Western Dietary Pattern Research Articles

“This is Part of Everything that is Wrong with the World” – A Comparative Analysis of Sustainability Framing in Social Media Discussions About Food in Five Countries

ABSTRACT Current western food systems are attested to be clearly unsustainable – but are people aware of this in their everyday life as they deal with the food offerings of their preferred supermarkets? To discover which links people actually make between the ecological, economical, and social impacts of the food systems and their personal food choices, our comparative, qualitative content analysis looks at everyday discussions on Facebook pages of supermarket chains in Canada, Germany, United Kingdom, United States, and South Africa (n = 1.775 comments). Our findings reveal that the term “sustainability” is never explicitly mentioned. Yet, people in UK and Germany, which rank high on the Environmental Performance Index (EPI), do link food closely to a number of very concrete sustainability issues (e.g. CO2-emissions, biodiversity, plastic waste) and intra-generational justice (e.g. fair wages). They discuss a broad variety of problems, even though these discussions do not get political (e.g. promoting political activism, petitions, or buycotts). In the samples from Canada and the US, countries which rate lower on the Environmental Performance Index, sustainability issues and food get rarely linked. The findings indicate that higher ambitions in sustainable development on a policy level go hand in hand with higher awareness in everyday life discussions.

Navigating practical applications of food waste valorisation based on the effects of food waste origins and storage conditions

Food wastes used as feedstock in biorefineries are of both research and market interest for solving related environmental issues and valorising to value-added products. However, the distinct conditions and characteristics governing the valorisation of different types of food waste remain to be addressed, such as different origins and storage conditions of food wastes. In this study, the characteristics of four types of food waste (student canteen waste, bakery waste, Chinese food waste, and Western food waste) after designed storage experiments (storage temperature − 4°C, 25 °C, and 35 °C; storage duration 1–3 days) were first investigated, followed by enzymatic hydrolysis to obtain food waste hydrolysates that can be applied to microalgal fermentation. The results showed that the characteristics of the food wastes and their corresponding hydrolysates differed based on their origins. Furthermore, cultivation of the microalgae Euglena gracilis demonstrated the feasibility of using food waste hydrolysates as the sole nutrient source, and both the origin and storage conditions of food wastes were found to affect microalgal growth and paramylon production. Possible inhibitors that could account for the different performances of food waste hydrolysates were identified by untargeted metabolite analysis. In summary, this study provides insights into the application of different types of food waste under complex conditions in biorefineries and the utilisation of their hydrolysates via in-depth metabolite analysis.

Research on English Translation of Sichuan Cuisine

Sichuan cuisine, one of the eight famous schools of Chinese cuisine, is popular at home and abroad. With the expanding cultural exchange between Chinese and Western food, the translation of Sichuan cuisine shows its importance. Based on the translation principles of literal translation, free translation, and transliteration, this paper studies the characteristics of the naming and translation of Sichuan cuisine and proposes corresponding translation methods. It is found that the translation strategy is related to the food name. The name of cuisines made up of main ingredients and cooking methods can be translated literally; those named without this information can use free translation; and local specialties can be translated by transliteration. This dissertation is conducive to spreading Sichuan cuisine worldwide.

Assessing CO2 Emissions of Online Food Delivery in Japan

The COVID-19 pandemic and the subsequent lockdown of cities have led to the rapid growth of online food delivery (OFD). Moreover, there are concerns that OFD platforms may impose offers on users in order to continue to increase their market share, leading to numerous environmental issues such as overconsumption and a significant increase in plastic packaging waste. Most studies have focused on the environmental impacts associated with food packaging and have been mostly limited to China. However, less research has been carried out on the overall CO2 emissions of an OFD order including food. In this study, the CO2 emissions of an OFD order were assessed by considering the production, distribution, consumption and disposal of the ingredients, based on lifecycle thinking and existing secondary data, for three representative food groups (Western food, Japanese food and Chinese food) in Japan. This study found that the food production of an OFD order accounts for more than 70% of the CO2 emissions of the entire process, especially food ingredient production. Policy support and initiatives such as OFD platforms being able to serve different quantities of food based on actual consumer demand to avoid food waste, as well as changes in delivery methods, would help reduce the CO2 emissions of OFD.

Food insecurity was negatively associated with adherence to the “fruits, vegetables, and foods rich in animal protein” dietary pattern among university students’ households: the 2018 Mexican National Household Survey

BackgroundUniversity students are often affected by food insecurity (FI) and this situation has been associated with low consumption of fruit/vegetables and high intake of added sugars and sweet drinks. However, there needs to be more evidence on the association between FI and dietary patterns (DPs), assessing the overall diet and allowing analysis of commonly consumed food combinations. We aimed to analyze the association between FI and DPs in university students’ households.MethodsWe used data from 7659 university student households from the 2018 Mexican National Household Income and Expenditure Survey (ENIGH, for its acronym in Spanish). We obtained FI levels (mild, moderate, and severe) using the validated Mexican Food Security Scale (EMSA, Spanish acronym). Two DPs were identified by principal component analysis based on the weekly frequency of consumption of 12 food groups. Multivariate logistic regression adjusted by university student and household’s characteristics was applied.ResultsCompared to food security, households with mild-FI (OR:0.34; 95%CI:0.30, 0.40), moderate-FI (OR:0.20; 95%CI:0.16, 0.24) or severe-FI (OR:0.14; 95%CI:0.11, 0.19) were less likely to adhere to the dietary pattern “Fruits, vegetables and foods rich in animal protein” (fruits, vegetables, meat, fish or seafood, dairy products, and starchy vegetables). In addition, people with severe-FI (OR:0.51; 95% CI:0.34, 0.76) were also less likely to adhere to the dietary pattern “Traditional-Westernized” (pulses, oils or fats, sugar, sweets, industrialized drinks, foods made from corn/maize, wheat, rice, oats or bran, coffee, tea and eggs).ConclusionsIn these households FI impairs the ability to consume a healthy dietary pattern (fruits/vegetables and foods rich in animal protein). In addition, the intake of foods typical of the Mexican food culture reflecting the local Western dietary pattern is compromised in households with severe-FI.

Associations between Dietary Patterns, Anthropometric and Cardiometabolic Indices and the Number of MetS Components in Polish Adults with Metabolic Disorders.

Diet-therapy of metabolic syndrome (MetS) is of great importance due to significant health and social consequences. The aim of this study was (1) to determine dietary patterns (DPs), and (2) to search for associations between defined DPs, anthropometric and cardiometabolic indices, and the number of MetS components in Polish adults with metabolic disorders. The study was designed as a cross-sectional. The study group was 276 adults. Data about the frequency of consumption of selected food groups were collected. Anthropometric measurements: body height (H), body weight (BW), waist (WC), and hip (HC), as well as body composition, were taken. Blood samples were obtained for measurements of glucose and lipids. The obtained biochemical and anthropometric parameters were used to calculate the anthropometric and metabolic dysfunction indices. Three dietary patterns were identified in our study group: Western, Prudent and Low Food. Results of logistic regression analysis indicated rare consumption of fish as a predictor of risk of more severe forms of MetS. The possibility of using body roundness index (BRI) for fast diagnosis of cardiometabolic risk was found. In the management of MetS, the development of strategies to reduce the risk of more severe forms of MetS should be focused on increasing fish consumption and other prohealthy food.

Assessment of Western dietary patterns in Georgian population with prediabetes

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Maternal Western diet mediates susceptibility of offspring to Crohn’s-like colitis by deoxycholate generation

BackgroundThe Western dietary pattern, characterized by high consumption of fats and sugars, has been strongly associated with an increased risk of developing Crohn’s disease (CD). However, the potential impact of maternal obesity or prenatal exposure to a Western diet on offspring’s susceptibility to CD remains unclear. Herein, we investigated the effects and underlying mechanisms of a maternal high-fat/high-sugar Western-style diet (WD) on offspring’s susceptibility to 2,4,6-Trinitrobenzenesulfonic acid (TNBS)-induced Crohn’s-like colitis.MethodsMaternal dams were fed either a WD or a normal control diet (ND) for eight weeks prior to mating and continued throughout gestation and lactation. Post-weaning, the offspring were subjected to WD and ND to create four groups: ND-born offspring fed a normal diet (N–N) or Western diet (N-W), and WD-born offspring fed a normal (W–N) or Western diet (W-W). At eight weeks of age, they were administered TNBS to induce a CD model.ResultsOur findings revealed that the W–N group exhibited more severe intestinal inflammation than the N–N group, as demonstrated by a lower survival rate, increased weight loss, and a shorter colon length. The W–N group displayed a significant increase in Bacteroidetes, which was accompanied by an accumulation of deoxycholic acid (DCA). Further experimentation confirmed an increased generation of DCA in mice colonized with gut microbes from the W–N group. Moreover, DCA administration aggravated TNBS-induced colitis by promoting Gasdermin D (GSDMD)-mediated pyroptosis and IL-1beta (IL-1β) production in macrophages. Importantly, the deletion of GSDMD effectively restrains the effect of DCA on TNBS-induced colitis.ConclusionsOur study demonstrates that a maternal Western-style diet can alter gut microbiota composition and bile acid metabolism in mouse offspring, leading to an increased susceptibility to CD-like colitis. These findings highlight the importance of understanding the long-term consequences of maternal diet on offspring health and may have implications for the prevention and management of Crohn’s disease.5QpfrGmZ82qRXNutofRZ7nVideo

The relationship of dietary inflammatory index and dietary patterns with premenstrual syndrome among women in Kermanshah: An analytical cross-sectional study.

Premenstrual syndrome (PMS) is a common psychological condition that occurs continuously during the luteal phase of the menstrual cycle. Potential factors in this syndrome comprise the central nervous system, hormones, genetic background, and nutritional indicators. Little is known about foods or eating patterns that may be associated with this syndrome, yet nutritional factors can be considered in strategies for the management of PMS. The current study purposed to investigate the relationship between PMS and dietary inflammation index as well as PMS and food patterns. The present cross-sectional study was conducted on 125 women and girls aged 20-46 years who experienced symptoms of PMS. The inclusion criteria included cooperation and consent to enter the study, a body mass index of 18.5-25 kg/m2, no underlying disease, no use of contraceptives or antidepressants, and no use of multivitamin or mineral supplements. In the first stage of this study, participants' height, weight, waist circumference, and hip circumference were measured. In the second stage, eating habits were examined using a semiquantitative Food Frequency Questionnaire. This study found a significant correlation between glycemic load quintiles as well as between energy and macronutrient intake and the dietary inflammatory index; however, it revealed a direct correlation between PMS and both Western-mixed dietary and high-salt-high-sugar dietary patterns. Moreover, the Western food pattern was found to have a direct correlation with dietary inflammatory index, and the healthy food pattern had an inverse correlation with this index. This study showed that PMS symptoms are more severe with the consumption of high-salt-high-sugar or a Western-mixed food dietary pattern. It seems that an imbalance in hormones and neurotransmitters can affect the metabolism of proteins, carbohydrates, and fats. Also, some foods, such as vegetables, and low-fat and high-fiber diets reduce plasma estrogen levels and the duration of PMS symptoms.

Dietary Patterns and Risk of Lung Cancer: A Systematic Review and Meta-Analyses of Observational Studies.

Previous literature reviews summarized the associations between individual foods or food groups and lung cancer risk, but the relationship between dietary patterns and lung cancer riskhas received less attention. We conducted a systematic review and meta-analyses of observational studies on the associations between dietary patterns and lung cancerrisk. PubMed, Embase, and Web of Science were systematically searched from inception to February 2023. Random-effects models were used to pool relative risks (RR) on associations with at least two studies. Twelve studies reported on data-driven dietary patterns, and 17 studies reported on a priori dietary patterns. A prudent dietary pattern (high in vegetables, fruit, fish, and white meat) tended to be associated with a lower risk of lung cancer (RR = 0.81, 95% confidence interval [CI] = 0.66-1.01, n = 5). In contrast, Western dietary patterns, characterized by higher intakes of refined grains and red and processed meat, were significantly positively associated with lung cancer (RR = 1.32, 95% CI = 1.08-1.60, n = 6). Healthy dietary scores were consistently associated with a lower risk of lung cancer (Healthy Eating Index [HEI]: RR = 0.87, 95% CI = 0.80-0.95, n = 4; Alternate HEI: RR = 0.88, 95% CI = 0.81-0.95, n = 4; Dietary Approaches to Stop Hypertension: RR = 0.87, 95% CI = 0.77-0.98, n = 4; Mediterranean diet: RR = 0.87, 95% CI = 0.81-0.93, n = 10) while the dietary inflammatory index was associated with a higher risk of lung cancer (RR = 1.14, 95% CI = 1.07-1.22, n = 6). Our systematicreview indicates dietary patterns characterized by a higher intake of vegetables and fruits, a lower intake of animal products, and anti-inflammation may be associated with a reduced risk of lung cancer.

The Risk of Breast Cancer between Western and Mediterranean Dietary Patterns.

Breast cancer is a significant public health problem globally and prevention strategies have become of great interest as its incidence rises. Exploring the connection between dietary patterns and the reduction of breast cancer risk is considered a promising approach. High levels of fiber, phytochemicals, a good antioxidant profile, and a composition of advantageous fatty acids are characteristics of healthy dietary programs such as the Mediterranean diet. This review summarized and discussed the active compounds that are considered important in preventing breast cancer, including dietary components from recent related reports. These include polyunsaturated fatty acids, fiber, phytochemicals, and alcohol. Although the exact mechanism for preventing breast cancer using these dietary factors is not well understood, the combination of all the elements in a healthy diet plays a role in reducing breast cancer risk. Considering the elevated probability of breast cancer relapse and mortality, it is crucial to investigate the correlation between a nutritious dietary pattern and breast cancer, while identifying bioactive components that have the potential to mitigate the risk of breast cancer incidence.

High fried food consumption impacts anxiety and depression due to lipid metabolism disturbance and neuroinflammation

Western dietary patterns have been unfavorably linked with mental health. However, the long-term effects of habitual fried food consumption on anxiety and depression and underlying mechanisms remain unclear. Our population-based study with 140,728 people revealed that frequent fried food consumption, especially fried potato consumption, is strongly associated with 12% and 7% higher risk of anxiety and depression, respectively. The associations were more pronounced among male and younger consumers. Consistently, long-term exposure to acrylamide, a representative food processing contaminant in fried products, exacerbates scototaxis and thigmotaxis, and further impairs exploration ability and sociality of adult zebrafish, showing anxiety- and depressive-like behaviors. Moreover, treatment with acrylamide significantly down-regulates the gene expression of tjp2a related to the permeability of blood-brain barrier. Multiomics analysis showed that chronic exposure to acrylamide induces cerebral lipid metabolism disturbance and neuroinflammation. PPAR signaling pathway mediates acrylamide-induced lipid metabolism disorder in the brain of zebrafish. Especially, chronic exposure to acrylamide dysregulates sphingolipid and phospholipid metabolism, which plays important roles in the development of anxiety and depression symptoms. In addition, acrylamide promotes lipid peroxidation and oxidation stress, which participate in cerebral neuroinflammation. Acrylamide dramatically increases the markers of lipid peroxidation, including (±)5-HETE, 11(S)-HETE, 5-oxoETE, and up-regulates the expression of proinflammatory lipid mediators such as (±)12-HETE and 14(S)-HDHA, indicating elevated cerebral inflammatory status after chronic exposure to acrylamide. Together, these results both epidemiologically and mechanistically provide strong evidence to unravel the mechanism of acrylamide-triggered anxiety and depression, and highlight the significance of reducing fried food consumption for mental health.

High adherence to Western dietary pattern and prostate cancer risk: findings from the EPIC-Spain cohort.

To explore the association between three previously identified dietary patterns (Western, Prudent and Mediterranean) and prostate cancer (PCa) risk by tumour aggressiveness. The Spanish cohort of the European Prospective Investigation into Cancer and Nutrition study provided dietary and epidemiological information from 15 296 men recruited during the period 1992-1996. The associations between the adherence to the three dietary patterns and PCa risk (global, for Gleason grade groups6 and >6, and for International Society of Urological Pathology [ISUP] grade 1+2 and ISUP grade 3+4+5) was explored with multivariable Cox proportional hazards regression models stratified by centre and age. While no effect on PCa risk was detected for the Prudent and Mediterranean dietary patterns, a suggestion of a detrimental effect of the Western dietary pattern was found (hazard ratio [HR]Q4vsQ1 1.29 [95% confidence interval {CI} 0.96;1.72]). This effect was only observed for Gleason grade group >6 (HRQ3vsQ1 1.61 [95% CI 1.00; 2.59] and HRQ4vsQ1 1.60 [95% CI 0.96; 2.67]) and in particular ISUP grade 3+4+5 tumours (HRQ2vsQ1 1.97 [95% CI 0.98; 3.93]; HRQ3vsQ1 2.72 (95% CI 1.35; 5.51); HRQ4vsQ1 2.29 [95% CI 1.07; 4.92]). Our results suggest that a high adherence to a healthy diet such as that represented by the Prudent and Mediterranean dietary patterns is not enough to prevent prostate cancer. Additionally, reducing adherence to a Western-type diet seems to be necessary.

The relationship between dietary patterns and insomnia in young women.

There is mounting evidence that eating habits affect sleeping patterns and their quality. The goal of this study was to evaluate the associations between major dietary patterns, identified using principal component analysis (PCA) and insomnia in young women. The study subjects comprised 159 healthy young women aged 18-25 years. Neuropsychological assessment was performed using standard instruments, including a cognitive ability questionnaire (CAQ), depression and anxiety stress scales (DASS-21), insomnia severity index (ISI), Epworth sleepiness scale (ESS), and quality of life questionnaire (QLQ). Dietary patterns were obtained from a 65-item validated food frequency questionnaire (FFQ) in this study, using PCA. Two major dietary patterns were identified that were termed: "Traditional" and "Western." The Western pattern was characterized by a high intake of snacks, nuts, dairy products, tea, fast foods, chicken, and vegetable oils. Subjects with moderate/severe insomnia were found to have lower scores for total cognitive ability task, nocturnal sleep hours, and physical and mental health, but higher scores for depression, anxiety, stress, and daytime sleepiness compared to those without insomnia (p < 0.05). After adjustment for potential confounders, high adherence to the Western dietary pattern was associated with higher odds of insomnia (OR = 5.9; 95% confidence intervals: 1.9-18.7; p = 0.003). Our findings indicated adherence to Western pattern may increase the odds of insomnia. Prospective research is required to determine the feasibility of targeting dietary patterns to decrease the odds of insomnia.

Abstract 2869: The role of regulatory T cells in NASH-mediated HCC development

Abstract Objective Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease, ranging from simple steatosis to an advanced form of non-alcoholic steatohepatitis (NASH) without effective treatment. NASH can progress to liver cirrhosis and hepatocellular carcinoma (HCC) in association with increased production of liver-resident regulatory T cells (Treg). This study aims to identify the role of Tregs in NASH-driven HCC development. Methods Wild-type C57BL/6 mice were fed with a choline-low high-fat high-sugar diet (CL-HFS), which recapitulates the Western-pattern diet, to induce NASH, then received transplantation of oncogenic hepatocytes by intrasplenic injection to induce an orthotopic HCC. Wild-type mice fed with a normal diet were used for control. Hepatic immune cell profiling was characterized by flow cytometry to identify the cellular basis mediating CL-HFS-induced NASH. The metagenomic assay was applied to identify NASH-relevant gut microbiota in the liver tissue. Results CL-HFS caused successful development of NASH and liver fibrosis in wild-type mice. Fast orthotopic tumor growth was detected in NASH-bearing mice compared to wild-type mice. Strongly positive staining of glypican 3 (GPC3), increased frequency of Tregs, and increased expression of Col1α1, Col4α1, and α-SMA were detected in livers and tumors from NASH-bearing mice compared to wild-type mice by IHC and flow cytometry. Metagenomic assay detected the lipid-producing bacterial genus Bacillus in NASH liver, which was demonstrated to increase the frequency of Tregs in healthy spleen cells. Conclusion CL-HFS-caused NASH promotes HCC growth likely by increasing liver-resident Tregs and liver-infiltrating Bacillus. Keywords: Non-alcoholic fatty liver disease (NAFLD), Non-alcoholic steatohepatitis (NASH), choline-low high-fat high-sugar diet (CL-HFS), regulatory T cells (Tregs), Bacillus, hepatocellular carcinoma (HCC). Citation Format: Ming Yang, Eric T. Kimchi, Kevin F. Staveley-O’Carroll, Guangfu Li. The role of regulatory T cells in NASH-mediated HCC development [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2869.

Dietary pattern association with CD4 cells count in patients living with human immunodeficiency virus: A cross-sectional study

Background:Considering contradictory reports about the impact of dietary pattern on CD4 cell count in previous studies and the potential importance of diet on the immune system, this study aimed to assess the association between dietary patterns and CD4 count among HIV-infected patients.Methods:This cross-sectional study was conducted among HIV-infected patients aged 18–60 who registered in the referral Voluntary Counseling and Testing Center of Shiraz, Iran. The principal component analysis identified nutritional patterns and factors. The association between the score of the dietary patterns and CD4 count was considered in two categories of CD4 more/less than 500 and using backward logistic regression after adjusting for confounders.Results:A total of 226 participants were included in the analysis. CD4 was significantly lower in males ( p &lt; 0.001). Participants with illegal drug use ( p &lt; 0.001), HCV ( p = 0.001), and HBV ( p &lt; 0.001) had lower serum CD4. Four extracted dietary patterns were a Plant-rich diet, Healthy animal-based proteins, a Western diet, and Affordable calorie and protein patterns. There was an association between CD4 and Western diet patterns in the best model in which age, gender, weight, and HBV were included. Each unit increase in Western diet score increased the odds of CD4 less than 500 by 57% (OR = 1.57; CI 95% 1.06–2.34, p = 0.02).Conclusion:Among the four dietary patterns, the Western diet comprising a high intake of refined sugar and grain, saturated and trans fats, and animal protein sources, especially high-fat red meat, had a statistically significant relationship with a decrease in CD4 cell count.

Dietary patterns and their association with cardiovascular risk factors in Ethiopia: A community-based cross-sectional study.

To identify the dietary patterns and their association with cardiovascular risk factors among adult people in urban and rural areas of Wolaita, southern Ethiopia. A total of 2,483 participants aged 25-64 years were selected using a three-stage random sampling. Data for this study were collected using structured questionnaires, the previous 24-h dietary intake assessment, anthropometric, blood pressure, and biochemical measurements. We used factor analysis to identify dietary patterns. Factors associated with dietary patterns were analyzed using multiple linear regression models. The adjusted regression coefficients with their 95% CI were used to ascertain the association. We identified three major dietary patterns that explained 51% of the variance in food consumption. The western dietary pattern was characterized by the consumption of meat/organ meat, biscuits/sweets, chicken stew, pasta-macaroni recipes, butter, white wheat bread, egg recipe, and Ethiopian dish shiro-wet, and was positively associated with urban residence, obesity, hypertension, blood glucose, and total cholesterol levels. Adherence to the consumption of tubers, whole-grain maize products, coffee leaves-and-herbs beverage, legumes, and sweet potatoes featured the traditional dietary pattern. The traditional dietary pattern showed a positive relationship with rural residence, physical activity, and obesity, and it had a negative relationship with hypertension. The healthy dietary pattern was characterized by the intake of green leafy vegetables, green pepper, and whole-grain maize products, and negatively related to obesity, and hypertension, while positively related to urban residence. The coexistence of western, traditional, and healthy dietary patterns in the present study indicates the transition to a new dietary pattern in the study area. All dietary patterns were associated with one or more cardiovascular risk factors, but the western dietary pattern was associated with most of these, while the traditional diet showed fewer such associations. Therefore, it might be useful to promote healthy and traditional dietary patterns along with physical activity. Interventions related to the current findings, if initiated early in life, may benefit the public in preventing cardiovascular risk factors such as obesity, hypertension, and type 2-diabetes.

Editors' Note: Association Between Dietary Habits in Midlife With Dementia Incidence Over a 20-Year Period.

In a 2-decade prospective population-based study from Sweden, Dr. Glans and colleagues investigated the association between adherence to conventional dietary recommendations or to a modified Mediterranean diet and subsequent risk of developing all-cause dementia, Alzheimer disease (AD), vascular dementia (VaD), or accumulation of AD-related β-amyloid pathology in the CSF, among 28,025 participants. They concluded that these dietary habits were not significantly associated with a reduced risk for developing all-cause dementia, AD dementia, VaD, or AD pathology. In response, Dr. Kawada cites a previous study that found significant interactions between dietary patterns and APOE-ε4 status in relation to incident dementia, with a healthy dietary pattern being associated with lower dementia incidence in ε4 noncarriers and a Western dietary pattern associated with higher dementia incidence in ε4 carriers. Dr. Kawada argues that studies examining the long-term effect of dietary patterns on incident dementia should consider the contribution of genetic factors. In another response, Dr. Hoffman notes that the researchers' use of a modified Mediterranean diet score does not explicitly measure for extra virgin olive oil (EVOO), which may be an important component for maintaining cognitive health, citing epidemiologic and animal studies in this regard. He contends that it is important to consider the role of EVOO as part of a Mediterranean diet for cognitive health to better inform the implementation of this diet in non-Mediterranean countries. Responding to these comments, the authors note that they did not find any significant interaction effects between conventional dietary recommendations or a modified Mediterranean diet and APOE-ε4 status with respect to subsequent dementia but do not comment about the role of extra virgin olive oil. Overall, this exchange highlights enduring uncertainties about the role of specific dietary factors in mitigating the long-term risk of dementia. In a 2-decade prospective population-based study from Sweden, Dr. Glans and colleagues investigated the association between adherence to conventional dietary recommendations or to a modified Mediterranean diet and subsequent risk of developing all-cause dementia, Alzheimer disease (AD), vascular dementia (VaD), or accumulation of AD-related β-amyloid pathology in the CSF, among 28,025 participants. They concluded that these dietary habits were not significantly associated with a reduced risk for developing all-cause dementia, AD dementia, VaD, or AD pathology. In response, Dr. Kawada cites a previous study that found significant interactions between dietary patterns and APOE-ε4 status in relation to incident dementia, with a healthy dietary pattern being associated with lower dementia incidence in ε4 noncarriers and a Western dietary pattern associated with higher dementia incidence in ε4 carriers. Dr. Kawada argues that studies examining the long-term effect of dietary patterns on incident dementia should consider the contribution of genetic factors. In another response, Dr. Hoffman notes that the researchers' use of a modified Mediterranean diet score does not explicitly measure for extra virgin olive oil (EVOO), which may be an important component for maintaining cognitive health, citing epidemiologic and animal studies in this regard. He contends that it is important to consider the role of EVOO as part of a Mediterranean diet for cognitive health to better inform the implementation of this diet in non-Mediterranean countries. Responding to these comments, the authors note that they did not find any significant interaction effects between conventional dietary recommendations or a modified Mediterranean diet and APOE-ε4 status with respect to subsequent dementia but do not comment about the role of extra virgin olive oil. Overall, this exchange highlights enduring uncertainties about the role of specific dietary factors in mitigating the long-term risk of dementia.

Diet and metabolic syndrome: a narrative review

Metabolic syndrome (MetS) is a highly prevalent condition defined by the presence of at least three out of five risk factors including central obesity, increased fasting glucose, high blood pressure, and dyslipidaemia. Metabolic syndrome is associated with a 2-fold increase in cardiovascular outcomes and a 1.5-fold increase in all-cause mortality. Excess energy intake and Western dietary pattern may influence the development of metabolic syndrome. By contrast, both Mediterranean diet (Med-diet) and Dietary Approaches to Stop Hypertension (DASH) diet, with or without calorie restriction, have positive effects. For the prevention and management of MetS, it is recommended to increase the daily intake of fiber-rich and low-glycaemic-index foods and the consumption of fish and dairy products, especially yogurt and nuts. Moreover, it is advisable to consume a large variety of unprocessed cereals, legumes, and fruit. Finally, it is suggested to replace saturated fatty acids with monounsaturated and polyunsaturated fatty acids and to limit the consumption of free sugars to less than 10% of the total energy intake. The aim of this narrative review is to analyze current evidence on the different dietary patterns and nutrients that may affect prevention and treatment of MetS and to discuss the underlying pathophysiological mechanisms.

Maternal dietary components in the development of gestational diabetes mellitus: a systematic review of observational studies to timely promotion of health

BackgroundThere is ample evidence that considers diet as an important factor in the prevention of gestational diabetes mellitus (GDM). The aim of this review is to synthesise the existing evidence on the relationship between GDM and maternal dietary components.MethodsWe performed a systematic bibliographic search in Medline, Latin American and Caribbean Health Sciences Literature (Lilacs) and the Latin American Nutrition Archive (ALAN) of regional and local literature, limiting the searches to observational studies published between 2016 and 2022. Search terms related to nutrients, foods, dietary patterns and the relationship to GDM risk were used. The review included 44 articles, 12 of which were from America. The articles considered different topics about maternal dietary components as follows: 14 are about nutrient intake, 8 about food intake, 4 combined nutrient and food analysis and 18 about dietary patterns.ResultsIron, processed meat and a low carbohydrate diet were positively associated with GDM. Antioxidant nutrients, folic acid, fruits, vegetables, legumes and eggs were negatively associated with GDM. Generally, western dietary patterns increase GDM risk, and prudent dietary patterns or plant-based diets decrease the risk.ConclusionsDiet is considered one of the causes of GDM. However, there is no homogeneity in how people eat nor in how researchers assess diet in different contextual conditions of the world.