Suboptimal Diet Research Articles

Phenolic Compounds Impact on Rheumatoid Arthritis, Inflammatory Bowel Disease and Microbiota Modulation.

Non-communicable chronic diseases (NCDs) are nowadays the principal cause of death, especially in most industrialized nations. These illnesses have increased exponentially with the consumption of diets very high in fat and sugar, not to mention stress and physical inactivity among other factors. The potential impact of suboptimal diets on NCDs’ morbidity and mortality rates brings to the forefront the necessity for a new way of improving dietary habits. The literature provides extensive scientific work that presents evidence that phenolic compounds from diets have antioxidant, anti-inflammatory and antiproliferative activities that impact human health. Gut microbiota modulation by some phenolic compounds leads to favorable changes in abundance, diversity, and in the immune system. However, polyphenol’s limited bioavailability needs to be overcome, highlighting their application in new delivery systems and providing their health benefits in well-established ways such as health maintenance, treatment or adjuvant to conventional pharmacological treatments. In this context, novel dietary approaches, including new food supplements, have emerged to prevent diseases and preserve health.

Higher circulating α-carotene was associated with better cognitive function: an evaluation among the MIND trial participants.

There is emerging evidence linking fruit and vegetable consumption and cognitive function. However, studies focusing on the nutrients underlying this relationship are lacking. We aim to examine the association between plasma nutrients and cognition in a population at risk for cognitive decline with a suboptimal diet. The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) trial is a randomized controlled intervention that examines the effects of the MIND diet to prevent cognitive decline. The primary outcome is global cognition. A multivariate linear model was used to investigate the association between blood nutrients and global and/or domain-specific cognition. The model was adjusted for age, sex, education, study site, smoking status, cognitive activities and physical activities. High plasma α-carotene was associated with better global cognition. Participants in the highest tertile of plasma α-carotene had a higher global cognition z score of 0⋅17 when compared with individuals in the lowest tertile (P 0⋅002). Circulating α-carotene levels were also associated with higher semantic memory scores (P for trend 0⋅007). Lutein and zeaxanthin (combined) was positively associated with higher semantic memory scores (P for trend 0⋅009). Our study demonstrated that higher α-carotene levels in blood were associated with higher global cognition scores in a US population at risk for cognitive decline. The higher α-carotene levels in blood reflected greater intakes of fruits, other types of vegetables and lesser intakes of butter and margarine and meat. The higher circulating levels of lutein plus zeaxanthin reflected a dietary pattern with high intakes of fruits, green leafy, other vegetables and cheese, and low consumption of fried foods. Objective nutrient markers in the blood can better characterize dietary intake, which may facilitate the implementation of a tailored dietary intervention for the prevention of cognitive decline.

Plasmatic and Urinary 5-Hydroxyindolacetic Acid Measurements in Patients With Midgut Neuroendocrine Tumors: A GTE Study.

Although 24-hour urinary 5-hydroxyindolacetic acid (24u5HIAA) is a key biomarker in midgut neuroendocrine tumors (NETs), it may be inaccurate and inconvenient. We compared the diagnostic performances of 24u5HIAA, overnight urinary 5HIAA (Ou5HIAA), and plasmatic 5HIAA (p5HIAA) in midgut NETs. This prospective, multicenter study included 80 patients with metastatic midgut NETs and 17 control patients with irritable bowel syndrome. 24u5HIAA, Ou5HIAA, and p5HIAA were measured in urine and plasma collected on 2 consecutive days following a specific recommended diet. Reproducibility of the biomarkers was evaluated by the Spearman test. Diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUROC). Correlations with the main clinical features and declared observance to the specific diet were assessed using AUROC and logistic regression models. The reproducibility of 24u5HIAA, Ou5HIAA, and p5HIAA were excellent (ρ = 0.916; 0.897; 0.978, respectively, P < .001) with significant discrimination between patients and controls (AUROC = 0.795, P < .001; 0.757, P = .001; 0.717, P = .005, respectively). All 3 markers were correlated with the presence of carcinoid syndrome (AUROC = 0.702, P = .006; 0.701, P = .006; 0.697, P = .007, respectively), carcinoid heart disease (AUROC = 0.896; 0.887; 0.923, P < .001, respectively, P < .001), and liver metastatic involvement greater than 30% (AUROC = 0.827; 0.807; 0.849, P < .001, respectively, P < .001), independent from other traditional prognostic factors. Biomarker levels were similar between patients with optimal or suboptimal diet observance. Ou5HIAA and p5HIAA could be used as more convenient alternatives to 24u5HIAA in patients with metastatic midgut NETs. Prospective long-term studies with repeated dosages are needed.

Eating behaviors and dietary quality in childhood acute lymphoblastic leukemia survivors.

Childhood acute lymphoblastic leukemia (ALL) survivors' increased risk for adverse health outcomes could be mitigated through consuming a balanced diet. Nonetheless, >70% of adult survivors do not meet survivorship dietary recommendations. ALL treatment may amplify risk for restricted dietary preferences (picky eating) and poor self-regulation of food intake that could contribute to suboptimal diets in survivorship. This study aims to: (a) characterize differences in picky eating and self-regulation of food intake between survivors and peer controls; and (b) examine the associations between these eating behaviors and dietary quality in ALL survivors relative to peer controls. Participants were children (5-13years) with (n=32) and without (n=32) a history of ALL and their caregivers. Children's dietary quality (Healthy Eating Index-2015) was calculated from 24-h dietary recalls. Caregivers completed the Child Eating Behavior Questionnaire-Food Fussiness subscale and the Child Self-Regulation in Eating Questionnaire. Independent samples t-tests revealed survivors exhibited greater picky eating than peer controls but comparable self-regulation of food intake. Bootstrapped grouped multivariate regression results showed that for ALL survivors, greater picky eating was associated with worse dietary quality (controlling for age and self-regulation of food intake). For peer controls, worse self-regulation of food intake was associated with poorer dietary quality (controlling for picky eating and age). Results provide preliminary support that different eating behaviors contribute to poor dietary quality in children with and without an ALL history. These findings suggest that interventions to improve ALL survivors' dietary quality may benefit targeting picky eating.

Effect of feed grade acidifiers on total tract mineral retention, intestinal pH and phytate utilization by broiler finisher chickens

Mineral chelators such as organic acids have been reported to compete favourably with phytate by forming soluble complexes with feed minerals. Effect of feed grade acidifiers on total tract mineral retention and intestinal pH of broiler finisher chickens was investigated. A total of 300-broiler finisher chickens were assigned to four treatment groups. Each treatment was replicated thrice with twenty chickens per replicate in a completely randomized design. The control treatment (T1 ) was fed the control diet adequate in available phosphorus at 0.5% while other treatments (T2 -T4 ) were fed sub-optimal available phosphorus diets at 0.4%. Three blends of acidifiers; Fysal®, Orgacid® and Acidomix® were supplemented in the diets of chickens in treatments 2, 3 and 4 at 0.1% (1kg per ton/feed). Chickens fed diet supplemented with Fysal® showed the best (P&lt;0.05) results in total tract mineral retention 56.5+/-5.75 compared to the control and other treatments. The poor mineral retention i.e. 35 and 46% for calcium and phosphorus respectively by chickens fed the control diet was attributed to the insoluble phytate-mineral complex that limits mineral bioavailability. Intestinal segments of chickens fed acidified diets showed significant reduction (P&lt;0.05) in pH in the range of 5.26-7.16 across duodenum to ileum compared to the control group 6.83-8.76. It is concluded that feed acidification at 0.1% improves mineral utilization in broiler chickens as it competes favourably with phytate in the lumen of the gut leading to better nutrient utilization.

Erratum

Erratum

Food and Nutrient Intake and Diet Quality among Older Americans

A suboptimal diet and nutritional deficiencies can have important influences on health with significant impact among older adults. This study aims to assess the presence of suboptimal dietary intake among older Americans and identify risk and protective factors influencing diet quality. For this study, data from a nationally representative sample of 5,614 community-dwelling older adults over age 54 in the Health and Retirement Study – Health Care and Nutrition Survey were used. Descriptive analyses were conducted to assess average intake of 17 food groups and nutrients and the percentage of respondents who consumed an optimal amount of food and nutrients. Differences in diet quality by sociodemographic, psychosocial, environmental, and geographic factors were assessed using chi-square and OLS regression was used to identify risk and protective factors for good quality diet. Overall, only 10.7% of respondents had a good quality diet (HEI score 81 and above); the majority had diets considered poor or needing improvement. Less than 50% of respondents met dietary guidelines and nutritional goals for most individual food groups and nutrients. Respondents with low socioeconomic status, fewer psychosocial resources, and those who had limited access to healthy food outlets were more likely to have a diet of suboptimal quality. Efforts to remove identified barriers that put older adults at risk for poor nutrition and to provide resources that increase access to healthy food should be made to encourage healthy eating and enhance diet quality.

Basic Nutrition for Sports Participation, Part 2: Vitamins and Minerals.

Basic Nutrition for Sports Participation, Part 2: Vitamins and Minerals.

First permanent molars with accentuated line patterns: Assessment of childhood health in an urban complex of the fifth millennium before the present

ObjectivesThe objectives are 1) to calculate the position of highly accentuated lines in dental enamel of a group of individuals from Shahr-i-Sokhta, a thriving urban centre in Bronze Age South West Asia; 2) to identify peak frequencies of physiologically stressful periods during early childhood of these individuals; and 3) to relate these peak frequencies to developmental milestones at population level. DesignWe analysed highly accentuated lines in the enamel of nine (n = 9) permanent mandibular first molars of nine individuals from the 5th millennium before the present urban and long-distance-trading complex, Shahr-i Sokhta (Iran). Age at death ranged between 4.5 years and 18−20 years. Permanent mandibular first molar enamel begins to mineralise before birth, and is normally completed sometime between 2.1–3.3 years, giving us insight to early childhood physiological stress, the ages at which it occurs, and any peaks in the frequencies in highly accentuated line formation, through histological sections investigated using transmitted light microscopy. ResultsHighly accentuated line peak frequencies occur in the sample at c. four, nine, eleven, and twelve months. After 1 year of age, no more peaks occur. ConclusionThe peak frequencies coincide with the timing timing of the type of developmental milestones which may have exposed the individuals to an increased pathogen load, injury, or sub-optimal diet. We note similarity in peak timings in the few published, disparate populations, suggest a potential link with attainment of developmental milestones connected with morbidity, and propose reporting standardised statistics to enable exploration of differences between populations in terms of postnatal health-related stress.

Changes and challenges in markets for animal source foods: a qualitative study among market vendors in Addis Ababa, Ethiopia

Malnutrition is common in Addis Ababa, Ethiopia, in part due to suboptimal diets limited in essential nutrients. Despite previous dietary diversification efforts, animal source food (ASF) consumption remains low, potentially due to supply-side factors affecting ASF market vendors. This study sought to identify supply-side policies and interventions to support urban ASF market vendors and to alleviate the challenges they face. We conducted a qualitative study among 40 urban food market vendors (interviewed in February 2018) to investigate their perceptions of changes in ASF markets over time, the reasons behind these changes, and the challenges faced. Data were analysed using inductive thematic analysis. Findings showed that market vendors agreed that all ASF prices have increased in the past two years, driven by supply shortages, high input costs, consumer demand for ASFs and socio-economic status, among other less prominent causes. Vendors perceived their main challenges to be food supply, religious fasting, consumer demand, price increases and fluctuations, transportation, market infrastructure, and government policies. We identified several potential supply-side interventions and policies that can help optimize ASF markets and eliminate market inefficiencies, including: improving storage facilities to reduce dependability on seasonality; improving road infrastructure to reduce transportation costs and difficulties; stabilizing input costs; and improving the physical market infrastructure to ensure opportunities for business growth. These market-based policies and interventions can help support and stabilize ASF markets by alleviating the barriers faced by urban vendors.

Paternal low protein diet and the supplementation of methyl-donors impact fetal growth and placental development in mice

IntroductionPaternal low-protein diet can alter sperm methylation status, fetal growth and program offspring ill-health, however its impact on the placenta remains poorly defined. Here we examine the influence paternal low-protein diet has on fetal and placental development and the additional impact of supplementary methyl-donors on fetoplacental physiology. MethodsMale C57BL/6J mice were fed a control normal protein diet (NPD; 18% protein), a low-protein diet (LPD; 9% protein) or LPD with methyl-donor supplementation (MD-LPD; choline chloride, betaine, methionine, folic acid, vitamin B12) for a minimum of 8 weeks. Males were mated with 8–11 week old female C57BL/6J mice and fetal and placental tissue collected on embryonic day 17.5. ResultsPaternal LPD was associated with increased fetal weights compared to NPD and MD-LPD with 22% fetuses being above the 90th centile for fetal weight. However, LPD and MD-LPD placental weights were reduced when compared to NPD. Placentas from LPD fathers demonstrated a reduced junctional zone area and reduced free-fatty acid content. MD-LPD placentas did not mirror these finding, demonstrating an increased chorion area, a reduction in junctional-specific glycogen staining and reduced placental Dnmt3bexpression, none of which were apparent in either NPD or LPD placentas. DiscussionA sub-optimal paternal diet can influence fetal growth and placental development, and dietary methyl-donor supplementation alters placental morphology and gene expression differentially to that observed with LPD alone. Understanding how paternal diet and micro-nutrient supplementation influence placental development is crucial for determining connections between paternal well-being and future offspring health.

Genetic improvement of Orius laevigatus for better fitness feeding on pollen

In many protected crops, augmentative biological control heavily relies on generalist predators, which continuous presence on the crop allows an early response to pest immigration and outbreaks. Persistence is possible by their ability to feed on alternative food, such as pollen, plant-provided or artificially supplemented. However, fitness is decreased when feeding on alternative foods, hindering performance. We present a new approach to face this challenge: genetic improvement for better fitness feeding on suboptimal food. Orius laevigatus is one of the main biological control agents used in greenhouse vegetable crops. A breeding process was carried out on the basis of a broad intraspecific variability exploration for 10-day fecundity feeding on pollen (14.2–37.9 eggs/female for 30 wild and commercial populations). Life history traits were finally compared between our two selected strains and three commercial, wild and acclimated-to-pollen unselected populations, both on rich (Ephestia eggs) and suboptimal (dry honeybee pollen) diets. Selected lines showed considerably improved values for longevity (1.5-fold), early (1.3-fold) and lifetime fecundity (1.9-fold), nymphal survival (3.5-fold), intrinsic rate of natural increase (rm) (7.3-fold) and net reproductive rate (R0) (6.7-fold) as compared to reference unselected strains when they were fed on pollen, although still lower than on the optimal diet. Selection feeding on plant material resulted in no trade-offs when feeding on the factitious prey. This improvement was due to genetic gain rather than to phenotypic plasticity to tolerate nutritious restriction. Finally, some potential contributions of these improved lines not only for augmentative biocontrol but also for artificial rearing are provided.

From Pest to Profit—The Potential of Shipworms for Sustainable Aquaculture

We face a food crisis. Suboptimal diet is the biggest cause of death worldwide, food production the biggest greenhouse gas emitting sector, and by 2050 an extra 2.5 billion people need affordable nutrition. Current farming systems will fail to tackle this crisis, and there is an urgent need to diversify global food production and find effective solutions in currently underexploited food sectors. Shipworms, or shell-less Teredo clams, could prove a highly valuable component of such solutions. Historically viewed as a marine pest, they have unique physiological characteristics which make them an ideal food source, including exceptionally fast growth rates, the ability to feed on waste wood or sustainable microalgae, and a high protein and omega 3 content. Today only a select few traditional cultures in the Philippines consume shipworms, but there is considerable opportunity to develop mechanisms to farm shipworms and provide a sustainable, nutrient rich, affordable food source. This will require significant challenges to be overcome, ranging from fundamental research to industry development to food processing and marketing. Leveraging new innovations in breeding, aquaculture feeds, growth systems, food processing methodologies and consumer engagement can however offer powerful solutions, and could help turn what was once a maritime villain into a nutritional saviour.

1200 high-quality metagenome-assembled genomes from the rumen of African cattle and their relevance in the context of sub-optimal feeding

BackgroundThe Boran (Bos indicus), indigenous Zebu cattle breed from sub-Saharan Africa, is remarkably well adapted to harsh tropical environments. Due to financial constraints and low-quality forage, African livestock are rarely fed at 100% maintenance energy requirements (MER) and the effect of sub-optimal restricted feeding on the rumen microbiome of African Zebu cattle remains largely unexplored. We collected 24 rumen fluid samples from six Boran cattle fed at sub-optimal and optimal MER levels and characterised their rumen microbial composition by performing shotgun metagenomics and de novo assembly of metagenome-assembled genomes (MAGs). These MAGs were used as reference database to investigate the effect of diet restriction on the composition and functional potential of the rumen microbiome of African cattle.ResultsWe report 1200 newly discovered MAGs from the rumen of Boran cattle. A total of 850 were dereplicated, and their uniqueness confirmed with pairwise comparisons (based on Mash distances) between African MAGs and other publicly available genomes from the rumen. A genome-centric investigation into sub-optimal diets highlighted a statistically significant effect on rumen microbial abundance profiles and a previously unobserved relationship between whole microbiome shifts in functional potential and taxon-level associations in metabolic pathways.ConclusionsThis study is the first to identify 1200 high-quality African rumen-specific MAGs and provides further insight into the rumen function in harsh environments with food scarcity. The genomic information from the rumen microbiome of an indigenous African cattle breed sheds light on the microbiome contribution to rumen functionality and constitutes a vital resource in addressing food security in developing countries.

Diet Quality, Carotenoid Status, and Body Composition in NCAA Division I Athletes.

Objectives: In this paper, we examined diet quality and associations between changes in skin carotenoids and body composition among selected NCAA Division I athletes. Methods: Athletes from women's (rowing, swimming, gymnastics) and men's (swimming, wrestling) teams at a large Midwest university (N = 129) completed one online food frequency questionnaire and 2 in-person visits, once in-season and once out-of-season, to assess skin carotenoids and body composition. Diet quality was assessed via Healthy Eating Index-2015 (HEI). Carotenoids were measured via resonance Raman spectroscopy and body composition via dual-energy x-ray absorptiometry. ANOVA and Pearson correlations were used to test differences between teams and determine association between changes from in-season to out-of-season. Results: Mean HEI score for all athletes was 71.0. Women's rowing reported the highest diet quality (73.5), men's wrestling lowest (56.5). Skin carotenoids decreased for all teams, except men's wrestling, from in-season to out-of-season. Body fat percentage increased for women and decreased for men. There was a moderate inverse association between changes in skin carotenoids and body fat percentage (r = -.334, p = .001). Conclusions: Suboptimal diet quality coupled with decreases in skin carotenoids and increases in body fat percentage from in-season to out-of-season may justify dietitian-led interventions year-round to improve dietary patterns in collegiate athletes.

Determinants of Dietary Diversity Consumption and Nutritional Status of Pregnant Women Attending Armed Forces Comprehensive Specialized Hospital, Addis Ababa, Ethiopia

The nutritional status of a woman during pregnancy is important as a suboptimal diet impacts negatively on the health of the mother, the fetus and the newborn. There is limited knowledge in the area of malnutrition and factors’ affecting it among pregnant women despite evidence showing that maternal nutrition has important direct and/or indirect consequences for all other age. The objective of the study was to assess the determinants of dietary diversity and nutritional status of pregnant women attending antenatal clinic at Armed Forces Comprehensive Specialized Hospital. The study was cross-sectional and conducted by using both quantitative and qualitative methods. A multistage sampling procedure was employed to draw 320 samples, pregnant women. The women were selected in random through balloting among the first five pregnant women to arrive at the antenatal clinic and thereafter systematic sampling was used and every fourth woman that arrived were sampled until the sample size is met. The data were analyzed by using a software STATA version 14. Descriptive statistics to determine the dietary diversity and nutritional status were done and also to characterize the nutritional status. The statistical model namely, logistic and ordered logistic regression was used for factors affecting the dietary diversity and nutritional status. A P value of &lt;0.1 was considered statistically significant. According to the logistic model interpretation, negative relation implies that the dependent and independent variables are inversely related; while the positive association is the outcome and independent variable have direct relations. The findings of the descriptive analysis indicated that low dietary diversity was experienced by 61.56 percent of the respondents and the rest of the study population was in a high dietary diversity. Based on Mid-upper arm circumference cut-offs 0.31 percent were severely malnourished, while 3.44 percent were moderately malnourished and 96.25 percent were well nourished. Findings from logistic regression revealed that income, meals that were eaten in the last 24 hours, and anemia have positively and significantly affects dietary diversity while not taking iron-fortified foods affects negatively. The results from the ordered logit model indicate that severe undernutrition is determined by not taking micronutrient daily positively where ever income and cleaning utensil properly impact negatively, although moderate undernutrition is associated with not taking micronutrient daily positively and negatively with cleaning utensil properly. Though being nourished is affected by not taking micronutrient daily negatively and positively by cleaning utensil properly. Whereas by World Health Organization hemoglobin cut-offs 2.50 percent, 11.56 percent, and 85.94 percent were in severe anemia, moderate anemia, and normal hemoglobin level respectively. The results from the multinomial regression model reveal that severe anemia is negatively associated with dietary diversity. At the same time, moderate anemia is affected positively by not taking micronutrient daily and negatively by age, dietary diversity score and morbidity status of the pregnant women. Similarly being in normal hemoglobin cut-off was affected positively by age, dietary diversity and morbidity, negatively affected by not taking micronutrient daily. Finally, the findings conclude that dietary diversity and nutritional status were very poor and socio-demographic, socio-economic, micronutrient supplementation, morbidity, environmental factors, and dietary diversity influence the nutritional status of pregnant women. It is recommended that promotion of dietary diversity and modification of diets be carried out through practical demonstrations in the community and health facilities and there should be income generation practices and entrepreneur encouragements should be practiced.

Impact of diet on CVD and diabetes mortality in Latin America and the Caribbean: a comparative risk assessment analysis.

To quantify diet-related burdens of cardiometabolic diseases (CMD) by country, age and sex in Latin America and the Caribbean (LAC). Intakes of eleven key dietary factors were obtained from the Global Dietary Database Consortium. Aetiologic effects of dietary factors on CMD outcomes were obtained from meta-analyses. We combined these inputs with cause-specific mortality data to compute country-, age- and sex-specific absolute and proportional CMD mortality of eleven dietary factors in 1990 and 2010. Thirty-two countries in LAC. Adults aged 25 years and older. In 2010, an estimated 513 371 (95 % uncertainty interval (UI) 423 286-547 841; 53·8 %) cardiometabolic deaths were related to suboptimal diet. Largest diet-related CMD burdens were related to low intake of nuts/seeds (109 831 deaths (95 % UI 71 920-121 079); 11·5 %), low fruit intake (106 285 deaths (95 % UI 94 904-112 320); 11·1 %) and high processed meat consumption (89 381 deaths (95 % UI 82 984-97 196); 9·4 %). Among countries, highest CMD burdens (deaths per million adults) attributable to diet were in Trinidad and Tobago (1779) and Guyana (1700) and the lowest were in Peru (492) and The Bahamas (504). Between 1990 and 2010, greatest decline (35 %) in diet-attributable CMD mortality was related to greater consumption of fruit, while greatest increase (7·2 %) was related to increased intakes of sugar-sweetened beverages. Suboptimal intakes of commonly consumed foods were associated with substantial CMD mortality in LAC with significant heterogeneity across countries. Improved access to healthful foods, such as nuts and fruits, and limits in availability of unhealthful factors, such as processed foods, would reduce diet-related burdens of CMD in LAC.

The Impact of Suboptimal Diet on Type 2 Diabetes at Global, Regional, National, and Sub-National Levels: A Comparative Risk Assessment Analysis

Abstract Objectives To prioritize dietary factors for reducing the growing burden of type 2 diabetes (T2D) worldwide, we estimated the impact of suboptimal diet on T2D incidence at global, regional, national, and subnational levels between 1990 and 2015. Methods A comparative risk assessment framework estimated T2D incidence attributable to suboptimal diet in strata jointly stratified by year, nation, age, and sex, across 185 countries. We estimated direct (dietary composition) etiologic effects of 8 factors including nuts/seeds, whole grains, yogurt, processed meats, unprocessed red meats, glycemic load (estimated from refined grains), sugar-sweetened beverages (SSBs) and potatoes. Population demographics were from the United Nations; stratum-specific mean dietary intakes and distributions from Global Dietary Database (GDD), diet-T2D etiologic effects from meta-analyses of prospective cohort studies; and T2D incidence from the Global Burden of Disease study. These inputs and their uncertainties were used to calculate the stratum-specific population attributable fraction (PAF) and then absolute attributable cases, with joint effects estimated using multiplicative PAFs. Results In 2015, suboptimal intakes of these 8 factors were jointly estimated to cause 10.9 million T2D cases (95% UI 7.2–15.3), representing 59.6% of all cases (39.3–83.3%) among adults age 25 + y globally. Low intake of whole grains (3.6 million cases (3.4–3.8)) followed by high intake of SSBs (2.7 million cases (2.5–2.9)) had the largest estimated attributable burdens. Across 7 world regions, highest diet-attributable burdens of T2D were in High Income Countries (2516 cases per million (2115, 2870)) and Former Soviet Union (2341 cases per million (1465, 2970)); and lowest in Sub-Saharan Africa (797 cases per million (333, 1435)). The proportion of T2D attributable to suboptimal diet was generally greater in males vs. females and in younger vs. older age groups. Results for specific countries, trends over time, and further sensitivity analyses will be presented. Conclusions These novel findings provide the most updated estimates of diet-attributable T2D globally, helping to inform priorities for targeted healthcare system, policy, industry and public health interventions to reduce T2D. Funding Sources Gates Foundation.

Association of Walnut Consumption with Total and Cause-Specific Mortality and Life Expectancy in U.S. Women and Men

Abstract Objectives We aim to 1) examine the association between walnut consumption and subsequent total and cause-specific mortality; 2) to estimate life expectancy that would be potentially gained by varying intake of walnuts in U.S. women and men. Methods Walnut consumption was assessed using validated food frequency questionnaires in 1998 (baseline year) and updated every 4 years. We included data from 68,308 women of the Nurses’ Health Study (1998–2016) and 26,760 men of the Health Professionals Follow-up Study (1998–2016) who were free of cancer, heart disease, and stroke at baseline. We used Cox regression models adjusting for confounders to estimate mortality risk associated with walnut consumption stratified by sex and dietary quality. We used population based multistate life tables to calculate the differences in life expectancy and years lived in relation to walnut consumption. Results During up to 18 years of follow-up, we documented 30,502 deaths from any cause. The multivariable-adjusted hazard ratios (HRs) for total mortality across categories of walnut intake (servings/week), as compared to non-consumers, were 0.91 (95% confidence interval [CI], 0.89–0.94), for &amp;lt;1 serving/week, 0.87 (95% CI, 0.83–0.92) for 1 serving/week, 0.79 (95% CI, 0.75–0.85), for 2–4 servings/week, and 0.77 (95% CI,: 0.71–0.81) for &amp;gt;= 5 servings/week (P for trend &amp;lt;0.0001). Per 0.5 serving/day walnut consumption was associated of a reduced risk of total mortality (HR: 0.82, 95% CI,: 0.77–0.88), CVD mortality (HR: 0.78, 95% CI,: 0.67–0.33), and cancer mortality (HR: 0.93, 95% CI:, 0.81–1.07) in participants with a suboptimal diet (AHEI score &amp;lt;60% of cohort distribution). A greater life expectancy of 1.78 years in women and 1.94 years in men was observed among those who consumed walnuts more than 5 servings/week, compared to non-consumers at age 60. Conclusions Higher walnut consumption was associated with lower risk for total mortality and longer estimated life expectancy among U.S. men and women of two prospective cohort studies. Our results provide evidence on the potential role of walnut in the prevention of premature death. Funding Sources UM1 CA186107, UM1 CA176726, UM1 CA167552 Y.L. was partly funded by the California Walnut Commission. The funders have no roles in the design and conduct of the study.

Disparities in Health and Economic Burden of Cancer Attributable to Suboptimal Diet in the United States

Abstract Objectives Suboptimal diet contributes to substantial health disparities among low-income and racial and ethnic minorities, but influences on cancer disparities are not well established. We quantified the health and economic burdens of cancer attributable to suboptimal diet among US adults overall and in key demographic subgroups. Methods Using a probabilistic cohort state transition model, we incorporated national representative demographics and dietary data, national cancer incidence and cancer survival, diet-cancer etiologic associations, and cancer-related healthcare costs to estimate new cancer cases, cancer deaths, and cancer costs attributable to suboptimal intakes of 7 dietary factors (fruits, vegetables, dairy, whole grains, processed meats, red meats, sugar sweetened beverages) among US adults aged 20 + years over their lifetime. Uncertainties in inputs were incorporated using probabilistic sensitivity analyses in 1000 simulations. Results Suboptimal intakes of these 7 dietary factors were estimated to jointly cause 1.76 (95% UI: 1.69–1.81) million new cancer cases, representing 4.6% (4.5–4.8%) of total cases of these cancers, 1.04 (1.00–1.08) million cancer death, and $215B (206–223) cancer-related healthcare costs in US adults over their lifetime. The top 3 diet-attributable cancers were colorectal (n = 824,000 new cases, 17% of the total), oral cavity and pharynx (n = 204,000, 8.4%), and endometrial cancer (n = 175,000, 5.8%). Among subgroups, diet-attributable new cancer cases per 100,000 population were 16% higher for men (805 [777–843]) than women, 20% higher for non-Hispanic blacks (939 [901–954]) than non-Hispanic white, 12% higher for below college educated (771[727–817]) than college graduates, 14% higher for lower income individuals (income-to-poverty ratio &amp;lt; 1.3: 810 [771–839]) and 21% higher for SNAP participants (872 [830–920]) compared to high income individuals. Similar patterns were observed for diet-associated cancer death and cancer costs. Conclusions Our novel findings suggest that suboptimal intakes of 7 dietary factors are contributing to substantial cancer burdens and healthcare costs in the US, with major additional disparities among key population subgroups. These results help inform dietary and policy priorities to reduce diet-related cancer and disparities in the US. Funding Sources NIH/NIMHD.