Dietary Factors Research Articles

Predictive role of the dietary inflammatory index on stroke risk among hypertensive patients

This study aims to evaluate the association between the dietary inflammatory index (DII) and stroke risk in hypertensive patients. Data were sourced from the National Health and Nutrition Examination Survey (NHANES) spanning 1999–2020, including 23,712 hypertensive patients. DII scores were calculated based on dietary intake data, and stroke diagnoses were determined through self-reported physician diagnoses. The relationship between DII and stroke risk was assessed using multivariable logistic regression models. Dose–response relationships and subgroup differences were explored through stratified analysis and restricted cubic spline (RCS) methods. Key dietary factors associated with stroke were identified using least absolute shrinkage and selection operator (LASSO) regression and incorporated into a risk prediction nomogram model. The model’s discriminatory ability for stroke was evaluated using receiver operating characteristic (ROC) curves. After adjusting for confounding factors, the highest DII quartile was associated with an adjusted odds ratio (OR) of 1.44 (95% CI 1.19, 1.74) for stroke compared to the lowest quartile, and each unit increase in DII was associated with an OR of 1.08 (95% CI 1.04–1.13) for stroke prevalence. The RCS curve demonstrated a nonlinear relationship between DII and stroke, with a turning point at 0.29. The nomogram model based on key dietary factors identified by LASSO regression had an area under the curve (AUC) of 70.93% (95% CI 69.81%–72.06%). There is a nonlinear relationship between DII and stroke risk in hypertensive patients. Given the inherent limitations of a cross-sectional study design, further research is needed to establish causality.

Unlocking the Power of the Mediterranean Diet: Two in One—Dual Benefits for Rheumatic and Thyroid Autoimmune Diseases

In recent years, autoimmune diseases are becoming more and more prevalent worldwide, with this rapid rise being influenced by environmental factors linked to lifestyle changes in modern societies. In this context, the role of diet has been the topic of extensive research as evidence has mounted that particular dietary patterns may contribute to or modulate autoimmunity. The present review specifically focuses on the Mediterranean diet (MD) as a whole dietary pattern, and on its peculiar components, such as n-3 polyunsaturated fatty acids (PUFAs), polyphenols and fiber. We explored their potential benefits in a spectrum of both systemic and organ-specific autoimmune disorders, including rheumatic diseases (like rheumatic arthritis and systemic lupus erythematosus), and thyroid diseases (like Hashimoto’s thyroiditis), since they often occur in the same individuals. Here, we offer a comprehensive review about the influence of dietary factors on these autoimmune diseases and potential translation into therapeutic interventions, as an adjuvant therapeutic approach to improve autoimmunity-related outcomes.

Decoding the genetic and environmental forces in propelling the surge of early-onset colorectal cancer.

Early-onset colorectal cancer (EOCRC) shows a different epidemiological trend compared to later-onset colorectal cancer, with its incidence rising in most regions and countries worldwide. However, the reasons behind this trend remain unclear. The etiology of EOCRC is complex and could involve both genetic and environmental factors. Apart from Lynch syndrome and Familial Adenomatous Polyposis, sporadic EOCRC exhibits a broad spectrum of pathogenic germline mutations, genetic polymorphisms, methylation changes, and chromosomal instability. Early-life exposures and environmental risk factors, including lifestyle and dietary risk factors, have been found to be associated with EOCRC risk. Meanwhile, specific chronic diseases, such as inflammatory bowel disease, diabetes, and metabolic syndrome, have been associated with EOCRC. Interactions between genetic and environmental risk factors in EOCRC have also been explored. Here we present findings from a narrative review of epidemiological studies on the assessment of early-life exposures, of EOCRC-specific environmental factors, and their interactions with susceptible loci. We also present results from EOCRC-specific genome-wide association studies that could be used to perform Mendelian randomization analyses to ascertain potential causal links between environmental factors and EOCRC.

Global regional, and national burden of type 2 diabetes attributable to dietary factors from 1990 to 2021

The study comprehensively assesses the global burden of type 2 diabetes (T2D) linked to dietary factors from 1990 to 2021. Data from the Global Burden of Disease Study 2021 (GBD 2021) was analyzed for T2D dietary risk factors across 204 countries, using age-standardized metrics and SDI quintiles, with joinpoint regression and other analytical methods. The results revealed a significant increase in the global burden of T2D, with a 1.92-fold rise in DALYs and a 1.28-fold rise in total mortality cases due to dietary risks. High intake of processed meat and sugar-sweetened beverages were identified as major contributors to the increasing burden, whereas the age-standardized mortality rates attributable to low vegetable intake declined over time. The study also emphasized the impact of age, period, and cohort effects on the incidence of T2D, along with the growing health disparity gaps between high and low SDI countries. The study emphasizes the importance of dietary interventions to reduce T2D burden, suggesting a decrease in processed meat and sugary drink consumption and an increase in vegetable intake. It calls for global strategies to address health disparities and improve equitable access to health resources.

Seasonal variation in gut microbiota of migratory wild raptors: a case study in white-tailed eagles

BackgroundMigration poses significant energetic challenges for migratory birds, during which both intrinsic and extrinsic factors affecting the gut microbiota alter substantially. While the temporal dynamics of gut microbiota in wild birds across migration seasons have garnered increasing attention, research on the seasonal variation in wild raptors remains limited despite their distinct gut microbiota structures. Furthermore, raptors, being the highest trophic level in the food chain, have been found to harbor more pathogens and antibiotic resistance genes (ARGs). In this study, we characterized the diversity and composition of the gut microbiota of wild white-tailed eagles at a critical stopover site along the East Asian Flyway (EAF). Fecal samples were collected during both autumn and spring migration seasons and microbial compositions were analyzed using high-throughput sequencing.ResultsThe most prevalent bacterial phylum in the gut microbiome of white-tailed eagles during both migration seasons was Firmicutes. The diversity of the gut microbiota is elevated in the spring migration season and the bacterial community composition significantly differed between two seasons. Individuals in spring migration show elevated levels of Clostridium_sensu_stricto_13 and Brochothrix, most likely related to the consumption of carrion. Conversely, individuals in autumn migration showed a higher prevalence of potential pathogens such as Fusobacterium and Escherichia-Shigella. Furthermore, we found that specific genera were seasonally enriched, probably reflecting distinct environmental exposures along migration routes.ConclusionsThis study revealed substantial seasonal variation in the gut microbiota of migratory white-tailed eagles, most likely shaped by dietary shifts, environmental factors, and physiological stress during migration. The higher prevalence of pathogens during autumn migration highlights potential health risks for eagles and their ecosystems, emphasizing the need for targeted conservation strategies at stopover sites. These findings contribute to understanding the dynamic interactions between migration and gut microbiota in wild raptors and provide valuable insights into their ecological and health management. While dietary differences may play a role, further research is needed to directly assess their impact.

Dietary factors and oral cancer risk: a comprehensive Mendelian randomization analysis in a European population

BackgroundOral cancer is one of the most prevalent malignant tumors in the field of oral and maxillofacial surgery. The main etiological factors are tobacco and alcohol, and diet is now considered an important factor in its development. However, it remains to be elucidated whether the associations between specific diets and oral cancer risk are causal. Therefore, in this study, we performed two-sample Mendelian randomization (MR) analyses to estimate the associations of specific diets with the risk of oral cavity cancer (OCC).MethodsWe conducted a two-sample MR analysis to assess the causal effect of diet on the risk of OCC. Six types of diets, including champagne or white wine (sample size: 175,549), red wine (sample size: 211,628), dried fruit (sample size: 409,125), fresh fruit (sample size: 433,186), average weekly beer plus cider (sample size: 327,634), and never eat eggs, dairy, wheat, sugar: wheat products (sample size: 461,046), were included as exposures. Summary statistics of OCC were obtained from a genome-wide association study (GWAS) including 1223 OCC cases and 2928 controls of European ancestry. We used the inverse-variance weighted (IVW) method as the primary method, with the weighted median and MR Egger used as supplementary methods for causal inference. Sensitivity analyses, including the Cochran Q test, Egger intercept test, MR-PRESSO test, and leave-one-out analysis, were performed to verify the robustness of the MR results.ResultsThe univariate MR showed that champagne or white wine consumption (β = 11.80, p = 0.006), average weekly beer plus cider intake (β = 4.73, p = 0.003), red wine consumption (β = 8.22, p = 0.024), and the never eat eggs, dairy, wheat, sugar: wheat products (β = 14.34, p = 0.002) increased the risk of OCC; Whereas fresh fruit consumption (β = − 3.20, p = 0.038), dried fruit consumption (β = − 2.98, p = 0.012) were protective. The multivariable MR estimates, after controlling for other diets, were as follows: when controlling for the never eat eggs, dairy, wheat, sugar: wheat products and fresh fruit consumption, the effect of average weekly beer plus cider intake on OCC risk was significant, and when controlling for dried fruit consumption, the effect had a P-value close to significant (p = 0.052). The two-step MR showed human characterization: When assessing the impact of dried fruit consumption and fresh fruit consumption, we observed a mediation effect of appendicular lean mass. Furthermore, when assessing the impact of dried fruit consumption and average weekly beer plus cider intake, we observed a mediation effect of standing height. Human system: When exploring the influence of never eat eggs, dairy, wheat, sugar: wheat products, we found a mediation effect of the occurrence of hypothyroidism. Likewise, when assessing the impact of fresh fruit consumption, we found the mediation effect of other diseases of the digestive system. Human metabolite: For the never eat eggs, dairy, wheat, sugar: wheat products, we observed a mediation effect of triglyceride levels in LDL and triglyceride levels in small LDL.ConclusionsThis study provides champagne or white wine consumption, average weekly beer plus cider intake, red wine consumption, and the never eat eggs, dairy, wheat, sugar: wheat products may increased the risk of OCC; Whereas fresh fruit and dried fruit consumption may were protective. This study analyzed the pathways by which dietary factors influence OCC in aspect of human characterization, human system, and human metabolite. These findings may help inform future research on preventing or treating OCC by modifying dietary factors.

Global burden of TBL cancer in older adults: the role of dietary factors (1990–2021)

BackgroundThe incidence and mortality rates of trachea, bronchus, and lung cancers (TBL) continue to rise globally. Despite a trend of increasing cases among younger populations, the majority of patients with TBL remain concentrated in the 50 + age group. A comprehensive analysis of data from the Global Burden of Disease (GBD) database reveals that fruit-deficient diets significantly contribute to both mortality and disability-adjusted life years (DALYs) associated with TBL, particularly in patients aged 55 and older, thus posing a major global health challenge. This highlights the critical need to address the burden of this dietary risk factor in older populations. Leveraging the unparalleled value of GBD research in assessing health impacts, this study emphasizes the importance of mitigating the influence of poor dietary habits on elderly populations. The goal is to support informed public health decisions and strategies that can advance global health outcomes.MethodsBetween 1990 and 2021, this study systematically analyzed key indicators for patients with TBL aged 55 + , including morbidity, mortality, DALYs, age-standardized incidence rates (ASIRs), age-standardized mortality rates (ASMRs), and age-standardized DALYs (ASDRs). A thorough risk association analysis was conducted regarding the role of fruit-poor diets in TBL incidence. Data visualization and graphing were performed using JD_GBDR (V2.32) to explore disease characteristics and risk factors, enabling rigorous analysis of the impact of dietary patterns on TBL outcomes in this demographic.ResultsFrom 1990 to 2021, the global incidence of TBL has shown a marked increase in individuals aged 55 and older. By 2021, cases are projected to reach 2.02 million, with deaths rising to 1.8 million. Over the past 30 years, morbidity has surged by 116.82%, mortality by 99.88%, and DALYs by 80.56%. Notably, within the TBL patient group aged over 55, insufficient fruit intake has emerged as a key factor, contributing to 56,583 deaths—a 39.33% increase in mortality since 1990—and 1,200,556 DALYs, reflecting a 26.48% rise. These figures underscore the significant role of inadequate fruit intake in the disease progression of older patients with TBL, directly influencing mortality rates and DALY outcomes.ConclusionThe study reveals an overall upward trajectory in global morbidity, mortality, and DALYs among patients with TBL aged 55 and older between 1990 and 2021. The growing impact of inadequate fruit intake on both mortality and disability-adjusted life years highlights the severity of this risk. Regional variations may occur due to local factors, including environment, healthcare access, and economic conditions. This research offers valuable insights into the global burden and distinct risk factors of TBL in older populations, with particular emphasis on the influence of dietary factors. Future studies and public health strategies must address these elements to effectively tackle the challenges associated with TBL.

Risk correlates of cardiovascular diseases, diabetes, and periodontal diseases: a cross-sectional study in India

BackgroundQuantifying shared risk factors among periodontal disease (PD), cardiovascular disease (CVD), type 2 diabetes (DM2) can bolster Common Risk Factor Approach (CRFA), enabling integration of PD prevention into non-communicable disease (NCD) prevention strategies. The objective of the study is to assess extent of overlap of shared risk factors between CVD, DM2, PD.Materials and methodsThis is an analytical cross-sectional study conducted at a tertiary care medical and dental teaching hospital in South India, from July 2022 to April 2024. Study included 600 participants (ages 18–75) divided into three groups: Group A: DM2, CVD, or both and PD; Group B: DM2 or CVD; and Group C: PD alone. Various demographic, metabolic, habit related, dietary and periodontal disease severity related risk factors were evaluated in the study.ResultsAmong 600 participants, 55.5% were male, 58.8% were under 50 years. Statistically significant odds ratios (ORs) for shared risk factors between Group A and Group B were observed for age > 50 (0.58), sedentary lifestyle (0.43), fat intake > 41 g/d (1.87), HbA1C ≥ 6.5% (0.56), FBS > 126 mg/dL (2.35) and family history of NCDs (9.8). For Group A versus Group C, statistically significant ORs were seen for age > 50 (0.55), HbA1c 5.7%-6.4% (0.34), triglycerides > 150 mg/dL (0.04), education (0.52), alcohol use (1.53) and poor oral hygiene (3.01). Severity of periodontal disease assessed using PSR, HbA1c, triglycerides, fat intake, age, education, obesity were identified as vital shared risk factors.Conclusion and relevanceAge, education, obesity, PSR, HbA1c, triglycerides emerged as significant shared risk factors. Integrating these factors into surveillance tools may enhance NCD and PD risk identification, supporting CRFA-based healthcare approach.Trial registrationCTRI/ 2022/06/043279 registered on 15th of June 2022.

A nutrient wide association study of cardiovascular disease prevalence in older adults from NHANES 2007 to 2018

Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, particularly among older adults. Identifying modifiable dietary factors associated with CVD prevalence is essential for prevention. This cross-sectional study analyzed 7,341 adults aged ≥ 65 years from NHANES 2007–2018. CVD was defined based on self-reported physician-diagnosed conditions, including coronary heart disease, heart failure, angina, heart attack, or stroke. A nutrient-wide association study (NWAS) evaluated associations between 56 dietary nutrients and CVD prevalence using multivariable logistic regression. Dose–response relationships were assessed using restricted cubic spline (RCS) models. Model discrimination was evaluated using receiver operating characteristic (ROC) analysis. Eight nutrients were significantly associated with CVD prevalence after adjusting for confounders and correcting for multiple comparisons: PUFAs 20:4 (OR 0.88, 95% CI 0.80–0.97, P = 0.024), 22:5 (OR 0.72, 95% CI 0.56–0.92, P = 0.019), and 22:6 (OR 0.92, 95% CI 0.87–0.99, P = 0.032); total choline (OR 0.96, 95% CI 0.93–0.99, P = 0.024); cholesterol (OR 0.89, 95% CI 0.82–0.96, P = 0.037); protein (OR 0.82, 95% CI 0.76–0.89, P = 0.040); vitamin A (OR 0.95, 95% CI 0.91–0.99, P = 0.045); and total sugars (OR 0.97, 95% CI 0.96–0.98, P = 0.049). Clustering analysis identified protective effects of fat-soluble vitamins and unsaturated fatty acids. The inclusion of these nutrients significantly improved model discrimination (P < 0.05). This study identified key dietary nutrients and clusters associated with CVD prevalence and characterized their dose–response relationships. Integrating these nutrients into predictive models enhances CVD risk discrimination, providing actionable dietary targets for prevention strategies in older adults.

Nutritional knowledge, fiber intake, body mass index, and sex associated with constipation symptoms in Peruvian adults

Functional constipation is a common gastrointestinal disorder influenced by dietary, anthropometric, and demographic factors. However, the combined impact of these factors on constipation symptoms remains underexplored, particularly within the Peruvian population. To assess the association of nutritional knowledge, fiber-rich food consumption, body mass index (BMI), and sex with functional constipation symptoms in Peruvian adults. A cross-sectional study was conducted among 404 Peruvian adults selected through non-probability sampling. Nutritional knowledge (assessed using the Dietary Fiber Habits and Knowledge Questionnaire), fiber-rich food consumption (measured with the Block Instrument), BMI (self-reported and calculated), and constipation symptoms (evaluated using the Rome III International Diagnostic Questionnaire) were analyzed. Hierarchical regression analysis was performed to evaluate the impact of the variables on constipation symptoms. The hierarchical regression analysis, conducted in four blocks, demonstrated a progressive increase in the explained variance. In the fourth block, nutritional knowledge (β = − 0.173, p = 0.006, CI [− 0.296, − 0.050]) and consumption of high-fiber foods (β = − 0.227, p < 0.001, CI [− 0.351, − 0.103]) were associated with a reduction in constipation symptoms, while BMI (β = 0.230, p < 0.001, CI [0.108, 0.353]) and being female (β = 0.153, p = 0.014, CI [0.031, 0.274]) were associated with an increase in symptoms. The final model accounted for 16.4% of the total variance (adjusted R2 = 0.164), with fiber consumption contributing to a 5.2% increase in explained variance (∆R2 = 0.052). These findings underscore the importance of implementing public health educational and dietary strategies to address constipation through preventive and personalized approaches.

Clinical and dietary risk factors of hyperuricemia in Korean children and adolescents: the 8th Korea National Health and Nutrition Examination Survey.

Clinical and dietary risk factors of hyperuricemia in Korean children and adolescents: the 8th Korea National Health and Nutrition Examination Survey.

The Impact of Dietary Sugars and Saturated Fats on Body and Liver Fat in a Healthcare Worker Population

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent disease influenced by dietary factors. While high sugar and fat consumption are associated with weight gain, their specific impact on liver fat accumulation remains unclear. This study aimed to evaluate the relationship between sugar and saturated fat intake and liver and body fat composition. Methods: A cross-sectional study was conducted from September 2021 to February 2023 in workers from a tertiary care center in Mexico City. Anthropometric measurements, body composition (bioelectrical impedance analysis and skinfold assessment), physical activity, and liver fat (vibration-controlled transient elastography) were measured. Dietary intake was assessed with a 24-h recall questionnaire and analyzed with specialized software. Linear and logistic regression models were fitted to study the relationship between nutrient intake and liver/body fat. Results: A total of 534 healthcare workers (median age: 41.5 years, 61.4% female) were included. Hepatic steatosis was present in 42.5% of participants. Higher carbohydrate intake was associated with increased liver fat (β = 0.23, 95% CI: 0.02–0.45), with each additional 15 g of carbohydrates increasing the odds of steatosis by 5% (OR = 1.053, 95% CI: 1.006–1.102). Fat and sugar intake were associated with higher body fat but not liver fat. Conclusions: Carbohydrate intake was linked to liver fat accumulation, whereas fat and sugar intake were primarily associated with body fat. Tailored dietary recommendations could be informed by these findings. Prospective dietary assessment methods and a nutritional geometry approach could be applied in future studies.

Dietary Quality Index-International and the odds of irritable bowel syndrome: a case-control study.

Irritable bowel syndrome (IBS) is a common gut-brain interaction disorder. The etiology of IBS is not entirely elucidated, however, among the risk factors, dietary factors are regarded as crucial. Previous studies have primarily investigated the association of single nutrients and food groups with odds of IBS, rather than diet quality, which considers the interaction of food groups in odds of disease. Thus, the current study sought to investigate the association of dietary quality index-international (DQI-I) and odds of IBS in Iranian adults. In this case-control study, dietary intakes of 100 IBS cases and 310 healthy controls were examined using a validated Dish-based Semi-quantitative Food Frequency Questionnaire (DS-FFQ). DQI-I score was then calculated based and categorized into tertiles. The Persian version of the Rome IV questionnaire was utilized to assess IBS. Multivariable logistic regression was used to assess the association of DQI-I score and the odds of IBS. After controlling for potential confounders, no significant association was shown between DQI-I scores and IBS odds among whole and gender-stratified groups. Although DQI-I represents a healthy diet, the results of the current case-control study demonstrated that, a higher DQI-I score was not associated with reduced odds of IBS in fully adjusted regression models. Considering inherent limitations as well as the scarce evidence regarding the association between DQI-I and odds of IBS, further large-scale, prospective studies are required to confirm our findings.

The Role of Lipid Metabolism Disorders in Rhinitis and Asthma.

The current core theory of rhinitis and asthma is referred to as the antigen-antibody theory. However, the academic perspective is insufficient to explain the issues that arise in the epidemiology, pathophysiology, and clinical treatment of these diseases. So, the academic field of lipid metabolism disorders emerged. This perspective aims to explore two aspects: firstly, the overall approach and definition (starting with a new origin of the digestive tract rather than antigens from the respiratory tract; the non-digestion of various nutrients and the effects of probiotics result in a series of pathological and physiological changes in the body) and secondly, key aspects, such as 1. Dietary factors and lipid disorders that occur first, followed by airway hyperresponsiveness and asthma; 2. The prominent role of lipid droplet morphology in mast cells manifested as a bridge between lipid metabolites and lipid mediators released during allergies; and 3. Low-energy diet intervention with a significant effect on patients. This perspective offers valuable insights into new factors for the primary prevention of these diseases and exploring new avenues for the treatment of such diseases.

A Review of Mental Health: Epidemiology, Interventions, and Treatment Modalities

Abstract: Psychiatric problems are widespread globally, with depression ranking as the third most prevalent factor. By 2030, it is forecasted to become the leading factor contributing to the occurrence of diseases. The state of one's mental health has a substantial influence on their sense of value, relationships with others, and day-to-day functioning. Signs and symptoms of mental health issues can include enduring feelings of sadness, disruptions in sleep patterns, reduced energy levels, alterations in appetite, changes in behaviour and thoughts, difficulties with concentration, substance abuse, detachment from reality, managing daily stress, problems in relationships, deterioration in personal care, and a noticeable decline in performance at school, work, or social activities. These symptoms may result in social isolation, emotional eruptions, intense rage, suicidal ideation, impaired focus, and challenges in interpersonal interactions. Having an optimal state of mental health can significantly improve the overall quality of life, whilst having a substandard state of well-being can worsen it. There is a strong association between poor mental health and a range of diseases, such as chronic inflammation, cardiovascular dysfunction, asthma, metabolic disorders, diabetes, cancer, autoimmune syndromes, and neurological diseases. Various elements, including biological, psychological, behavioural, dietary, and social factors, might exert an influence on mental health. The government implements actions and projects to improve global mental health, and there are multiple ways available for assessing mental health. Medicinal therapies such as Ayurvedic, Homeopathic, Allopathic, and Unani can be utilized to enhance mental health. The extent to which psychological therapy can improve mental health is still a mystery to us. A thorough literature review was conducted using various databases (e.g., PubMed, Scopus) and government websites, focusing on mental health, including epidemiology, interventions, and treatment methods. Additionally, the potential impacts of climate change on mental health were examined. This study aimed to address the limitations of previous reviews by evaluating the effectiveness of various psychological interventions, regardless of their theoretical foundation, and assessing the influence of different moderators in a single systematic review and meta-analysis. While further research is needed, the review offers insights into the design of psychological interventions to enhance mental well-being.

The burden of colorectal cancer attributable to diet low in whole grains from 1990 to 2021: a global, regional and national analysis

BackgroundColorectal cancer (CRC) is a major global health issue, with rising incidence and mortality rates. Dietary factors, especially whole grains consumption, are critical in determining CRC risk. Understanding CRC deaths and disability-adjusted life years (DALYs) related to low whole grains diets is important for prevention. The purpose of the study is to investigate temporal and geographic trends in CRC deaths and DALYs attributable to diet low in whole grains at the global, regional, and national levels from 1990 to 2021.MethodsThe data on CRC burden attributable to diet low in whole grains from 1990 to 2021 were extracted from the Global Burden of Diseases (GBD) 2021 database. We described the CRC burden attributable to diet low in whole grains across various years, genders, age groups (5-year age groups from 25 to 94 years and 95+ years), different Socio-demographic Index (SDI) regions and countries. To illustrate the temporal trends in the burden of CRC, we calculated the estimated annual percentage change (EAPC) from 1990 to 2021.ResultsFrom 1990 to 2021, the global number of CRC deaths attributable to diet low in whole grains increased from 101,813 (95% UI: 42,588 to 151,170) to 186,257 (95% UI: 76,127 to 284,803), representing a 82.94% growth. Similarly, the number of DALYs increased from 2,540,867 (95% UI: 1,050,794 to 3,754,416) to 4,327,219 (95% UI: 1,754,865 to 6,578,232), representing a 70.30% growth. However, both the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) exhibited a decline, with an EAPC of −0.82 (95% CI: −0.85 to −0.78) and − 0.84 (95% CI: −0.87 to −0.81), respectively. The disease burden is heavier in high SDI and high-middle SDI regions. However, between 1990 and 2021, the only region where both ASMR and ASDR increased was low-middle SDI, while in all other regions, they showed a declining trend. In 2021, East Asia had the highest number of CRC deaths and DALYs attributable to diet low in whole grains at the regional level, followed by Western Europe and High-income North America. Additionally, the burden is greater among males and the elderly. Between 1990 and 2021, the number of CRC deaths attributable to diet low in whole grains rose by 102.13% among males and by 63.20% among females. Generally, both the global age-specific mortality rate and the DALYs rate tend to increase with age. SDI demonstrates a nonlinear “S”-shaped correlation with both ASMR and ASDR of CRC attributable to diet low in whole grains. In 2021, the EAPC in ASMR of CRC attributable to diet low in whole grains was negatively associated with SDI (R = −0.402, p &amp;lt; 0.001), reaching the highest EAPC at approximately SDI of 0.51 and the lowest at 0.85. Similarly, the correlation between EAPC in ASDR and SDI in 2021 exhibited a similar pattern.ConclusionDespite a decline in the ASMR and ASDR of CRC attributable to diet low in whole grains from 1990 to 2021 globally, the absolute number of cases continues to increase, with a particularly notable burden observed in High-middle and High SDI regions, as well as among males and the elderly population. It is imperative to intensify efforts in CRC prevention and health education, specifically targeting these high-risk groups to raise public awareness and consumption of whole grains. Furthermore, screening initiatives should be intensified among these demographics to address the elevated risk of CRC mortality due to insufficient whole grains consumption.

Role of Pyroptosis in inflammatory bowel disease.

Role of Pyroptosis in inflammatory bowel disease.

Obesity, composite dietary antioxidant index, and their interactive association with the risk of cardiometabolic multimorbidity in the elderly from a large national survey

BackgroundDietary antioxidants and obesity are considered significant targets for disease prevention in the elderly. However, a possible cardiometabolic multimorbidity (CMM) correlated to dietary antioxidants and obesity is unknown. This study aimed to examine the relationship between dietary antioxidants and obesity with CMM in the older population.MethodsWe used data from the NHANES 2003–2018 cycles, including older adults aged 60 and above. Dietary antioxidant status was assessed using the CDAI, calculated from six micronutrients (vitamins A, C, E, selenium, zinc, and carotenoids), and obesity was classified based on BMI. We applied restricted cubic spline models to explore nonlinear associations and logistic regression to assess the associations between pro-oxidant diet, obesity, and CMM. The joint effects of pro-oxidant diet and obesity on CMM were evaluated using additive interaction indices: RERI, AP, and SI, to determine the synergistic impact of these factors. Subgroup analyses by age, sex, ethnicity, and hypertension status were also conducted to assess the synergistic effect of these factors within different population groups.ResultsA total of 13,178 older adults (mean age 69.85 ± 0.10 years; 45.1% male) were included in this study. A pro-oxidant diet and obesity jointly increased CMM risk, with the Pro-oxidant diet & Obese group having the highest risk (adjusted OR 3.11, 95% CI: 2.39–4.04), indicating that their likelihood of CMM was more than three times higher compared to the reference group (Anti-oxidant diet & Non-Obese group). The Anti-oxidant diet & Obese group (adjusted OR 2.03, 95% CI: 1.59–2.59) and the Pro-oxidant diet & Non-Obese group (adjusted OR 1.33, 95% CI: 1.08–1.64) also showed elevated risks, although to a lesser extent. These findings suggest that both dietary factors and obesity independently contribute to CMM risk, but their combined effect is more pronounced. The interaction between a pro-oxidant diet and obesity was synergistic, with the RERI indicating a positive interaction (0.75, 95% CI: 0.21, 1.29), the AP showing 24% of the combined effect due to their interaction, and the SI indicating a synergistic effect greater than additive (SI 1.55, 95% CI: 1.11–2.16). Subgroup analyses showed stronger interactions in females, younger individuals, non-Hispanic Whites, and those with hypertension.ConclusionsObesity and a pro-oxidative diet are correlated with the occurrence of CMM; there exists an interaction between obesity and a pro-oxidative diet concerning the initiation and advancement of CMM. Subgroup studies revealed more pronounced interactions among females, younger adults, non-Hispanic Whites, and individuals with hypertension.

Associations of healthy eating index 2020 and its components with non-alcoholic fatty liver disease in type 2 diabetes patients and the mediating roles of metabolic indicators: NHANES 2007–2018

BackgroundNon-alcoholic fatty liver disease (NAFLD) represents a major public health issue, especially among individuals diagnosed with Type 2 diabetes mellitus (T2DM), where its prevalence can reach up to 70%. This research examines the relationship between the Healthy Eating Index 2020 (HEI-2020) and its individual components with the occurrence of NAFLD in T2DM patients, while also investigating the potential mediating effects of various metabolic indicators.MethodsData from the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2018 were utilized. This cross-section study included 1,770 T2DM patients, who were divided into NAFLD and non-NAFLD groups using the Fatty Liver Index as a diagnostic tool. The HEI-2020, which assesses diet quality, was computed based on 24-h dietary recall data. Key metabolic indicators such as the triglyceride-glucose (TyG) index, metabolic score (MS), mean arterial pressure, uric acid levels, and total cholesterol were evaluated.ResultsThe findings indicated that higher HEI-2020 scores were associated with a lower likelihood of NAFLD (odds ratio 0.978, 95% confidence interval: 0.959–0.998), with the strongest inverse associations observed in the top quartiles of diet quality. Whole fruits, greens and beans, and saturated fat were crucial dietary factors. Mediation analysis demonstrated that the TyG index and MS accounted for 5.11 and 36.94% of the relationship between HEI-2020 and NAFLD, respectively.ConclusionGreater adherence to the HEI-2020 is associated with a lower likelihood of NAFLD in T2DM patients, with metabolic indicators partially mediating this association. Enhancing diet quality, particularly by increasing the consumption of whole fruits and greens while reducing saturated fat intake, may be important in managing metabolic health and liver function in this vulnerable population.

Knowledge, attitudes, and practices toward colorectal cancer lifestyle risk factors among adults in Saudi Arabia

BackgroundDespite an apparent increase in early-onset colorectal cancer (CRC) in Saudi Arabia, with the majority of patients being diagnosed at an advanced disease stage, no previous assessment of the knowledge, attitudes, and practices (KAP) toward its dietary and lifestyle-related risk factors has been reported. The aim of this study was to investigate the KAP levels with respect to these risk factors for CRC and examine possible associations between the studied variables among the Saudi population.MethodsThis cross-sectional study involved 1,040 participants aged 18 years or older. Data were collected by convenience sampling via a self-administered online questionnaire in Saudi Arabia between June and December 2023.ResultsA majority of participants (77.8%) displayed low knowledge about the dietary and lifestyle-related risk factors for CRC, while only 22.2% possessed high knowledge. Similarly, 78.6% of participants exhibited negative attitudes toward these risk factors, with just 21.4% having positive attitudes. Furthermore, 75.0% of participants reported engaging in poor practices, leaving only 25.0% demonstrating good practices related to CRC risk factors.ConclusionsThe findings of this study indicate insufficient KAP levels toward dietary and lifestyle-related risk factors for CRC in Saudi Arabia, highlighting the urgent need for nationwide initiatives and programs to promote improved knowledge, attitudes, and practices and reduce the effect of the risk factors contributing to CRC.