The prognostic nutritional index (PNI) is a prognostic nutritional-immune marker, but its association with long-term mortality and phenotypic aging among adults with a history of digestive system cancer is uncertain. We analyzed 338 adults with self-reported digestive system cancer in NHANES 1999-2010 and 2015-2018. PNI was modeled continuously and using sample-derived categories (<= 48, >48-52, and >52). In the fully adjusted Cox model, each 1-unit higher PNI was associated with lower all-cause mortality (hazard ratio [HR], 0.91; 95% confidence interval [CI], 0.88-0.95), while HRs were 0.47 (0.31-0.70) and 0.42 (0.28-0.62) for the middle and highest categories versus the lowest. Restricted cubic splines indicated nonlinearity, with the main separation occurring between the lowest category and the two higher categories. PNI correlated inversely with PhenoAgeAccel (Spearman rho = -0.241). Exploratory pathway analysis suggested an indirect-effect component through PhenoAgeAccel; after removing albumin-and lymphocyte-related terms from the aging construct, the estimated indirect-effect proportion decreased from 26.3% to 16.1%. Higher PNI was associated with lower mortality, but the sample-derived thresholds and aging-pathway findings require cautious, noncausal interpretation.
While the nutritional composition of fast food and consumption of highly processed or fast-food meals have been evaluated for colorectal cancer (CRC), the impact of fast-food consumption from fast-food restaurants and the residential proximity to fast-food outlets on the risk of CRC is unknown. This ongoing clinical case-control study includes 302 consented participants who self-reported their fast-food consumption while residential proximities to fast-food outlets at enrollment and retrospectively in the year 2015 were determined. Multivariable logistic regression models estimated the adjusted odds ratios (aORs) with a 95% confidence interval (CI) of CRC incidence associated with fast-food consumption frequency and residential proximity to fast-food outlets after adjusting for confounders. The data reflects that increased fast-food consumption was significantly associated with higher CRC incidence (aOR:2.25; 95%CI:1.16-3.97; p-value:0.01). Nonetheless, associations between CRC incidence and residential proximity to fast-food outlets were found to be statistically non-significant at enrollment (aOR:0.75; 95%CI:0.40-1.41; p-value:0.37) or in the year 2015 (aOR:0.57; 95%CI:0.26-1.26; p-value:0.16). Thus, while daily to weekly consumption of fast food may increase the risk of CRC, residing closer to a fast-food outlet was not associated with CRC incidence. Further epidemiologic studies are warranted to validate these findings, which together may help inform future dietary recommendations.
