnicity. The non-linear tests showed an approximately linear association for HEI-2020, aMED, and DASH, but a significant non-linear association for DII ( p = 0.024). Subgroups of females, younger than 50 years old, non-Hispanic White, smokers, and the ratio of family income to poverty ≤ 2.4 were more consistent with the association found in the total population. Conclusion A poor habit for DASH was robustly linked to the occurrence of periodontitis, while the other three dietary patterns were not. Our research suggests that including the DASH index in the evaluation of periodontitis risk and implementing targeted prevention strategies may be beneficial.

Comparison of the Mediterranean Diet and Other Therapeutic Strategies in Metabolic Syndrome: A Systematic Review and Meta-Analysis

2025-06-19

Alejandro Bruna-Mejías , Jessica San Martin , Danna Arciniegas-Diaz +7 more | International Journal of Molecular Sciences

The Mediterranean diet (MD) is one of the healthiest diets, high in fiber, antioxidants, and unsaturated fats. MD improves lipid profiles, reduces inflammation, controls blood pressure, decreases insulin resistance, and … The Mediterranean diet (MD) is one of the healthiest diets, high in fiber, antioxidants, and unsaturated fats. MD improves lipid profiles, reduces inflammation, controls blood pressure, decreases insulin resistance, and enhances the sensitivity to this hormone, lowering the risks of Metabolic syndrome (MS). MS is characterized by central obesity, hypertension, insulin resistance, and dyslipidemia, increasing the risk of cardiovascular disease and type II diabetes. The objective of this study was to know the effectiveness of the MD versus other treatments in patients with MS. A systematic search across multiple databases, Medline, Embase, Web of Science, Scopus, Google Scholar, and Cinahl, was conducted using keywords such as "Mediterranean diet", "Mediterranean food", "eat mediterranean", "Metabolic syndrome", and "x syndrome". A total of 12 studies met the inclusion criteria. Mediterranean diet at different doses versus other diets or other treatments showed significant improvements in clinical parameters, including BMI (mean difference of -0.83 95% CI: -0.93 to -0.74; p < 0.00001),waist circumference (mean difference = -1.81, CI = -2.63 to -0.99, p < 0.00001) triglycerides (mean difference = -22.38, CI = -32.86 to -11.90, p < 0.00001), Glucose (mean difference = -4.28, CI = -7.64 to -0.93, p = 0.005) and, HOMA IR (mean difference = -0.72, CI = -0.78 to -0.65, p < 0.00001), and Insulin resistance (mean difference = -2.98, CI = -3.27 to -2.69, p < 0.00001), all of which improved, Although there were more outcomes, these are the most important changes for patients with metabolic syndrome. MD improves metabolic and cardiovascular health, but study heterogeneity limits the results' generalizability. Because of that, further research is needed to standardize approaches and explore their mechanisms. MD should be part of an optimized strategy that includes education and physical activity. The strength of the evidence was very low according to the GRADE approach. Further research is needed to support the efficacy of the Mediterranean diet in patients with MS.

The impact of the Mediterranean diet and close monitoring on glycemic control and weight management in poorly controlled type 2 diabetes

2025-06-19

Mehmet Erbakan , Cündullah Torun | Mediterranean Journal of Nutrition and Metabolism

Background Despite the increasing availability of medications for managing type 2 diabetes mellitus (T2DM), a significant proportion of patients fail to achieve optimal glycemic control. Objective This study aimed to … Background Despite the increasing availability of medications for managing type 2 diabetes mellitus (T2DM), a significant proportion of patients fail to achieve optimal glycemic control. Objective This study aimed to evaluate adherence to treatment and lifestyle recommendations and their association with achieving diabetes management goals after a 12-month structured follow-up program. Methods In this retrospective cohort study, adults with poorly controlled T2DM (baseline HbA1c ≥ 10%) who completed a 12-month follow-up were analyzed. The program included close monitoring, structured education, and lifestyle guidance. The Mediterranean Diet Adherence Screener (MEDAS) was employed to evaluate participants’ adherence to the Mediterranean diet. The primary outcomes were overall adherence to lifestyle recommendations and its association with variations in HbA1c and body weight. Results The study included 127 patients (58.3% male) with a mean age of 55.4 ± 10.6 years, and baseline HbA1c of 12.1 ± 1.8%. At 12 months, 92.1% of patients achieved an HbA1c reduction, with a mean change of −3.8 ± 2.8% (p < 0.001). Weight loss was observed in 52.8% of patients, with a mean change of −0.9 ± 8.2 kg (p = 0.064). Medication adherence increased from 52.8% to 84%, but only 22.8% of patients consulted a diabetes specialist dietitian. The mean MEDAS score was 6.4 ± 1.9, with 26% of patients categorized as low, 66.7% as moderate, and 6.3% as high. MEDAS scores were not associated with changes in HbA1c or body weight (p = 0.248 and p = 0.732 respectively). Conclusion While promoting healthy lifestyle behaviors and medication adherence improves glycemic control in poorly controlled diabetes, adherence to the Mediterranean diet and achieving substantial weight loss remain challenging.

Linking the Planetary Health Diet Index to sarcopenia: the mediating effect of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR)

2025-06-19

Huan Chen , Zhao Wang , Changsin Lee +5 more | Frontiers in Nutrition

Background The Planetary Health Diet Index (PHDI), which promotes plant-based food consumption and limits red meat and processed food intake, aligns with goals for human health and environmental sustainability. Sarcopenia, … Background The Planetary Health Diet Index (PHDI), which promotes plant-based food consumption and limits red meat and processed food intake, aligns with goals for human health and environmental sustainability. Sarcopenia, characterized by progressive muscle loss, has been increasingly associated with dietary and metabolic factors. This study aims to explore the relationship between PHDI and sarcopenia and investigates the potential mediating role of the non-high-density lipoprotein to high-density lipoprotein cholesterol ratio (NHHR). Methods A total of 9,094 individuals from the National Health and Nutrition Examination Survey (NHANES), conducted between 2011 and 2018, were included in this analysis. Multivariable logistic regression, smooth curve fitting, and subgroup analyses were applied to explore the association between the PHDI and the likelihood of sarcopenia. Additionally, mediation analysis was performed to assess the potential mediating role of NHHR. Results The findings indicated a notable negative association between PHDI and sarcopenia. After adjusting for confounding factors, a 10-unit increase in PHDI was associated with an 14% lower likelihood of sarcopenia [Odds Ratio (OR) = 0.86, 95% Confidence Interval (CI): 0.79, 0.94]. Participants in the highest PHDI tertile (T3) were observed to have a 38% reduced likelihood of sarcopenia compared to those in the lowest tertile (T1) [OR = 0.62, 95% CI: 0.43, 0.90]. Analysis of the dose–response curve suggested a linear relationship between PHDI and sarcopenia. Furthermore, a significant positive association was identified between NHHR and sarcopenia [OR = 1.09, 95% CI: 1.03, 1.16], with NHHR found to decrease as PHDI increased [beta coefficient ( β ) = −0.09, 95% CI: −0.11, −0.06]. Mediation analysis revealed that NHHR partially mediated the relationship between PHDI and sarcopenia, accounting for 8.33% of the total effect. Conclusion This study highlights the observed negative correlation between PHDI and sarcopenia, with NHHR acting as a partial mediator. These findings emphasize the potential importance of dietary patterns in strategies aimed at preventing sarcopenia.

Association between dietary inflammatory index and periodontitis in American adults: exploring the mediating role of biological aging

2025-06-19

Haoyang Hua , Shaofa Xu , Yifan Wang +2 more | Frontiers in Nutrition

Background Dietary patterns are associated with inflammatory states. However, there are few reports about its relationship with periodontitis and its mechanism. This study investigated the relationship between dietary inflammatory index … Background Dietary patterns are associated with inflammatory states. However, there are few reports about its relationship with periodontitis and its mechanism. This study investigated the relationship between dietary inflammatory index (DII) and periodontitis, and the mediating role of biological aging in this relationship. Methods Data from the National Health and Nutrition Examination Survey from 2009 to 2014 were utilized, including adults aged 20 years and above. The relationship between DII and periodontitis was assessed using multivariate logistic regression analysis, and restricted cubic splines were employed to test for potential non-linear associations. Subgroup analyses were conducted to explore potential influencing factors related to DII and periodontitis. In addition, the mediating role of biological aging in dietary inflammatory indices and periodontitis was further explored. Results A total of 10,096 participants were included in the study. The results indicated a positive correlation between DII scores and the prevalence of periodontitis. In the fully adjusted model, participants in the highest DII quartile had a 23% higher risk of periodontitis compared to those in the lowest quartile (OR = 1.23, 95% CI: 1.01, 1.48, p = 0.04). Subgroup analysis consistently observed a positive correlation between DII and the risk of periodontitis across all subgroups. Mediation analyses suggest some direct and indirect effects of biological aging between a pro-inflammatory diet and periodontitis. Conclusion DII scores were positively associated with the prevalence of periodontitis in U.S. adults, suggesting that dietary patterns may have a significant impact on the prevalence of periodontitis. It also provides further insight into the mechanistic link between biological aging-mediated DII and the development of periodontitis.

The global burden of chronic kidney disease due to diabetes mellitus type 2 attributable to diet high in sugar-sweetened beverages among the elderly: a comprehensive analysis from 1990 to 2021

2025-06-19

Ben Hu , Xiaohan Qiu , Zuojie Luo +3 more | Frontiers in Nutrition

Background The consumption of sugar-sweetened beverages (SSBs) has been linked to numerous health complications, including chronic kidney disease due to type 2 diabetes mellitus (CKD-T2DM). However, the global burden of … Background The consumption of sugar-sweetened beverages (SSBs) has been linked to numerous health complications, including chronic kidney disease due to type 2 diabetes mellitus (CKD-T2DM). However, the global burden of CKD-T2DM attributable to high SSB consumption among elderly populations remains poorly characterized. Methods Using data from the Global Burden of Disease Study 2021, we examined age-standardized mortality rates (ASMR) and disability-adjusted life year rates (ASDR) of CKD-T2DM attributable to high SSB consumption among individuals aged 60 years and older across 204 countries and territories from 1990 to 2021. We employed joinpoint regression analysis to assess temporal trends and conducted decomposition analysis to quantify the contributions of population growth, aging, and epidemiological changes to the observed burden. Results Globally, the ASMR of CKD-T2DM attributable to high SSB consumption among elderly increased from 0.21 (95% UI: 0.10–0.38) per 100,000 in 1990 to 0.37 (95% UI: 0.18–0.62) per 100,000 in 2021, with an average annual percent change (AAPC) of 1.89% (95% CI: 1.47–2.31). The ASDR similarly increased from 4.5 (95% UI: 2.12–7.66) to 7.24 (95% UI: 3.49–11.69) per 100,000. We observed pronounced socioeconomic and geographical disparities, with high socio-demographic index (SDI) regions experiencing the highest burden and fastest increase. Notably, decomposition analysis revealed that population growth was the primary driver of increased burden globally, while epidemiological changes played a more dominant role in high SDI regions. Conclusion Our findings highlight a substantial and increasing burden of CKD-T2DM attributable to high SSB consumption among elderly populations globally, with distinct patterns across socioeconomic development levels. These results underscore the importance of targeted interventions to reduce SSB consumption, particularly in regions experiencing rapid increases in disease burden, as part of comprehensive strategies to address the growing challenge of diet-related kidney disease in aging populations.

Nonlinear association of a composite metabolic index (ZJU index) with hypertension: a cross-sectional study of NHANES 2003–2018

2025-06-18

Haibo Gong , Jing Chen , Xiao Chen +2 more | Frontiers in Cardiovascular Medicine

Objective To explore the association between the composite metabolic index (ZJU index) and hypertension using data from the National Health and Nutrition Examination Survey (NHANES). Methods NHANES data from 2003 … Objective To explore the association between the composite metabolic index (ZJU index) and hypertension using data from the National Health and Nutrition Examination Survey (NHANES). Methods NHANES data from 2003 to 2018 were analyzed. Participants were categorized into hypertension and non-hypertension groups. Logistic regression models evaluated the relationship between ZJU index and hypertension. Restricted cubic spline (RCS) and threshold effect analyses assessed nonlinear associations. Subgroup and interaction analyses tested robustness and heterogeneity. The predictive ability of the ZJU index across age groups was evaluated using receiver operating characteristic (ROC) curves. Results After adjusting for covariates, each unit increase in ZJU index was associated with a 7% higher odds of hypertension (OR = 1.07; 95% CI: 1.06–1.07). Participants with higher ZJU index values had significantly increased risk compared to the reference group (OR = 3.73; 95% CI: 3.25–4.29). RCS analyses indicated a nonlinear positive association, with a threshold inflection point at 53.22. Subgroup analyses confirmed consistent associations across all subgroups, while significant interactions were observed for age, education, diabetes history, and smoking status ( P &lt; 0.05). The ZJU index showed moderate predictive ability in individuals under 60 years (AUC = 0.691) and low predictive value in those aged 60 and above (AUC = 0.604). Conclusions An elevated ZJU index is significantly associated with increased hypertension risk among U.S. adults, with a nonlinear dose-response relationship observed.

Beneficial Effect of the Mediterranean Diet on the Reduction of Prediabetes—Results of the Bialystok PLUS Study

2025-06-18

Magdalena Zalewska , Małgorzata Elżbieta Zujko , Jacek Jamiołkowski +3 more | Nutrients

Background: The Mediterranean diet is considered one of the healthiest and safest diets for preventing chronic diseases. The primary objective of this study was to assess the association between adherence … Background: The Mediterranean diet is considered one of the healthiest and safest diets for preventing chronic diseases. The primary objective of this study was to assess the association between adherence to the Mediterranean diet and the occurrence of prediabetes in a representative population of Bialystok, Poland. Prediabetes is a condition characterized by elevated blood glucose levels that are higher than normal but not yet in the diabetic range, indicating an increased risk of developing type 2 diabetes. Methods: The study participants were selected into healthy control (HC) and prediabetic (PreD) groups based on age and gender. Biochemical measurements included total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), fasting glucose (FG), glycated hemoglobin (HbA1c), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6). Additionally, blood pressure, handgrip strength, anthropometric parameters, and body composition were measured. Information on patients' social data, medical history, and lifestyle history was collected using questionnaires developed for this study. A standardized questionnaire, the Satisfaction with Life Scale (SWLS), was used to assess life satisfaction. Dietary total antioxidant capacity (DTAC) and dietary total polyphenol intake (DTPI) were determined using a 3-day nutritional interview and appropriate databases containing information on polyphenols and the antioxidant potential of food products. To assess adherence to the Mediterranean diet recommendations, a 9-item Mediterranean Diet Index (MDI) was used. Results: It was found that the mean MDI for the entire group was low (3.98 ± 1.74), and the HC was characterized by a significantly higher MDI compared to the PreD. A statistically significant positive correlation was found between MDI and HDL-C, whereas a negative correlation was found between MDI and FG, homeostatic model assessment for insulin resistance (HOMA-IR), diastolic blood pressure (DBP), IL-6, body mass index (BMI), waist-hip ratio (WHR), waist circumference, visceral fat mass, android/gynoid fat ratio. Conclusions: Abdominal obesity was shown to significantly reduce life satisfaction. In model 3, after adjusting for age, sex, dietary energy intake, alcohol consumption, and smoking, each additional MDI point indicated a 10% lower risk of prediabetes.

Dose-response association of dietary inflammatory potential with risk of cancer: systematic review and meta-analysis of prospective cohort studies

2025-06-18

Mengdi Wang , Jinli Zhang , Xueru Fu +7 more | European Journal of Cancer Prevention

Observational studies indicated that the overall inflammatory potential of diets has been implicated in cancer etiology; however, the results were inconsistent. We aimed to estimate the dose-response association of dietary … Observational studies indicated that the overall inflammatory potential of diets has been implicated in cancer etiology; however, the results were inconsistent. We aimed to estimate the dose-response association of dietary inflammatory potential with cancer outcomes based on prospective cohort studies. PubMed, Embase and Web of Science databases were searched up to 11 November 2023 for prospective cohort studies. The dietary inflammatory potential was assessed by the dietary inflammatory index (DII) or energy-adjusted DII (E-DII). Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random-effects models. Restricted cubic splines were used to illustrate the possible linear or nonlinear associations. Ultimately, 30 articles including 33 studies with 4 090 977 participants were included. As compared the highest to the lowest DII category, the pooled RRs (95% CIs) for overall cancer, colorectal cancer, lung cancer, and renal cancer were 1.19 (1.11–1.27), 1.30 (1.16–1.44), 1.13 (1.04–1.23), and 1.45 (1.14–1.83), respectively; for E-DII, the RRs (95% CIs) was 1.08 (1.01–1.16) for overall cancer and 1.23 (1.13–1.33) for colorectal cancer. For each 1-unit increase in DII, the risk increased by 3% (RR = 1.03, 95% CI: 1.02–1.04) for overall cancer, 3% (RR = 1.03, 95% CI: 1.02–1.05) for colorectal cancer, and 7% (RR = 1.07, 95% CI: 1.03–1.12) for renal cancer; for E-DII, the risk increased by 1% (RR = 1.01, 95% CI: 1.00–1.02) for overall cancer and 3% (RR = 1.03, 95% CI: 1.02–1.05) for colorectal cancer. Additionally, restricted cubic splines showed linear relationships of DII ( P nonlinearity = 0.080) and E-DII ( P nonlinearity = 0.273) with overall cancer risk. The higher dietary inflammatory potential was associated with an increased risk of cancer.

Comparison of Preconception Diet Scores Across Studies: The PrePARED Consortium

2025-06-18

Lixuan Ji , Janaki Sundaresan , Cailey Cranny +7 more | Nutrients

Preconception diet and nutritional status are important determinants of reproductive and pregnancy health. As a comprehensive evaluation, this paper describes harmonization of diet data across multiple cohorts including over 50,000 … Preconception diet and nutritional status are important determinants of reproductive and pregnancy health. As a comprehensive evaluation, this paper describes harmonization of diet data across multiple cohorts including over 50,000 participants and the differences between them. This information may be useful for developing targeted strategies to improve women's diet prior to pregnancy for optimal prenatal health outcomes. The Preconception Period Analysis of Risks and Exposures influencing health and Development (PrePARED) consortium incorporates studies covering the preconception period and includes both couples planning pregnancy and studies covering the reproductive period but not focused on pregnancy. We harmonized data on 56,520 participants from seven cohort studies that collected data during the preconception period. We generated data on diet quality according to the International Federation of Gynecology and Obstetrics (FIGO) nutrition checklist to examine diet quality measures across the cohorts and compare estimates of diet quality across studies. Four studies used food frequency questionnaires; one used a study-specific diet history; one used two 24 h dietary recalls; and one used a short series of general diet questions. Positive responses on the six FIGO questions were tallied to calculate a total diet quality score. Cohort samples varied in terms of age; socioeconomic status; race; ethnicity; and geographic region. Across the cohorts, participants met a median of three or four of the FIGO criteria for diet quality; those most commonly met were recommendations for consumption of meat and protein, while those least commonly met were recommendations for limiting consumption of processed foods and snacks. There was greater variation in meeting recommendations for the consumption of fruits and vegetables; dairy; fish; and whole grains. The percentage meeting ≤ 2 criteria ranged from 6.4% (Coronary Artery Risk Development in Young Adults) to 40.4% (Bogalusa Heart Study). There was wide variability across preconception cohort studies in the extent to which participants met FIGO dietary guidelines. Although studies were conducted in populations that were not likely to be malnourished, it was rare for women to meet all the preconception dietary recommendations. These findings illustrate a need for strategies to promote meeting dietary guidelines prior to conception to improve health outcomes.

Joint association of the newly proposed dietary index for gut microbiota and sleep disorders with survival among US adult population with diabetes and pre-diabetes

2025-06-18

Ke Si , Chuanqin Shi , Yajing Huang +5 more | Nutrition Journal

Abstract Background Diet and sleep disorders are associated with risks of metabolic diseases such as diabetes. The dietary index for gut microbiota (DI-GM) is a newly proposed index designed to … Abstract Background Diet and sleep disorders are associated with risks of metabolic diseases such as diabetes. The dietary index for gut microbiota (DI-GM) is a newly proposed index designed to assess dietary quality associated with maintaining a healthy gut microbiota. The authors aim to investigate the separate and joint prognostic effect of DI-GM and sleep disorders on the survival of US population with diabetes and pre-diabetes. Methods Data were from the National Health and Nutrition Examination Survey (NHANES) 2007–2018 at baseline linked to the 2019 National Death Index records. Dietary recall data were collected to calculate the DI-GM and sleep disorders were assessed by self-reported questionnaires. The Cox proportional hazard model were used to evaluate the associations between separate and joint prognostic effects of DI-GM and sleep disorders with mortality outcomes among diabetic and pre-diabetic patients. Results A total of 10718 Participants with diabetes and pre-diabetes were ultimately included in this study (weighted population: 67,232,394, weighted mean age [SE]: 57.0 [0.1] years; weighted female proportion: 51.8%). Among these participants, higher DI-GM was more prevalent in those without sleep disorders. During the median follow-up of 13.3 years, 1448 deaths occurred, including 346 participants died from cancer, and 367 died from cardiovascular disease (CVD)..Multivariable models indicated that the joint effects of DI-GM (≥ 6) and no sleep disorders were associated with lower risks for all-cause (HR 0.53, 95% CI: 0.38–0.79) and CVD mortality (HR 0.36, 95% CI: 0.19–0.65). Conclusions In a nationally representative sample of US population with diabetes and pre-diabetes, high DI-GM combined with no sleep disorders was associated with significantly reduced all-cause and CVD mortality risks.

Sustainability of the Mediterranean Diet: A Nutritional and Environmental Imperative

2025-06-18

| Journal of Sustainability Research

Associations of dietary patterns and obesity development in school‐aged children: results from the <scp>CHILD</scp> Cohort Study

2025-06-18

Zheng Hao Chen , Geraldine M. Jacobson , Myrtha E. Reyna +7 more | Obesity

Abstract Objective We aimed to understand data‐driven dietary patterns in Canadian preschoolers and their impact on obesity development among male and female individuals. Methods In the prospective, population‐based Canadian pregnancy … Abstract Objective We aimed to understand data‐driven dietary patterns in Canadian preschoolers and their impact on obesity development among male and female individuals. Methods In the prospective, population‐based Canadian pregnancy cohort, the CHILD Cohort Study ( N = 2219), dietary intake was assessed at age 3 years using a previously developed 112‐item food frequency questionnaire. At age 5 years, we measured height, weight, and waist circumference and calculated BMI and waist circumference z scores. Obesity was defined as BMI z score > 2. We used principal components analysis to derive dietary patterns and multivariable‐adjusted regression analyses to determine dietary patterns' associations with BMI and waist circumference z scores, as well as obesity status. Results Among Canadian preschoolers, we identified three dietary patterns: “Prudent” (high in vegetables, fruits, legumes, and fish); “Western‐like” (high in fast foods, red/processed meats, and carbonated drinks); and “Refined Grain‐Snack” (high in refined grains, dairy, and salty snacks). At age 5 years, 4.7% of the children were living with obesity (3.1% male individuals and 1.6% female individuals). Females adhering to the Refined Grain‐Snack pattern had higher waist circumference z scores (β = 0.14; 95% CI: 0.03–0.25) and 2.74‐fold odds of living with obesity (95% CI: 1.29–5.85). No significant associations were observed among male individuals or with other dietary patterns and obesity outcomes among female individuals. Conclusions Preschool dietary patterns are associated with sex‐biased obesity development, highlighting the need for further research to explore these differences and inform targeted obesity prevention strategies during this important developmental period.

The association between nutrients intake, diet quality and food insecurity with depression in patients with coronary artery disease

2025-06-18

Mohammad Dehghani , Javad Kojuri , Afsane Ahmadi +3 more | Journal of Health Population and Nutrition

Depression is a prevalent mental health disorder in patients with cardiovascular disease worldwide. The purpose of this observational study was to determine the association between nutrients intake, food insecurity, and … Depression is a prevalent mental health disorder in patients with cardiovascular disease worldwide. The purpose of this observational study was to determine the association between nutrients intake, food insecurity, and diet quality with depression in patients with coronary artery diseases (CAD). This cross-sectional study was conducted on 225 coronary artery patients. Nutrients intake, diet quality (by calculating Framingham Nutrition Risk Score (FNRS)), food insecurity and depression status of patients were obtained by using standard validated questionnaires. Relevant statistical analyses including logistic regression were used to analyze all data. P-value ≤ 0.05 was considered significant. The multivariate-adjusted regression model showed that a higher intake of total fat (P = 0.02, OR = 1.031) increases the odds of depression. However, a higher intake of PUFA and Vitamin B12 was associated with its lower odds. (P = 0.005, OR = 0.87 and P = 0.005, OR = 0.73, respectively). It also indicated food insecurity was associated with depression in CAD patients (P < 0.001, OR = 6.92). FNRS could not show any significant association. This study indicated that the dietary intake of PUFA and vitamin B12 were negatively associated with depression, while the intake of total fat from diet was directly associated with depression and might be considered as a risk factor in CAD patients. Furthermore, food insecurity was strongly and positively associated with depression in these patients. However, diet quality based on FNRS was not associated with depression among patients with CAD.

Dietary niacin intake and mortality outcomes in hypertensive populations: analysis from NHANES 2003–2016

2025-06-18

Long Yang , Xia Shen , Zulihuma Seyiti +7 more | Journal of Health Population and Nutrition

The rising prevalence of hypertension underscores the urgent need for effective management strategies. While niacin-based medications and supplements have shown promise in improving outcomes among patients with hypertension, the impact … The rising prevalence of hypertension underscores the urgent need for effective management strategies. While niacin-based medications and supplements have shown promise in improving outcomes among patients with hypertension, the impact of dietary niacin intake on prognosis remains an area requiring further investigation. Using data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2016, this study examined the association between dietary niacin intake and mortality risk among 13,237 individuals with hypertension. During a median follow-up of 103 months, 3,151 participants (23.80%) died from all causes, and 864 (7.89%) died from cardiovascular diseases. In multivariable-adjusted Cox proportional hazards models, dietary niacin intake was independently associated with a lower risk of both all-cause mortality (HR = 0.993, 95% CI: 0.986-1.000, p = 0.036) and cardiovascular mortality (HR = 0.984, 95% CI: 0.971-0.997, p = 0.017). Niacin intake was categorized into quartiles: Q1 (< 15.5 mg/day), Q2 (15.5-21.1 mg/day), Q3 (21.1-28.2 mg/day), and Q4 (> 28.2 mg/day). Cox regression analysis indicated that participants in the Q3 group had a significantly lower risk of all-cause mortality compared to those in Q1 (HR = 0.788, 95% CI: 0.657-0.944, p = 0.010). Moreover, restricted cubic spline (RCS) analysis revealed a U-shaped association between dietary niacin intake and all-cause mortality (P for nonlinearity = 0.016). These findings highlight the potential benefits of dietary niacin in reducing mortality risk among hypertensive individuals and suggest that moderate increases in dietary niacin intake may represent a feasible strategy for reducing mortality risk in this population.

Dietary Habits, Residential Air Pollution, and Chronic Obstructive Pulmonary Disease

2025-06-18

Dong Liu , Junyi Ma , Xiu Ming Cui +3 more | Nutrients

Background: The role of dietary patterns in the development of chronic obstructive pulmonary disease (COPD), particularly under varying levels of ambient air pollution, remains insufficiently understood. Aims: We aimed to … Background: The role of dietary patterns in the development of chronic obstructive pulmonary disease (COPD), particularly under varying levels of ambient air pollution, remains insufficiently understood. Aims: We aimed to investigate the association between adherence to multiple established dietary patterns and the risk of incident COPD, and to assess potential effect modification by exposure to ambient air pollutants. Methods: We conducted a prospective study including 206,463 participants from the UK Biobank free of COPD at baseline. Individual-level residential air pollution exposure was estimated for the year 2010. Nine dietary indices were derived from 24 h dietary recalls. Associations with incident COPD were assessed using Cox proportional hazards models. Effect modification was examined using smoking-specific tertiles of nitrogen oxides (NO, NO2, and NOx) and particulate matter (PM2.5, PM2.5-10, and PM10). Results: Greater adherence to healthy dietary patterns was associated with a 14% to 34% reduced risk of COPD (highest vs. lowest quintile). In contrast, high adherence to the Unhealthful plant-based diet index (PDI) was associated with a 34% increased risk (HR = 1.34, 95% CI: 1.16-1.54). Notably, the protective associations of the AHA, EAT-Lancet, and MIND dietary patterns were most pronounced in settings with relatively high air pollution, as evidenced by elevated levels in at least four air quality indicators (p for interaction < 0.05). Conclusions: Adherence to AHA, EAT-Lancet, and MIND dietary patterns is associated with a reduced risk of incident COPD, with potentially amplified benefits observed in areas with higher ambient air pollution.

Functional data analysis for wearable sensor data: a systematic review

2025-06-18

Nihan Acar‐Denizli , Pedro Delicado | AStA Advances in Statistical Analysis

Red Meat Consumption, Iron Status, and Cardiometabolic Risk in Qatari Adults: A Cross-Sectional Gender-Stratified Analysis from the QPHI-QBB Data in Qatar

2025-06-18

Hanaa Mousa , Nadin M. Abdel Razeq , Yasmen Khial +1 more | Foods

Red meat, a significant source of heme iron, may influence iron status and metabolic health, particularly in Qatar, where consumption is high. Understanding these associations is essential for addressing iron … Red meat, a significant source of heme iron, may influence iron status and metabolic health, particularly in Qatar, where consumption is high. Understanding these associations is essential for addressing iron deficiency and cardiovascular risk in this population. We conducted a cross-sectional study using data from 13,778 Qatari adults enrolled in the Qatar Biobank (men: n = 5770; women: n = 8008). Red meat intake was assessed via the Food Frequency Questionnaire and categorized as low (≤1/month), moderate (2-4/month), and high (≥5/month) intake. Hematological and metabolic biomarkers were analyzed. Two-sample t-tests compared biomarker levels by gender. Multiple linear regression examined associations between red meat intake and iron profile indicators, adjusting for age, gender, supplement use, diabetes, hypercholesterolemia, and hypertension. High red meat consumption was associated with increased ferritin (Coef = 134.685, p < 0.001) and hemoglobin (Coef = 0.918, p = 0.017). Males showed higher hemoglobin (14.8-14.9 vs. 12.4-12.5 g/dL, p < 0.0001) and total cholesterol (5.17 ± 1.10 vs. 5.02 ± 1.01 mmol/L, p = 0.0125). TIBC showed no significant gender differences across categories (p > 0.15) but varied significantly within each gender across red meat consumption categories (males: p < 0.0000; females: p < 0.0000). Higher red meat intake is associated with improved iron status, particularly ferritin levels, and gender-specific effects on hemoglobin and cholesterol levels. Moderate red meat intake may support iron health while maintaining a favorable lipid profile.

Sweetened Beverages and Incident All-Cause Dementia Among Older Adults

2025-06-18

Hui Chen , Yihong Ding , Klodian Dhana +7 more | JAMA Psychiatry

Importance Intake of sweetened beverages, including sugar-sweetened beverages (SSB) and artificially sweetened beverages (ASB), has been linked to multiple health outcomes, but their associations with dementia risk among older adults … Importance Intake of sweetened beverages, including sugar-sweetened beverages (SSB) and artificially sweetened beverages (ASB), has been linked to multiple health outcomes, but their associations with dementia risk among older adults are unclear. Objective To assess whether the consumption of SSB and ASB is associated with the risk of all-cause dementia in older adults. Design, Setting, and Participants This multicohort study examined data from US adults aged 65 and older enrolled in the Health and Retirement Study (2013), the Atherosclerosis Risk in Communities study (1987-1995), the Chicago Healthy and Aging Project (1993-2012), the Rush Memory and Aging Project (1997-2005), the Framingham Heart Study original cohort (1986-1994), and its offspring cohort (1991-2001). Data were analyzed from May 27 to September 24, 2024. Exposures SSB and ASB intake was assessed using validated food frequency questionnaires. Main Outcomes and Measures The primary outcome was all-cause dementia ascertained at least 2 years after baseline from active research follow-ups and passive surveillance. Cox proportional hazard regression models were used to assess the associations of SSB and ASB with incident dementia. Results Of 10 974 participants (60.0% female, mean [SD] age: 73.2 [6.8] years), 2445 developed incident all-cause dementia over 116 067 person-years of follow-up. Consumption of SSB and ASB in older adulthood was not associated with dementia risk in later life. The pooled hazard ratio (HR) per serving per week for SSB was 0.99 (95% CI, 0.98-1.01; P = .18; I 2 = 0%) and for ASB was 1.00 (95% CI, 0.99-1.01; P = .99; I 2 = 1%). The pooled HRs comparing the highest (≥1 serving per day) with lowest (0 to &amp;lt;1 serving per month) consumption groups were 0.90 (95% CI, 0.78-1.03) for SSB and 1.00 (95% CI, 0.83-1.21) for ASB. These findings were similar across cohorts and subgroups. In contrast, an inverse association was observed for the Mediterranean diet score (HR, 0.92; 95% CI, 0.85-0.99 per 5-unit increment) as a positive control. Conclusions and Relevance In this study, late-life consumption of SSB or ASB was not associated with the risk of dementia. However, given their detrimental effects on metabolic health and related chronic diseases during early life and midlife, the effects of early-life consumption of SSB and ASB on the risk of dementia warrant further investigation.

Burden and inequalities of chronic kidney disease attributable to diet globally, regionally and temporally, 1990–2021

2025-06-18

Nana Wei , Yang Miao , Pingping Zheng +1 more | Frontiers in Nutrition

Background Modifiable dietary habits are a crucial means of reducing the risk of CKD. However, there is currently a lack of global-scale analysis on the burden of CKD attributable to … Background Modifiable dietary habits are a crucial means of reducing the risk of CKD. However, there is currently a lack of global-scale analysis on the burden of CKD attributable to diet. This study aimed to examine the burden of CKD potentially associated to diet globally, regionally and temporally. Method Our research utilized data sourced from the 2021 edition of the Global Burden of Disease (GBD) study. We gathered information on the worldwide impact of diet-related CKD spanning from 1990 to 2021, categorizing this impact based on various factors including gender, age, GBD geographical regions, and individual countries. To assess the evolving trend of diet-attributable CKD burden over this period, we employed the Joinpoint regression model, calculating the average annual percent change (AAPC) for a comprehensive understanding. Cluster analysis was employed to classify countries into distinct dietary risk categories. Results In 2021, globally, CKD burden potentially associated to diet resulted in 317,010 deaths (95% UI: 185,370–454,850) and 7,971,280 DALYs lost (95%UI: 4,630,030–11,451,430). These figures accounted for 20.75% of all CKD-related deaths and 17.93% of all CKD-related DALYs. The age-standardized mortality and DALY rates potentially associated to diet rose notably, reaching 3.83 (95%UI: 2.25–5.49) and 93.52 (95%UI: 54.29–134.38) per 100,000 population, respectively. However, significant regional variations were observed in these rates, with Central Sub-Saharan Africa experiencing the highest and Eastern Europe the lowest. High-income North America experienced a particularly steep increase, with an AAPC of 2.93% (95% CI: 2.85, 3.01%) for deaths and 2.51% (95%CI: 2.44, 2.56%) for DALYs. Among dietary factors, insufficient intake of fruits and vegetables emerged as the primary contributor to the CKD burden. By cluster analysis, seven clusters of dietary risk patterns were identified. Conclusion Diet may play a substantial role in the burden of CKD, with notable variations across different regions. It is imperative to implement enhanced dietary guidelines, with particular attention to mitigating the challenges faced by low-income countries and reversing the upward trend in high-income countries.

Dietary carbohydrate intake and risks of overall and 21 site-specific cancers: a prospective cohort study

2025-06-18

Shuhui Chen , Baojie Hua , Bin Liu +7 more | Frontiers in Nutrition

Background Cancer is among the world’s top causes of death, and diet plays an important role in cancer risk. However, few studies have addressed a comprehensive atlas that details the … Background Cancer is among the world’s top causes of death, and diet plays an important role in cancer risk. However, few studies have addressed a comprehensive atlas that details the connections between dietary carbohydrates and cancer risk. Methods We conducted a large population-based prospective cohort research based on the UK Biobank including 194,388 participants. The Oxford WebQ, a web-based 24-h recall questionnaire, was used to collect dietary information of each study participant. Using the Cox proportional hazards model, we calculated the hazard ratios (HRs) with 95% confidence intervals (CIs) for the associations of energy-adjusted carbohydrates intake and the incidence of overall cancer as well as 21 site-specific cancers. Results A total of 19,990 incidences of cancer (excluding non-melanoma skin cancer) were recorded with a median follow-up of 12.8 years. Energy-adjusted fiber was associated with a reduced risk of overall cancer [HR per IQR increase (95% CI): 0.97 (0.96, 0.99); P FDR : 0.045] and esophageal [0.79 (0.68, 0.91); 0.024], colorectal [0.92 (0.87, 0.97); 0.025], lung [0.87 (0.81, 0.94); 0.014], and kidney cancer [0.85 (0.76, 0.94); 0.031]. Energy-adjusted free sugars were tied to a higher risk of lung [1.12 (1.05, 1.19); 0.024] and kidney cancer [1.15 (1.05, 1.26); 0.039], while non-free sugars were associated with a reduced risk of overall cancer [0.97 (0.95, 0.99); 0.031], colorectal [0.89 (0.84, 0.94); 0.006] and lung cancer [0.86 (0.79, 0.93); 0.014]. Finally, energy-adjusted sucrose was associated with an elevated risk of both lung cancer [1.10 (1.04, 1.17); 0.024] and non-Hodgkin lymphoma [1.15 (1.07, 1.23); 0.008]. Conclusion Increased consumption of dietary fiber and non-free sugars is associated with a reduced risk of certain cancers (e.g., overall cancer, esophageal, colorectal, lung, and kidney cancers), potentially due to their anti-inflammatory effects, short-chain fatty acid production, and other protective mechanisms. In contrast, higher intakes of free sugars and sucrose are associated with an elevated risk (e.g., lung, kidney cancer, and non-Hodgkin lymphoma), which may be attributed to inflammation and oxidative stress.

Awareness and Practice of Dietary Recommendations for Cancer Prevention among Participants of the 2023 Korean National Cancer Prevention for Dietary Awareness and Practice Survey

2025-06-18

Yoonjoo Choi , Hyein Jung , Byungmi Kim | Cancer Research and Treatment

Most cancers are preventable by improving dietary habits, individuals with poor dietary behaviors should be encouraged to adopt more active steps to prevent cancer. We surveyed Korean adults to identify … Most cancers are preventable by improving dietary habits, individuals with poor dietary behaviors should be encouraged to adopt more active steps to prevent cancer. We surveyed Korean adults to identify the awareness and practice of the recommended guidelines for dietary factors. The 2023 Korean National Cancer Prevention for Dietary Awareness and Practice Survey was a cross-sectional online survey of 4,000 adults aged 20-69. The survey included questions on sociodemographics, lifestyle, and awareness and practice of five dietary recommendations (consuming fruits and vegetables, consuming a balanced diet, avoiding salt, charred foods, and alcohol intake). Despite more than 90.0% being aware that each dietary recommendation can be a risk determinant for cancer, the practice rate for recommendations showed lower rates than recognition. Especially, in both males and females, the younger (odds ratio [OR]: 1.971 in males and OR: 4.863 in females), with no nutritional education (OR: 2.715 in males and 2.093 in females), and the obese (OR: 1.451 in males, and OR: 1.579 in females) had higher odds of significant non-adherents (failed to comply with 3-5 recommendations) than participants who older, had nutritional education, and normal body mass index, respectively. Although there is high awareness of dietary recommendations for cancer prevention, participants who were younger, had no nutritional education, or were obese showed poor adherence to cancer-preventive dietary practices. Our findings highlight the need for targeted interventions to improve the dietary habits of this at-risk population.

Association of dietary fiber intake with all-cause and cardiovascular mortality in diabetes and prediabetes

2025-06-18

Qing Chen , Lixin Tao , Yunchao Wang | Diabetology & Metabolic Syndrome

To examine the association between dietary fiber intake and mortality risks (all-cause and cardiovascular) among U.S. adults with diabetes or prediabetes, and to evaluate the dose-response patterns of these associations. … To examine the association between dietary fiber intake and mortality risks (all-cause and cardiovascular) among U.S. adults with diabetes or prediabetes, and to evaluate the dose-response patterns of these associations. This longitudinal cohort study analyzed data from 3259 adults with diabetes or prediabetes from the 2011-2018 National Health and Nutrition Examination Survey (NHANES). Dietary fiber intake was assessed using two 24-hour dietary recall interviews. Mortality data were obtained through December 31, 2019. Multiple Cox proportional hazards models were used to evaluate associations between fiber intake and mortality outcomes, adjusting for demographic and health-related covariates. Higher dietary fiber intake was significantly associated with reduced all-cause mortality risk (HR = 0.98, 95% CI: 0.97-0.99, P = 0.0039). For cardiovascular mortality, a non-linear relationship was identified with a threshold at 26.2 g/day. Below this threshold, each gram increase in fiber intake was associated with a 3% reduction in cardiovascular mortality risk (HR = 0.97, 95% CI: 0.94-0.99, P = 0.0352), while no significant benefit was observed above this threshold. Dietary fiber intake shows a protective effect against all-cause mortality in U.S. adults with diabetes or prediabetes. For cardiovascular mortality, moderate fiber intake up to 26.2 g/day appears beneficial, while higher intake may not provide additional cardiovascular benefits. These findings provide important evidence for developing targeted dietary recommendations in diabetes management.

UPDATE OF THE FOOD COMPOSITION DATABASE FOR EPIDEMIOLOGICAL STUDIES IN ITALY: FOCUS ON CEREALS AND CEREAL PRODUCTS

2025-06-17

Giulia Carioni , Federica Fiori , Davide Radice +3 more | Journal of Food Composition and Analysis