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Estay K, Escalona V. Raw or Cooked? Exploring Vegetable Acceptance Among Chilean Children from Different Socioeconomic Backgrounds. Foods 2025; 14:1133. [PMID: 40238276 PMCID: PMC11989230 DOI: 10.3390/foods14071133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2025] [Revised: 03/06/2025] [Accepted: 03/08/2025] [Indexed: 04/18/2025] Open
Abstract
This study explores how socioeconomic status (SES) influences the acceptability of familiar vegetables in Chilean children aged 9-10, examining its relationship with sex, BMI, and preparation methods. A sensory evaluation was conducted in two stages to assess responses across sensory dimensions: appearance, aroma, taste, texture, and overall-opinion. In the first stage, 363 children evaluated eight vegetables: tomatoes, lettuce, corn, cucumber, carrots, beets, broccoli, and cauliflower. Results show significant differences across samples for all sensory dimensions (p < 0.0001), with tomatoes, lettuce, corn and cucumber receiving the highest ratings. The second stage involved 191 children, who evaluated the three least preferred vegetables (carrots, beets, and cauliflower) in raw and cooked forms. Raw vegetables received higher ratings than cooked across all sensory dimensions, except for beets in appearance, where raw scored lower. Significant differences were found for carrots and cauliflower (p < 0.0001), while the difference for beets was not statistically significant. SES had limited influence on vegetable liking, while BMI showed some interactions with texture and aroma ratings. These findings suggest lower vegetable consumption in vulnerable groups may not stem from reduced liking of familiar vegetables. Increasing availability could help, along with exploring preparation methods for less-liked vegetables, particularly raw options, which appear promising.
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Affiliation(s)
- Karinna Estay
- Departamento de Agroindustria y Enología, Facultad de Ciencias Agronómicas, Universidad de Chile, Av. Santa Rosa 11315, La Pintana 8820808, Chile
| | - Victor Escalona
- Departamento de Producción Agrícola, Facultad de Ciencias Agronómicas, Universidad de Chile, Av. Santa Rosa 11315, La Pintana 8820808, Chile
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Kechagia I, Panagiotakos D. An evidence-based assessment of the nutritional recommendations for the prevention of diabetes mellitus. Hormones (Athens) 2025; 24:59-70. [PMID: 39287760 DOI: 10.1007/s42000-024-00604-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 09/04/2024] [Indexed: 09/19/2024]
Abstract
There are accumulating levels of scientific knowledge concerning the dietary recommendations for the prevention of type 2 diabetes mellitus (T2DM). PURPOSE This systematic review presents the most recent scientific knowledge concerning dietary recommendations for T2DM published in the English language by various scientific societies during the past 10 years. METHODS The recommendations are herein presented and discussed in the light of a critical, evidence-based appraisal aiming to provide a comprehensive guide for the clinician in daily practice. RESULTS In the case of overweight or obesity, the cornerstone of the primary prevention of T2DM is the combination of a healthy body weight (body mass index < 25 kg/m2) or a reduction of fat by at least 7% and the implementation of at least 150 min of moderate physical activity per week. Restriction of calories and of dietary fat is recommended, the latter as well as several dietary patterns providing a holistic approach to dieting and all having been correlated with decreased risk of T2DM. Among these dietary patterns are the Mediterranean diet, the DASH diet (Dietary Approaches to Stop Hypertension), the low-glycemic diet, and the HEI-Healthy Eating Index and AHEI-Alternative Healthy Eating Index. Micronutrient deficiencies of, for example, vitamin D, chromium and magnesium, may be associated with insulin resistance in T2DM. CONCLUSION Overall, the combination of nutrition through dietary patterns that are mainly plant-based and which emphasize wholegrains, legumes, nuts, fruits, and vegetables and that include only small percentages of refined and processed foods, together with physical activity, has been associated with decreased T2DM risk.
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Affiliation(s)
- Ioanna Kechagia
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University of Athens, 70 Eleftheriou Venizelou, Kallithea, 176 76, Athens, Greece
- Department of Clinical Dietetics-Nutrition, HYGEIA Hospital, Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University of Athens, 70 Eleftheriou Venizelou, Kallithea, 176 76, Athens, Greece.
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Udensi J, Loughman J, Loskutova E, Byrne HJ. Effects of supplementation of macular pigment carotenoids on ocular health: a Raman spectroscopic study of human blood serum of glaucoma patients. Analyst 2025; 150:630-641. [PMID: 39846082 DOI: 10.1039/d4an01337a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2025]
Abstract
Carotenoids are known for their antioxidant and vision protection roles, with dietary supplements often promoted for eye health. An initial trial, the European Nutrition in Glaucoma Management (ENIGMA), assessed macular pigment optical density (MPOD) and other ocular parameters before and after supplementing glaucoma patients with macular pigment (MP) carotenoids. The trial confirmed significant improvements in clinical ocular health. Blood, containing all major dietary carotenoids, serves as an efficient medium for in vivo analysis of carotenoids. Raman spectroscopy, an effective analytical tool, was used to measure the impact of supplementation on serum carotenoid levels and their correlation with MPOD and other ocular responses. Serum samples from baseline and 18-month supplemented participants were analysed. An inverse relationship was found between the percentage change in Raman intensity over the supplementation period and baseline Raman serum measurements, indicating greater relative benefits for people with low MPOD/serum carotenoids pre-supplementation. Partial least squares regression (PLSR) was employed to analyse the spectra after pre-processing, and the loadings reflected the carotenoid content and structural profile. MPOD results correlated at all eccentricities, with a coefficient of determination (R2) of 0.62-0.92 and %Root mean squared error of <44%. Structural, functional, and perceptual parameters also showed good correlation with serum Raman measurements. The results support the ENIGMA trial conclusions, and suggest strategies for optimizing patient responses to supplementation based on baseline carotenoid levels. Additionally, Raman spectroscopy of serum carotenoids shows significant potential as a simple and reliable method for investigating macular pigment carotenoids and assessing patient health.
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Affiliation(s)
- Joy Udensi
- Physical to Life Sciences Research Hub, Technological University Dublin, City Campus, Aungier Street, Dublin 2, D02 HW71, Ireland.
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland.
- Centre for Eye Research, Ireland, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
| | - James Loughman
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland.
- Centre for Eye Research, Ireland, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
| | - Ekaterina Loskutova
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland.
- Centre for Eye Research, Ireland, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
| | - Hugh J Byrne
- Physical to Life Sciences Research Hub, Technological University Dublin, City Campus, Aungier Street, Dublin 2, D02 HW71, Ireland.
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Rathi N, Worsley A, Bruening M. Perceived influences of fruit and vegetable consumption among Indian adolescents - A qualitative inquiry. BMC Public Health 2025; 25:271. [PMID: 39844068 PMCID: PMC11753150 DOI: 10.1186/s12889-025-21408-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 01/10/2025] [Indexed: 01/24/2025] Open
Abstract
BACKGROUND Fruits and vegetables are primary sources of vitamins and minerals that may alleviate the risk of chronic illnesses. However, Indian adolescents consume inadequate amounts of fruits and vegetables, with less than 10% meeting recommendations. Micronutrient deficiencies are a major public health problem in India. For example, the prevalence of iron-deficiency anemia and Vitamin A deficiency in adolescents is 28.5% and 14.4%, respectively. To promote fruit and vegetable consumption among Indian adolescents, we need to identify the factors which may influence the consumption. The aim of this qualitative inquiry was to explore perceived influences of fruit and vegetable consumption among Indian adolescents. METHODS Using purposive sampling, adolescents aged 10-19 years were recruited from two public and two private (independent) schools in Varanasi, India. Face-to-face interviews along with the 'draw and tell' technique were used for data collection. Interviews were conducted in English as well as in Hindi depending on the preferences of the adolescents. The conversations were digitally recorded and transcribed verbatim. The transcribed data were subjected to thematic analysis. Data were coded inductively, and themes were extracted using NVivo software program. RESULTS A total of 58 adolescents (53% female; 74% urban) with mean age 13.6 years completed the interviews. Nine major themes and associated sub-themes emerged, including: (i) Sensory properties (i.e., taste, color, flavor, texture); (ii) Health and immunity; (iii) Allergy; (iv) Home food environment (i.e., influence of mothers, availability and accessibility of fruits and vegetables); (v) Cost; (vi) Food preparation; (vii) Influence of peers; (viii) School food environment; (ix) Proclivity for energy-dense, nutrient-poor foods and beverages. CONCLUSIONS The emerging themes and sub-themes show that multiple factors are likely to affect fruit and vegetable consumption in adolescents, aligning with literature on adolescent fruit and vegetable consumption in international settings. Behavioral interventions should be designed to create enabling environments to encourage fruit and vegetable consumption in Indian adolescents by removing barriers at the individual, household, and community levels, thereby reducing the enduring prevalence of micronutrient deficiencies.
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Affiliation(s)
- Neha Rathi
- Department of Home Science, Mahila Mahavidyalaya, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India.
| | - Anthony Worsley
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Meg Bruening
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, 16802, USA
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Savelieff MG, Elafros MA, Viswanathan V, Jensen TS, Bennett DL, Feldman EL. The global and regional burden of diabetic peripheral neuropathy. Nat Rev Neurol 2025; 21:17-31. [PMID: 39639140 DOI: 10.1038/s41582-024-01041-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2024] [Indexed: 12/07/2024]
Abstract
Diabetic peripheral neuropathy (DPN) is length-dependent peripheral nerve damage arising as a complication of type 1 or type 2 diabetes in up to 50% of patients. DPN poses a substantial burden on patients, who can experience impaired gait and loss of balance, predisposing them to falls and fractures, and neuropathic pain, which is frequently difficult to treat and reduces quality of life. Advanced DPN can lead to diabetic foot ulcers and non-healing wounds that often necessitate lower-limb amputation. From a socioeconomic perspective, DPN increases both direct health-care costs and indirect costs from loss of productivity owing to neuropathy-related disability. In this Review, we highlight the importance of understanding country-specific and region-specific variations in DPN prevalence to inform public health policy and allocate resources appropriately. We also explore how identification of DPN risk factors can guide treatment and prevention strategies and aid the development of health-care infrastructure for populations at risk. We review evidence that metabolic factors beyond hyperglycaemia contribute to DPN development, necessitating a shift from pure glycaemic control to multi-targeted metabolic control, including weight loss and improvements in lipid profiles.
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Affiliation(s)
- Masha G Savelieff
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, ND, USA
| | - Melissa A Elafros
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, USA
| | - Vijay Viswanathan
- MV Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre, Royapuram, Chennai, India
| | - Troels S Jensen
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
- Danish Pain Research Center, Aarhus University, Aarhus, Denmark
| | - David L Bennett
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Eva L Feldman
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
- NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, USA.
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Nguyen NN, Tran LTD, Ho NDK, Huynh LBP, Nguyen HS, Chen YC. Dietary nitrate, nitrite, and nitrosamine in association with diabetes: a systematic review and meta-analysis. Nutr Rev 2024; 82:1473-1481. [PMID: 38007611 DOI: 10.1093/nutrit/nuad148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023] Open
Abstract
CONTEXT Diabetes is a global health concern, and diet is a contributing factor to diabetes. Findings regarding the connection between nitrate, nitrite, and nitrosamine and diabetes risk are inconsistent. OBJECTIVE The aim was to examine the effects of these dietary compounds on diabetes risk. DATA SOURCES The data were sourced from PubMed, EMBASE, Scopus, and Web of Science until February 28, 2023. Studies that reported individual-level consumption of these compounds were included. Review articles or ecological studies were excluded. DATA EXTRACTION The number of events and total observations were recorded. DATA ANALYSIS The pooled odds ratio (OR) was calculated and displayed in a forest plot. Subgroup and sensitivity analyses were predefined. A dose-response meta-analysis was conducted to determine the exposure intervals that may increase the risk of disease. Six observational reports that met the inclusion criteria were included, involving 108 615 individuals. Participants in the highest quantile of nitrite intake had a greater risk of diabetes compared with those in the lowest quantile (OR, 1.61; 95% confidence interval [CI], 1.08-2.39; I2 = 74%, P = 0.02). Higher nitrosamine consumption tended to increase diabetes risk (OR, 1.52; 95% CI, 0.76-3.04; I2 = 76%; P = 0.24). The relationship was stronger for type 1 (OR, 1.79; 95% CI, 1.20-2.67; I2 = 58%; P < 0.01) than for type 2 diabetes (OR, 1.42; 95% CI, 0.86-2.37; I2 = 71%; P = 0.17). Additionally, nitrite consumption had a dose-dependent association with both phenotypes. No association was found between diabetes risk and high nitrate intake (OR, 1.01; 95% CI, 0.87-1.18; I2 = 28%; P = 0.87). CONCLUSION Attention should be paid to the consumption of nitrite-containing foods. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42023394462 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=394462).
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Affiliation(s)
- Nam N Nguyen
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Linh T D Tran
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ngan D K Ho
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Linh B P Huynh
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Hung S Nguyen
- Department of Pediatrics, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
- Intensive Care Unit Department, Children's Hospital 1, Ho Chi Minh City, Viet Nam
| | - Yang-Ching Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Zheng G, Ran S, Zhang J, Qian AM, Hua J, Wang C, Vaughn MG, Tabet M, Lin H. Fresh fruit, dried fruit, raw vegetables, and cooked vegetables consumption associated with progression trajectory of type 2 diabetes: a multi-state analysis of a prospective cohort. Eur J Nutr 2024; 63:1719-1730. [PMID: 38520525 DOI: 10.1007/s00394-024-03362-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/10/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE To examine the effects of fresh fruit, dried fruit, raw vegetables, and cooked vegetables on type 2 diabetes (T2D) progression trajectory. METHODS We included 429,886 participants in the UK Biobank who were free of diabetes and diabetes complications at baseline. Food groups were determined using a validated food frequency questionnaire. Outcomes were T2D incidence, complications, and mortality. Multi-state model was used to analyze the effects of food groups on T2D progression. RESULTS During a follow-up of 12.6 years, 10,333 incident T2D cases were identified, of whom, 3961 (38.3%) developed T2D complications and 1169 (29.5%) died. We found that impacts of four food groups on T2D progression varied depending on disease stage. For example, compared to participants who ate less than one piece of dried fruit per day, the hazard ratios and 95% confidence intervals for those who ate ≥ 2 pieces of dried fruit per day were 0.82 (0.77, 0.87), 0.88 (0.85, 0.92), and 0.86 (0.78, 0.95) for transitions from diabetes-free state to incident T2D, from diabetes-free state to total death, and from incident T2D to T2D complications, respectively. Higher intake of fresh fruit was significantly associated with lower risk of disease progression from diabetes-free state to all-cause death. Higher intake of raw and cooked vegetables was significantly associated with lower risks of disease progression from diabetes-free state to incident T2D and to total death. CONCLUSIONS These findings indicate that higher intake of fresh fruit, dried fruit, raw vegetables, and cooked vegetables could be beneficial for primary and secondary prevention of T2D.
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Affiliation(s)
- Guzhengyue Zheng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-sen Road, Yuexiu District, Guangzhou, Guangdong, 510080, P. R. China
| | - Shanshan Ran
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-sen Road, Yuexiu District, Guangzhou, Guangdong, 510080, P. R. China
| | - Jingyi Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-sen Road, Yuexiu District, Guangzhou, Guangdong, 510080, P. R. China
| | - Aaron M Qian
- Department of Psychology, College of Arts and Sciences, Saint Louis University, United States of America, Tegeler Hall, 3700 Lindell Boulevard, Saint Louis, MO, 63103, USA
| | - Junjie Hua
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-sen Road, Yuexiu District, Guangzhou, Guangdong, 510080, P. R. China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, P. R. China
| | - Michael G Vaughn
- School of Social Work, Saint Louis University, Tegeler Hall, 3550 Lindell Boulevard, Saint Louis, MO, 63103, USA
| | - Maya Tabet
- College of Global Population Health, University of Health Sciences and Pharmacy in Saint Louis, United States of America, 1 Pharmacy Place, Saint Louis, MO, 63110, USA
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, 2nd Yat-sen Road, Yuexiu District, Guangzhou, Guangdong, 510080, P. R. China.
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Ma X, Li P, Liu Y, Liu L, Xu J, Wang X, Zhou S, Ren X, Wang Y, Yuan L. Suboptimal diet quality is associated with the incidence of type 2 diabetes mellitus in middle-aged and older populations in China: evidence from a population-based cross-sectional study. Nutr Res 2024; 127:123-132. [PMID: 38943730 DOI: 10.1016/j.nutres.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 07/01/2024]
Abstract
The association between dietary quality and type 2 diabetes mellitus (T2DM) based on the Chinese Dietary Balance Index (DBI-16) is seldom reported. We hypothesized that poor dietary quality might increase the risk of T2DM in the middle-aged and older populations. A total of 1816 individuals (≥50 years) were included in the study. Demographic characteristics and dietary intake data were collected. Logistic regression and restricted cubic spline (RCS) analyses were conducted to explore the association between DBI-16 indexes and the risk of T2DM. The insufficient intake of vegetables and dairy might decrease the risk of T2DM (ORVegetable = 0.77, 95% CI = 0.60-0.97; ORDairy = 0.58, 95% CI = 0.35-0.96), but the individuals with insufficient intake of fruit were more likely to have a higher risk of T2DM (ORfruit = 2.26, 95% CI = 1.69-3.06). Compared with the subjects with the lowest quartile of Low Bound Score (LBS) or Diet Quality Distance (DQD), the individuals with Q2 and Q3 level of LBS (ORQ2 = 1.40, 95% CI = 1.03-1.90, P = .033; ORQ3 = 1.52, 95% CI = 1.11-2.08, P < .01) or DQD (ORQ2 = 1.45, 95% CI = 1.06-1.99, P = .021; ORQ3 = 1.64, 95% CI = 1.20-2.24, P < .01) showed increased risk of T2DM with a nonlinear association observed by RCS analysis. We concluded that imbalanced dietary intake, especially insufficient daily fruit intake, might predict an increased risk of T2DM in the middle-aged and elderly Chinese.
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Affiliation(s)
- Xiaojun Ma
- School of Public Health, Capital Medical Universiyt, Beijing China; China-British Joint Laboratory of Nutrition Prevention and Control of Chronic Diseases
| | - Pengfei Li
- School of Public Health, Capital Medical Universiyt, Beijing China; China-British Joint Laboratory of Nutrition Prevention and Control of Chronic Diseases
| | - Yu Liu
- School of Public Health, Capital Medical Universiyt, Beijing China; China-British Joint Laboratory of Nutrition Prevention and Control of Chronic Diseases
| | - Lu Liu
- School of Public Health, Capital Medical Universiyt, Beijing China; China-British Joint Laboratory of Nutrition Prevention and Control of Chronic Diseases
| | - Jingjing Xu
- School of Public Health, Capital Medical Universiyt, Beijing China; China-British Joint Laboratory of Nutrition Prevention and Control of Chronic Diseases
| | - Xixiang Wang
- School of Public Health, Capital Medical Universiyt, Beijing China; China-British Joint Laboratory of Nutrition Prevention and Control of Chronic Diseases
| | - Shaobo Zhou
- School of Science, Faculty of Engineering and Science, University of Greenwich, Chatham, UK
| | - Xiuwen Ren
- School of Public Health, Capital Medical Universiyt, Beijing China; China-British Joint Laboratory of Nutrition Prevention and Control of Chronic Diseases
| | - Ying Wang
- Suzhou Research Center of Medical School, Suzhou Hospital, Affiliated Hospital of Medical School, Nanjing University, Suzhou, China
| | - Linhong Yuan
- School of Public Health, Capital Medical Universiyt, Beijing China; China-British Joint Laboratory of Nutrition Prevention and Control of Chronic Diseases.
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Tilahun WM, Simegn MB, Geremew H, Gebreegziabher ZA, Abay LY, Tesfie TK. Spatial variation of zero fruits/vegetables consumption and associated factors among children aged 6-23 months in Ethiopia: geographical weighted regression analysis. Front Nutr 2024; 11:1374845. [PMID: 38818130 PMCID: PMC11137304 DOI: 10.3389/fnut.2024.1374845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/03/2024] [Indexed: 06/01/2024] Open
Abstract
Background After 6 months, nutrient-dense, varied diets containing fruits and vegetables are crucial to supplement breastfeeding. Like many other low-income countries, Ethiopia has very low FV consumption. Zero vegetable or fruit (ZVF) consumption has been shown to significantly raise the risk of non-communicable diseases and has been ranked among the top 10 risk factors for mortality. And it is associated with poor health, an increased risk of obesity, and a higher risk of non-communicable diseases. Thus, this study's goal was to investigate the spatial distribution of ZVF consumption and its spatial determinants among children aged 6-23 months in Ethiopia. Methods A cross-sectional study design was employed. A total of 1,489 weighted samples were included from kids' datasets from the 2019 Ethiopian mini-demographic and health survey. STATA version 16, ArcGIS version 10.8, Kuldorff's SaTScan version 9.6, and MGWR version 2.0 software were used for analysis. Spatial regression analyses (geographical weighted regression and ordinary least squares analysis) were conducted. Models were compared using AICc and adjusted R2. A p-value of less than 0.05 was used to declare statistically significant spatial predictors, and the corresponding local coefficients were mapped. Results The spatial distribution of ZVF consumption among children aged 6-23 months was non-random in Ethiopia. Spatial scan analysis revealed a total of 120 significant clusters. Maternal education, wealth status, age of the child, place of delivery, number of under-five children in the house, and current pregnancy status were significant predictors of the spatial variation of ZVF consumption. Conclusion Significant geographic variation in ZVF consumption was found in this study throughout Ethiopia's regions. Significant predictors of the spatial variation in ZVF consumption were maternal education, wealth status, child age, place of delivery, number of under-five children in the home, and status as a pregnant woman at the time of birth. Therefore, in order to improve children's adequate consumption of fruit and vegetables, area-based interventions that can consider these significant factors into account are needed.
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Affiliation(s)
- Werkneh Melkie Tilahun
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Mulat Belay Simegn
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Habtamu Geremew
- College of Health Science, Oda Bultum University, Chiro, Ethiopia
| | - Zenebe Abebe Gebreegziabher
- Department of Epidemiology and Biostatistics, School of Public Health, Debre Birhan University, Debre Birhan, Ethiopia
| | - Lamrot Yohannes Abay
- Department of Environmental and Occupational Health and Safety, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Tigabu Kidie Tesfie
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Skurk T, Grünerbel A, Hummel S, Kabisch S, Keuthage W, Müssig K, Nussbaumer H, Rubin D, Simon MC, Tombek A, Weber KS. Nutritional Recommendations for the Prevention of Type 2 Diabetes Mellitus. Exp Clin Endocrinol Diabetes 2024; 132:68-82. [PMID: 38232741 DOI: 10.1055/a-2166-6943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Affiliation(s)
- Thomas Skurk
- ZIEL - Institute for Food & Health, Core Facility Human Studies, Technical University Munich, Freising, Germany
| | | | - Sandra Hummel
- Helmholtz Diabetes Centre Institute of Diabetes Research Munich, Research Centre for Health and Environment (GmbH), Munich-Neuherberg, Germany
| | - Stefan Kabisch
- German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
| | - Winfried Keuthage
- Specialist Practice for Diabetes and Nutritional Medicine, Münster, Germany
| | - Karsten Müssig
- Department of Internal Medicine, Gastroenterology and Diabetology, Niels Stensen Hospitals, Franziskus Hospital Harderberg, Georgsmarienhütte, Germany
| | | | - Diana Rubin
- Vivantes Hospital Spandau, Berlin, Germany
- Vivantes Humboldt Hospital, Berlin, Germany
| | - Marie-Christine Simon
- Institute of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Astrid Tombek
- Diabetes Centre Bad Mergentheim, Bad Mergentheim, Germany
| | - Katharina S Weber
- Institute for Epidemiology, Christian-Albrechts University of Kiel, Kiel, Germany
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Hamamah S, Iatcu OC, Covasa M. Nutrition at the Intersection between Gut Microbiota Eubiosis and Effective Management of Type 2 Diabetes. Nutrients 2024; 16:269. [PMID: 38257161 PMCID: PMC10820857 DOI: 10.3390/nu16020269] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/15/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
Nutrition is one of the most influential environmental factors in both taxonomical shifts in gut microbiota as well as in the development of type 2 diabetes mellitus (T2DM). Emerging evidence has shown that the effects of nutrition on both these parameters is not mutually exclusive and that changes in gut microbiota and related metabolites such as short-chain fatty acids (SCFAs) and branched-chain amino acids (BCAAs) may influence systemic inflammation and signaling pathways that contribute to pathophysiological processes associated with T2DM. With this background, our review highlights the effects of macronutrients, carbohydrates, proteins, and lipids, as well as micronutrients, vitamins, and minerals, on T2DM, specifically through their alterations in gut microbiota and the metabolites they produce. Additionally, we describe the influences of common food groups, which incorporate varying combinations of these macronutrients and micronutrients, on both microbiota and metabolic parameters in the context of diabetes mellitus. Overall, nutrition is one of the first line modifiable therapies in the management of T2DM and a better understanding of the mechanisms by which gut microbiota influence its pathophysiology provides opportunities for optimizing dietary interventions.
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Affiliation(s)
- Sevag Hamamah
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA 91766, USA;
| | - Oana C. Iatcu
- Department of Biomedical Sciences, College of Medicine and Biological Science, University of Suceava, 720229 Suceava, Romania
| | - Mihai Covasa
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA 91766, USA;
- Department of Biomedical Sciences, College of Medicine and Biological Science, University of Suceava, 720229 Suceava, Romania
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12
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Misir A, Viechtbauer W, de Vries H, Mesters I. Twelve Month Efficacy of Computer-Tailored Communication in Boosting Fruit and Vegetable Consumption Among Adults Aged Forty and over: A Three-Level Meta-Analysis and Systematic Review of Randomized Controlled Trials. Adv Nutr 2024; 15:100150. [PMID: 37979693 PMCID: PMC10756964 DOI: 10.1016/j.advnut.2023.100150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/29/2023] [Accepted: 11/03/2023] [Indexed: 11/20/2023] Open
Abstract
Computer-tailored health communication (CTC) can enhance fruit and vegetable (F&V) intake and, consequently, health by providing personalized feedback. However, few studies have examined the long-term effects of such interventions in middle-aged and older adults. This research aimed to assess the 12-mo efficacy of CTC in promoting F&V consumption and potentially identify who among middle-aged and older adults changed their diet after the intervention. The protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) on 2021-12-09, code CRD42022330491. The research was performed without external funding. We searched 6 databases (MEDLINE via PubMed, EMBASE, Scopus, Web of Science Core Collection, Cochrane Library, and PsycINFO) for randomized controlled trials (RCTs) comparing CTC interventions for increasing F&V intake with usual care/no intervention control in adults aged ≥40, measured 12 mo after the pretest. The search covered the period from 1 January 1990 to 1 January 2022. We selected 16 RCTs with 25,496 baseline participants for the review systematic literature reviews (SLR) and 11 RCTs with 19 measurements for the meta-analysis (MA). We assessed risk of bias with the JBI Critical Appraisal Checklist. The SLR revealed that at 1-y postCTC intervention, most of the treatment groups increased F&V intake more than the control groups. The overall bias in the data set was not high. The MA model on 11 RCTs revealed a significant effect size for F&V consumption in intervention groups compared with control, standardized mean difference of 0.21 (confidence interval [CI]: 0.12, 0.30), P = 0.0004. The evidence suggests that CTC is a suitable strategy for public interventions aiming to increase F&V intake in adults aged ≥40. The design of CTC for public interventions should consider the process of change and stages of change addressing awareness, attitudes, self-efficacy, and social influence as promising concepts for influencing behavior change.
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Affiliation(s)
- Andreja Misir
- Department of Epidemiology, Maastricht University, Maastricht, Netherlands.
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University, Maastricht, Netherlands
| | - Ilse Mesters
- Department of Epidemiology, Maastricht University, Maastricht, Netherlands
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13
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Basu A, Richardson LA, Carlos A, Abubakr NH, Weltman RL, Ebersole JL. The Associations of Cardiometabolic and Dietary Variables with Clinical Periodontitis in Adults with and without Type 2 Diabetes: A Cross-Sectional Study. Nutrients 2023; 16:81. [PMID: 38201914 PMCID: PMC10780717 DOI: 10.3390/nu16010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Periodontitis is a commonly occurring inflammatory oral disease affecting a large proportion of global and US adults and is characterized by the destruction of the tooth-supporting apparatus. Its etiology is multifactorial, and type 2 diabetes and diet play critical roles in its remission and progression. However, few studies have addressed nutritional and serum vitamin D status in adults with periodontitis in the presence of diabetes. A cross-sectional study (n = 78), and a sub-set of age- and BMI-matched case-control studies (n = 50), were conducted to examine differences in dietary and cardiometabolic variables, and serum vitamin D in adults with periodontitis with or without diabetes. Participants provided fasting blood samples and 24-h diet recalls on at least two different days. Data on health history, body weight, height, nutritional habits, and clinical features of periodontitis were also collected. The Mann-Whitney U Test (with exact p-value estimation by Monte Carlo simulation) was used to examine differences by diabetes status in continuous and ordinal variables. Results revealed significantly lower serum vitamin D, and dietary intake of fruits, vegetables, dairy, vitamins A and C in adults with periodontitis with vs. without diabetes in the sub-study (all p < 0.05). In the overall sample, adults with diabetes presented with higher caries risk measures and lower numbers of teeth than those without diabetes; plaque and bleeding scores did not differ by diabetes status. Finally, a significant associations of food habits was observed, especially consuming protein-rich foods twice a day with a lower bleeding score, and daily consumption of fried or fast foods with a fewer number of teeth present (all p < 0.05). The present findings show significant dietary and serum vitamin D inadequacies among adults with periodontitis, and diabetes further aggravates the observed malnourishment and oral health.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA;
| | - Leigh Ann Richardson
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA;
| | - Alicia Carlos
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA; (A.C.); (N.H.A.); (J.L.E.)
| | - Neamat Hassan Abubakr
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA; (A.C.); (N.H.A.); (J.L.E.)
| | - Robin L. Weltman
- Department of Clinical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA;
| | - Jeffrey L. Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA; (A.C.); (N.H.A.); (J.L.E.)
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14
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Marshall GA, Garner JA, Hanson KL, Ammerman AS, Jilcott Pitts SB, Kolodinsky J, Sitaker M, Seguin-Fowler RA. Fruit and Vegetable Preparation Changes During and After Cost-Offset Community-Supported Agriculture Plus Nutrition Education. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:575-584. [PMID: 37389499 DOI: 10.1016/j.jneb.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 04/27/2023] [Accepted: 05/08/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE Inadequate consumption of fruits and vegetables (FV) can negatively impact health. Cost-offset, or subsidized, community-supported agriculture (CO-CSA) may change FV preparation behaviors among caregivers in low-income households. We assessed changes in FV preparation frequency and methods during and after participation in a CO-CSA plus tailored nutrition education intervention. DESIGN Longitudinal comparison of outcomes at baseline, end of CO-CSA season, and 1 year later. PARTICIPANTS Caregivers of children aged 2-12 years from households with low income in rural areas of 4 US states (n = 148). INTERVENTION Summer season, half-price CO-CSA share plus tailored nutrition education classes. Comparison to a control group not included in this analysis. VARIABLES MEASURED Monthly frequency of preparing 9 FV for children's snacks and 5 vegetables for dinner; use of healthy preparation methods for dinner. ANALYSIS Repeated measures ANCOVA including state with Bonferroni correction and 95% confidence. RESULTS At baseline, caregivers prepared fruit for children's snacks and vegetables for dinner almost daily and vegetables for children's snacks every other day. The frequency of total FV preparation and most vegetable varieties increased during the intervention. Increases in total vegetables for snacks, dinner, and leafy greens were maintained 1 year later (n = 107). CONCLUSIONS AND IMPLICATIONS Community-supported agriculture plus education is a promising approach to sustained increases in vegetable preparation for children's snacks and dinner meals.
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Affiliation(s)
- Grace A Marshall
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY.
| | - Jennifer A Garner
- John Glenn College of Public Affairs, The Ohio State University, Columbus, OH; Division of Medical Dietetics, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH
| | - Karla L Hanson
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY
| | - Alice S Ammerman
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Jane Kolodinsky
- Department of Community Development and Applied Economics, University of Vermont, Burlington, VT
| | - Marilyn Sitaker
- Extension Agriculture and Natural Resources, Washington State University, Olympia, WA
| | - Rebecca A Seguin-Fowler
- Institute for Advancing Health Through Agriculture, Texas A&M University System, College Station, TX
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15
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Li M, Jeeyavudeen MS, Arunagirinathan G, Pappachan J. Is Type 2 Diabetes Mellitus a Behavioural Disorder? An Evidence Review for Type 2 Diabetes Mellitus Prevention and Remission through Lifestyle Modification. TOUCHREVIEWS IN ENDOCRINOLOGY 2023; 19:7-15. [PMID: 37313234 PMCID: PMC10258624 DOI: 10.17925/ee.2023.19.1.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/27/2023] [Indexed: 06/15/2023]
Abstract
The prevalence of type 2 diabetes mellitus (T2DM) is steadily rising worldwide due to an increasingly sedentary lifestyle combined with unhealthy food habits. Currently, the burden of diabetes on healthcare systems is unprecedented and rising daily. Several observational studies and randomized controlled trials provide clinical evidence that T2DM remission is possible by adopting dietary interventions and a strict exercise training protocol. Notably, these studies provide ample evidence for remission in patients with T2DM or for prevention in those with risk factors for the disease through various non-pharmacological behavioural interventions. In this article, we present two clinical cases of individuals who showed remission from T2DM/prediabetes via behavioural changes, especially through the adoption of a low-energy diet and exercise. We also discuss the recent advances in T2DM and obesity research, focusing on nutritional interventions and exercise and their benefits for weight loss, improved metabolic profile, enhanced glycaemic control and remission of diabetes.
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Affiliation(s)
- Matthias Li
- The University of Manchester Medical School, Manchester, UK
| | | | | | - Joseph Pappachan
- The University of Manchester Medical School, Manchester, UK
- Lancashire Teaching Hospitals NHS Trust and Manchester Metropolitan University, Manchester, UK
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16
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Jarvis SE, Malik VS. Healthy and Environmentally Sustainable Dietary Patterns for Type 2 Diabetes: Dietary Approaches as Co-benefits to the Overlapping Crises. J Indian Inst Sci 2023. [DOI: 10.1007/s41745-023-00358-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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17
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Cao Z, Wong MY, Cheng GH. Logistic regression with correlated measurement error and misclassification in covariates. Stat Methods Med Res 2023; 32:789-805. [PMID: 36790894 DOI: 10.1177/09622802231154324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Many areas of research, such as nutritional epidemiology, may encounter measurement errors of continuous covariates and misclassification of categorical variables when modeling. It is well known that ignoring measurement errors or misclassification can lead to biased results. But most research has focused on solving these two problems separately. Addressing both measurement error and misclassification simultaneously in a single analysis is less actively studied. In this article, we propose a new correction method for a logistic regression to handle correlated error variables involved in multivariate continuous covariates and misclassification in a categorical variable simultaneously. It is not computationally intensive since a closed-form of the approximate likelihood function conditional on observed covariates is derived. The asymptotic normality of this proposed estimator is established under regularity conditions and its finite-sample performance is empirically examined by simulation studies. We apply this new estimation method to handle measurement error in some nutrients of interest and misclassification of a categorical variable named physical activity in the European Prospective Investigation into Cancer and Nutrition-InterAct Study data. Analyses show that fruit is negatively associated with type 2 diabetes for a group of women doing active physical activity, protein has positive association with type 2 diabetes for the group of less active physical activity, and actual physical activity has a greater effect on reducing the risk of type 2 diabetes than observed physical activity.
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Affiliation(s)
- Zhiqiang Cao
- College of Big Data and Internet, 507738Shenzhen Technology University, Shenzhen, China
| | - Man Yu Wong
- Department of Mathematics, 58207The Hong Kong University of Science and Technology, Hong Kong, China
| | - Garvin Hl Cheng
- Department of Mathematics, 58207The Hong Kong University of Science and Technology, Hong Kong, China
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18
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Davis JN, Landry MJ, Vandyousefi S, Jeans MR, Hudson EA, Hoelscher DM, van den Berg AE, Pérez A. Effects of a School-Based Nutrition, Gardening, and Cooking Intervention on Metabolic Parameters in High-risk Youth: A Secondary Analysis of a Cluster Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2250375. [PMID: 36626172 PMCID: PMC9856961 DOI: 10.1001/jamanetworkopen.2022.50375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
IMPORTANCE Although school-based gardening programs for children have consistently been shown to improve dietary behaviors, no cluster randomized clinical trial (RCT) has evaluated the effects of a school-based gardening intervention on metabolic outcomes. OBJECTIVE To evaluate the effects of a school-based gardening, nutrition, and cooking intervention (Texas Sprouts) on changes in metabolic outcomes in elementary schoolchildren. DESIGN, SETTING, AND PARTICIPANTS This study was a secondary analysis of a cluster RCT, conducted over 3 years from 2016 to 2019, at low-income elementary schools with majority Hispanic students in the greater Austin, Texas, area. Data were analyzed from January to August 2022. INTERVENTIONS Texas Sprouts was 1 school year long (9 months) and consisted of (1) Garden Leadership Committee formation; (2) a 0.25-acre outdoor teaching garden; (3) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school year; and (4) 9 monthly parent lessons. The delayed intervention was implemented the following academic year and received an identical intervention. MAIN OUTCOMES AND MEASURES The following measures were obtained at baseline and postintervention (9 months): demographics via survey; measured height, weight, and body mass index parameters; and glucose, insulin, homeostatic model assessment of insulin resistance, and a lipid panel via an optional fasting blood draw. RESULTS Sixteen elementary schools were randomly assigned to either Texas Sprouts intervention (8 schools) or to delayed intervention (control, 8 schools). A total of 3302 children (aged 7-12 years) were enrolled in Texas Sprouts, and fasting blood samples were obtained from 1104 children (or 33% of those enrolled) at baseline. The final analytic sample included 695 children (307 boys [44.17%]; mean [SE] age, 9.28 [0.04] years; 480 Hispanic children [69.02%]; 452 [65.03%] eligible for free or reduced lunch) with complete demographic data and baseline and postintervention (9-month) fasting blood draws. Compared with control schools, children from Texas Sprouts schools had a 0.02% reduction in mean hemoglobin A1c (95% CI, 0.03%-0.14%; P = .005) and a 6.40 mg/dL reduction in mean low-density lipoprotein cholesterol (95% CI, 3.82-8.97 mg/dL; P = .048). There were no intervention effects on glucose, insulin, homeostatic model assessment of insulin resistance, or other lipid parameters. CONCLUSIONS AND RELEVANCE In this cluster RCT, Texas Sprouts improved glucose control and reduced low-density lipoprotein cholesterol in high-risk youth. These findings suggest that elementary schools should incorporate garden-based interventions as a way to improve metabolic parameters in children. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02668744.
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Affiliation(s)
- Jaimie N. Davis
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, Austin
| | - Matthew J. Landry
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, Austin
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, California
| | - Sarvenaz Vandyousefi
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, Austin
- Bellevue Hospital Center, Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, New York
| | - Matthew R. Jeans
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, Austin
- Health Equity Alliance, The Health Management Academy, Arlington, Virginia
| | - Erin A. Hudson
- Department of Nutritional Sciences, College of Natural Sciences, University of Texas at Austin, Austin
| | - Deanna M. Hoelscher
- Michael & Susan Dell Center for Healthy Living, Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, Austin
| | - Alexandra E. van den Berg
- Michael & Susan Dell Center for Healthy Living, Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, Austin
| | - Adriana Pérez
- Michael & Susan Dell Center for Healthy Living, Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, Austin
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19
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Jin Y, Arroo R. The protective effects of flavonoids and carotenoids against diabetic complications-A review of in vivo evidence. Front Nutr 2023; 10:1020950. [PMID: 37032781 PMCID: PMC10080163 DOI: 10.3389/fnut.2023.1020950] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 02/24/2023] [Indexed: 04/11/2023] Open
Abstract
Diabetes mellitus is a chronic metabolic disorder caused either by inadequate insulin secretion, impaired insulin function, or both. Uncontrolled diabetes is characterized by hyperglycemia which over time leads to fatal damage to both macro-and microvascular systems, causing complications such as cardiovascular diseases, retinopathy and nephropathy. Diabetes management is conventionally delivered through modifications of diet and lifestyle and pharmacological treatment, using antidiabetic drugs, and ultimately insulin injections. However, the side effects and financial cost of medications often reduce patient compliance to treatment, negatively affecting their health outcomes. Natural phytochemicals from edible plants such as fruits and vegetables (F&V) and medicinal herbs have drawn a growing interest as potential therapeutic agents for treating diabetes and preventing the onset and progression of diabetic complications. Flavonoids, the most abundant polyphenols in the human diet, have shown antidiabetic effects in numerous in vitro and preclinical studies. The underlying mechanisms have been linked to their antioxidant, anti-inflammatory and immunomodulatory activities. Carotenoids, another major group of dietary phytochemicals, have also shown antidiabetic potential in recent in vitro and in vivo experimental models, possibly through a mechanism of action similar to that of flavonoids. However, scientific evidence on the efficacy of these phytochemicals in treating diabetes or preventing the onset and progression of its complications in clinical settings is scarce, which delays the translation of animal study evidence to human applications and also limits the knowledge on their modes of actions in diabetes management. This review is aimed to highlight the potential roles of flavonoids and carotenoids in preventing or ameliorating diabetes-related complications based on in vivo study evidence, i.e., an array of preclinical animal studies and human intervention trials. The current general consensus of the underlying mechanisms of action exerted by both groups of phytochemicals is that their anti-inflammatory action is key. However, other potential mechanisms of action are considered. In total, 50 in vivo studies were selected for a review after a comprehensive database search via PubMed and ScienceDirect from January 2002 to August 2022. The key words used for analysis are type-2 diabetes (T2DM), diabetic complications, flavonoids, carotenoids, antioxidant, anti-inflammatory, mechanisms of prevention and amelioration, animal studies and human interventions.
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Affiliation(s)
- Yannan Jin
- Leicester School of Allied Health Sciences, Faculty of Health & Life Sciences, De Montfort University, Leicester, United Kingdom
- *Correspondence: Yannan Jin,
| | - Randolph Arroo
- Leicester School of Pharmacy, Faculty of Health & Life Sciences, De Montfort University, Leicester, United Kingdom
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20
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Udensi J, Loughman J, Loskutova E, Byrne HJ. Raman Spectroscopy of Carotenoid Compounds for Clinical Applications-A Review. Molecules 2022; 27:9017. [PMID: 36558154 PMCID: PMC9784873 DOI: 10.3390/molecules27249017] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Carotenoid compounds are ubiquitous in nature, providing the characteristic colouring of many algae, bacteria, fruits and vegetables. They are a critical component of the human diet and play a key role in human nutrition, health and disease. Therefore, the clinical importance of qualitative and quantitative carotene content analysis is increasingly recognised. In this review, the structural and optical properties of carotenoid compounds are reviewed, differentiating between those of carotenes and xanthophylls. The strong non-resonant and resonant Raman spectroscopic signatures of carotenoids are described, and advances in the use of Raman spectroscopy to identify carotenoids in biological environments are reviewed. Focus is drawn to applications in nutritional analysis, optometry and serology, based on in vitro and ex vivo measurements in skin, retina and blood, and progress towards establishing the technique in a clinical environment, as well as challenges and future perspectives, are explored.
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Affiliation(s)
- Joy Udensi
- FOCAS Research Institute, Technological University Dublin, City Campus, Camden Row, Dublin 8, D08 CKP1 Dublin, Ireland
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
- Centre for Eye Research, Ireland, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
| | - James Loughman
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
- Centre for Eye Research, Ireland, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
| | - Ekaterina Loskutova
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
- Centre for Eye Research, Ireland, Technological University Dublin, City Campus, Grangegorman, Dublin 7, D07 EWV4 Dublin, Ireland
| | - Hugh J. Byrne
- FOCAS Research Institute, Technological University Dublin, City Campus, Camden Row, Dublin 8, D08 CKP1 Dublin, Ireland
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21
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Kokkinopoulou A, Kafatos A. Impact of Christian Orthodox Church dietary recommendations on metabolic syndrome risk factors: a scoping review. Nutr Res Rev 2022; 35:221-235. [PMID: 34108056 DOI: 10.1017/s0954422421000184] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Fasting has been a practice among followers of different religions for many years. Christian Orthodox Church (COC) fasting is a periodic vegetarian-type diet in which seafood and snails are allowed on most fasting days. The present scoping review aimed to present available data regarding the benefits of COC fasting on metabolic syndrome (MetS) risk factors. Databases were searched for available studies. Twenty publications, with a total of 1226 fasting participants, provided data on the effects on different variables of MetS, including blood pressure, blood lipids and anthropometric measurements. Fasters' diet is characterised by low saturated and trans fat intake, high complex carbohydrate and fibre consumption, due to permissible foods. COC fasting has no deficiency in essential amino acid intake since seafood and snails are allowed on fasting days. Fasters have healthier blood lipid profiles during and after COC fasting periods, and total cholesterol, LDL-cholesterol, systolic blood pressure, body weight and BMI are reduced after a fasting period. Due to restricted or forbidden intake of specific foods during the COC fasting periods, one might expect that fasters have reduced intake of macro- and micronutrients, but as shown in the available literature, there are no deficiencies. Future research on COC fasting is needed in areas not investigated at all, like MetS, before reaching definite conclusions.
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Affiliation(s)
- A Kokkinopoulou
- Department of Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, Heraklion, Greece
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - A Kafatos
- Department of Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, Heraklion, Greece
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22
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Stanaway JD, Afshin A, Ashbaugh C, Bisignano C, Brauer M, Ferrara G, Garcia V, Haile D, Hay SI, He J, Iannucci V, Lescinsky H, Mullany EC, Parent MC, Serfes AL, Sorensen RJD, Aravkin AY, Zheng P, Murray CJL. Health effects associated with vegetable consumption: a Burden of Proof study. Nat Med 2022; 28:2066-2074. [PMID: 36216936 PMCID: PMC9556321 DOI: 10.1038/s41591-022-01970-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/26/2022] [Indexed: 12/14/2022]
Abstract
Previous research suggests a protective effect of vegetable consumption against chronic disease, but the quality of evidence underlying those findings remains uncertain. We applied a Bayesian meta-regression tool to estimate the mean risk function and quantify the quality of evidence for associations between vegetable consumption and ischemic heart disease (IHD), ischemic stroke, hemorrhagic stroke, type 2 diabetes and esophageal cancer. Increasing from no vegetable consumption to the theoretical minimum risk exposure level (306-372 g daily) was associated with a 23.2% decline (95% uncertainty interval, including between-study heterogeneity: 16.4-29.4) in ischemic stroke risk; a 22.9% (13.6-31.3) decline in IHD risk; a 15.9% (1.7-28.1) decline in hemorrhagic stroke risk; a 28.5% (-0.02-51.4) decline in esophageal cancer risk; and a 26.1% (-3.6-48.3) decline in type 2 diabetes risk. We found statistically significant protective effects of vegetable consumption for ischemic stroke (three stars), IHD (two stars), hemorrhagic stroke (two stars) and esophageal cancer (two stars). Including between-study heterogeneity, we did not detect a significant association with type 2 diabetes, corresponding to a one-star rating. Although current evidence supports increased efforts and policies to promote vegetable consumption, remaining uncertainties suggest the need for continued research.
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Affiliation(s)
- Jeffrey D Stanaway
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
| | - Ashkan Afshin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Charlie Ashbaugh
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Catherine Bisignano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Michael Brauer
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Giannina Ferrara
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Vanessa Garcia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Demewoz Haile
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Jiawei He
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Vincent Iannucci
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Haley Lescinsky
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin C Mullany
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Marie C Parent
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Audrey L Serfes
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Reed J D Sorensen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Aleksandr Y Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Applied Mathematics, University of Washington, Seattle, WA, USA
| | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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Wu Y, He X, Zhou J, Wang Y, Yu L, Li X, Liu T, Luo J. Impact of healthy lifestyle on the risk of type 2 diabetes mellitus in southwest China: A prospective cohort study. J Diabetes Investig 2022; 13:2091-2100. [PMID: 36121185 DOI: 10.1111/jdi.13909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/18/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022] Open
Abstract
AIMS To explore the influence of nine healthy lifestyle factors on the risk of type 2 diabetes mellitus in adults in Guizhou, China. METHODS Data were obtained from a large population-based prospective cohort study in Guizhou Province, China. A total of 7,319 participants aged ≥18 years without diabetes at baseline were included in this study and were followed up from 2016 to 2020. A healthy lifestyle score was calculated based on the number of healthy lifestyle factors. RESULTS During an average of 7.1 person-years of follow-up, 764 participants were diagnosed with type 2 diabetes mellitus. Compared with those of participants who scored 0-3 for a healthy lifestyle, the hazard ratios (95% confidence intervals) of those who scored 4, 5, 6, and ≥7 were 0.676 (0.523-0.874), 0.599 (0.464-0.773), 0.512 (0.390-0.673), and 0.393 (0.282-0.550), respectively, showing a gradual downward trend (P for trend <0.01). More importantly, they had lower fasting and 2 h post-load plasma glucose levels and fewer changes in plasma glucose levels during follow-up. If ≥7 healthy lifestyle factors were maintained, 33.8% of incident diabetes cases could have been prevented. Never smoking was the strongest protective factor against type 2 diabetes mellitus. CONCLUSIONS A healthy lifestyle can effectively decrease plasma glucose levels and reduce the incidence of type 2 diabetes mellitus in adults in Guizhou, China. In addition, not smoking may be an effective way to prevent type 2 diabetes mellitus.
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Affiliation(s)
- Yanli Wu
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Xi He
- Department of Endocrinology and Metabolism, Guizhou Provincial People's Hospital, Guiyang, China
| | - Jie Zhou
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Yiying Wang
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Lisha Yu
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Xuejiao Li
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Tao Liu
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Jianhua Luo
- Department of Endocrinology and Metabolism, Guizhou Provincial People's Hospital, Guiyang, China
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Association between Adequate Fruit and Vegetable Intake and CVDs-Associated Risk Factors among the Malaysian Adults: Findings from a Nationally Representative Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159173. [PMID: 35954528 PMCID: PMC9368066 DOI: 10.3390/ijerph19159173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 02/05/2023]
Abstract
This study aimed to investigate the relationship between adequate fruit and vegetable intake, and cardiovascular diseases (CVDs)-associated risk factors (i.e., diabetes, hypertension and hypercholesterolemia) among Malaysian adults without history of chronic diseases. We analyzed the data from 11,172 Malaysian adults (i.e., 5554 male and 5618 female), who participated in the population-based National Health and Morbidity Survey 2015. Multiple logistic regression was employed to determine the relationship between adequate daily intake of fruit and vegetables (i.e., ≥5 servings per day) and undiagnosed diabetes, undiagnosed hypertension, and undiagnosed hypercholesterolemia, after adjustment for sociodemographic characteristics and lifestyle risk factors. The mean age (±SE) of these participants was 40.79 (±0.17) years old. Our data demonstrated an adequate daily intake of fruit and vegetables was inversely associated with undiagnosed hypercholesterolemia (adjusted OR: 0.71; 95% CI: 0.51–0.98). Further analyses demonstrated an inverse association between the adequate daily intake of vegetables alone and undiagnosed hypertension (adjusted OR: 0.71; 95% CI: 0.51–0.98). The findings from this study suggest the need for a holistic public health approach to reinforce public awareness about diet-related diseases, which will eventually aid in the prevention of CVDs among Malaysian adults in the long run.
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25
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Healthful Plant-Based Diet and Incidence of Type 2 Diabetes in Asian Population. Nutrients 2022; 14:nu14153078. [PMID: 35893932 PMCID: PMC9332860 DOI: 10.3390/nu14153078] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/20/2022] [Accepted: 07/25/2022] [Indexed: 01/27/2023] Open
Abstract
Plant-based diets have been suggested to be beneficial for type 2 diabetes (T2D). However, studies investigating the association between the healthiness of a plant-based diet and T2D risk are limited. This study explored the prospective association between scores from three different plant-based diet indices and risk of T2D and investigated whether associations differ by demographic and lifestyle factors in the Korean population. Data were derived from the Korean Genome and Epidemiology Study (KoGES), a prospective cohort study initiated between 2001 and 2002. Dietary intakes were assessed using a validated food frequency questionnaire. Scores for three plant-based diet indices (overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI)) were measured. A total of 7363 Korean adults aged 40–69 years without T2D and related chronic diseases at baseline were included. Incident T2D was defined as elevated plasma glucose (≥126 mg/dL), self-report of a doctor’s diagnosis of T2D, or use of oral hypoglycemic drug. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for T2D risk. During a follow-up period of 14 years, 977 participants developed T2D. A 10-point higher score in hPDI was associated with a 14% lower risk of T2D (HR: 0.86, 95% CI, 0.77–0.95), adjusting for potential confounders. In subgroup analysis, inverse associations between hPDI and T2D risk were stronger in participants with a family history of T2D (HR: 0.58, 95% CI, 0.44 0.76) or history of hypertension (HR: 0.73, 95% CI, 0.60 0.89) than those without a family history of T2D (p interaction = 0.01) or history of hypertension (p interaction = 0.04). Considering the quality of the plant foods may be important for the prevention of T2D in the Korean population, which habitually consumes diets rich in plant foods.
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Nyanchoka MA, van Stuijvenberg ME, Tambe AB, Zuma MK, Mbhenyane XG. Fruit and Vegetable Consumption Patterns and Risk of Chronic Diseases of Lifestyle among University Students in Kenya. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19126965. [PMID: 35742215 PMCID: PMC9222637 DOI: 10.3390/ijerph19126965] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 02/03/2023]
Abstract
This study assesses the fruit and vegetable consumption patterns and risk factors for chronic diseases of lifestyle (CDL) among young adults attending Kenyatta University, Kenya. Four hundred and twenty-three young adults aged 19–30 years participated in the cross-sectional study. Males were 75.0% less likely to be overweight than females (OR = 0.25; 0.13–0.47). The mean overall consumption of fruit and/or vegetables amounted to 3.6 servings in a typical day. Eight in ten participants consumed lower amounts of fruits and vegetables than recommended by the WHO. At least one combined risk factor of CDL was observed among 91.3% of the young adults. About 8.7% of the participants were classified as low risk for CDL (having none of the five risk factors), 48.9% had one risk factor, 32.9% had two risk factors, 8.5% had three risk factors, while 0.9% had four risk factors. A significant relationship between daily fruit consumption and waist circumference was observed. These findings show the dire need to develop public health nutrition activities aimed at increasing the intake of fruit and vegetables and sensitizing young adults, and the general population, to the risk factors of CDL.
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Affiliation(s)
- Moriasi Abednego Nyanchoka
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa; (M.A.N.); (A.B.T.)
| | | | - Ayuk Betrand Tambe
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa; (M.A.N.); (A.B.T.)
| | - Mthokozisi Kwazi Zuma
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa; (M.A.N.); (A.B.T.)
| | - Xikombiso Gertrude Mbhenyane
- Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 8000, South Africa; (M.A.N.); (A.B.T.)
- Correspondence:
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27
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Nekitsing C, Hetherington MM. Implementing a 'Vegetables First' Approach to Complementary Feeding. Curr Nutr Rep 2022; 11:301-310. [PMID: 35152358 PMCID: PMC9174121 DOI: 10.1007/s13668-022-00399-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW To provide a rationale for promoting a vegetables first approach to complementary feeding (CF), building on prior exposure to vegetable flavours experienced in utero and via breastfeeding (chemosensory continuity). RECENT FINDINGS Vegetables confer selective health benefits but population intakes are below recommendations globally; maternal intake of vegetables during both pregnancy and lactation promotes familiarity with some vegetable flavours. Building on this exposure, vegetables as a first food during CF further promote acceptance. However, experiments testing efficacy of a vegetables first approach to CF demonstrate increased liking and intake, some evidence of generalisability but little evidence of sustained effects beyond infancy. The aim to increase the quantity and variety of vegetables eaten by children is both desirable, to improve nutrient quality of the diet, and achievable. However, longer, larger, randomised control trials are needed to evidence any longer term, sustainable benefits to liking and intake of vegetables.
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Barouti AA, Tynelius P, Lager A, Björklund A. Fruit and vegetable intake and risk of prediabetes and type 2 diabetes: results from a 20-year long prospective cohort study in Swedish men and women. Eur J Nutr 2022; 61:3175-3187. [PMID: 35435501 PMCID: PMC9363331 DOI: 10.1007/s00394-022-02871-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 03/08/2022] [Indexed: 12/29/2022]
Abstract
Purpose To investigate the association between fruit and vegetable intake (FVI) and the risk of developing prediabetes and type 2 diabetes (T2D) in a Swedish prospective cohort study. Methods Subjects were 6961 men and women aged 35–56 years old at baseline, participating in the Stockholm Diabetes Prevention Program cohort. By design, the cohort was enriched by 50% with subjects that had family history of diabetes. Anthropometric measurements, oral glucose tolerance tests and questionnaires on lifestyle and dietary factors were carried out at baseline and two follow-up occasions. Cox proportional hazard models were used to estimate hazard ratios with 95% CIs. Results During a mean follow-up time of 20 ± 4 years, 1024 subjects developed T2D and 870 prediabetes. After adjustments for confounders, the highest tertile of total FVI was associated with a lower risk of developing T2D in men (HR 0.76, 95% CI 0.60–0.96). There was also an inverse association between total fruit intake and prediabetes risk in men, with the HR for the highest tertile being 0.76 (95% CI 0.58–1.00). As for subtypes, higher intake of apples/pears was inversely associated with T2D risk in both sexes, whereas higher intakes of banana, cabbage and tomato were positively associated with T2D or prediabetes risk in either men or women. Conclusion We found an inverse association between higher total FVI and T2D risk and between higher fruit intake and prediabetes risk, in men but not in women. Certain fruit and vegetable subtypes showed varying results and require further investigation. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-022-02871-6.
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Affiliation(s)
- Afroditi Alexandra Barouti
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Diabetes, Academic Specialist Center, Region Stockholm, Stockholm, Sweden
| | - Per Tynelius
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anton Lager
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anneli Björklund
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. .,Center for Diabetes, Academic Specialist Center, Region Stockholm, Stockholm, Sweden.
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Forsberg S, Olsson V, Bredie WL, Wendin K. Vegetables for older adults –general preferences and smart adaptations for those with motoric eating difficulties. Int J Gastron Food Sci 2022. [DOI: 10.1016/j.ijgfs.2022.100528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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30
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Agovi H, Pierguidi L, Dinnella C, Viggiano MP, Monteleone E, Spinelli S. Attentional bias for vegetables is negatively associated with acceptability and is related to sensory properties. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2021.104429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Cao Z, Wong MY. Approximate profile likelihood estimation for Cox regression with covariate measurement error. Stat Med 2022; 41:910-931. [PMID: 35067954 DOI: 10.1002/sim.9324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/24/2021] [Accepted: 12/21/2021] [Indexed: 11/09/2022]
Abstract
In nutritional epidemiology, measurement error in covariates is a well-known problem since dietary intakes are usually assessed through self-reporting. In this article, we consider an additive error model in which error variables are highly correlated, and propose a new method called approximate profile likelihood estimation (APLE) for covariates measured with error in the Cox regression. Asymptotic normality of this estimator is established under regularity conditions, and simulation studies are conducted to examine the finite sample performance of the proposed estimator empirically. Moreover, the popular correction method called regression calibration is shown to be a special case of APLE. We then apply APLE to deal with measurement error in some nutrients of interest in the EPIC-InterAct Study under a sensitivity analysis framework.
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Affiliation(s)
- Zhiqiang Cao
- College of Big Data and Internet, Shenzhen Technology University, Shenzhen, China
| | - Man Yu Wong
- Department of Mathematics, The Hong Kong University of Science and Technology, Hong Kong, China
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32
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Halvorsen RE, Elvestad M, Molin M, Aune D. Fruit and vegetable consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of prospective studies. BMJ Nutr Prev Health 2022; 4:519-531. [PMID: 35028521 PMCID: PMC8718861 DOI: 10.1136/bmjnph-2020-000218] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/28/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The association between intake of fruit and vegetables and their subtypes, and the risk of type 2 diabetes has been investigated in several studies, but the results have been inconsistent. OBJECTIVE We conducted an updated systematic review and dose-response meta-analysis of prospective studies on intakes of fruit and vegetables and fruit and vegetable subtypes and the risk of type 2 diabetes. DESIGN PubMed and Embase databases were searched up to 20 October 2020. Prospective cohort studies of fruit and vegetable consumption and type 2 diabetes mellitus were included. Summary relative risks (RRs) and 95% CIs were estimated using a random effects model. RESULTS We included 23 cohort studies. The summary RR for high versus low intake and per 200 g/day were 0.93 (95% CI: 0.89 to 0.98, I2=0%, n=10 studies) and 0.98 (95% CI: 0.95 to 1.01, I2=37.8%, n=7) for fruit and vegetables combined, 0.93 (95% CI: 0.90 to 0.97, I2=9.3%, n=20) and 0.96 (95% CI: 0.92 to 1.00, I2=68.4%, n=19) for fruits and 0.95 (95% CI: 0.88 to 1.02, I2=60.4%, n=17) and 0.97 (95% CI: 0.94 to 1.01, I2=39.2%, n=16) for vegetables, respectively. Inverse associations were observed for apples, apples and pears, blueberries, grapefruit and grapes and raisins, while positive associations were observed for intakes of cantaloupe, fruit drinks, fruit juice, brussels sprouts, cauliflower and potatoes, however, most of these associations were based on few studies and need further investigation in additional studies. CONCLUSIONS This meta-analysis found a weak inverse association between fruit and vegetable intake and type 2 diabetes risk. There is indication of both inverse and positive associations between intake of several fruit and vegetables subtypes and type 2 diabetes risk, however, further studies are needed before firm conclusions can be made.
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Affiliation(s)
- Rine Elise Halvorsen
- Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Mathilde Elvestad
- Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Marianne Molin
- Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway.,Department of Nutrition, Bjørknes University College, Oslo, Norway
| | - Dagfinn Aune
- Department of Nutrition, Bjørknes University College, Oslo, Norway.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.,Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Ashor AW, Al-Rammahi TMM, Abdulrazzaq VM, Siervo M. Adherence to a healthy dietary pattern is associated with greater anti-oxidant capacity and improved glycemic control in Iraqi patients with Type 2 Diabetes. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2022. [DOI: 10.3233/mnm-210016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Healthy dietary patterns are typically associated with improved metabolic and cardiovascular health in population-based cohorts. This study aims to investigate whether a healthy dietary score, derived from UK Diabetes and Diet Questionnaire (UKDDQ), is significantly associated with measures of metabolic health and nutritional status in patients with T2DM. METHODS: This cross-sectional study included 85 patients with T2DM (age: 51.7±9.4, BMI: 30.6±5.3) and 20 healthy volunteers (age: 48.4±8.6, BMI: 29.5±5) recruited from the Al-Hassan Diabetes and Endocrinology Specialized Center, Karbala, Iraq. Body weight, height and body mass index (BMI) and resting clinic blood pressure were measured. All participants completed the UKDDQ to assess the quality of the diet. Metabolic and nutritional biomarkers were measured in fasting blood samples. A composite nutritional heathy index score (CNHI-score) based on the sum of z-scores for plasma vitamin A, C and E concentrations was derived. RESULTS: In patients with T2DM the UKDDQ score was associated with lower fasting blood glucose (FBG) (r = –0.33; P < 0.01), hemoglobin A1C (r = –0.49; P < 0.001), total cholesterol (TC) (r = –0.26; P = 0.02) concentrations. In patients with T2DM, the CNHI-score significantly associated with UKDDQ (r = 0.43; P < 0.001). In addition, a higher CNHI-score was associated with FBG (r = –0.61; P < 0.001), HbA1C (r = –0.83; P < 0.001), TC (r = –0.30; P < 0.01) and triglyceride (r = –0.30; P < 0.01) concentrations. CONCLUSIONS: A healthy diet is associated with a higher concentration of anti-oxidant vitamins and better glycemic and lipid profile in healthy subjects and in patients with T2DM.
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Affiliation(s)
- Ammar Waham Ashor
- Department of Internal Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
- Natioanl Diabetes Center, Mustansiriyah University, Baghdad, Iraq
| | | | | | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen’s Medical Centre, Nottingham, NG7 2UH, UK
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Parental insulin resistance is associated with unhealthy lifestyle behaviours independently of body mass index in children: The Feel4Diabetes study. Eur J Pediatr 2022; 181:2513-2522. [PMID: 35347419 PMCID: PMC9110461 DOI: 10.1007/s00431-022-04449-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/12/2022] [Accepted: 03/16/2022] [Indexed: 02/02/2023]
Abstract
UNLABELLED Parental health is associated with children's health and lifestyles. Thus, the aim of the present study was to assess lifestyle behaviours of children of parents with insulin resistance (IR) and at risk of type 2 diabetes. 2117 European families from the Feel4Diabetes-study were identified as being at risk for diabetes with the FINDRISC questionnaire and included in the present study. One parent and one child per family were included. Parental IR was considered when homeostasis model assessment (HOMA) was equal or higher than 2.5. Children's screen-time, physical activity and diet were assessed and clustered by K-means. Weight and height were measured and children's body mass index (BMI) was calculated. For children, a Healthy Diet Score (HDS) was calculated. Linear regression and multilevel logistic regression analyses were performed to assess the associations between parental IR and children's lifestyle behaviours in 2021. Children of parents with IR had higher BMI (p < 0.001) and spent more screen time (p = 0.014) than those of non-IR parents. Children of parents with IR had a lower value in the breakfast and vegetable components of the HDS (p = 0.008 and p = 0.05). Four lifestyle clusters were found. Children of IR parents had higher odds of being in a non-healthy cluster (OR: 1.19; 95%CI: 1.001-1.437). CONCLUSION Having an IR parent was associated with a high screen time and an increased probability of having an unhealthy lifestyle pattern in children. These data point out that children's lifestyles should be assessed in families with IR parents to provide tailored interventions. WHAT IS KNOWN • Children with diabetic or insulin-resistant parents could also develop this condition. • Unhealthy lifestyles are directly related with insulin resistance even in children. WHAT IS NEW • Children from parents with insulin resistance have higher chances of unhealthy lifestyles. • A higher BMI was found for those children with an insulin-resistant parent.
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Kacker S, Saboo N. A study to correlate effect of dietary modification on biochemical and cardiovascular parameters among prediabetics. J Family Med Prim Care 2022; 11:1126-1133. [PMID: 35495794 PMCID: PMC9051732 DOI: 10.4103/jfmpc.jfmpc_1902_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/17/2021] [Accepted: 12/29/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives: Dietary factors are important in the prevention and treatment of prediabetes and diabetes mellitus (DM). This study was designed to evaluate the prevalence, associated risk factors, dietary modification, and calories consumption calculated by the food frequency questionnaire and correlate them with the metabolic parameters, namely blood glucose, HbA1c, lipid profile, and cardiovascular parameters as heart rate variability and carotid intima media thickness (CIMT) among the prediabetics. Methods: An experimental interventional study was carried out in the Department of Physiology and Medicine at the RUHS College of Medical Sciences and Associated Group of Hospitals. The assessments were done at baseline and after 6 months of post-dietary modification. The total duration of the study was 6 months. A total of 250 prediabetic subjects were enrolled. Study Group A (n = 125) was engaged in dietary modification, whereas Group B (n = 125) was considered as control. The dietary assessment was done by a food frequency questionnaire. Result: After dietary modification, a decrease in the body mass index (1.3%), systolic blood pressure (3.1%), diastolic blood pressure (3.1%), blood glucose (2.8%), triglyceride (2.8%), high density lipoprotein (0.9%), HbA1c (2%), cholesterol (1.4%), and low-frequency/high-frequency ratios (1%), carotid intima media thickness (1.6%), as compared to control, was noticed after 6 months of dietary modification. Conclusion: This study suggested that prediabetics required health education including nutritional education as diet modification can play an important role to encourage diabetes-onset prevention and its related complications. The health-care providers and workers should increase the awareness about the importance of diet and encourage the prediabetics toward a healthy lifestyle, which may help in the quality of life and appropriate self-care, primary prevention of diabetes and its complications. CTRI Registration: CTRI/2017/06/008825.
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Sadeghi F, Amanat S, Bakhtiari M, Asadimehr H, Okhovat MA, Hosseinzadeh M, Mazloomi SM, Gholamalizadeh M, Doaei S. The effects of high fructose fruits and honey on the serum level of metabolic factors and nonalcoholic fatty liver disease. J Diabetes Metab Disord 2021; 20:1647-1654. [PMID: 34900816 DOI: 10.1007/s40200-021-00916-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 10/09/2021] [Indexed: 12/31/2022]
Abstract
Introduction The effect of the natural sources of fructose such as high fructose fruits and honey on the risk of fatty liver is still challenging. This study aimed to compare the effect of fructose, high fructose fruits, and honey on the metabolic factors and non-alcoholic fatty liver disease (NAFLD). Methods Forty-four rats were divided into four groups including normal diet group, high fructose group (HF), high fructose fruits group (HFF), and honey group (HO). After 120 days of intervention, the levels of insulin resistance, hepatic enzyme, and lipid profile were measured. Also, the expression levels of the acetyl-coA carboxylase (ACC), sterol regulatory element-binding protein 1c (SREBP-1c), Interleukin 6 (IL-6), and transforming growth factor-beta (TGF-β) genes were assessed. In addition, a histopathologic assessment was performed on liver tissues. Results Insulin resistance (IR) increased significantly in the HF, HFF, and HO groups (All P < 0.05). The levels of liver enzymes was significantly increased only in the group receiving the HF regimen (P < 0.01). A significant decrease in total cholesterol and HDL-C (high density lipoprotein cholesterol) levels was found in HO group compared to the control group (P < 0.05). The expression levels of ACC and SREBP-1c genes in HF, HFF, and HO groups were significantly higher than the control group (All P < 0.05). The HF group had a greater increase in the level of gene expression of IL-6 and TGF-β (All P < 0.05). Histopathological assessment did not find any changes in fatty liver formation and inflammatory damage. Conclusion Consumption of fructose-rich honey and fruits improved the status of inflammatory markers and liver enzymes compared with the industrial fructose-rich products.
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Affiliation(s)
- Fatemeh Sadeghi
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sasan Amanat
- Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran
| | - Mohammad Bakhtiari
- Department of Anatomical Sciences, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mohammad Ali Okhovat
- Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masood Hosseinzadeh
- Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mohammad Mazloomi
- Nutrition Research Center, Department of Food Hygiene and Quality Control, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Gholamalizadeh
- Student Research Committee, Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeid Doaei
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al-Zahra Hospital, School of Health, Guilan University of Medical Sciences, Rasht, Iran
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Connolly EL, Sim M, Travica N, Marx W, Beasy G, Lynch GS, Bondonno CP, Lewis JR, Hodgson JM, Blekkenhorst LC. Glucosinolates From Cruciferous Vegetables and Their Potential Role in Chronic Disease: Investigating the Preclinical and Clinical Evidence. Front Pharmacol 2021; 12:767975. [PMID: 34764875 PMCID: PMC8575925 DOI: 10.3389/fphar.2021.767975] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/11/2021] [Indexed: 01/04/2023] Open
Abstract
An increasing body of evidence highlights the strong potential for a diet rich in fruit and vegetables to delay, and often prevent, the onset of chronic diseases, including cardiometabolic, neurological, and musculoskeletal conditions, and certain cancers. A possible protective component, glucosinolates, which are phytochemicals found almost exclusively in cruciferous vegetables, have been identified from preclinical and clinical studies. Current research suggests that glucosinolates (and isothiocyanates) act via several mechanisms, ultimately exhibiting anti-inflammatory, antioxidant, and chemo-protective effects. This review summarizes the current knowledge surrounding cruciferous vegetables and their glucosinolates in relation to the specified health conditions. Although there is evidence that consumption of a high glucosinolate diet is linked with reduced incidence of chronic diseases, future large-scale placebo-controlled human trials including standardized glucosinolate supplements are needed.
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Affiliation(s)
- Emma L Connolly
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Marc Sim
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.,Medical School, Royal Perth Hospital Research Foundation, The University of Western Australia, Perth, WA, Australia
| | - Nikolaj Travica
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Wolfgang Marx
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Gemma Beasy
- Quadram Institute Bioscience, Norwich, United Kingdom
| | - Gordon S Lynch
- Department of Anatomy and Physiology, Centre for Muscle Research, School of Biomedical Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Catherine P Bondonno
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.,Medical School, Royal Perth Hospital Research Foundation, The University of Western Australia, Perth, WA, Australia
| | - Joshua R Lewis
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.,Medical School, Royal Perth Hospital Research Foundation, The University of Western Australia, Perth, WA, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Jonathan M Hodgson
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.,Medical School, Royal Perth Hospital Research Foundation, The University of Western Australia, Perth, WA, Australia
| | - Lauren C Blekkenhorst
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.,Medical School, Royal Perth Hospital Research Foundation, The University of Western Australia, Perth, WA, Australia
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Sun H, Dong H, Zhang Y, Lan X, Pang X, Cai C, Bai D, Zhang J, Li F, Zeng G. Specific fruit but not total fruit intake during early pregnancy is inversely associated with gestational diabetes mellitus risk: a prospective cohort study. Public Health Nutr 2021; 24:4054-4063. [PMID: 33947494 PMCID: PMC10195381 DOI: 10.1017/s1368980021001920] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/26/2021] [Accepted: 04/29/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Fruit intake may influence gestational diabetes mellitus (GDM) risk. However, prospective evidence remains controversial and limited. The current study aimed to investigate whether total fruit and specific fruit intake influence GDM risk. DESIGN A prospective cohort study was conducted. Dietary information was collected by a 3-d 24-h dietary recall. All participants underwent a standard 75-g oral glucose tolerance test at 24-28 gestational weeks. Log-binomial models were used to estimate the association between fruit intake and GDM risk, and the results are presented as relative risks (RR) and 95 % CI. SETTING Southwest China. PARTICIPANTS Totally, 1453 healthy pregnant women in 2017. RESULTS Total fruit intake was not associated with lower GDM risk (RR of 1·03 (95 % CI 0·83, 1·27) (Ptrend = 0·789)). The RR of GDM risk was 0·73 for the highest anthocyanin-rich fruit intake quartile compared with the lowest quartile (95 % CI 0·56, 0·93; Ptrend = 0·015). A higher grape intake had a linear inverse association with GDM risk (Q4 v. Q1: RR = 0·65; 95 % CI 0·43, 0·98; Ptrend = 0·044), and after further adjustment for anthocyanin intake, the inverse association tended to be non-linear (Q4 v. Q1: RR = 0·65; 95 % CI 0·44, 0·98; Ptrend = 0·079). However, we did not find an association between glycaemic index-grouped fruit, glycaemic load-grouped fruit or other fruit subtype intake and GDM risk. CONCLUSIONS In conclusion, specific fruit intake (particularly anthocyanin-rich fruit and grapes) but not total fruit intake was inversely associated with GDM risk.
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Affiliation(s)
- Hong Sun
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Hongli Dong
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Yiqi Zhang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Xi Lan
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Xinxin Pang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Congjie Cai
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Dan Bai
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Ju Zhang
- Department of Clinical Nutrition, Sichuan Provincial Hospital for Women and Children, Chengdu, SC, People’s Republic of China
| | - Fei Li
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
| | - Guo Zeng
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin Nan Road, Chengdu, SC610041, People’s Republic of China
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Jia X, Xuan L, Dai H, Zhu W, Deng C, Wang T, Li M, Zhao Z, Xu Y, Lu J, Bi Y, Wang W, Chen Y, Xu M, Ning G. Fruit intake, genetic risk and type 2 diabetes: a population-based gene-diet interaction analysis. Eur J Nutr 2021; 60:2769-2779. [PMID: 33399975 PMCID: PMC8275558 DOI: 10.1007/s00394-020-02449-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 11/24/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE Whether the association between fruit and type 2 diabetes (T2D) is modified by the genetic predisposition of T2D was yet elucidated. The current study is meant to examine the gene-dietary fruit intake interactions in the risk of T2D and related glycemic traits. METHODS We performed a cross-sectional study in 11,657 participants aged ≥ 40 years from a community-based population in Shanghai, China. Fruit intake information was collected by a validated food frequency questionnaire by asking the frequency of consumption of typical food items over the previous 12 months. T2D-genetic risk score (GRS) was constructed by 34 well established T2D common variants in East Asians. The risk of T2D, fasting, 2 h-postprandial plasma glucose, and glycated hemoglobin A1c associated with T2D-GRS and each individual single nucleotide polymorphisms (SNPs) were tested. RESULTS The risk of T2D associated with each 1-point of T2D-GRS was gradually decreased from the lower fruit intake level (< 1 times/week) [the odds ratio (OR) and 95% confidence interval (CI) was 1.10 (1.07-1.13)], to higher levels (1-3 and > 3 times/week) [the corresponding ORs and 95% CIs were 1.08 (1.05-1.10) and 1.07 (1.05-1.08); P for interaction = 0.04]. Analyses for associations with fasting, 2 h-postprandial plasma glucose and glycated hemoglobin A1c demonstrated consistent tendencies (all P for interaction ≤ 0.03). The inverse associations of fruit intake with risk of T2D and glucose traits were more prominent in the higher T2D-GRS tertile. CONCLUSIONS Fruit intakes interact with the genetic predisposition of T2D on the risk of diabetes and related glucose metabolic traits. Fruit intake alleviates the association between genetic predisposition of T2D and the risk of diabetes; the association of fruit intake with a lower risk of diabetes was more prominent in population with a stronger genetic predisposition of T2D.
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Affiliation(s)
- Xu Jia
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liping Xuan
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huajie Dai
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Zhu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chanjuan Deng
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Cao Z, Wong MY. Moment estimation method of parameters in additive measurement error model. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 206:106090. [PMID: 33964801 DOI: 10.1016/j.cmpb.2021.106090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In nutritional epidemiology, covariates in some studies such as the EPIC are prone to measurement error. Estimation of unknown parameters in most measurement error models for food frequency questionnaire (FFQ) and nutrient biomarkers requires replicated measurements. But, the EPIC-InterAct Study did not collect replicated measurements for FFQ or 24-hour dietary recalls (24HR). The method of correcting measurement error in this case is worth studying. METHODS A moment method is applied to estimate unknown parameters of the proposed error model with correlated errors between biased measurements of FFQ and 24HR. Then, correction factor and reliability ratio of each error-prone nutrient can be obtained correspondingly. Afterwards, regression calibration (RC) under a Cox model is used to correct measurement error of nutrients of interest in the EPIC-InterAct data. RESULTS Compared to the naive estimation, estimation results for dietary intakes could be very different when we take measurement error into consideration. Using RC as the correction method, hazard ratios (HR) of vegetable plus fruit, fat and energy for males become 1.01 (95% CI 0.75-1.35), 1.30 (95% CI 1.12-1.51) and 1.16 (95% CI 1.04-1.28), respectively, and HR of energy for females becomes 0.99 (95% CI 0.91-1.08). These HRs are greatly different from those by naive estimation. CONCLUSIONS Although there is no repeated measurement for FFQ and 24HR, we can still estimate all unknown parameters in our proposed error model under four assumptions and then correct measurement error in nutrients of interest in EPIC-InterAct Study by RC for avoiding some misleading results from naive estimation.
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Affiliation(s)
- Zhiqiang Cao
- College of Big Data and Internet, Shenzhen Technology University, Shenzhen, PR China.
| | - Man Yu Wong
- Department of Mathematics, The Hong Kong University of Science and Technology, Hong Kong SAR, PR China
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Assessment of dietary intake of bioactive food compounds according to income level in the Brazilian population. Br J Nutr 2021; 127:1232-1239. [PMID: 34100352 DOI: 10.1017/s0007114521001987] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
There is an inverse association between bioactive compounds intake and disease risk. The knowledge of its consumption according to socio-economic strata is important, which allows identification of potential intervention targets. Thus, we aimed to investigate bioactive compounds intake according to income level in Brazilian population. Data were obtained from the Brazilian Household Budget Survey, a cross-sectional survey which included data on individual food intake of 34,003 subjects aged 10 years and over collected using two 24-h dietary records. Polyphenol and carotenoid content of foods was identified using published databases. Total polyphenol and carotenoid intake were determined according to per capita income, as well as main food sources. Total polyphenols and flavonoids intake increased with income level, and subjects with lower income showed higher phenolic acids intake than individuals in highest income (p = 0.0001). Total carotenoids and classes intake (with exception to β-cryptoxanthin and zeaxanthin) were higher among subjects in highest income quartile, compared to the lowest quartile (p = 0.0001). Coffee was major source to total polyphenols and phenolic acids intake, and orange juice was main flavonoid provider in individuals from all income levels. In the upper income quartile, total carotenoid was supplied mainly by tomato and kale, and fruits had important contribution to carotenoid intake in the lowest income quartile. There is important influence of income level on diet quality regarding intake of foods with bioactive compounds, and individuals with lower income may experience lower quality diets due to less availability of foods with bioactive compounds.
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Sayegh M, Henderson J, Farquharson AJ, Horgan G, Ranawana V, Drew JE. Inter-Individual Variation in Postprandial Glycemic Responses in Women Co-Ingesting Green Leafy Vegetables with a Carbohydrate Meal: Interactions with the Sirtuin System. Mol Nutr Food Res 2021; 65:e2000923. [PMID: 33852192 DOI: 10.1002/mnfr.202000923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/17/2021] [Indexed: 11/12/2022]
Abstract
SCOPE Green leafy vegetables (GLV) may improve postprandial glycemic responses (PGR) and metabolic health. However, inter-individual variations (IIV) preclude conclusive evidence. Sirtuin system is emerging as a key player in blood glucose control. This study investigates IIV in PGR in women co-ingesting GLV with a carbohydrate meal and interactions with the sirtuin system. METHODS AND RESULTS Volunteers (n = 31 women) consume rice, rice with bok choy, or spinach (75g available carbohydrate) on separate occasions. Postprandial glucose, insulin, adropin, and lipid levels are measured. Anthropometric measurements and sex hormones are measured. GeXP assay measures whole blood postprandial gene expression profiles of 25 markers involved in sirtuin signaling. GLV consumption has no significant effect on PGR, which shows high variation. PGR correlated with age, but no other consistent associations are observed. Sirtuin gene expression profiles reveal distinct stratified subgroups associated with PGR, lipid, insulin, fat mass, waist/hip circumferences, and adropin levels. CONCLUSION PGR to co-ingesting GLV with a carbohydrate meal are highly variable in this cohort and fail to reveal a significant reduction in PGR. Variable responses are largely independent of menopausal status and meal consumed. However, lower expression of sirtuin gene targets is associated with higher PGR and with markers linked to health status.
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Affiliation(s)
- Marietta Sayegh
- The Rowett Institute, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Jaye Henderson
- The Rowett Institute, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Andrew J Farquharson
- The Rowett Institute, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Graham Horgan
- Biomathematics and Statistics Scotland, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Viren Ranawana
- The Rowett Institute, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Janice E Drew
- The Rowett Institute, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK
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Strong and Bitter Vegetables from Traditional Cultivars and Cropping Methods Improve the Health Status of Type 2 Diabetics: A Randomized Control Trial. Nutrients 2021; 13:nu13061813. [PMID: 34073610 PMCID: PMC8227621 DOI: 10.3390/nu13061813] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 12/14/2022] Open
Abstract
Vegetables rich in bitter-tasting phytochemicals may exert enhanced beneficial effects against key factors associated with type two diabetes (T2D). This study investigates whether selected cultivars of bitter and strong-tasting (BST) Brassica and root vegetables exert greater health benefits on T2D patients compared to equivalent modern mild and sweet tasting (MST) vegetables. A 12-week randomized, controlled, parallel intervention study involved 92 T2D patients, who were allocated three different diets: (1) 500 g daily of bitter and strong-tasting (BST) vegetables; (2) 500 g daily of mild and sweet-tasting (MST) vegetables; (3) 120 g daily MST normal diet (control). Both vegetable diets contained root vegetables and cabbages selected based on sensory differences and content of phytochemicals. Prior to and after the study, all participants underwent an oral glucose tolerance test (OGTT), 24 h blood pressure measurements, DEXA scans, and fasted blood samples. Both diets high in vegetables significantly reduced the participants' BMI, total body fat mass, and HbA1c levels compared to control, but in the BST group, significant differences were also found regarding incremental area under the curve glucose 240 min (OGTT) and fasting glucose levels. A high daily intake of root vegetables and cabbages showed significant health improvements in both vegetable groups. BST vegetables had the greatest impact on insulin sensitivity, body fat mass, and blood pressure compared to control; moreover, they further improved glycemic control compared to MST vegetables.
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Higher intakes of fruits and vegetables are related to fewer menopausal symptoms: a cross-sectional study. ACTA ACUST UNITED AC 2021; 27:593-604. [PMID: 32068682 DOI: 10.1097/gme.0000000000001511] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The aim of this study was to explore the associations between fruit and vegetable (FV) intake, and its subgroups and menopausal symptoms along with its subtypes in postmenopausal women. METHODS This cross-sectional study included 393 postmenopausal women in municipality health centers in the south of Tehran, Iran. Sociodemographic data, dietary intakes, and anthropometric measures were obtained from individuals. Menopause rating scale (MRS) questionnaire was employed to measure menopausal symptoms. The total MRS score (TMRSS) was the sum of the somatic score (SS), psychological score (PS), and urogenital score (US). Participants were divided into low and high total MRS and its domain scores. RESULTS After adjustment for confounding variables, an inverse relationship was found between total FV with TMRSS (odds ratio [OR] 0.23, 95% confidence interval [CI] 0.06-0.81) and SS (OR 0.30, 95% CI 0.11-0.82). In addition, the consumption of total fruits was significantly related to lower SS (OR 0.27, 95% CI 0.10-0.71). Only intake of citrus fruits was inversely associated with TMRSS (OR 0.23, 95% CI 0.07-0.71) and SS (OR 0.28, 95% CI 0.11-0.70). Likewise, intakes of total FV (OR 2.46, 95% CI 1.37-4.41), total vegetables (OR 2.54, 95% CI 1.10-5.88), green leafy vegetables (OR 3.59, 95% CI 1.47-8.75), dark yellow vegetables (OR 2.28, 95% CI 1.00-5.18), other vegetables (OR 5.23, 95% CI 1.17-15.39), and citrus fruits were linked to higher US (OR 4.35, 95% CI 1.77-10.71). CONCLUSION The results of the present study showed that some FV subgroups had inverse associations with climacteric symptoms, whereas higher intake of some subgroups of FV appeared to be associated with more urogenital symptoms in postmenopausal women.
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Wang DD, Li Y, Bhupathiraju SN, Rosner BA, Sun Q, Giovannucci EL, Rimm EB, Manson JE, Willett WC, Stampfer MJ, Hu FB. Fruit and Vegetable Intake and Mortality: Results From 2 Prospective Cohort Studies of US Men and Women and a Meta-Analysis of 26 Cohort Studies. Circulation 2021; 143:1642-1654. [PMID: 33641343 PMCID: PMC8084888 DOI: 10.1161/circulationaha.120.048996] [Citation(s) in RCA: 217] [Impact Index Per Article: 54.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 12/17/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The optimal intake levels of fruit and vegetables for maintaining long-term health are uncertain. METHODS We followed 66 719 women from the Nurses' Health Study (1984-2014) and 42 016 men from the Health Professionals Follow-up Study (1986-2014) who were free from cardiovascular disease (CVD), cancer, and diabetes at baseline. Diet was assessed using a validated semiquantitative food frequency questionnaire at baseline and updated every 2 to 4 years. We also conducted a dose-response meta-analysis, including results from our 2 cohorts and 24 other prospective cohort studies. RESULTS We documented 33 898 deaths during the follow-up. After adjustment for known and suspected confounding variables and risk factors, we observed nonlinear inverse associations of fruit and vegetable intake with total mortality and cause-specific mortality attributable to cancer, CVD, and respiratory disease (all Pnonlinear<0.001). Intake of ≈5 servings per day of fruit and vegetables, or 2 servings of fruit and 3 servings of vegetables, was associated with the lowest mortality, and above that level, higher intake was not associated with additional risk reduction. In comparison with the reference level (2 servings/d), daily intake of 5 servings of fruit and vegetables was associated with hazard ratios (95% CI) of 0.87 (0.85-0.90) for total mortality, 0.88 (0.83-0.94) for CVD mortality, 0.90 (0.86-0.95) for cancer mortality, and 0.65 (0.59-0.72) for respiratory disease mortality. The dose-response meta-analysis that included 145 015 deaths accrued in 1 892 885 participants yielded similar results (summary risk ratio of mortality for 5 servings/d=0.87 [95% CI, 0.85-0.88]; Pnonlinear<0.001). Higher intakes of most subgroups of fruits and vegetables were associated with lower mortality, with the exception of starchy vegetables such as peas and corn. Intakes of fruit juices and potatoes were not associated with total and cause-specific mortality. CONCLUSIONS Higher intakes of fruit and vegetables were associated with lower mortality; the risk reduction plateaued at ≈5 servings of fruit and vegetables per day. These findings support current dietary recommendations to increase intake of fruits and vegetables, but not fruit juices and potatoes.
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Affiliation(s)
- Dong D. Wang
- Channing Division for Network Medicine, Brigham and Women’s Hospital and Harvard Medical School
- The Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Yanping Li
- The Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Shilpa N. Bhupathiraju
- Channing Division for Network Medicine, Brigham and Women’s Hospital and Harvard Medical School
- The Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Bernard A. Rosner
- Channing Division for Network Medicine, Brigham and Women’s Hospital and Harvard Medical School
- The Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Qi Sun
- Channing Division for Network Medicine, Brigham and Women’s Hospital and Harvard Medical School
- The Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Edward L. Giovannucci
- Channing Division for Network Medicine, Brigham and Women’s Hospital and Harvard Medical School
- The Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
- The Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Eric B. Rimm
- Channing Division for Network Medicine, Brigham and Women’s Hospital and Harvard Medical School
- The Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
- The Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - JoAnn E. Manson
- Channing Division for Network Medicine, Brigham and Women’s Hospital and Harvard Medical School
- The Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
- The Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School
| | - Walter C. Willett
- Channing Division for Network Medicine, Brigham and Women’s Hospital and Harvard Medical School
- The Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
- The Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Meir J. Stampfer
- Channing Division for Network Medicine, Brigham and Women’s Hospital and Harvard Medical School
- The Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
- The Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Frank B. Hu
- Channing Division for Network Medicine, Brigham and Women’s Hospital and Harvard Medical School
- The Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
- The Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
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Owen EJ, Patel S, Flannery O, Dew TP, O'Connor LM. Derivation and Validation of a Total Fruit and Vegetable Intake Prediction Model to Identify Targets for Biomarker Discovery Using the UK National Diet and Nutrition Survey. J Nutr 2021; 151:962-969. [PMID: 33484153 DOI: 10.1093/jn/nxaa406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/21/2020] [Accepted: 11/23/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Dietary assessments in research and clinical settings are largely reliant on self-reported questionnaires. It is acknowledged that these are subject to measurement error and biases and that objective approaches would be beneficial. Dietary biomarkers have been purported as a complementary approach to improve the accuracy of dietary assessments. Tentative biomarkers have been identified for many individual fruits and vegetables (FVs), but an objective total FV intake assessment tool has not been established. OBJECTIVES To derive and validate a prediction model of total FV intake (TFVpred) to inform future biomarker studies. METHODS Data from the National Diet and Nutrition Survey (NDNS) were used for this analysis. A modeling group (MG) consisting of participants aged >11 years from the NDNS years 5-6 was created (n = 1746). Intake data for 96 FVs were analyzed by stepwise regression to derive a model that satisfied 3 selection criteria: SEE ≤80, R2 >0.7, and ≤10 predictors. The TFVpred model was validated using comparative data from a validation group (VG) created from the NDNS years 7-8 (n = 1865). Pearson's correlation coefficients were assessed between observed and predicted values in the MG and VG. Bland-Altman plots were used to assess agreement between TFVpred estimates and total FV intake. RESULTS A TFVpred model, comprised of tomatoes, apples, carrots, bananas, pears, strawberries, and onions, satisfied the selection criteria (R2 = 0.761; SEE = 78.81). Observed and predicted total FV intake values were positively correlated in the MG (r = 0.872; P < 0.001; R2 = 0.761) and the VG (r = 0.838; P < 0.001; R2 = 0.702). In the MG and VG, 95.0% and 94.9%, respectively, of TFVpred model residuals were within the limits of agreement. CONCLUSIONS Intakes of a concise FV list can be used to predict total FV intakes in a UK population. The individual FVs included in the TFVpred model present targets for biomarker discovery aimed at objectively assessing total FV intake.
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Affiliation(s)
- Elliot J Owen
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom.,Future Food Beacon of Excellence, University of Nottingham, Sutton Bonington, United Kingdom
| | - Sumaiya Patel
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Orla Flannery
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Tristan P Dew
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom.,Future Food Beacon of Excellence, University of Nottingham, Sutton Bonington, United Kingdom.,School of Biosciences, University of Nottingham, Sutton Bonington, United Kingdom
| | - Laura M O'Connor
- Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
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Morze J, Danielewicz A, Przybyłowicz K, Zeng H, Hoffmann G, Schwingshackl L. An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer. Eur J Nutr 2021; 60:1561-1586. [PMID: 32770356 PMCID: PMC7987633 DOI: 10.1007/s00394-020-02346-6] [Citation(s) in RCA: 205] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/21/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE The aim of current systematic review was to update the body of evidence on associations between adherence to the Mediterranean diet (MedDiet) and risk of cancer mortality, site-specific cancer in the general population; all-cause, and cancer mortality as well as cancer reoccurrence among cancer survivors. METHODS A literature search for randomized controlled trials (RCTs), case-control and cohort studies published up to April 2020 was performed using PubMed and Scopus. Study-specific risk estimates for the highest versus lowest adherence to the MedDiet category were pooled using random-effects meta-analyses. Certainty of evidence from cohort studies and RCTs was evaluated using the NutriGrade scoring system. RESULTS The updated search revealed 44 studies not identified in the previous review. Altogether, 117 studies including 3,202,496 participants were enclosed for meta-analysis. The highest adherence to MedDiet was inversely associated with cancer mortality (RRcohort: 0.87, 95% CI 0.82, 0.92; N = 18 studies), all-cause mortality among cancer survivors (RRcohort: 0.75, 95% CI 0.66, 0.86; N = 8), breast (RRobservational: 0.94, 95% CI 0.90, 0.97; N = 23), colorectal (RRobservational: 0.83, 95% CI 0.76, 0.90; N = 17), head and neck (RRobservational: 0.56, 95% CI 0.44, 0.72; N = 9), respiratory (RRcohort: 0.84, 95% CI 0.76, 0.94; N = 5), gastric (RRobservational: 0.70, 95% CI 0.61, 0.80; N = 7), bladder (RRobservational: 0.87, 95% CI 0.76, 0.98; N = 4), and liver cancer (RRobservational: 0.64, 95% CI 0.54, 0.75; N = 4). Adhering to MedDiet did not modify risk of blood, esophageal, pancreatic and prostate cancer risk. CONCLUSION In conclusion, our results suggest that highest adherence to the MedDiet was related to lower risk of cancer mortality in the general population, and all-cause mortality among cancer survivors as well as colorectal, head and neck, respiratory, gastric, liver and bladder cancer risks. Moderate certainty of evidence from cohort studies suggest an inverse association for cancer mortality and colorectal cancer, but most of the comparisons were rated as low or very low certainty of evidence.
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Affiliation(s)
- Jakub Morze
- Department of Cardiology and Internal Diseases, University of Warmia and Mazury, al. Warszawska 30, 10-082, Olsztyn, Poland.
- Department of Human Nutrition, University of Warmia and Mazury, ul. Sloneczna 45f, 10-718, Olsztyn, Poland.
| | - Anna Danielewicz
- Department of Human Nutrition, University of Warmia and Mazury, ul. Sloneczna 45f, 10-718, Olsztyn, Poland
| | - Katarzyna Przybyłowicz
- Department of Human Nutrition, University of Warmia and Mazury, ul. Sloneczna 45f, 10-718, Olsztyn, Poland
| | - Hongmei Zeng
- National Cancer Registry Office, National Cancer Center, 17 South Lane, Beijing, 100021, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Building 2, Boston, MA, 02551, USA
| | - Georg Hoffmann
- Department of Nutritional Sciences, University of Vienna, Althanstraße 14, UZA II, 1090, Vienna, Austria
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Straße 153, 79110, Freiburg, Germany
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Kumar PC, Oberoi HS, Azeez S. Basella- an Underutilized Green Leafy Vegetable with a Potential for Functional Food Development. FOOD REVIEWS INTERNATIONAL 2021. [DOI: 10.1080/87559129.2021.1874410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Pushpa Chethan Kumar
- Division of Post Harvest Technology and Agricultural Engineering, ICAR-Indian Institute of Horticultural Research, Bengaluru, India
| | - Harinder Singh Oberoi
- Division of Post Harvest Technology and Agricultural Engineering, ICAR-Indian Institute of Horticultural Research, Bengaluru, India
- Food Safety and Standards Authority of India, New Delhi, India
| | - Shamina Azeez
- Division of Basic Sciences, ICAR-Indian Institute of Horticultural Research, Bengaluru, India
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Griffiths K, Lee JJ, Frenneaux MP, Feelisch M, Madhani M. Nitrite and myocardial ischaemia reperfusion injury. Where are we now? Pharmacol Ther 2021; 223:107819. [PMID: 33600852 DOI: 10.1016/j.pharmthera.2021.107819] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/25/2021] [Indexed: 02/06/2023]
Abstract
Cardiovascular disease remains the leading cause of death worldwide despite major advances in technology and treatment, with coronary heart disease (CHD) being a key contributor. Following an acute myocardial infarction (AMI), it is imperative that blood flow is rapidly restored to the ischaemic myocardium. However, this restoration is associated with an increased risk of additional complications and further cardiomyocyte death, termed myocardial ischaemia reperfusion injury (IRI). Endogenously produced nitric oxide (NO) plays an important role in protecting the myocardium from IRI. It is well established that NO mediates many of its downstream functions through the 'canonical' NO-sGC-cGMP pathway, which is vital for cardiovascular homeostasis; however, this pathway can become impaired in the face of inadequate delivery of necessary substrates, in particular L-arginine, oxygen and reducing equivalents. Recently, it has been shown that during conditions of ischaemia an alternative pathway for NO generation exists, which has become known as the 'nitrate-nitrite-NO pathway'. This pathway has been reported to improve endothelial dysfunction, protect against myocardial IRI and attenuate infarct size in various experimental models. Furthermore, emerging evidence suggests that nitrite itself provides multi-faceted protection, in an NO-independent fashion, against a myriad of pathophysiologies attributed to IRI. In this review, we explore the existing pre-clinical and clinical evidence for the role of nitrate and nitrite in cardioprotection and discuss the lessons learnt from the clinical trials for nitrite as a perconditioning agent. We also discuss the potential future for nitrite as a pre-conditioning intervention in man.
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Affiliation(s)
- Kayleigh Griffiths
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Jordan J Lee
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Michael P Frenneaux
- Norwich Medical School, University of East Anglia, Bob Champion Research and Education Building, Norwich Research Park, Norwich NR4 7UQ, UK
| | - Martin Feelisch
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Melanie Madhani
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK.
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Gkouskou K, Lazou E, Skoufas E, Eliopoulos AG. Genetically Guided Mediterranean Diet for the Personalized Nutritional Management of Type 2 Diabetes Mellitus. Nutrients 2021; 13:nu13020355. [PMID: 33503923 PMCID: PMC7912380 DOI: 10.3390/nu13020355] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/20/2021] [Accepted: 01/20/2021] [Indexed: 12/29/2022] Open
Abstract
The current consensus for the prevention and management of type 2 diabetes mellitus (T2DM) is that high-quality diets and adherence to a healthy lifestyle provide significant health benefits. Remarkably, however, there is little agreement on the proportions of macronutrients in the diet that should be recommended to people suffering from pre-diabetes or T2DM. We herein discuss emerging evidence that underscores the importance of gene-diet interactions in the improvement of glycemic biomarkers in T2DM. We propose that we can achieve better glycemic control in T2DM patients by coupling Mediterranean diets to genetic information as a predictor for optimal diet macronutrient composition in a personalized manner. We provide evidence to support this concept by presenting a case study of a T2DM patient who achieved rapid glycemic control when adhered to a personalized, genetically-guided Mediterranean Diet.
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Affiliation(s)
- Kalliopi Gkouskou
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece; (E.L.); (E.S.)
- Embiodiagnostics Biology Research Company, 71305 Heraklion, Greece
- Correspondence: (K.G.); (A.G.E.); Tel.: +30-2107462356 (A.G.E.)
| | - Evgenia Lazou
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece; (E.L.); (E.S.)
| | - Efstathios Skoufas
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece; (E.L.); (E.S.)
| | - Aristides G. Eliopoulos
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece; (E.L.); (E.S.)
- Center for New Biotechnologies and Precision Medicine, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, Greece
- Center of Basic Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
- Correspondence: (K.G.); (A.G.E.); Tel.: +30-2107462356 (A.G.E.)
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