Total and added sugar intakes, sugar types, and cancer risk: results from the prospective NutriNet-Santé cohort

Association of tea consumption with all-cause/cardiovascular disease mortality in the chronic kidney disease population: an assessment of participation in the national cohort

BACKGROUND

While there are numerous benefits to tea consumption, its long-term impact on patients with chronic kidney disease (CKD) remains unclear.

METHOD

Our analysis included 17,575 individuals with CKD from an initial 45,019 participants in the National Health and Nutrition Examination Survey (NHANES) (1999-2018). Individuals with extreme dietary habits, pregnancy, or non-CKD conditions were excluded. Key cohort demographics revealed a mean age of 62.3 years, with 52.1% female participants, and 57.3% identified as non-Hispanic White. A total of 5,835 deaths were recorded during follow-up, including 1,823 cardiovascular-related deaths. Cox and restricted cubic spline regression was used to examine the linear or nonlinear association of tea consumption with mortality. The substitution analysis explored the effects of replacing a specific type of tea with another type of tea. Subgroup analysis stratified by sex, age, body mass index (BMI), diabetes, cancer, cardiovascular disease (CVD), and urinary albumin. Sensitivity analysis was performed to ensure the reliability of our findings.

RESULTS

After adjusting for age, sex, race, education level, marital, annual household income, energy intake, total water intake, protein intake, carbohydrate intake, dietary fiber, sugar beverages, milk whole, total monounsaturated fatty acids, total polyunsaturated fatty acids, total saturated fatty acids, smoking, metabolic equivalent of task for physical activity level (MET-PA), BMI, diabetes, hypertension, urinary albumin, estimated glomerular filtration rate (eGFR), CVD, cancer, serum sodium, serum potassium, and serum phosphorus, setting the individuals without tea consumption record as reference. Consuming up to 4 cups of tea per day was significantly associated with lower all-cause mortality compared with that never drinking tea, among CKD patients at 1-2 stages [Hazard Ratio (HR) = 0.89; 95% Confidence Interval (CI) = 0.79, 0.99; p = 0.04], while the association between tea consumption and CVD mortality didn't reach statistical significance. Dose-response effect was observed, showing that consuming up to three to five cups of tea per day was associated with mitigated risks of all-cause mortality, particularly in early CKD stages (non-linear p > 0.05). A 1 cup per day higher intake of oxidized tea was associated with a 10% lower risk of all-cause mortality in CKD stage 1-2 [HR = 0.90; 95%CI = 0.82, 0.99; p = 0.03]. Replacing 1 cup of green tea with 1 cup of oxidized tea per day was associated with an 8% and 11% lower risk of all-cause mortality [HR = 0.92; 95%CI = 0.86, 0.98; p = 0.01] and CVD mortality [HR = 0.89; 95%CI = 0.80, 1.00; p < 0.05], respectively, in individuals with CKD stages 1-2.

CONCLUSION

Tea consumption showed protective effects on all-cause mortality in CKD population, with potential benefits observed in terms of both the cups quantity and types of tea consumed. These findings appeared to be more prominent among early stages CKD population.

Association between myopia and refined carbohydrate consumption: A cross-sectional study from the Constances cohort

BACKGROUND & AIMS

The effects of refined carbohydrate consumption on the prevalence of myopia have been little studied. The aim of this study is to explore the potential link between this consumption and myopia in individuals aged 40 or under in the population-based Constances cohort, in conjunction with other known risk and confounding factors.

METHODS

The association between the probability of myopia in at least one eye and refined carbohydrate consumption was tested for 5271 participants, aged 40 or younger, in conjunction with education level, physical activity, energy intake, age, sex, fasting blood glucose, Body Mass Index (BMI), and Mediterranean diet quality. Refined carbohydrate intake was estimated by glycemic load. Myopia was assessed by the Monoyer score. Significant sex interactions led to stratified analysis by sex.

RESULTS

The risk of myopia was significantly increased for men with refined carbohydrate consumption (p = 0.012, Odd Ratio (OR) = 1.12, Confidence Interval (CI) = 1.02-1.22) but not for women (p = 0.657, OR = 1.02, CI = 0.94-1.10). Some previously identified myopia risk factors were concurrently observed: a higher level of education increased the probability of myopia in both sexes (men p < 10-11, OR = 1.36, CI = 1.24-1.49; women p = < 10-4, OR = 1.19, CI = 1.09-1.28), while a higher level of physical activity might be protective in men (p = 0.08, OR = 0.93, CI = 0.85-1.01).

CONCLUSION

This research reveals how high refined carbohydrate consumption might influence myopia and confirms recent studies on its risk factors. It also highlights significant sex differences in the prevalence and factors associated with myopia, emphasizing that modifiable risk factors, crucial for public health initiatives, may vary between men and women.

Risk Factors and Prevention of Cancer and CVDs: A Chicken and Egg Situation

Cardiovascular diseases and cancer are the two primary causes of mortality worldwide. Although traditionally regarded as distinct pathologies, they share numerous pathophysiological mechanisms and risk factors, including chronic inflammation, insulin resistance, obesity, and metabolic dysregulation. Notably, several cancers have been identified as closely linked to cardiovascular diseases, including lung, breast, prostate, and colorectal cancers, as well as hematological malignancies, such as leukemia and lymphoma. Additionally, renal and pancreatic cancers exhibit a significant association with cardiovascular complications, partly due to shared risk factors and the cardiotoxic effects of cancer therapies. Addressing the overlapping risk factors through lifestyle modifications-such as regular physical activity, a balanced diet, and cessation of smoking and alcohol-has proven effective in reducing both CV and oncological morbidity and mortality. Furthermore, even in patients with established cancer, structured interventions targeting physical activity, nutritional optimization, and smoking cessation have been associated with improved outcomes. Beyond lifestyle modifications, pharmacological strategies play a crucial role in the prevention of both diseases. Several cardiovascular medications, including statins, aspirin, beta-blockers, and metformin, exhibit pleiotropic effects that extend beyond their primary indications, demonstrating potential anti-neoplastic properties in preclinical and observational studies. Recently, novel therapeutic agents have garnered attention for their possible cardioprotective and metabolic benefits. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is), initially developed for managing type 2 diabetes, have shown CV and renal protective effects, alongside emerging evidence of their role in modulating cancer-related metabolic pathways. Inclisiran, a small interfering RNA targeting PCSK9, effectively lowers LDL cholesterol and may contribute to reducing CV risk, with potential implications for tumor biology. Additionally, sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor, has revolutionized heart failure management by improving hemodynamic parameters and exerting anti-inflammatory effects that may have broader implications for chronic disease prevention. Given the intricate interplay between CVD and cancer, further research is essential to clarify the exact mechanisms linking these conditions and assessing the potential of CV therapies in cancer prevention. This review aims to examine shared risk factors, consider the role of pharmacological and lifestyle interventions, and emphasize crucial epidemiological and mechanistic insights into the intersection of CV and oncological health.

Healthy nutrition in primary care: instrument on the knowledge, perception, and sugary product consumption in the adult population

Introduction

Introduction: it is necessary to develop an instrument that enables identifying unhealthy eating habits, and to know those erroneous concepts that the adult population may have in relation to sugary products to be able to design and implement appropriate nutritional education strategies for this population sector. Aim: to perform the content validation of a questionnaire to determine the level of knowledge, perception, and habits of sugary product consumption in the adult population through expert judgement. Methods: it is a content and psychometric validation study, carried out between September and October of the last year, in which 13 experts participated, who assessed each one of the instrument's items. Fleiss' kappa coefficient was used with the aim of measuring the degree of agreement. A pre-test was performed with 237 participants to measure the degree of comprehensibility of the instrument. Results: the strength of agreement reached for the dimensions of knowledge and opinion regarding sugary product consumption was almost perfect, and substantial for behaviour with respect to said products. The strength of agreement fluctuated between moderate and almost perfect for each pair of experts. The characteristics of sufficiency and relevance obtained the highest scores using Fleiss' according to the degree of overall agreement between experts. The new version of the questionnaire achieved a high degree of comprehensibility. Conclusions: the results suggest that the instrument is valid and can be applied in future studies to evaluate knowledge, perceptions and habits about sugary products in the adult population, thus contributing to the prevention of chronic diseases and the promotion of a better quality of life.

Dietary Glycemic Index, Glycemic Load, Sugar, and Fiber Intake in Association With Breast Cancer Risk: An Updated Meta-analysis

CONTEXT

Several prospective cohort studies have investigated the association between glycemic index (GI), glycemic load (GL), dietary sugar, and total dietary fiber intake, with female breast cancer (BC) risk and reported inconsistent results. In the last decade, several large epidemiological studies have investigated these associations, suggesting the need to revisit the current body of evidence.

OBJECTIVE

The aim of this study was to update a systematic review and meta-analysis conducted by Schlesinger et al in 2017 using recent scientific evidence published since 2015.

DATA SOURCES

Publications indexed in PubMed, Embase, and The Cochrane Library were retrieved from the inception of the database up to January 2024.

DATA EXTRACTION

Two reviewers independently extracted data and assessed each study's quality.

DATA ANALYSIS

A random-effects model was used to estimate summary risk ratios (RRs) and 95% CIs for a meta-analysis that included 33 publications, with 26 prospective cohort studies cumulatively enrolling 2 212 645 women, among whom 79 777 were diagnosed with incident BC.

RESULTS

Dietary GI and GL (highest vs lowest exposure intake) were both associated with 5% higher BC risk-RR (95% CI): 1.05 (1.01-1.09; P = .007) and 1.05 (0.97-1.13; P = .24), respectively. No clear associations were observed for sugar and total dietary fiber intake (highest vs lowest exposure intake)-RR (95% CI): 1.12 (0.95-1.11; P = .16) and 0.93 (0.86-1.00; P = .05), respectively. For the latter, the association was more pronounced among premenopausal women (RR: 0.78; 95% CI: 0.68-0.90; P = .0008).

CONCLUSION

This meta-analysis supports a significant positive association between high dietary GI intake and higher risk of BC and a significant inverse association between high dietary fiber intake and lower risk of BC. Interventions promoting a high-fiber and low-sugar diet may be useful components of BC-prevention strategies.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42023463143.

Association between the Chinese Dietary Balance Index-based dietary quality and depressive symptoms in breast cancer patients

PURPOSE

This cross-sectional study explored the association between dietary quality and the risk of depressive symptoms in breast cancer patients.

METHODS

Dietary intake was assessed by 3-day, 24-h dietary recall, followed by dietary quality evaluation by the Chinese Dietary Balance Index-16 (DBI-16). Depressive symptoms were assessed by Center for Epidemiologic Studies Depression Scale (CES-D).

RESULTS

A total of 160 breast cancer patients with a mean age of 53.07 ± 9.50 years were recruited. Fifty of these patients had a CES-D score higher than 16 and were defined as depressed. Compared with non-depressed patients, depressed patients had significantly inadequate fruit intake (P = 0.002). A higher proportion of depressed patients had moderately inadequate dietary intake (lower bound scores, LBS, between 25 ~ 36) compared with non-depressed patients (14.0% vs. 0.9%), and there was a significant difference in the distribution of inadequate intake levels between the two groups (P = 0.003). The depressed patients also had a significantly lower diet variety (P = 0.009). Logistic regression analysis showed that after controlling for age, menopausal status, and employment, LBS was positively associated with depressive symptoms (OR = 1.086; 95% CI 1.005-1.174; P = 0.036), whereas the fruit score (OR = 0.674; 95% CI 0.522-0.871; P = 0.003) and diet variety score (OR = 0.637; 95% CI 0.462-0.878; P = 0.006) were both negatively associated.

CONCLUSION

Diet might be one of the determinants of depressive symptoms in breast cancer patients. A balanced diet with more fruits, increased diet variety, and adequate nutrients might be a promising strategy to prevent or treat depressive symptoms in breast cancer patients.

How Do the Indices based on the EAT-Lancet Recommendations Measure Adherence to Healthy and Sustainable Diets? A Comparison of Measurement Performance in Adults from a French National Survey

Background

Measuring adherence to EAT-Lancet recommendations for healthy and sustainable diets is challenging, leading to diverse methods and a lack of consensus on standardized metrics. Available indices vary mainly in scoring systems, food components, units, energy adjustments, and cut-off points.

Objectives

To evaluate and compare the measurement performance of 9 dietary indices for assessing adherence to EAT-Lancet reference diet.

Methods

This cross-sectional study utilized repeated 24-h dietary recall data from 1723 adults in the French Third Individual and National Study on Food Consumption Survey (INCA3, 2014-2015). Sociodemographic, nutritional, and environmental variables were analyzed to assess the validity and reliability of dietary indices.

Results

The 4 indices assessing their food components with proportional scoring captured dietary variability, were less dependent on energy intake and converged to a large extent with nutritional indicators. Although the 3 binary indices showed a stronger correlation with environmental indicators, 1 proportional index converged with both domains. Indices had valid unidimensional structures, meaning that the combination of food components within each index accurately reflected the same construct, supporting the use of total scores. Furthermore, the indices differed between sociodemographic groups, demonstrating concurrent-criterion validity. Higher scores were associated with higher nutritional quality and lower environmental impact, but with unfavorable results for zinc intake, vitamin B12, and water use. A low concordance rate (32%-43%) indicated that indices categorized individuals differently.

Conclusions

Researchers must align study objectives with the applicability, assumptions, and significance of chosen indices. Indices using proportional scoring allow a global understanding of dietary health and sustainability, being advantageous in precision-focused research (for example, clinical trials or epidemiological research). Conversely, indices based on binary scoring offer a simplified perspective, serving as valuable tools for surveys, observational studies, and public health. Recognizing their strengths and limitations is crucial for a comprehensive assessment of diets and their implications.

The role of dietary sugars in cancer risk: A comprehensive review of current evidence

GOAL OF THE REVIEW

The objective of this review is to conduct a thorough examination of the current evidence regarding the correlation between dietary sugar intake and cancer risk. This will encompass the biological mechanisms, the diverse effects of various sugar types, and the potential implications for cancer treatment and dietary recommendations.

INTRODUCTION

Nutritional and epidemiological studies now focus much on the relationship between sugar intake and cancer. The data is still conflicting even if some studies imply that excessive sugar intake can help cancer develop by means of insulin resistance and chronic inflammation.

DISCUSSION

Through processes such as insulin resistance, inflammation, and angiogenesis, dietary sugars can impact carcinogenesis. Fructose increases angiogenesis by VEGF overexpression while glucose stimulates cancer cell growth by the Warburg effect. Contradicting data on the contribution of sugar to cancer emphasizes the need of consistent research techniques to simplify these dynamics. Reducing added sugar consumption in cancer prevention and management is especially crucial given that sugar affects immune function and treatment resistance, which could lead to new therapeutic targets.

CONCLUSION

High sugar intake is linked to mechanisms such as the Warburg effect, insulin resistance, and chronic inflammation, which may contribute to cancer risk under specific conditions. However, the evidence is not universally conclusive, and additional large-scale, long-term research are required to better understand these processes. To help in cancer prevention and management, public health guidelines should emphasize reducing added sugar consumption and promoting a balanced diet rich in natural foods.

Recent advances in the role of high-salt diet in anti- and pro-cancer progression

Dietary behaviors significantly influence tumor progression, with increasing focus on high-salt diets (HSD) in recent years. Traditionally, HSD has been regarded as a major risk factor for multiple health issues, including hypertension, cardiovascular disease, kidney disease, cancer, and osteoporosis. However, recent studies have uncovered a novel aspect of HSD, suggesting that HSD may inhibit tumor growth in specific pathological conditions by modulating the activity of immune cells that infiltrate tumors and enhancing the effectiveness of PD-1 immunotherapy. This review focused on the duel molecular mechanisms of HSD in cancer development, which are based on the tumor microenvironment, the gut microbiota, and the involvement of sodium transporter channels. The objective of this review is to explore whether HSD could be a potential future oncological therapeutic strategy under specific situation.

The Longitudinal Effect of Sugar-Sweetened Beverage Consumption and Risk of All-Cause and Cause-Specific Mortality in Korean Adults: Results From the Health Examinees Study

OBJECTIVE

High consumption of sugar-sweetened beverages (SSBs) is associated with an increased risk of all-cause and cardiovascular disease (CVD) mortality; however, the data and results for Asian populations, particularly in Korea, are limited and unclear. Therefore, this research aimed to investigate the association between types of SSB consumption and risk of all-cause and cause-specific mortality in South Korean adults.

METHODS

This prospective study included Korean adults aged 40 to 79 who participated in the Health Examinees Study. The baseline survey was conducted from 2004 to 2013, and death data were obtained until December 2022. A food frequency questionnaire was used to assess SSB intake, and all-cause, CVD, and cancer mortality were estimated. The SSB included total SSB, soda, and other drinks (Korean traditional SSB).

RESULTS

A total of 126,856 participants were included (mean [standard deviation]: age, 53.1 [8.3] years; 82,311 [64.9%] women). During a mean follow-up of 11.0 years, 5741 all-cause, 936 CVD, and 2662 cancer deaths were recorded. Increased soda consumption was associated with higher all-cause mortality (1-3 servings/wk: hazard ratio [HR], 1.125; 95% confidence interval [CI], 1.003-2.263; ≥3 servings/wk: HR, 1.190, 95% CI, 1.011-1.401), compared with low soda intake (never-<1 serving/wk). However, there was no association between total SSB consumption and other drinks with all-cause and cause-specific mortality. In the dose-response analysis, a trend in which a higher risk of all-cause and CVD cancers was observed with increasing soda intake.

CONCLUSION

In this large prospective study, soda intake of >1 serving/wk was associated with an increased risk of all-cause mortality among Korean adults. However, there was no association between total SSB or other drinks and mortality. As the consumption of SSBs increases in the Korean population, appropriate control strategies are needed to reduce SSB consumption and the disease burden.

Atherosclerotic Cardiovascular Disease in Cancer Survivors: Current Evidence, Risk Prediction, Prevention, and Management

While advances in cancer treatment have led to improved survival rates, cancer survivors are at a significant risk of developing atherosclerotic cardiovascular disease (ASCVD). This review examines the risk, diagnosis, and prevention of ASCVD in this population. Cancer survivors, especially those diagnosed with certain types, face a significantly higher risk of developing ASCVD than the general population. We introduce the "triad model" to explain this increased risk of ASCVD among cancer patients. This model includes three interconnected components: common catalysts, cancer influence, and treatment impact. The factors contributing to this model are the shared risk factors between cancer and ASCVD, such as smoking, obesity, and systemic inflammation; the direct effects of cancer on cardiovascular health through chronic systemic inflammation and endothelial damage; and the significant effects of anticancer treatments, including chemotherapy and radiation, which can worsen cardiovascular complications and hasten the progression of ASCVD. Furthermore, cancer survivors are at a higher risk of developing and dying from ASCVD, highlighting the necessity for tailored guidelines and strategies for ASCVD prevention and management in this population. The review explores the utility of diagnostic tools, such as coronary artery calcium scoring, in predicting and managing ASCVD risk. It also emphasizes the importance of prevention strategies that include regular cardiovascular monitoring and lifestyle modifications. Finally, the relationship between cancer survival and cardiovascular health highlights the importance of integrated and comprehensive care approaches. Continued research, the development of prediction models, and specific preventative strategies are essential to improve cancer survivors' overall health outcomes.

Free sugars in the Canadian diet: a research summary and future directions for food policy

Until recently, most dietary guidelines and related food policies in Canada focused on total sugars, but recent evidence suggests that free sugars are of greater public health concern. Starting in 2017, our research group received federal funding to fill critical gaps related to free sugars and health. In this commentary, we describe our work related to tracking free sugars in the Canadian food supply and simulating the diet and health impacts of product reformulation. We then summarize how our work has influenced policymaking in Canada with examples of our knowledge translation efforts, and provide a future research and policy agenda based on our findings. Overall, there is significant room for Canadian food policies to target free sugars reductions in food and diets to address overconsumption of this nutrient of public health concern.

Dietary Nutrient Adequacy in Aeronautical Military Personnel in Spain: Strengths and Weaknesses

BACKGROUND/OBJECTIVES

Aeronautical military personnel operate under intense physical and mental stress, requiring high psychophysical aptitude. Adequate nutrition is essential to sustain operational readiness and mitigate the risk of chronic diseases and other health issues. This study aims to evaluate the nutritional status of aeronautical military personnel group in Spain through dietary parameters.

METHODS

A total of 390 male aeronautical military personnel, who attended the Centro de Instrucción de Medicina Aeroespacial (Madrid, Spain), were evaluated. Energy and nutrient intakes were estimated by three non-consecutive 24-h dietary recalls (DIAL® program).

RESULTS

The median energy intake was 2134 kcal/day, with significant variations across professional groups, highest in parachutists (2347 kcal/day). Protein intake was 18.2% TE, while carbohydrate intake was 37.6% TE, below standards, with 83.8% of participants not meeting the EFSA guidelines. However, a high intake of added sugars was observed (10% TE). Fat intake (38.3% TE) and saturated fats (11.7% TE) exceeded recommendations. Micronutrient deficiencies were notable for vitamin D (98% below recommendations), folate (56.4%), vitamin C (40.2%), calcium (50.3%), iodine (76.6%), and zinc (59%). Elevated cholesterol intake (352 mg/day) and inadequate fiber intake (18.5 g/day) were also observed.

CONCLUSIONS

This study highlights imbalanced dietary patterns among Spanish aeronautical military personnel, with high protein, fat, cholesterol and added sugar consumption, low carbohydrate, and inadequate intake of critical micronutrients and fiber. These findings emphasize the need for targeted dietary interventions, nutritional monitoring protocols, and specific guidelines to enhance health and performance in this specialized group.

Exploring the link between dietary patterns and gastric adenocarcinoma in Brazil: a mediation analysis

BACKGROUND

The causal pathway between different dietary patterns (DPs) and gastric adenocarcinoma (GA) remains largely unexplored. The study aimed to identify DPs and evaluate how selected nutrients mediate the relationship between DPs and GA.

METHODS

This multicenter case-control study in Brazil involved 1751 participants (600 cases, 377 endoscopic controls, and 774 hospital controls). DPs were identified through exploratory factor analysis. A counterfactual-based mediation analysis was performed to decompose the total effect of DPs on GA into direct and indirect effects mediated by saturated fatty acids, added sugars, total fiber, and sodium intakes. Effects were expressed as ORs and 95% CIs.

RESULTS

Two DPs were identified-"unhealthy dietary pattern" (UDP) and "healthy dietary pattern" (HDP), which were associated with an increased and decreased risk of GA, respectively. Added sugars partly mediated the association between UDP and GA (percentage mediated between 7.3 and 21.7%), while sodium intake mediated most of the association between HDP and GA (percentage mediated between 52.4 and 100%). No significant mediating effects were detected for saturated fatty acids and total fiber.

CONCLUSIONS

This study contributes innovative insights into the DPs-GA relationships, highlighting the significant mediating roles of sodium and added sugars, offering valuable information for preventive strategies and public health interventions targeting GA.

Added sugars and risk of osteoarthritis in adults: A case-control study based on National Health and Nutrition Examination Survey 2007-2018

OBJECTIVE

Added sugars have been associated with a variety of adverse health consequences, but their relationship with osteoarthritis is unclear. This study aimed to demonstrate the association between added sugars and osteoarthritis.

METHODS

We used the National Health and Nutrition Examination Survey (NHANES) database from 2007 to 2018 to explore the association between added sugars and osteoarthritis.

RESULTS

In our study, 2,746 adults were included. The average age of the chosen participants was 43.77 years, with 52.33% males and 47.67% females. There were 2,152 in the osteoarthritis group and 594 in the non-osteoarthritis group, weighted to represent 11,854,966 participants. In the fully adjusted multivariable model 3, added sugars were found as a risk factor for osteoarthritis (OR = 1.01; 95% CI 1.00 to 1.01), with populations in the fourth quartile having a greater prevalence of osteoarthritis (OR = 1.40; 95% CI 1.09 to 1.81). When added sugars were treated as a continuous variable in subgroup analysis, the results indicated that never consumed alcohol (OR = 1.02; 95% CI 1.01 to 1.04) and no history of diabetes (OR = 1.02; 95% CI 1.01 to 1.04)were more Likely tend to osteoarthritis. When added sugars were treated as a categorical variable in subgroup analysis, the results indicated that compared to the first group, in the fourth quartile population, females (OR = 1.44; 95% CI 1.02 to 2.02), low BMI (OR = 1.88; 95% CI 1.06 to 3.33), never smoking (OR = 1.55; 95% CI 1.05 to 2.30), never consumed alcohol (OR = 3.31; 95% CI 1.42 to 7.74), no history of hypertension (OR = 1.51; 95% CI 1.00 to 2.27), and no history of diabetes (OR = 1.44; 95% CI 1.11 to 1.87) were more likely tend to osteoarthritis.

CONCLUSION

Added sugars are a risk factor for osteoarthritis, especially in females, low BMI, never smoking, never consumed alcohol, no history of hypertension, and no history of diabetes.

Longitudinal Analysis of Sweet Taste Preference Through Genetic and Phenotypic Data Integration

Understanding the genetic basis of sweet taste preference is crucial for potential implications in diet-related health outcomes, such as obesity. This study identified genes and single nucleotide polymorphisms (SNPs) associated with sweet taste preferences over time. Data from the American Nurses' Health Study (NHS1) and Health Professionals Follow-up Study (HPFS) cohorts were analyzed. Using tools like PLINK and METAL for genetic associations and FUMA for functional annotation, the study identified eight SNPs associated with sweet taste preferences. Notably, rs80115239 and rs12878143 were identified as key determinants of the highest and lowest associations with sweet taste preferences, respectively. Individuals with the rs80115239 (AA) genotype displayed a higher preference for sweet tastes, including chocolate and cake, but a lower preference for physical activity, fruits, and vegetables, particularly in females from the NHS1 cohort, linking this genotype to a higher obesity risk. Conversely, those with the rs12878143 (CC) genotype preferred fruits, vegetables, coffee, and tea, with a lower preference for sweetened beverages, but the correlation with obesity risk was less clear due to inconsistent data. In conclusion, these findings highlight the genetic influences on sweet taste preference and their potential role in personalized dietary recommendations and obesity management strategies.

Association of sugar consumption with risk of depression and anxiety: a systematic review and meta-analysis

Background

Sugar consumption has increased dramatically around the world, and at the same time, the prevalence of mental illnesses such as depression and anxiety continues to increase. While previous research has explored the impact of various dietary factors on mental health, the specific impact of dietary sugar consumption on the risk of depression and anxiety disorders remains elusive. This study aimed to comprehensively assess this relationship through a systematic review and meta-analysis.

Methods

PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Network (CNKI), and WangFang were systematically searched for studies of the association between total dietary sugar intake and risk of depression and/or anxiety. The articles that meet the criteria are screened and included in the systematic review, and the data are extracted after assessing their quality. Stata 18.0 software was used for the meta-analysis.

Results

Forty studies with 1,212,107 participants were included in the analysis. Results showed that sugar intake increased the risk of depression by 21% (OR = 1.21, 95% CI: 1.14, 1.27), while the overall association between sugar intake and anxiety risk was not statistically significant (OR = 1.11, 95% CI: 0.93, 1.28). Despite high heterogeneity (I 2 = 99.7%), the results were statistically significant (p < 0.000). Subgroup analyses showed that the association between sugar consumption and depression risk remains consistent across different study designs (cross-sectional, cohort, and case-control studies) and different sample sizes (<5,000, 5,000-10,000, >10,000). Women have a higher risk of depression than men (OR = 1.19, 95% CI: 1.04, 1.35). Among the different exposure measures, the Food Frequency Questionnaire (FFQ) showed the most significant effect (OR = 1.32, 95% CI: 1.08, 1.67, I 2 = 99.7%, p < 0.000). The measuring tool of subgroup analysis showed that there was a significant correlation between sugar intake and risk of depression, PHQ-9 (OR = 1.29, 95% CI: 1.17, 1.42, I2 = 86.5%, p < 0.000), and CES-D (OR = 1.28, 95% CI: 1.14, 1.44, I 2 = 71.3%, p < 0.000). High-quality cross-sectional and cohort studies showed a significant association between sugar intake and depression risk, with most results being robust. While the overall analysis of sugar intake and anxiety risk was not significant, some subgroups approached significance, particularly in studies with a sample size of <5,000 (OR = 1.14, 95% CI: 0.89, 1.46) and studies using the FFQ questionnaire (OR = 1.31, 95% CI: 0.90, 1.89).

Conclusion

Total dietary sugar consumption was significantly associated with increased risk of depression in the general population, whereas the association with risk of anxiety was not significant. Further high-quality studies are needed to verify these associations and ensure their reliability. This study highlights the impact of dietary sugar intake on mental health, identifies potentially high-risk groups through subgroup analysis, and provides new insights into the prevention of depression and anxiety.

Systematic review registration

CRD42024540548.

Patterns of beverages consumption and prevalence of non-communicable chronic diseases

Beverages consumption influences diet quality in general and has been associated with the development of non-communicable chronic diseases (NCCD). We aimed to verify the association between beverage consumption patterns and the prevalence of NCCD. A cross-sectional household and population-based study was conducted with 489 individuals aged 20 years and older. The presence of NCCD (arterial hypertension, diabetes, cancer and hypercholesterolemia) was obtained by self-report, while obesity was diagnosed by measuring body weight, height and waist circumference. Beverage consumption patterns were obtained by principal component analysis. The association between beverages patterns and the prevalence of NCCD was verified using Poisson regression, expressed as prevalence ratio (PR) and adjusted for potential confounding factors. Three beverage patterns were identified: ‘ultra-processed beverages’, ‘alcoholic beverages’ and ‘healthy beverages’. Individuals with greater adherence to the Ultra-processed Beverages Pattern had a 2·77 times higher prevalence of cancer (PR: 3·77; 95 % CI 1·57, 9·07). Higher adherence to the Alcoholic Beverages Pattern was associated with a higher prevalence of obesity (PR: 1·97; 95 % CI 1·13, 3·44). In contrast, individuals in the second tertile of adherence to the Healthy Beverages Pattern had a 39 % lower prevalence of hypercholesterolemia (PR: 0·61; 95 % CI 0·40, 0·92), and individuals in the third tertile had a 10 % lower prevalence of abdominal obesity estimated by the waist-to-height ratio (PR: 0·90; 95 % CI 0·83, 0·97). Beverage consumption patterns may be associated with a higher prevalence of NCCD, regardless of other risk factors. It is therefore important to conduct more studies investigating the impact of beverages patterns on health.

New Sweet-Tasting Gypenosides from "Jiaogulan" (Gynostemma pentaphyllum) and Their Interactions with the Homology Model of Sweet Taste Receptors

Gynostemma pentaphyllum has been used as an herbal tea, vegetable, and dietary supplement for hundreds of years in East Asia. The sweet variety, grown in large areas in Fujian Province, China, is an essential source of "Jiaogulan" herbal tea. However, its sweet components are unknown. To investigate the sweet constituents of Fujian "Jiaogulan" and discover new natural high-potency sweeteners, phytochemical and sensory evaluations were combined to obtain 15 saponins, of which 11 (1-11) were sweet-tasting, including 2 new ones with sweetness intensities 20-200 times higher than that of sucrose, and four (12-15) were bitter-tasting. Their structures were elucidated using spectroscopic methods (NMR, MS, IR, UV), hydrolysis, and comparison with literature data. The contents of the 15 saponins were quantitatively analyzed using UPLC-MS/MS in multiple reaction monitoring mode. The contents of 1 and 2 sweet-tasting gypenosides were 9.913 ± 1.735 and 35.852 ± 1.739 mg/kg, respectively. The content of the sweetest compound (6) was 124.969 ± 0.961 mg/kg. Additionally, compound 4 was the most abundant sweet component (422.530 ± 3.702 mg/kg). Furthermore, molecular docking results suggested interactions of sweet saponins with sweet taste receptors. In general, this study revealed the material basis of the Fujian "Jiaogulan" taste.

Epidemiological breast cancer prediction by country: A novel machine learning approach

Breast cancer remains a significant contributor to cancer-related deaths among women globally. We seek for this study to examine the correlation between the incidence rates of breast cancer and newly identified risk factors. Additionally, we aim to utilize machine learning models to predict breast cancer incidence at a country level. Following an extensive review of the available literature, we have identified a range of recently studied risk factors associated with breast cancer. Subsequently, we gathered data on these factors and breast cancer incidence rates from numerous online sources encompassing 151 countries. To evaluate the relationship between these factors and breast cancer incidence, we assessed the normality of the data and conducted Spearman's correlation test. Furthermore, we refined six regression models to forecast future breast cancer incidence rates. Our findings indicate that the incidence of breast cancer is most positively correlated with the average age of women in a country, as well as factors such as meat consumption, CO2 emissions, depression, sugar consumption, tobacco use, milk intake, mobile cells, alcohol consumption, pesticides, and oral contraceptive use. As for prediction, the CatBoost Regressor successfully predicted future breast cancer incidence with an R squared value of 0.84 ± 0.03. An increased incidence of breast cancer is mainly associated with dietary habits and lifestyle. Our findings and recommendations can serve as a baseline for developing educational programs intended to heighten awareness amongst women in countries with heightened risk.

Metabolism changes caused by glucose in normal and cancer human brain cell lines by Raman imaging and chemometric methods

Glucose is the main source of energy for the human brain. This paper presents a non-invasive technique to study metabolic changes caused by glucose in human brain cell lines. In this paper we present the spectroscopic characterization of human normal brain (NHA; astrocytes) and human cancer brain (CRL-1718; astrocytoma and U-87 MG; glioblastoma) control cell lines and cell lines upon supplementation with glucose. Based on Raman techniques we have identified biomarkers that can monitor metabolic changes in lipid droplets, mitochondria and nucleus caused by glucose. We have studied the vibrations at 750 cm-1, 1444 cm-1, 1584 cm-1 and 1656 cm-1 as a function of malignancy grade. We have compared the concentration of cytochrome, lipids and proteins in the grade of cancer aggressiveness in normal and cancer human brain cell lines. Chemometric analysis has shown that control normal, control cancer brain cell lines and normal and cancer cell lines after supplementation with glucose can be distinguished based on their unique vibrational properties. PLSDA (Partial Least Squares Discriminant Analysis) and ANOVA tests have confirmed the main role of cytochromes, proteins and lipids in differentiation of control human brain cells and cells upon supplementation with glucose. We have shown that Raman techniques combined with chemometric analysis provide additional insight to monitor the biology of astrocytes, astrocytoma and glioblastoma after glucose supplementation.

Testosterone Nanoemulsion Prevents Prostate Cancer: PC-3 and LNCaP Cell Viability In Vitro

For many years, it has been speculated that elevated testosterone levels may be critically involved in the genesis and proliferation of prostate cancer.

METHODS

The effect of testosterone on the metabolic activity of hormone-independent [PC-3] and hormone-dependent [LNCAP] cancer cells was investigated in vitro. Additionally, the impact of testosterone nanoemulsion [nanocare®] on cell viability was accessed by flow cytometry.

RESULTS

Despite the dependency of the normal prostate and of most prostatic cancers upon androgens, the obtained results indicate that, contrary to prevailing opinion, the supplementation of testosterone with higher doses in nanoemulsion was able to lower the metabolic activity and viability of prostate cancer cells.

CONCLUSIONS

We conclude that the growth of hormone-independent and hormone-dependent prostate cancer cells was reduced by the exposure of a nanoemulsion of bioidentical testostosterone in vitro. To the best of our knowledge, this is the first time that the potential effect of a testosterone nanoemulsion on the metabolic activity of prostate cancer cells has been shown. Such tests suggest that the growth of hormone-independent and hormone-dependent prostate cancer cells was reduced by the administration of bioidentical testostosterone, and this might be an interesting strategy for prostate cancer treatment in diagnosed patients.

Association between added sugars and frailty in U.S. adults: a cross-sectional study from the National Health and Nutrition Examination Survey 2007-2018

Objective

There are various detrimental effects of excessive added sugar consumption on health, but the association of added sugars with frailty remains elusive. We aimed to examine the association between added sugar intake and frailty among American adults in the present cross-sectional study.

Methods

This cross-sectional study is based on the National Health and Nutrition Examination Survey (NHANES) database. Data from NHANES spanning from 2007 to 2018 on frailty, added sugars, and covariates were collected. Added sugars were categorized into quartiles according to the recommended percentages by institutions. Weighted multivariable logistic regression was used to analyze the relationship between frailty and added sugars. Subgroup analysis was conducted based on sex, age, body mass index (BMI), smoking, alcohol consumption, hypertension, and diabetes status.

Results

This study included 16,381 participants, with 13,352 (81.51%) in the non-frailty group and 3,029 (18.49%) in the frailty group. We found that added sugars were positively associated with frailty, and subgroup analysis showed that participants who were male, over the age of 60, had a low BMI, had previously smoked and consumed alcohol, had no hypertension, or had diabetes mellitus (DM) were more likely to be frail. Added sugar intake was positively associated with frailty. Subgroup analysis showed that the association was strongest in males, those aged >60, those with a low BMI, former smokers, former alcohol consumers, and people with no hypertension or DM. When added sugars are classified by energy percentage, populations with more than 25% of their energy coming from added sugars have similar results, with a higher prevalence of frailty.

Conclusion

Added sugars are positively associated with a higher risk of frailty, and the association is stable among different populations.

Effects of sugary drinks, coffee, tea and fruit juice on incidence rate, mortality and cardiovascular complications of type2 diabetes patients: a systematic review and meta-analysis

Aims

Despite more and more studies indicate that beverages play an important role in type 2 diabetes mellitus(T2DM), the efficacy of intaking different beverages for T2DM has not been clearly stated in one article. The meta-analysis was performed, which aims to assess the effects of beverages on mortality and cardiovascular complications in patients with type 2 diabetes and the incidence of T2DM.

Method

PubMed, Embase, Web of Science and Cochrane Library databases were search up to March, 2023 to identify relevant studies, including studies researching beverage consumption, the incidence and mortality of T2DM and incidence of cardiovascular disease, a kind of complication of T2DM. The way to explore the source of heterogeneity is performing subgroup analyses and sensitivity analyses. Funnel plots and Egger's regression test were performed to assess publication bias. The Hazard ratio (HR) and 95% confidence intervals (95% CIs) were used to analysis the results. Fifteen observational studies were included in our meta-analysis.

Results

Fifteen eligible articles were included sugar-sweetened beverages(SSB) consumption increased the mortality and incidence of T2DM ( Hazard ratio (HR), 1.20; 95% confidence interval (CI), 1.05-1.38; P = 0.01 and HR, 1.15; 95% CI,1.06-1.24; P = 0.001), respectively. Artificially-sweetened beverages (ASB) consumption was not associated with the mortality and incidence of T2DM (HR,0.96;95%CI, 0.86-1.07; P = 0.464 and HR, 1.15; 95% CI,1.05-1.26; P = 0.003), respectively. Fruit juice consumption increased the incidence of T2DM (HR,1.08;95%CI,1.02-1.14, P = 0.296).Tea or coffee consumption can reduce the incidence of T2DM (HR, 0.89; 95%CI,0.81-0.98; P = 0.016). Tea or coffee consumption was associated with a lower risk of mortality of T2DM (HR,0.84; 95% Cl, 0.75-0.94; P = 0.002 and HR,0.75; 95% CI, 0.65-0.87; P < 0.001), respectively. Additionally, beverage consumption was not associated with cardiovascular disease in T2DM patients (HR,1.03; 95% Cl, 0.82-1.30, P > 0.05).

Conclusions

High consumption of SSBs led to a higher risk and mortality of T2DM, while high consumption of coffee or tea showed significant associations with a lower risk of the incidence and mortality of T2DM.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-024-01396-5.

Integrating Computational and Experimental Methods to Identify Novel Sweet Peptides from Egg and Soy Proteins

Sweetness in food delivers a delightful sensory experience, underscoring the crucial role of sweeteners in the food industry. However, the widespread use of sweeteners has sparked health concerns. This underscores the importance of developing and screening natural, health-conscious sweeteners. Our study represents a groundbreaking venture into the discovery of such sweeteners derived from egg and soy proteins. Employing virtual hydrolysis as a novel technique, our research entailed a comprehensive screening process that evaluated biological activity, solubility, and toxicity of the derived compounds. We harnessed cutting-edge machine learning methodologies, specifically the latest graph neural network models, for predicting the sweetness of molecules. Subsequent refinements were made through molecular docking screenings and molecular dynamics simulations. This meticulous research approach culminated in the identification of three promising sweet peptides: DCY(Asp-Cys-Tyr), GGR(Gly-Gly-Arg), and IGR(Ile-Gly-Arg). Their binding affinity with T1R2/T1R3 was lower than -15 kcal/mol. Using an electronic tongue, we verified the taste profiles of these peptides, with IGR emerging as the most favorable in terms of taste with a sweetness value of 19.29 and bitterness value of 1.71. This study not only reveals the potential of these natural peptides as healthier alternatives to traditional sweeteners in food applications but also demonstrates the successful synergy of computational predictions and experimental validations in the realm of flavor science.

Excess glucose alone depress young mesenchymal stromal/stem cell osteogenesis and mitochondria activity within hours/days via NAD+/SIRT1 axis

BACKGROUND

The impact of global overconsumption of simple sugars on bone health, which peaks in adolescence/early adulthood and correlates with osteoporosis (OP) and fracture risk decades, is unclear. Mesenchymal stromal/stem cells (MSCs) are the progenitors of osteoblasts/bone-forming cells, and known to decrease their osteogenic differentiation capacity with age. Alarmingly, while there is correlative evidence that adolescents consuming greatest amounts of simple sugars have the lowest bone mass, there is no mechanistic understanding on the causality of this correlation.

METHODS

Bioinformatics analyses for energetics pathways involved during MSC differentiation using human cell information was performed. In vitro dissection of normal versus high glucose (HG) conditions on osteo-/adipo-lineage commitment and mitochondrial function was assessed using multi-sources of non-senescent human and murine MSCs; for in vivo validation, young mice was fed normal or HG-added water with subsequent analyses of bone marrow CD45- MSCs.

RESULTS

Bioinformatics analyses revealed mitochondrial and glucose-related metabolic pathways as integral to MSC osteo-/adipo-lineage commitment. Functionally, in vitro HG alone without differentiation induction decreased both MSC mitochondrial activity and osteogenesis while enhancing adipogenesis by 8 h' time due to depletion of nicotinamide adenine dinucleotide (NAD+), a vital mitochondrial co-enzyme and co-factor to Sirtuin (SIRT) 1, a longevity gene also involved in osteogenesis. In vivo, HG intake in young mice depleted MSC NAD+, with oral NAD+ precursor supplementation rapidly reversing both mitochondrial decline and osteo-/adipo-commitment in a SIRT1-dependent fashion within 1 ~ 5 days.

CONCLUSIONS

We found a surprisingly rapid impact of excessive glucose, a single dietary factor, on MSC SIRT1 function and osteogenesis in youthful settings, and the crucial role of NAD+-a single molecule-on both MSC mitochondrial function and lineage commitment. These findings have strong implications on future global OP and disability risks in light of current worldwide overconsumption of simple sugars.

Exploring dietary changes and supplement use among cancer patients in Norway: prevalence, motivations, disclosure, information, and perceived risks and benefits: a cross sectional study

BACKGROUND

Cancer is the leading cause of death in Norway, with prostate, breast, lung, and colon cancers being the most prevalent types. Adopting a healthy and varied diet can help reduce cancer risk and recurrence. However, access to dietary counselling remains limited for cancer patients in Norway. This study aimed to investigate the prevalence of dietary supplement use and dietary changes made by cancer patients and survivors. Additionally, it sought to explore the reason(s) for such practices, communication with healthcare providers, sources of information, and reported benefits and potential harms resulting from these changes and supplement use.

METHODS

Conducted in collaboration with the Norwegian Cancer Society (NCS), this online cross-sectional study targeted members of their user panel who had either current or previous cancer (n = 706). The study took place in September/October 2021, utilizing a modified cancer-specific version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). Out of 468 participants (315 women and 153 men), 67.2% consented to participate. Between-group analyses were conducted using Pearson chi-square tests and Fisher exact tests for categorical variables, while independent sample t-tests were applied for continuous variables.

RESULTS

The majority of the participants (97%) reported making changes to their diet (78%) and/or incorporating dietary supplements (73%) in response to their cancer diagnosis. The primary goal of these changes was to strengthen their body and immune system. Almost half of the participants (49%) reported that they found these changes beneficial and discussed them openly with their healthcare providers, with family physicians being the most common point of discussion (25%). Adverse effects were reported by only a few participants, mostly mild. Information about dietary changes and supplements was primarily sourced from the internet or healthcare providers.

CONCLUSIONS

This study highlights that most individuals affected by cancer attribute to dietary adjustment. It also emphasizes the importance of addressing adherence to dietary recommendations and using reliable sources of information. Additionally, the study highlights the potential, yet currently underutilized, role of healthcare professionals in initiating dialogues about dietary interventions to address any unmet needs of patients. Such proactive engagement may contribute to the promotion of reliable sources of information and the prevention of non-evidence-based and potentially harmful diets or supplement adoption.

Multiple dietary patterns and the association between long-term air pollution exposure with type 2 diabetes risk: Findings from UK Biobank cohort study

BACKGROUND

Evidence of modifying effect of various dietary patterns (DPs) on risk of type 2 diabetes (T2D) induced by long-term exposure to air pollution (AP) is still rather lacking, which therefore we aimed to explore in this study.

METHODS

We included 78,230 UK Biobank participants aged 40-70 years with at least 2 typical 24-hour dietary assessments and without baseline diabetes. The annual average concentration of particulate matter with diameter micrometers ≤2.5 (PM2.5) and ≤10 (PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOX) estimated by land use regression model was the alternative proxy of long-term AP exposure. Three well-known prior DPs such as Mediterranean diet (MED), dietary approaches to stop hypertension diet (DASH), and empirical dietary inflammatory pattern (EDIP), as well as three posterior DPs derived by the rank reduced regression model were used to capture participants' dietary habits. Cox regression models were used to estimate AP-T2D and DP-T2D associations. Modifying effect of DPs on AP-T2D association was assessed using stratified analysis and heterogeneity test.

RESULTS

During a median follow-up 12.19 years, 1,693 participants developed T2D. PM2.5, PM10, NO2, and NOX significantly increased the T2D risk (P <0.05), with hazard ratio (HR) and 95% confidence interval (95% CI) for per interquartile range increase being 1.09 (1.02,1.15), 1.04 (1.00, 1.09), 1.11 (1.04, 1.18), and 1.08 (1.03, 1.14), respectively. Comparing high with low adherence, healthy DPs were associated with a 14-41% lower T2D risk. Participants with high adherence to MED, DASH, and anti-EDIP, alongside the posterior anti-oxidative dietary pattern (AODP) had attenuated and statistically non-significant NO2-T2D and NOX-T2D associations (Pmodify <0.05).

CONCLUSIONS

Multiple forms of healthy DPs help reduce the T2D risk associated with long-term exposure to NO2 and NOX. Our findings indicate that adherence to healthy DPs is a feasible T2D prevention strategy for people long-term suffering from NO2 and NOX pollution.

Trajectories and associations of symptoms of mental health and well-being with insulin resistance and metabolic health in women with gestational diabetes

BACKGROUND

Gestational diabetes mellitus (GDM) is characterized by increased insulin resistance and carries perinatal and long-term risks for the mother and her offspring. There is a link between perinatal depression or anxiety and GDM. Mental health problems are associated with higher insulin resistance and could explain the underlying association between GDM and depression or anxiety symptoms. We investigated the trajectories and associations between symptoms of mental health and well-being with insulin resistance and metabolic health in women with GDM.

METHODS

This study included the control group (n = 106) of a randomized controlled trial in women with GDM that were followed-up during pregnancy and up to 1-year postpartum. We measured symptoms of mental health (Edinburgh Postnatal Depression Scale (EPDS), Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A), well-being (The World Health Organization Well-Being Index (WHO-5)) and metabolic health, including insulin resistance variables (HOMA-insulin resistance (IR) and Matsuda Index of insulin sensitivity) as well as weight during pregnancy and in the postpartum.

RESULTS

Participants' pre pregnancy weight and BMI were 69.7 kg ± 16.1 and 25.9 kg/m2 ± 5.5 respectively. HOMA-IR was higher during pregnancy compared to 6-8 weeks postpartum and increased between 6-8 weeks and 1-year postpartum (all p < 0.05). Matsuda index decreased between 6-8 weeks and 1-year postpartum (p < 0.001). EPDS scores decreased between pregnancy and both 6-8 weeks and 1-year postpartum (all p < 0.05). HADS-A scores did not change between pregnancy and the postpartum. WHO-5 scores improved significantly from pregnancy and both 6-8 weeks and 1-year postpartum (p < 0.001). Correlation coefficients within outcome at the three different time points were high for metabolic measures and ranged between 0.94 and 0.96 for weight, from 0.77 to 0.89 for HOMA-IR and 0.64 for the Matsuda index (all p < 0.001). Mental health and well-being variables were moderately correlated in all three time points including r = 0.36-0.55 for the EPDS (p < 0.001), r = 0.58 for HADS (p < 0.001), and r = 0.43-0.52 for the WHO-5 (p < 0.01). After adjustment for age and pre-pregnancy BMI, Matsuda index was negatively associated with EPDS scores and positively associated to WHO-5 scores at 6-8 weeks postpartum. No other association between insulin resistance and mental health or well-being outcomes were found.

CONCLUSION

While insulin resistance fluctuated with values being lowest in the early postpartum and increasing thereafter, both depression and well-being scores decreased between pregnancy and the postpartum and did not change in the postpartum period. Intraindividual variability was larger for mental health and well-being than for metabolic health outcomes at different time points, indicating a higher plasticity for mental health and well-being outcomes that could be acted upon. We found only few associations between mental health and well-being and metabolic health outcomes.

Common Misconceptions about Diet and Breast Cancer: An Unclear Issue to Dispel

Breast cancer (BC) constitutes a prevalent health condition among women. Recent years have witnessed the identification of dietary proto-oncogenic factors that deserve attention. Besides the well-known role of alcohol and red and processed meat in BC development, the impact of other dietary components remains unclear. Our narrative review aims to explore the diet-BC relationship, focusing on sugar, dairy, and soy consumption. We conducted a PubMed literature search covering the last decade (2013-2023) and included 35 papers. We found limited evidence on the association between high sugar intake and BC incidence. On the other hand, dairy and soy consumption displayed a protective effect in the majority of the analyzed papers. However, a significant degree of heterogeneity was reported among the results. Menopausal status and the specific BC molecular subtypes were the main factors influencing the interpretation of the results. Exploring dietary factors and BC revealed inconsistencies: high glycemic index post-menopause may be a risk factor, while sugar-sweetened drinks and artificial sweeteners yielded conflicting results; fermented dairy showed potential benefits, non-fermented dairy presented inconsistent findings; soy impact on BC varied according to molecular subtype, with some studies suggesting a positive association in luminal-like BC. Hence, further investigation is crucial to obtain a uniform consensus on the diet-BC relationship.

Role of the VEGF in virus-associated cancers

The role of numerous risk factors, including consumption of alcohol, smoking, having diet high in fat and sugar and many other items, on caner progression cannot be denied. Viral diseases are one these factors, and they can initiate some signalling pathways causing cancer. For example, they can be effective on providing oxygen and nutrients by inducing VEGF expression. In this review article, we summarised the mechanisms of angiogenesis and VEGF expression in cancerous tissues which are infected with oncoviruses (Epstein-Barr virus, Human papillomavirus infection, Human T-lymphotropic virus, Kaposi's sarcoma-associated herpesvirus, Hepatitis B and hepatitis C virus).

Male Breast Cancer: Current Scenario and Future Perspectives

Male breast cancer (MBC), one of the rare types of cancer among men where the global incidence rate is 1.8% of all breast cancers cases with a yearly increase in a pace of 1.1%. Since the last 10 years, the incidence has been increased from 7.2% to 10.3% and the mortality rate was decreased from 11% to 3.8%. Nevertheless, the rate of diagnoses has been expected to be around 2.6% in the near future, still there is a great lack in studies to characterize the MBC including the developed countries. Based on our search, it is evidenced from the literature that the number of risk factors for the cause of MBC are significant, which includes the increase in age, family genetic history, mutations in specific genes due to various environmental impacts, hormonal imbalance and unregulated expression receptors for specific hormones of high levels of estrogen or androgen receptors compared to females. MBCs are broadly classified into ductal and lobular carcinomas with further sub-types, with some of the symptoms including a lump or swelling in the breast, redness of flaky skin in the breast, irritation and nipple discharge that is similar to the female breast cancer (FBC). The most common diagnostic tools currently in use are the ultrasound guided sonography, mammography, and biopsies. Treatment modalities for MBC include surgery, radiotherapy, chemotherapy, hormonal therapy, and targeted therapies. However, the guidelines followed for the diagnosis and treatment modalities of MBC are mostly based on FBC that is due to the lack of prospective studies related to MBC. However, there are distinct clinical and molecular features of MBC, it is a need to develop different clinical methods with more multinational approaches to help oncologist to improve care for MBC patients.

Biological role of fructose in the male reproductive system: Potential implications for prostate cancer

BACKGROUND

Over the last 20 years, fructose has gradually emerged as a potential metabolic substrate capable of promoting the growth and progression of various cancers, including prostate cancer (PCa). The biological and molecular mechanisms that underlie the effects of fructose on cancer are beginning to be elucidated.

METHODS

This review summarizes the biological function of fructose as a potential carbon source for PCa cells and its role in the functionality of the male reproductive tract under normal conditions.

RESULTS

The most recent biological advances related to fructose transport and metabolism as well as their implications in PCa growth and progression suggest that fructose represent a potential carbon source for PCa cells. Consequently, fructose derivatives may represent efficient radiotracers for obtaining PCa images via positron emission tomography and fructose transporters/fructose-metabolizing enzymes could be utilized as potential diagnostic and/or predictive biomarkers for PCa.

CONCLUSION

The existing data suggest that restriction of fructose from the diet could be a useful therapeutic strategy for patients with PCa.

Use of sugar in coffee and tea and long-term risk of mortality in older adult Danish men: 32 years of follow-up from a prospective cohort study

BACKGROUND

Tea and coffee are the most consumed beverages worldwide and very often sweetened with sugar. However, the association between the use of sugar in tea or coffee and adverse events is currently unclear.

OBJECTIVES

To investigate the association between the addition of sugar to coffee or tea, and the risk of all-cause mortality, cardiovascular mortality, cancer mortality and incident diabetes mellitus.

METHODS

Participants from the prospective Copenhagen Male Study, included from 1985 to 1986, without cardiovascular disease, cancer or diabetes mellitus at inclusion, who reported regular coffee or tea consumption were included. Self-reported number of cups of coffee and tea and use of sugar were derived from the study questionnaires. Quantity of sugar use was not reported. Primary outcome was all-cause mortality and secondary endpoints were cardiovascular mortality, cancer mortality and incident diabetes mellitus, all assessed through the Danish national registries. The association between adding sugar and all-cause mortality was analyzed by Cox regression analysis. Age, smoking status, daily alcohol intake, systolic blood pressure, body mass index, number of cups of coffee and/or tea consumed per day and socioeconomic status were included as covariates. Vital status of patients up and until 22.03.2017 was assessed. Sugar could be added to either coffee, tea or both.

RESULTS

In total, 2923 men (mean age at inclusion: 63±5 years) were included, of which 1007 (34.5%) added sugar. In 32 years of follow-up, 2581 participants (88.3%) died, 1677 in the non-sugar group (87.5%) versus 904 in the sugar group (89.9%). Hazard ratio of the sugar group compared to the non-sugar group was 1.06 (95% CI 0.98;1.16) for all-cause mortality. An interaction term between number of cups of coffee and/or tea per day and adding sugar was 0.99 (0.96;1.01). A subgroup analysis of coffee-only drinkers showed a hazard ratio of 1.11 (0.99;1.26). The interaction term was 0.98 (0.94;1.02). Hazard ratios for the sugar group compared to the non-sugar group were 1.11 (95% CI 0.97;1.26) for cardiovascular disease mortality, 1.01 (95% CI 0.87;1.17) for cancer mortality and 1.04 (95% CI 0.79;1.36) for incident diabetes mellitus.

CONCLUSION

In the present population of Danish men, use of sugar in tea and/or coffee was not significantly associated with increased risk of mortality or incident diabetes.

Sweet Taste Receptors and Associated Sweet Peptides: Insights into Structure and Function

Long-term consumption of a high-sugar diet may contribute to the pathogenesis of several chronic diseases, such as obesity and type 2 diabetes. Sweet peptides derived from a wide range of food sources can enhance sweet taste without compromising the sensory properties. Therefore, the research and application of sweet peptides are promising strategies for reducing sugar consumption. This work first outlined the necessity for global sugar reduction, followed by the introduction of sweet taste receptors and their associated transduction mechanisms. Subsequently, recent research progress in sweet peptides from different protein sources was summarized. Furthermore, the main methods for the preparation and evaluation of sweet peptides were presented. In addition, the current challenges and potential applications are also discussed. Sweet peptides can stimulate sweetness perception by binding sweet taste receptors T1R2 and T1R3 in taste buds, which is an effective strategy for reducing sugar consumption. At present, sweet peptides are mainly prepared artificially by synthesis, hydrolysis, microbial fermentation, and bioengineering strategies. Furthermore, sensory evaluation, electronic tongues, and cell models have been used to assess the sweet taste intensity. The present review can provide a theoretical reference for reducing sugar consumption with the aid of sweet peptides in the food industry.

Added sugar intake among the saudi population

Diet is a contributor to the pathogenesis of many non-communicable diseases. Among contributors to poor diet is high added sugar consumption, which is unfortunately on the rise nowadays. The recommended sugar intake by The American Heart Association (AHA) is 24g/day and 36g/day for women and men, respectively. The study's aim is to assess added sugar intake among adults in Saudi Arabia. A cross-sectional study design was used via an online survey among adults in Saudi Arabia using convenience sampling, and social media platforms were used to collect the data. The authors conducted descriptive statistics to present demographic variables using Chi-square χ2 tests for categorical and t-tests for continuous variables. All statistical tests used a 95% confidence interval with a two-sided P-value <0.05 as significance level. A total of 1163 respondents were included in the study. The study has shown an overall added sugar intake average of 73 g/day. There was a significant difference in means of overall added sugar intake across genders for the age group 18-30 and the age group >60. Equivalently, there was a statistically significant difference in means of added sugar intake food across gender (P-value 0.008). Females tended to consume more added sugar in their food than males. The highest consumption was in the Northern region (123.71 g/day), followed by the Southern region (98.52 g/day), the Western region (86.14 g/day), and lastly, the Central and Eastern regions (66.95 and 62.02 g/day, respectively). The total added sugar intake of added sugar is extremely high in Saudi Arabia. Poor dietary habits lead to many adverse health consequences, including obesity and diabetes. Healthcare providers and public health officials are highly encouraged to shed light on added sugar consumption and create opportunities to promote healthy dietary patterns. The Saudi population is recommended to abide by the added sugar dietary recommendations to avoid future chronic medical conditions.

Association between added sugars and kidney stones in U.S. adults: data from National Health and Nutrition Examination Survey 2007-2018

Purpose

Added sugar is associated with a variety of adverse health outcomes, but its association with kidney stones is unclear. This study was to determine whether added sugar is associated with kidney stones.

Materials and methods

This nationally representative study used National Health and Nutrition Examination Survey (NHANES) datasets from 2007 to 2018 for analysis. People aged ≥20 years who reported a history of kidney stones and provided dietary recall data on added sugars were included. Weighted proportions, multivariable logistic regression analysis and stratified logistic regression were used to evaluate the associations between added sugars and kidney stones by adjusting potential confounders.

Results

Totally 28,303 adults were included, with weighted mean age [95% confidence interval (CI)] of 48.03 (47.56, 48.51) years, 47.74% (47.09, 48.40%) males and 52.26% (51.60, 52.91%) females. The overall mean (95% CI) energy intake from added sugars was 272.10 (266.59, 277.60) kilocalories. In the fully-adjusted multivariable model, the percentage of energy intake from added sugars was positively correlated with kidney stones. Compared to the first quartile of added sugar energy intake percentage, the population in the fourth quartile had a higher prevalence of kidney stones (OR = 1.39; 95% CI 1.17 to 1.65). Compared with the less than 5% calories from added sugar population, the more than or equal to 25% calories from added sugar had a higher kidney stone prevalence (OR = 1.88; 95% CI 1.52 to 2.32).

Conclusion

A higher percentage of energy intake from added sugars is significantly associated with a higher prevalence of kidney stones. This study provides cross-sectional evidence for the relationship between added sugars and health outcomes.

Adherence to the Paleolithic diet and Paleolithic-like lifestyle reduce the risk of colorectal cancer in the United States: a prospective cohort study

BACKGROUND

The plant-based paleolithic diet (PD) and the paleolithic-like lifestyle (PLL) may reduce the risk of chronic diseases, including colorectal adenomas. These dietary and lifestyle approaches are proposed to exert their effects through mechanisms such as reducing inflammation, oxidative stress, and insulin levels. However, whether PD and PLL is associated with the risk of colorectal cancer (CRC) has not been determined.

METHODS

A cohort of 74,721 individuals who participated in the PLCO study were included in this analysis. Adherence to the PD and PLL was assessed using PD and PLL scores, where higher scores indicated greater adherence. Multivariable Cox models were utilized to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of CRC and its subsites (proximal colon cancer and distal CRC). Subgroup analyses were conducted to identify potential effect modifiers.

RESULTS

During a mean follow-up of 9.2 years, a total of 694 CRC cases were identified. Participants in the highest compared with the lowest quartiles of PD score had a lower risk of CRC (Q4 vs Q1: HR 0.76, 95% CI 0.61-0.95, P_trend = 0.009) and proximal colon cancer (Q4 vs Q1: HR 0.73, 95% CI 0.55-0.97, P_trend = 0.02). A stronger inverse association was observed for PLL score with the risk of CRC (Q4 vs Q1: HR 0.64, 95% CI 0.51-0.81, P_trend < 0.001), proximal colon (Q4 vs Q1: HR 0.62, 95% CI 0.46-0.83, P_trend = 0.001) and distal CRC (Q4 vs Q1: HR 0.69, 95% CI 0.48-0.98, P_trend = 0.03). Subgroup analyses revealed the inverse association of PD score with the risk of CRC was more pronounced in participants with BMI < 30 (Q4 vs Q1: HR 0.68, 95% CI 0.53-0.87) than in those with BMI ≥ 30 (Q4 vs Q1: HR 1.07, 95% CI 0.68-1.67) (P_interaction = 0.02).

CONCLUSIONS

Our findings suggest that adhering to the PD and PLL could be a new option to reduce CRC risk.

Associations between missing teeth and the risk of cancer in Korea: a nationwide cohort study

BACKGROUND

Poor dental health is correlated with an increased risk of cancer. Using a nationwide population cohort database, we investigated which cancer is highly associated with poor dental health and which dental indicator mostly influences cancer risk.

METHODS

This study was conducted using the National Health Checkups (NHC) and National Health Insurance System (NHIS) database in Korea. NHC in Korea includes dental examinations. We retrieved subjects who underwent NHC between 2002 and 2003 and their medical information in NHIS database was followed until December 31,2015.

RESULTS

Data for 200,170 who participated in the NHC between 2002 and 2003 were analysed. During the maximum follow-up period of 13 years, 15,506 (7.75%) subjects were diagnosed with cancer. The median time to cancer diagnosis after the dental examination was 87 months (range, 51-119 months). The proportion of people with missing teeth was higher in the cancer-diagnosed group than in the non-diagnosed group (26.27% vs. 22.59%, p < 0.001). Among several dental health factors, missing teeth were significantly associated with higher cancer risk. Subjects with missing teeth showed a 12% increased cancer risk compared to those without missing teeth (odds ratio [OR] 1.12, 95% confidence interval [CI], 1.08-1.16). The risk was significantly higher, especially in lung, head and neck, pancreatic, liver, biliary, and esophageal cancers (OR 1.27 [95% CI, 1.14-1.41], 1.32 [95% CI, 1.13-1.55], 1.27 [95% CI, 1.02-1.58], 1.24 [95% CI, 1.1-1.4], 1.28 [95% CI, 1.03-1.6], 1.4 [95% CI, 1.04-1.88], respectively).

CONCLUSIONS

Missing teeth were the most important dental indicator associated with cancer risk. Korean adults with missing teeth should be cautious about the risk of several cancers, particularly head and neck, lung, gastrointestinal, hepatobiliary, and pancreatic cancer.

Ultra-processed food consumption and cancer risk: A systematic review and meta-analysis

BACKGROUND

Ultra-processed foods (UPF) have become a staple of the diet in many countries, concomitant with increases in non-communicable diseases including cancer.

AIM

The aim of this systematic literature review was to evaluate associations between the consumption of UPF and cancer risk.

METHODS

A systematic literature search for observational studies investigating the association between cancer risk and UPF consumption, determined by the NOVA classification system, was performed. Random-effects meta-analyses were conducted. Independent review and risk of bias assessment was performed independently by the authors using the National Institutes of Health's Study Quality Assessment Tools.

RESULTS

Eleven reports were identified, including eight retrospective case-control studies and three prospective cohorts. The outcome was risk of total cancer and/or one or more of the following cancers: colorectal, breast, prostate, pancreatic, chronic lymphocytic leukemia and central nervous system tumors. Nine studies reported a significant positive association between UPF intake and all the assessed cancers except prostate, after adjustment for confounding factors including obesity and total energy intake. A 10% increment in the diet's proportion of UPF was associated with increased risk of overall cancer (HR = 1.13, 95% CI 1.07 to 1.18) and breast cancer (HR = 1.11, 95% CI 1.01 to 1.21). In addition, a high intake of UPF was associated with increased risk of colorectal cancer (ORT3 vs. T1 = 1.30, 95% CI 1.11 to 1.51) and pancreatic cancer (HRQ4 vs. Q1 = 1.49, 95% CI 1.07 to 2.07). More modest associations were found for chronic lymphocytic leukemia and central nervous system tumors. Common limitations of several of the studies included no prior assessment of diet before known diagnosis (the case-control studies), higher participation rates among cases, and likely misclassification of several foods as UPF or non-UPF.

CONCLUSION

In conclusion, the available suggestive evidence shows a consistent significant association between intake of UPF and the risk of overall and several cancers, including colorectal-, breast- and pancreatic cancer. These data may inform updated dietary guidelines, policy makers and the public towards improving public health.

The Causal Effect of Dietary Composition on the Risk of Breast Cancer: A Mendelian Randomization Study

Breast cancer has become the most common malignancy among women, posing a severe health risk to women worldwide and creating a heavy social burden. Based on current observational studies, the dietary factor may have a causal relationship with breast cancer. Therefore, exploring how dietary composition affects breast cancer incidence will provide nutrition strategies for clinicians and women. We performed a two-sample Mendelian randomization (MR) analysis to find the causal effect of four kinds of relative macronutrient intake (protein, carbohydrate, sugar, and fat) on the risk of breast cancer and its subtypes [Luminal A, Luminal B, Luminal B HER2-negative, HER2-positive, Triple-negative, Estrogen receptor (ER) positive, and ER-negative breast cancer]. The Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) test, MR-Egger intercept test, Cochran's Q statistic, funnel plot, and leave-one-out (Loo) analysis were all used in a sensitivity analysis to test the robustness of MR. Genetically, a higher relative protein intake was found as a protective factor for Luminal A and overall breast cancer, which was inconsistent with recent findings. A higher relative sugar intake could genetically promote the risk of Luminal B and HER2-positive breast cancer. Conclusions: A higher protein proportion in diet genetically reduces the risk of breast cancer, while higher relative sugar intake does the opposite.

Association of soft drinks and 100% fruit juice consumption with risk of cancer: a systematic review and dose-response meta-analysis of prospective cohort studies

BACKGROUND

Studies of the associations between soft drinks and the risk of cancer showed inconsistent results. No previous published systematic reviews and meta-analysis has investigated a dose-response association between exposure dose and cancer risk or assessed the certainty of currently available evidence. Therefore, we aim to demonstrate the associations and assessed the certainty of the evidence to show our confidence in the associations.

METHODS

We searched Embase, PubMed, Web of Science, and the Cochrane Library from inception to Jun 2022, to include relevant prospective cohort studies. We used a restricted cubic spline model to conduct a dose-response meta-analysis and calculated the absolute effect estimates to present the results. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of the evidence.

RESULTS

Forty-two articles including on 37 cohorts enrolled 4,518,547 participants were included. With low certainty evidence, increased consumption of sugar-sweetened beverages (SSBs) per 250 mL/day was significantly associated with a 17% greater risk of breast cancer, a 10% greater risk of colorectal cancer, a 30% greater risk of biliary tract cancer, and a 10% greater risk of prostate cancer; increased consumption of artificially sweetened beverages (ASBs)re per 250 mL/day was significantly associated with a 16% greater risk of leukemia; increased consumption of 100% fruit juice per 250 mL/day was significantly associated with a 31% greater risk of overall cancer, 22% greater risk of melanoma, 2% greater risk of squamous cell carcinoma, and 29% greater risk of thyroid cancer. The associations with other specific cancer were no significant. We found linear dose-response associations between consumption of SSBs and the risk of breast and kidney cancer, and between consumption of ASBs and 100% fruit juices and the risk of pancreatic cancer.

CONCLUSIONS

An increment in consumption of SSBs of 250 mL/day was positively associated with increased risk of breast, colorectal, and biliary tract cancer. Fruit juices consumption was also positively associated with the risk of overall cancer, thyroid cancer, and melanoma. The magnitude of absolute effects, however, was small and mainly based on low or very low certainty of evidence. The association of ASBs consumption with specific cancer risk was uncertain.

TRIAL REGISTRATION

PROSPERO: CRD42020152223.

Palaeolithic diet score and risk of breast cancer among postmenopausal women overall and by hormone receptor and histologic subtypes

BACKGROUND

The Palaeolithic diet (PD) has gained popularity globally. There is emerging evidence of its putative health benefits as short-term effects on chronic diseases have been reported. We evaluated the association between long-term adherence to the PD and breast cancer (BC) risk among postmenopausal women.

METHODS

65,574 women from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale (E3N) cohort were followed from 1993 to 2014. Incident BC cases were identified and validated. The PD score was calculated using dietary intake self-reported at baseline (1993) and follow-up (2005) or baseline only if censored before follow-up. Multivariable Cox proportional hazards regression models were used to estimate BC hazard ratios (HR) and 95% confidence intervals (CI).

RESULTS

Over a mean follow-up of 20 years, 3968 incident BC cases occurred. An increase of 1 standard deviation in the PD score was associated with an 8% lower BC risk, fully-adjusted model: HR1-SD 0.92, 95% CI; 0.89, 0.95. Compared to women with low adherence to the PD, women with high adherence had a 17% lower BC risk, HRQ5 vs Q1 0.83, 95% CI; 0.75, 0.92, Ptrend < 0.01. When considering BC subtypes, we observed the same pattern of association (Pheterogeneity > 0.10 for all).

CONCLUSIONS

High adherence to a PD characterised by fruit, vegetables, nuts, fish, and lean meat and limited in dairy, grains, legumes, refined sugar, and alcohol was associated with a lower BC risk. The lack of heterogeneity according to BC subtypes could indicate the involvement of non-hormonal mechanisms. The protocol is registered at clinicaltrials.gov as NCT03285230.

REGISTRY

The protocol is registered at clinicaltrials.gov as NCT03285230.

Regulator of G-Protein Signalling 9: A New Candidate Gene for Sweet Food Liking?

Genetics plays an important role in individual differences in food liking, which influences food choices and health. Sweet food liking is a complex trait and has been associated with increased body mass index (BMI) and related comorbidities. This genome-wide association study (GWAS) aimed to investigate the genetics of sweet food liking using two adult discovery cohorts (n = 1109, n = 373) and an independent replication cohort (n = 1073). In addition, we tested the association of our strongest result on parameters related to behaviour (food adventurousness (FA) and reward dependence (RD) and health status (BMI and blood glucose). The results demonstrate a novel strong association between the Regulator of G-Protein Signalling 9 (RGS9I) gene, strongest single nucleotide polymorphism (SNP) rs58931966 (p-value 7.05 × 10^-9 in the combined sample of discovery and replication), and sweet food liking, with the minor allele (A) being associated with a decreased sweet food liking. We also found that the A allele of the rs58931966 SNP was associated with decreased FA and RD, and increased BMI and blood glucose (p-values < 0.05). Differences were highlighted in sex-specific analysis on BMI and glucose. Our results highlight a novel genetic association with food liking and are indicative of genetic variation influencing the psychological-biological drivers of food preference. If confirmed in other studies, such genetic associations could allow a greater understanding of chronic disease management from both a habitual dietary intake and reward-related perspective.

EAT-Lancet Healthy Reference Diet score and diabetes incidence in a cohort of Mexican women

To improve the health of our planet and develop sustainable food policies, it is important to understand the health impact of a diet pattern that considers planetary and population health. We used data from the Mexican Teachers' Cohort (MTC) to estimate the association between the EAT-Lancet healthy reference diet (EAT-HRD) and type 2 diabetes (T2D) incidence. We included 74,671 women aged ≥25 years, free of T2D at baseline. A validated food frequency questionnaire (FFQ) was used to assess dietary intake. We created an EAT-HRD score based on 15 food groups recommended by the EAT-Lancet Commission (range from 0 to 15). T2D cases were identified through self-report and cross-linkage with clinical and administrative databases. We used Cox proportional hazards models to estimate the association between categories of the EAT-HRD score with T2D incidence. During a median follow-up of 2.16 y (IQR 1.8-4.3 y), we identified 3241 T2D incident cases. The median EAT-HRD score was 6 (IQR 5-7). In multivariable analyses, when comparing extreme categories, higher adherence to the EAT-HRD score was associated with lower T2D incidence (HR 0.90; 95% CI 0.75, 1.10), yet, the estimation was imprecise. Compared to those who did not meet the EAT-HRD recommendations, adhering to the red meat, legumes, and fish recommendations was associated with lower T2D incidence. Meeting the recommendation of dairy and added sugars was associated with an increased incidence of T2D. Higher adherence to a diet designed to promote environmental and human health may help prevent T2D incidence among women in a middle-income country.

Nutritional Composition and Purchasing Patterns of Supermarket Prepared Foods Over Time

INTRODUCTION

Prepared (ready-to-eat) foods are sold in >90% of U.S. supermarkets, but little is known about their nutritional quality. This study examined trends in purchases of supermarket prepared foods and compared their nutritional profile with that of supermarket packaged foods and restaurant foods.

METHODS

Nutrition data were obtained on prepared foods sold from 2015 to 2019 in 2 supermarket chains (∼1,200 stores). One chain (193 stores) provided transaction-level sales data from 2015 to 2017. Analyses (conducted in 2021-2022) examined trends in the number of different prepared foods offered by the chains and trends in purchases of calories, total sugar, saturated fat, and sodium from prepared foods. Calorie and nutrient densities (i.e., per 100 g of food) and prevalence of being high in calories or nutrients (on the basis of Chilean standards) were analyzed among supermarket prepared foods, supermarket packaged foods, and restaurant foods consumed in the National Health and Nutrition Examination Surveys 2015-2018.

RESULTS

The number of different prepared foods offered at supermarket chains increased from 1,930 in 2015 to 4,113 in 2019. Calories per transaction purchased from supermarket prepared foods increased by 1.0 calories/month (95% CI=0.8, 1.1), a ∼3% annual increase, with similar trends for other nutrients. At supermarkets, >90% of prepared bakery and deli items and 61% of prepared entrees/sides were high in calories or another nutrient of concern, similar to supermarket packaged foods and restaurant foods.

CONCLUSIONS

Supply of and demand for supermarket prepared foods have grown substantially over time. These trends are concerning given these foods' overall poor nutritional quality.

Anti-Arthritic and Anti-Cancer Activities of Polyphenols: A Review of the Most Recent In Vitro Assays

Polyphenols have gained widespread attention as they are effective in the prevention and management of various diseases, including cancer diseases (CD) and rheumatoid arthritis (RA). They are natural organic substances present in fruits, vegetables, and spices. Polyphenols interact with various kinds of receptors and membranes. They modulate different signal cascades and interact with the enzymes responsible for CD and RA. These interactions involve cellular machinery, from cell membranes to major nuclear components, and provide information on their beneficial effects on health. These actions provide evidence for their pharmaceutical exploitation in the treatment of CD and RA. In this review, we discuss different pathways, modulated by polyphenols, which are involved in CD and RA. A search of the most recent relevant publications was carried out with the following criteria: publication date, 2012-2022; language, English; study design, in vitro; and the investigation of polyphenols present in extra virgin olive, grapes, and spices in the context of RA and CD, including, when available, the underlying molecular mechanisms. This review is valuable for clarifying the mechanisms of polyphenols targeting the pathways of senescence and leading to the development of CD and RA treatments. Herein, we focus on research reports that emphasize antioxidant properties.

Healthy Eating Index-2015 in relation to risk of metabolic dysfunction-associated fatty liver disease among US population: National Health and Nutrition Examination Survey 2017-2018

Background

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a serious chronic disease in the US. Dietary patterns provide good guidance for the prevention of chronic diseases. The Healthy Eating Index (HEI-2015) is a dietary pattern based on the dietary characteristics of the US.

Objective

Since the relation between HEI-2015 and MAFLD is unclear, this study examined their associations using the US National Health and Nutrition Examination Surveys (NHAENS) during 2017-2018.

Methods

This study included data from 4,062 participants aged ≥20 years, without viral hepatitis or pregnancy. MAFLD is defined as hepatic steatosis with one or more of the following: (1) overweight or obesity (body mass index ≥25 kg/m²); (2) type 2 diabetes; or (3) two or more other metabolic risk abnormalities. HEI-2015 scores were calculated from food intake information collected by the 24-h meal review method. The relationship of HEI-2015 with MAFLD was calculated using survey-weighted logistic regression analysis after adjusting for sex, age, race, education level, smoking status, alcohol use, levels of C-reactive protein, Aspartate Aminotransferase, Alanine Aminotransferase, a body shape index, minutes of sedentary activity, levels of cholesterol and glucose, energy take, drugs use, hypertension, and diabetes.

Results

When compared to the study population with no MAFLD, the patients with MAFLD showed a lower weighted mean HEI (48.0 ± 0.6). HEI-2015 was inversely associated with MAFLD in the fully adjusted model [Q4 vs. Q1, OR = 0.567 (0.407-0.790), P = -0.002]. Among the 13 HEI-2015 components, total vegetables, greens and beans, total fruits, whole fruits, and whole grains were negatively associated with MAFLD, while added sugars were positively associated with MAFLD. This inverse association was consistent in subgroups of the participants stratified by sex, age, education level, race, body shape index, minutes of sedentary activity, hypertension, and diabetes.

Conclusion

A higher HEI-2015 is associated with a lowered risk of MAFLD which is more obvious among participations who were women, young, Mexican Americans, with higher education, and with no hypertension or diabetes.

Total Usual Nutrient Intakes and Nutritional Status of United Arab Emirates Children (4 Years-12.9 Years): Findings from the Kids Nutrition and Health Survey (KNHS) 2021

This study aims at investigating the anthropometric status and food consumption patterns of children in the United Arab Emirates (UAE) and assessing their adherence to nutrient and dietary recommendations. It is a population-based cross-sectional survey of 690 children (4-12.9 years), from 3 major Emirates. Socio-demographic and anthropometric characteristics were collected. Dietary intakes were assessed using the 24-hour recall approach. Of the total sample, 4% were stunted, 8% were wasted and 28% were overweight/obese. A third of participating children consumed above the Estimated Energy Requirement, while the majority's intakes carbohydrate, total fat, and protein were within the recommendations; whereas over 70% and 90% of participants consumed above the WHO daily limits of free sugars and saturated fats, respectively. Inadequate intakes of linoleic acid (36% of children), alpha-linolenic acid (91%) and dietary fiber (100%) were observed. All children failed to meet the recommendation for vitamin D and considerable proportions had inadequate intakes of vitamin A, calcium, zinc, folate, and magnesium. Compared with the American Heart Association/American Academy of Pediatrics recommendations, low dietary adherence was noted for fruits (9%), vegetables (4%), and milk/dairy (14%). These findings may be used in the development of nutritional policies aimed at improving the diets of children in the UAE.