Whether joint eating-timing configurations show comparable mortality associations across chronic diseases is uncertain. We analysed 26 712 adults aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES) 2005-2016 who had two reliable 24-h dietary recalls and mortality linkage. Participant-level mean first eating time and eating-window duration were standardised and classified by K-means. Survey-weighted Cox models incorporated strata and primary sampling units within six chronic disease domains; missing covariates were multiply imputed in thirty datasets and prespecified Benjamini-Hochberg false-discovery-rate families addressed multiplicity. Three patterns represented 30·2 % (early-start), 57·2 % (intermediate) and 12·6 % (late-start) of the weighted population. During 224 837·9 person-years, 3279 deaths occurred. None of the six all-cause mortality global tests met the prespecified false-discovery-rate threshold (all q ≥ 0·281). In the cancer domain, the late-start pattern yielded a higher estimated hazard of cancer mortality than early-start (hazard ratio 1·88, 95 % CI 1·15-3·06; P = 0·012), but the global q was 0·052 and pairwise q was 0·073. This association attenuated after exclusion of early deaths and was not reproduced in an independent Day 1 analysis. Proportional hazards were not supported in three models, for which estimates weakened or crossed the null over follow-up. Eating-timing patterns were not universal mortality predictors across chronic diseases. Their nutritional relevance appears context-dependent, and repeated timing assessments with clinical measures of disease severity are needed before these patterns can inform personalised nutritional care.
Abstract Epidemiologic evidence on the association between sugar-sweetened beverage (SSB) consumption and sleep-related symptoms or perceived stress remains limited, especially among middle-aged and older adults. This study examined the associations between SSB consumption and observed sleep apnoea, snoring, daytime tiredness and perceived stress among Korean adults aged 40 years and older. Cross-sectional data from the Korea National Health and Nutrition Examination Survey 2019–2023 were analysed ( n 17 255). SSB consumption was assessed via 24-h dietary recall and categorised as non-consumers, moderate consumers (Q1–Q3) and high consumers (Q4). Multivariable logistic regression with complex survey design adjustment was used to estimate OR and 95 % confidence intervals (CI). Among 17 255 participants (mean age 60·2 years, 57·5 % women), 10 169 (58·9 %) were SSB consumers. Compared with non-consumers ( n 7086), the highest intake group (Q4, n 2542) showed higher odds of observed sleep apnoea (OR 1·32; 95 % CI 1·09–1·60) and perceived stress (OR 1·23; 95 % CI 1·08–1·40). In sex-stratified analyses, the association with observed sleep apnoea was significant among men (OR 1·29; 95 % CI 1·04–1·60) but not women (OR 1·22; 95 % CI 0·89–1·67), although formal interaction analyses did not support significant effect modification by sex. Higher odds of perceived stress were observed in both men (OR 1·24; 95 % CI 1·02–1·50) and women (OR 1·22; 95 % CI 1·02–1·45). No significant associations were found for snoring or daytime tiredness. Higher SSB consumption was associated with observed sleep apnoea and perceived stress, and prospective studies are needed to clarify temporal relationships and underlying mechanisms.
Canada's food guide (CFG), updated in 2019, recommends choosing lower fat milk, fortified plant-based milk alternatives, and unsweetened beverages. This study examined trends in household purchases of dairy and plant-based beverages (PBBs), following CFG release, as well as price differences between beverage categories. NielsenIQ HomeScan data from 2018 to 2020 (∼4500 households/year) in Québec and Ontario were analyzed for annual purchases of total dairy beverages (milk, drinkable yogurt/kefir, milkshakes) and total PBBs (milk alternatives, plant-based drinkable yogurt/kefir). Product descriptions/Universal product codes (n=1451) were matched to online nutrition information. Mixed linear models examined changes in volume purchased over time, adjusting for household sociodemographic characteristics, and linear regressions examined price differences. On average, households purchased 97.0L of total dairy beverages and 8.8L of total PBBs annually, with 2% milk (45.7L) and almond beverages (4.9L) being the most purchased in these categories. Purchases of total dairy beverages, dairy beverages with added sugars, skim, 1%, and 2% milk were lower in 2019 than in 2018. However, purchases were higher in 2020 than in 2019 for total dairy beverages, 2% and whole milk, total PBBs, almond beverages, and "other" types of milk alternatives. Soy beverage purchases remained unchanged. Households with children purchased more dairy with added sugars and whole milk, and fewer PBBs. Differences by province, education, and ethnicity were also found. PBBs were slightly more expensive than dairy beverages ($0.23CAD/100ml vs $0.21CAD/100ml, p<0.01), with higher prices in Québec than Ontario. Overall, results suggest partial alignment with 2019 CFG recommendations.
The heterogeneity in associations between circulating fatty acids (FA) and mortality remained underexplored. Proteomics can profile the human physiological status. This study aimed to estimate interactions between FA and proteins in relation to mortality. We randomly divided 30,190 UK Biobank participants into train and test datasets. Multivariable Cox regression was utilized to assess the associations between FA and all-cause mortality and to explore proteome-wide interactions of FA in relation to mortality. Subgroup analyses were conducted to examine heterogeneity across varied protein levels. We also explored interactions between proteins and FA in relation to cause-specific mortality. We documented 3,345 deaths during 13.9 years of follow-up. MUFA-pct, Non-LA Omega-6 pct, Omega-6/Omega-3 ratio and SFA-pct were positively associated with all-cause mortality, while PUFA-pct, DHA-pct, LA-pct, and Omega-3-pct were negatively associated. We identified several robust interactions of proteins with MUFA-pct (n = 3), Omega-3-pct (n = 4), and Omega-6/Omega-3 ratio (n = 2). In subgroup analyses, individuals with high-level TNFRSF1B, MMP10, and CRHBP had higher all-cause mortality risks associated with MUFA-pct, while protective associations between Omega-3-pct and all-cause mortality were stronger among individuals with high-level TSPAN8, PLAU, ITGA5, and CEACAM1. Moreover, participants with high-level TSPAN8 and PLAU had higher risks of all-cause mortality with Omega-6/Omega-3 ratio. For cause-specific mortality, interaction and subgroup results were largely consistent with those of all-cause mortality. Our findings can provide new insights into heterogeneity in FA-mortality associations and highlight potential protein targets for personalized interventions across individuals with different physiological status.
Prospective evidence linking overall diet quality to gastroesophageal reflux disease (GERD) is limited, and metabolic pathways remain unclear. In a cohort of 183 878 adults free of GERD at baseline, we examined nine dietary pattern scores derived from repeated 24-h dietary recalls and assessed associations with incident GERD over a median follow-up of 13·2 years, during which 15 401 cases occurred. Higher adherence to healthy patterns including Mediterranean diet, Mediterranean-Dietary Approaches to Stop Hypertension Diet Intervention for Neurodegenerative Delay, Dietary Approaches to Stop Hypertension and dietary index for gut microbiota was associated with lower GERD risk (highest v. lowest tertile hazard ratios 0·87-0·89), whereas a pro-inflammatory pattern (Energy-adjusted Diet Inflammatory Index) was linked to higher risk (hazard ratio 1·11). In a metabolomics sub-cohort (N 98 669), diet-related NMR metabolomic signatures, derived from 168 biomarkers using Elastic Net regression, reflected similar associations and mediated 11·1-32·2 % of the diet-GERD relationship. Associations were largely consistent across subgroups and robust in sensitivity analyses, supporting a potential role of systemic metabolic profiles in mediating the effects of diet on GERD and highlighting metabolic mechanisms underlying diet-related disease risk.
The aim of this study was to provide robust evidence on the long-term use of non-nutritive sweetened (NNS) beverages on weight management, by comparing NNS beverages and water during 1 year of assisted weight management followed by a voluntary, unassisted 1-year extension. In this parallel-group, open-label, controlled equivalence trial, 493 adults with body mass index 27-35 kg/m2 who regularly consumed cold beverages were randomised 1:1 to water (n 246) or NNS beverages (n 247). Participants joined a group behavioural weight-management programme comprising assisted meetings weekly (12-week weight-loss phase) then monthly (40-week weight-maintenance phase), followed by unassisted monitoring for 52 weeks with a final meeting at week 104. The final 52 week unassisted phase was completed by 220 participants (water: n 117; NNS beverages: n 103), 27·7% of whom were NNS beverage-naïve (naïve was defined as NNS beverages comprising ≤ 25% of beverages in the 5 years before screening). In the unassisted monitoring phase, the primary endpoint was weight change from baseline at week 104 (equivalence: two-sided P > 0·05). Participants consuming water maintained a weight loss of 3·7 kg over 104 weeks, compared with 4·8 kg with NNS beverages; the between-group difference was not significant. After the final 52-week unassisted phase of the 104-week behavioural weight-management programme, water and NNS beverages showed equivalence regarding weight change from baseline. Our findings suggest people can lose weight, and maintain it for two years, when drinking either NNS beverages or water and taking part in weight-management programmes.
While 24-h dietary recalls (24HDR) are increasingly used to assess polyphenol-disease associations, their performance for measuring total dietary polyphenols and their subclasses remains unknown. In the Anhui Lifestyle Validation Study, 432 community-dwelling adults completed 12-d dietary recalls, structured as four seasonal sets of three consecutive 24HDR (2 weekdays and 1 weekend day each) between July 2021 and July 2022. Reproducibility of dietary total polyphenols, flavonoids, lignans and phenolic acids assessed by different number of non-consecutive 24HDR was evaluated by intraclass correlation coefficient (ICC). Relative validity was evaluated by comparing estimates from different numbers of 24HDR with the internal reference using deattenuated Spearman's correlation coefficients (rc). The reproducibility from two 24HDR was weak for these four polyphenol categories (ICC: 0·10-0·39), while three 24HDR yielded a reasonable reproducibility for total polyphenols (ICC: 0·40, 95 % CI 0·31-0·50), flavonoids (ICC: 0·42, 95 % CI 0·33-0·51) and phenolic acids (ICC: 0·45, 95 % CI 0·16-0·66), but not for lignans (ICC: 0·11, 95 % CI 0·01-0·26). Increasing days up to 4-6 seemed not to appreciably improve the reproducibility (ICC range: 0·13-0·17 for lignans, 0·41-0·56 for others). The relative validity against the internal reference of these four polyphenol categories was moderate for two 24HDR (rc: 0·50-0·74) and improved for ≥ 3 24HDR (r c : 0·76-1·00). Older age, female sex and weekend administration were associated with lower reproducibility of three 24HDR-based assessments of phenolic acids or flavonoids. Overall, our results suggest that three non-consecutive 24HDR may have acceptable performance in measuring most dietary polyphenol intake except for lignans.
Previous studies have suggested that a high intake of nuts may reduce the risk of hypertension, however, the available data have been limited. Several additional studies have recently been published on the topic. We therefore conducted a systematic review and meta-analysis of cohort studies on nut consumption and hypertension to provide an updated assessment of the evidence. PubMed and Embase databases were searched up to 4th April 2026 for prospective cohort studies with adjusted relative risk estimates published in the English language on the association between nut consumption and hypertension risk. Random effects models were used to estimate summary relative risks (RRs) and 95% confidence intervals (CIs) for the association between nut consumption and hypertension. We used World Cancer Research Fund (WCRF) criteria to assess the strength of the evidence. Eight studies (20,665 cases, x) were included in the meta-analysis. The summary RR for the highest vs. lowest category of nut intake was 0.84 (95% CI: 0.77-0.91, I2=50%, pheterogeneity=0.05, n=8) and per 28 g/d was 0.80 (95% CI: 0.71-0.89, I2=75%, pheterogeneity<0.0001, n=8). There was no indication of publication bias with Begg's test (p=0.71) or Egger's test (p=0.10) or by visual inspection of the funnel plot. There was some indication of nonlinearity (pnonlinearity=0.07) and there was a 26% reduction in risk when comparing 30g/d vs. 0 g/d. Using WCRF criteria to assess the strength of evidence, we graded the likelihood of causality as probable. In this meta-analysis of prospective cohort studies, we found further evidence for a reduced risk of hypertension with higher intake of nuts. These findings support dietary guideline recommendations to include a serving of nuts per day.
Omega-3 polyunsaturated fatty acids (PUFAs) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), possess anti-inflammatory properties, yet their association with obesity-depression comorbidity remains unclear. This study investigated the association among US adults and explored underlying mechanisms. We performed a cross-sectional analysis of 4,423 individuals participating in the National Health and Nutrition Examination Survey (NHANES) 2003-2004 & 2011-2014. Serum fatty acids were quantified by gas chromatography. Obesity was defined using anthropometric criteria, and depression was assessed using the PHQ-9 or antidepressant use. Multivariable logistic regression estimated odds ratios (ORs) per standard deviation (SD) increase in PUFA levels. Mechanistic explore through network pharmacology identified potential pathways, which were examined using correlation analyses with inflammatory indices. Higher omega-3 PUFA levels were associated with lower odds of central obesity comorbid depression in females (OR: 0.82, 95% CI: 0.69-0.96) and older adults (OR: 0.79, 95% CI: 0.64-0.97). DHA was significantly associated with lower odds of central obesity (OR: 0.83, 95% CI: 0.73-0.95), depressive symptoms (OR: 0.88, 95% CI: 0.77-1.00), and their comorbidity (OR: 0.85, 95% CI: 0.74-0.98), whereas no significant associations were found for EPA. Mechanistic exploration implicated DHA in TNF and IL-17 signaling pathways, supported by inverse correlations with monocyte-to-HDL ratio (r: -0.138, P < 0.001) and lymphocyte-to-HDL ratio (r: -0.108, P < 0.001). In conclusion, serum DHA is inversely associated with obesity-depression comorbidity, with potential involvement of anti-inflammatory pathways. These findings underscore the potential of DHA for the management of obesity comorbid depression and the need for further interventional trials.
Little is known about the combined association of physical activity (PA) and dietary quality (DQ) with stroke and its mortality outcomes. This study aims to investigate the individual and combined association of PA and DQ on odds of prevalent stroke and mortality among stroke survivors. We analysed data from 20 225 adults participating in the 2007-2018 National Health and Nutrition Examination Survey, including 838 stroke survivors. PA was measured by the self-reported metabolic equivalent to task (MET) minutes per week and DQ by Healthy Eating Index 2020 (HEI-2020). Logistic regression models evaluated associations with the odds of prevalent stroke, and Cox proportional hazards regression models assessed mortality risks among stroke survivors. Compared with no PA-lower DQ (reference), low PA-lower DQ (adjusted OR 0·49, 95 % CI 0·32-0·75), low PA-higher DQ (adjusted OR 0·56, 95 % CI 0·34-0·92), high PA-lower DQ (adjusted OR 0·66, 95 % CI 0·44-0·99) and high PA-higher DQ (adjusted OR 0·50, 95 % CI 0·34-0·73) were significantly associated with lower odds of stroke. Among stroke survivors, reduced mortality was observed for low PA-higher DQ (adjusted hazard ratio (HR) 0·43; 95 % CI 0·19-0·95), high PA-lower DQ (HR 0·36; 95 % CI 0·17-0·75) and high PA-higher DQ (HR 0·47; 95 % CI 0·27-0·83). This large observational study showed that a combination of appropriate PA and higher DQ is associated with reduced odds of stroke and mortality among stroke survivors. These findings support lifestyle modification as a strategy for stroke prevention and survivor care.
Lipopolysaccharide (LPS) has been implicated in increased gut permeability and low-grade mucosal inflammation, conditions that are linked to the pathophysiology of irritable bowel syndrome (IBS). Because increased dietary fat intake can both trigger IBS symptoms and promote LPS translocation in the gut, this study aimed to better understand how a turmeric formula (TF) affects fasting and postprandial LPS response, after a high-fat challenge in patients with IBS (primary outcome). Secondary outcomes included postprandial ApolipoproteinB48 (Apo-B48) and triglycerides (TG) as markers of chylomicron-mediated LPS translocation, as well as gastrointestinal (GI) symptoms and stool pattern. In this randomized, double-blind, placebo-controlled cross-over trial, eighteen patients with IBS completed two high-fat challenge tests after 3-day supplementation with either 300 mg TF or placebo. Blood was collected in the fasting state and up to 5 hours postprandially. Data were analyzed using repeated measures mixed models. TF did not significantly alter postprandial LPS levels compared with placebo but significantly reduced postprandial Apo-B48 and TG (mean ratios 0.82 and 0.87, p=0.04 and p=0.01, respectively). Fasting LPS and TG showed a non-significant reduction after TF (mean ratios 0.79 and 0.87; both p=0.06, respectively). No differences were observed in gastrointestinal symptoms or stool characteristics. To conclude, TF did not influence dietary fat-mediated LPS translocation, but it reduced postprandial chylomicron markers, indicating a potential attenuation of chylomicron-mediated postprandial inflammation. Together with the observed trend towards reduced fasting LPS levels, these findings suggest that TF might have beneficial effects on low-grade subclinical inflammation, which could be relevant for IBS patients.
Epidemiologic evidence on the association between sugar-sweetened beverage (SSB) consumption and sleep-related symptoms or perceived stress remains limited, especially among middle-aged and older adults. This study examined the associations between SSB consumption and observed sleep apnea, snoring, daytime tiredness, and perceived stress among Korean adults aged 40 years and older. Cross-sectional data from the Korea National Health and Nutrition Examination Survey 2019-2023 were analyzed (n = 17,255). SSB consumption was assessed via 24-hour dietary recall and categorized as non-consumers, moderate consumers (Q1-Q3), and high consumers (Q4). Multivariable logistic regression with complex survey design adjustment was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Among 17,255 participants (mean age 60.2 years, 57.5% women), 10,169 (58.9%) were SSB consumers. Compared with non-consumers (n = 7,086), the highest intake group (Q4, n = 2,542) showed higher odds of observed sleep apnea (OR 1.32; 95% CI 1.09-1.60) and perceived stress (OR 1.23; 95% CI 1.08-1.40). In sex-stratified analyses, the association with observed sleep apnea was significant among men (OR 1.29; 95% CI 1.04-1.60) but not women (OR 1.22; 95% CI 0.89-1.67), although formal interaction analyses did not support significant effect modification by sex. Higher odds of perceived stress were observed in both men (OR 1.24; 95% CI 1.02-1.50) and women (OR 1.22; 95% CI 1.02-1.45). No significant associations were found for snoring or daytime tiredness. Higher SSB consumption was associated with observed sleep apnea and perceived stress, and prospective studies are needed to clarify temporal relationships and underlying mechanisms.
Studies assessing potential differences in trace element status among vegans, lacto-ovo-vegetarians (LOV) and omnivores (OMN) are largely lacking. In this cross-sectional study, urinary levels of twelve elements were analysed in thirty-eight vegans, thirty-seven LOV and forty OMN. After adjustment for covariates, non-creatinine-adjusted As levels were lower in LOV (-54 %) and vegans (-54 %) compared with OMN (P = 0·009). Compared with OMN, vegans (but not LOV) had lower Hg (-48 %; P = 0·028) and higher Cd levels (+42 %; P = 0·023). Other elements (Al, Co, Cu, Pb, Mo, Ni, Tl, Sn and Zn) were similar between groups. Analyses normalised to urinary creatinine confirmed lower As levels in LOV (-63 %) and vegans (-59 %; P < 0·001), but suggested similar Hg and Cd levels in OMN, LOV and vegans, higher Co in LOV (+53 %; P = 0·035) and higher Cu in vegans (+17 %; P = 0·040). Trends (non-significant after adjustment for multiple testing) were noted for Ni (LOV: +119 %), Co (vegans: +43 %) and Zn (vegans: -26 %; compared with OMN). LOV and vegans had similar urinary levels (P ≥ 0·207). Urinary creatinine levels were similar across all groups (P ≥ 0·912). Eight additional elements were not detected (Bi, Au, In, Ir, Pd and Ag) or were detected only in a few samples (Pt and Zr). Overall, LOV and vegans exhibited a lower As burden than OMN. A higher Cd and lower Hg burden in vegans were not confirmed in creatinine-adjusted analyses. Similar studies are warranted to validate results. Biomonitoring studies may benefit from considering vegetarian status, particularly for As exposure.
Dyslipidaemia is associated with chronic low-grade inflammation and immune dysfunction, but the immunological effects of dietary phytosterols in humans remain unclear. We conducted a secondary analysis of an outcome-assessor-blinded, randomised controlled feeding trial to evaluate the effects of a high-phytosterol (HPS) diet, using phytosterol-enriched corn-wheat germ blended oil (CWGO), compared with a low-phytosterol (LPS) diet using peanut oil, on systemic inflammatory markers, humoural immune markers and peripheral blood lymphocyte subsets in Chinese adults with dyslipidaemia. After a 2-week run-in period, 104 participants were randomised to the HPS group (n 52) or the LPS group (n 52) for 12 weeks. In intention-to-treat analyses, the HPS group had a higher CD4+:CD8+ ratio at 12 weeks than the LPS group (adjusted mean difference: 0·561; 95 % CI 0·060, 1·063; P = 0·03) and a lower CD8+ T-cell count (adjusted mean difference: -116·315 cells/μl; 95 % CI -215·781, -16·849; P = 0·02). No significant between-group differences were observed for systemic inflammatory markers, humoral immune markers or most other lymphocyte subset outcomes. In per-protocol analyses, the difference in CD4+:CD8+ ratio remained significant, whereas the reduction in CD8+ T-cell count was attenuated. These exploratory findings suggest that a 12-week phytosterol-enriched CWGO intervention may be associated with changes in T-cell subset balance in adults with dyslipidaemia, although the results should be interpreted cautiously given the exploratory nature of this secondary analysis.
Dietary acid load (DAL), which reflects diet's overall acid-base balance, has been proposed to influence glucose metabolism; however, epidemiological findings on its relationship with diabetes risk remain inconsistent. While Western studies suggest that higher DAL is associated with higher diabetes risk, particularly among women, findings from East Asian populations have been inconsistent, particularly regarding sex-specific associations. The present prospective study examined the association between DAL and 5-year diabetes incidence among Japanese adults, focusing on sex-specific differences. Data were obtained from 19 040 participants (7037 men and 12 003 women) in the Japan Collaborative Cohort Study. DAL was estimated based on the potential renal acid load (PRAL) and net endogenous acid production (NEAP) derived from a validated food-frequency questionnaire. Odds ratios and 95 % confidence intervals for incident diabetes were estimated separately for men and women across PRAL and NEAP quartiles using multivariable logistic regression with multiple imputations for missing covariates. During follow-up, 490 new diabetes cases were identified (245 in each sex). Among women, higher DAL was significantly associated with a higher risk of diabetes; OR (95 % CI) from multivariable-adjusted model, including socio-demographic, lifestyle, health status and macronutrient covariates, comparing the highest with the lowest quartiles were 1·61 (1·09, 2·37) for PRAL and 1·72 (1·18, 2·52) for NEAP. No clear associations were observed among men. The findings provide a foundation for further studies in East Asian populations using more precise dietary assessment methods to clarify the association between DAL and incident diabetes and to inform dietary guidelines and preventive strategies.
This cross-sectional study examined the independent and combined associations of breakfast frequency, forced vital capacity (FVC) and psychological symptoms among Chinese adolescents. A total of 2776 adolescents aged 12-17 years were recruited from three regions of Anhui Province using stratified cluster random sampling. Breakfast frequency was self-reported as days per week over the past month and categorised as low, medium or high. FVC was measured with a standardised electronic spirometer (CSTF-FH) following CNSSCH (Chinese National Student Physical Fitness Survey) protocols. Psychological symptoms were assessed using the Multidimensional Subhealth Assessment Questionnaire for Adolescents (MSQA) and dichotomised according to established cut-offs. Covariates included age, height, weight, grip strength, standing long jump, sleep duration and parental education. Binary logistic regression was used, building three models. The overall prevalence of psychological symptoms was 14 %. Breakfast frequency was inversely correlated with psychological symptoms (P < 0·001). Low breakfast frequency (1-2 d/week) was associated with a higher symptom rate (31 %) than high frequency (5-7 d/week, 12 %) and increased odds of symptoms (OR = 3·34, 95 % CI 2·04, 5·60). No independent association was found between FVC and psychological symptoms. However, adolescents with both low breakfast frequency and low FVC had 4·10 times higher odds of psychological symptoms (95 % CI 1·83, 9·21, P < 0·001) than those with high breakfast frequency and high FVC. These findings suggest that low breakfast frequency is a robust correlate of psychological symptoms in adolescents, and that the combination of low breakfast frequency with low FVC identifies a particularly high-risk group.
Evidence suggests that plant-based dietary patterns - favouring plant-based foods without being strictly vegetarian or vegan - may prevent obesity and offer health benefits. Since not all plant-based foods are equally healthy, it is essential to distinguish between healthful and unhealthful plant-based options. This study aimed to analyse the associations between different plant-based dietary patterns and the incidence of obesity-related cancers. We followed-up 16 256 participants from the 'Seguimiento Universidad de Navarra' prospective cohort. Based on a validated FFQ, we calculated adapted overall, healthful and unhealthful plant-based diet index scores. Scores were assessed at baseline and repeatedly after 10 years of follow-up. Hazard ratios (HR) and 95 % CI were estimated using multivariable-adjusted time-dependent Cox regression models. After a median follow-up of 13 years, 221 incident obesity-related cancer cases were confirmed. Overall plant-based and unhealthful plant-based dietary patterns showed no association. Contrarily, participants in the highest tertile of the healthful plant-based diet score had a lower obesity-related cancer risk (HRT3vsT1 0·67; 95 % CI, 0·47, 0·97; Ptrend = 0·031). This association persisted after updating dietary information at 10-year follow-up (HRT3vsT1 0·68; 95 % CI, 0·47, 0·99; Ptrend = 0·037) and was stronger for women (HRT3vsT1 0·52; 95 % CI, 0·32, 0·86; pinteraction = 0·04). In this large prospective cohort, greater alignment with a healthful plant-based dietary pattern was associated with a decreased risk of obesity-related cancer, whereas alignment with overall and unhealthful plant-based dietary patterns showed no association.
Protein intake and the resulting postprandial aminoacidemia are important anabolic stimuli. However, considerable individual variation in postprandial amino acid (AA) kinetics can be expected. In this study, the aim was to quantify the variability in postprandial AA kinetics within and between individuals after consumption of a moderately digestible plant protein concentrate (lucerne (alfalfa), LPC) and an easily digestible animal protein concentrate (whey, WPC). Eighteen healthy young adults consumed a 20 g protein drink on five occasions (3xLPC; 2xWPC). Plasma AA kinetics were calculated, and a mixed model was fitted to describe within- and between-individual variability and to calculate the intra-class correlation coefficient (ICC). AA kinetics showed significant variation between and within individuals, both for WPC and LPC. Between-individual variation in postprandial response for total AA (TAA) or total essential AA (TEAA) was in general larger than within-individual variation for WPC with the ICC with or without blood volume (BV) correction ranging from 0·45 to 0·77. For LPC, the within-individual variation of the TAA response was higher than the between-individual variation, and for TEAA they were more or less equal, with the ICC with or without BV correction ranging from 0·34 to 0·58 for LPC. Subjects with a high level of aminoacidemia for one protein source were not necessarily those with a high level for the other protein source. Our results indicate that between- and within-person variation in postprandial AA kinetics are substantial and should not be neglected.
Deficiency in vitamin D can increase the risk of type 2 diabetes (T2D). Yet, the association between 25-hydroxyvitamin D (25(OH)D) levels and the serum proteome in subjects at risk of T2D remains unknown. This proteomic analysis aimed to examine the correlations between serum proteins and 25(OH)D levels stratified as insufficient (< 50 nmol/l), adequate (50-74·9 nmol/l) and optimal (≥ 75 nmol/l) and (2) to identify biological pathways linked to these proteins that may reduce T2D risk. In this cross-over study, twenty-five hyperinsulinaemic French-Canadian adults from the Quebec City metropolitan area (Canada) were evaluated at four timepoints: before and after 6 weeks of either adequate dairy intake (∼2 servings/d) or high dairy intake (≥ 4 servings/d). Serum 25(OH)D concentrations were measured using an immunoassay, and serum protein profiling was performed using liquid chromatography-tandem MS. Gene ontology analysis identified biological pathways. Dairy intake did not significantly change 25(OH)D serum levels. Nevertheless, in ten subjects with optimal 25(OH)D levels, positively correlated proteins were mainly involved in Ig-mediated immune response, regulation of blood coagulation, acute-phase response and adaptive immunity. Negatively correlated proteins were enriched in classical complement activation, innate immune response, acute-phase response and proteolysis. In six subjects with adequate 25(OH)D levels, correlated proteins were associated mainly with innate immune responses. No significant biological pathway enrichment was observed in subjects with insufficient 25(OH)D. Overall, individuals with higher or optimal serum 25(OH)D levels exhibit a greater number of proteins enriched in various immune system response pathways, processes known to influence T2D development.
Unhealthy food consumption is rising in rural South Asia, yet food environments in the region remain understudied. To address this gap, we characterised rural food environments and assessed how food affordability, accessibility, availability and desirability are associated with dietary patterns and quality in Bangladesh, India and Nepal. We used household (n 9711) and market (n 1646) data from the Transforming Agrifood Systems in South Asia (TAFSSA) survey conducted in five rural districts in 2023: Nalanda (India), Surkhet and Banke (Nepal) and Rangpur and Rajshahi (Bangladesh). Participants included adult women, men and adolescents. Primary outcomes included weekly consumption of twenty-five food items and Global Diet Quality Scores (GDQS): GDQS plus (0-32) and GDQS minus (0-17). Predictors included proximity to markets, food prices, vendor density, food availability and exposure to advertising or nutrition messaging. Multivariate regressions were used to assess associations and were adjusted for sociodemographic and household characteristics. Diets in these settings were characterised by low healthy food intake (GDQS plus scores ranged from 6·6 to 7·7) and high unhealthy food intake (GDQS minus scores from 9·3 to 11·7). Ultra-processed food vendors were present in > 80 % of villages. Snacking was the strongest predictor of both higher healthy (+1·11 GDQS plus) and unhealthy (-0·67 GDQS minus) food intake (P < 0·001), indicating that snacking increases overall dietary intake. Key predictors of suboptimal diets include low affordability of nutritious foods, alongside the widespread availability and desirability of inexpensive ultra-processed products. These findings highlight structural and behavioural drivers of rural dietary transitions and provide evidence to guide food system interventions aimed at improving nutrition in underserved populations.
