Alternate Diet Research Articles

Hybrid Spreadable Cheese Analogues with Faba Bean and Mealworm (Tenebrio molitor) Flours: Optimisation Using Desirability-Based Mixture Design.

Hybrid products could help bridge the gap as new alternative diets emerge in response to the demand for less animal protein, while recent studies suggest that the Western population is not yet ready to fully embrace an alternative protein-based diet. This study used a desirability-based mixture design to model hybrid spreadable cheese analogues (SCAs). The design combined milk protein concentrate (MPC), Tenebrio molitor (IF) and faba bean (FBP) flours, representing 7.1% of the formula. Nine SCAs with different MPC/FBP/IF ratios were formulated. Incorporating the IF negatively impacted the desirable texture properties. The FBP flour improved the texture (increasing firmness and stickiness and decreasing spreadability), but only when combined with MPC. Sensory analysis showed that hybrid SCAs (≤50% MPC) C2, C7 and C9 had a more characteristic cheesy flavour than the commercial plant-based reference, and sample C2 had a texture profile similar to the dairy reference. Samples containing IF (C7 and C9) showed a better flavour profile than that without IF (C2). The SCAs had higher protein and lower saturated fat, starch and sugar content than commercial analogues. The study suggests that incorporating alternative proteins in hybrid products can be an effective approach to reduce animal protein content, specifically dairy, in food formulations.

The Association of Specific Dietary Patterns with Cardiometabolic Outcomes in Women with a History of Gestational Diabetes Mellitus: A Scoping Review

Gestational diabetes mellitus is associated with a significantly increased risk of later type 2 diabetes (T2DM) and cardiovascular disease (CVD). Post-natal interventions aim to reduce this risk by addressing diet and lifestyle factors and frequently focus on restricting energy or macronutrient intake. With increased interest in the role of complete dietary patterns in the prevention of cardiometabolic disease, we sought to evaluate what is known about the role of dietary patterns in reducing cardiometabolic risk in women with previous GDM. A systematic search was conducted to identify studies relating to dietary pattern and cardiometabolic parameters in women with a history of GDM. The search criteria returned 6014 individual studies. In total, 71 full texts were reviewed, with 24 studies included in the final review. Eleven individual dietary patterns were identified, with the Alternative Health Eating Index (AHEI), Mediterranean diet (MD), and low glycaemic index (GI) as the most commonly featured dietary patterns. Relevant reported outcomes included incident T2DM and glucose tolerance parameters, as well as several cardiovascular risk factors. Dietary patterns which have previously been extensively demonstrated to reduce the risk of cardiovascular and metabolic disorders in the general population, including AHEI, MD, and DASH, were found to be associated with a reduction in the incidence of T2DM, hypertension, and additional risk factors for cardiometabolic disease in women with a history of GDM. Notable gaps in the literature were identified, including the relationship between dietary patterns and incident CVD, as well as the relationship between a low GI diet and the development of T2DM in this population.

Mango Peel Nanofiltration Concentrates to Enhance Anaerobic Digestion of Slurry from Piglets Fed with Laminaria.

The environmental impact of biowaste generated during animal production can be mitigated by applying a circular economy model: recycling, reinventing the life cycle of biowaste, and developing it for a new use. The aim of this study was to evaluate the effect of adding sugar concentrate solutions obtained from the nanofiltration of fruit biowaste (mango peel) to slurry from piglets fed with diets incorporating macroalgae on biogas production performance. The nanofiltration of ultrafiltration permeates from aqueous extracts of mango peel was carried out using membranes with a molecular weight cut-off of 130 Da until a volume concentration factor of 2.0 was reached. A slurry resulting from piglets fed with an alternative diet with the incorporation of 10% Laminaria was used as a substrate. Three different trials were performed sequentially: (i) a control trial (AD0) with faeces resulting from a cereal and soybean-meal-based diet (S0); (ii) a trial with S1 (10% L. digitata) (AD1), and (iii) an AcoD trial to assess the effect of the addition of a co-substrate (20%) to S1 (80%). The trials were performed in a continuous-stirred tank reactor (CSTR) under mesophilic conditions (37.0 ± 0.4 °C), with a hydraulic retention time (HRT) of 13 days. The specific methane production (SMP) increased by 29% during the anaerobic co-digestion process. These results can support the design of alternative valorisation routes for these biowastes, contributing to sustainable development goals.

Florivory is an alternative but suboptimal diet for an invasive leaf‐feeding beetle

AbstractFlowers can be a valuable food source for primarily leaf‐feeding insects. They may also be an alternative diet when preferred foods are unavailable. Here we explored the value of florivory for the invasive viburnum leaf beetle (VLB). In the field, VLB larvae have been observed to feed on V. tinus inflorescences in the absence of young leaves, their preferred food. Under controlled conditions, we measured VLB larval performance when larvae were fed young V. tinus leaves, old (from the previous year's growth) V. tinus leaves, and V. tinus inflorescences. VLB larvae could complete their development by feeding solely on V. tinus inflorescences, with a negative impact on performance: larval survivorship to adult stage and adult mass decreased and developmental time increased when larvae fed on inflorescences. Survivorship was null when larvae were fed old leaves. Florivory appears to be a suboptimal diet for VLB, which may be used as a last resort when better food sources are absent. These results illustrate the importance of plasticity for the nutritional ecology of herbivorous insects. Dietary flexibility may have facilitated VLB's adoption of novel host plants in its invasive range.

Nutritional innovations in superior European sea bass (Dicentrarchus labrax) genotypes: Implications on fish performance and feed utilization

The sustainable development of the aquaculture industry relies on the use of alternative conventional and emergent raw materials that contributes to a circular economy and to reduce the dependency on fish meals and fish oils coming from oceanic fish populations. Additionally, the genetic selection of farmed fish that can display higher growth and feed utilization when fed alternative feeds, is pointed out to be a complementary valuable tool to facilitate the implementation of circular economy approaches. The main purpose of the present study was to determine the effectiveness of genetic selection for growth in European sea bass, in response to a challenge with an alternative diet that aimed to partially replaced fishmeal (FM) by poultry meal (PM) and totally replace fish oil (FO) by a blend of poultry oil (PO) with a novel microalgae oil. The two families of fish juveniles were obtained by in vitro fertilization of selected for a multi-trait including high growth (genetically selected, GS) or non-selected (wild type, WT) broodstocks and then were nutritionally challenged with a control diet that mirrored a standard commercial diet with fishmeal (20%) and fish oil (7%), or a Future diet that partially replaced the FM by PM and totally replaced the FO by a blend of rapeseed oil, PO, and a novel DHA rich-algal oil. From the second month of feeding until the end of the trial, European sea bass that was selected since for 7 generations performed better in terms of growth than the wild-type genotype, possibly related with an apparent favored feed and nutrient utilization. Furthermore, selection decreased the perivisceral fat and increased the nutritional value of flesh by increasing DHA (in g/ 100 g flesh) and ARA contents. In contrast, the dietary treatment showed little effect on fish growth performance, denoting the successful partial replacement of FM by PM and the total replacement of FO by a blend of poultry oil and an emergent microalgal oil. However, Future diet tended to reduce the ADCs of some amino acids, as well as showed an additive effect to genotype in increasing the n-3 PUFA of flesh. Altogether, our data demonstrate that multi-trait genetic selection of European sea bass improve fish plasticity to cope with the variations of ingredients in alternative feeds with low FM/FO.

Indices of Mediterranean diet adherence and breast cancer risk in a community-based cohort.

A Mediterranean-style dietary pattern is believed to have cancer-protective effects. We compared the prospective associations between adherence to four established Mediterranean diet indices and breast cancer risk (including total, postmenopausal, and hormone receptor positive cases) in women in the Framingham Offspring Study. The four indices used two different approaches to measuring adherence to a Mediterranean diet: (a) scores based on the population-specific median intakes of Mediterranean diet-related foods in a given population (i.e., alternate Mediterranean Diet (aMED) index and Mediterranean Diet Score (MDS) index), and (b) scores based on compliance with recommended intakes of relevant foods from the Mediterranean diet pyramid [i.e., Mediterranean Diet (MeDiet) index and Mediterranean Style Dietary Pattern (MSDP) index]. Dietary data were derived from semiquantitative food frequency questionnaires collected in 1991-95. Participants included 1579 women aged ≤ 30 years who were free of prevalent cancer. Women were followed through 2014, and Cox proportional-hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for various confounders. During a median follow-up of approximately 18 years, 87 breast cancer cases were documented. Women in the highest (vs. lowest) score category of the pyramid-based scores (i.e., MeDiet or MSDP) had approximately 45% statistically significantly lower breast cancer risks. These effects were even stronger for any hormone receptor positive cases using the MeDiet index (highest vs. lowest score categories: HR = 0.45, 95% CI: 0.22-0.90). Neither of the median intake-based scores (i.e., aMED, MDS) was associated with breast cancer risk. Our results suggest that the methodology and the composition of Mediterranean diet indices influence their ability to assess conformity to this specific diet pattern and predict breast cancer risk.

Diet Quality and All-Cause Mortality in Women with Breast Cancer from the Breast Cancer Family Registry.

The impact of diet on breast cancer survival remains inconclusive. We assessed associations of all-cause mortality with adherence to the four diet quality indices: Healthy Eating Index-2015 (HEI-2015), Alternative Healthy Eating Index (AHEI), Alternative Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH). Dietary intake data were evaluated for 6,157 North American women enrolled in the Breast Cancer Family Registry who had been diagnosed with invasive breast cancer from 1993 to 2011 and were followed through 2018. Pre-diagnosis (n = 4,557) or post-diagnosis (n = 1,600) dietary intake was estimated through a food frequency questionnaire. During a median follow-up time of 11.3 years, 1,265 deaths occurred. Cox proportional hazards models were used to estimate multivariable-adjusted HR and 95% confidence intervals (CI). Women in the highest versus lowest quartile of adherence to the HEI-2015, AHEI, aMED, and DASH indices had a lower risk of all-cause mortality. HR (95% CI) were 0.88 (0.74-1.04; Ptrend = 0.12) for HEI-2015; 0.82 (0.69-0.97; Ptrend = 0.02) for AHEI; 0.73 (0.59-0.92; Ptrend = 0.02) for aMED; and 0.78 (0.65-0.94; Ptrend = 0.006) for DASH. In subgroup analyses, the associations with higher adherence to the four indices were similar for pre- or post-diagnosis dietary intake and were confined to women with a body mass index <25 kg/m2 and women with hormone receptor positive tumors. Higher adherence to the HEI-2015, AHEI, aMED, and DASH indices was associated with lower mortality among women with breast cancer. Adherence to a healthy diet may improve survival of women with breast cancer.

Increasing sustainability in pork production by using high inclusion levels of co-products DDGS, wheat middling and canola meal doesn't affect pig growth performance and meat quality but reduce boar taint.

the present study is to examine the effect of high inclusion of co-products in pig diets (referred to as an alternative diet) during the finishing stage on pig growth performance, meat quality and boar taint compounds. Growing pigs were fed an alternative diet made with distillers dried grains with solubles (DDGS, 25%), canola meal (CM, 20%), and wheat middling (WM, 15%) or a control diet based on barley and soybean meal (SBM) to investigate the impact of co-products on pig performance and meat quality. Sixteen female and sixteen entire male Duroc × (Large White × Landrace) pigs (22.6 ± 2.07 kg, body weight ± SE) were equally allocated to the diets. Pigs fed the alternative diet had a lower feed intake; however, growth rate and feed conversion efficiency were unaffected by diet. A diet by sex interaction was found for gain:feed whereby males fed the alternative diet had the best feed conversion (P < 0.01). Pork from pigs fed the alternative diet had lower a* and Chroma and protein % (P < 0.05), while other meat quality characteristics were unaffected. The alternative diet reduced backfat skatole levels (P < 0.001). A diet containing a high inclusion levels of co-products can be fed to pigs during the finishing stage without detrimental effects on pig performance or meat quality and with the potential to enhance pork flavour. This finding suggests a solution to increase the sustainable development of pig production.

Diet quality, ultra-processed food consumption, and quality of life in a cross-sectional cohort of adults and teens with celiac disease.

Coeliac disease (CeD), a common autoimmune condition, requires strict adherence to a gluten-free diet (GFD). Adherence to the GFD has been associated with quality of life (QOL). However, there may be other diet-related concerns, such as overall diet patterns, including diet quality or ultra-processed food (UPF) consumption, possibly associated with QOL among people with CeD following a GFD that have not been examined. Diet quality was determined based on 24-h diet recalls of a cross-sectional prospectively recruited sample of 80 participants (50 adults and 30 teens) with biopsy-confirmed CeD ('Study Sample') using the Healthy Eating Index and Alternate Mediterranean Diet score. The amount of UPF consumed was assessed using Nova, a food processing classification system. QOL was measured using Celiac Disease-Specific Quality of Life (CDQOL) and Celiac Disease Pediatric-Specific Quality of Life (CDPQOL). The Study Sample's diet patterns were compared with National Health and Nutrition Examination Survey (NHANES) groups (25 adults reporting prior CeD and GFD; 51 adults with new CeD and no GFD; 15,777 adults and 2296 teens without CeD). The relationship of the Study Sample's diet patterns with CDQOL/CDPQOL was assessed using analysis of covariance. The Study Sample's diet patterns were suboptimal but generally favourable compared with all NHANES groups. Compared to Study Adults with the highest tertile of UPF, those with the lowest tertile had significantly higher CDQOL (mean: 67.6 vs. 78.3, p < 0.001). Compared to Study Teens with the lowest tertile of AMED, those with the highest tertile had significantly higher CDPQOL (mean: 67.0 vs. 79.9, p < 0.01). Maintaining high diet quality and minimising UPF may be important for CeD-specific QOL among individuals with CeD maintaining a GFD.

Dietary Quality Indices in Early Pregnancy and Rate of Gestational Weight Gain among a Prospective Multi-Racial and Ethnic Cohort.

Meeting the Institute of Medicine (IOM) gestational weight gain (GWG) guidelines is associated with a reduced risk of adverse perinatal outcomes. Overall diet quality comprehensively assesses dietary components and accounts for interactions between them. While GWG is influenced by maternal diet, its association with overall diet quality-measured by various dietary quality indices-is not well-defined. We prospectively estimated the relationship between four established dietary quality indices and the risk of GWG rate above (excessive) or below (inadequate) IOM guidelines in a multi-racial and ethnic cohort of 2914 pregnant people from the Pregnancy Environment and Lifestyle Study (2014-2019). We assessed diet quality using the Healthy Eating Index 2010 (HEI-2010), alternate Mediterranean Diet (aMED), Dietary Approaches to Stop Hypertension (DASH), and Empirical Dietary Inflammatory Index (EDIP). Following the first trimester, 56% of the cohort had excessive GWG, and 14% had inadequate GWG. Poor diet quality (below the 75th percentile), measured by HEI-2010, was associated with a higher risk of excessive GWG in the second and third trimesters [RR = 1.03 (1.00, 1.06)]. Effect modification of this relationship by race and ethnicity and pre-pregnancy BMI was assessed. We found poor diet quality to be associated with elevated risk of excessive GWG among Black participants [RR = 1.14 (1.02, 1.28)] and White participants [RR 1.07 (1.01, 1.12)]. This was also the case for participants with pre-pregnancy BMI < 25.0 [RR 1.05 (1.00, 1.10)]. These results suggest that diet quality measured by the HEI-2010 is associated with excessive GWG, and the associations appear to be stronger among pregnant people without overweight or obesity and pregnant people who identify as Black or White race and ethnicity.

Review: Ripples of the Universe: Spirituality in Sedona, Arizona, by Susannah Crockford

Review: <i>Ripples of the Universe: Spirituality in Sedona, Arizona</i>, by Susannah Crockford

Exploring the use of alternative diets in people living with cancer.

There is significant use of alternative diets by people living with cancer, with data suggesting this has continued to increase since the 1980s. Commonly used alternative diets include the ketogenic diet, Gerson therapy, alkaline diets and fasting diets. This article explains the latest trends in relation to alternative diets, discusses the reasons why people may want to use these and examines their hypothesised mechanisms of action. The author outlines and critically reviews the evidence underpinning the use of such diets in those living with cancer, and suggests that this remains weak. The article also explores the challenges that nurses may experience when a person living with cancer wishes to adopt an alternative diet, and provides practical advice and recommendations on nutrition.

Metabolomic biomarkers of the mediterranean diet in pregnant individuals: A prospective study

Metabolomic profiling is a systematic approach to identifying biomarkers for dietary patterns. Yet, metabolomic markers for dietary patterns in pregnant individuals have not been investigated. The aim of this study was to identify plasma metabolomic markers and metabolite panels that are associated with the Mediterranean diet in pregnant individuals. This is a prospective study of 186 pregnant individuals who had both dietary intake and metabolomic profiles measured from the Fetal Growth Studies-Singletons cohort. Dietary intakes during the peri-conception/1st trimester and the second trimester were accessed at 8-13 and 16-22 weeks of gestation, respectively. Adherence to the Mediterranean diet was measured by the alternate Mediterranean Diet (aMED) score. Fasting plasma samples were collected at 16-22 weeks and untargeted metabolomics profiling was performed using the mass spectrometry-based platforms. Metabolites individually or jointly associated with aMED scores were identified using linear regression and least absolute shrinkage and selection operator (LASSO) regression models with adjustment for potential confounders, respectively. Among 459 annotated metabolites, 64 and 41 were individually associated with the aMED scores of the diet during the peri-conception/1st trimester and during the second trimester, respectively. Fourteen metabolites were associated with the Mediterranean diet in both time windows. Most Mediterranean diet-related metabolites were lipids (e.g., acylcarnitine, cholesteryl esters (CEs), linoleic acid, long-chain triglycerides (TGs), and phosphatidylcholines (PCs), amino acids, and sugar alcohols. LASSO regressions also identified a 10 metabolite-panel that were jointly associated with aMED score of the diet during the peri-conception/1st trimester (AUC: 0.74; 95% CI: 0.57, 0.91) and a 3 metabolites-panel in the 2nd trimester (AUC: 0.68; 95% CI: 0.50, 0.86). We identified plasma metabolomic markers for the Mediterranean diet among pregnant individuals. Some of them have also been reported in previous studies among non-pregnant populations, whereas others are novel. The results from our study warrant replication in pregnant individuals by future studies. This study was registered at ClinicalTrials.gov.

Nutrition Literacy Is Not Sufficient to Induce Needed Dietary Changes in Nonalcoholic Fatty Liver Disease.

Dietary and lifestyle changes are the first line of therapy for nonalcoholic fatty liver disease (NAFLD), the most prevalent liver disease in the western world. Nutrition literacy is the ability to understand nutrition information and implement that knowledge. We aimed to compare indicators of nutrition literacy in subjects with and without NAFLD in a representative US cohort. In a cross-sectional study using data from the National Health and Nutrition Examination Survey 2017-2018 cycle, we included 2,938 adult subjects with complete dietary and vibration-controlled transient elastography data and no alternative reason for hepatic steatosis. Nutrition literacy was assessed using questionnaires. Diet perception accuracy was assessed by comparing self-reported diet quality with objective diet quality scores-the Healthy Eating Index and alternative Mediterranean diet score-to assess real-world application of nutrition knowledge. Nutrition literacy was not different between subjects with or without NAFLD ( P = 0.17): more than 90% of subjects reported using nutrition labels, and most of them correctly identified the meaning of daily value. Subjects with NAFLD had a lower-quality diet (Healthy Eating Index, P = 0.018; alternative Mediterranean diet, P = 0.013) and rated their diet as poorer ( P < 0.001). On self-assessment, only 27.8% of subjects overestimated their diet quality, while 37.5% consumed more calories than their self-assessed needs. Both accuracy measures were similar between subjects with NAFLD and those without ( P = 0.71 and 0.63, respectively). Subjects with NAFLD were more likely to report being advised to lose weight (42.1% vs 16.5%, P < 0.001) or to attempt losing weight (71.9% vs 60.9%, P < 0.001). Diet quality was not better in subjects with NAFLD who received dietary recommendations. Subjects with NAFLD have poor diet quality despite receiving medical recommendations to lose weight and having nutrition literacy and perception that are comparable with subjects without NAFLD. Educational approaches may not be sufficient to promote weight loss and improve diet quality in NAFLD.

CULTURED MEAT: AN APPRAISAL FROM THE FIQH AND SUFI VIEWS OF MUSLIM SCHOLARS

Meat comprises of important nutrients for human body. As population of human increases, the demand for meat also keeps increasing. Therefore, a new alternative is introduced by inventing a cultured meat obtained from the outer side of the animal's body and became the rumours in the 1930s. In spite of that, the idea of cultured meat invention was only realized in 2013 by a Dutch scientist which was invented a burger-shaped cultured beef. However, this invention did not exist in the time of the Prophet, his companions and the tābi'īn and it becomes a polemic among the Muslim community regarding of its halal status nowadays. The existence of cultured meat in the current society needs a clear explanation and procedure in fiqh because it is one of the new discoveries in food industry. This study is important as to provide a good understanding and new knowledge to the Muslim society. A clear fiqh approaches will give guidelines to the society whether considering it as a staple or alternative diet. Otherwise, they may avoid to consume cultured meat product as a precaution from haram and uncertainty (shubhah) and also may ensure of the purity of soul abreast with the main objective in sufism’s live. This study used qualitative descriptive research method by analyzing some previous studies as secondary sources that have been recorded elsewhere, processed, printed and disseminated to the public. The results found that cultured meat is a new discovery in Malaysia. Although the original law for this cultured meat is halal law, if it does not meet the shariah principles and criteria, it is considered haram. This review paper highlights on the halal status of cultured meat from fiqh and sufism in terms of the transformative form of Allah’s creation. Based on the primary sources of fiqh and sufism, the status of cultured meat is considered halal provided if in the condition of shortage of meat is affected the needs of population and also it causes no harm to people to consume as to enhance the prosperity of human beings. Further research must also be done to verify that it is also tayyiban and fulfils the maqasid in Islamic nutrition and the effects of consumption to consumers.

Healthy Eating Patterns and Risk of Total and Cause-Specific Mortality

The current Dietary Guidelines for Americans recommend multiple healthy eating patterns. However, few studies have examined the associations of adherence to different dietary patterns with long-term risk of total and cause-specific mortality. To examine the associations of dietary scores for 4 healthy eating patterns with risk of total and cause-specific mortality. This prospective cohort study included initially healthy women from the Nurses' Health Study (NHS; 1984-2020) and men from the Health Professionals Follow-up Study (HPFS; 1986-2020). Healthy Eating Index 2015 (HEI-2015), Alternate Mediterranean Diet (AMED) score, Healthful Plant-based Diet Index (HPDI), and Alternate Healthy Eating Index (AHEI). The main outcomes were total and cause-specific mortality overall and stratified by race and ethnicity and other potential risk factors. The final study sample included 75 230 women from the NHS (mean [SD] baseline age, 50.2 [7.2] years) and 44 085 men from the HPFS (mean [SD] baseline age, 53.3 [9.6] years). During a total of 3 559 056 person-years of follow-up, 31 263 women and 22 900 men died. When comparing the highest with the lowest quintiles, the pooled multivariable-adjusted HRs of total mortality were 0.81 (95% CI, 0.79-0.84) for HEI-2015, 0.82 (95% CI, 0.79-0.84) for AMED score, 0.86 (95% CI, 0.83-0.89) for HPDI, and 0.80 (95% CI, 0.77-0.82) for AHEI (P < .001 for trend for all). All dietary scores were significantly inversely associated with death from cardiovascular disease, cancer, and respiratory disease. The AMED score and AHEI were inversely associated with mortality from neurodegenerative disease. The inverse associations between these scores and risk of mortality were consistent in different racial and ethnic groups, including Hispanic, non-Hispanic Black, and non-Hispanic White individuals. In this cohort study of 2 large prospective cohorts with up to 36 years of follow-up, greater adherence to various healthy eating patterns was consistently associated with lower risk of total and cause-specific mortality. These findings support the recommendations of Dietary Guidelines for Americans that multiple healthy eating patterns can be adapted to individual food traditions and preferences.

Usage of Complementary and Alternative Methods, Lifestyle, and Psychological Variables in Cancer Care.

People who are undergoing cancer treatment often ask themselves what they can do in addition to conventional medical therapy with regard to nutrition, activity, and complementary methods. However, we know little about the motivation why people opt for one or the other measure. The aim of this study was therefore to examine the extent of physical activity (PA), healthy nutrition, and the use of complementary methods in relation to both demographic and psychological data. A questionnaire was used to collect data on demographic data, resilience, coherence, self-efficacy, spirituality, satisfaction, and complementary and alternative medicine (CAM) behavior, PA, and diet. Between March and July 2021, data from 446 patients were collected. Regression models and correlation analyzes were used to examine the associations between CAM use, diet and PA with the other variables surveyed. CAM usage could only be predicted based on the patient's spirituality. Women used CAM more often and ate more healthily. Healthy eating was also related to younger age, shorter medical history, resilience, satisfaction, and coherence. In addition, the results showed that daily PA was related to the level of resilience, spirituality, and self-efficacy. Which people or why patients use CAM remains a question to be further investigated. Our data suggest that CAM seeks to address similar needs that others find in spirituality. In order to promote a healthy diet and PA in cancer patients in the future, various psychological variables seem conceivable. Resilience stands out, which is related to an overall healthier lifestyle.

Association between a priori and a posteriori dietary patterns and the risk of type 2 diabetes: a representative cohort study in Taiwan.

The present study aimed to investigate the relationship between dietary patterns and the risk of type 2 diabetes mellitus (T2DM) among Taiwanese individuals. Data were collected using a nationwide cohort study (2001-15) from the Triple-High Database. Dietary intake was assessed using the twenty-group food frequency questionnaire and used to calculate alternate Mediterranean diet (aMED) and Dietary Approaches to Stop Hypertension (DASH) scores. Principal component analysis (PCA) and partial least-squares (PLS) regression were used to derive dietary patterns, with incident T2DM as the outcome. Multivariable-adjusted hazard ratios and 95 % confidence intervals were calculated using time-dependent Cox proportional hazards (Cox PH) regression analysis, and subgroup analyses were performed. A total of 4705 participants were enrolled in the study, and 995 had newly developed T2DM during the median 5⋅28-year follow-up period (30⋅7 per 1000 person-years). Six dietary patterns were extracted (PCA: Western, prudent, dairy and plant-based; PLS: health-conscious, fish-vegetable and fruit-seafood). The highest aMED score quartile had a 25 % (hazard ratio 0⋅75; 95 % CI 0⋅61, 0⋅92; P = 0⋅039) lower risk of T2DM than the lowest quartile. This association remained significant after adjustment (adjusted hazard ratio 0⋅74; 95 % CI 0⋅60, 0⋅91; P = 0⋅010), and no effect modifier was found for aMED. The DASH scores, PCA and PLS dietary patterns were not significant after adjustment. In conclusion, high adherence to a MED-type dietary pattern by Taiwanese foods was associated with a lower risk of T2DM in the Taiwanese population, regardless of unhealthy lifestyle habits.

Abstract C102: Interactions of a polygenic risk score and modifiable lifestyle factors for breast cancer in the Multiethnic Cohort

Abstract Purpose: A polygenic risk score (PRS) has demonstrated great potential in stratifying breast cancer risk in non-African ancestry populations. Several modifiable lifestyle risk factors have been identified for breast cancer, although little is known regarding their effects among women with varying genetic risk. Methods: In the Multiethnic Cohort (MEC), we conducted a nested case-control study of 3,229 breast cancer cases and 3,921 controls from five major racial/ethnic groups (White, African American, Latino, Japanese American, and Native Hawaiian). We examined a PRS of 313 variants in association with breast cancer risk and evaluated the interaction with selected modifiable lifestyle factors on the risk of breast cancer. The modifiable lifestyle factors examined included body mass index (BMI), physical activity, smoking, alcohol consumption, and five diet quality indexes, such as the Healthy Eating Index (HEI)-2010, the Alternative Healthy Eating Index (AHEI)-2010, the alternate Mediterranean Diet score (aMED), the Dietary Approaches to Stop Hypertension score (DASH), and the Dietary Inflammatory Index (DII). Results: The 313-variant PRS was strongly associated with breast cancer risk across the five racial/ethnic groups, with per standard deviation (SD) odds ratios (OR) of 2.07 (95% CI=1.63-2.63) in Native Hawaiian, 1.72 (95% CI=1.54-1.92) in White, 1.56 (95% CI=1.36-1.77) in Latina, 1.45 (95% CI=1.31-1.60) in Japanese American, and 1.32 (95% CI=1.20-1.44) in African American women. For the lifestyle factors, BMI (OR=0.84, 95% CI=0.75-0.93, for &amp;lt;25 vs. ≥ 25 kg/m2) and alcohol consumption (OR=1.14, 95% CI=1.02-1.26 for drinkers vs. non-drinkers) were significantly associated with breast cancer risk. We also observed a suggestive positive association for smoking (OR=1.14, 95% CI=0.98-1.32 for current vs. never/past smokers) and a suggestive inverse association for AHEI-2010 (OR=0.96, 95%CI=0.91-1.01 per SD increment). No association was observed for physical activity or other dietary indexes. We found that the association of BMI and AHEI-2010 with breast cancer risk depended on PRS. Specifically, among women with above-average genetic risk (50-100% of PRS), the OR of breast cancer was 0.77 (95% CI=0.66-0.88) for women with a BMI &amp;lt;25 kg/m2 (vs. BMI³25 kg/m2), while among women with below-average genetic risk (0-50% of PRS) the OR was 0.96 (95%CI=0.81-1.14, P-heterogeneity=0.04). In contrast, a significant inverse association of AHEI-2010 (per SD) with breast cancer risk was only observed in women with below-average genetic risk (OR=0.90, 95%=0.83-0.97) but not among women with above-average genetic risk (OR=1.00, 95%CI=0.94-1.08, P-heterogeneity=0.04). Conclusions: In line with previous reports, the 313-variant PRS was effective in stratifying breast cancer risk, with diminished transferability for women of African ancestry. Our findings also suggest that maintaining a healthy BMI may offset the genetic risk of breast cancer, while adhering to a healthy dietary pattern may further reduce risk for women with lower genetic risk. Citation Format: Alisha Chou, Fei Chen, Peggy Wan, Xin Sheng, Song-Yi Park, Daniel O. Stram, Lynne R. Wilkens, Loic Le Marchand, Christopher A. Haiman. Interactions of a polygenic risk score and modifiable lifestyle factors for breast cancer in the Multiethnic Cohort [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C102.

Healthy dietary patterns and risk of cardiovascular disease in diabetic patients: a prospective cohort study.

Purpose: Evidence is limited regarding the associations of different dietary patterns with cardiovascular disease (CVD) risk among the population with diabetes. Thus, we aimed to explore the associations between three dietary patterns and CVD incidence among the population with diabetes. Materials and methods: We prospectively followed 22 473 diabetic patients from the UK Biobank at the baseline. The healthy dietary pattern was derived from a food frequency questionnaire; meanwhile, the Alternate Mediterranean Diet (AMED) and the Dietary Approaches to Stop Hypertension (DASH) diet were assessed based on the Oxford WebQ online 24 h dietary questionnaire. Results: During an average of 10.8 years of follow-up, 5209 incident CVD cases, including 3552 coronary heart disease (CHD) events and 881 strokes, were documented. After multivariate adjustment, a higher healthy diet score was negatively associated with CVD, CHD, and stroke incidence. The hazard ratios and 95% confidence intervals across increasing quintiles of healthy diet score were 0.86 (0.79-0.95), 0.83 (0.75-0.93), and 0.71 (0.57-0.88) for CVD, CHD, and stroke, respectively. A similar protective association with CVD incidence was found for the AMED but not the DASH diet. Conclusions: Adherence to healthy dietary patterns is related to a lower risk of developing CVD among diabetic patients. Our findings further provide vigorous evidence for formulating dietary adherence guidelines for diabetic patients to reduce the burden of CVD complications.