Multiple Dietary Factors Research Articles

Diabetes websites lack information on dietary causes, risk factors, and preventions for type 2 diabetes.

Type 2 diabetes (T2D) is a growing public health burden throughout the world. Many people looking for information on how to prevent T2D will search on diabetes websites. Multiple dietary factors have a significant association with T2D risk, such as high intake of added sugars, refined carbohydrates, saturated fat, and red meat or processed meat; and decreased intake of dietary fiber, and fruits/vegetables. Despite this dietary information being available in the scientific literature, it is unclear whether this information is available in gray literature (websites). In this study, we evaluate the use of specific terms from diabetes websites that are significantly associated with causes/risk factors and preventions for T2D from three term categories: (A) dietary factors, (B) nondietary nongenetic (lifestyle-associated) factors, and (C) genetic (non-modifiable) factors. We also evaluate the effect of website type (business, government, nonprofit) on term usage among websites. We used web scraping and coding tools to quantify the use of specific terms from 73 diabetes websites. To determine the effect of term category and website type on the usage of specific terms among 73 websites, a repeated measures general linear model was performed. We found that dietary risk factors that are significantly associated with T2D (e.g., sugar, processed carbohydrates, dietary fat, fruits/vegetables, fiber, processed meat/red meat) were mentioned in significantly fewer websites than either nondietary nongenetic factors (e.g., obesity, physical activity, dyslipidemia, blood pressure) or genetic factors (age, family history, ethnicity). Among websites that provided "eat healthy" guidance, one third provided zero dietary factors associated with type 2 diabetes, and only 30% provided more than two specific dietary factors associates with type 2 diabetes. We also observed that mean percent usage of all terms associated with T2D causes/risk factors and preventions was significantly lower among government websites compared to business websites and nonprofit websites. Diabetes websites need to increase their usage of dietary factors when discussing causes/risk factors and preventions for T2D; as dietary factors are modifiable and strongly associated with all nondietary nongenetic risk factors, in addition to T2D risk.

Abstract MP07: Changes in Weight From Sugar- or Artificially-Sweetened Beverages or Water Intake in a Prospective Cohort

Background: It is still unclear if sustained intake of artificially sweetened beverages (ASB) in lieu of sugar-sweetened beverages (SSB) is associated with long-term weight reduction or maintenance. This study aimed to evaluate the long-term changes in weight and BMI in relation to changes in ASB intake, and to estimate the effects of replacing SSB with ASB or water on body weight. Hypothesis: Habitual ASB intake is unrelated to weight or BMI changes. The modeled substitutions are expected to show a reduction in weight and BMI, larger for water than for ASB. Methods: We used data from the Nurses' Health Study I, a prospective cohort study conducted among female US nurses aged 39 to 65y at enrolment and assessed every four years from 1986 to 2010. Food-frequency questionnaires evaluated usual dietary intake including beverages (in 12 oz servings/day). Self-administered questionnaires collected lifestyle and anthropometric information. We excluded participants with any major disease at baseline (e.g., diabetes, cancer, cardiovascular disease), and censored those reaching 65 years during follow-up. Pregnant or lactating women were not considered during these periods. We evaluated the association between changes in ASB intake with changes in weight and BMI using generalized estimating models adjusting for multiple dietary and lifestyle risk factors. Substitution models assessed how replacing SSB with ASB, SSB with water, or ASB with water relates to weight and BMI changes, adjusting for the same covariates. Results: Among 51,805 participants, 64.6% consumed ASB at baseline averaging 0.25 ± 0.53 servings/day. Over 4-year follow-up intervals, a one-serving/day increase of ASB was associated with an estimated weight change of -0.06 kg (95% CI: -0.11, -0.02) and BMI change of -0.02 kg/m 2 (95% CI: -0.04, -0.01). Substituting SSB with ASB was associated with -0.37 kg change in weight (95% CI: -0.41, -0.33) and -0.14 kg/m 2 in BMI (95% CI: -0.17, -0.11). Similar estimates were observed when replacing SSB with water ( β =-0.35 kg, 95% CI: -0.41, -0.30 for weight and β =-0.13, kg/m 2 , 95% CI: -0.15, -0.11 for BMI). Substituting ASB with water was not associated with changes in weight ( β =-0.004 kg, 95% CI: -0.05, 0.04) or BMI ( β =-0.0002 kg/m 2 , 95% CI: -0.02, 0.02). Conclusion: A long-term daily increase in ASB intake was not associated with greater weight gain in US women. Replacing SSB with ASB was associated with significantly less weight gain, likely by reducing energy intake. Change in water was not associated with weight changes, suggesting it may help sustain weight maintenance when replacing SSB. Future studies should evaluate the roles of changes in intakes of water, ASB, and SSB in relation to changes in other weight- and metabolically-related outcomes in diverse populations of both sexes.

Healthy Aging at Family Mealtimes: Associations of Clean Cooking, Protein Intake, and Dining Together with Mental Health of Chinese Older Adults amid COVID-19 Pandemic.

The present study aims to examine whether multiple dietary factors affect the mental health of older adults amid the COVID-19 pandemic. It proposes an integrative dietary framework that highlights environmental, nutritional, and social aspects of diet for healthy aging. Based on a sample of 7858 Chinese older adults, the associations between diet and depressive symptoms, along with the rural-urban divide, were examined using zero-inflated negative binomial regression. Overall, protein intake (incidence-rate ratio [IRR] = 0.89, p < 0.001), frequency of family dining together (IRR = 0.98, p < 0.001), and using tap water for cooking (IRR = 0.92, p < 0.01) were associated with lower incidence rates of depressive symptoms among older adults. Among rural older adults, frequency of family dining together (IRR = 0.97, p < 0.001) and tap water use (IRR = 0.89, p < 0.001) were associated with fewer depressive symptoms. However, urban residents who had a higher frequency of family dining together (IRR = 0.98, p < 0.05) and protein intake (IRR = 0.81, p < 0.001) exhibited fewer depressive symptoms. The findings revealed multifaceted dietary pathways towards healthy aging, which call for policies and interventions that improve diet quality for community-dwelling older adults.

DNA Methylation in Cancer: Epigenetic View of Dietary and Lifestyle Factors.

Alterations in DNA methylation play an important role in cancer development and progression. Dietary nutrients and lifestyle behaviors can influence DNA methylation patterns and thereby modulate cancer risk. To comprehensively review available evidence on how dietary and lifestyle factors impact DNA methylation and contribute to carcinogenesis through epigenetic mechanisms. A literature search was conducted using PubMed to identify relevant studies published between 2005 and 2022 that examined relationships between dietary/lifestyle factors and DNA methylation in cancer. Studies investigating the effects of dietary components (eg, micronutrients, phytochemicals), physical activity, smoking, and obesity on global and gene-specific DNA methylation changes in animal and human cancer models were included. Data on specific dietary/lifestyle exposures, cancer types, DNA methylation targets and underlying mechanisms were extracted. Multiple dietary and lifestyle factors were found to influence DNA methylation patterns through effects on DNA methyltransferase activity, methyl donor availability, and generation of oxidative stress. Altered methylation of specific genes regulating cell proliferation, apoptosis, and inflammation were linked to cancer development and progression. Dietary and lifestyle interventions aimed at modulating DNA methylation have potential for both cancer prevention and treatment through epigenetic mechanisms. Further research is needed to identify actionable targets for nutrition and lifestyle-based epigenetic therapies.

Jeremiah Stamler, MD (1919-2022).

Jeremiah Stamler, MD (1919-2022).

Associations of Obesity and Neighborhood Factors With Urinary Stone Parameters

Obesity is associated with kidney stone disease, but it is unknown whether this association differs by SES. This study assessed the extent to which obesity and neighborhood characteristics jointly contribute to urinary risk factors for kidney stone disease. This was a retrospective analysis of adult patients with kidney stone disease evaluated with 24-hour urine collection (2001-2020). Neighborhood-level socioeconomic data were obtained for a principal component analysis, which identified 3 linearly independent factors. Associations between these factors and 24-hour urine measurements were assessed using linear regression as well as groupings of 24-hour urine results using multivariable logistic regression. Finally, multiplicative interactions were assessed testing effect modification by obesity, and analyses stratified by obesity were performed. Analyses were performed in 2021. In total, 1,264 patients met the study criteria. Factors retained on principal component analysis represented SES, family structure, and housing characteristics. On linear regression, there was a significant inverse correlation between SES and 24-hour urine sodium (p=0.0002). On multivariable logistic regression, obesity was associated with increased odds of multiple stone risk factors (OR=1.61; 95% CI=1.15, 2.26) and multiple dietary factors (OR=1.33; 95% CI=1.06, 1.67). No significant and consistent multiplicative interactions were observed between obesity and quartiles of neighborhood SES, family structure, or housing characteristics. Obesity was associated with the presence of multiple stone risk factors and multiple dietary factors; however, the strength and magnitude of these associations did not vary significantly by neighborhood SES, family structure, and housing characteristics.

MP26-14 ASSOCIATIONS OF FOOD ACCESS AND NEIGHBORHOOD WALKABILITY WITH URINARY RISK FACTORS FOR KIDNEY STONE DISEASE

You have accessJournal of UrologyCME1 May 2022MP26-14 ASSOCIATIONS OF FOOD ACCESS AND NEIGHBORHOOD WALKABILITY WITH URINARY RISK FACTORS FOR KIDNEY STONE DISEASE Joseph Crivelli, David Redden, Naim Maalouf, Kyle Wood, Dean Assimos, and Gabriela Oates Joseph CrivelliJoseph Crivelli More articles by this author , David ReddenDavid Redden More articles by this author , Naim MaaloufNaim Maalouf More articles by this author , Kyle WoodKyle Wood More articles by this author , Dean AssimosDean Assimos More articles by this author , and Gabriela OatesGabriela Oates More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002569.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Differences in nutrition and lifestyle can explain some differences in 24-hour urine measurements among kidney stone formers. Socioeconomic aspects of these factors underlying stone formation require further investigation. We evaluated associations of neighborhood indices of food access and walkability with 24-hour urine measurements among patients with kidney stone disease (KSD). METHODS: We performed a retrospective analysis of adult patients with KSD evaluated with 24-hour urine collection (2001-2020). Based on the Food Access Research Atlas, low-income neighborhoods >0.5 miles (urban areas) or >10 miles (rural areas) from a full-service grocery store met the definition of low food access. Using the National Walkability Index (NWI), we identified neighborhoods with low walkability (NWI ≤5.75). We then assessed associations of these measures of food access and walkability with groupings of 24-hour urine abnormalities (stone risk factors and dietary factors, as defined by a commercial vendor; see Table) through multivariable logistic regression, as well as individual 24-hour urine measurements through analysis of covariance (ANCOVA) with adjustment for multiple testing. RESULTS: Among 1,119 patients with KSD and at least one adequate 24-hour urine collection based on urinary creatinine, 173 (15.5%) were from neighborhoods with low food access and 516 (46.1%) were from neighborhoods with low walkability. Using multivariable logistic regression (Table), patients from neighborhoods with low food access had higher odds of multiple (>1) stone risk factors (odds ratio: 1.78, 95% confidence interval: 1.03 to 3.09), but not multiple dietary factors. Patients from neighborhoods with low walkability did not have increased odds of multiple stone risk factors or dietary factors. Using ANCOVA, neighborhoods with low food access and or low walkability were not associated with significant differences in individual 24-hour urine measurements. CONCLUSIONS: Among patients with KSD, residence in a neighborhood with low food access was associated with multiple stone risk factors on 24-hour urine testing, though there were no significant differences in individual urinary measurements. The contribution of other sociodemographic factors to 24-hour urine abnormalities should be evaluated. Source of Funding: NIH 5P20DK119788 (DA) and 5K08DK115833 (KW) © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e445 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joseph Crivelli More articles by this author David Redden More articles by this author Naim Maalouf More articles by this author Kyle Wood More articles by this author Dean Assimos More articles by this author Gabriela Oates More articles by this author Expand All Advertisement PDF DownloadLoading ...

Bidirectional Responses of Eight Neuroinflammation-Related Transcriptional Factors to 64 Flavonoids in Astrocytes with Transposable Insulated Signaling Pathway Reporters.

Neuroinflammation is implicated in a variety of pathologies and is mechanistically linked to hyperactivation of glial cells in the central nervous system (CNS), predominantly in response to external stimuli. Multiple dietary factors were reported to alter neuroinflammation, but their actions on the relevant transcription factors in glia are not sufficiently understood. Here, an in vitro protocol employing cultured astroglial cells, which carry reporters of multiple signaling pathways associated with inflammation, was developed for screening environmental factors and synthetic drugs. Immortalized rat astrocyte line DI TNC1 was stably transfected with piggyBac transposon vectors containing a series of insulated reporters for the transcriptional activity of NF-κB, AP-1, signal transducer and activator of transcription 1 (STAT1), signal transducer and activator of transcription 3 (STAT3), aromatic hydrocarbon receptor (AhR), Nrf2, peroxisome proliferator-activated receptor γ (PPARγ), and HIF-1α, which is quantified via luciferase assay. Concatenated green fluorescent protein (GFP) expression was employed for simultaneous evaluation of cellular viability. Responses to a set of 64 natural and synthetic monomeric flavonoids representing six main structural classes (flavan-3-ols, flavanones, flavones, flavonols, isoflavones, and anthocyan(id)ins) were obtained at 10 and 50 μM concentrations. Except for HIF-1α, the activity of NF-κB and other transcription factors (TFs) in astrocytes was predominantly inhibited by flavan-3-ols and anthocyan(id)ins, while flavones and isoflavones generally activated these TFs. In addition, we obtained dose-response profiles for 11 flavonoids (apigenin, baicalein, catechin, cyanidin, epigallocatechin gallate, genistein, hesperetin, kaempferol, luteolin, naringenin, and quercetin) within the 1-100 μM range and in the presence of immune-stimulants and immune-suppressors. The flavonoid concentration profiles for TF-activation reveal biphasic response curves from the astrocytes. Apart from epigallocatechin gallate (EGCG), flavonoids failed to inhibit the NF-κB activation by proinflammatory agents [lipopolysaccharide (LPS), cytokines], but most of the tested polyphenols synergized with STAT3 inhibitors (stattic, ruxolitinib) against the activation of this TF in the astrocytes. We conclude that transposable insulated reporters of transcriptional activation represent a convenient neurochemistry tool in screening for activators/inhibitors of signaling pathways.

Abstract 846: Associations of dietary and lifestyle oxidative balance scores with all-cancer, all-CVD, and all-cause mortality risk among older women: The Iowa Women's Health Study

Abstract Background: Substantial basic science evidence suggests that oxidative stress may play a role in aging-related health outcomes, including cancer and cardiovascular diseases (CVD), and oxidative stress markers were linked with all-cancer, all-CVD, and all-cause mortality in epidemiologic studies. However, the associations of many individual dietary and lifestyle anti-/pro-oxidant exposures with mortality are inconsistent. Oxidative balance scores (OBS) that incorporated multiple dietary and lifestyle factors were previously developed and reported to reflect the collective oxidative effects of multiple exposures. Methods: We investigated associations of 11-component dietary and 4-component (physical activity, adiposity, alcohol, and smoking) lifestyle OBS (higher scores were considered more anti-oxidative) with all-cancer, all-CVD, and all-cause mortality among women 55 - 69 years of age at baseline in the prospective Iowa Women's Health Study (1986 - 2012). We assessed OBS-mortality associations using multivariable Cox proportional hazards regression. Results: Of the 34,137 cancer-free women included in the analytic cohort, 18,058 died (4,521 from cancer, and 6,825 from CVD) during a mean/median 22.0/26.1 person-years of follow up. Among participants in the highest relative to the lowest lifestyle OBS quintiles, the adjusted hazards ratios and their 95% confidence intervals for all-cancer, all-CVD, and all-cause mortality were 0.47 (0.43, 0.52), 0.54 (0.54, 0.58), and 0.50 (0.48, 0.53) (all Ptrend &amp;lt; 0.001), respectively. The associations of the dietary OBS with mortality were close to null. Conclusion: Our findings, combined with results from previous studies, suggest that a predominance of antioxidant over pro-oxidant lifestyle exposures may be associated with lower all-cancer, all-CVD, and all-cause mortality risk. Citation Format: Ziling Mao, Anna E. Prizment, DeAnn Lazovich, Boberd M. Bostick. Associations of dietary and lifestyle oxidative balance scores with all-cancer, all-CVD, and all-cause mortality risk among older women: The Iowa Women's Health Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 846.

Assessment of dietary intake among patients with peptic ulcer

One of the major and most common diseases of the stomach is peptic ulcer. It occurs when the mucus secretion in the stomach decreases, acid secretion increases or both at the same time. There are multiple dietary and lifestyle factors that can cause peptic ulcers. However, peptic ulcers can be treated by consuming a balanced diet along with medications. Objective: Assessment of dietary intake among patients with peptic ulcers. Methods: The assessment was carried out at Services hospital, Lahore. A sample of 100 patients aged between 20-80 years was taken by using non-probability convenient sampling. Data was collected with the help of pre-tested questionnaire and was analyzed by using SPSS version 21.0. Results: The results showed that chapatti was most commonly consumed by peptic ulcer patients from the carbohydrates group. Most patients consumed milk and chicken from the protein group while fats were not consumed in abundance. Fruits and vegetables made an integral part of the weekly dietary intake of the patients. Conclusions: Patients with peptic ulcers cannot consume spicy foods and fried items. In order to achieve complete cure, they tend to consume foods that provide satiety and do not cause any discomfort. A balanced diet along with proper medication can help alleviate symptoms of peptic ulcers.

Identification of Gene-Diet Interactions Impacting Glycemic Biomarkers in the Multi-Ethnic TOPMed Cohorts

ObjectivesIdentification of robust gene-diet interactions impacting cardiometabolic traits has been limited due to low statistical power and poor replication across populations. Emerging statistical methods increase power by simultaneously testing genetic interactions with multiple exposures, an especially appealing strategy for complex and highly-correlated dietary traits. Furthermore, meta-analysis across ancestrally and behaviorally diverse populations may allow for more robust discoveries. Here, our objective was to leverage multi-exposure interaction tests in a diverse set of cohorts to identify interactions involving macronutrient ratios and impacting multiple biomarkers of glycemia. MethodsSeven cohorts from the TOPMed consortium (total N ∼ 20,000) contributed whole-genome sequencing data, self-reported dietary data, and glycemic trait measurements (fasting glucose and insulin (FG and FI) and hemoglobin A1c). Three macronutrient ratios were defined to model realistic dietary exchanges and minimize collinearity: carbohydrate: fat, polyunsaturated: saturated fat, and fiber: carbohydrate. For each glycemic trait outcome and common genetic variant, we fit a model including all three ratios and their genetic interactions, with joint significance testing in each cohort followed by cross-cohort meta-analysis. ResultsFour variants showed promising sub-threshold signals (p < 1 × 10–7), though none reached genome-wide significance. For example, diet ratios collectively interacted with rs2276620 in the oxysterol-binding OSBPL6 gene to influence FG (p = 6.5 × 10–8) and rs114448070 in the beta cell function-associated KAT2B gene (p = 5.4 × 10–8) to influence FI. These associations were contributed to by multiple cohorts and multiple dietary factors, emphasizing the value of this multi-cohort and multi-exposure approach to GDI variant detection. ConclusionsOur approach takes advantage of population diversity and multi-faceted dietary exposures to understand genetic effects on the diet-glycemia relationship and support the development of genome-based precision nutrition. Our results will be updated with additional cohorts and gene-based tests using rare genetic variants, which are less common but may have stronger effects. Funding SourcesKEW is supported by an NIDDK T32 award.

A Novel Diet-Health Index Reveals Worsening Trends and Widening Disparities in the Health Impacts of Diet in the United States

Abstract Objectives Poor diets are associated with poor health outcomes, but existing metrics of diet quality do not directly include the health effects of diet. Using a novel international diet-health index (IDHI), we can measure diet-related health impacts from multiple dietary factors simultaneously, given a population's health status and most prevalent causes of death and disability. Methods We obtained individual-level data on intake of 12 dietary factors and exposure to 2 metabolic risk factors from the National Health and Nutrition Examination Survey (NHANES), 2003–2014, and computed the IDHI for 12 cardio-metabolic diseases and 15 cancers in the U.S. by sex, race, education, and income. We then compared IDHI to a modified Alternative Healthy Eating Index (mAHEI) using 10 of the 12 dietary factors and validated the indices using the National Center for Health Statistics (NCHS) linked dataset for total mortality through 2015. Results IDHI declined from −0.314 (95% CI: −0.323, −0.305) in 2003/04 to −0.325 (−0.334, −0.316) in 2013/14 (P = 0.007 for trend). Non-Hispanic Black Americans have persistently lower IDHI than other groups, and disparities in IDHI have widened over time by level of income (P = 0.004 for interaction), and education (P = 0.047 for interaction). IDHI was more closely correlated with the mAHEI at higher levels of diet quality, and both indices were strongly associated with total mortality. Conclusions The IDHI is a valid tool for measuring diet-related health impacts in the context of a population's most prevalent diseases, potentially offering tailored guidance regarding how best to reduce diet-related health disparities. Funding Sources No funding.

Associations of dietary and lifestyle oxidative balance scores with mortality risk among older women: the Iowa Women's Health Study.

Substantial basic science evidence suggests that oxidative stress may play a role in aging-related health outcomes, including cardiovascular diseases (CVD) and cancer, and oxidative stress markers were linked with all-cause and cause-specific mortality in epidemiologic studies. However, the associations of many individual dietary and lifestyle anti-/pro-oxidant exposures with mortality are inconsistent. Oxidative balance scores (OBS) that incorporated multiple dietary and lifestyle factors were previously developed and reported to reflect the collective oxidative effects of multiple exposures. We investigated associations of 11-component dietary and 4-component (physical activity, adiposity, alcohol, and smoking) lifestyle OBS (higher scores were considered more anti-oxidative) with all-cause and cause-specific mortality among women 55-69years of age at baseline in the prospective Iowa Women's Health Study (1986-2012). We assessed OBS-mortality associations using multivariable Cox proportional hazards regression. Of the 34,137 cancer-free women included in the analytic cohort, 18,058 died (4521 from cancer, and 6825 from CVD) during a mean/median 22.0/26.1 person-years of follow-up. Among participants in the highest relative to the lowest lifestyle OBS quintiles, the adjusted hazards ratios and their 95% confidence intervals for all-cause, all-cancer, and all-CVD mortality were 0.50 (0.48, 0.53), 0.47 (0.43, 0.52), and 0.54 (0.50, 0.58) (all Ptrend < 0.001), respectively. The associations of the dietary OBS with mortality were close to null. Our findings, combined with results from previous studies, suggest that a predominance of antioxidant over pro-oxidant lifestyle exposures may be associated with lower all-cause, all-CVD, and all-cancer mortality risk.

Physiological effects of nutrients on insulin release by pancreatic beta cells

Obesity and type 2 diabetes (T2D) are growing health problems associated with a loss of insulin sensitivity. Both conditions arise from a long-term energy imbalance, and frequently, lifestyle measures can be useful in its prevention, including physical activity and a healthy diet. Pancreatic β-cells are determinant nutrient sensors that participate in energetic homeostasis needs. However, when pancreatic β-cells are incapable of secreting enough insulin to counteract the reduced sensitivity, the pathology evolves to an insulin resistance condition. The primary nutrient that stimulates insulin secretion is glucose, but also, there are multiple dietary and hormonal factors influencing that response. Many studies of the physiology of β-cells have highlighted the importance of glucose, fructose, amino acids, and free fatty acids on insulin secretion. The present review summarizes recent research on how β-cells respond to the most abundant nutrients that influence insulin secretion. Taken together, understand the subjacent mechanisms of each nutrient on β-cells can help to unravel the effects of mixed variables and complexity in the context of β-cell pathology.

PM2.5 induces intestinal damage by affecting gut microbiota and metabolites of rats fed a high-carbohydrate diet.

PM2.5 has a major impact on the gastrointestinal system, but the specific mechanism behind this action is not fully understood. Current studies have focused on the relationship between PM2.5 and intestinal flora disorder, while ignoring the important influence of diet on gut microbes. In this study, SD rats were fed either a normal, high-fat, or high-carbohydrate diet for two months and exposed to PM2.5 (7mg/kg b.w.) by intratracheal instillation. The results showed that the body and kidney weights of the rats in the high-fat diet group were significantly increased relative to those with a normal diet, and changes in the intestinal microbes and metabolites induced by PM2.5 were observed. Rats in the high-carbohydrate diet group had a significant response, and the diversity and richness indices of the flora were reduced (p<0.05); additionally, intestinal Biffidobacterium and Lactobacillus were enriched, while many endogenous metabolites were found. Some amino acids derivatives and long-chain fatty acids were increased (p<0.05). Both diet structure and PM2.5 exposure can affect the composition of gut microbiota, and intestinal metabolites may be associated with cell membrane damage when a high-carbohydrate diet interacts with PM2.5. This study considers multiple dietary factors to further supplement the evidence of intestinal damage via PM2.5.

Association Between Coffee Intake and Incident Heart Failure Risk: A Machine Learning Analysis of the FHS, the ARIC Study, and the CHS.

Coronary heart disease, heart failure (HF), and stroke are complex diseases with multiple phenotypes. While many risk factors for these diseases are well known, investigation of as-yet unidentified risk factors may improve risk assessment and patient adherence to prevention guidelines. We investigated the diet domain in FHS (Framingham Heart Study), CHS (Cardiovascular Heart Study), and the ARIC study (Atherosclerosis Risk in Communities) to identify potential lifestyle and behavioral factors associated with coronary heart disease, HF, and stroke. We used machine learning feature selection based on random forest analysis to identify potential risk factors associated with coronary heart disease, stroke, and HF in FHS. We evaluated the significance of selected variables using univariable and multivariable Cox proportional hazards analysis adjusted for known cardiovascular risks. Findings from FHS were then validated using CHS and ARIC. We identified multiple dietary and behavioral risk factors for cardiovascular disease outcomes including marital status, red meat consumption, whole milk consumption, and coffee consumption. Among these dietary variables, increasing coffee consumption was associated with decreasing long-term risk of HF congruently in FHS, ARIC, and CHS. Higher coffee intake was found to be associated with reduced risk of HF in all three studies. Further study is warranted to better define the role, possible causality, and potential mechanism of coffee consumption as a potential modifiable risk factor for HF.

Modeling Effects of Complex Diet Mixtures on Cardiovascular Incidence in African American Women: The Women’s Health Initiative

Abstract Objectives Cardiovascular disease (CVD) is the leading cause of premature morbidity and mortality among African American women, and diet plays a crucial role in its prevention. Diet consists of a complex mixture of foods and nutrients, yet few existing statistical methods can account for potential nonlinear and interactive relationships between multiple dietary factors and their effects on health. To realistically assess dietary impacts on CVD risk among African American women, we utilized an innovative statistical approach, Bayesian Kernel Machine Regression (BKMR), which takes into consideration the relationship between multiple dietary factors, as mixtures and as individual components, and CVD risk. Methods Using data from 2724 healthy African American participants of the Women's Health Initiative Observational Study, we examined the association of nine dietary factors (fruits, vegetables, fish, red meat, poultry, nuts, whole grains, dairy, and sodium), collected through a validated food frequency questionnaire, with both systolic blood pressure (SBP) and CVD incidence. Through a kernel machine representation, BKMR regresses the outcome on a smooth function of the exposures, adjusting for potential confounders and allowing for possible nonlinearities and interactions. We used BKMR for modeling the continuous outcome, SBP, and its probit extension for the binary outcome, CVD incidence. Results Whole grain and fish had the strongest associations with SBP. SBP decreased by 0.78 mmHg (95% credible interval (CI): −1.70, 0.14) and increased by 0.70 mmHg (95% CI: −0.12, 1.52) for an interquartile range (IQR) increase in whole grain and fish consumption, respectively. We saw a linear and increasing association between the diet mixture and CVD incidence. This trend was mainly driven by red meat consumption as the primary dietary risk factor to CVD incidence: an IQR increase in red meat consumption was associated with a 0.06-unit (95% CI: −0.02, 0.14) increase in the probit CVD risk. No evidence for interactions and nonlinearities was observed. Conclusions BKMR is a novel method for modeling complex dietary mixtures by incorporating potential nonlinearities and interactions, allowing identification of major dietary factors associated with elevated SBP and CVD incidence among a population disproportionally affected by CVD. Funding Sources NHLBI.

Dietary Profiles, Nutritional Biochemistry Status, and Attention-deficit/hyperactivity Disorder: Path Analysis for a Case-control Study (P18-106-19)

ObjectivesStudies suggested that attention-deficit/hyperactivity disorder (ADHD) is associated with multiple dietary factors. Earlier studies addressed issues related to dietary allergens and toxicants. Recent attention has turned to nutrient imbalance resulted from unhealthy dietary habit. This study aims to investigate dietary and nutritional biochemistry profiles of ADHD and to explore their potential relationship by path analysis. MethodsWe enrolled 216 children with ADHD and 216 age-, height- and gender-matched controls from 31 elementary schools in Taiwan. Dietary intake of the participants was assessed using food frequency questionnaire (FFQ). Fasting blood samples were collected to determine the serum levels of multiple nutritional markers, including several potential vitamins, minerals, and fatty acids. Moreover, we employed a structural equation model (SEM) to link diet, nutritional markers and ADHD. ResultsCompared to healthy control, ADHD children had significantly lower serum levels of vitamin B12, folate, vitamin B6, ferritin concentration, and monounsaturated fatty acids (MUFA), but higher levels of serum saturated fatty acids (SFA), n-6/n-3 fatty acid ratio, and inorganic phosphorous concentration (Table 1). Children with ADHD had more intakes of nutrient-poor foods such as high sugar and high fat foods, and had less intakes of vegetable, fruit, protein-rich foods than their counterpart (Table 2). SEM analysis showed that the poor nutritional biochemistry profiles linked the association between unhealthy dietary patterns and ADHD (Figure 1). ConclusionsWe found that lower serum levels of B-vitamins and imbalanced mineral and fatty acid distributions were risk factors of ADHD and path analysis suggests that unhealthy dietary pattern may be a predecessor of the poor nutritional biochemistry status. Managing diet and nutrition conditions should be trialed and considered among methods to improve ADHD symptoms in children. Funding SourcesNational Science Council of Taiwan R.O.C.; Academia Sinica. Supporting Tables, Images and/or Graphs▪▪▪

Abstract P132: Establishing a New Observational Study of Cardiovascular Risk Factors and Chronic Diseases in Puerto Rico: The PROSPECT Study

Introduction: Evidence supports a direct link between psychosocial and food-related environmental risk factors, and cardiometabolic conditions. These associations remain markedly understudied at the population level in Puerto Rico (PR), despite the clear and pressing need to alleviate striking disparities in chronic disease in the island. On September 2017, Hurricane Maria devastated PR, imposing urgency for studying trends and associations of risk factors for cardiometabolic conditions under times of distress. Hypothesis and aims: We aimed to design and establish ‘PROSPECT: Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic disease Trends’ to study longitudinal associations in psychosocial, food-related, and cardiometabolic risk factors. Methods: PROSPECT was designed as an island-wide, longitudinal population cohort that is recruiting 2,000 adults ages 30-75y using a multi-frame sampling combining probabilistic plus community approaches, with examinations and interviews done in a network of partner clinics across the island. Trained interviewers are collecting comprehensive data on multiple psychosocial, dietary, and food-related factors, cardiovascular disease (CVD) biological markers, and medical record data, with follow-up at 2-years, using standardized protocols and validated questionnaires. PROSPECT emulates the goals and methods of other US and Caribbean cohorts inclusive of mainland Puerto Ricans and other Latinos for comparison. Results: Expected results include estimates of baseline and 2y prevalence and incidence of psychosocial, dietary, and food environment risk factors, and CVD biological markers; measures of associations between 2y changes in risk factors and CVD biological markers; and estimates of differences in prevalence and 2y changes in risk factors, CVD biological markers, and chronic diseases, with emphasis on CVD, by urban vs. rural area, and pre vs. post-Maria. A supplemental study is investigating how food and water shortages following Hurricane Maria may have triggered allostatic load (i.e. physiological stress) and how social connectedness moderates this in PROSPECT participants, with additional context from qualitative narrative interviews. Conclusions: Ultimately, PROSPECT will create a biorepository and participant database for prospective use, and bolster research, academic, and public health partnerships in PR and the US. The study is yielding seminal data to identify priorities on CVD-related disparities, and address them by tailoring public health programs and policy that will effectively improve cardiovascular health in PR, an island with an underserved and high-risk population, under times of distress.

Circulating γ-Tocopherol Concentrations Are Inversely Associated with Antioxidant Exposures and Directly Associated with Systemic Oxidative Stress and Inflammation in Adults

BackgroundAlthough α- and γ-tocopherol are co-consumed antioxidants, circulating γ-tocopherol concentrations were paradoxically found to be inversely associated with total vitamin E intake and circulating α-tocopherol concentrations. There are limited data on this apparent paradox or on determinants of circulating γ-tocopherol concentrations. ObjectiveTo help clarify possible determinants of circulating γ-tocopherol concentrations, we investigated associations of circulating γ-tocopherol concentrations with various dietary and lifestyle factors and biomarkers of oxidative stress and inflammation. MethodsWe pooled cross-sectional data from 2 outpatient, adult, elective colonoscopy populations (pooled n = 419) on whom extensive dietary, lifestyle, and medical information was collected, and the following plasma concentrations were measured: α- and γ-tocopherol (via HPLC), F2-isoprostanes (FiPs; via gas chromatography–mass spectrometry), and high-sensitivity C-reactive protein (hsCRP; via latex-enhanced immunonephelometry). Multivariable general linear models were used to assess mean γ-tocopherol differences across quantiles of plasma antioxidant micronutrients, FiPs, and hsCRP; an oxidative balance score [OBS; a composite of anti- and pro-oxidant dietary and lifestyle exposures (a higher score indicates higher antioxidant relative to pro-oxidant exposures)]; and multiple dietary and lifestyle factors. ResultsAdjusted for serum total cholesterol, mean γ-tocopherol concentrations among those in the highest relative to the lowest tertiles of circulating α-tocopherol and β-carotene, the OBS, and total calcium and dietary fiber intakes were 31.0% (P < 0.0001), 29.0% (P < 0.0001), 27.6% (P = 0.0001), 29.7% (P < 0.0001), and 18.6% (P = 0.008) lower, respectively. For those in the highest relative to the lowest tertiles of circulating FiPs and hsCRP, mean γ-tocopherol concentrations were 50% (P < 0.0001) and 39.0% (P < 0.0001) higher, respectively. ConclusionThese findings support the conclusion that circulating γ-tocopherol concentrations are inversely associated with antioxidant exposures and directly associated with systemic oxidative stress and inflammation in adults. Additional research on possible mechanisms underlying these findings and on whether circulating γ-tocopherol may serve as a biomarker of oxidative stress, inflammation, or both is needed.