Validated Food Frequency Questionnaire Research Articles

Association between dietary factors and breast cancer risk: a matched case-control study in Vietnam

BackgroundThe role of diet in breast cancer prevention is controversial and limited in low-middle-income countries (LMICs). This study aimed to investigate the association between different dietary factors and breast cancer risk in Vietnamese women.MethodsThree hundred seventy newly histologically confirmed breast cancer cases and 370 controls matched by 5-year age from September 2019 to March 2020 in Ho Chi Minh City were recorded dietary intake using a validated food frequency questionnaire. Odds ratios (OR) and 95% confidence intervals (95% CI) were evaluated using conditional logistic regression and adjusted with potential confounders.ResultsCompared to the lowest quartile of intake, we found that the highest intake of vegetables, fruit, soybean products, coffee, and egg significantly decreased breast cancer risk, including dark green vegetables (OR 0.46, 95% CI 0.27-0.78, ptrend=0.022), legumes (OR 0.19, 95% CI 0.08-0.44, ptrend <0.001), starchy vegetables (OR 0.37, 95% CI 0.21-0.66, ptrend=0.003), other vegetables (OR 0.46, 95% CI 0.28-0.77, ptrend=0.106), fruits (OR 0.44, 95% CI 0.26-0.74, ptrend <0.001), soybean product (OR 0.45, 95% CI 0.24-0.86, ptrend=0.311), coffee (OR 0.47, 95% CI 0.23-0.95, ptrend 0.004), and egg (OR 0.4, 95% CI 0.23-0.71, ptrend=0.002).ConclusionGreater consumption of vegetables, fruit, soybean products, coffee, and eggs is associated with a lower risk of breast cancer. This study provides evidence of breast cancer prevention by increasing the intake of these dietary groups, especially in LMICs.

Anti-inflammatory diet mitigate cardiovascular risks due to particulate matter exposure in women during pregnancy: A perspective cohort study from China

BackgroundParticulate matter (PM) exposure during pregnancy may increase cardiovascular risk (CVR). However, the specific time windows of exposure contributing to this association and the potential biological mechanisms underlying it remain unclear. ObjectiveTo determine the sensitive time window for CVR related to PM exposure. We investigated whether levels of inflammatory biomarkers mediate the relationship between PM exposure and CVR, and examined the potential impact of an anti-inflammatory diet on this association. MethodsFrom 2015 to 2021, 9294 pregnant women from three Hefei hospitals were included. We used a 1 × 1 km satellite dataset to assess PM1, PM2.5, and PM10 exposure. High-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were measured as inflammatory biomarkers. The empirical dietary inflammatory pattern (EDIP) score, based on a validated food frequency questionnaire. The CVR score was calculated using five clinical metrics based on American Heart Association criteria. ResultsWe found a significant association between PM exposure and increased CVR score, especially during the 2nd to 8th weeks of the first trimester. For every increase of 10-μg/m3 of PM1, PM2.5, and PM10, there was an associated increase in CVR of 0.51 (95%CI: 0.21, 082), 0.25 (95% CI: 0.11 to 0.39), and 0.29 (95% CI: 0.09 to 0.37), respectively. Mediation analysis revealed that the proportion of the association between PM1, PM2.5, and PM10 exposure and CVR mediated by inflammatory biomarkers was 24.3%, 22.4%, and 20.1%, respectively. Stratified analyses showed no positive correlation between PM exposure and CVR in the anti-inflammatory diet (low EDIP) group. The β coefficients were 0.52 for PM1 (95% CI: -0.06 to 1.11), 0.31 for PM2.5 (95% CI: -0.04 to 0.79), and 0.25 for PM10 (95% CI: -0.03 to 0.54). ConclusionsPM exposure, particularly during weeks 2–8 of pregnancy, correlates with CVR, partly mediated by levels of inflammatory biomarkers. An anti-inflammatory diet mitigates CVR associated with PM exposure.

Association Between Dietary Magnesium Intake with Serum Brain-Derived Neurotrophic Factor (BDNF) and Adropin Levels and Metabolic Health Status in Iranian Adults.

Given the sparse conclusive findings regarding the association of magnesium intake with metabolic health status and limited evidence relating magnesium intake to metabolic biomarkers, our objective was to evaluate the association of metabolic health status, adropin, and brain-derived neurotrophic factor (BDNF) in relation to dietary magnesium intake. In this cross-sectional study, 527 male and female adults were investigated in Isfahan City. The data regarding usual dietary intakes were gathered using a valid and reliable 168-item food frequency questionnaire. Biochemical variables, anthropometric indices, and blood pressure were assessed following standard methods. The criteria suggested by Wildman et al. were used to classify participants as metabolically unhealthy (MU) and metabolically healthy (MH). Moderate magnesium intake was associated with 71% reduced odds of MU (OR T2 vs. T1 = 0.29; 95% CI: 0.12-0.70). In the stratified analysis, the inverse association between moderate intake of magnesium and MU was seen only in overweight/obese subjects but not in normal-weight ones. A significant difference was found in serum levels of adropin between the first and second tertile of dietary magnesium intake among overweight/obese subjects (62.74 ± 4.99 vs. 50.13 ± 2.54, P = 0.03). After adjustment for potential covariates, this association became attenuated (59.06 ± 3.47 vs. 50.02 ± 3.64, P = 0.20). No statistically significant link was obtained between dietary intake of magnesium and circulating BDNF levels. Moderate dietary intake of magnesium may exert beneficial effects on metabolic health and serum levels of adropin, especially in obese/overweight individuals. Further prospective studies will be required to approve our findings.

Maternal diet in pregnancy and the risk of inflammatory bowel disease in the offspring: a prospective cohort study

BackgroundDiet has been hypothesized as a risk factor for development of inflammatory bowel disease (IBD). ObjectiveTo explore associations between maternal diet diversity and quality in pregnancy and the offspring’s risk of IBD. MethodsWe used data from a nationwide cohort study on 85,129 Norwegian children followed from birth (1999–2009) with information on maternal diet in pregnancy from validated food frequency questionnaires. Hazard ratios (aHRs) for IBD, Crohn’s disease (CD), and ulcerative colitis (UC) by maternal diet diversity, quality and intake amounts of individual food groups were adjusted for maternal body mass index, parental IBD, and socio-demographic factors. Sensitivity analyses adjusted for the child's early-life diet quality and antibiotic treatment. Dietary exposures were classified into tertiles, comparing low (reference) to medium, and high levels. ResultsDuring a mean follow-up time of 16.1 years (1,367,837 person-years of follow-up), 268 children developed IBD (CD, n=119; UC, n=76; IBD-unclassified, n=73). High compared with low diet diversity in pregnancy was associated with a lower risk of UC in the offspring (aHR 0.46, 95% confidence interval 0.25-0.87), with consistent findings after further adjustment for the child's early-life diet quality and antibiotic treatment. High compared with low diet diversity in pregnancy yielded aHRs of 0.81 for CD (0.51-1.28) and 0.75 for any IBD (0.55-1.02) in the offspring. A high compared with low diet quality in pregnancy or intakes of specific food groups were not associated with the offspring’s risk of IBD or its subtypes. ConclusionsOur findings suggest that a higher maternal diet diversity in pregnancy may be associated with a lower risk of UC in the offspring.

The association of dietary total antioxidant capacity and gestational diabetes: a prospective cohort study from the Mothers and their children’s health (MATCH)

Background/ObjectivesThere is evidence to support the hypothesis that a diet rich in antioxidants can help safeguard against the development of gestational diabetes mellitus (GDM). This study aimed to investigate the association between dietary total antioxidant capacity (DTAC) during early pregnancy and the risk of GDM.Subjects/MethodsWe included 1856 pregnant women in their first trimester from the Mothers and their Children’s Health (MATCH) prospective cohort study. Prepregnancy dietary intake was assessed using a validated food frequency questionnaire (FFQ) and was used to calculate the DTAC score. Incident GDM was diagnosed based on the American Diabetes Association criteria. We estimated the association between DTAC and GDM using propensity score–based inverse probability weighting (IPW).ResultsOverall, 369 (14.6%) of the pregnant women were identified with GDM. The mean DTAC score and the corresponding standard deviation (SD) was 2.82± (2.56) mmol/100 g, with a range of 0.01 to 18.55. The adjusted risk of GDM decreased by 34% (95% CI = 10%, 52%, p = 0.023) for each DTAC score increase. The results showed that women in the highest quartile of DTAC had a lower risk of developing GDM compared to those in the lowest quartile (adjusted RR: 0.29, 95% CI: 0.12, 0.68, p = 0.005).ConclusionDTAC in early pregnancy is significantly associated with a lower risk of GDM. Additional larger cohort studies are needed to validate these findings.

Is Starch Intake Associated With Periodontal Status? An 11-Year Longitudinal Analysis Among Finnish Adults.

To evaluate the association between baseline starch intake (amount and sources) and changes in periodontal status over 11 years in adults. Adults aged 30-82 years, who participated in the Finnish Health 2000 survey and were re-examined in 2004/2005 and/or 2011 were included in the study. The consumption of total starch and six relevant food groups (potatoes, fried potatoes, roots and tubers, pasta, wholegrains and legumes) over the past year was determined at baseline with a validated food frequency questionnaire. The number of teeth with periodontal pocketing ≥ 4 mm (NTPP) was recorded during clinical examinations in 2000, 2004/2005 and 2011. The association between baseline starch intake and the 11-year change in the NTPP was tested in mixed-effects negative binomial regression models, adjusting for covariates. A total of 1369 adults were included in the analysis. The mean NTPP was 4.1 ± 5.6, 6.3 ± 5.6, and 4.8 ± 5.9 in waves 1, 2 and 3, respectively. Baseline starch intake (in g/day or % energy intake) was not associated with changes in the NTPP after adjustment for covariates. In analysis by food groups, the baseline intake of wholegrains was negatively associated with the NTPP at baseline. This study found no evidence of an association between baseline starch intake and changes in periodontal status. Baseline intake of wholegrains was associated with better periodontal status at baseline.

Predicted vitamin D levels and risk of depression in the SUN Project: A prospective cohort study

The current study aimed to investigate the association between predicted vitamin D status and depression in a prospective Spanish cohort of university graduates. The SUN Project is a dynamic cohort study designed to investigate multiple aspects of health and lifestyle. Participants were asked to complete a comprehensive questionnaire consisting of 556 items, that included a validated food-frequency questionnaire. Participants initially free of depression were classified as incident cases if they reported a medical diagnosis of depression during follow-up. Serum vitamin D levels were predicted by a previously validated equation. Vitamin D deficiency was defined as vitamin D levels below 20 ng/mL. Cox models were used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (95% CI). We included 15,175 Spanish university graduates [mean (SD) age: 36.9 year (11.5)] followed-up for a median of 12.7 years. Among 192,976 person-years of follow-up, we identified 753 incident cases of depression. Participants with vitamin D deficiency had a 27% higher risk of depression as compared to those with vitamin D sufficiency (HR: 1.27, 95% CI: 1.09–1.48; p = 0.002) after adjusting for potential confounders. Furthermore, a significant effect modification by female sex was observed with higher depression risks associated with vitamin D deficiency in women than in men (p for interaction = 0.034). In educated middle-aged Spanish adults, we observed a direct association between vitamin D deficiency and the risk of depression, that was stronger among women.

Urban-rural differences in food consumption and central obesity among middle-aged adults: A cross-sectional population study in Indonesia

Background: The prevalence of central obesity is increasing in many regions, including low- and middle-income countries. It has been identified that a poor diet has become a significant risk factor for central obesity. However, the relationship between diet and the prevalence of central obesity among rural and urban communities remains unclear in low- and middle-income countries. Aim: This study aimed to analyze the association of food consumption with central obesity among middle-aged adults (45–59 years) in urban and rural areas in Indonesia. Methods: This was a cross-sectional study using secondary data from a national survey (Indonesia Basic Health Survey) in Indonesia in 2018. A total of 154,449 subjects were analyzed for the study. We used the International Diabetes Federation to define central obesity. Food consumption was measured using a validated food frequency questionnaire. Multivariable logistic regression was used to explore the association between food consumption and central obesity. Results: Frequent consumption of refined desserts, fried food, processed food, and inadequate consumption of fruit was significantly associated with central obesity in urban and rural areas ( p &lt; 0.05). In contrast, frequent consumption of seasoning and inadequate consumption of vegetables was significantly associated with central obesity only in rural areas ( p &lt; 0.05). Conclusion: Food consumption has a different association with central obesity risk in rural and urban areas in Indonesia.

Dietary phytochemical index and its relationship with diabetic sensorimotor polyneuropathy: a case-control study

Phytochemicals are compounds found in fruits, vegetables, whole grains, nuts and legumes that are non-nutritive but have bioactive properties. A high intake of these compounds is essential for optimal health and disease prevention. No study has investigated the association between Dietary Phytochemical Index (DPI) and polyneuropathy in patients with diabetes. This study aimed to examine the association between DPI and Diabetic Sensory-motor Polyneuropathy (DSPN) in a case-control study. In this case-control study, a total of 185 diabetic patients with DSPN (case group) and 185 sex- and age-matched diabetic patients without neuropathy (control group) were enrolled in this study. Participants were 30–60 years old. A validated food frequency questionnaire was used to measure the dietary intake of all participants. Daily energy derived from phytochemical-rich foods was used to calculate the DPI score. Toronto clinical neuropathy score was applied to define DSPN. Anthropometric data and fasting blood glucose levels were measured using standard methods. The Binary logistic regression was used to estimate Crude and multivariable-adjusted OR (95% CI) for DSPN across tertiles of DPI for the whole population. In the crude model, there was a significant trend across the tertile of DPI (OR highest vs. lowest tertile of DPI = 0.33; 95%CI 0.18, 0.52; P-trend < 0.001). After controlling for age, sex, and energy, a significant reverse association was observed between DPI and DSPN (OR highest vs. lowest tertile of DPI = 0.27; 95%CI 0.15, 0·48; P-trend < 0.001). Moreover, after adjusting for a wide range of confounding variables such as energy intake, physical activity, education, smoking status, and HbA1c, participants in the third tertile of DPI had 75% reduced odds for DSPN (95%CI 0.14, 0.45; P-trend < 0.001). Finally in the full adjusted model, after further adjustment for BMI, observed significant association was remained (OR highest vs. lowest tertile of DPI: 0.24; 95% CI 0.13, 0.14; P-trend < 0.001). Higher intakes of phytochemical-rich foods are associated with lower odds of DSPN.

Maternal Folic Acid and Dietary Folate Intake in Relation to Sex Ratio at Birth and Sex-Specific Birth Weight in China.

It is well-established that prenatal folic acid supplements can reduce neural tube defects. However, the associations between folic acid supplementation, dietary folate intake, and overall folate intake with sex-specific birth outcomes are not yet fully understood. This study aims to investigate the association of periconceptional folic acid supplement, dietary folate, and total folate intake with the sex ratio at birth and sex-specific birth weight. Data were sourced from a cross-sectional survey conducted between August and December 2013 in Northwest China, involving 7318 infants and their mothers, recruited using a stratified multistage random sampling method. Folic acid supplements (400 μg/d) were ascertained via a retrospective in-person interview. Dietary folate was evaluated using a validated food frequency questionnaire. Birth outcomes, including sex and weight at birth, were obtained from the Medical Certificate of Birth. Generalized linear models were employed to calculate relative risks (RRs) or differences with 95% confidence intervals (CIs). No association or dose-response relationship was observed between folic acid supplement, dietary folate, and total folate intake during periconception and the likelihood of male births. However, women who took folic acid supplements during pre- and post-conception were associated with an increased male birth weight by 52.8 (8.1 to 97.5) g. Additionally, the total folate intake during periconception was associated with birth weight for males (upper vs. lower tertile: β = 38.8, 95%CI: 5.0 to 72.5 g, p-trend = 0.024) and females (upper vs. lower tertile: β = 42.4, 95%CI: 6.7 to 78.1; p-trend = 0.022). Our findings indicate that periconceptional total folate intake does not correlate with sex ratio at birth but was positively linked to infant birth weights, regardless of gender. These findings offer novel insights into potential benefits of total folate intake, beyond the prevention of neural tube defects, for policymakers and public health.

The association of dietary inflammatory indices and mortality in patients with cirrhosis: a cohort based study

Dietary intake has an undeniable role in the development and progression as well as the prevention and treatment of cirrhosis. This study was conducted with the aim of investigating the association between dietary inflammatory indices and total mortality in patients with cirrhosis. A total of 166 outpatients with cirrhosis who were diagnosed within the last 6 months were followed up for 48 months in this cohort study. A 168-question valid food frequency questionnaire was used to evaluate dietary intake. Accordingly, the dietary inflammatory index (DII), empirical dietary inflammatory pattern (EDIP) and dietary inflammatory score (DIS) were calculated. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated through cox proportional hazards regression models for an association of cirrhosis mortality and three dietary inflammatory indices. After full adjustment for confounders, the results showed that mortality risk increased significantly with increasing dietary inflammatory indices. Compared to the first tertile, the risk of mortality due to cirrhosis was associated with 4.8 times increase in the third tertile of DII (HR = 4.8, 95% CI = 1.1–19.8, p trend = 0.029), 3.3 times in the third tertile of EDIP (HR = 3.3, 95% CI = 1.3–8, p trend = 0.004), and 2.2 times increased in the third tertile of DIS (HR = 2.2, 95% CI = 1–4.7, p trend = 0.032). The results of the present study indicated a significant association between dietary inflammatory indices and total mortality among patients with cirrhosis. Additional research is necessary to confirm our findings.

Associations Between Intakes of Carotenoids and Tocopherols with Risk of Pancreatic Cancer in a Population-Based Case-Control Study

Objective Experimental studies suggest that carotenoids and tocopherols modulate pancreatic carcinogenesis because they have antioxidant and other functions. We investigated the associations between intakes of these compounds and the risk of pancreatic cancer in a case-control study conducted in 1994–1998. Methods The present analysis included 150 cases of pancreatic cancer recruited from all hospitals in the metropolitan area of the Twin Cities and Mayo Clinic and 459 controls randomly selected from the general population and frequency matched to cases by age, sex, and race. The intakes of carotenoids and tocopherols were assessed with a validated food frequency questionnaire. Unconditional logistic regression analysis was performed to evaluate the associations of interest. Results The energy-adjusted intake of lutein/zeaxanthin was significantly lower in cases (2410 µg/day) than in controls (3020 µg/day). After adjustment for confounders, persons in the fourth quartile of lutein/zeaxanthin intake had a reduced risk of pancreatic cancer compared with those in the first quartile [odds ratio (OR) (95% CI): 0.40 (0.17-0.91)]. There were no significant associations with intakes of other carotenoids and tocopherols considered and with a composite score created from all individual carotenoids examined. We did not detect any significant interactions of intakes of carotenoids and tocopherols with age, sex, cigarette smoking, or alcohol intake in relation to pancreatic cancer risk. Conclusion The present study suggests an inverse association between lutein/zeaxanthin intake and pancreatic cancer risk, but a potential beneficial effect was not observed for other carotenoids and tocopherols.

Role of Dietary Patterns in the Progression and Management of Heart Failure in Pakistani Patients: A Multicenter Study.

Heart failure (HF) is a chronic condition with increasing prevalence in Pakistan due to common cardiovascular risk factors. Dietary interventions are known to influence HF outcomes, but data specific to Pakistani patients are limited. This study aimed to evaluate the impact of dietary patterns on HF progression and management in Pakistani patients, alongside the effects on quality of life and biochemical markers. A prospective cohort study was conducted across four medical centers in Pakistan, enrolling 170 HF patients. Dietary patterns were assessed using a validated Food Frequency Questionnaire (FFQ) tailored to the South Asian population. The primary outcomes measured were changes in the ejection fraction, New York Heart Association (NYHA) class, and hospitalization rates. Secondary outcomes included changes in quality of life and biochemical markers. Multivariate logistic regression was used to adjust for confounding variables, and Bonferroni corrections were applied to account for multiple comparisons. Adherence to a heart-healthy diet significantly improved the ejection fraction (from 35% to 38%, p = 0.04), reduced hospitalization rates (22%, p = 0.03), and improved NYHA class (45%, p = 0.05). Subgroup analysis showed a 10% reduction in mortality among patients over the age of 65 (p = 0.01) and 18% in diabetic patients (p = 0.02). Dietary interventions play a critical role in HF management among Pakistani patients. Culturally tailored dietary guidelines should be integrated into clinical practice to improve patient outcomes.

Soft drink consumption and increased risk of nonalcoholic fatty liver disease: Results from the health workers cohort study

Introduction and ObjectivesNonalcoholic fatty liver disease (NAFLD) is a common clinical condition and an important public health problem. Some epidemiological studies have suggested that soft drinks (SD) intake is associated with NAFLD. However, the evidence is inconsistent. Our objective was to assess the association between SD consumption and the risk of NAFLD in a Mexican adult population. Materials and MethodsA total of 1,759 participants from the Health Workers Cohort Study (HWCS) were included in the analyses. SD intake was measured using a validated food frequency questionnaire. We classified SD consumption as follows: a) less than 1 serving per week, b) 1 to less than 3.5 servings per week, and c) 3.5 or more servings per week. Hepatic steatosis index (HSI) was calculated based on sex, BMI, and blood transaminase levels, and was categorized as NAFLD ≥ 36. To assess the relation between SD and NAFLD, we followed two approaches: fixed effects logistic regression and generalized estimating equations. ResultsAfter adjusting for demographic characteristics, lifestyle factors, and dietary intake, the odds ratio (OR) and 95 % confidence interval (95 % CI) for NAFLD were 1.26 (95 % CI: 1.08, 1.48) for 1 to less than 3.5 servings per week and 1.42 (95 % CI: 1.19, 1.69) for ≥3.5 servings/week category in both sexes. When stratifying the analysis by sex, we observed that the association tended to be greater in men than in women. ConclusionsThe results from our prospective study indicate that SD consumption is associated with an increased risk of NAFLD.

Association between dietary antioxidant indices and hypertension among Chinese adults.

The effect of dietary antioxidants on blood pressure (BP) regulation and hypertension risk remains largely unknown. This study aimed to comprehensively assess the impacts of dietary antioxidants on systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP), and hypertension risk among Chinese adults. The cross-sectional study assessed data from 12,046 Chinese adults, evaluating dietary antioxidant quality scores (DAQS) and total antioxidant capacity (DTAC) via a validated food frequency questionnaire. MAP was derived using the formula DBP + (0.412 ×PP), with PP calculated as SBP - DBP. The relationship between DAQS, DTAC, and hypertension prevalence was analyzed using multivariable logistic regression. Among participants not taking antihypertensive medications, those in the highest groups of DTAC and DAQS had significantly lower SBP, DBP, MAP, and PP compared to those in the lowest groups (all p-trends <0.001). Relative to the lowest quintile (Q1) ofDTAC (adjusted odds ratios (OR) for hypertension decreased in Q2 (OR 0.90, 95%CI 0.79-1.03), Q3 (OR 0.65, 95% CI 0.56-0.76), Q4 (OR 0.51, 95% CI 0.43-0.60), and Q5 (OR 0.38, 95% CI 0.31-0.46) (p trend <0.001). For DQAS, hypertension OR of category 5 was 0.38 (95% CI 0.32-0.46) compared to that of category 1. Increased vitamin A, Zinc, and selenium intake correlated with reduced hypertension risk. A significant non-linear DTAC and linear DAQS relationships were observed and hypertension risk. Antioxidant-rich diets markedly lowered SBP, DBP, MAP, PP, and hypertension risk.

Dietary patterns and periodontitis: A systematic review.

The systematic review aimed to investigate the associations between index-based dietary patterns and the risk and severity of periodontitis. Four public databases were searched for relevant published articles. Two independent researchers conducted the study selection, quality assessment, and data extraction. Methodological quality of the selected studies was evaluated using Joanna Briggs Institute Checklists. The review was registered with PROSPERO (CRD42023395049). Twenty-five studies were eligible for this review, including 23 cross-sectional studies and two prospective cohort studies. The most utilized dietary indices were the Healthy Eating Index (HEI), the Mediterranean Diet Score (MDS), and the Dietary Inflammatory Index (DII). The results indicated a positive association between higher diet quality (i.e., higher HEI and MDSs and lower DII scores) and healthier periodontal status. Subgroup meta-analysis for four studies utilizing HEI and CDC/AAP case definition indicates the protective effect of higher HEI scores on the risk of periodontitis (OR [95% CI] = 0.77[0.68, 0.88]) with statistical significance (Z = 3.91 [p < 0.0001]). Dietary assessment was conducted by validated food frequency questionnaires (FFQ) in 52% of the studies and 24-h dietary recalls in 36% of the studies. One study utilized a validated 15-item questionnaire to measure patients' adherence to the Mediterranean Diet (QueMD). The quality assessment showed that all studies were of high quality. High HEI and MDSs and low DII scores were associated with a low risk of periodontitis and better periodontal conditions. The standardized and repeatable diet guidelines might be provided for preventing periodontitis. Future prospective studies and clinical trials are needed to confirm this causal association.

Prospective associations between an empirically derived dietary pattern and life satisfaction in Malaysian adolescents

BackgroundLittle is known on the prospective associations between an empirically derived dietary pattern (DP) and life satisfaction among adolescents. This PUTRA-Adol follow-up study aimed to assess the prospective associations between the empirically derived DP and life satisfaction during adolescence.MethodsA total of 585 and 262 adolescents participated in the baseline PUTRA-Adol study in 2016 and PUTRA-Adol follow-up study in 2019–2020, respectively. These adolescents were recruited from three southern states in peninsular Malaysia, namely Negeri Sembilan, Melaka and Johor. Dietary assessments were estimated using a validated food frequency questionnaire (FFQ) while a Multidimensional Students’ Life Satisfaction Scale (MSLSS) was used to measure life satisfaction at baseline in 2016 as well as at follow-up in 2019–2020. A DP characterised by foods high in free sugar and energy dense was identified using reduced rank regression (RRR), cross-sectionally at baseline and was reported elsewhere. Similar RRR analysis was used to find a DP that best explained the variation in response variables linked to poorer life satisfaction, including dietary energy density (DED), fiber density, and percentage of energy from total fat and sugar at the PUTRA-Adol follow-up study. Prospective relationship between adherence to the identified DPs and overall life satisfaction scores as well as its domains between 2016 and 2019–2020 were evaluated using generalized estimating equation models (GEE).ResultsA DP characterized by high intakes of percentage energy from sugar, fibre and low in DED and percentage energy from total fat was identified at the 2019–2020 follow-up. The identified DP explained 11% of total variations in the response variables and was characterized by high intakes of sweets, sugar sweetened beverages (SSB) and fruits. Female adolescents [67.6(8.9)] had a mean (SD) of life satisfaction that was higher than male adolescents [67.5(10.8)] p < 0.05 in 2019–2020. Prospective analysis found a significant positive association between the identified DP and school domain, in male adolescents (β = 0.117; 95% CI 0.001, 0.234) and an inverse relationship between the DP z-score and self-domain in all adolescents (β = − 0.060; 95% CI − 0.115, − 0.005) from 2016 to 2019–2020.ConclusionsAn increasing score for the predominant ‘High sugar and High fibre’ DP was prospectively associated with increasing life satisfaction score for the school domain in male adolescents and decreasing score for self-domain in both male and females during adolescence. A lifestyle intervention targeting reduced dietary intakes, particularly sugar, may improve life satisfaction in adolescents and promote healthier future without compromising dietary intakes for chronic disease prevention later in life.

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

Longitudinal Study of Seafood and Fish Oil Supplement Intake and Risk of Persistent Tinnitus

BackgroundPersistent tinnitus is common, disabling, and difficult to treat. Diet has been implicated in tinnitus etiology, but studies are inconsistent and longitudinal data are scarce. Seafood intake is associated with lower risk of hearing loss, but the longitudinal association with tinnitus is unknown. ObjectiveWe examined the independent associations of seafood intake, fish oil supplement use, and risk of developing persistent tinnitus. MethodsThis prospective cohort study followed 73,482 females in the Nurses' Health Study II from 1991 to 2021. Diet was assessed using a validated food frequency questionnaire every 4 years. Multivariable-adjusted Cox proportional hazards regression was used to evaluate independent associations between total seafood intake, specific types of fish, shellfish, fish oil supplements, and risk of persistent tinnitus (defined as tinnitus experienced daily). ResultsAfter 1,998,421 person-years of follow-up, 9,362 cases of incident persistent tinnitus were reported. Seafood intake was independently associated with lower risk of developing persistent tinnitus. Compared with participants who never or rarely consumed seafood, the multivariable-adjusted hazard ratios (MVHR,95% CI) for tinnitus were 0.87 (0.78, 0.95) among participants who consumed 1 serving/week, 0.77 (0.68, 0.86) for 2-4 servings/week, and 0.79 (0.64, 0.96) for 5+/servings/week (p-trend<0.0001). Examined individually, higher intakes of tuna fish, light-meat fish and shellfish were associated with lower risk. Compared with participants who never or rarely consumed the specific type, the MVHRs for consumption of 1+ servings/week were 0.84 (0.78, 0.90)(p-trend <0.0001) for tuna fish, 0.91 (0.83, 0.99)(p-trend=0.04) for light-meat fish, and 0.82 (0.72, 0.93)(p-trend<0.0001) for shellfish. Higher risk for dark-meat fish intake was suggested (MVHR: 1.09 (0.99,1.21)(p-trend=0.04). Fish oil supplement use (yes/no) was associated with higher risk (MVHR: 1.12 (1.06,1.19)). ConclusionRegular consumption of tuna fish, light-meat fish or shellfish is associated with lower risk of developing persistent tinnitus in females. Fish oil supplement use is associated with higher risk.

Dietary total antioxidant capacity in relation to disease severity and risk of mortality in cirrhosis; results from a cohort study

Liver Cirrhosis, defined as the final stage of chronic liver disease, may become more prevalent in the lower level of body defense against oxidation and inflammation. Therefore, we assessed the association of dietary total antioxidant capacity (DTAC) with the severity and mortality of cirrhosis in a cohort study. 120 newly diagnosed cirrhosis patients from Tehran, Iran, participated in this study. The patients’ habitual diet was assessed using a 168-item validated food frequency questionnaire. Both ferric-reducing antioxidant potential (FRAP) and oxygen radical scavenging capacity (ORAC) methods were computed to achieve DTAC scores. The association between DTAC with disease severity and mortality was estimated by multivariate linear regression and cox proportional hazards regression models. Dietary total antioxidant capacity-ORAC had a significant inverse association with disease severity in both crude and adjusted models (P for trend: <0.001 and 0.016 respectively). The risk of mortality in the first and second tertiles of ORAC was 5.56 (95 % CI: 2.25–13.75; P = 0.002) and 3.20 (95 % CI: 1.25–8.19; P = 0.015) higher than those in the third category, respectively. In conclusion, a higher antioxidant capacity of diet is associated with less disease severity and mortality risk in cirrhosis.