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Bahrami G, Mohammadifard N, Haghighatdoost F, Emamjomeh A, Najafi F, Farshidi H, Lotfizadeh M, Kazemi T, Shafiei S, Roohafza H, Sabri M, Sarrafzadegan N. The association between soft drinks consumption and risk of mental disorders among Iranian adults: The LIPOKAP study. J Affect Disord 2024; 363:8-14. [PMID: 39019222 DOI: 10.1016/j.jad.2024.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 06/11/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVE With rising demand for soft drinks (SDs) in low-income countries, studies examining mental disorders in relation to SDs are rather scarce. Therefore, we aimed to explore this association in a sample of Iranian adults. METHODS This cross-sectional study was carried out within the framework of the multi-centric LIPOKAP project, with 1970 Iranian healthy adults. Dietary intake and symptoms of depression and anxiety were collected using validated, Persian versions of a food frequency questionnaire and a Hospital Anxiety and Depression Scale (HADS), respectively. Artificial juices were considered fruit-flavored carbonated sugar beverages, sugar-sweetened beverages (SSB) included fruit-flavored carbonated sugar beverages and carbonated colas, and soft drinks included SSB and drinks containing non-nutritive sweeteners. RESULTS The mean age of the participants was 39.8 ± 13.9 years. Compared to lower intake, higher intake of SDs (OR = 1.30, 95 % CI: 1.01, 1.69; P = 0.041), SSBs (OR = 1.30, 95 % CI: 1.00, 1.67; P = 0.045) and artificial juice (OR = 1.63, 95 % CI: 1.24, 2.13; P < 0.001) was associated with higher risk of depression in adjusted model. These associations were sex-specific and more evident in males. No significant association was found between any of the drinks and anxiety risk except for artificial juice in men which was directly associated with anxiety risk (OR = 1.66, 95 % CI: 1.06, 2.61; P = 0.028). CONCLUSION This study found a positive association between SDs, SSBs and artificial juice and depression, but not anxiety. These associations varied between men and women. Prospective cohort studies are warranted to confirm our results and reveal the causal relationship.
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Affiliation(s)
- Ghazaleh Bahrami
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Ali Emamjomeh
- Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farid Najafi
- Research Center for Environmental determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Farshidi
- Hormozgan Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandarabbas, Iran
| | - Masoud Lotfizadeh
- School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Tooba Kazemi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Sania Shafiei
- Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadreza Sabri
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada
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Fabios E, Zazpe I, García-Blanco L, de la O V, Martínez-González MÁ, Martín-Calvo N. Macronutrient quality and its association with micronutrient adequacy in children. Clin Nutr ESPEN 2024; 63:796-804. [PMID: 39173908 DOI: 10.1016/j.clnesp.2024.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 06/19/2024] [Accepted: 08/13/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND & AIMS The double burden of malnutrition compels us to reconsider macronutrients from a diet quality perspective. The Macronutrient Quality Index (MQI) has been designed to reflect overall macronutrient quality and is based on three sub-indexes: the carbohydrate quality index (CQI), the healthy plate protein quality index (HPPQI) and the fat quality index (FQI). Nutritional adequacy is an essential aspect of diet quality that should be captured by reliable dietary indexes. METHODS We analyzed the association between the Macronutrient Quality Index (MQI) and micronutrient adequacy. Participants were children aged 4 and 5 years, recruited in the SENDO cohort. Baseline information was collected through a self-administered online questionnaire, which included information on sociodemographic, dietary, and lifestyle variables. Dietary information was obtained using a 147-item validated semi-quantitative food frequency questionnaire. Participants were categorized into tertiles based on their MQI score. We evaluated the intake of 20 micronutrients and assessed the probability of micronutrient adequacy using the Estimated Average Requirement cut-off point. RESULTS Children in the highest tertile of MQI had 0.33-fold lower odds (95%CI 0.17-0.66) of having ≥3 inadequate micronutrient intakes than their peers in the lowest tertile, after adjusting for potential confounders. The adjusted proportions of children with inadequate intake of ≥3 micronutrients were 18%, 14% and 11% in the first, second, and third tertiles of MQI respectively. The MQI appears to be capable of capturing nutrient adequacy in children, although our results suggest that a modified MQI, with eggs and dairy products weighted positively, might be more adequate for the pediatric population.
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Affiliation(s)
- Elise Fabios
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain
| | - Itziar Zazpe
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain; IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain; Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain; Department of Nutrition, Food Science and Physiology, School of Pharmacy, University of Navarra, Pamplona, Spain
| | - Lorena García-Blanco
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain; Olite Primary Care Health Center. Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain
| | - Victor de la O
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain; Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, Spain
| | - Miguel Ángel Martínez-González
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain; IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain; Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain
| | - Nerea Martín-Calvo
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain; IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain; Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn), Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain.
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Haghighatdoost F, Feizi A, Hajihashemi P, Shahoon H, Ani A, Roohafza H, Adibi P. The association of the Prime Diet Quality Score (PDQS) with depression and anxiety symptoms: the Isfahan functional disorders (ISFUN) cohort study. Nutr Neurosci 2024:1-10. [PMID: 38985816 DOI: 10.1080/1028415x.2024.2372190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
Background: Due to scarce epidemiologic data regarding the Prime Diet Quality Score (PDQS) and mental health disorders, this study aimed to investigate the association of PDQS with depression and anxiety symptoms in Iranian adults.Methods: This cross-sectional analysis was performed using the baseline data collected for the Isfahan functional disorders (ISFUN) cohort study. ISFUN was established in 2017 and enrolled apparently healthy adults, aged 18-65 years in Isfahan, Iran. Information on usual dietary intakes was collected using a validated Dish-based, 106-item food frequency questionnaire. The severity of depression and anxiety was assessed using a validated Iranian version of the Hospital Anxiety and Depression Scale.Results: A total number of1892 participants were enrolled in the present study. In total, 54.50% of subjects were female. In the fully adjusted model, participants with PDQS lower than median compared with those with PDQS higher than median had higher risk of depression (OR = 1.62; 95% CI: 1.11, 2.37) and anxiety (OR: 1.57; 95% CI: 1.08, 2.27). In stratified analysis by sex, males with PDQS lower than median compared with those with PDQS higher than median had greater risk for depressive (OR: 1.57) and anxiety symptoms (OR = 1.52). However, in females, no significant association was found between PDQS and odds of depression, and anxiety in the fully adjusted model.Conclusion: We found evidence indicating a significant inverse association between PDQS and depression and anxiety symptoms among Iranian adults. Further studies, in particular with prospective design, are required to confirm these findings.
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Affiliation(s)
- Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Hajihashemi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hassan Shahoon
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Ani
- Department of Bioinformatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Li XY, Zhang YX, Wang XB, Nan YX, Wang DD, Sun MH, Chen HY, Guo RH, Leng X, Du Q, Pan BC, Wu QJ, Zhao YH. Associations between dietary macronutrient quality and asthenozoospermia risk: a hospital-based case-control study. Food Funct 2024; 15:6383-6394. [PMID: 38819120 DOI: 10.1039/d4fo01234h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Background & aims: Macronutrients are the main part of the human diet and can affect multiple health outcomes. Nevertheless, associations between dietary macronutrient quality and asthenozoospermia risk have not been reported to date. Thus, this study aimed to be the first to explore the associations between macronutrient quality and asthenozoospermia risk using the novel multidimensional macronutrient quality index (MQI). Methods: A case-control study was conducted at infertility clinics of Shengjing Hospital of China Medical University during June and December 2020, including 552 asthenozoospermia cases and 585 normozoospermia controls. Data on diet were collected using a validated food frequency questionnaire. MQI was estimated according to the carbohydrate quality index (CQI), fat quality index (FQI), and protein quality index (PQI). Binary logistic regression models were performed to calculate the odds ratio (OR) with a 95% confidence interval (CI). Subgroup and interaction analyses were performed based on age, body mass index, physical activity, smoking, drinking, and education level. Dose-response relationships were evaluated by restricted cubic splines. Sensitivity analyses were performed in two ways. First, participants with a dietary change were excluded to lower potential reverse causation. Then, we used the healthy plate protein source quality index instead of PQI to redefine MQI. Results: No statistically significant association was observed between dietary MQI and asthenozoospermia risk (OR = 1.24, 95% CI: 0.88-1.73). The sub-indices of MQI, CQI, FQI, and PQI, failed to be identified as having a statistically significant association with asthenozoospermia risk (OR = 1.35, 95% CI: 0.92-1.97 for CQI; OR = 1.13, 95% CI: 0.84-1.53 for FQI; OR = 1.28, 95% CI: 0.92-1.78 for PQI). However, CQI showed a positive association with the risk of asthenozoospermia among non-drinkers (Ptrend < 0.05) and highly educated participants (OR = 1.82, 95% CI: 1.13-2.94; Ptrend < 0.05). Additionally, there was a multiplicative interaction between CQI and education level for asthenozoospermia risk (P < 0.05). Conclusions: Our findings demonstrated no association of MQI and its sub-indices with asthenozoospermia risk except for CQI. Although our findings are mostly non-significant, they contribute novel knowledge to this research field and lay the foundation for future studies.
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Affiliation(s)
- Xiao-Ying Li
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Xiao Zhang
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiao-Bin Wang
- Center for Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Yu-Xin Nan
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Dong-Dong Wang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ming-Hun Sun
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Hong-Yu Chen
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ren-Hao Guo
- Center for Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Xu Leng
- Center for Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Qiang Du
- Center for Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Bo-Chen Pan
- Center for Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- NHC Key Laboratory of Advanced Reproductive Medicine and Fertility (China Medical University), National Health Commission, Shenyang, China
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
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Basso M, Zorzan I, Johnstone N, Barberis M, Cohen Kadosh K. Diet quality and anxiety: a critical overview with focus on the gut microbiome. Front Nutr 2024; 11:1346483. [PMID: 38812941 PMCID: PMC11133642 DOI: 10.3389/fnut.2024.1346483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/05/2024] [Indexed: 05/31/2024] Open
Abstract
Anxiety disorders disproportionally affect females and are frequently comorbid with eating disorders. With the emerging field of nutritional psychiatry, focus has been put on the impact of diet quality in anxiety pathophysiology and gut microbiome underlying mechanisms. While the relationship between diet and anxiety is bidirectional, improving dietary habits could better facilitate the actions of pharmacological and psychological therapies, or prevent their use. A better understanding of how gut bacteria mediate and moderate such relationship could further contribute to develop personalized programs and inform probiotics and prebiotics manufacturing. To date, studies that look simultaneously at diet, the gut microbiome, and anxiety are missing as only pairwise relationships among them have been investigated. Therefore, this study aims at summarizing and integrating the existing knowledge on the dietary effects on anxiety with focus on gut microbiome. Findings on the effects of diet on anxiety are critically summarized and reinterpreted in relation to findings on (i) the effects of diet on the gut microbiome composition, and (ii) the associations between the abundance of certain gut bacteria and anxiety. This novel interpretation suggests a theoretical model where the relationship between diet and anxiety is mediated and/or modulated by the gut microbiome through multiple mechanisms. In parallel, this study critically evaluates methodologies employed in the nutritional field to investigate the effects of diet on anxiety highlighting a lack of systematic operationalization and assessment strategies. Therefore, it ultimately proposes a novel evidence-based approach that can enhance studies validity, reliability, systematicity, and translation to clinical and community settings.
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Affiliation(s)
- Melissa Basso
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Irene Zorzan
- Molecular Systems Biology, School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- Centre for Mathematical and Computational Biology, CMCB, University of Surrey, Guildford, United Kingdom
| | - Nicola Johnstone
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Matteo Barberis
- Molecular Systems Biology, School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- Centre for Mathematical and Computational Biology, CMCB, University of Surrey, Guildford, United Kingdom
- Synthetic Systems Biology and Nuclear Organization, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Kathrin Cohen Kadosh
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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Cheng Z, Fu F, Lian Y, Zhan Z, Zhang W. Low-carbohydrate-diet score, dietary macronutrient intake, and depression among adults in the United States. J Affect Disord 2024; 352:125-132. [PMID: 38367707 DOI: 10.1016/j.jad.2024.02.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/10/2024] [Accepted: 02/14/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND The aim was to ascertain whether low-carbohydrate-diet (LCD) score and dietary macronutrient intake are associated with depression. METHODS This cross-sectional study included 23,204 United States adults from the National Health and Nutrition Examination Survey (NHANES) 2005-2018. Dietary macronutrient intake was evaluated by the average of two 24-h dietary recall interviews. LCD score was calculated by summing the 11 quantiles values of the percentages of energy derived from carbohydrate, protein, and fat. Major depression was defined as a nine-item Patient Health Questionnaire score of 10 or more. Logistic regression and restricted cubic spline models were used to explore the relationship between LCD score, dietary macronutrient intake, and depression. RESULTS LCD score was significantly associated with the risk of depression after adjustment for covariates (odds ratio, 0.98; 95 % confidence interval, 0.97-0.99; p < 0.001). Restricted cubic splines showed that the pattern of this inverse association was nonlinear. Among macronutrients, carbohydrate and protein intake was nonlinearly associated with the risk of depression, whereas fat intake was not related to the risk of depression. A decreased risk of depression was observed when the carbohydrate intake was moderate (45.3 %-59.1 %). The pattern of the association between protein intake and the risk of depression was L-shaped. CONCLUSIONS LCD score was inversely associated with the risk of depression in a nonlinear manner in a nationally representative sample of adults from the United States. Furthermore, moderate carbohydrate intake and high protein intake were correlated with a lower risk of depression.
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Affiliation(s)
- Zicheng Cheng
- Department of Neurology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Fangwang Fu
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yizhi Lian
- Department of Neurology, Affiliated Yueqing Hospital of Wenzhou Medical University, Yueqing, China
| | - Zhenxiang Zhan
- Department of Neurology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.
| | - Wenyuan Zhang
- Department of Neurology, Affiliated Yueqing Hospital of Wenzhou Medical University, Yueqing, China.
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Lu A, Li J, Liu Y, Du X, Wang Y, Wang X. Dietary fiber intake is positively associated with health-related quality of life in patients with hypertension: The mediating role of anxiety in mental component summary. Nutr Res 2023; 118:94-103. [PMID: 37603904 DOI: 10.1016/j.nutres.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/23/2023]
Abstract
Few studies have focused on the exploration of the relationship between dietary fiber intake (DFI) and health-related quality of life (HRQoL) and its mediators in hypertensive patients. This study is a cross-sectional survey and the data were obtained from hypertensive patients from Suzhou, China. The DFI, office systolic blood pressure and diastolic blood pressure, anxiety and depression, and HRQoL were investigated. We hypothesized that blood pressure, anxiety, and depression mediated the association between DFI and HRQoL, and used Pearson correlations, linear regression, and bootstrap tests to validate this relationship. A total of 211 hypertensive patients aged 20 to 64 years were included in this study. The average DFI was 12.4 ± 5.2 g/d, and the scores of physical component summary and mental component summary (MCS) were 46.5 ± 6.1 and 46.4 ± 6.4, respectively. DFI was positively correlated with physical component summary (r = 0.17, p = 0.014) and MCS (r = 0.27, P < .001). After controlling for sociodemographic and clinical characteristics, neither systolic blood pressure nor diastolic blood pressure showed mediating effects in the mediated model of DFI on MCS, whereas anxiety (b = -0.30; 95% confidence interval, -0.41 to -0.18) fully mediated the improvement in MCS by DFI (F = 11.14, P < .001). Because the MCS of HRQoL encompassed the assessment of depression, we did not analyze the mediating effect of depression in this model in order to avoid variable duplication. The decreased DFI is a risk factor for lower HRQoL, and anxiety mediated the relationship between DFI and MCS. Further research should focus on increasing DFI and reducing anxiety levels in hypertensive patients to improve their quality of life.
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Affiliation(s)
- Anping Lu
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China; School of Nursing, Medical College, Soochow University, Suzhou 215006, China.
| | - Jingjing Li
- Department of Rheumatology and Immunology, Shenzhen People's Hospital, Shenzhen 518020, China.
| | - Yuanyuan Liu
- Division of Digestion, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
| | - Xiaojiao Du
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
| | - Yun Wang
- Nephrology Department, The Second Affiliated Hospital of Soochow University, Suzhou 215006, China.
| | - Xiaohua Wang
- Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
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Zheng G, Gong TT, Ma QP, Wei YF, Du ZD, Zhao JQ, Zou BJ, Yan S, Liu FH, Sun ML, Xiao Q, Gao S, Wu QJ, Zhao YH. The association of macronutrient quality and its interactions with energy intake with survival among patients with ovarian cancer: results from a prospective cohort study. Am J Clin Nutr 2023:S0002-9165(23)46306-X. [PMID: 37001589 DOI: 10.1016/j.ajcnut.2023.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/07/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Emerging evidence supports shifting the focus from the quantity of macronutrients to quality to obtain greater benefits for the prognosis of ovarian cancer (OC). Additionally, despite the high relevance between macronutrient quality and quantity, the interaction of these parameters on OC survival remains unknown. OBJECTIVE A multidimensional macronutrient quality index (MQI) was applied to investigate the association between overall macronutrient quality and the survival of patients with OC. METHODS A prospective cohort study was conducted with 701 females diagnosed with OC who were enrolled from 2015 to 2020. Dietary intake information was obtained from a validated food frequency questionnaire. The MQI was calculated based on 3 quality indices: carbohydrate quality index (CQI), fat quality index (FQI), and protein quality index (PQI). Cox proportional hazards regression was conducted to calculate HRs and 95% CIs. Furthermore, we evaluated whether energy intake status (total energy intake and energy balance) modified the association between MQI and OC survival. RESULTS During a median follow-up period of 38 (interquartile: 35-40) mo, 130 deaths occurred. The prediagnosis high MQI scores were associated with substantially improved survival among females with OC (HRtertile 3 vs. tertile 1 = 0.50, 95% CI: 0.33, 0.77). For sub-indices of the MQI, higher CQI (HR = 0.60, 95% CI: 0.36, 0.99), higher FQI (HR = 0.55, 95% CI: 0.34, 0.87), and higher PQI (HR = 0.58, 95% CI: 0.35, 0.94) scores were all associated with better survival. Notably, significant interactions were observed for the MQI score with total energy intake and energy balance as well as the quantity and quality of carbohydrates on survival. CONCLUSIONS Intake of high-quality macronutrients before diagnosis was associated with improved survival among females with OC, especially for those with energy imbalance. Am J Clin Nutr 2023;xxx:xx-xx.
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Affiliation(s)
- Gang Zheng
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Peng Ma
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Fan Wei
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Zong-Da Du
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Jun-Qi Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Bing-Jie Zou
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Shi Yan
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China
| | - Ming-Li Sun
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qian Xiao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Song Gao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China; Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Reproductive and Genetic Medicine (China Medical University), National Health Commission, Shenyang, China.
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China; Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Liaoning Province, Shenyang, China.
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Kose J, Duquenne P, Srour B, Debras C, Léger D, Péneau S, Galan P, Hercberg S, Touvier M, Andreeva VA. Synthèse narrative sur le lien entre les apports en glucides et la santé mentale : focus sur l’anxiété et l’insomnie chez les adultes. CAHIERS DE NUTRITION ET DE DIÉTÉTIQUE 2022. [DOI: 10.1016/j.cnd.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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