Dietary Total Energy Intake Research Articles

The association between adult asthma in the United States and dietary total energy intake: a retrospective cross-sectional analysis from NHANES

BackgroundEpidemiological research links asthma progression to dietary nonallergic factors, particularly high-calorie intake. However, evidence supporting the relationship with total dietary calorie consumption remains scarce.ObjectiveThis study aimed to explore the potential correlation between asthma occurrence and total dietary energy intake.MethodsA retrospective cross-sectional study of 21,354 US adults collected comprehensive participant data, including demographics, blood parameters, fatty acids, zinc, fiber intake, and asthma outcomes. Statistical analyses included interaction effects analysis, smooth curve fitting, and logistic regression.ResultsOf 21,354 participants, 14.77% self-reported asthma diagnosis. After adjusting for confounders, odds ratios (OR) for asthma decreased with higher energy intake: Q2 (OR = 0.77, 95% CI: 0.69–0.86, p < .001), Q3 (OR = 0.66, 95% CI: 0.59–0.75, p < .001), and Q4 (OR = 0.61, 95% CI: 0.53–0.69, p < .001) compared to Q1 (< 17.73 kcal/kg/day). A non-linear (L-shaped) association between energy intake and asthma was observed (p < .001), with a critical threshold around 24 kcal/kg/day, supported by subgroup and sensitivity analyses.ConclusionThis study reveals an L-shaped trend between total energy intake and asthma in US adults, with a significant threshold at approximately 24 kcal/kg/day.

Higher anthocyanin intake is associated with a lower risk of non-alcoholic fatty liver disease in the United States adult population.

Flavonoids are a class of plant chemicals known to have health-promoting properties, including six subclasses. Anthocyanin is one of the subclasses that have anti-inflammatory and antioxidant activities. However, the relationship between flavonoid subclass intake and the risk of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis has not been verified in representative samples of the United States. This is a cross-sectional study based on the data from the National Health and Nutrition Examination Survey (NHANES) and the Food and Nutrient Database for Dietary Studies (FNDDS) in 2017-2018. The intake of flavonoid subclasses of the participants was obtained from two 24 h dietary recalls. The NAFLD and liver fibrosis were defined based on the international consensus criteria. The relationship between flavonoid subclass intake and NAFLD and liver fibrosis was evaluated using a multivariate logistic regression model corrected for multiple confounding factors. Subgroup analysis, trend tests, interaction tests and restricted cubic spline were carried out to further explore this relationship. In addition, we also explored the relationship between anthocyanin and liver serum biomarkers, dietary total energy intake and healthy eating index (HEI)-2015 scores. A total of 2,288 participants were included in the analysis. The intake of anthocyanin was significantly negatively associated with the risk of NAFLD, but not other flavonoid subclasses. A higher anthocyanin intake was significantly associated with a lower risk of NAFLD (quartile 4, OR 0.470, 95% CI 0.275-0.803). The results of subgroup analysis showed that the protective effect of dietary anthocyanin intake on NAFLD was more pronounced in participants of non-Hispanic whites, with hypertension and without diabetes (P for interaction <0.05). Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), dietary total energy intake was significantly negatively correlated with dietary anthocyanin intake. We did not find any protective effect of flavonoid subclass intake on liver fibrosis. Anthocyanin, but not other flavonoid subclasses, can significantly reduce the risk of NAFLD. The protective effect was more pronounced in non-Hispanic whites, participants without diabetes and those with hypertension. Our study provides new evidence that anthocyanin intake has a reverse significant association with the risk for NAFLD.

Current Energy Availability Is Not Associated With The Menstrual Status Among Japanese Female Athletes

PURPOSE: Energy availability (EA) is defined as dietary total energy intake (TEI) minus exercise energy expenditure (EEE) normalized to fat-free mass (FFM). It is well known that chronic reduction in EA, below 30 kcal/kg FFM/day, is associated with impairments of a variety of body function such as menstrual disorder, endocrine dysfunction and decreased bone mineral density (BMD). Little is known regarding EA and the physiological parameters of Japanese female athletes classified according to menstrual status. Therefore, this study aimed to determine the current EA status, hormonal status and BMD in Japanese female athletes. METHODS: Eighteen female collegiate athletes were classified into two groups; the eumenorrheic group (EU, 22±1 years, n = 7) and the menstrual disorder group (MD, 20±1 years, n = 11). The ovulation status was checked before the experimental period using an ovulation test kit, and the date were collected during the early follicular phase in EU group. TEI was assessed using 7-days dietary records, EEE was measured via HR-VO2 methods, and hormonal status was measured from a fasting blood sample. Body composition and BMD were measured by dual energy X-ray absorptiometry. The eating attitude test (EAT-26) was used to assess susceptibility to eating disorders. RESULTS: EA was not significantly different between EU and MD groups (32.2±9.6 kcal/kg FFM/day vs 32.6±8.1 kcal/kg FFM/day). Further, no significant differences were observed in terms of body composition, BMD, and EAT-26 score between the two groups. However, triiodothyronine (T3; 84±14 ng/dL vs 114±21 ng/dL, p<0.01) and progesterone (P4; 0.2±0.1 ng/mL vs 0.4±0.1 ng/mL, p<0.05) were significantly lower in MD group than those in EU group. CONCLUSIONS: The results of the present study suggested that the menstrual status is not associated with current EA, but may be related to chronic energy deficiency among Japanese female athletes.

Diet and cardiometabolic side effects in children treated with second-generation antipsychotics

Second-generation antipsychotic (SGA) treatment in children is associated with metabolic side effects including weight gain, dyslipidemia, and insulin resistance. The objective of this study is to determine if SGA treatment in children affects dietary intakes and relationship to metabolic side effects. Three-day food records assessed dietary energy and macronutrient intakes in a cross-sectional population of SGA-treated (n=35) and SGA-naïve (n=29) children. SGA-treated children had more overweight/obesity (BMI≥85th percentile for age and sex, p=0.001); waist circumference (WC)≥90th percentile for age and sex (p=0.007); waist:height ratio (WHtR)≥85th percentile for age and sex (p=0.004), greater HOMA-IR, (p=0.001) and plasma triglycerides (p=0.017), and lower plasma HDL (p=0.029). Dietary energy intakes were not different between SGA-naïve and SGA-treated children [1734±486 vs 1971±649 (-135, 408)kcal/day, mean±SD (95% CI)] after adjustments for sex, age, Tanner stage, psychostimulant use, and height. Similarly, no differences in macronutrient intakes were observed. In models adjusted for SGA treatment and physical activity, no relationships between dietary intakes and BMI were found, but dietary total energy intakes were positively associated with waist circumference z-scores (p=0.019), systolic blood pressure z-scores (p=0.028, also adjusted for BMI) and HOMA-IR (p=0.013, also adjusted for age, sex, BMI). All of the children had poor diets with 87.5% having >7% of daily energy from saturated fat; 62.5% having >20% of daily energy from sugar; and almost 60% having sodium intakes above the tolerable upper intake level. SGA treatment is not associated with greater dietary energy intakes in children. However, dietary energy intakes are associated with greater waist circumference and systolic blood pressure z-scores and HOMA-IR in children with mental health conditions.

Alcohol Intake, Insulin Resistance, and Abdominal Obesity in Elderly Men

Moderate and high alcohol intake have been associated with decreased and increased risk of type 2 diabetes, respectively. Insulin resistance, insulin secretion, and abdominal obesity are major predictors of diabetes, but the links with alcohol intake remain contradictory because of limited data. In a population-based cohort of 807 men (age, 70 years), we studied whether alcohol intake was related to insulin sensitivity, measured with the gold standard technique (euglycemic clamp), insulin secretion (early insulin response), or adiposity [BMI, waist circumference (WC), waist-to-hip ratio]. Alcohol intake was self-reported (questionnaire) and was assessed from a validated 7-day dietary record. The cross-sectional associations were evaluated using multivariable linear regression, adjusting for smoking, education level, physical activity, dietary total energy intake, hypertension, diabetes, triglycerides, and cholesterol. In multivariable models, self-estimated alcohol intake was not related to insulin sensitivity, early insulin response, or BMI, but was positively related to WC (beta-coefficient, 0.77; 95% confidence interval, 0.15 to 1.39; p=0.02) and waist-to-hip ratio (0.006 [0.002-0.009], p=0.003). The association with WC and waist-to-hip ratio was most pronounced in men in the lowest tertile of BMI. The results using dietary records were similar. Evaluated in a large sample in elderly men, neither insulin sensitivity measured by clamp technique nor insulin secretion was significantly associated with alcohol intake. However, high alcohol intake was associated with abdominal obesity, which might explain the higher diabetes risk previously observed in high alcohol consumers.