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Oyelere AM, Kok DE, Bos D, Gunter MJ, Ferrari P, Keski-Rahkonen P, de Wilt JHW, van Halteren HK, Kouwenhoven EA, van Duijnhoven FJB, Kampman E. Coffee consumption is associated with a reduced risk of colorectal cancer recurrence and all-cause mortality. Int J Cancer 2024; 154:2054-2063. [PMID: 38346920 DOI: 10.1002/ijc.34879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 04/14/2024]
Abstract
Coffee consumption has been associated with a reduced risk of developing colorectal cancer (CRC). However, it is not clear whether coffee consumption is related to CRC progression. Hence, we assessed the association of coffee consumption with CRC recurrence and all-cause mortality using data from a prospective cohort study of 1719 stage I-III CRC patients in the Netherlands. Coffee consumption and other lifestyle characteristics were self-reported using questionnaires at the time of diagnosis. We retrieved recurrence and all-cause mortality data from the Netherlands Cancer Registry and the Personal Records Database, respectively. Cox proportional hazard regression models with and without restricted cubic splines were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) adjusted for age, sex, education, smoking status, cancer stage and tumor location. We observed 257 recurrences during a 6.2-year median follow-up and 309 deaths during a 6.6-year median follow-up. Consuming more than 4 cups/d of coffee compared to an intake of <2 cups/d was associated with a 32% lower risk of CRC recurrence (95% CI: 0.49, 0.94,). The association between coffee consumption and all-cause mortality was U-shaped; coffee intake seemed optimal at 3-5 cups/d with the lowest risk at 4 cups/d (HR: 0.68, 95% CI: 0.53, 0.88). Our results suggest that coffee consumption may be associated with a lower risk of CRC recurrence and all-cause mortality. The association between coffee consumption and all-cause mortality appeared nonlinear. More studies are needed to understand the mechanism by which coffee consumption might improve CRC prognosis.
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Affiliation(s)
- Abisola M Oyelere
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Daniel Bos
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
- Department of Epidemiology and Biostatistics School of Public Health, Imperial College London, London, UK
| | - Pietro Ferrari
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Pekka Keski-Rahkonen
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Johannes H W de Wilt
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Henk K van Halteren
- Department of Internal Medicine, Admiraal de Ruyter Ziekenhuis, Goes, The Netherlands
| | | | | | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
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2
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Schenkelaars N, van Rossem L, Willemsen SP, Faas MM, Schoenmakers S, Steegers-Theunissen RPM. The intake of ultra-processed foods and homocysteine levels in women with(out) overweight and obesity: The Rotterdam Periconceptional Cohort. Eur J Nutr 2024; 63:1257-1269. [PMID: 38383813 PMCID: PMC11139698 DOI: 10.1007/s00394-024-03334-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 01/20/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE Today's diet consists of a substantial proportion of ultra-processed foods (UPF), especially in women with overweight and obesity in the reproductive period. High UPF intake results in an inadequate and unbalanced diet leading to derangements of several metabolic pathways detrimental to pregnancy and birth outcomes. Therefore, we aim to investigate whether UPF intake in the periconceptional period affects total homocysteine plasma levels (tHcy). METHODS 1532 participants were included from the prospective Rotterdam Periconceptional Cohort. UPF intake was calculated using Food Frequency Questionnaires including items classified as 4 in the Nova classification, and tHcy was measured by using liquid chromatography-tandem mass spectrometry system, with an interassay coefficient of variation of < 5.5%. Multivariable linear regression modeling was used and adjusted for covariates and significant interaction terms. RESULTS Women with overweight or obesity showed significantly higher percentage of UPF intake (respectively, 50.3 and 51.3%) and higher tHcy (respectively, 6.6 and 6.3 µmol/L, Kruskal-Wallis test; respectively, p < 0.001 and p = 0.04) compared to women with normal BMI (UPF intake: 46.8%, tHcy: 6.1 µmol/L). A 10% higher intake of UPF was associated with an increase in tHcy (adjusted: β = 1.31, 95% CI = 0.38-2.23). Analysis stratified for BMI classification showed comparable associations in normal weight participants (adjusted: β = 1.07, 95% CI = 0.06-2.07); however, no significant association in participants with overweight (adjusted: β = 0.06, 95% CI = - 0.95-1.07) and obesity (adjusted: β = 1.70, 95% CI = - 0.52-3.92) was shown. CONCLUSION This study showed that a higher intake of UPF is associated with increased tHcy. Better knowledge and awareness of the nutritional quality of the diet in the periconceptional period may contribute to 1-CM and subsequently improve pregnancy course and outcome. TRIAL REGISTRATION NUMBER AND DATE NTR4356, November 2010.
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Affiliation(s)
- Nicole Schenkelaars
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Lenie van Rossem
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Sten P Willemsen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
- Department of Biostatistics, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3000 CA, Rotterdam, The Netherlands
| | - Marijke M Faas
- Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Sam Schoenmakers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Régine P M Steegers-Theunissen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
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van Lanen AS, Kok DE, Wesselink E, Derksen JWG, May AM, Smit KC, Koopman M, de Wilt J, Kampman E, van Duijnhoven FJB. Associations between low- and high-fat dairy intake and recurrence risk in people with stage I-III colorectal cancer differ by sex and primary tumour location. Int J Cancer 2024. [PMID: 38700376 DOI: 10.1002/ijc.34959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/07/2024] [Accepted: 03/05/2024] [Indexed: 05/05/2024]
Abstract
We previously demonstrated that intake of low-fat dairy, but not high-fat dairy, was associated with a decreased colorectal cancer (CRC) recurrence risk. These risks, however, may differ by sex, primary tumour location, and disease stage. Combining data from two similar prospective cohort studies of people with stage I-III CRC enabled these subgroup analyses. Participants completed a food frequency questionnaire at diagnosis (n = 2283). We examined associations between low- and high-fat dairy intake and recurrence risk using multivariable Cox proportional hazard models, stratified by sex, and primary tumour location (colon and rectum), and disease stage (I/II and III). Upper quartiles were compared to lower quartiles of intake, and recurrence was defined as a locoregional recurrence and/or metastasis. During a median follow-up of 5.0 years, 331 recurrences were detected. A higher intake of low-fat dairy was associated with a reduced risk of recurrence (hazard ratio [HR]: 0.60, 95% confidence interval [CI]: 0.43-0.83), which seemed more pronounced in men (HR: 0.51, 95% CI: 0.34-0.77) than in women (HR: 0.84, 95% CI: 0.47-1.49). A higher intake of high-fat dairy was associated with an increased risk of recurrence in participants with colon cancer (HR: 1.60, 95% CI: 1.03-2.50), but not rectal cancer (HR: 0.88, 95% CI: 0.54-1.45). No differences in associations were observed between strata of disease stage. Concluding, our findings imply that dietary advice regarding low-fat dairy intake may be especially important for men with CRC, and that dietary advice regarding high-fat dairy intake may be specifically important in people with colon cancer.
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Affiliation(s)
- Anne-Sophie van Lanen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Evertine Wesselink
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Jeroen W G Derksen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Karel C Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Miriam Koopman
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Johannes de Wilt
- Department of Surgery, Radboud University Medical Center, University of Nijmegen, Nijmegen, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
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Kok DE, van Duijnhoven FJ, Lubberman FJ, McKay JA, Lanen ASV, Winkels RM, Wesselink E, van Halteren HK, de Wilt JH, Ulrich CM, Ulvik A, Ueland PM, Kampman E. Intake and biomarkers of folate and folic acid as determinants of chemotherapy-induced toxicities in patients with colorectal cancer: a cohort study. Am J Clin Nutr 2024; 119:294-301. [PMID: 38070682 DOI: 10.1016/j.ajcnut.2023.11.023] [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: 07/07/2023] [Revised: 10/10/2023] [Accepted: 11/28/2023] [Indexed: 12/25/2023] Open
Abstract
BACKGROUND Capecitabine is an oral chemotherapeutic drug showing antitumor activity through inhibition of thymidylate synthase, an enzyme involved in folate metabolism. There are concerns about the high intake of certain vitamins, and specifically folate, during chemotherapy with capecitabine. Whether folate or folic acid, the synthetic variant of the vitamin, impact treatment toxicity remains unclear. OBJECTIVE We studied associations between intake and biomarkers of folate as well as folic acid and toxicities in patients with colorectal cancer (CRC) receiving capecitabine. METHODS Within the prospective COLON (Colorectal cancer: Longitudinal, Observational study on Nutritional and lifestyle factors that influence recurrence, survival, and quality of life) cohort, 290 patients with stage II to III CRC receiving capecitabine were identified. Dietary and supplemental intake of folate and folic acid were assessed at diagnosis and during chemotherapy using questionnaires (available for 280 patients). Plasma folate and folic acid levels were determined by liquid chromatography tandem mass spectrometry (LC-MS/MS) and were available for 212 patients. Toxicities were defined as toxicity-related modifications of treatment, including dose reductions, regimen switches, and early discontinuation. Associations of intake and biomarkers of folate and folic acid with toxicities were determined using Cox proportional hazards regression adjusted for age and sex. RESULTS In total, 153 (53%) patients experienced toxicities leading to modification of capecitabine treatment. Folate intake and plasma folate levels were not associated with risk of toxicities. However, use of folic acid-containing supplements during treatment (hazard ratio (HR) 1.81 and 95% confidence interval (CI) 1.15-2.85) and presence of folic acid in plasma at diagnosis (HR 2.09, 95% CI: 1.24, 3.52) and during treatment (HR 2.31, 95% CI: 1.29, 4.13) were associated with an increased risk of toxicities. CONCLUSIONS This study suggests a potential association between folic acid and capecitabine-induced toxicities, providing a rationale to study diet-drug interactions and raise further awareness of the use of dietary supplements during oncological treatment. CLINICAL TRIAL DETAILS This trial was registered at clinicaltrials.gov as NCT03191110.
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Affiliation(s)
- Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands.
| | - Fränzel Jb van Duijnhoven
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Floor Je Lubberman
- Department of Clinical Pharmacy, Hospital Gelderse Vallei, Ede, the Netherlands
| | - Jill A McKay
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Anne-Sophie van Lanen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Renate M Winkels
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Evertine Wesselink
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Henk K van Halteren
- Department of Medical Oncology, Admiraal de Ruyter Hospital, Goes, the Netherlands
| | | | - Cornelia M Ulrich
- Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, United States
| | | | | | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
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Alblas G, Lamb HJ, Rosendaal FR, van Hoek B, Coenraad MJ, de Mutsert R. Prevalence of non-alcoholic fatty liver in the general Dutch population and in groups at increased risk. Nutr Metab Cardiovasc Dis 2023; 33:2497-2507. [PMID: 37798233 DOI: 10.1016/j.numecd.2023.08.008] [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: 05/04/2023] [Revised: 08/04/2023] [Accepted: 08/10/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND AND AIM Non-alcoholic fatty liver disease (NAFLD) is defined as a liver fat content ≥5.56%. It is of clinical interest to know the prevalence of NAFLD in people with a combination of metabolic risk factors. We aimed to examine the prevalence of NAFLD, including groups with metabolic risk factors. METHODS AND RESULTS In this cross-sectional analysis of the Netherlands Epidemiology of Obesity (NEO) study, liver fat content was assessed using proton magnetic resonance spectroscopy (H-MRS). Participants with excessive alcohol consumption or missing values were excluded, leaving a total of 1570 participants for the analyses. Mean (SD) age of the population was 55 years, BMI 25.9 (4.0) kg/m2 and 46% were men. The prevalence of NAFLD was 27% (95% CI 24-30). The prevalence of NAFLD was increased in participants with hypertriglyceridemia (57%, 52-63), obesity (62%, 58-66) and diabetes (69%, 61-77). The prevalence of NAFLD was highest in those with diabetes and obesity (79%, 71-87), obesity and hypertriglyceridemia (81%, 76-86) and with diabetes and hypertriglyceridemia (86%, 77-95). NAFLD was also present in 12% (8-16) of participants without overweight. CONCLUSIONS The prevalence of NAFLD in a middle-aged population in the Netherlands in 2010 was 27%. The prevalence of NAFLD is particularly increased in individuals with diabetes, obesity, and hypertriglyceridemia. This information may help clinicians and general practitioners in the risk stratification of their patients in daily practice.
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Affiliation(s)
- Gabrielle Alblas
- Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R Rosendaal
- Department of Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Bart van Hoek
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Minneke J Coenraad
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Renée de Mutsert
- Department of Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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van Lanen AS, Kok DE, Wesselink E, Winkels RM, van Halteren HK, de Wilt JHW, Kampman E, van Duijnhoven FJB. Pre- and post-diagnostic dairy intake in relation to recurrence and all-cause mortality in people with stage I-III colorectal cancer. Eur J Nutr 2023; 62:2891-2904. [PMID: 37393586 PMCID: PMC10468734 DOI: 10.1007/s00394-023-03201-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/23/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE Higher dairy consumption is associated with a lower risk of colorectal cancer (CRC), but no studies thus far have investigated its relation with recurrence in CRC. Few studies have investigated total dairy in relation to mortality in CRC, and yielded inconsistent results. METHODS In this prospective cohort study, people newly diagnosed with stage I-III CRC filled out a food frequency questionnaire at diagnosis (n = 1812) and six months after diagnosis (n = 1672). We examined associations between pre- and post-diagnostic intake of total dairy, low-fat dairy, high-fat dairy, milk, yoghurt, and cheese with recurrence and all-cause mortality using multivariable Cox proportional hazard models and restricted cubic splines (RCS). RESULTS A total of 176 recurrences and 301 deaths occurred during a median follow-up of 3.0 and 5.9 years, respectively. Before diagnosis, a higher low-fat dairy intake was associated with a lower risk of recurrence (HRQ4vsQ1: 0.42, 95% CI 0.26-0.67; PRCS: 0.008) and all-cause mortality (HRQ4vsQ1: 0.58, 95% CI 0.41-0.81; PRCS < 0.001), whereas a higher high-fat dairy consumption tended to be associated with an increased all-cause mortality risk (HRQ4vsQ1: 1.41, 95% CI 0.98-2.01; PRCS: 0.030). After diagnosis, only the associations between low- and high-fat dairy in relation to all-cause mortality remained. CONCLUSIONS This study demonstrated that higher pre- and post-diagnostic intakes of low-fat dairy were associated with a reduced all-cause mortality risk in people with stage I-III CRC, whereas higher intakes of high-fat dairy were associated with an increased all-cause mortality risk. Also, a higher pre-diagnostic low-fat dairy intake was associated with a reduced risk of recurrence. TRIAL REGISTRATION Clinical Trials.gov identifier: NCT03191110.
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Affiliation(s)
- Anne-Sophie van Lanen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
| | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Evertine Wesselink
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Renate M Winkels
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Henk K van Halteren
- Department of Internal Medicine, Admiraal de Ruyter Hospital, Goes, The Netherlands
| | - Johannes H W de Wilt
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
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Parsons E, Rifas-Shiman SL, Bozack AK, Baccarelli AA, DeMeo DL, Hivert MF, Godderis L, Duca RC, Oken E, Cardenas A. Prenatal trimester-specific intake of micronutrients: global DNA methylation and hydroxymethylation at birth and persistence in childhood. J Dev Orig Health Dis 2023; 14:311-318. [PMID: 36515010 PMCID: PMC9998337 DOI: 10.1017/s2040174422000642] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The prenatal environment may program health and disease susceptibility via epigenetic mechanisms. We evaluated associations of maternal trimester-specific intake of micronutrients with global DNA methylation (%5mC) and 5-hydroxymethylation (%5hmC) at birth in cord blood and tested for persistence into childhood. We quantified global %5mC and %5hmC in cord blood cells (n = 434) and in leukocytes collected in early (n = 108) and mid-childhood (n = 390) from children in Project Viva, a pre-birth cohort from Boston, MA. Validated food frequency questionnaires estimated maternal first- and second-trimester intakes of vitamin B2, vitamin B6, vitamin B12, folate, betaine, choline, methionine, iron, and zinc. Mean (SD) cord blood %5mC and %5hmC was 5.62% (2.04) and 0.25% (0.15), respectively. Each μg increase in first-trimester B12 intake was associated with 0.002 lower %5hmC in cord blood (95% CI: -0.005, -0.0003), and this association persisted in early childhood (β = -0.007; 95% CI: -0.01, -0.001) but not mid-childhood. Second-trimester iron (mg) was associated with 0.01 lower %5mC (95% CI: -0.02, -0.002) and 0.001 lower %5hmC (95% CI: -0.01, -0.00001) in cord blood only. Increased second-trimester zinc (mg) intake was associated with 0.003 greater %5hmC in early childhood (β = 0.003; 95% CI: 0.0004, 0.006). Second-trimester folate was positively associated with %5hmC in early childhood only (β = 0.08, 95% CI: 0.003, 0.16). Associations did not survive multiple testing adjustment; future replication is needed. Trimester-specific nutrients may impact various sensitive windows of epigenetic programming some with lasting effects in childhood. Further research is needed to understand the role of gene-specific epigenetic changes and how global DNA methylation measures relate to child health.
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Affiliation(s)
- Ella Parsons
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Anne K. Bozack
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Andrea A. Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Dawn L. DeMeo
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Lode Godderis
- Centre for Environment & Health, Department of Public Health & Primary Care, University of Leuven (KU Leuven), Belgium
- IDEWE, External service for prevention and protection at work, Heverlee, Belgium
| | - Radu-Corneliu Duca
- Centre for Environment & Health, Department of Public Health & Primary Care, University of Leuven (KU Leuven), Belgium
- Environmantal Hygiene and Biological Surveillance at the National Health Laboratory (LNS), Luxembourg
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
- Center for Computational Biology, University of California, Berkeley, Berkeley, CA, USA
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8
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van der Velde JHPM, Boone SC, Winters-van Eekelen E, Hesselink MKC, Schrauwen-Hinderling VB, Schrauwen P, Lamb HJ, Rosendaal FR, de Mutsert R. Timing of physical activity in relation to liver fat content and insulin resistance. Diabetologia 2023; 66:461-471. [PMID: 36316401 PMCID: PMC9892088 DOI: 10.1007/s00125-022-05813-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/08/2022] [Indexed: 02/05/2023]
Abstract
AIMS/HYPOTHESIS We hypothesised that the insulin-sensitising effect of physical activity depends on the timing of the activity. Here, we examined cross-sectional associations of breaks in sedentary time and timing of physical activity with liver fat content and insulin resistance in a Dutch cohort. METHODS In 775 participants of the Netherlands Epidemiology of Obesity (NEO) study, we assessed sedentary time, breaks in sedentary time and different intensities of physical activity using activity sensors, and liver fat content by magnetic resonance spectroscopy (n=256). Participants were categorised as being most active in the morning (06:00-12:00 hours), afternoon (12:00-18:00 hours) or evening (18:00-00:00 hours) or as engaging in moderate-to-vigorous-physical activity (MVPA) evenly distributed throughout the day. Most active in a certain time block was defined as spending the majority (%) of total daily MVPA in that block. We examined associations between sedentary time, breaks and timing of MVPA with liver fat content and HOMA-IR using linear regression analyses, adjusted for demographic and lifestyle factors including total body fat. Associations of timing of MVPA were additionally adjusted for total MVPA. RESULTS The participants (42% men) had a mean (SD) age of 56 (4) years and a mean (SD) BMI of 26.2 (4.1) kg/m2. Total sedentary time was not associated with liver fat content or insulin resistance, whereas the amount of breaks in sedentary time was associated with higher liver fat content. Total MVPA (-5%/h [95% CI -10%/h, 0%/h]) and timing of MVPA were associated with reduced insulin resistance but not with liver fat content. Compared with participants who had an even distribution of MVPA throughout the day, insulin resistance was similar (-3% [95% CI -25%, 16%]) in those most active in morning, whereas it was reduced in participants who were most active in the afternoon (-18% [95% CI -33%, -2%]) or evening (-25% [95% CI -49%, -4%]). CONCLUSIONS/INTERPRETATION The number of daily breaks in sedentary time was not associated with lower liver fat content or reduced insulin resistance. Moderate-to-vigorous activity in the afternoon or evening was associated with a reduction of up to 25% in insulin resistance. Further studies should assess whether timing of physical activity is also important for the occurrence of type 2 diabetes.
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Affiliation(s)
| | - Sebastiaan C Boone
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Matthijs K C Hesselink
- Department of Nutrition and Movement Sciences, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Vera B Schrauwen-Hinderling
- Department of Nutrition and Movement Sciences, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Patrick Schrauwen
- Department of Nutrition and Movement Sciences, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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van Zundert S, van der Padt S, Willemsen S, Rousian M, Mirzaian M, van Schaik R, Steegers-Theunissen R, van Rossem L. Periconceptional Maternal Protein Intake from Animal and Plant Sources and the Impact on Early and Late Prenatal Growth and Birthweight: The Rotterdam Periconceptional Cohort. Nutrients 2022; 14:nu14245309. [PMID: 36558467 PMCID: PMC9785913 DOI: 10.3390/nu14245309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/09/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022] Open
Abstract
Plant-based diets continue to rise in popularity, including among women of reproductive age, while consequences for pregnancy outcomes have hardly been studied. During pregnancy, maternal diet is the only source of proteins for the developing fetus. Hence, we investigated the effects of periconceptional maternal animal and plant protein intake on prenatal growth and birthweight. 501 pregnancies were included from the prospective Rotterdam Periconceptional Cohort. Embryonic growth was depicted by crown-rump length (CRL) and embryonic volume (EV) at 7, 9 and 11 weeks using 3D ultrasound scans. Estimated fetal weight (EFW) at 20 weeks and birthweight were retrieved from medical records and standardized. Multivariable mixed models were used for CRL and EV trajectories, and linear regression for EFW and birthweight. A 10 g/day higher maternal animal protein intake was positively associated with increased embryonic growth (CRL: β = 0.023 √mm, p = 0.052; EV: β = 0.015 ∛cm, p = 0.012). A positive association, albeit non-significant, was found between maternal animal protein intake and EFW, and birthweight. No clear associations emerged between maternal plant protein intake and prenatal growth and birthweight, with effect estimates close to zero. In conclusion, maternal animal protein intake during the periconception period was positively associated with early and late prenatal growth and birthweight, while no associations were found between maternal plant protein intake and prenatal growth and birthweight.
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Affiliation(s)
- Sofie van Zundert
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Simone van der Padt
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Sten Willemsen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Biostatistics, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Melek Rousian
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Mina Mirzaian
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Ron van Schaik
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Régine Steegers-Theunissen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Correspondence:
| | - Lenie van Rossem
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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10
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A high periconceptional maternal ultra-processed food consumption impairs embryonic growth: The Rotterdam periconceptional cohort. Clin Nutr 2022; 41:1667-1675. [DOI: 10.1016/j.clnu.2022.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/19/2022]
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11
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Aarts E, Akkerman A, Altgassen M, Bartels R, Beckers D, Bevelander K, Bijleveld E, Blaney Davidson E, Boleij A, Bralten J, Cillessen T, Claassen J, Cools R, Cornelissen I, Dresler M, Eijsvogels T, Faber M, Fernández G, Figner B, Fritsche M, Füllbrunn S, Gayet S, van Gelder MMHJ, van Gerven M, Geurts S, Greven CU, Groefsema M, Haak K, Hagoort P, Hartman Y, van der Heijden B, Hermans E, Heuvelmans V, Hintz F, den Hollander J, Hulsman AM, Idesis S, Jaeger M, Janse E, Janzing J, Kessels RPC, Karremans JC, de Kleijn W, Klein M, Klumpers F, Kohn N, Korzilius H, Krahmer B, de Lange F, van Leeuwen J, Liu H, Luijten M, Manders P, Manevska K, Marques JP, Matthews J, McQueen JM, Medendorp P, Melis R, Meyer A, Oosterman J, Overbeek L, Peelen M, Popma J, Postma G, Roelofs K, van Rossenberg YGT, Schaap G, Scheepers P, Selen L, Starren M, Swinkels DW, Tendolkar I, Thijssen D, Timmerman H, Tutunji R, Tuladhar A, Veling H, Verhagen M, Verkroost J, Vink J, Vriezekolk V, Vrijsen J, Vyrastekova J, van der Wal S, Willems R, Willemsen A. Protocol of the Healthy Brain Study: An accessible resource for understanding the human brain and how it dynamically and individually operates in its bio-social context. PLoS One 2021; 16:e0260952. [PMID: 34965252 PMCID: PMC8716054 DOI: 10.1371/journal.pone.0260952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 11/20/2021] [Indexed: 12/29/2022] Open
Abstract
The endeavor to understand the human brain has seen more progress in the last few decades than in the previous two millennia. Still, our understanding of how the human brain relates to behavior in the real world and how this link is modulated by biological, social, and environmental factors is limited. To address this, we designed the Healthy Brain Study (HBS), an interdisciplinary, longitudinal, cohort study based on multidimensional, dynamic assessments in both the laboratory and the real world. Here, we describe the rationale and design of the currently ongoing HBS. The HBS is examining a population-based sample of 1,000 healthy participants (age 30–39) who are thoroughly studied across an entire year. Data are collected through cognitive, affective, behavioral, and physiological testing, neuroimaging, bio-sampling, questionnaires, ecological momentary assessment, and real-world assessments using wearable devices. These data will become an accessible resource for the scientific community enabling the next step in understanding the human brain and how it dynamically and individually operates in its bio-social context. An access procedure to the collected data and bio-samples is in place and published on https://www.healthybrainstudy.nl/en/data-and-methods/access. Trail registration:https://www.trialregister.nl/trial/7955.
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Affiliation(s)
- Healthy Brain Study consortium
- Radboud University, Nijmegen, The Netherlands
- Radboud University Medical Center, Nijmegen, The Netherlands
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Esther Aarts
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Agnes Akkerman
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | | | - Ronald Bartels
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Debby Beckers
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Erik Bijleveld
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | | | - Janita Bralten
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Toon Cillessen
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Jurgen Claassen
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roshan Cools
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Martin Dresler
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Myrthe Faber
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Guillén Fernández
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- * E-mail:
| | - Bernd Figner
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Matthias Fritsche
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Sascha Füllbrunn
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - Surya Gayet
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | | | - Marcel van Gerven
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Sabine Geurts
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Corina U. Greven
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Martine Groefsema
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Koen Haak
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter Hagoort
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Yvonne Hartman
- Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Erno Hermans
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Florian Hintz
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | | | - Anneloes M. Hulsman
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Sebastian Idesis
- Center for Brain and Cognition, University Pompeu Fabra, Barcelona, Spain
| | - Martin Jaeger
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Esther Janse
- Centre for Language Studies, Radboud University, Nijmegen, The Netherlands
| | - Joost Janzing
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Johan C. Karremans
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Willemien de Kleijn
- School of Psychology and Artificial Intelligence, Radboud University, Nijmegen, The Netherlands
| | - Marieke Klein
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Floris Klumpers
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Nils Kohn
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hubert Korzilius
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - Bas Krahmer
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Floris de Lange
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Judith van Leeuwen
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Huaiyu Liu
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Peggy Manders
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Katerina Manevska
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - José P. Marques
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Jon Matthews
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - James M. McQueen
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Pieter Medendorp
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - René Melis
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Antje Meyer
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Joukje Oosterman
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Lucy Overbeek
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marius Peelen
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Jean Popma
- Interdisciplinary Hub for Security, Privacy and Data Governance, Radboud University, Nijmegen, The Netherlands
| | - Geert Postma
- Institute for Molecules and Materials, Radboud University, Nijmegen, The Netherlands
| | - Karin Roelofs
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Gabi Schaap
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Paul Scheepers
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Luc Selen
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Marianne Starren
- Centre for Language Studies, Radboud University, Nijmegen, The Netherlands
| | | | - Indira Tendolkar
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dick Thijssen
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hans Timmerman
- University Medical Center Groningen, Groningen, The Netherlands
| | - Rayyan Tutunji
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anil Tuladhar
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Harm Veling
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Maaike Verhagen
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Jacqueline Vink
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Janna Vrijsen
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jana Vyrastekova
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | | | - Roel Willems
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Centre for Language Studies, Radboud University, Nijmegen, The Netherlands
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12
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Winters-VAN Eekelen E, VAN DER Velde JHPM, Boone SC, Westgate K, Brage S, Lamb HJ, Rosendaal FR, DE Mutsert R. Objectively Measured Physical Activity and Body Fatness: Associations with Total Body Fat, Visceral Fat, and Liver Fat. Med Sci Sports Exerc 2021; 53:2309-2317. [PMID: 34081059 PMCID: PMC7611840 DOI: 10.1249/mss.0000000000002712] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE It remains unclear to what extent habitual physical activity and sedentary time (ST) are associated with visceral fat and liver fat. We studied the substitution of ST with time spent physically active and total body fat (TBF), visceral adipose tissue (VAT), and hepatic triglyceride content (HTGC) in middle-age men and women. DESIGN In this cross-sectional analysis of the Netherlands Epidemiology of Obesity study, physical activity was assessed in 228 participants using a combined accelerometer and heart rate monitor. TBF was assessed by the Tanita bioelectrical impedance, VAT by magnetic resonance imaging, and HTGC by proton-MR spectroscopy. Behavioral intensity distribution was categorized as ST, time spent in light physical activity (LPA), and moderate to vigorous physical activity (MVPA). To estimate the effect of replacing 30 min·d-1 of ST with 30 min·d-1 LPA or MVPA, we performed isotemporal substitution analyses, adjusted for sex, age, ethnicity, education, the Dutch Healthy Diet index, and smoking. RESULTS Included participants (41% men) had a mean ± SD age of 56 ± 6 yr and spent 88 ± 56 min in MVPA and 9.0 ± 2.1 h of ST. Replacing 30 min·d-1 of ST with 30 min of MVPA was associated with 1.3% less TBF (95% confidence interval = -2.0 to -0.7), 7.8 cm2 less VAT (-11.6 to -4.0), and 0.89 times HTGC (0.82-0.97). Replacement with LPA was not associated with TBF (-0.03%; -0.5 to 0.4), VAT (-1.7 cm2; -4.4 to 0.9), or HTGC (0.98 times; 0.92-1.04). CONCLUSIONS Reallocation of time spent sedentary with time spent in MVPA, but not LPA, was associated with less TBF, visceral fat, and liver fat. These findings contribute to the development of more specified guidelines on ST and physical activity.
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Affiliation(s)
| | | | - Sebastiaan C Boone
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, THE NETHERLANDS
| | - Kate Westgate
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UNITED KINGDOM
| | - Søren Brage
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UNITED KINGDOM
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, THE NETHERLANDS
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, THE NETHERLANDS
| | - Renée DE Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, THE NETHERLANDS
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13
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Meulmeester FL, Luo J, Martens LG, Ashrafi N, de Mutsert R, Mook-Kanamori DO, Lamb HJ, Rosendaal FR, Willems van Dijk K, Mills K, van Heemst D, Noordam R. Association of measures of body fat with serum alpha-tocopherol and its metabolites in middle-aged individuals. Nutr Metab Cardiovasc Dis 2021; 31:2407-2415. [PMID: 34158242 DOI: 10.1016/j.numecd.2021.05.001] [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: 12/30/2020] [Revised: 05/04/2021] [Accepted: 05/04/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS The accumulation of fat increases the formation of lipid peroxides, which are partly scavenged by alpha-tocopherol (α-TOH). Here, we aimed to investigate the associations between different measures of (abdominal) fat and levels of urinary α-TOH metabolites in middle-aged individuals. METHODS AND RESULTS In this cross-sectional analysis in the Netherlands Epidemiology of Obesity study (N = 511, 53% women; mean [SD] age of 55 [6.1] years), serum α-TOH and α-TOH metabolites from 24-h urine were measured as alpha-tocopheronolactone hydroquinone (α-TLHQ, oxidized) and alpha-carboxymethyl-hydroxychroman (α-CEHC, enzymatically converted) using liquid-chromatography-tandem mass spectrometry. Body mass index and total body fat were measured, and abdominal subcutaneous and visceral adipose tissue (aSAT and VAT) were assessed using magnetic resonance imaging. Using multivariable-adjusted linear regression analyses, we analysed the associations of BMI, TBF, aSAT and VAT with levels of urinary α-TOH metabolites, adjusted for confounders. We observed no evidence for associations between body fat measures and serum α-TOH. Higher BMI and TBF were associated with lower urinary levels of TLHQ (0.95 [95%CI: 0.90, 1.00] and 0.94 [0.88, 1.01] times per SD, respectively) and with lower TLHQ relative to CEHC (0.93 [0.90, 0.98] and 0.93 [0.87, 0.98] times per SD, respectively). We observed similar associations for VAT (TLHQ: 0.94 [0.89, 0.99] times per SD), but not for aSAT. CONCLUSIONS Opposite to our research hypothesis, higher abdominal adiposity was moderately associated with lower levels of oxidized α-TOH metabolites, which might reflect lower vitamin E antioxidative activity in individuals with higher abdominal fat instead.
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Affiliation(s)
- Fleur L Meulmeester
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands; NIHR Great Ormond Street Biomedical Research Centre, Great Ormond Street Hospital and UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Jiao Luo
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Leon G Martens
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Nadia Ashrafi
- NIHR Great Ormond Street Biomedical Research Centre, Great Ormond Street Hospital and UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Dennis O Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Ko Willems van Dijk
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands; Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Kevin Mills
- NIHR Great Ormond Street Biomedical Research Centre, Great Ormond Street Hospital and UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Diana van Heemst
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
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14
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Haslam DE, Peloso GM, Guirette M, Imamura F, Bartz TM, Pitsillides AN, Wang CA, Li-Gao R, Westra JM, Pitkänen N, Young KL, Graff M, Wood AC, Braun KVE, Luan J, Kähönen M, Kiefte-de Jong JC, Ghanbari M, Tintle N, Lemaitre RN, Mook-Kanamori DO, North K, Helminen M, Mossavar-Rahmani Y, Snetselaar L, Martin LW, Viikari JS, Oddy WH, Pennell CE, Rosendall FR, Ikram MA, Uitterlinden AG, Psaty BM, Mozaffarian D, Rotter JI, Taylor KD, Lehtimäki T, Raitakari OT, Livingston KA, Voortman T, Forouhi NG, Wareham NJ, de Mutsert R, Rich SS, Manson JE, Mora S, Ridker PM, Merino J, Meigs JB, Dashti HS, Chasman DI, Lichtenstein AH, Smith CE, Dupuis J, Herman MA, McKeown NM. Sugar-Sweetened Beverage Consumption May Modify Associations Between Genetic Variants in the CHREBP (Carbohydrate Responsive Element Binding Protein) Locus and HDL-C (High-Density Lipoprotein Cholesterol) and Triglyceride Concentrations. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2021; 14:e003288. [PMID: 34270325 PMCID: PMC8373451 DOI: 10.1161/circgen.120.003288] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Supplemental Digital Content is available in the text. Background: ChREBP (carbohydrate responsive element binding protein) is a transcription factor that responds to sugar consumption. Sugar-sweetened beverage (SSB) consumption and genetic variants in the CHREBP locus have separately been linked to HDL-C (high-density lipoprotein cholesterol) and triglyceride concentrations. We hypothesized that SSB consumption would modify the association between genetic variants in the CHREBP locus and dyslipidemia. Methods: Data from 11 cohorts from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium (N=63 599) and the UK Biobank (N=59 220) were used to quantify associations of SSB consumption, genetic variants, and their interaction on HDL-C and triglyceride concentrations using linear regression models. A total of 1606 single nucleotide polymorphisms within or near CHREBP were considered. SSB consumption was estimated from validated questionnaires, and participants were grouped by their estimated intake. Results: In a meta-analysis, rs71556729 was significantly associated with higher HDL-C concentrations only among the highest SSB consumers (β, 2.12 [95% CI, 1.16–3.07] mg/dL per allele; P<0.0001), but not significantly among the lowest SSB consumers (P=0.81; PDiff <0.0001). Similar results were observed for 2 additional variants (rs35709627 and rs71556736). For triglyceride, rs55673514 was positively associated with triglyceride concentrations only among the highest SSB consumers (β, 0.06 [95% CI, 0.02–0.09] ln-mg/dL per allele, P=0.001) but not the lowest SSB consumers (P=0.84; PDiff=0.0005). Conclusions: Our results identified genetic variants in the CHREBP locus that may protect against SSB-associated reductions in HDL-C and other variants that may exacerbate SSB-associated increases in triglyceride concentrations. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT00005133, NCT00005121, NCT00005487, and NCT00000479.
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Affiliation(s)
- Danielle E Haslam
- Nutritional Epidemiology Program (D.E.H., M. Guirette, K.A.L., N.M.M.), Tufts University, Boston, MA.,Channing Division of Network Medicine (D.E.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Nutrition (D.E.H.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Gina M Peloso
- Department of Biostatistics, Boston University School of Public Health, MA (G.M.P., A.N.P., J.D.)
| | - Melanie Guirette
- Nutritional Epidemiology Program (D.E.H., M. Guirette, K.A.L., N.M.M.), Tufts University, Boston, MA
| | - Fumiaki Imamura
- Medical Research Council Epidemiology Unit, University of Cambridge, United Kingdom (F.I., J.L., N.G.F., N.J.W.)
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Departments of Biostatistics (T.M.B.), University of Washington, Seattle.,Department of Medicine (T.M.B., R.N.L., B.M.P.), University of Washington, Seattle
| | - Achilleas N Pitsillides
- Department of Biostatistics, Boston University School of Public Health, MA (G.M.P., A.N.P., J.D.)
| | - Carol A Wang
- School of Medicine and Public Health, Faculty of Medicine and Health, The University of Newcastle, NSW, Australia (C.A.W., C.E.P.)
| | - Ruifang Li-Gao
- Department of Clinical Epidemiology (R.L.G., D.O.M.-K., F.R.R., R.dM.), Leiden University Medical Center, the Netherlands
| | | | - Niina Pitkänen
- Auria Biobank (N.P.), University of Turku, Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine (N.P., O.T.R.), University of Turku, Finland
| | - Kristin L Young
- Department of Epidemiology, Gillings School of Global Public Health (K.L.Y., M. Graff, K.N.), University of North Carolina, Chapel Hill
| | - Mariaelisa Graff
- Department of Epidemiology, Gillings School of Global Public Health (K.L.Y., M. Graff, K.N.), University of North Carolina, Chapel Hill
| | - Alexis C Wood
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX (A.C.W.)
| | - Kim V E Braun
- Department of Epidemiology (K.V.E.B., J.C.K.-d.J., M. Ghanbari, M.A.I.), Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Jian'an Luan
- Medical Research Council Epidemiology Unit, University of Cambridge, United Kingdom (F.I., J.L., N.G.F., N.J.W.)
| | - Mika Kähönen
- Department of Clinical Physiology (M.K.), Tampere University Hospital, Finland.,Department of Clinical Physiology (M.K.), Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland
| | - Jessica C Kiefte-de Jong
- Department of Public Health and Primary Care (J.C.L.d.J., D.O.M.-K.), Leiden University Medical Center, the Netherlands.,Department of Epidemiology (K.V.E.B., J.C.K.-d.J., M. Ghanbari, M.A.I.), Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Mohsen Ghanbari
- Department of Epidemiology (K.V.E.B., J.C.K.-d.J., M. Ghanbari, M.A.I.), Erasmus MC University Medical Center Rotterdam, the Netherlands
| | | | - Rozenn N Lemaitre
- Department of Medicine (T.M.B., R.N.L., B.M.P.), University of Washington, Seattle
| | - Dennis O Mook-Kanamori
- Department of Clinical Epidemiology (R.L.G., D.O.M.-K., F.R.R., R.dM.), Leiden University Medical Center, the Netherlands.,Department of Public Health and Primary Care (J.C.L.d.J., D.O.M.-K.), Leiden University Medical Center, the Netherlands
| | - Kari North
- Department of Epidemiology, Gillings School of Global Public Health (K.L.Y., M. Graff, K.N.), University of North Carolina, Chapel Hill.,Carolina Center for Genome Science (K.N.), University of North Carolina, Chapel Hill
| | - Mika Helminen
- Research Development and Innovation Centre (M.H.), Tampere University Hospital, Finland.,Faculty of Social Sciences, Health Sciences, Tampere University, Finland (M.H.)
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (Y.M.-R.)
| | - Linda Snetselaar
- Department of Epidemiology, University of Iowa, Iowa City (L.S.)
| | - Lisa W Martin
- George Washington University School of Medicine and Health Sciences, Washington, D.C. (L.W.M.)
| | - Jorma S Viikari
- Department of Medicine (J.S.V.), University of Turku, Finland.,Division of Medicine (J.S.V.), Turku University Hospital, Finland
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, HOB, Australia (W.H.O.)
| | - Craig E Pennell
- Nutrition and Genomics Laboratory (C.E.S.), Tufts University, Boston, MA.,School of Medicine and Public Health, Faculty of Medicine and Health, The University of Newcastle, NSW, Australia (C.A.W., C.E.P.)
| | - Frits R Rosendall
- Department of Clinical Epidemiology (R.L.G., D.O.M.-K., F.R.R., R.dM.), Leiden University Medical Center, the Netherlands
| | - M Arfan Ikram
- Department of Epidemiology (K.V.E.B., J.C.K.-d.J., M. Ghanbari, M.A.I.), Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Andre G Uitterlinden
- Department of Internal Medicine (A.G.U.), Erasmus MC University Medical Center Rotterdam, the Netherlands
| | - Bruce M Psaty
- Department of Medicine (T.M.B., R.N.L., B.M.P.), University of Washington, Seattle.,Departments of Epidemiology and Health Services (B.M.P.), University of Washington, Seattle.,Kaiser Permanente Washington Health Research Institute, Seattle, WA (B.M.P.)
| | - Dariush Mozaffarian
- Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging, and Friedman School of Nutrition Science and Policy (D.M.), Tufts University, Boston, MA
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA (J.I.R., K.D.T.)
| | - Kent D Taylor
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA (J.I.R., K.D.T.)
| | - Terho Lehtimäki
- Department of Clinical Chemistry (T.L.), Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Finland.,Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland (T.L.)
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine (N.P., O.T.R.), University of Turku, Finland.,Centre for Population Health Research (O.T.R.), University of Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Finland
| | - Kara A Livingston
- Nutritional Epidemiology Program (D.E.H., M. Guirette, K.A.L., N.M.M.), Tufts University, Boston, MA
| | | | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge, United Kingdom (F.I., J.L., N.G.F., N.J.W.)
| | - Nick J Wareham
- Medical Research Council Epidemiology Unit, University of Cambridge, United Kingdom (F.I., J.L., N.G.F., N.J.W.)
| | - Renée de Mutsert
- Department of Clinical Epidemiology (R.L.G., D.O.M.-K., F.R.R., R.dM.), Leiden University Medical Center, the Netherlands
| | - Steven S Rich
- Center for Public Health Genomics and Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville (S.S.R.)
| | - JoAnn E Manson
- Channing Division of Network Medicine (D.E.H., J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Division of Preventive Medicine (J.E.M., S.M., P.M.R., D.I.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Epidemiology (J.E.M.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Samia Mora
- Division of Preventive Medicine (J.E.M., S.M., P.M.R., D.I.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Cardiovascular Division of Medicine and Center for Lipid Metabolomics (S.M., P.M.R.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Paul M Ridker
- Division of Preventive Medicine (J.E.M., S.M., P.M.R., D.I.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Cardiovascular Division of Medicine and Center for Lipid Metabolomics (S.M., P.M.R.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jordi Merino
- Program in Medical and Population Genetics (J.M., J.B.M., H.S.D.), Broad Institute of MIT and Harvard, Cambridge, MA.,Program in Metabolism (J.M., J.B.M.), Broad Institute of MIT and Harvard, Cambridge, MA.,Department of Medicine, Harvard Medical School, Boston, MA (J.M., J.B.M.).,Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Spain (J.M.).,Diabetes Unit and Center for Genomic Medicine (J.M., H.S.D.), Massachusetts General Hospital and Harvard Medical School, Boston
| | - James B Meigs
- Program in Medical and Population Genetics (J.M., J.B.M., H.S.D.), Broad Institute of MIT and Harvard, Cambridge, MA.,Program in Metabolism (J.M., J.B.M.), Broad Institute of MIT and Harvard, Cambridge, MA.,Department of Medicine, Harvard Medical School, Boston, MA (J.M., J.B.M.).,Division of General Internal Medicine (J.B.M.), Massachusetts General Hospital and Harvard Medical School, Boston
| | - Hassan S Dashti
- Program in Medical and Population Genetics (J.M., J.B.M., H.S.D.), Broad Institute of MIT and Harvard, Cambridge, MA.,Diabetes Unit and Center for Genomic Medicine (J.M., H.S.D.), Massachusetts General Hospital and Harvard Medical School, Boston.,Department of Anesthesia, Critical Care and Pain Medicine (H.S.D.), Massachusetts General Hospital and Harvard Medical School, Boston
| | - Daniel I Chasman
- Division of Preventive Medicine (J.E.M., S.M., P.M.R., D.I.C.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | | | | | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, MA (G.M.P., A.N.P., J.D.)
| | - Mark A Herman
- Division Of Endocrinology, Metabolism, and Nutrition, Department of Medicine and Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC (M.A.H.)
| | - Nicola M McKeown
- Nutritional Epidemiology Program (D.E.H., M. Guirette, K.A.L., N.M.M.), Tufts University, Boston, MA
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15
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Kok DE, Arron MNN, Huibregtse T, Kruyt FM, Bac DJ, van Halteren HK, Kouwenhoven EA, Wesselink E, Winkels RM, van Zutphen M, van Duijnhoven FJB, de Wilt JHW, Kampman E. Association of Habitual Preoperative Dietary Fiber Intake With Complications After Colorectal Cancer Surgery. JAMA Surg 2021; 156:2781033. [PMID: 34132738 PMCID: PMC8209565 DOI: 10.1001/jamasurg.2021.2311] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/31/2021] [Indexed: 02/04/2023]
Abstract
IMPORTANCE Postoperative complications are associated with increased morbidity and mortality among patients with colorectal cancer. As a modifiable factor associated with gut health, dietary fiber intake is of interest with regard to the risk of complications after surgery for colorectal cancer. OBJECTIVE To examine the association between preoperative dietary fiber intake and risk of complications after surgery for colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the Colorectal Longitudinal, Observational Study on Nutritional and Lifestyle Factors (COLON) study, which recruited adult patients with colorectal cancer at any stage at diagnosis from 11 hospitals in the Netherlands between August 2010 and December 2017. The present study included patients with stage I to IV colorectal cancer who underwent elective abdominal surgery. Data were analyzed between December 2019 and September 2020. EXPOSURES Habitual dietary fiber intake was assessed at diagnosis using a 204-item food frequency questionnaire. MAIN OUTCOMES AND MEASURES Any complications, surgical complications, and anastomotic leakage occurring during the 30 days after surgery for colorectal cancer. The association between fiber intake and risk of postoperative complications was assessed using logistic regression analyses. Additional analyses stratified by sex, tumor location, and fiber source were performed. RESULTS Among the 1399 patients included in the analysis, the median age at inclusion was 66 years (interquartile range, 61-72 years) and 896 (64%) were men. Any complications occurred in 397 patients (28%), and surgical complications occurred in 235 patients (17%). Of 1237 patients with an anastomosis, 67 (5%) experienced anastomotic leakage. Higher dietary fiber intake (per 10 g per day) was associated with a lower risk of any complications (odds ratio [OR], 0.75; 95% CI, 0.62-0.92) and surgical complications (OR, 0.76; 95% CI, 0.60-0.97), whereas no association with anastomotic leakage was found (OR, 0.97; 95% CI, 0.66-1.43). Among women, higher dietary intake was associated with any complications (OR, 0.64; 95% CI, 0.44-0.94), whereas there was no association among men (OR, 0.79; 95% CI, 0.63-1.01). Fiber intake from vegetables (per 1 g per day) was inversely associated with any (OR, 0.90; 95% CI, 0.83-0.99) and surgical (OR, 0.87; 95% CI, 0.78-0.97) complications. CONCLUSIONS AND RELEVANCE In this cohort study, higher habitual dietary fiber intake before surgery was associated with a lower risk of postoperative complications among patients with colorectal cancer. The findings suggest that improving preoperative dietary fiber intake may be considered in future prehabilitation programs for patients undergoing surgery for colorectal cancer.
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Affiliation(s)
- Dieuwertje E. Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Melissa N. N. Arron
- Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tess Huibregtse
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Flip M. Kruyt
- Department of Surgery, Hospital Gelderse Vallei, Ede, the Netherlands
| | - Dirk Jan Bac
- Department of Gastroenterology and Hepatology, Hospital Gelderse Vallei, Ede, the Netherlands
| | - Henk K. van Halteren
- Department of Internal Medicine, Admiraal de Ruyter Hospital, Goes, the Netherlands
| | | | - Evertine Wesselink
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Renate M. Winkels
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Moniek van Zutphen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | | | | | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
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16
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Serban CL, Banu AM, Putnoky S, Butica SI, Niculescu MD, Putnoky S. Relative Validation of a Four Weeks Retrospective Food Frequency Questionnaire versus 7-Day Paper-Based Food Records in Estimating the Intake of Energy and Nutrients in Adults. NUTRITION AND DIETARY SUPPLEMENTS 2021. [DOI: 10.2147/nds.s310260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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17
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Brouwer JGM, Snellen M, Bisseling TM, Koornstra JJ, Vasen HFA, Kampman E, van Duijnhoven FJB. Is a colorectal neoplasm diagnosis a trigger to change dietary and other lifestyle habits for persons with Lynch syndrome? A prospective cohort study. Fam Cancer 2021; 20:125-135. [PMID: 32770331 PMCID: PMC8064993 DOI: 10.1007/s10689-020-00201-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 07/30/2020] [Indexed: 12/20/2022]
Abstract
A cancer diagnosis is suggested to be associated with changes in dietary and lifestyle habits. Whether this applies to persons with familial cancer, such as Lynch syndrome (LS) is unknown. We investigated whether a colorectal neoplasm (CRN) diagnosis in persons with LS is associated with changes in dietary and lifestyle habits over time. We used data of confirmed LS mutation carriers from the GEOLynch study, a prospective cohort study. Information on dietary intake and lifestyle habits was collected with a validated semi-quantitative food frequency questionnaire and a general questionnaire administered at baseline (2006-2008) and follow-up (2012-2017). Participants' medical records were used to identify CRN diagnoses. Changes in dietary and lifestyle habits in the CRN and the no-CRN group were compared using multivariable linear regression models for continuous variables and cross-tables with percentage change at follow-up compared with baseline for categorical variables. Of the 324 included participants, 146 developed a CRN (CRN group) between baseline and follow-up, while 178 did not (no-CRN group). Smoking cessation was more often reported in the CRN than in the no-CRN group (41.4% vs. 35.0%). There were no differences in changes of energy intake, alcohol, red meat, processed meat, dairy, fruit, vegetables and dietary fiber consumption, BMI, physical activity and NSAID use. Apart from a potentially higher likelihood of smoking cessation, we found little evidence that a CRN diagnosis is associated with changes in lifestyle habits in persons with LS.
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Affiliation(s)
- Jesca G M Brouwer
- Division of Human Nutrition and Health, Wageningen University & Research, P.O. Box 17, 6700 AA, Wageningen, The Netherlands
| | - Merel Snellen
- Division of Human Nutrition and Health, Wageningen University & Research, P.O. Box 17, 6700 AA, Wageningen, The Netherlands
| | - Tanya M Bisseling
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan Jacob Koornstra
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hans F A Vasen
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, P.O. Box 17, 6700 AA, Wageningen, The Netherlands
| | - Fränzel J B van Duijnhoven
- Division of Human Nutrition and Health, Wageningen University & Research, P.O. Box 17, 6700 AA, Wageningen, The Netherlands.
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18
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McCullough ML, Wang Y, Hartman TJ, Hodge RA, Flanders WD, Stevens VL, Sampson L, Mitchell DC, Patel AV. The Cancer Prevention Study-3 FFQ Is a Reliable and Valid Measure of Nutrient Intakes among Racial/Ethnic Subgroups, Compared with 24-Hour Recalls and Biomarkers. J Nutr 2021; 151:636-648. [PMID: 33484132 DOI: 10.1093/jn/nxaa358] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/26/2020] [Accepted: 10/15/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Valid assessment of dietary intake in diverse populations is important for studies of chronic disease risk in the United States. OBJECTIVES We evaluated the reproducibility and validity of a food frequency questionnaire (FFQ) modified for the American Cancer Society's Cancer Prevention Study-3 (CPS-3) prospective cohort, among a racially/ethnically diverse subgroup. METHODS The Diet Assessment Substudy included 677 CPS-3 participants (64% women; 61% non-Hispanic white, 24% non-Hispanic black, 15% Hispanic), aged 31-70 y, who completed 2 FFQs 1 y apart (FFQ1, FFQ2), 4-6 telephone-administered 24-h dietary recalls (24HRs), and 2 fasting blood samples and 24-h urine collections ∼6 mo apart in the interim. Spearman rank correlation coefficients (ρ) were used to evaluate FFQ reproducibility and validity compared with 24HRs for 67 nutrient exposures. For 18 of these nutrients, we used the method of triads to calculate validity coefficients (VCs, ρ) from pairwise correlations of FFQ2, 24HRs, and biomarkers. Analyses were stratified by sex, race/ethnicity, education, and BMI. RESULTS Mean (range) FFQ reproducibility correlations were ρ = 0.65 (0.50-0.91) for men and ρ = 0.63 (0.37-0.89) for women; mean (range) energy-adjusted, deattenuated correlations of FFQ2 with 24HRs were ρ = 0.60 (0.33-0.84) for men and ρ = 0.55 (0.21-0.79) for women. FFQ2 VCs (ρ) among men ranged from 0.42 for β-cryptoxanthin to 0.91 for omega-3 (n-3) fatty acids and, among women, from 0.41 for sodium to 0.79 for total vitamin D. Mean FFQ reproducibility and validity were highest among whites (ρ = 0.68, ρ = 0.58, respectively) and slightly lower among blacks (ρ = 0.57, ρ = 0.49, respectively) and Hispanics (ρ = 0.59, 0.55, respectively). FFQ reproducibility and validity were slightly lower among those with less than a 4-y college degree, and those with a BMI ≥30 kg/m2. CONCLUSIONS Reproducibility and validity of the CPS-3 FFQ were comparable with similar studies for most nutrients, among all subgroups. These findings support future dietary analyses in the contemporary CPS-3 cohort and other similar cohorts.
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Affiliation(s)
| | - Ying Wang
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Terryl J Hartman
- Department of Epidemiology, Rollins School of Public Health Emory University, Atlanta, GA, USA.,Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Rebecca A Hodge
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - W Dana Flanders
- Department of Epidemiology, Rollins School of Public Health Emory University, Atlanta, GA, USA.,Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Victoria L Stevens
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Laura Sampson
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Diane C Mitchell
- Dietary Assessment Center, Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
| | - Alpa V Patel
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
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19
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Inflammation Is a Mediating Factor in the Association between Lifestyle and Fatigue in Colorectal Cancer Patients. Cancers (Basel) 2020; 12:cancers12123701. [PMID: 33317113 PMCID: PMC7763620 DOI: 10.3390/cancers12123701] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 01/30/2023] Open
Abstract
Simple Summary Fatigue is common among colorectal cancer patients. A healthier lifestyle may beneficially affect fatigue, although data are sparse. A healthier lifestyle may result in lower levels of inflammation, which is one of the suggested mechanisms by which lifestyle could influence fatigue. In an observational study, we investigated 1) whether a healthier lifestyle was associated with less fatigue among colorectal cancer patients, and 2) whether this association could be explained by inflammation. We showed that a healthier lifestyle was associated with less fatigue, and that inflammation levels mediated this association. Future intervention studies should investigate whether improving lifestyle after cancer diagnosis results in lowering of inflammation markers and subsequent fatigue. Abstract Fatigue is very common among colorectal cancer (CRC) patients. We examined the association between adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle recommendations and fatigue among stage I-III CRC patients, and whether inflammation mediated this association. Data from two prospective cohort studies were used. Adherence to the WCRF/AICR recommendations was expressed as a score ranging from 0–7, and assessed shortly after diagnosis. Six months post-diagnosis, fatigue was assessed with the European Organization for Research and Treatment of Cancer quality of life questionnaire C30 (EORTC QLQ-C30), and in a subpopulation, the plasma levels of inflammation markers (IL6, IL8, TNFα, and hsCRP) were assessed. Multiple linear regression analyses were performed to investigate the association between adherence to the WCRF/AICR recommendations and fatigue. To test mediation by inflammation, the PROCESS analytic tool developed by Hayes was used. A higher WCRF/AICR adherence score was associated with less fatigue six months after diagnosis (n = 1417, β −2.22, 95%CI −3.65; −0.78). In the population of analysis for the mediation analyses (n = 551), the total association between lifestyle and fatigue was (β −2.17, 95% CI −4.60; 0.25). A statistically significant indirect association via inflammation was observed (β −0.97, 95% CI −1.92; −0.21), explaining 45% of the total association between lifestyle and fatigue (−0.97/−2.17 × 100). Thus, inflammation is probably one of the underlying mechanisms linking lifestyle to fatigue.
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20
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Baart AM, Balvers MGJ, de Vries JHM, Ten Haaf DSM, Hopman MTE, Klein Gunnewiek JMT. Relationship between intake and plasma concentrations of vitamin B12 and folate in 873 adults with a physically active lifestyle: a cross-sectional study. J Hum Nutr Diet 2020; 34:324-333. [PMID: 32955764 PMCID: PMC8048838 DOI: 10.1111/jhn.12814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Vitamin B12 and folate function as co-factors in pathways used during physical activity. Physical activity may therefore increase vitamin requirements, leading to a risk of deficient plasma concentrations. We aimed to investigate the relationship between intake and plasma concentrations of vitamin B12 and folate in physically active adults, as well as identify other determinants of vitamin B12 and folate plasma concentrations. METHODS The study population consisted of 873 adults (528 men and 345 women), aged 19-78 years, who participated in a 4-day walking event. The relationship between intake and plasma concentrations of vitamin B12 and folate was assessed using correlation and linear regression analyses. In addition, potential other determinants (sex, age, body mass index, energy intake and physical activity) of vitamin plasma concentrations were investigated. RESULTS Significant positive correlations were observed between intake and plasma concentrations of vitamin B12 [Pearson's correlation coefficient = 0.15; 95% confidence interval (CI) = 0.08-0.21] and folate (Pearson's correlation coefficient = 0.18; 95% CI = 0.12-0.25). In addition to vitamin intake, sex, age and energy intake were also determinants of both vitamin B12 and folate plasma concentrations in multivariable regression models. CONCLUSIONS The results suggest a positive association between intake and plasma concentrations for both vitamin B12 and folate in physically active people. By contrast to our hypothesis, physical activity was not a determinant of vitamin B12 and folate plasma concentrations. However, sex, age and energy intake were found to be determinants. Thus, when studying the relationship between intake and plasma concentrations of vitamin B12 or folate, these factors should be taken into account.
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Affiliation(s)
- A M Baart
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.,Clinical Chemistry and Haematology Laboratory, Gelderse Vallei Hospital, Ede, The Netherlands
| | - M G J Balvers
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.,Clinical Chemistry and Haematology Laboratory, Gelderse Vallei Hospital, Ede, The Netherlands
| | - J H M de Vries
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - D S M Ten Haaf
- Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M T E Hopman
- Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J M T Klein Gunnewiek
- Clinical Chemistry and Haematology Laboratory, Gelderse Vallei Hospital, Ede, The Netherlands
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21
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Eijkelboom AH, Brouwer JGM, Vasen HFA, Bisseling TM, Koornstra JJ, Kampman E, van Duijnhoven FJB. Diet quality and colorectal tumor risk in persons with Lynch syndrome. Cancer Epidemiol 2020; 69:101809. [PMID: 32947154 DOI: 10.1016/j.canep.2020.101809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Persons with Lynch syndrome (LS) have an increased risk of developing colorectal tumors (CRTs). Adherence to diet quality indices associated with colorectal cancer (CRC) risk in the general population has not been studied before in LS. METHODS Dietary habits of 490 participants with LS from a prospective cohort study was collected using a food frequency questionnaire. The Dutch Healthy Diet index 2015 (DHD15-index) and Dietary Approaches to Stop Hypertension (DASH) were used to score food-based diet quality. Diet quality scores were divided into tertiles where a higher tertile reflects a higher diet quality. Multivariable Cox proportional hazard regression models were used to estimate the association between the DHD15-index, DASH score and CRT risk. RESULTS During a median follow-up time of 53.4 months, 210 participants (42.9%) developed CRTs. The DHD-index and DASH score were not associated with CRT risk; hazard ratios for highest vs. lowest tertile were 1.00 (95% Confidence Interval (CI): 0.67-1.48) and 1.11 (95% CI: 0.74-1.69), respectively. No linear trends across the DHD-index and DASH score tertiles were observed (P-trend = 0.97 and 0.83 respectively). CONCLUSION In contrast to observations in the general population, no evidence for an association between the food-based DHD15-index or DASH score and CRT risk was observed in persons with LS. Further studies are needed investigating the association between diet quality and mechanisms leading to the development of LS-associated tumors.
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Affiliation(s)
- Anouk H Eijkelboom
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands.
| | - Jesca G M Brouwer
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands.
| | - Hans F A Vasen
- The Netherlands Foundation for the Detection of Hereditary Tumors, Leiden, the Netherlands.
| | - Tanya M Bisseling
- Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
| | - Jan J Koornstra
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands.
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Voortman T, Steegers-Theunissen RP, Bergen NE, Jaddoe VWV, Looman CWN, Kiefte-de Jong JC, Schalekamp-Timmermans S. Validation of a Semi-Quantitative Food-Frequency Questionnaire for Dutch Pregnant Women from the General Population Using the Method or Triads. Nutrients 2020; 12:nu12051341. [PMID: 32397149 PMCID: PMC7284899 DOI: 10.3390/nu12051341] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/01/2020] [Accepted: 05/04/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE We aimed to validate a food-frequency questionnaire (FFQ) for Dutch pregnant women, against three 24 h-recalls and blood concentrations of B-vitamins and fatty acids, using the method of triads. METHODS We included 83 pregnant women from the general population of Rotterdam, the Netherlands, at a median gestational age of 15.6 weeks. Participants completed three non-consecutive 24 h-recalls, and subsequently filled out the 293-item FFQ. Participants provided blood samples from which we analyzed serum folate and vitamin B12, as well as red blood cell folate, linoleic acid, and total saturated, monounsaturated, and polyunsaturated fatty acids. RESULTS Estimated energy intake did not differ between the FFQ and 24 h-recalls. Deattenuated Pearson's correlation coefficients, between energy-adjusted nutrient intake estimates from the FFQ and the 24 h-recalls, ranged from 0.41 (fat) to 0.88 (fiber) for macronutrients, and were around 0.6 for most micronutrients, except for vitamin E (0.27). Using the triad method, we obtained validity coefficients of 0.86 (95% Confidence Interval (CI) 0.36, 1.00) for serum folate, 0.86 (95% CI 0.18, 1.00) for red blood cell folate, and 1.00 (95% CI 0.42, 1.00) for vitamin B12. Validity coefficients for serum fatty acids ranged from 0.22 to 0.67. CONCLUSION This FFQ is a reliable tool for estimating intake of energy, macronutrients, folate and vitamin B12 among women in mid-pregnancy.
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Affiliation(s)
- Trudy Voortman
- Department of Epidemiology, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (T.V.); (J.C.K.-d.J.)
| | | | - Nienke E. Bergen
- Department of Obstetrics and Gynecology, 3000 CA Erasmus MC, Rotterdam, The Netherlands; (R.P.S.-T.); (N.E.B.)
- The Generation R Study Group, Erasmus MC, 3000 CA Rotterdam, The Netherlands;
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus MC, 3000 CA Rotterdam, The Netherlands;
- Department of Pediatrics, Erasmus MC, 3000 CA Rotterdam, The Netherlands
| | - Caspar W. N. Looman
- Department of Public Health, Erasmus MC, 3000 CA Rotterdam, The Netherlands;
| | - Jessica C. Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, 3000 CA Rotterdam, The Netherlands; (T.V.); (J.C.K.-d.J.)
- Department of Public Health and Primary Care, LUMC Campus, 2511 VA The Hague, The Netherlands
| | - Sarah Schalekamp-Timmermans
- Department of Obstetrics and Gynecology, 3000 CA Erasmus MC, Rotterdam, The Netherlands; (R.P.S.-T.); (N.E.B.)
- The Generation R Study Group, Erasmus MC, 3000 CA Rotterdam, The Netherlands;
- Correspondence:
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23
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Verkouter I, Noordam R, le Cessie S, van Dam RM, Lamb HJ, Rosendaal FR, van Heemst D, de Mutsert R. The Association between Adult Weight Gain and Insulin Resistance at Middle Age: Mediation by Visceral Fat and Liver Fat. J Clin Med 2019; 8:jcm8101559. [PMID: 31569345 PMCID: PMC6832997 DOI: 10.3390/jcm8101559] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/11/2019] [Accepted: 09/24/2019] [Indexed: 12/18/2022] Open
Abstract
We aimed to investigate the role of the amount of visceral fat and liver fat in the association between adult weight change and insulin resistance at middle age. In the Netherlands Epidemiology of Obesity study, adult weight change was calculated with recalled body weight at age 20 years and measured body weight at middle age. Measures of insulin resistance were calculated using both fasting and postprandial glucose and insulin concentrations. Visceral fat was assessed by magnetic resonance (MR) imaging and liver fat by proton-MR spectroscopy (N = 1758). We examined the association between adult weight change and insulin resistance with linear regression, adjusted for confounding factors. To investigate mediation, we additionally adjusted for total body fat, visceral fat, and liver fat. In participants who gained ≥50% of body weight during adulthood, homeostatic model assessment for insulin resistance (HOMA-IR) was 3.22 (95% CI 2.76; 3.77) times higher than in weight maintainers. In a joint model, total body fat mediated this association for 8.1% (95% CI −9.2; 25.4), visceral fat for 32.0% (18.6; 45.4%) and liver fat for 22.5% (15.0; 30.1). The association between adult weight gain and insulin resistance at middle age is largely mediated by both visceral fat and liver fat.
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Affiliation(s)
- Inge Verkouter
- Department of Clinical Epidemiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
| | - Raymond Noordam
- Department of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
| | - Saskia le Cessie
- Department of Clinical Epidemiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Rob M van Dam
- Saw Swee Hock School of Public Health and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore 117549, Singapore.
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
| | - Diana van Heemst
- Department of Internal Medicine, Section Gerontology and Geriatrics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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24
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van Eekelen E, Geelen A, Alssema M, Lamb HJ, de Roos A, Rosendaal FR, de Mutsert R. Adherence to dietary guidelines in relation to visceral fat and liver fat in middle-aged men and women: the NEO study. Int J Obes (Lond) 2019; 44:297-306. [PMID: 31462693 PMCID: PMC6997120 DOI: 10.1038/s41366-019-0441-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 06/26/2019] [Accepted: 07/15/2019] [Indexed: 11/19/2022]
Abstract
Background It is unclear to what extent adherence to dietary guidelines may specifically affect visceral fat and liver fat. We aimed to study the association between the Dutch Healthy Diet Index (DHD-index) and total body fat, visceral adipose tissue (VAT) and hepatic triglyceride content (HTGC) in middle-aged men and women. Design In this cross-sectional study, VAT was assessed by magnetic resonance imaging (MRI) in 2580 participants, and HTGC by proton-MR spectroscopy in 2083 participants. Habitual dietary intake and physical activity were estimated by questionnaire. Adherence to the current Dutch dietary guidelines was estimated by the 2015 DHD-index score based on the thirteen components (vegetables, fruit, wholegrain products, legumes, nuts, dairy, fish, tea, liquid fats, red meat, processed meat, sweetened beverages, and alcohol). The DHD-index ranges between 0 and 130 with a higher score indicating a healthier diet. We used linear regression to examine associations of the DHD-index with VAT and HTGC, adjusted for age, smoking, education, ethnicity, basal metabolic rate, energy restricted diet, menopausal state, physical activity, total energy intake, and total body fat. We additionally excluded the components one by one to examine individual contributions to the associations. Results Included participants (43% men) had a mean (SD) age of 56 (6) years and DHD-index score of 71 (15). A 10-point higher DHD-index score was associated with 2.3 cm2 less visceral fat (95% CI; −3.5; −1.0 cm2) and less liver fat (0.94 times, 95% CI; 0.90; 0.98). Of all components, exclusion of dairy attenuated the associations with TBF and VAT. Conclusions Adherence to the dietary guidelines as estimated by the DHD-index was associated with less total body fat, and with less visceral and liver fat after adjustment for total body fat. These findings might contribute to better understanding of the mechanisms underlying associations between dietary habits and cardiometabolic diseases.
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Affiliation(s)
- Esther van Eekelen
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Anouk Geelen
- Department of Human Nutrition, Wageningen University & Research, Wageningen, The Netherlands
| | - Marjan Alssema
- Unilever Research and Development, Vlaardingen, The Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Albert de Roos
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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25
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Winkels RM, van Brakel L, van Baar H, Beelman RB, van Duijnhoven FJB, Geijsen A, van Halteren HK, Hansson BME, Richie JP, Sun D, Wesselink E, van Zutphen M, Kampman E, Kok DE. Are Ergothioneine Levels in Blood Associated with Chronic Peripheral Neuropathy in Colorectal Cancer Patients Who Underwent Chemotherapy? Nutr Cancer 2019; 72:451-459. [PMID: 31298929 DOI: 10.1080/01635581.2019.1637005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Chronic Chemotherapy-Induced Peripheral Neuropathy (CIPN) is highly prevalent among colorectal cancer (CRC) patients. Ergothioneine (ET) - a dietary antioxidant -protected against CIPN in experimental models, but human studies are lacking. We explored whether whole blood ET levels were associated with chronic peripheral neuropathy among CRC patients who had completed chemotherapy.Methods: At diagnosis, median ET-concentration in whole blood of 159 CRC patients was 10.2 μg/ml (7.2-15.8). Patients completed questionnaires on peripheral neuropathy 6 months after completion of chemotherapy. We calculated prevalence ratios (PR) to assess associations of ET-concentrations and prevalence of peripheral neuropathy and used linear regression to assess associations with severity of peripheral neuropathy.Results: Prevalence of total and sensory peripheral neuropathy were both 81%. Higher ET-concentrations tended to be associated with lower prevalence of total and sensory peripheral neuropathy, but not statistically significant (highest versus lowest tertile of ET: PR = 0.93(0.78, 1.11) for total neuropathy, and PR = 0.84(0.70, 1.02) for sensory neuropathy). ET-concentrations were not associated with severity of neuropathy.Conclusion: Statistically significant associations were not observed, possibly because of limited sample size. Although data may putatively suggest higher levels of ET to be associated with a lower prevalence of neuropathy, analyses should be repeated in larger populations with larger variability in ET-concentrations.
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Affiliation(s)
- Renate M Winkels
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Lieve van Brakel
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.,Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Harm van Baar
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Robert B Beelman
- Department of Food Science, Penn State College of Agricultural Sciences, University Park, PA, USA
| | | | - Anne Geijsen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | | | - Bibi M E Hansson
- Department of Surgery, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
| | - John P Richie
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Dongxiao Sun
- Department of Pharmacology, Penn State College of Medicine, Hershey, PA, USA
| | - Evertine Wesselink
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Moniek van Zutphen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
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26
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Using enhanced regression calibration to combine dietary intake estimates from 24 h recall and FFQ reduces bias in diet-disease associations. Public Health Nutr 2019; 22:2738-2746. [PMID: 31262375 DOI: 10.1017/s1368980019001563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To illustrate the impact of combining 24 h recall (24hR) and FFQ estimates using regression calibration (RC) and enhanced regression calibration (ERC) on diet-disease associations. SETTING Wageningen area, the Netherlands, 2011-2013. DESIGN Five approaches for obtaining self-reported dietary intake estimates of protein and K were compared: (i) uncorrected FFQ intakes (FFQ); (ii) uncorrected average of two 24hR ( $\overline {\rm R}$ ); (iii) average of FFQ and $\overline {\rm R}$ ( ${\overline {\rm F}}\,\overline {\rm R}}$ ); (iv) RC from regression of 24hR v. FFQ; and (v) ERC by adding individual random effects to the RC approach. Empirical attenuation factors (AF) were derived by regression of urinary biomarker measurements v. the resulting intake estimates. PARTICIPANTS Data of 236 individuals collected within the National Dietary Assessment Reference Database. RESULTS Both FFQ and 24hR dietary intake estimates were measured with substantial error. Using statistical techniques to correct for measurement error (i.e. RC and ERC) reduced bias in diet-disease associations as indicated by their AF approaching 1 (RC 1·14, ERC 0·95 for protein; RC 1·28, ERC 1·34 for K). The larger sd and narrower 95% CI of AF obtained with ERC compared with RC indicated that using ERC has more power than using RC. However, the difference in AF between RC and ERC was not statistically significant, indicating no significantly better de-attenuation by using ERC compared with RC. AF larger than 1, observed for the ERC for K, indicated possible overcorrection. CONCLUSIONS Our study highlights the potential of combining FFQ and 24hR data. Using RC and ERC resulted in less biased associations for protein and K.
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27
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Oliai Araghi S, Braun KVE, van der Velde N, van Dijk SC, van Schoor NM, Zillikens MC, de Groot LCPGM, Uitterlinden AG, Stricker BH, Voortman T, Kiefte-de Jong JC. B-vitamins and body composition: integrating observational and experimental evidence from the B-PROOF study. Eur J Nutr 2019; 59:1253-1262. [PMID: 31076856 PMCID: PMC7098930 DOI: 10.1007/s00394-019-01985-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 04/30/2019] [Indexed: 11/06/2022]
Abstract
Purpose Higher folate and vitamin-B12 have been linked to lower risk of overweight. However, whether this is a causal effect of these B-vitamins on obesity risk remains unclear and evidence in older individuals is scarce. This study aimed to assess the role of B-vitamin supplementation and levels on body composition in older individuals. Methods A double-blind, randomized controlled trial in 2919 participants aged ≥ 65 years with elevated homocysteine levels. The intervention comprised a 2-year supplementation with a combination of folic acid (400 µg) and vitamin B12 (500 µg), or with placebo. Serum folate, vitamin-B12, active vitamin-B12 (HoloTC), methylmalonic acid (MMA), and anthropometrics were measured at baseline and after 2 years of follow-up. Dietary intake of folate and vitamin-B12 was measured at baseline in a subsample (n = 603) using a validated food-frequency questionnaire. Fat mass index (FMI) and fat-free mass index (FFMI) were assessed with Dual Energy X-ray absorptiometry (DXA). Results Cross-sectional analyses showed that a 1 nmol/L higher serum folate was associated with a 0.021 kg/m2 lower BMI (95% CI − 0.039; − 0.004). Higher HoloTC (per pmol/L log-transformed) was associated with a 0.955 kg/m2 higher FMI (95% CI 0.262; 1.647), and higher MMA (per μgmol/L) was associated with a 1.108 kg/m2 lower FMI (95% CI − 1.899; − 0.316). However, random allocation of B-vitamins did not have a significant effect on changes in BMI, FMI or FFMI during 2 years of intervention. Conclusions Although observational data suggested that folate and vitamin B12 status are associated with body composition, random allocation of a supplement with both B-vitamins combined versus placebo did not confirm an effect on BMI or body composition. Electronic supplementary material The online version of this article (10.1007/s00394-019-01985-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sadaf Oliai Araghi
- Department of Internal Medicine, Erasmus University Medical Center, Postbus 2040, 3000 CA, Rotterdam, The Netherlands
| | - Kim V E Braun
- Department of Epidemiology, Erasmus University Medical Center, Postbus 2040, 3000 CA, Rotterdam, The Netherlands
| | - Nathalie van der Velde
- Department of Internal Medicine, Erasmus University Medical Center, Postbus 2040, 3000 CA, Rotterdam, The Netherlands.,Section of Geriatric Medicine, Department of Internal Medicine, Academic Medical Centre, Amsterdam Public Health Research Institute, Postbus 22660, 1100 DD, Amsterdam-Zuidoost, The Netherlands
| | - Suzanne C van Dijk
- Department of Internal Medicine, Erasmus University Medical Center, Postbus 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Geriatric Medicine, Franciscus Gasthuis & Vlietland, Postbus 215, 3100 AE, Schiedam, The Netherlands
| | - Natasja M van Schoor
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Postbus 7057, 1007 MB, Amsterdam, The Netherlands
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus University Medical Center, Postbus 2040, 3000 CA, Rotterdam, The Netherlands
| | - Lisette C P G M de Groot
- Division of Human Nutrition and Health, Wageningen University, Postbus 9101, 6700 HB, Wageningen, The Netherlands
| | - Andre G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, Postbus 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Postbus 2040, 3000 CA, Rotterdam, The Netherlands
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus University Medical Center, Postbus 2040, 3000 CA, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical Center, Postbus 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus University Medical Center, Postbus 2040, 3000 CA, Rotterdam, The Netherlands. .,Department of Public Health and Primary Care, Leiden University Medical Center/LUMC Campus, The Hague, The Netherlands.
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28
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Drareni K, Dougkas A, Giboreau A, Laville M, Souquet PJ, Bensafi M. Relationship between food behavior and taste and smell alterations in cancer patients undergoing chemotherapy: A structured review. Semin Oncol 2019; 46:160-172. [DOI: 10.1053/j.seminoncol.2019.05.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/23/2019] [Accepted: 05/29/2019] [Indexed: 12/12/2022]
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29
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van Eekelen E, Beulens JWJ, Geelen A, Schrauwen-Hinderling VB, Lamb H, de Roos A, Rosendaal F, de Mutsert R. Consumption of Alcoholic and Sugar-Sweetened Beverages is Associated with Increased Liver Fat Content in Middle-Aged Men and Women. J Nutr 2019; 149:649-658. [PMID: 30949667 DOI: 10.1093/jn/nxy313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/26/2018] [Accepted: 12/05/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Fatty liver is the leading cause of chronic liver diseases and increases the risk of cardiovascular disease. Besides alcohol consumption, energy-containing nonalcoholic beverages may contribute to liver fat accumulation. OBJECTIVE We aimed to study the consumption of alcoholic and nonalcoholic beverages and their mutual replacement in relation to hepatic triglyceride content (HTGC) in middle-aged men and women. METHODS In this cross-sectional analysis, HTGC was assessed by proton magnetic resonance spectroscopy. Habitual consumption of alcoholic and nonalcoholic beverages was assessed using a validated food-frequency questionnaire. All beverages were converted to standard servings and to percentage of total energy intake (En%). We performed linear regression to examine the association of alcoholic and nonalcoholic beverages with HTGC, adjusted for age, sex, smoking, education, ethnicity, physical activity, total energy intake, and total body fat. We studied replacement of alcoholic beverages with nonalcoholic beverages per 1 serving/d and per 5 En%/d. RESULTS After exclusion of individuals with missing values, 1966 participants (47% men) were analyzed, with a mean ± SD age of 55 ± 6 y, BMI of 26 ± 4 kg/m2, and HTGC of 5.7% ± 7.9%. Each extra alcoholic serving per day was associated with more liver fat (1.09 times; 95% CI: 1.05, 1.12). Replacing 5 En% of alcoholic beverages with milk was associated with less liver fat (0.89 times; 95% CI: 0.81, 0.98), whereas replacement with 5 En% of sugar-sweetened beverages was associated with liver fat to an extent similar to alcoholic beverages (1.00 times; 95% CI: 0.91, 1.09). CONCLUSION In a population-based cohort, consumption of each extra daily alcoholic beverage was associated with more liver fat. In isocaloric replacement of alcoholic beverages, milk was associated with less liver fat, whereas sugar-sweetened beverages were equally associated with liver fat. This suggests that intake of alcohol and sugars may contribute to liver fat accumulation. This trial was registered at clinicaltrials.gov as NCT03410316.
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Affiliation(s)
- Esther van Eekelen
- Departments of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Joline W J Beulens
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Anouk Geelen
- Division of Human Nutrition, Wageningen University & Research, Wageningen, Netherlands
| | - Vera B Schrauwen-Hinderling
- Department of Nutrition and Movement Sciences, Maastricht University Medical Center, NUTRIM School of Nutrition and Translational Research in Metabolism.,Department of Radiology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Hildo Lamb
- Departments of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | - Albert de Roos
- Departments of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | - Frits Rosendaal
- Departments of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Renée de Mutsert
- Departments of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
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30
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Looman M, Geelen A, Samlal RAK, Heijligenberg R, Klein Gunnewiek JMT, Balvers MGJ, Wijnberger LDE, Brouwer-Brolsma EM, Feskens EJM. Changes in Micronutrient Intake and Status, Diet Quality and Glucose Tolerance from Preconception to the Second Trimester of Pregnancy. Nutrients 2019; 11:nu11020460. [PMID: 30813281 PMCID: PMC6412670 DOI: 10.3390/nu11020460] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 02/10/2019] [Accepted: 02/19/2019] [Indexed: 12/14/2022] Open
Abstract
Data on changes in dietary intake and related blood parameters throughout pregnancy are scarce; moreover, few studies have examined their association with glucose homeostasis. Therefore, we monitored intake of folate, vitamin B6, vitamin B12, vitamin D and iron, their status markers, and diet quality from preconception to the second trimester of pregnancy, and we examined whether these dietary factors were associated with glucose homeostasis during pregnancy. We included 105 women aged 18⁻40 years with a desire to get pregnancy or who were already <24 weeks pregnant. Women at increased gestational diabetes (GDM) risk were oversampled. Measurements were scheduled at preconception (n = 67), and 12 (n =53) and 24 weeks of pregnancy (n =66), including a fasting venipuncture, 75-grams oral glucose tolerance test, and completion of a validated food frequency questionnaire. Changes in micronutrient intake and status, and associations between dietary factors and glucose homeostasis, were examined using adjusted repeated measures mixed models. Micronutrient intake of folate, vitamin B6 and vitamin D and related status markers significantly changed throughout pregnancy, which was predominantly due to changes in the intake of supplements. Micronutrient intake or status levels were not associated with glucose homeostasis, except for iron intake (FE µg/day) with fasting glucose (β = -0.069 mmol/L, p = 0.013) and HbA1c (β = -0.4843 mmol, p = 0.002). Diet quality was inversely associated with fasting glucose (β = -0.006 mmol/L for each DHD15-index point, p = 0.017). It was shown that micronutrient intakes and their status markers significantly changed during pregnancy. Only iron intake and diet quality were inversely associated with glucose homeostasis.
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Affiliation(s)
- Moniek Looman
- Division of Human Nutrition, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands.
| | - Anouk Geelen
- Division of Human Nutrition, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands.
| | - Rahul A K Samlal
- Department of Gynaecology and Obstetrics, Hospital Gelderse Vallei Ede, P.O. Box 9025, 6710 HN Ede, The Netherlands.
| | - Rik Heijligenberg
- Department of Internal Medicine, Hospital Gelderse Vallei Ede, P.O. Box 9025, 6710 HN Ede, The Netherlands.
| | - Jacqueline M T Klein Gunnewiek
- Clinical Chemistry and Haematology Laboratory, Hospital Gelderse Vallei Ede, P.O. Box 9025, 6710 HN Ede, The Netherlands.
| | - Michiel G J Balvers
- Clinical Chemistry and Haematology Laboratory, Hospital Gelderse Vallei Ede, P.O. Box 9025, 6710 HN Ede, The Netherlands.
| | - Lia D E Wijnberger
- Department of Obstetrics and Gynaecology, Rijnstate Hospital, P.O. Box 9555, 6800 TA Arnhem, The Netherlands.
| | - Elske M Brouwer-Brolsma
- Division of Human Nutrition, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands.
| | - Edith J M Feskens
- Division of Human Nutrition, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands.
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Surowiec I, Noordam R, Bennett K, Beekman M, Slagboom PE, Lundstedt T, van Heemst D. Metabolomic and lipidomic assessment of the metabolic syndrome in Dutch middle-aged individuals reveals novel biological signatures separating health and disease. Metabolomics 2019; 15:23. [PMID: 30830468 PMCID: PMC6373335 DOI: 10.1007/s11306-019-1484-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 01/31/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND We aimed to identify novel metabolite and lipid signatures connected with the metabolic syndrome in a Dutch middle-aged population. METHODS 115 individuals with a metabolic syndrome score ranging from 0 to 5 [50 cases of the metabolic syndrome (score ≥ 3) and 65 controls] were enrolled from the Leiden Longevity Study, and LC/GC-MS metabolomics and lipidomics profiling were performed on fasting plasma samples. Data were analysed with principal component analysis and orthogonal projections to latent structures (OPLS) to study metabolite/lipid signatures associated with the metabolic syndrome. In addition, univariate analyses were done with linear regression, adjusted for age and sex, for the study of individual metabolites/lipids in relation to the metabolic syndrome. RESULTS Data was available on 103 metabolites and 223 lipids. In the OPLS model with metabolic syndrome score (Y-variable), 9 metabolites were negatively correlated and 26 metabolites (mostly acylcarnitines, amino acids and keto acids) were positively correlated with the metabolic syndrome score. In addition, a total of 100 lipids (mainly triacylglycerides) were positively correlated and 10 lipids from different lipid classes were negatively correlated with the metabolic syndrome score. In the univariate analyses, the metabolic syndrome (score) was associated with multiple individual metabolites (e.g., valeryl carnitine, pyruvic acid, lactic acid, alanine) and lipids [e.g., diglyceride(34:1), diglyceride(36:2)]. CONCLUSION In this first study on metabolomics/lipidomics of the metabolic syndrome, we identified multiple novel metabolite and lipid signatures, from different chemical classes, that were connected to the metabolic syndrome and are of interest to cardiometabolic disease biology.
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Affiliation(s)
| | - Raymond Noordam
- AcureOmics AB, Umeå, Sweden
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | | | - Marian Beekman
- Department of Medical Statistics and Bioinformatics, Section of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - P Eline Slagboom
- Department of Medical Statistics and Bioinformatics, Section of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Diana van Heemst
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
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van Eekelen E, Geelen A, Alssema M, Lamb HJ, de Roos A, Rosendaal FR, de Mutsert R. Sweet Snacks Are Positively and Fruits and Vegetables Are Negatively Associated with Visceral or Liver Fat Content in Middle-Aged Men and Women. J Nutr 2019; 149:304-313. [PMID: 30657914 PMCID: PMC6374148 DOI: 10.1093/jn/nxy260] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 07/30/2018] [Accepted: 09/11/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Visceral adipose tissue (VAT) and hepatic triglyceride content (HTGC) are major risk factors for cardiometabolic diseases. OBJECTIVE We aimed to investigate the association of dietary intake of the main food groups with VAT and HTGC in middle-aged men and women. METHODS We used data from the Netherlands Epidemiology of Obesity study, a population-based study including 6671 participants aged 45-65 y at baseline. In this cross-sectional analysis, VAT and HTGC were assessed by magnetic resonance imaging and spectroscopy, respectively, as the primary outcomes. Habitual intake of main food groups (dairy, meat, fish, fruits and vegetables, sweet snacks, and fats and oils) was estimated through the use of a food-frequency questionnaire. We examined associations of intake of different food groups with VAT and HTGC by linear regression analysis stratified by sex and adjusted for age, smoking, education, ethnicity, physical activity, basal metabolic rate, energy-restricted diet, menopausal state, and total energy intake. RESULTS In women, a 100-g/d higher intake of dairy was associated with 2.0 cm2 less VAT (95% CI: -3.4, -0.7 cm2) and a 0.95-fold lower HTGC (95% CI: 0.90-, 0.99-fold). Moreover, a 100-g/d higher intake of fruit and vegetables was associated with 1.6 cm2 less VAT (95% CI: -2.9, -0.2 cm2) in women. Fruit and vegetables were negatively associated (0.95; 95% CI: 0.91, 1.00) with HTGC, and sweet snacks were positively associated (1.29; 95% CI: 1.03, 1.63). Patterns were weaker but similar in men. Fish intake was not associated with VAT or HTGC and plant-based fat and oil intake were only associated with VAT after adjustment for total body fat. CONCLUSIONS Despite some variation in the strength of the associations between men and women, dietary intake of sweet snacks was positively associated with HTGC, and fruit and vegetable intake were negatively associated with visceral and liver fat content. Prospective studies are needed to confirm these results. The Netherlands Epidemiology of Obesity study is registered at clinicaltrials.gov with identifier NCT03410316.
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Affiliation(s)
- Esther van Eekelen
- Departments of Clinical Epidemiology and,Address correspondence to EvE (e-mail: )
| | - Anouk Geelen
- Division of Human Nutrition, Wageningen University & Research, Wageningen, Netherlands
| | - Marjan Alssema
- Unilever Research and Development, Vlaardingen, Netherlands,Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
| | - Hildo J Lamb
- Radiology, Leiden University Medical Center, Leiden, Netherlands
| | - Albert de Roos
- Radiology, Leiden University Medical Center, Leiden, Netherlands
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Elffers T, Trompet S, de Mutsert R, Maan A, Lamb H, Macfarlane P, Rosendaal F, Jukema J. Borderline Q-waves in individuals without overt cardiovascular disease: Relations with adiposity, subclinical atherosclerosis and vascular stiffness. Int J Cardiol 2019; 274:331-336. [DOI: 10.1016/j.ijcard.2018.08.088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 08/16/2018] [Accepted: 08/29/2018] [Indexed: 01/18/2023]
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Supplement Use and Dietary Sources of Folate, Vitamin D, and n-3 Fatty Acids during Preconception: The GLIMP2 Study. Nutrients 2018; 10:nu10080962. [PMID: 30046020 PMCID: PMC6115753 DOI: 10.3390/nu10080962] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 02/06/2023] Open
Abstract
An adequate nutritional status during the preconception period is important, particularly for folate, vitamin D, and n-3 fatty acids (i.e., EPA+DHA). We aimed to determine supplement intake and the main dietary sources of folate, vitamin D, and EPA+DHA using the data of 66 Dutch women aged 18–40 years who wished to become pregnant. Additionally, associations of these intakes with their blood levels were examined. Dietary intake was assessed with a validated food frequency questionnaire, and supplement use with a structured questionnaire. 25-hydroxyvitamin D levels were determined in serum and folate and phospholipid EPA+DHA levels in plasma. Partial Spearman’s correlations, restricted cubic splines and trend analyses over tertiles of nutrient intakes were performed to examine intake-status associations. A large proportion of women did not meet the Dutch recommended intakes of folate (50%), vitamin D (67%), and EPA+DHA (52%). Vegetables were the main contributor to dietary folate intake (25%), oils and fats to dietary vitamin D intake (39%), and fish to dietary EPA+DHA intake (69%). Fourteen percent of the women had an inadequate folate status and 23% an inadequate vitamin D status. Supplemental folate intake, supplemental and dietary vitamin D intake and dietary EPA+DHA intake were significantly associated with their blood levels. In conclusion, even in our highly educated population, a large proportion did not achieve recommended folate, vitamin D and n-3 fatty acid intakes. Promotion of folate and vitamin D supplement use and fish consumption is needed to improve intakes and blood levels of these nutrients in women who wish to become pregnant.
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Novaković R, Geelen A, Ristić-Medić D, Nikolić M, Souverein OW, McNulty H, Duffy M, Hoey L, Dullemeijer C, Renkema JMS, Gurinović M, Glibetić M, de Groot LCPGM, Van't Veer P. Systematic Review of Observational Studies with Dose-Response Meta-Analysis between Folate Intake and Status Biomarkers in Adults and the Elderly. ANNALS OF NUTRITION AND METABOLISM 2018; 73:30-43. [PMID: 29879709 DOI: 10.1159/000490003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/14/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Dietary reference values for folate intake vary widely across Europe. METHODS MEDLINE and Embase through November 2016 were searched for data on the association between folate intake and biomarkers (serum/plasma folate, red blood cell [RBC] folate, plasma homocysteine) from observational studies in healthy adults and elderly. The regression coefficient of biomarkers on intake (β) was extracted from each study, and the overall and stratified pooled β and SE (β) were obtained by random effects meta-analysis on a double log scale. These dose-response estimates may be used to derive folate intake reference values. RESULTS For every doubling in folate intake, the changes in serum/plasma folate, RBC folate and plasma homocysteine were +22, +21, and -16% respectively. The overall pooled regression coefficients were β = 0.29 (95% CI 0.21-0.37) for serum/plasma folate (26 estimates from 17 studies), β = 0.28 (95% CI 0.21-0.36) for RBC (13 estimates from 11 studies), and β = -0.21 (95% CI -0.31 to -0.11) for plasma homocysteine (10 estimates from 6 studies). CONCLUSION These estimates along with those from randomized controlled trials can be used for underpinning dietary recommendations for folate in adults and elderly.
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Affiliation(s)
- Romana Novaković
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Anouk Geelen
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, the Netherlands
| | - Danijela Ristić-Medić
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Marina Nikolić
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Olga W Souverein
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, the Netherlands
| | - Helene McNulty
- School of Biomedical Sciences, University of Ulster, Coleraine Campus, Londonderry, United Kingdom
| | - Maresa Duffy
- School of Biomedical Sciences, University of Ulster, Coleraine Campus, Londonderry, United Kingdom
| | - Leane Hoey
- School of Biomedical Sciences, University of Ulster, Coleraine Campus, Londonderry, United Kingdom
| | - Carla Dullemeijer
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, the Netherlands
| | - Jacoba M S Renkema
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, the Netherlands
| | - Mirjana Gurinović
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Marija Glibetić
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Lisette C P G M de Groot
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, the Netherlands
| | - Pieter Van't Veer
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, the Netherlands
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Parisi F, Rousian M, Koning IV, Willemsen SP, de Vries JHM, Steegers EAP, Steegers-Theunissen RPM. Periconceptional maternal dairy-rich dietary pattern is associated with prenatal cerebellar growth. PLoS One 2018; 13:e0197901. [PMID: 29791504 PMCID: PMC5965865 DOI: 10.1371/journal.pone.0197901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 05/10/2018] [Indexed: 12/22/2022] Open
Abstract
Background Maternal nutrition during pregnancy has been related to intrauterine brain development and neurodevelopmental disabilities in adult life. We aim to investigate associations between periconceptional maternal dietary patterns and prenatal cerebellar growth from the first trimester onwards. Materials and methods 126 women with singleton non-malformed pregnancies were enrolled before 8 weeks of gestation in the Rotterdam periconceptional cohort between 2013 and 2015. Periconceptional maternal dietary patterns were extracted from food frequency questionnaires and associated with blood biomarkers and micronutrient intakes. Serial two-dimensional and three-dimensional ultrasound scans were performed at 9, 11, 22, 26 and 32 weeks of gestation for transcerebellar diameter (TCD) measurement. Linear mixed models were estimated to investigate associations between periconceptional maternal dietary patterns and longitudinal TCD measurements as a function of gestational age. Results We performed a median of 4 scans per pregnancy, resulting in 570 total datasets. The success rate of TCD measurements was 87% (range 65–100%), depending on gestational age. The Mediterranean, Western, egg-rich and dairy-rich dietary patterns were extracted, explaining 37.2% of the overall variance of food intake in this population. The dairy-rich dietary pattern was positively associated with cerebellar growth trajectories (β = 0.02 (95% CI: 0.01; 0.03) √mm, p = 0.01). Maternal strong adherence to this dietary pattern increased TCD measurements by 0.8 standard deviation scores (SDs) compared to weak adherence, reflected in increased TCD estimates of 0.44 mm at 9 weeks (+6.8%), 0.88 mm at 22 weeks (+3.6%), and 1.17 mm at 32 weeks (+2.8%). No significant associations were detected for the Mediterranean, Western and egg-rich dietary patterns. Conclusions This study shows a positive association between periconceptional maternal adherence to a dairy-rich dietary pattern and human prenatal TCD measurements as a proxy of cerebellar growth. Next step is the investigation of the impact on neurodevelopmental outcomes in the offspring.
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Affiliation(s)
- Francesca Parisi
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Melek Rousian
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Irene V. Koning
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sten P. Willemsen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Biostatistics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Eric A. P. Steegers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Régine P. M. Steegers-Theunissen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- * E-mail:
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Kabagambe EK, Lipworth L, Labadie RF, Hood LJ, Francis DO. Erythrocyte folate, serum vitamin B12, and hearing loss in the 2003-2004 National Health And Nutrition Examination Survey (NHANES). Eur J Clin Nutr 2018; 72:720-727. [PMID: 29379142 PMCID: PMC5948125 DOI: 10.1038/s41430-018-0101-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 12/04/2017] [Accepted: 12/05/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVES Studies based on food frequency questionnaires suggest that folate and vitamin B12 intake could protect against hearing loss. We investigated whether erythrocyte folate and serum vitamin B12 levels are independently associated with hearing loss in humans. SUBJECTS/METHODS Participants in the 2003-2004 US National Health and Nutrition Examination Survey who had data on hearing, folate, and vitamin B12 levels were included. Pure-tone average (PTA) at 0.5, 1.0, 2.0, and 4.0 kHz was computed for each ear. We used weighted logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the relation between quartiles of folate and vitamin B12, and hearing loss (present if PTA > 25 dB in either ear and absent if PTA ≤ 25 dB in both ears). RESULTS Participants (n = 1149) were 20-69 (mean 42) years old and 16.4% had hearing loss in at least one ear. Our data suggest a U-shaped relationship between folate and hearing loss. Compared to the 1st quartile, the ORs (95% CIs) for hearing loss were 0.87 (0.49-1.53), 0.70 (0.49-1.00), and 1.08 (0.61-1.94) for the 2nd, 3rd, and 4th quartile of erythrocyte folate in analyses adjusted for age, sex, vitamin B12, smoking, alcohol use, body mass index, race/ethnicity, exposure to noise, income, and education. Although we observed inverse associations between vitamin B12 and hearing loss, the associations were not statistically significant (P > 0.05). CONCLUSIONS Our data show a U-shaped relationship between erythrocyte folate levels and hearing loss, suggesting a need to evaluate whether optimizing blood folate levels could prevent hearing loss.
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Affiliation(s)
- Edmond K Kabagambe
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Loren Lipworth
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Robert F Labadie
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Linda J Hood
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - David O Francis
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN, USA
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Vaes AMM, Tieland M, Toussaint N, Nilwik R, Verdijk LB, van Loon LJC, de Groot LCPGM. Cholecalciferol or 25-Hydroxycholecalciferol Supplementation Does Not Affect Muscle Strength and Physical Performance in Prefrail and Frail Older Adults. J Nutr 2018; 148:712-720. [PMID: 30053278 DOI: 10.1093/jn/nxy024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 01/30/2018] [Indexed: 01/06/2023] Open
Abstract
Background Vitamin D supplementation is proposed as a potential treatment strategy to counteract functional decline in older adults. However, data from randomized trials are either limited or inconsistent. Objective This study investigated the effect of daily supplementation with 25-hydroxycholecalciferol [25(OH)D3] or cholecalciferol (vitamin D3) on muscle strength and physical performance in older adults. Methods This was a randomized, double-blind, placebo-controlled trial of 6 mo including 78 prefrail or frail (according to the Fried criteria), community-dwelling older adults (n = 43 men) aged ≥65 y, with a baseline 25-hydroxyvitamin D [25(OH)D] concentration between 20 and 50 nmol/L. Participants were supplemented daily with 10 µg 25(OH)D3, 20 µg vitamin D3, or a placebo capsule. Serum 25(OH)D was measured by liquid chromatography-tandem mass spectrometry. The primary outcome was maximal isometric knee-extension strength (Biodex System 4); secondary outcomes included knee-flexion and hand grip strength, Short-Physical Performance Battery score, Timed Up and Go score, postural sway, muscle mass (dual-energy X-ray absorptiometry), and muscle fiber type and size. Results The mean baseline serum 25(OH)D concentration was 37.7 nmol/L (95% CI: 35.4, 39.9 nmol/L). After 6 mo of supplementation, concentrations increased to 98.7 nmol/L (95% CI: 93.1, 104.4 nmol/L) in the 25(OH)D3 group and to 72.0 nmol/L (95% CI: 66.1, 77.8 nmol/L) in the vitamin D3 group, compared with 47.5 nmol/L (95% CI: 41.8, 53.3 nmol/L) in the placebo group (P-interaction < 0.01). Knee-extension strength did not significantly change in the 25(OH)D3 group (5.9 Nm; 95% CI: -6.2, 18.0 Nm), in the vitamin D3 group (5.5 Nm; 95% CI: -6.8, 17.8 Nm), or in the placebo group (1.8 Nm; 95% CI: -10.7, 14.4 Nm) (P-interaction = 0.74). Furthermore, mean changes in physical performance tests, muscle mass, and muscle fiber type and size did not differ between the groups. Conclusion Increasing the serum 25(OH)D concentration over a period of 6 mo did not significantly change muscle strength and physical performance in prefrail and frail older adults. This trial was registered at www.clinicaltrials.gov as NCT02349282.
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Affiliation(s)
- Anouk M M Vaes
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Michael Tieland
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Nicole Toussaint
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Rachel Nilwik
- Department of Human Biology and Movement Sciences, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, Netherlands
| | - Lex B Verdijk
- Top Institute Food and Nutrition, Wageningen, Netherlands
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Early first trimester maternal 'high fish and olive oil and low meat' dietary pattern is associated with accelerated human embryonic development. Eur J Clin Nutr 2018; 72:1655-1662. [PMID: 29674630 DOI: 10.1038/s41430-018-0161-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/23/2018] [Accepted: 03/04/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVES Maternal dietary patterns were associated with embryonic growth and congenital anomalies. We aim to evaluate associations between early first trimester maternal dietary patterns and embryonic morphological development among pregnancies with non-malformed outcome. SUBJECTS/METHODS A total of 228 strictly dated, singleton pregnancies without congenital malformations were enrolled in a periconceptional hospital-based cohort. Principal component analysis was performed to extract early first trimester maternal dietary patterns from food frequency questionnaires. Serial transvaginal three-dimensional ultrasound (3D US) scans were performed between 6+0 and 10+2 gestational weeks and internal and external morphological criteria were used to define Carnegie stages in a virtual reality system. Associations between dietary patterns and Carnegie stages were investigated using linear mixed models. RESULTS A total of 726 3D US scans were included (median: three scans per pregnancy). The 'high fish and olive oil and low meat' dietary pattern was associated with accelerated embryonic development in the study population (β = 0.12 (95%CI: 0.00; 0.24), p < 0.05). Weak adherence to this dietary pattern delayed embryonic development by 2.1 days (95%CI: 1.6; 2.6) compared to strong adherence. The 'high vegetables, fruit and grain' dietary pattern accelerated embryonic development in the strictly dated spontaneous pregnancy subgroup without adjustment for energy intake. CONCLUSIONS Early first trimester maternal dietary patterns impacts human embryonic morphological development among pregnancies without congenital malformations. The clinical meaning of delayed embryonic development needs further investigation.
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Elffers TW, de Mutsert R, Lamb HJ, Maan AC, Macfarlane PW, Willems van Dijk K, Rosendaal FR, Jukema JW, Trompet S. Relation of Overall and Abdominal Adiposity With Electrocardiogram Parameters of Subclinical Cardiovascular Disease in Individuals Aged 45 to 65 Years (from the Netherlands Epidemiology of Obesity Study). Am J Cardiol 2018; 121:570-578. [PMID: 29310809 DOI: 10.1016/j.amjcard.2017.11.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 11/23/2017] [Accepted: 11/28/2017] [Indexed: 11/18/2022]
Abstract
Overall and abdominal obesity are well-established risk factors for cardiometabolic disease. However, associations of overall and abdominal adiposity with electrocardiographic (ECG) markers of subclinical cardiovascular disease (CVD) have not yet been fully elucidated. Therefore, we investigated these associations in a population without preexisting CVD. We performed cross-sectional analyses in the Netherlands Epidemiology of Obesity Study. Body mass index (BMI), total body fat, and waist circumference were assessed in all participants, and abdominal subcutaneous adipose tissue and visceral adipose tissue (by magnetic resonance imaging) were assessed in a random subgroup. ECG parameters were determined using 12-lead electrocardiograms. We performed linear regression analyses, adjusting for potential confounding factors and, when investigating abdominal adiposity, additionally for total body fat. After exclusion of participants with preexisting CVD (n = 654), 5,939 individuals (42% men) were analyzed, with a mean (SD) age of 55 (6) years and BMI of 26.3 (4.4) kg/m2. Measures of both overall and abdominal adiposity were associated with ECG parameters but none of these measures was more strongly associated than the others. For example, heart rate (beats/min) increased per SD higher BMI (2.2; 95% confidence interval 1.9,2.5), total body fat (2.9; 2.4,3.4), subcutaneous adipose tissue (2.3;1.7,2.9), waist circumference (2.1; 1.4,2.8), and visceral adipose tissue (1.7; 0.8,2.5). In subgroup analyses based on gender and cardiovascular risk factors, no consistent interactions were observed. In conclusion, in a middle-aged population without preexisting CVD, measures of both overall and abdominal adiposity were associated with ECG parameters. Future studies should evaluate the added value of adiposity measures in electrocardiography-based diagnoses and the prognostic value of adding adiposity measures to risk prediction tools.
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Affiliation(s)
- Theodora W Elffers
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Arie C Maan
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter W Macfarlane
- Institute of Health and Wellbeing, University of Glasgow, United Kingdom
| | - Ko Willems van Dijk
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands; Division Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Stella Trompet
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
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de Batlle J, Matejcic M, Chajes V, Moreno-Macias H, Amadou A, Slimani N, Cox DG, Clavel-Chapelon F, Fagherazzi G, Romieu I. Determinants of folate and vitamin B12 plasma levels in the French E3N-EPIC cohort. Eur J Nutr 2018; 57:751-760. [PMID: 28004270 DOI: 10.1007/s00394-016-1365-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 12/14/2016] [Indexed: 01/09/2023]
Abstract
PURPOSE Impaired B vitamin status has been identified as a risk factor for major chronic diseases. This study aims at examining the determinants of plasma folate and vitamin B12 concentrations, considering lifestyle factors and MTHFR polymorphisms. METHODS A total of 988 women aged 40-65 years from the French E3N cohort were investigated. Intakes of folate and vitamin B12 were assessed using food frequency questionnaires, and plasma concentrations were measured by microbiological assay. Dietary scores were computed to summarize folate and vitamin B12 dietary sources. MTHFR-C677T and MTHFR-A1298C were determined by Kaspar assay. Pearson's partial correlation coefficients and multivariable linear regression models were used to assess correlations between main determinants and plasma folate and vitamin B12 levels. RESULTS The partial correlation coefficient between dietary intakes and plasma folate was 0.19 (p value <0.001) and 0.08 (p value = 0.008) for vitamin B12. Dietary scores were the main determinant of B vitamin plasma concentrations with a percent change per unit increase of 12.64% (p value <0.001) for folate and 7.6% (p value <0.001) for vitamin B12. Homozygous (T/T) or heterozygous (C/T) women for MTHFR-C677T had lower plasma folate concentrations [C/T: -6.48% (p value = 0.038) and T/T: -15.89% (p value <0.001)] compared to women carrying the C/C genotype. Other determinants of B vitamin plasma concentration include: smoking status for folate, and age and hormone replacement therapy for vitamin B12. CONCLUSIONS We confirmed previous findings on the role of diet as main determinant of folate and vitamin B12 plasma concentrations. However, the impact of genetic polymorphisms and lifestyle factors on plasma B vitamin concentrations should not be neglected.
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Affiliation(s)
- Jordi de Batlle
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008, Lyon, France.
| | - Marco Matejcic
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008, Lyon, France
| | - Veronique Chajes
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008, Lyon, France
| | | | - Amina Amadou
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008, Lyon, France
| | - Nadia Slimani
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008, Lyon, France
| | - David G Cox
- INSERM U1052, Cancer Research Center of Lyon, Centre Léon Bérard, Lyon, France
| | - Françoise Clavel-Chapelon
- Team 9: Lifestyle, Genes and Health: Integrative Trans-generational Epidemiology, Center for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale (INSERM), U1018, Villejuif, France
- Université Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Guy Fagherazzi
- Team 9: Lifestyle, Genes and Health: Integrative Trans-generational Epidemiology, Center for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale (INSERM), U1018, Villejuif, France
- Université Paris-Sud, Villejuif, France
- Gustave Roussy Institute, Villejuif, France
| | - Isabelle Romieu
- International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69008, Lyon, France
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Głąbska D, Książek A, Guzek D. Development and Validation of the Brief Folate-Specific Food Frequency Questionnaire for Young Women's Diet Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1574. [PMID: 29240683 PMCID: PMC5750992 DOI: 10.3390/ijerph14121574] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 12/05/2017] [Accepted: 12/07/2017] [Indexed: 12/12/2022]
Abstract
The tools enabling brief assessment of folate intake may be of great value for public health purposes. The aim of the presented study was to design a brief folate-specific food frequency questionnaire for Central and Eastern European population of women, as well as to assess the validity and reproducibility of the designed Folate-Intake Calculation-Food Frequency Questionnaire (Fol-IC-FFQ) on a group of Polish women aged 20-30 years. Participants collected 3-day dietary records and completed the Fol-IC-FFQ twice (FFQ1: directly after the dietary record; and FFQ2: six weeks later). The analysis included an assessment of validity (comparison of the results of FFQ1 and 3-day dietary record) and of reproducibility (comparison of the results of FFQ1 and FFQ2). In assessment of validity, a Bland-Altman index of 5.3% was observed. In assessment of reproducibility, a Bland-Altman index of 2.7% was observed, the share of individuals classified into the same intake adequacy category was over 85%, the share of individuals classified into the same tertile was almost 75%, the weighted κ statistic indicated substantial agreement (0.67) and correlation was significant (p = 0.0000; R = 0.7995). Assessment of the Fol-IC-FFQ revealed a satisfactory level of validity and very good level of reproducibility in the population of young Polish women. The Fol-IC-FFQ may be considered a valid tool for the assessment of folate intake in young Polish women and a promising tool for the assessment of folate intake in young women in Central and Eastern Europe.
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Affiliation(s)
- Dominika Głąbska
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159c Nowoursynowska Street, 02-776 Warsaw, Poland.
| | - Aneta Książek
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159c Nowoursynowska Street, 02-776 Warsaw, Poland.
| | - Dominika Guzek
- Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159c Nowoursynowska Street, 02-776 Warsaw, Poland.
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Parisi F, Rousian M, Huijgen NA, Koning AHJ, Willemsen SP, de Vries JHM, Cetin I, Steegers EAP, Steegers-Theunissen RPM. Periconceptional maternal 'high fish and olive oil, low meat' dietary pattern is associated with increased embryonic growth: The Rotterdam Periconceptional Cohort (Predict) Study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 50:709-716. [PMID: 28078758 DOI: 10.1002/uog.17408] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 01/02/2017] [Accepted: 01/10/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To investigate the association between periconceptional maternal dietary pattern and first-trimester embryonic growth. METHODS This was a prospective cohort study of 228 women with a singleton ongoing pregnancy, of which 135 were strictly dated spontaneous pregnancies and 93 were pregnancies achieved after in-vitro fertilization or intracytoplasmatic sperm injection (IVF/ICSI). All women underwent serial transvaginal three-dimensional ultrasound (3D-US) examinations from 6 + 0 to 13 + 0 weeks' gestation. Crown-rump length (CRL) and embryonic volume (EV) measurements were performed using a virtual reality system. Information on periconceptional maternal dietary intake was collected via food frequency questionnaires. Principal component analysis was performed to identify dietary patterns. Associations between dietary patterns and CRL and EV trajectories were investigated using linear mixed models adjusted for potential confounders. RESULTS A median of five (range, one to seven) 3D-US scans per pregnancy were performed. Of 1162 datasets, quality was sufficient to perform CRL measurements in 991 (85.3%) and EV measurements in 899 (77.4%). A dietary pattern comprising high intake of fish and olive oil and a very low intake of meat was identified as beneficial for embryonic growth. In strictly dated spontaneous pregnancies, strong adherence to the 'high fish and olive oil, low meat' dietary pattern was associated with a 1.9 mm (95% CI, 0.1-3.63 mm) increase in CRL (+14.6%) at 7 weeks and a 3.4 mm (95% CI, 0.2-7.81 mm) increase (+6.9%) at 11 weeks, whereas EV increased by 0.06 cm3 (95% CI, 0.01-0.13 cm3 ) (+20.4%) at 7 weeks and 1.43 cm3 (95% CI, 0.99-1.87 cm3 ) (+14.4%) at 11 weeks. No significant association was observed in the total study population or in the IVF/ICSI subgroup. CONCLUSION Periconceptional maternal adherence to a high fish and olive oil, low meat dietary pattern is positively associated with embryonic growth in spontaneously conceived pregnancies. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- F Parisi
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - M Rousian
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - N A Huijgen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - A H J Koning
- Department of Bioinformatics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - S P Willemsen
- Department of Biostatistics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - J H M de Vries
- Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - I Cetin
- Center for Fetal Research Giorgio Pardi, Department of Biomedical and Clinical Sciences, Hospital Luigi Sacco, Università degli Studi di Milano, Milan, Italy
| | - E A P Steegers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - R P M Steegers-Theunissen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
- Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
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IJpma I, Renken RJ, Gietema JA, Slart RH, Mensink MG, Lefrandt JD, Ter Horst GJ, Reyners AK. Changes in taste and smell function, dietary intake, food preference, and body composition in testicular cancer patients treated with cisplatin-based chemotherapy. Clin Nutr 2017; 36:1642-1648. [DOI: 10.1016/j.clnu.2016.10.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/28/2016] [Accepted: 10/13/2016] [Indexed: 10/20/2022]
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45
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Brouwer JG, Makama M, van Woudenbergh GJ, Vasen HF, Nagengast FM, Kleibeuker JH, Kampman E, van Duijnhoven FJ. Inflammatory potential of the diet and colorectal tumor risk in persons with Lynch syndrome. Am J Clin Nutr 2017; 106:1287-1294. [PMID: 28931533 DOI: 10.3945/ajcn.117.152900] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 08/28/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Persons with Lynch syndrome (LS) have high lifetime risk of developing colorectal tumors (CRTs) because of a germline mutation in one of their mismatch repair (MMR) genes. An important process in the development of CRTs is inflammation, which has been shown to be modulated by diet.Objective: We aimed to investigate the association between the inflammatory potential of the diet and the risk of CRTs in persons with LS.Design: We used the dietary intake of 457 persons with LS from a prospective cohort study to calculate the adapted dietary inflammatory index (ADII). The ADII was split into tertiles in which the highest tertile reflects the most proinflammatory potential of the diet. Cox proportional hazard models, with robust sandwich variance estimates to adjust for dependency within families, were used to calculate HRs and 95% CIs of CRTs by ADII tertile. HRs were adjusted for age, smoking status, and education level, and number of colonoscopies as a time-dependent variable. A potential effect measure modification was explored by stratifying the results by mutated MMR gene, sex, and a history of CRTs. We performed sensitivity analyses by repeating the analyses in non-nonsteroidal anti-inflammatory drug (NSAID) users (n = 315).Results: During a median follow-up time of 59 mo, 200 participants (43.8%) developed CRTs. No significant association was shown between highest compared with lowest ADII tertiles (HR for highest compared with lowest tertiles: 1.37; 95% CI: 0.80, 2.34). Stratification by mutated MMR gene, sex, and CRT history did not show significantly differential associations (P-interactions ≥ 0.64). In non-NSAID users, an HR of 1.60 (95% CI: 0.88, 2.93) for highest compared with lowest tertiles was shown. No significant effect modification was shown in this group either (P-interactions ≥ 0.24).Conclusion: A proinflammatory potential of the diet does not seem to be significantly associated with CRT risk in persons with LS.
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Affiliation(s)
- Jesca Gm Brouwer
- Division of Human Nutrition, Wageningen University & Research, Wageningen, Netherlands
| | - Maureen Makama
- Division of Human Nutrition, Wageningen University & Research, Wageningen, Netherlands
| | - Geertruida J van Woudenbergh
- Division of Human Nutrition, Wageningen University & Research, Wageningen, Netherlands.,Christelijke Hogeschool, Ede, Netherlands
| | - Hans Fa Vasen
- Netherlands Foundation for the Detection of Hereditary Tumors, Leiden, Netherlands
| | - Fokko M Nagengast
- Department of Gastroenterology, Radboud University Medical Center, Nijmegen, Netherlands; and
| | - Jan H Kleibeuker
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Ellen Kampman
- Division of Human Nutrition, Wageningen University & Research, Wageningen, Netherlands
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Body fat distribution, in particular visceral fat, is associated with cardiometabolic risk factors in obese women. PLoS One 2017; 12:e0185403. [PMID: 28957363 PMCID: PMC5619737 DOI: 10.1371/journal.pone.0185403] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 09/12/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Body fat distribution is, next to overall obesity, an important risk factor for cardiometabolic outcomes in the general population. In particular, visceral adipose tissue (VAT) is strongly associated with cardiometabolic risk factors. Since it is unclear whether body fat distribution is also important in men and women with obesity we investigated the associations between measures of body fat distribution and cardiometabolic risk factors in men and women with obesity. METHODS In this cross-sectional analysis of obese men and women (BMI≥30 kg/m2) included in the Netherlands Epidemiology of Obesity Study, waist:hip ratio(WHR), waist circumference, and MRI-based abdominal subcutaneous adipose tissue (aSAT) and VAT were determined. Associations between measures of body fat distribution and presence of ≥1 risk factor, such as hypertension or hypertriglyceridemia, were examined using logistic regression analyses; stratified by sex and adjusted for age, ethnicity, education, tobacco smoking, alcohol consumption, physical activity and depending on the association additionally for total body fat or VAT. RESULTS We included 2,983 obese individuals (57% women) with a mean age of 56 and standard deviation (SD) of 6 and mean BMI of 34.0 kg/m2 (4.0), after exclusion of individuals with missing values of cardiometabolic risk factors (n = 33). 241 individuals were obese without other cardiometabolic risk factors. In obese women, all measures of body fat distribution except aSAT (OR per SD:0.76, 95%CI: 0.53, 1.10) were associated with having ≥1 cardiometabolic risk factor, of which VAT most strongly associated (5.77; 3.02, 11.01). In obese men, associations of body fat distribution and the presence of cardiometabolic risk factors were attenuated. (e.g. VAT:1.42; 0.84, 2.41). CONCLUSIONS In obese women, but less so in men, measures of body fat distribution, of which VAT most strongly, are associated with cardiometabolic risk factors.
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Galesloot TE, Vermeulen SH, Swinkels DW, de Vegt F, Franke B, den Heijer M, de Graaf J, Verbeek ALM, Kiemeney LALM. Cohort Profile: The Nijmegen Biomedical Study (NBS). Int J Epidemiol 2017; 46:1099-1100j. [PMID: 28082374 PMCID: PMC5837647 DOI: 10.1093/ije/dyw268] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2016] [Indexed: 01/23/2023] Open
Affiliation(s)
- Tessel E Galesloot
- Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Sita H Vermeulen
- Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Dorine W Swinkels
- Radboud university medical center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - F de Vegt
- Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - B Franke
- Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Departments of Human Genetics and Psychiatry, Nijmegen, The Netherlands
| | - M den Heijer
- Department of Internal Medicine, VU Medical Centre, Amsterdam, The Netherlands
| | - J de Graaf
- Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - André LM Verbeek
- Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Lambertus ALM Kiemeney
- Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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da Silva DCG, Segheto W, de Lima MFC, Pessoa MC, Pelúzio MCG, Marchioni DML, Cunha DB, Longo GZ. Using the method of triads in the validation of a food frequency questionnaire to assess the consumption of fatty acids in adults. J Hum Nutr Diet 2017; 31:85-95. [DOI: 10.1111/jhn.12497] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- D. C. G. da Silva
- Department of Nutrition and Health; Federal University of Viçosa; Viçosa Brazil
| | - W. Segheto
- Department of Nutrition and Health; Federal University of Viçosa; Viçosa Brazil
| | - M. F. C. de Lima
- Department of Nutrition and Health; Federal University of Viçosa; Viçosa Brazil
| | - M. C. Pessoa
- Nursing Department; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - M. C. G. Pelúzio
- Department of Nutrition and Health; Federal University of Viçosa; Viçosa Brazil
| | - D. M. L. Marchioni
- Nutrition Department; School of Public Health; University of São Paulo; São Paulo Brazil
| | - D. B. Cunha
- Department of Epidemiology; University of the State Rio de Janeiro; Rio de Janeiro Brazil
| | - G. Z. Longo
- Department of Nutrition and Health; Federal University of Viçosa; Viçosa Brazil
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Bonten TN, de Mutsert R, Rosendaal FR, Jukema JW, van der Bom JG, de Jongh RT, den Heijer M. Chronic use of low-dose aspirin is not associated with lower bone mineral density in the general population. Int J Cardiol 2017; 244:298-302. [PMID: 28673738 DOI: 10.1016/j.ijcard.2017.06.089] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/01/2017] [Accepted: 06/22/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Low-dose aspirin is the cornerstone of secondary prevention of cardiovascular disease. Previous studies suggested that the use of aspirin is associated with an increased fracture risk. However, there is uncertainty whether this is due to an effect of aspirin on bone mineral density (BMD). METHODS Between 2008 and 2012, information on medication use and dual X-ray absorptiometry measured vertebral and femoral BMD of 916 participants was collected in the Netherland Epidemiology of Obesity study. The cross-sectional association between chronic low-dose aspirin use and BMD was estimated using linear regression, controlling for demography, body composition, comorbidity and other medication use which could affect BMD. A subgroup analysis in postmenopausal women (n=329) was conducted. RESULTS After full adjustment, there was no difference between aspirin users and non-users for vertebral BMD (adjusted mean difference: 0.036 (95% CI -0.027 to 0.100) g/cm2) and femoral BMD (adjusted mean difference: 0.001 (-0.067 to 0.069) g/cm2). Also in the subgroup of postmenopausal women, aspirin use was not associated with lower vertebral (adjusted mean difference: 0.069 (-0.046 to 0.184) g/cm2) or femoral BMD (adjusted mean difference: -0.055 (-0.139;0.029) g/cm2). CONCLUSION Chronic use of low-dose aspirin is not associated with lower BMD in the general population. The increased risk of fractures observed in aspirin users in previous studies is therefore more likely to be the result of common causes of aspirin use and fractures, but not of direct effects of aspirin on BMD.
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Affiliation(s)
- T N Bonten
- Department of Public Health & Primary Care, Leiden University Medical Center, Leiden, The Netherlands; Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands.
| | - R de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, The Netherlands
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, The Netherlands
| | - J W Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - J G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, The Netherlands; JJ van Rood Center for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands
| | - R T de Jongh
- Department of Internal Medicine, VU Medical Center, Amsterdam, The Netherlands
| | - M den Heijer
- Department of Clinical Epidemiology, Leiden University Medical Center, The Netherlands; Department of Internal Medicine, VU Medical Center, Amsterdam, The Netherlands
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Oostingh EC, Steegers-Theunissen RP, de Vries JH, Laven JS, Koster MP. Strong adherence to a healthy dietary pattern is associated with better semen quality, especially in men with poor semen quality. Fertil Steril 2017; 107:916-923.e2. [DOI: 10.1016/j.fertnstert.2017.02.103] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 02/10/2017] [Accepted: 02/11/2017] [Indexed: 01/24/2023]
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