A Whole-Grain Diet Increases Whole-Body Protein Balance Compared with a Macronutrient-Matched Refined-Grain Diet

Relationships of sarcopenia symptoms and dietary patterns with lung cancer risk: a prospective cohort study

Background: Few studies focused on the effects of sarcopenia on lung cancer in the general population and optimizing nutritional intake may be a feasible way to manage sarcopenia. We sought to systematically investigate the associations of sarcopenia symptoms with lung cancer incidence and mortality in the general population, and whether dietary patterns could modify these risks. Methods: A total of 361 763 participants (mean age: 56.2 years; and men: 46.7%) were included in this prospective UK Biobank study. Sarcopenia symptoms (low handgrip strength, low muscle mass and slow walking pace) were determined according to European Working Group of Sarcopenia in Older People 2 (EWGSOP2) criteria. Individuals without any of the three sarcopenia symptoms were classified as the normal control group. Based on the baseline data from food frequency questionnaires, primary dietary patterns were identified through principal component analysis. Cox proportional hazards models were used to examine associations between sarcopenia symptoms as well as dietary patterns and lung cancer. Then we explored the joint effects of sarcopenia symptoms and dietary patterns on lung cancer risk. Results: A total of 3532 incident lung cancer cases and 2073 deaths were documented during a median follow-up of 12 years. All the sarcopenia symptoms were associated with a higher risk of lung cancer incidence than the normal control group, especially in people aged <60 (Pinteraction < 0.05). Particularly, a stronger association was observed for slow walking pace with incidence (hazard ratio [HR]: 1.49, 95% confidence interval [CI]: 1.34-1.65) and mortality (HR: 1.54, 95% CI: 1.35-1.75) of lung cancer. Higher adherence to the wholegrain pattern was associated with a greater reduction in the risk of lung cancer incidence (HRQ4vs.Q1: 0.71, 95% CI: 0.65-0.79) and mortality (HRQ4vs.Q1: 0.68, 95% CI: 0.60-0.77). The joint analysis demonstrated that the risk of lung cancer-related outcomes associated with low handgrip strength gradually reduced as the quartile of wholegrain pattern scores increased (Ptrend < 0.05). Conclusions: Our study indicated that individuals with sarcopenia symptoms suffered a higher risk of lung cancer incidence and mortality even in younger age. A diet abundant in whole grains may help to improve sarcopenia symptoms and reduce adverse lung cancer-related outcomes associated with low handgrip strength.

Diet quality is associated with adipose tissue and muscle mass: the Coronary Artery Risk Development in Young Adults (CARDIA) study

BACKGROUND

Aging is associated with changes in body composition, and preventing loss of muscle mass and accumulation of excess adipose tissue in middle-aged adults may reduce age-related conditions at older ages. Dietary intake is one lifestyle factor shown to improve or maintain body composition. However, few studies have examined the Healthy Eating Index2015 (HEI2015), a measure of diet quality, and the association with body composition in adult men and women.

METHODS

Participant data (n = 3017) from the Coronary Artery Risk Development in Young Adults (CARDIA) study were used to examine the associations of the HEI2015 with body composition measures at Year 25 (Y25), including (1) 25 year-change in weight, body mass index (BMI), and waist circumference and (2) a computed tomography (CT) scan at Y25 measured muscle mass, muscle quality (better quality = less lipid within the muscle), and adipose tissue depots visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and adipose within skeletal muscle (intermuscular adipose tissue; IMAT). Dietary intake was assessed by a diet history three times over 20 years, at years 0, 7, and 20. HEI2015, averaged over three exams, was created and categorized into quintiles. Multiple regression analysis evaluated the associations of body composition stratified across quintiles of HEI2015 adjusted for demographic characteristics, energy intake, lifestyle factors, and baseline anthropometric measures as appropriate. Race-sex interaction was tested (Pinteraction  > 0.30).

RESULTS

Over 25 years of follow-up, averaged HEI2015 was significantly and inversely associated with weight gain (Quintile 1 (Q1) 37.3 lb vs. 32.9 in Q5; Ptrend  = 0.01), change in BMI (Q1 5.8 kg/m2 vs. 5.0 in Q5; Ptrend  = 0.005), and change in waist circumference (Q1 17.5 cm vs. 15.2 cm in Q5; Ptrend  < 0.001). By Y25, HEI2015 was inversely associated with VAT Q1 136.8 cm3 vs. 116.6 in Q5; Ptrend  < 0.001) and IMAT volumes (Q1 9.52 vs. 8.12 cm3 in Q5; Ptrend  < 0.001). Although total muscle volume declined (Ptrend  = 0.03), lean muscle mass volume was similar across quintiles (Ptrend  = 0.55). The IMAT/total muscle mass ratio declined across HEI2015 quintiles (Ptrend  < 0.001). Finally, higher HEI2015 was associated with better muscle quality at Y25 (higher value = less lipid within the muscle; Q1 41.1 vs. 42.2 HU in Q5; Ptrend  = 0.002). HEI2015 was nonlinearly, but inversely, associated with SAT (nonlinear P = 0.011).

CONCLUSIONS

Improving diet quality in young to middle-aged adults is a recommended strategy to promote better measures of body composition. Our study findings suggest that healthier food choices may influence body composition.

Non-Classical Aspects of Obesity Pathogenesis and Their Relative Clinical Importance for Obesity Treatment

Obesity is a chronic disease and a major public health problem due to its association with non-communicable diseases and all-cause mortality. An increased energy intake and decreased physical activity have been long recognized as the classical parameters that contribute to the development of obesity. However, several other, non-classical factors have also been associated with obesity through various complex mechanisms. Some of them are diet related, such as diet quality, dietary habits and speed of eating. Other factors are non-dietary, such as endocrine-disrupting chemicals, sleep quality and quantity, psychotropic medications and light at night. The scope of the present narrative review is to address these non-classical factors that are implicated in the pathogenesis of obesity, to clarify their potential role in the management of obesity and, where possible, to provide some practical clinical recommendations.

The Risk of Breast Cancer between Western and Mediterranean Dietary Patterns

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

Emerging Nutrition Approaches to Support the Mind and Muscle for Healthy Aging

This narrative review highlights recent advances and ongoing trials using nutrition approaches for healthy aging. Focus will be placed on nutrition therapies that target cognition ("the mind") and mobility ("the muscle"), both critical components to maintaining a high quality of life for older adults. For "the mind," two seemingly incongruent therapies are being investigated to improve cognition-the MIND diet (high in carbohydrates and anti-oxidant fruits and vegetables) and the ketogenic diet (low in carbohydrates, high in fats). For "the muscle," a focus on protein and energy intake has dominated the literature, yet a recent clinical trial supports the use of whole-grains as a tool to improve whole-body protein turnover-a primary regulator of lean body mass and muscle. Finally, emerging data and clinical trials on caloric restriction have solidified this strategy as the only nutritional approach to slow intrinsic factors of whole-body aging, which may positively impact both "the mind" and "the muscle."