Nitrate and nitrite, present in foods and drinking water, may contribute to gastric cancer (GC) through the formation of carcinogenic N-nitrosamines, but risks likely vary by source and endogenous nitrosating factors. In the Danish Diet, Cancer, and Health Cohort, source-specific nitrate and nitrite intakes (plant sources, naturally-occurring animal sources, additive-permitted meat sources, and drinking water) were estimated from a food frequency questionnaire using food databases and water monitoring data. Associations with GC, identified via the Danish Cancer Registry, were examined using multivariable-adjusted Cox proportional hazards models. Analyses were stratified by GC risk factors and factors hypothesized to influence endogenous N-nitrosamine formation to explore potential effect modification. Among 54,610 participants, 260 incident cases of GC (120 cardia, 59 non-cardia, and 81 overlapping/unclassified) were identified over 27 years. Plant sourced nitrite intake was associated with lower GC rates [HRQ5vQ1 (95

BACKGROUND:Vitamin K-dependent proteins are important for maintaining lung structure and function, yet few studies have examined dietary vitamin K intake in relation to chronic respiratory disease. OBJECTIVES:This study aimed to investigate the associations between dietary intakes of vitamin K1 and vitamin K2 and the incidence of chronic obstructive pulmonary disease (COPD), asthma, and lung function. METHODS:We analyzed data from 179,062 UK Biobank participants without COPD or asthma. Associations between dietary vitamin K1 and K2 intakes, estimated using the Oxford WebQ 24-h recall, and incident COPD and asthma, identified through hospital, death, and primary care records, were examined using Cox proportional hazards models. In cross-sectional analyses, associations of vitamin K intake with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and the FEV1/FVC ratio were assessed using splines within multiple regression. Stratified analyses were performed by sex, smoking status, and occupation. RESULTS:Over 10.5-y follow-up, higher vitamin K1 intakes were associated with lower COPD rates, with inverse associations reaching a plateau above ∼250 μg/d [HRquintile (Q)5 compared with Q1: 0.84; 95% confidence interval (CI): 0.75, 0.94], whereas no association was observed for vitamin K2. No associations were observed between vitamin K1 or vitamin K2 intakes and asthma. Higher vitamin K1 intakes (Q5 compared with Q1) were associated with better lung function (FVC: 44 mL; 95% CI: 35, 53 mL and FEV1: 32 mL; 95% CI: 25, 40 mL), whereas vitamin K2 showed weaker and nonlinear associations. Stronger associations between vitamin K1 and lung function were evident in smokers and participants with high-risk occupations. CONCLUSIONS:Higher dietary vitamin K1 intake was associated with better lung function and a lower rate of COPD. As vitamin K1 is abundant in green leafy vegetables (e.g., ∼1 serving of kale, ∼1½-2 cups), higher consumption of these foods within a healthy diet may be associated with favorable respiratory health.

Introduction Nitrate and nitrite, present in ground and drinking water, as well as foods, may contribute to bladder cancer through the formation of carcinogenic N-nitrosamines. However, risk likely depends on both the source and endogenous nitrosating factors. Methods Among participants of the Danish Diet, Cancer, and Health Cohort (N = 54,610) with no history of cancer, source-specific nitrate and nitrite intakes (drinking water, plant sources, naturally occurring animal sources, and additive-permitted meat sources) were estimated from national water monitoring data and food frequency questionnaires using food databases. Bladder cancer cases were ascertained through the Danish Cancer Registry. Multivariable-adjusted Cox proportional hazards models were used to examine associations, and analyses were stratified by established bladder cancer risk factors and factors hypothesized to influence endogenous N-nitrosamine formation to explore potential effect modification. Results During 27 years of follow-up, 1,058 bladder cancer cases were identified. No associations were observed for nitrate intake [HRlog (95% CI) per doubling of intake (mg/d): drinking water: 0.88 (0.73, 1.08), plant sources: 0.91 (0.74, 1.12), naturally occurring animal sources: 0.83 (0.67, 1.02), additive permitted meat sources 1.06 (0.84, 1.32)]. Similar estimates were observed for source-specific nitrite intakes. Associations did not appear to be modified by bladder cancer risk factors or endogenous nitrosating factors. Conclusion The lack of associations between nitrate and nitrite exposure and bladder cancer may reflect either a true absence of effect or exposure levels that are too low be biologically relevant for bladder carcinogenesis. Future studies in populations with higher exposure levels are warranted.

PURPOSE:Adequate fruit and vegetable (FV) intake is the foundation of a healthy diet; however, intake is especially low among stroke survivors. This study explores barriers and motivators to FV intake in female stroke survivors and informs strategies to improve well-being. METHODS:Female stroke survivors completed questionnaires and attended either a focus group or an interview, with the resulting transcripts analysed using reflexive thematic analysis. RESULTS:Ten female stroke survivors aged (mean [SD]) 66.3 [17.1] years completed the study. Across the focus groups (n = 3) and interviews (n = 2), three themes emerged: (1) "Navigating alone," reported that survivors felt left to fend for themselves for dietary support and education. (2) "If it's good for me" identified a willingness to improve FV intake and nutrition literacy. (3) "Make it easy" highlighted the need for compensatory strategies to raise FV intake. Barriers to FV intake included physical impairments, fatigue, and memory loss. These barriers impacted food shopping, preparation, and consumption, necessitating reliance on family and compensatory strategies. Motivators included education, simplified recipes, reminders, and pre-prepared options. CONCLUSION:Female stroke survivors wanted more dietary education, FV knowledge, support, and practical stroke-appropriate resources. Incorporating these findings into rehabilitation planning may improve the well-being of female stroke survivors.

Periodontal disease, an inflammatory condition affecting the tissue surrounding the teeth, has been associated with various systemic health issues. Dietary nitrate and nitrite are found in a range of plant and animal foods and, depending upon source, have been linked with both positive and negative health effects, including improved oral health with plant sources. This study aimed to investigate the associations between source-dependent (plant- and animal-sourced) nitrate and nitrite intake and odds of periodontal disease. We explored cross-sectional and longitudinal associations between tertiles of source-dependent nitrate and nitrite intake and the odds of periodontal disease using multivariable logistic regression models (cross-sectional analyses) and generalised estimating equations (longitudinal analyses) in 158,778 and 83,026 participants, respectively, from the UK Biobank. Dietary nitrate/nitrite intake was estimated from 24 h dietary assessments and a comprehensive food composition database. Higher intake of plant-derived nitrate was associated with significantly lower odds of periodontal disease in cross-sectional (OR [95

This study aimed to explore whether health effects of dietary nitrate depend on its source, by investigating associations between plant and animal-sourced dietary nitrate groups with markers of inflammation and CVD risk factors. Among 100 non-smoking adults (mean age 49 (sd 13) years, 31 % male), dietary nitrate intake was assessed using FFQ (n 100) and 3-d food diary (n 89), combined with nitrate food composition databases. Nitrate intake was classified into plant, naturally occurring animal and additive-permitted meat-sourced groups. Associations between source-dependent nitrate intakes and lipoprotein-associated phospholipase A2 (Lp-PLA2), C-reactive protein (CRP), fasting plasma lipids, anthropometry and blood pressure were examined using multivariable linear regression, adjusted for socio-demographic, lifestyle and dietary confounders. Each 1 sd (∼57 mg/d) increment in plant-sourced nitrate intake was associated with a 0·191 sd lower LDL-cholesterol (β = -0·191, 95 % CI (-0·369, -0·004), P = 0·045; equivalent to -0·21 mmol/l) in primary models, though this association was attenuated in sensitivity analyses. Naturally occurring animal-sourced nitrate intake was not associated with any outcomes. A 1 sd (0·08 mg/d) increment in additive-permitted meat-sourced nitrate intake was associated with a 0·208 sd lower HDL-cholesterol (β = -0·208, (-0·362, -0·054), P = 0·009; equivalent to -0·10 mmol/l) and a 0·192 sd higher waist circumference (β = 0·192, (0·005, 0·380), P = 0·042; equivalent to +1·29 cm) but not with LDL-cholesterol, TAG, blood pressure, Lp-PLA2 or CRP. These preliminary findings suggest potential differential associations between nitrate source and cardiometabolic markers that warrant confirmation in larger studies.

BACKGROUND AND AIMS:Dietary nitrate and nitrite may have source-dependent effects on liver health: plant-sourced nitrate may confer hepatoprotective benefits via its conversion to nitric oxide, whereas nitrate and nitrite from animal foods, processed meats, or contaminated drinking water may promote liver injury via their conversion to N-nitrosamines. We aimed to examine associations between source-specific nitrate and nitrite intakes and incident metabolic dysfunction-associated steatotic liver disease (MASLD) in two large cohorts. Secondary aims were to assess associations with liver MRI biomarkers and to evaluate whether nitric oxide-pathway gene variants modify associations with plant-sourced nitrate/nitrite. METHODS:We analysed 53,854 participants from the Danish Diet, Cancer and Health (DCH) cohort and 197,198 from the UK Biobank. Source-specific nitrate and nitrite intakes were estimated using food frequency questionnaires (DCH) and 24-h dietary assessments (UK Biobank) in combination with food composition databases and national water quality data. Associations with incident cases of severe MASLD-identified from hospital records-were examined using multivariable-adjusted Cox models, with fixed-effects meta-analysis. In the UK Biobank, analyses were stratified by nitric oxide pathway variants, and associations with liver imaging biomarkers were assessed using generalised regression models. RESULTS:Over 25.1 years (DCH) and 13.5 years (UK Biobank), 166 and 1768 participants developed MASLD, respectively. Moderate plant-sourced nitrate intake was associated with lower MASLD rates [pooled HRQ3vsQ1 (95%CI): 0.84 (0.76-0.94)] with similar patterns for plant- and vegetable-sourced nitrite. No association was observed for animal-sourced nitrate, whereas higher intakes of animal-sourced nitrite [HRQ5vsQ1: 1.23 (1.09-1.39)] and additive permitted meat-sourced nitrate [HRT3vsT1: 1.21 (1.05-1.38)] were associated with higher rates. Plant nitrate intake was associated with more favourable liver imaging biomarkers, while animal- and additive-sourced exposures were linked to less favourable profiles. Protective associations of plant-sourced nitrate and nitrite were modified by nitric oxide pathway genetic variants. CONCLUSION:The health impact of nitrate and nitrite depends on source: moderate plant-sourced intakes (∼1 cup baby spinach/day) were linked to lower MASLD rates, while higher intakes from animal and additive sources were associated with higher rates.

BACKGROUND AND AIMS:Vitamin K is essential for processes that inhibit vascular and valvular calcification, attributes of atherosclerotic cardiovascular diseases (ASCVDs) and aortic stenosis (AS). Relationships between dietary vitamin K1 and K2 intakes, ASCVD and AS were explored. METHODS:In 112,111 participants from the UK Biobank without ASCVD or AS (median age 59.7 years, 57.3% female), dietary vitamin K1 (μg/day) and K2 (μgPKeq/day) intakes were calculated from Oxford WebQ 24-h dietary questionnaires, using vitamin K food composition databases. Associations with incident ASCVD, ASCVD subtypes and AS, obtained from self-reports, primary care data, hospital records and death registries, were examined using restricted cubic splines within multivariable-adjusted Cox proportional hazards models. RESULTS:Over a median follow-up of 10.5 years, 8696 ASCVD cases were recorded. Non-linear associations between vitamin K1 intakes and ASCVD were observed within multivariable-adjusted models (pnon-linearity≤0.01). Higher vitamin K1 intakes were associated with a 7-10% lower risk of ASCVD, with no advantage observed beyond moderate intakes (HRQ3vsQ1 0.90 [0.85-0.95]). Lower risk relationships were also found for ischemic heart disease (IHD), ischemic stroke and peripheral arterial disease but not AS. The highest vitamin K2 intakes were associated with a greater risk of incident ASCVD (HRQ5vsQ1 1.07 [1.01-1.14]), IHD and AS. CONCLUSIONS:Among adults without prevalent ASCVD, those with higher dietary vitamin K1, but not K2, intakes had lower ASCVD risk. Positive associations with vitamin K2 may reflect food source confounding warranting further investigation. These findings reinforce the promotion of vitamin K1-rich vegetable consumption (e.g. spinach and broccoli) to support cardiovascular health.

Dietary nitrate is a precursor to nitric oxide, for which plausible mechanisms exist for both beneficial and detrimental influences in first clinical diagnosis of central nervous system demyelination (FCD), a common precursor to the diagnosis of multiple sclerosis (MS). Whether dietary nitrate has any role in FCD onset is unclear. We tested associations between nitrate intake from food sources (plant, vegetable, animal, processed meat, and unprocessed meat) and likelihood of FCD. We used data from the Ausimmune Study (264 cases, 474 controls) and logistic regression with full propensity score matching. In females, higher nitrate intake from plant-based foods (odds ratio [OR] per 60 mg/day = 0.50; 95 % confidence interval [CI] 0.31, 0.81; p = <0.01) and vegetables (OR per 60 mg/day = 0.39; 95 % CI 0.22, 0.70; p = <0.01), but not other sources, was statistically significantly associated with lower likelihood of FCD. In males, no associations were found between any source of nitrate intake and likelihood of FCD. Our results support further research to explore a possible beneficial role for plant-derived nitrate in people at higher risk of MS.

Currently no data exists on S-methyl-L-cysteine sulfoxide (SMCSO) levels in Australian-sourced vegetables and limited data exists for glucosinolates. The effect of various cooking methods on the retention of SMCSO and glucosinolates in Australian-sourced vegetables is also limited. This study measured SMCSO and ten glucosinolates in a selection of Australian-sourced Brassica vegetables, both raw and after steaming. We additionally measured SMCSO and glucosinolate levels in broccoli after microwaving, stir-frying and boiling. SMCSO contributed greater dry weight (0.6-1.9%) than total glucosinolates combined (0.3-1.2%) in these raw cruciferous vegetables. SMCSO levels from highest to lowest were: Brussels sprouts > broccoli > red cabbage > kale > cauliflower > white cabbage > Chinese cabbage; and glucosinolate levels were: Brussels sprouts > white cabbage > broccoli > kale > red cabbage > Chinese cabbage > cauliflower. Both SMCSO and the ten main glucosinolates quantified were relatively stable after light steaming across all vegetables measured, and after microwaving broccoli. Boiling and stir-frying broccoli led to significant losses in SMCSO and the two dominant glucosinolates, glucoraphanin and glucobrassicin (all p < 0.05). Mild steaming and/or microwaving were preferable in retaining SMCSO and glucosinolates, whilst boiling and stir-frying were least favorable.

BACKGROUND:Dietary nitrate, as a nitric oxide (NO) precursor, may support brain health and protect against dementia. OBJECTIVE:Our primary aim was to investigate whether dietary nitrate is associated with neuroimaging markers of brain health linked with Alzheimer's disease (AD). PARTICIPANTS:Study participants were cognitively unimpaired individuals from the Australian Imaging, Biomarkers and Lifestyle Study of Ageing (AIBL) who had β-amyloid positron emission tomography (PET) scans (n = 554) and magnetic resonance imaging (MRI) scans (n = 335) and had completed a Food Frequency Questionnaire at baseline. METHODS:Source-specific nitrate intakes were estimated using comprehensive nitrate food composition databases. Rates of cerebral β-amyloid (Aβ) deposition, measured using PET, and rates of brain atrophy, measured using MRI, were assessed between baseline and 126-months follow-up, at intervals of 18 months. Multivariable-adjusted linear mixed effect models were used to examine associations between baseline source-specific nitrate intake and rates of (i) cerebral Aβ deposition and (ii) brain atrophy, over the 126 months of follow-up. Analyses were carried out following stratification of the sample by established dementia Alzheimer's disease (AD) risk factors including sex and presence or absence of the apolipoprotein E (APOE) ε4 allele. RESULTS:In women carriers of the APOE ε4 allele, higher plant sourced nitrate intake (median intake 121 mg/day), was associated with a slower rate of cerebral Aβ deposition [β: 4.47 versus 8.99 Centiloid (CL) /18 months, p < 0.05] and right hippocampal atrophy [-0.01 versus -0.03 mm3 /18 months, p < 0.01], after multivariable adjustments. Moderate intake showed protective associations in men carriers and in both men and women non-carriers of APOE ε4. CONCLUSIONS:Associations were observed between plant-derived nitrate intake and cerebral Aβ deposition, particularly in high-risk populations (women and APOE ε4 carriers). Associations were also observed for brain volume atrophy, however these exhibited subgroup variability without clear patterns relative to sex and APOE ε4 allele carriage. These findings suggest a potential link between plant-sourced nitrate and AD related neuroimaging markers of brain health improved brain health, but further validation in larger studies is required.

Observational studies suggest higher intake of cruciferous vegetables (e.g., broccoli, cauliflower, kale) is associated with lower chronic disease risk (1,2) . Glucosinolates (GSL) and cysteine sulfoxides such as S- methyl cysteine sulfoxide (SMCSO) are sulfur-containing compounds found in high amounts in these vegetables (3) . Currently, no data exists on SMCSO levels in Australian-grown cruciferous vegetables and limited data exists for glucosinolates (GSL). The levels of SMCSO retained in cruciferous vegetables after various domestic cooking methods is unknown, and measurement of SMCSO and GSL levels in cooked Australian-grown cruciferous vegetables is limited. This study sought to (1) quantify SMCSO and GSL in Australian-grown cruciferous vegetables and (2) identify the most preferable cooking methods to retain levels in these vegetables. Using liquid chromatography mass spectrometry, we quantified SMCSO and ten GSL in seven cruciferous vegetables before and after steaming. We further quantified levels in broccoli before and after microwaving, stir-frying, and boiling. Each cooking method; steaming (3 minutes), microwaving (2 minutes), boiling (3 minutes), stir-frying (4 minutes); was chosen so vegetables remained firm and not overcooked to mimic healthy cooking recommendations (4) . Student t-tests were used to compare the differences in raw and steamed levels for all vegetables, and analysis of variance with Tukey post-hoc assessed the differences in raw and cooked broccoli (i.e., steamed, microwaved, boiled, stir-fried). Overall, SMCSO contributed greater dry weight (0.6–1.9%) than total GSL combined (0.3–1.2%). SMCSO levels from lowest to highest were Chinese cabbage < white cabbage < cauliflower < kale < red cabbage < broccoli < Brussels sprouts (6–19 mg/g dry weight [DW]) and GSL levels were cauliflower < Chinese cabbage < red cabbage < kale < broccoli < white cabbage < Brussels sprouts (3–12 mg/g DW). SMCSO increased after steaming (1–24%) in all vegetables except white cabbage (−31%), kale (−18%), and Chinese cabbage (−5%), but only reached statistical significance in Brussels sprouts (+16%, p < 0.05). Most vegetables increased total GSL (ranging 1–34%) after steaming, except kale (−38%) and Chinese cabbage (−8%). Stir-frying and boiling broccoli led to significant losses in SMCSO (−34% and −50%, respectively) and in the two dominant GSL in broccoli; glucoraphanin (−47% and −52%, respectively) and glucobrassicin (−46% and –51%, respectively) (all p < 0.05). We have quantified SMCSO and GSL levels in a selection of Australian-grown cruciferous vegetables (broccoli, kale, Brussels sprouts, cauliflower, red, white, and Chinese cabbages) before and after cooking. SMCSO and GSL levels were relatively stable after light steaming. Additionally, light steaming or microwaving were the most preferable methods to retain SMCSO and GSL levels in broccoli. Boiling or stir-frying broccoli were the least favourable. These results have important implications when estimating intake of these beneficial sulfur-containing compounds.

There is growing interest in the role that dietary nitrate plays in cardiovascular health, with plant-sourced and animal-sourced nitrate showing potentially positive or negative effects. Inflammation is a key factor in the development and progression of atherosclerosis, a major contributor to cardiovascular disease (CVD). A recent review highlighted the potential of nitrate to modulate inflammatory processes. (1) However, research investigating the association between dietary nitrate intake from different sources (plant-sourced nitrate, nitrate-additive-permitted meat, and meat with naturally-occurring nitrate) and inflammation in humans is limited. This study aimed to investigate associations between source-dependent nitrate intake and inflammatory markers—namely lipoprotein-associated phospholipase A2 (Lp-PLA2) and high sensitivity C-reactive protein, (hs-CRP)—as well as traditional CVD risk factors. Among 100 non-smoking adults (mean age 49 ± 13 years, 31% male), cross-sectional associations between nitrate intakes from plant and animal sources (estimated from food frequency questionnaire data in combination with comprehensive food databases specifying food nitrate content) (2,3) and 1) Lp-PLA2 and hs-CRP measured in fasting plasma samples, and 2) blood lipid levels, blood pressure and waist circumference, were examined. Linear and logistic regression models were adjusted for sociodemographic, lifestyle and dietary confounders. Participants were classified as high-risk (either diagnosis of type 2 diabetes or two or more other CVD risk factors), or low-risk (normal health metrics and an absence of chronic disease). After adjusting for demographic and lifestyle confounders, a 1 standard deviation (SD) (95.73 mg/day) increment in plant-sourced nitrate intake was associated with a 0.191 SD lower LDL cholesterol (β = -0.191, 95% CI [-0.376, -0.004], p = 0.045; equivalent to -0.21 mmol/L), but not with any of the other outcomes. In contrast, intakes of naturally occurring animal-sourced nitrate were not associated with any of the outcomes. A 1 SD (0.32 mg/day) increment in nitrate intake from additive-permitted meat-sources was associated with a 0.192 SD higher waist circumference (β = 0.192, [0.005, 0.380], p = 0.042; equivalent to +1.29 cm) and a 0.208 SD lower HDL cholesterol (β = -0.208, [-0.362, -0.054], p = 0.009; equivalent to -0.10 mmol/L), but not with LDL cholesterol, triglycerides, blood pressure, Lp-PLA2, or CRP. No clear differences between CVD risk groups were observed. In conclusion, while no associations were found between naturally occurring animal-sourced nitrate and inflammatory markers or any CVD risk factors, nitrate from additive-permitted meat-sources were negatively associated with waist circumference and HDL cholesterol, whereas plant-sourced nitrate showed favourable associations with LDL cholesterol.

Nutrition science has been represented as biomedical, environmental, societal and economic field, but quantum biology is sidestepped, thereby obscuring cognate problems and solutions. We are generally nourished for health, optimal well-being, longevity and personal security through sustainable livelihoods. Our nourish-ments include not only food and energy but also light from the sun, the firmament and the earth itself, along with information transmitted in subatomic particles and electromagnetic wave forms. We propose 'quantum nutrition' as an approach to reconcile quantum phenomena with nutritional biology. Appreciating quantum nutrition and recognizing its potential applications will provide opportunities for future health and well-being and for planetary habitability.

INTRODUCTION:Dietary nitrate, through conversion to nitric oxide, which supports vascular and nervous system function, may lower dementia risk but may also form neurodegenerative N-nitrosamines, depending on the nitrate source. METHODS:We investigated associations between source-specific nitrate and nitrite intake and incident and early-onset dementia (<65 years) in 54,804 dementia-free participants from the Danish Diet, Cancer and Health Cohort Study over ∼27 years. Nitrate and nitrite intakes were derived from food frequency questionnaires and nitrate and nitrite databases. RESULTS:Higher plant-sourced nitrate intake was non-linearly associated with lower rates of incident dementia (fifth vs first quintile hazard ratio 95% confidence interval: 0.90 [0.83, 0.98]), while increased risk was seen for higher intakes of animal-sourced, additive-permitted meat-sourced, and tap water-sourced nitrate. Similar associations were seen for source-specific nitrite intake and were more pronounced for early-onset dementia. No clear effect modification was observed. DISCUSSION:These findings highlight the importance of nitrate source in dementia risk and warrant further investigation. HIGHLIGHTS:Plant nitrate is associated with a lower risk of incident and early-onset dementia. Animal and tap water nitrate are associated with an increased risk of dementia. Encouraging consumption of plant-based nitrate sources may lower risk of dementia.

Vitamin K may inhibit vascular calcification, a common attribute of atherosclerotic vascular diseases (ASVDs). We examined associations between dietary vitamin K1 intakes and both subclinical atherosclerosis and ASVD events, including hospitalisations and mortality, in older women. 1,436 community-dwelling women (mean ± SD age 75.1 ± 2.7 years) were included. Vitamin K1 intakes were calculated from a validated food frequency questionnaire at baseline (1998), utilising a region-matched vitamin K food database. Common carotid artery intima–media thickness (CCA-IMT), a measure of subclinical atherosclerosis, was measured in 2001 (n = 1,090). Differences in CCA-IMT by quartiles (Q) of vitamin K1 intake were examined using multivariate analysis of variance. Associations between vitamin K1 intakes and ASVD outcomes (hospitalisations and/or deaths), obtained from linked health records over 14.5 years, were analysed using restricted cubic splines within multivariable-adjusted Cox-proportional hazard models. Women with higher vitamin K1 intakes had a 5.6

BACKGROUND:Growing evidence suggests that health outcomes of dietary nitrate and nitrite intake are food source dependent. Robust evaluations in dietary studies necessitate a comprehensive and current food composition database of nitrate/nitrite content, along with variation based on country or region of origin, calendar year, growing season, and cooking method. OBJECTIVES:The objectives of this study were to update the previous animal- and plant-based food nitrate/nitrite databases and investigate effects of cooking methods, seasonal and geographic variations, and longitudinal changes on nitrate and nitrite content to guide application of the database in observational and clinical studies. METHODS:Food nitrate/nitrite composition data was acquired from an extensive worldwide data collation. The animal- and plant-based food nitrate/nitrite databases were combined and substantially expanded. An in-depth data stratification and comparison were performed to explore retention factors of nitrate/nitrite, seasonal differences in vegetable nitrate, geographic variations, and the temporal change in food nitrate/nitrite content over 30 years. RESULTS:The aggregated database has >150,000 nitrate and nitrite values for 823 foods, being 5+ times their original size. Nitrite content in plant foods is presented for the first time, being ≤12.27 mg/kg of fresh weight. Retention factors of 55.00 (39.59-65.56) % (median (interquartile range)) and 279.53 (179.53-386.89) % are now suggested for boiled and fried plant foods, respectively, with a factor of 1.0 for other cooking methods. Significant seasonal variations in plant nitrate and geographic differences in both plant- and animal-based foods are identified, whereas several leafy vegetables show declining nitrate content over 30 years, and longitudinal changes in nitrate and nitrite in animal foods are minor. An objective language-model-assisted data extraction pipeline was established that accommodates regional differences in nitrate/nitrite data reporting. CONCLUSIONS:The newly developed database and automated nitrate/nitrite calculator will facilitate future nutritional health studies to estimate dietary nitrate/nitrite exposure more accurately and efficiently and determine the resulting health implications.

Introduction Nitrate and nitrite, present in food and drinking water, may contribute to colorectal cancer (CRC) through the formation of carcinogenic N-nitroso compounds (NOCs). This study examined source-specific associations with CRC and subtypes, considering potential dietary and lifestyle factors that influence NOC formation. Methods In the Danish Diet, Cancer, and Health Cohort (N=54,610), nitrate/nitrite intake was estimated from comprehensive databases and national monitoring data. Over 27 years, 2245 CRC cases (1508 colon and 737 rectal) were identified via the Danish Cancer Registry. Cox proportional hazards models adjusted for sociodemographic, diet, and lifestyle factors were used to examine associations, with stratified analyses by sex and factors influencing NOC formation. Results No associations were found between nitrate/nitrite intakes from plant, naturally-occurring animal sources, or additive-permitted meat sources and CRC. However, higher nitrate intake from tap water (mg/d) was associated with a higher rate of distal colon cancer [HRQ5vQ1 (95% CI); 1.48 (1.11, 1.97)], though not CRC overall. A nitrate concentration in tap water ≥9.25 mg/L was linked to a higher colon cancer rate [HR 1.52 (1.11, 2.07)] compared to <1.27 mg/L. This association appeared stronger in individuals with risk-promoting factors (smoking and high red meat intake) and weaker among those with a high intake of NOC inhibiting factors (vitamin C, vitamin E, folate, and flavonoids). Conclusion Nitrate/nitrite intakes from food sources were not associated with rate of CRC in the cohort, but tap water nitrate, at higher intake levels and at concentrations over ≥9.25 mg/L were linked to higher rates of distal colon and colon cancer, respectively.