High Intake Of Vegetables Research Articles

P1223 Maternal dietary patterns during pregnancy and offspring’s risk of paediatric Inflammatory Bowel Disease - a cohort study

Abstract Background The association between maternal dietary patterns during pregnancy and offspring’s risk of paediatric-onset inflammatory bowel disease (pIBD) is largely unknown. Therefore, we explored this link in mother-child dyads from the Danish National Birth Cohort (DNBC). Methods The DNBC is a nationwide cohort of pregnant mothers from Denmark enrolled between 1996 and 2002. In gestational week 25, a food frequency questionnaire assessed maternal intakes of >360 foods during the previous four weeks. The foods were divided into 37 groups, and intakes of the food groups (g/day) were z-score normalised to make them comparable. K-means cluster analysis determined maternal dietary patterns by grouping mother-child dyads into mutually exclusive clusters based on maternal intakes of the 37 food groups. The children were followed from birth to their 18-year birthday through national patient registries using their personal identification number. Medical information from the registries was used to identify the children who developed pIBD, defined as ≤18 years of age when they received their first IBD diagnosis (n=182). Cox proportional hazards model analysed associations of maternal dietary patterns with offspring’s hazard ratios (HR) for pIBD, using the most common pattern as the reference. Analyses were adjusted for parental IBD diagnosis and maternal educational level, gestational weight gain, smoking, energy intake, nutritional supplement use, and antibiotics use. Results The study included 63,877 singleton mother-child dyads from the DNBC. K-means cluster analysis identified five dietary patterns among the mothers: a diverse dietary pattern (n=16,386), a Western-like dietary pattern (n=22,901), a plant-rich dietary pattern (n=17,541), an animal-based dietary pattern (n=4,473), and a non-recommended dietary pattern (n=2,576). Mothers with a diverse dietary pattern had high intakes of most food groups, especially meat, fish, vegetables, fruits, potatoes, desserts, and legumes. This dietary pattern reduced offspring’s risk of pIBD by 44% compared to the Western-like dietary pattern (HR 0.56; 95% CI: 0.35-0.91), which was attributed to a decreased risk of Crohn’s disease (HR 0.41; 95% CI: 0.22-0.76) but not ulcerative colitis (HR 0.73; 95% CI: 0.38-1.39). No associations with pIBD were found for the plant-rich, animal-based, and non-recommended dietary patterns compared to the Western-like dietary pattern (p > 0.05). Conclusion In this prospective cohort study, we found that adhering to a diverse diet during pregnancy, characterised by high intakes of various food groups, protects the offspring against pIBD. Future studies should explore whether specific food groups or nutrients drive this association.

Impact of adherence to the Mediterranean diet on stroke risk.

Stroke is a leading cause of morbidity and mortality worldwide, and dietary patterns have emerged as a significant modifiable factor in stroke prevention. The Mediterranean diet, characterized by high intake of fruits, vegetables, whole grains, nuts, olive oil, and fish, has been widely recognized for its cardiovascular benefits. However, its specific impact on stroke risk requires further elucidation. We conducted a comprehensive meta-analysis of 30 studies, including both cohort and case-control designs, to evaluate the relationship between adherence to the Mediterranean diet and the risk of stroke. A systematic search was performed across multiple databases, and a random-effects model was used to estimate pooled hazard ratios (HRs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic, and publication bias was examined through funnel plots and Egger's regression test. Additionally, trial sequential analysis was conducted to determine the adequacy of the sample size. The meta-analysis revealed a significant reduction in stroke risk among individuals adhering to the Mediterranean diet, with a pooled HR of 0.88 (95% CI: 0.84-0.91). Notably, a significant heterogeneity was detected (I2 = 34%). The Z-score plot from trial sequential analysis confirmed that the sample sizes were sufficient to draw definitive conclusions. However, a potential publication bias was identified. The case-control studies confirmed a highly significant effect (HR = 0.54, 95% CI: 0.4-0.73). The funnel plots in both settings hinted at the presence of a potential publication bias, supported by a significant Egger's test. Our findings provide robust evidence supporting the protective effect of the Mediterranean diet against stroke. Despite the presence of some heterogeneity and potential publication bias, the cumulative evidence suggests that promoting the Mediterranean diet could serve as an effective public health strategy for stroke prevention. Further research is recommended to explore the underlying mechanisms and to assess the diet's impact across diverse populations.

Dietary habits as risk factor of gallstone disease in Benghazi, Libya: a case control study

Background: Gallstone disease is one of the most common diseases in developed and developing countries; recent studies have expressed evidence in the context of the role of nutrition in the gallstone disease etiology. The most common risk factors for gallstones formations are old age, female gender, obesity and diabetes mellitus. The dietary risk factors, includes consumption of carbohydrates, fats, proteins and dietary products, Moreover, healthy dietary pattern, coffee, rich sources of vitamins as fruits and vegetables do have protection role of gallstones. Our aim is to determine the dietary habits as a risk factor of gallstone diseases admitted in Al-Jala Hospital. Methods: An analytic case control study the data collected from documents of gall bladder stone (GBS) cases that have presented in surgical department and controls from other departments at Al Jala Hospital of Benghazi-Libya between January 2023 and December 2023. Results: The results of the study showed that cases diagnosed with GBS had high dietary intake of carbohydrates, fat, dairy products and meats and whereas had low dietary intake of vegetables and fruits which highly containing fibers, vitamins and minerals in contrast controls had low intake of carbohydrates, fat, dairy products and meats and whereas had high dietary intake of vegetables and fruit (vitamins and minerals) and caffeine. Conclusions: The study concluded that dietary risk factors that contributing to the high prevalence of gall stone formation were because of high intake of high carbohydrates, proteins and fatty diets and low intake of dietary fiber vitamins and minerals as well as caffeine also cases ender and high body mass index (BMI) play important role in gall stone formation.

Utilization of plant-based foods for effective prevention of chronic diseases: a longitudinal cohort study

The present study examined optimal dietary patterns of eight plant-based foods for preventing chronic diseases, including hypertension, stroke, myocardial infarction, and diabetes, using data from the China Health and Nutrition Survey (CHNS). We applied generalized estimating equations to assess time-based changes and gender differences, using residual balancing weights to control time-varying confounders, and employed a restricted cubic spline model to explore dose-response relationships by gender. The findings suggested that a high intake of vegetables and whole grains, along with moderate amounts of fruits, fungi and algae, could help reduce the risk of developing these four chronic diseases simultaneously. Additionally, men could benefit from moderate refined grain consumption, while women should consider increasing their intake of nuts and seeds. Our results indicated that adopting a plant-based diet could provide non-linear protective effects against chronic diseases, with the magnitude of this protection varying by gender.

The Key Nutrients in the Mediterranean Diet and Their Effects in Inflammatory Bowel Disease: A Narrative Review.

The gut microbiome, a collection of gut microorganisms, is crucial in the development and progression of inflammatory bowel diseases (IBD). Therefore, diet and dietary interventions are promising strategies to shape the gut microbiota for IBD management. Of all the diets studied in the IBD field, the Mediterranean diet has the least restrictive nature, promoting long-term adherence. The Mediterranean diet is rich in plants, with a high daily intake of fruits and vegetables (high in fiber, antioxidants, and vitamins), olive oil, whole grains, legumes, and nuts. It includes the moderate consumption of animal products such as oily fish (rich in mono- and polyunsaturated fatty acids), dairy products, and poultry, with a limited intake of red meat and processed foods. This diet is associated with a decreased risk of chronic diseases, including IBD. However, the mechanisms of specific nutrients behind these effects in the Mediterranean diet remain under investigation. Therefore, in this review, we aim to provide an overview of the nutrients that are abundant in the Mediterranean diet and their effects on IBD, with a main focus on preclinical evidence. While several nutrients like fructo-oligosaccharide, chitosan, plant-derived protein, polyphenols, omega-3 polyunsaturated fatty acids, and resveratrol have shown potential beneficial effects in preclinical models, clinical evidence is often limited. However, understanding the complex interactions between specific nutrients and IBD is essential to developing a tailored, multidisciplinary, and personalized approach for disease management; therefore, further research is required.

The Relationship of Pork Meat Consumption with Nutrient Intakes, Diet Quality, and Biomarkers of Health Status in Korean Older Adults.

Pork meat is a widely consumed protein food with the potential to differentially affect health and nutritional status across social and cultural contexts. We evaluated the association between pork meat consumption and nutrient intake, diet quality, and biomarkers of health among older adults (age ≥ 65 years) in Korea. Our analyses utilized dietary and health examination data from the 2016-2020 Korean National Health and Nutrition Examination Survey (n = 2068). Comparisons between variables derived from the nutrition survey and health examination by pork consumption (consumers vs. non-consumers) were assessed using regression analyses for survey data. Pork consumption was found to be associated with younger age, greater educational attainment, and lower likelihood of living in a rural area. Consumption was also associated with a higher intake of energy and all nutrients except vitamin B6, retinol, ⍵3, and zinc in males and vitamin B6 in females. Diet quality was modestly higher among male (67.91 ± 0.93 vs. 65.74 ± 0.74; p = 0.0308) and female (70.88 ± 0.96 vs. 67.00 ± 0.73; p < 0.0001) pork consumers. Differences in biomarkers were clinically irrelevant, with inconsistencies between genders. Handgrip strength was slightly higher among male (33.84 ± 0.52 vs. 31.91 ± 0.40; p < 0.0001) and female (20.76 ± 0.34 vs. 19.99 ± 0.22; p < 0.0001) pork consumers. In Korean older adults, pork consumption may contribute to a higher intake of energy and most nutrients, improved diet quality scores, higher vegetable intake, and small improvements in health biomarkers. Further well-designed studies are needed to confirm these findings.

Nutritional knowledge, attitudes and behaviours in rugby league; influences of age, body composition and ancestry.

Rugby league is a physically demanding sport that necessitates considerable nutritional intake, focusing on quality and type, in order to optimize training and competition demands. However, rugby league athletes are reported to have inadequate nutrition intake to match these demands. Some factors that may determine an athlete's nutrition intake have been reported in other sports, including (but not limited to, knowledge, time, cooking skills, food costs, income, belief in the importance of nutrition, body composition goals, and family/cultural support). However, these potential factors are relatively unexplored in rugby league, where a range of personal (age, body composition) or social (ancestry) influences could affect nutritional intake. Further exploration of these factors is warranted to understand the knowledge, attitudes and behavior underlying rugby league athletes' nutritional intake that can provide practitioners with a more detailed understanding of how to approach nutrition behaviors and attitudes in rugby league athletes. The primary aim was to describe the nutrition behaviors and knowledge of rugby league athletes. A secondary aim was to compare nutrition knowledge and behavior based on age, body composition and self-identified ancestry. Fifty professional rugby league athletes anonymously completed a seventy-six-question online survey. The survey consisted of three sections : 1) sports nutrition knowledge, 2) attitudes toward nutrition on performance , and 3) nutrition behaviors. All participants completed the online survey without assistance using their own personal device, with data entered via REDCap during pre-season. Nutrition knowledge was compared based on age (years), body composition (body fat percentage (%)) and ancestral groups (Pasifika, Aboriginal and/or Torres Strait Islander (ATSI) and Anglo- European).Pearson correlation was used for the relationship between nutrition knowledge, age and body composition. An Analysis of Covariance (ANCOVA) was used to determine nutrition knowledge differences between ancestral groups with age and body composition as covariates. Attitudes and behaviors were compared based on age groups (<20, 20-24 and >25 y), ancestry and body composition. Attitudes and behaviors were analyzed by Pearson correlation for body composition, one-way ANOVA for age groups and ANCOVA for ancestry with covariates age and body composition. Overall athletes' nutrition knowledge score was reported as 40 ± 12% (overall rating "poor"). Nutritional behaviors were significant for body composition, as those with lower body fat percentage had higher intakes of vegetables and dairy products (p = 0.046, p = 0.009), and ate more in the afternoon (lunch p = 0.048, afternoon snack p = 0.036). For ancestry, after adjustment for both age and body composition, Pasifika athletes were more inclined to miss breakfast and lunch compared to their Anglo-European (p = 0.037, p = 0.012) and ATSI (p = 0.022, p = 0.006) counterparts and ate more fruit than Anglo-Europeans (p = 0.006, p = 0.016). After adjustment for body composition, ATSI athletes also viewed the impact of nutrition on mental health and well-being significantly lower than Pasifika (p = 0.044). These findings suggest differences exist within rugby league athletes based on ancestral backgrounds and body composition for nutrition attitudes, behaviors and knowledge. Such outcomes could be used when designing nutrition education interventions, with consideration given to these factors to optimize long-term positive behavior change.

Longitudinal associations between fruit and vegetable intakes and depressive symptoms in middle-aged and older adults from four international twin cohorts

Beneficial associations between higher fruit and vegetable intakes and risk of depression appear to exist but few studies have focused on adults aged 45 + years and the potential that associations are due to residual confounding has not been tested. This longitudinal study of twins (n = 3483, age 45–90 years) from Australia, Denmark, Sweden and USA, assessed the associations between baseline fruit/vegetable intake and depressive symptoms over 5–11 years using linear mixed effects models. Intakes from food frequency questionnaires were trichotomized. Depressive symptoms were assessed using validated measures. The co-twin method was used to examine familial confounding. Compared with low intakes, both high fruit and high vegetable intakes were associated with lower depressive symptoms (fruit: β -.007 [95%CI − .014, < − .001], p = .040; vegetables: β − .006 [95%CI -.011, -.002], p = .002); whereas only moderate vegetable intakes, were associated with lower depressive symptoms (vegetables: β − .005 [95%CI − .009, − .001], p = .014). No familial confounding was found for vegetables, while the results for fruit were inconclusive, likely due to smaller sample size and the marginal significance of the main result. Higher fruit and vegetable intakes may protect against depressive symptoms, presenting another argument for increasing intakes in adults aged 45 + years.

Physical Activity Level and Dietary Intake Associated with Fat-Free Muscle Mass Changes During Intentional Weight Loss in Overweight and Obese Subjects.

The prevalence of obesity and related complications is increasing relentlessly worldwide. The effect of intentional weight loss strategies for obese individuals on fat-free muscle mass (FFMM) and metabolic and general health is not well known. The aim of this research is to measure the effects of dietary intake and physical activity level on FFMM change during intentional weight loss in obese subjects. Nine hundred and sixty-five overweight and obese community free-living subjects had the effects of physical activity level and dietary intake on FFMM change during intentional weight loss assessed in a prospective longitudinal study. Anthropometric, physical activity, dietary intake, inflammatory markers, and oxidative damage were assessed at baseline and follow-up. Validated questionnaires were used to measure dietary intake and physical activity. We compared FFMM loss or gain between subjects stratified by calorie, protein, and fruit and vegetable intake and physical activity levels. The Cox proportional hazards analysis was used to determine the independent effects of dietary intake and physical activity on FFMM changes. A total of 965 subjects [(mean (SD) age 39 ± 12 years, 801 (83%)] females] were assessed at baseline with follow-up for a period of 427 ± 223 days. Using the WHO criteria for body mass index (BMI), 284 (30%) subjects were found to be overweight and 584 (62%) were obese. We found significant correlations between fat-muscle mass ratio (FMR) and inflammatory and oxidative damage markers. After adjusting for important prognostic indicators, age, gender, occupation, physical activity, and fruit and vegetable consumption were found to be significantly associated with FFMM at baseline (p < 0.05). We found no statistically significant difference in dietary protein or amino acids intake in subjects who gained FFMM compared to those who lost FFMM both at baseline and follow-up. By contrast, high consumption of fruits and vegetable and increased calorie intake were associated with increased odds of FFMM gain (p < 0.05). Increased physical activity was independently associated with significant FFMM gain after adjusting for other important indicators ([hazard ratio (95% CI): 0.49 (0.25, 0.97); p = 0.039]. Increased physical activity and high calorie, fruit and vegetable intake are associated with FFMM preservation or gains during intentional weight loss in obese subjects.

The association between dietary dark green vegetable intake and cognitive function in US older adults.

Dark green vegetables include dark green leafy vegetables and broccoli. They are sources of many essential nutrients, including vitamins A, B and C, folate, fibre, carotenoids and flavonoids. This study aimed to explore the association between dietary dark green vegetable intake and cognitive function in US older adults. We included 2344 older adults (≥60 years old) from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 cycles. Dark green vegetable consumption was assessed using a continuous variable (cups/day) and two categorical variables. The first categorical variable classified participants into non-consumers and consumers based on whether they consumed dark green vegetables. The second categorical variable grouped participants into four levels of dark green vegetable consumption (non-consumers, consumers with low intakes, consumers with moderate intakes and consumers with high intakes). We used five continuous variables with non-normal distribution to assess cognitive function, including a composite z-score and the standardised scores of four individual cognitive tests. The four cognitive tests included the Immediate Recall Test (IRT), the Delayed Recall Test (DRT), the Animal Mobility Test (AFT) and the Digit Symbol Substitution Test (DSST). The standardised scores of the four cognitive tests were calculated using the mean and standard deviation of each cognitive test score. The composite z-score was calculated by averaging the standardised scores of four cognitive tests to evaluate global cognition. We used multiple linear regression models to examine the association between dietary dark green vegetable intake and cognitive function. Our findings indicated that dark green vegetable intake was positively associated with global cognition (β [95% CI]: 0.17 [0.04, 0.30]; p = 0.016) and IRT (β [95% CI]: 0.26 [0.08, 0.43]; p = 0.009) and DRT (β [95% CI]: 0.21 [0.05, 0.36]; p = 0.012) standardised scores. Individuals with high intake of dark green vegetables showed notably better global cognition (β [95% CI]: 0.16 [0.05, 0.28]; p = 0.010) and showed higher IRT (β [95% CI]: 0.22 [0.07, 0.38]; p = 0.010) and DRT standardised scores (β [95% CI]: 0.21 [0.07, 0.36]; p = 0.007) compared with the non-consumers. Blood neutrophil counts mediated the cognitive benefits of dark green vegetables (Proportion: 9.5%, p = 0.006). In conclusion, our findings suggest that dark green vegetable consumption may have favourable effects on cognitive function in US older adults, especially on immediate and delayed learning abilities. The underlying mechanisms include the ability of dark green vegetables to reduce blood neutrophil levels, an indicator of decreased systemic inflammation. Increasing dietary intake of dark green vegetables may be a beneficial intervention to improve cognitive health in the older US population.

Using fruit and vegetable intakes to illustrate the impacts of personalised nutrition feedback: Results from the MyPlanetDiet RCT

Previous research has shown personalised nutrition feedback is more effective than generic onesize-fits-all nutrition advice(1). Using fruit and vegetable intakes from the MyPlanetDiet randomized controlled trial, this analysis will determine if different severity of personalised nutrition feedback delivers greater dietary change.Participants were recruited from the general public and randomised to receive personalised feedback based on a more sustainable diet (intervention) or Healthy Eating Guidelines (control). Intervention participants received feedback on total fruit, total vegetables, dark green vegetables, and/or red/orange vegetables. Control participants received feedback on total fruit and vegetables, total vegetables, citrus fruits, and/or fruit juice. Participants completed dietary assessments (3x 24-hour recalls) at baseline (Week 0) and endpoint (Week 12) using Foodbook24, a validated online dietary assessment tool(2). Mean food group intakes and Healthy Eating Index scores were calculated. Personalised feedback messaging was assessed to measure the severity of fruit and vegetable feedback, ranging from zero messages (least severe) to four messages (most severe). Data are presented as mean ± standard error. Data were analysed via two-way mixed analysis of covariance and univariate general linear models using IMB SPSS Statistics (Version 29).Participants (n = 292) were 56% female and 42.3 ± 0.7 years old. Mean fruit and vegetable intake at baseline was 325.4 ± 183.3g. Almost all participants (97%) received feedback for at least one component of fruit and vegetable intake. Control participants were more likely to receive feedback on fruit (p&lt;0.001) while intervention participants were more likely to receive vegetable feedback (p&lt;0.001). There was a significant time*group interaction for fruit intake (p = 0.005) with larger increases in the control (+102.3g) than the intervention group (+38.6g). The intervention group had higher vegetable intakes (200.6 ± 7.9g) compared to control (164.2 ± 7.5g) at endpoint (p&lt;0.001). Those receiving more severe fruit and vegetable feedback had significantly lower intakes of fruit and vegetables at baseline (p&lt;0.001) but not endpoint (p = 0.80). There was a significant time*group interaction for fruit and vegetable intake (p&lt;0.001) between severity groups. Those with least severe feedback decreased fruit and vegetable intake (-57.4g) while those in the most severe group increased intakes by 162.2g. However, mean fruit and vegetable intake in the least severe group was still higher (472.9 ± 31.8g) at endpoint than in the most severe group (397.2 ± 23.6g). There was a significant time (p&lt;0.001) and time*group interaction (p = 0.039) in HEI scores with the smallest increase in the least severe group (+3.7) and the largest increase in the most severe feedback group (+9.6).More personalised nutrition feedback was associated with greater behaviour change when using fruit and vegetable intake as an example. Differences in messaging between control and intervention groups led to corresponding differences in dietary change. Different severity of personalised nutrition feedback resulted in participants having comparable fruit and vegetable intakes at endpoint.

The association of schooling, sibling life situation, and dietary habits with the estimated 24-h urinary salt excretion and sodium-to-potassium ratio in 3-year-old children

ABSTRACT Objectives We examined the association of schooling, sibling life situation, and dietary habits with the estimated 24-h urinary salt excretion and the urinary sodium-to-potassium (Na/K) ratio in 3-year-old children. Methods The subjects were 639 children who underwent a health checkup in four cities and towns in Kyoto Prefecture from January to November 2019. The children’s parents answered questionnaires about weekday childcare places, the birth order, and the awareness of reducing the salt intake. The questions on food intake frequency included 10 items. The estimated 24-h salt excretion and Na/K ratio were calculated from the participants’ first voiding urine in the morning. Results Data were available for 294 children. The median (interquartile range (IQR)) of salt excretion (g/day) was 2.6 (1.7–3.4), and urinary Na/K ratio (mmol ratio) was 2.6 (1.6–4.1). Multinomial logistic regression analysis showed that the group with older siblings was significantly associated with high salt (odds ratio 1.89 (95% confidence interval 1.04 to 3.46)). In the urinary Na/K ratio, the nursery group had a significantly lower Na/K (odds ratio 0.32 (0.17 to 0.60)). High processed meat products intake was associated with a higher Na/K (odds ratio 1.96 (1.05–3.66)), whereas high vegetable intake was associated with a lower Na/K (odds ratio 0.45 (0.23–0.87)). Other factors showed no significant associations. Conclusions In Japanese 3-year-old children, the estimated 24-h urinary salt excretion was associated with older siblings, and the urinary Na/K ratios were associated with schooling situation and the intake of processed meat products and vegetables.

Comparing the Dietary Habits and the Food Choices Between Italian and Dominican Adult Populations: Focus on Fruit and Vegetable Intakes and Their Association with Skin Carotenoid Levels.

The Mediterranean Diet (MD) is characterized by a high intake of fruits and vegetables (FVs), which is considered as an important contributor to the beneficial effects of the MD pattern. In this cross-sectional study, we compared the food choices, evaluated by dietary habit questionnaires, of a sample of 995 adults, including 601 and 394 participants from Southern Italy and the Dominican Republic, respectively. In addition, we focused on their FV consumption, assessed by the Mediterranean Diet Adherence Screener (MEDAS) questionnaire, and on its association with skin carotenoid levels as measured by the Veggie Meter®. We found that a significantly higher percentage of Italians had five meals/day and breakfast compared to Dominicans (five meals/day: 43 vs. 25, p < 0.05; breakfast: 89 vs. 79, p < 0.05), whereas a lower percentage of participants from Italy consumed snacks between the two meals compared to the Dominican Republic population (47 vs. 70, p < 0.005). Most of the participants from both populations had breakfast at home. However, 59.3% of Italians and 27.5% of Dominicans (p = 0.005) had breakfast between 7:00 and 9:00 a.m., whereas 5.8% and 27.5% (p = 0.001) had breakfast after 9:00 a.m., respectively. Milk/yogurt and eggs were the most consumed foods for breakfast in Italy and the Dominican Republic, respectively. Regarding the main meals, most of the Italians and Dominicans had a first course for lunch and a second course for dinner. Of note, we observed that approximately half of the Italians ate FVs in their main meals and had a higher carotenoid score than the Dominicans. Interestingly, in the multiple linear regression analysis, we found that the carotenoid score was positively associated with sex (β = 0.078; p = 0.009), age (β = 0.008; p = 0.001), vegetable consumption (β = 0.12; p = 0.041) and the perception of a healthy diet (β = 0.12; p = 0.001) in the Dominic Republic population, while the carotenoid score was directly associated with sex (β = 54.97; p < 0.0001) and both vegetable (β = 25.42; p = 0.0008) and fruit (β = 38.61; p < 0.0001) consumption in the Italian sample. Our findings confirm the need to promote nutrition-based interventions to encourage FV intake, particularly in non-Mediterranean countries.

Association of dietary patterns with serum uric acid and hyperuricemia in Chinese adults

Objective: To analyze the dietary patterns of Chinese adults and explore the relationship with serum uric acid (SUA) and hyperuricemia (HUA). Methods: A total of 9 358 adults were selected in the 2018 China Health and Nutrition Survey. Dietary intake data were collected by three consecutive 24-hour dietary recalls and weighing method. The social demographic information of the survey subjects was obtained through questionnaire surveys. The dietary patterns were extracted using factor analysis, and the relationship between dietary patterns and SUA was analyzed using multiple linear regression analysis. The correlation between HUA and dietary patterns was analyzed using logistic regression analysis models. Results: Four dietary patterns were identified: northern (high intakes of wheat, other cereals,and tubers); modern (high intakes of fruit, dairy, eggs, and nuts); southern (high intakes of rice and vegetables);animal food-wine (high intake of organ meats, seafood, and wine). The multiple linear regression analysis results showed that the northern pattern was negatively correlated with SUA (β=-0.438, 95%CI: -0.500--0.376); the modern pattern was negatively correlated with SUA (β=-0.134, 95%CI: -0.219--0.049); the southern model was significantly correlated with higher SUA (β=0.146, 95%CI: 0.079-0.214); the animal food-wine pattern was positively correlated with SUA (β=0.188, 95%CI: 0.123-0.252). Logistic regression analysis showed that compared with the northern model score Q1 group, the risk of developing HUA was reduced in Q3 and Q4 groups, with ORs values of 0.777 (95%CI: 0.650-0.929) and 0.509 (95%CI: 0.423-0.613), respectively; and compared with the modern model score Q1 group, the higher the scores in Q3 and Q4 groups, the HUA was lower, with ORs of 0.793 (95%CI: 0.660-0.953) and 0.768 (95%CI: 0.631-0.934), respectively. Compared with the animal food-wine pattern score Q1 group, the risk of developing HUA was increased in both Q3 and Q4 groups (Q3 group: OR=1.224, 95%CI: 1.012-1.480; Q4 group: OR=1.312, 95%CI: 1.086-1.584). Conclusions: Dietary patterns are associated with HUA. The northern and modern patterns are related to lower SUA levels and reduced risk of HUA, while the animal food-wine pattern increases the risk of HUA.

Relationship between maternal anemia during pregnancy and the risk of preeclampsia: A multicenter case-control study.

Introduction: Anemia, defined as a low hemoglobin level, is a common condition in pregnancy that can have adverse effects on maternal and fetal outcomes. Anemia can result from various causes, such as iron deficiency, vitamin B12 deficiency, folate deficiency, hemolysis, or bleeding. The association between anemia and preeclampsia is not fully understood, but some studies have suggested that anemia may increase the risk of developing preeclampsia, especially in women with iron deficiency or chronic inflammation. Objective: To assess the association of anemia during pregnancy and the risk of developing preeclampsia. Study Design and Setting: A multicenter unmatched case-control study was conducted. The study was conducted from 2 December 2020 to 1 January 2021 in West and North Gojjam zone governmental hospitals, North West Ethiopia. A total of 337 pregnant women (113 cases and 224 controls) who consented verbally and attended antenatal or delivery services were enrolled in the study. Population: The participants of this study were mothers attending attended antenatal care and delivery services. Data Management: The analysis involved manual checking, data entry using EpiData Manager, and subsequent analysis using SPSS version 23, with logistic regression and p-values <0.05 determining statistical significance. Results: Being nonanemic, high consumption of fat related, mid-upper arm circumference ≥25.6 cm, frequent consumption of milk products, and fruits and vegetables rich in vitamin A were found to be factors associated with the risk for developing preeclampsia. Conclusion and recommendations: Being nonanemic, diets that are characterized by a high intake of vitamin A-rich fruits and vegetables and milk products were significantly associated with a low risk of preeclampsia. On the other hand, high intake of fatty foods and obesity were associated with the development of preeclampsia. Therefore, preventing anemia encouraging and promoting healthy eating habits during pregnancy by including vitamin A-rich fruits and vegetables and milk products can effectively prevent the development of preeclampsia.

Dietary patterns during pregnancy and maternal and birth outcomes in women with type 1 diabetes: the Environmental Determinants of Islet Autoimmunity (ENDIA) study

Aims/hypothesisDietary patterns characterised by high intakes of vegetables may lower the risk of pre-eclampsia and premature birth in the general population. The effect of dietary patterns in women with type 1 diabetes, who have an increased risk of complications in pregnancy, is not known. The aim of this study was to investigate the relationship between dietary patterns and physical activity during pregnancy and maternal complications and birth outcomes in women with type 1 diabetes. We also compared dietary patterns in women with and without type 1 diabetes.MethodsDiet was assessed in the third trimester using a validated food frequency questionnaire in participants followed prospectively in the multi-centre Environmental Determinants of Islet Autoimmunity (ENDIA) study. Dietary patterns were characterised by principal component analysis. The Pregnancy Physical Activity Questionnaire was completed in each trimester. Data for maternal and birth outcomes were collected prospectively.ResultsQuestionnaires were completed by 973 participants during 1124 pregnancies. Women with type 1 diabetes (n=615 pregnancies with dietary data) were more likely to have a ‘fresh food’ dietary pattern than women without type 1 diabetes (OR 1.19, 95% CI 1.07, 1.31; p=0.001). In women with type 1 diabetes, an increase equivalent to a change from quartile 1 to 3 in ‘fresh food’ dietary pattern score was associated with a lower risk of pre-eclampsia (OR 0.37, 95% CI 0.17, 0.78; p=0.01) and premature birth (OR 0.35, 95% CI 0.20, 0.62, p<0.001). These associations were mediated in part by BMI and HbA1c. The ‘processed food’ dietary pattern was associated with an increased birthweight (β coefficient 56.8 g, 95% CI 2.8, 110.8; p=0.04). Physical activity did not relate to outcomes.Conclusions/interpretationA dietary pattern higher in fresh foods during pregnancy was associated with sizeable reductions in risk of pre-eclampsia and premature birth in women with type 1 diabetes.Graphical

Potential for reducing dementia risk: association of the CAIDE score with additional lifestyle components from the LIBRA score in a population at high risk of dementia

Objectives Various dementia risk scores exist that assess different factors. We investigated the association between the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score and modifiable risk factors in the Lifestyle for Brain Health (LIBRA) score in a German population at high risk of Alzheimer’s disease. Method Baseline data of 807 participants of AgeWell.de (mean age: 68.8 years (SD = 4.9)) were analysed. Stepwise multivariable regression was used to examine the association between the CAIDE score and additional risk factors of the LIBRA score. Additionally, we examined the association between dementia risk models and cognitive performance, as measured by the Montreal Cognitive Assessment. Results High cognitive activity (β = −0.016, p < 0.001) and high fruit and vegetable intake (β = −0.032, p < 0.001) correlated with lower CAIDE scores, while diabetes was associated with higher CAIDE scores (β = 0.191; p = 0.032). Although all were classified as high risk on CAIDE, 31.5% scored ≤0 points on LIBRA, indicating a lower risk of dementia. Higher CAIDE and LIBRA scores were associated with lower cognitive performance. Conclusion Regular cognitive activities and increased fruit and vegetable intake were associated with lower CAIDE scores. Different participants are classified as being at-risk based on the dementia risk score used.

Major dietary patterns and their associations with total weight loss and weight loss composition 2–4 years after sleeve gastrectomy

BackgroundFood intakes 1–2 years following bariatric surgery depend more on patients than the surgery’s gastrointestinal tract changes. This study aimed to determine the major dietary patterns of patients after the first two years of sleeve gastrectomy and to investigate their associations with total weight loss (TWL) and the proportion of TWL as fat mass (FM) and fat-free mass (FFM) loss.MethodsThis cross-sectional study included 146 patients undergoing sleeve gastrectomy 2–4 years after surgery. Dietary patterns were determined using principal component analysis based on the 19 food groups. The percentage of FM loss relative to TWL (%FML) and FFM loss relative to TWL (%FFML) were calculated. A suboptimal clinical response was defined as a TWL of less than 25%. High FM loss and excessive FFM loss were defined based on the highest tertiles. Linear and logistic regression models were used to derive unstandardized (B) coefficients and odds ratios (OR), with dietary pattern scores serving as both a continuous and a binary variable (higher vs. lower adherence groups based on median).ResultsTwo predominant dietary patterns were retained. Each 1-unit increase in the first dietary pattern score characterized by high intakes of fast foods, soft drinks, processed meats, sugar confectionary, salty snacks, grains, and organ meats was associated with higher %FFML (B = 1.99; 95% confidence interval (CI) 0.34, 3.66), lower %FML (B = − 1.84; 95% CI − 3.49, − 0.20), and higher odds of excessive FFM loss (OR = 1.84; 95% CI 1.09, 3.11). Participants with higher adherence to the first dietary pattern had lower %TWL, and greater odds of suboptimal clinical response and excessive FFM loss than those with lower adherence. Each 1-unit increase in score for the second dietary pattern characterized by a high intake of fruits, dairy, vegetables, legumes, eggs, nuts, red meats, poultry, and fish was associated with lower odds of suboptimal clinical response (OR = 0.51; 95% CI 0.31, 0.86).ConclusionPatients should be encouraged to modify their diet by reducing the consumption of ultra-processed foods and increasing their intake of high-quality protein sources, fruits, and vegetables to achieve the best postoperative outcome.

Triglyceride-Glucose Index, Modifiable Lifestyle, and Risk of Colorectal Cancer: A Prospective Analysis of the Korean Genome and Epidemiology Study.

Insulin-mediated pathways plausibly explain the pathogenesis of colorectal cancer (CRC). The triglyceride-glucose index (TyG) is a surrogate of insulin resistance (IR), but its association with CRC in the Korean population has not been evaluated. From the 2004-2013 Korean Genome and Epidemiology Study, 98,800 participants aged 40-69 years were followed through 2020. Data on CRC incidence were obtained from the Korean National Cancer Center registry. Cox regression models and restricted cubic splines were fitted to examine the association between the TyG; In [(triglycerides) × (fasting glucose)/2] and CRC incidence. Joint effects of modifiable lifestyle factors and TyG on CRC risk were also investigated. Median follow-up time was 10.6 years, and 699 CRC cases were observed. A unit-increment in TyG was associated with increased risk of CRC combined (hazard ratio, HR: 1.28, and 95% confidence interval, CI: 1.12-1.46), colon (1.29, 1.10-1.54), and rectal cancer (1.24, 1.01-1.52). Associations were dose-dependent, with linear associations observed for CRC and colon, but non-linear associations were observed for rectal cancer. A high TyG index (above 8.4) combined with overweight/obesity was linked to an increased risk of CRC (1.31, 1.07-1.61) and colon cancer (1.33, 1.03-1.72). When combined with low fruit and vegetable intake, the risks were higher for CRC (1.40, 1.12-1.74) and colon cancer (1.57, 1.18-2.09). Combined with high red meat consumption, the risks were elevated for CRC (1.32, 1.05-1.65) and colon cancer (1.52, 1.15-2.02). A high TyG index was associated with a higher risk of colorectal cancer, and the risk was highest among participants with a high BMI, low fruit and vegetable intake, and high intake of red meat, suggesting a role of both insulin resistance and modifiable lifestyle in colorectal cancer development.

Eating vegetables at school lunchtimes: Pilot and feasibility studies testing strategies to improve intake

Vegetable provision at schools in the UK has increased over recent years; however children still eat few of the vegetables that are served to them. Two experimental pilot and feasibility studies implemented a vegetables-served-first (study 1) plus experiential learning (study 2) approach to increase children's (3–5 years and 4–7 years respectively) vegetable consumption at school lunchtimes. Both studies involved vegetables-served-first 10-min before the rest of the meal, with experiential learning techniques (repeated exposure, “veg-first” dinner plates, vegetable songs, videos, and nutrition education) complementing the vegetable service in study 2. Study 1 (n = 38) found that vegetables-served-first, compared with serving all foods together, increased vegetable intake by ∼12 g. Study 2 (n = 69) found that vegetable consumption depended on individual schools. Schools where vegetable intake was low showed increases in consumption during intervention weeks, whereas schools with high vegetable intake showed little change. Acceptability of interventions was found to be good for children and schools that participated, although concerns about time to serve vegetables first and COVID-related environmental restrictions reduced feasibility for some schools. Child engagement could also be improved by offering a wider variety of vegetables during repeated exposure to reduce monotony. Future research should design interventions using co-design methods including schools to suit their context best, whilst also addressing the problem with a systems approach. Interventions which focus on child learning through experience need to take account of specific school environments including curricular needs, resources available for school lunch (including both time and space), provision of food, support from teachers and parents, and the culture around eating (e.g. encouragement, pressure to eat, lunchtime competing with playtime). Joined-up systems approaches could enhance both provision and uptake of vegetables at school meals.