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Falck F, Zhu X, Ghalebikesabi S, Kormaksson M, Vandemeulebroecke M, Zhang C, Martin R, Gardiner S, Kwok CH, West DM, Santos L, Tian C, Pang Y, Readie A, Ligozio G, Gandhi KK, Nichols TE, Mallon AM, Kelly L, Ohlssen D, Nicholson G. A framework for longitudinal latent factor modelling of treatment response in clinical trials with applications to Psoriatic Arthritis and Rheumatoid Arthritis. J Biomed Inform 2024; 154:104641. [PMID: 38642627 DOI: 10.1016/j.jbi.2024.104641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/10/2024] [Accepted: 04/11/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVE Clinical trials involve the collection of a wealth of data, comprising multiple diverse measurements performed at baseline and follow-up visits over the course of a trial. The most common primary analysis is restricted to a single, potentially composite endpoint at one time point. While such an analytical focus promotes simple and replicable conclusions, it does not necessarily fully capture the multi-faceted effects of a drug in a complex disease setting. Therefore, to complement existing approaches, we set out here to design a longitudinal multivariate analytical framework that accepts as input an entire clinical trial database, comprising all measurements, patients, and time points across multiple trials. METHODS Our framework composes probabilistic principal component analysis with a longitudinal linear mixed effects model, thereby enabling clinical interpretation of multivariate results, while handling data missing at random, and incorporating covariates and covariance structure in a computationally efficient and principled way. RESULTS We illustrate our approach by applying it to four phase III clinical trials of secukinumab in Psoriatic Arthritis (PsA) and Rheumatoid Arthritis (RA). We identify three clinically plausible latent factors that collectively explain 74.5% of empirical variation in the longitudinal patient database. We estimate longitudinal trajectories of these factors, thereby enabling joint characterisation of disease progression and drug effect. We perform benchmarking experiments demonstrating our method's competitive performance at estimating average treatment effects compared to existing statistical and machine learning methods, and showing that our modular approach leads to relatively computationally efficient model fitting. CONCLUSION Our multivariate longitudinal framework has the potential to illuminate the properties of existing composite endpoint methods, and to enable the development of novel clinical endpoints that provide enhanced and complementary perspectives on treatment response.
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Affiliation(s)
- Fabian Falck
- Department of Statistics, University of Oxford, UK; The Alan Turing Institute, London, UK
| | - Xuan Zhu
- Novartis Pharmaceuticals Corporation, East Hanover, United States
| | | | | | | | - Cong Zhang
- China Novartis Institutes for Bio-medical Research CO., Shanghai, China
| | - Ruvie Martin
- Novartis Pharmaceuticals Corporation, East Hanover, United States
| | - Stephen Gardiner
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Population Health, University of Oxford, UK
| | | | | | | | - Chengeng Tian
- China Novartis Institutes for Bio-medical Research CO., Shanghai, China
| | - Yu Pang
- China Novartis Institutes for Bio-medical Research CO., Shanghai, China
| | - Aimee Readie
- Novartis Pharmaceuticals Corporation, East Hanover, United States
| | - Gregory Ligozio
- Novartis Pharmaceuticals Corporation, East Hanover, United States
| | - Kunal K Gandhi
- Novartis Pharmaceuticals Corporation, East Hanover, United States
| | - Thomas E Nichols
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Population Health, University of Oxford, UK; Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | | | - Luke Kelly
- School of Mathematical Sciences, University College Cork, Ireland
| | - David Ohlssen
- Novartis Pharmaceuticals Corporation, East Hanover, United States
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Salamanca-González P, Valls-Zamora RM, Pedret-Figuerola A, Sorlí-Aguilar M, Santigosa-Ayala A, Catalin RE, Pallejà-Millán M, Solà-Alberich R, Martin-Lujan F. Effectiveness of a Motivational Nutritional Intervention through Social Networks 2.0 to Increase Adherence to the Mediterranean Diet and Improve Lung Function in Active Smokers: The DIET Study, a Randomized, Controlled and Parallel Clinical Trial in Primary Care. Nutrients 2021; 13:nu13103597. [PMID: 34684600 PMCID: PMC8538243 DOI: 10.3390/nu13103597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/30/2021] [Accepted: 10/08/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Diet can help preserve lung function in smokers, as well as aid individuals who avoid smoking. This study aimed to evaluate the effectiveness of a nutritional intervention, using the Social Networks 2.0 tool, to increase adherence to the Mediterranean diet (MD) and improve lung function in smokers without prior respiratory disease. Methods: A randomized controlled parallel design was used. The participants were assigned to either the intervention or control group. Data from representative smokers without respiratory disease (n = 77) aged 18–70 years were analyzed. The participants completed a validated semi-quantitative food-frequency questionnaire, and their adherence to the diet was evaluated by using the questionnaire called the Mediterranean Diet Adherence Score (MEDAS, with 14 items), which considers ≥9 points to indicate high adherence. The lung function was assessed by spirometry. Associations among variables were determined by logistic regression. Results: A comparison of the variables at the end of the study between the control and intervention groups showed that the intervention significantly increased adherence to the MD based on the MEDAS questionnaire (0.69 (2.1) vs. 2.05 (2.03); p = 0.009). Specifically, the consumption of fruits was increased after two years in both groups; however, a more significant increase was detected in the intervention group (121 (178) vs. 12.7 (167) in the control group; p-value = 0.008). In the unadjusted analysis, the intervention only showed a statistical significant increase in the score of adherence to the MD (β: 1.36; 95% CI 0.35; 2.3; p = 0.009), and this increase was maintained after adjusting for age and sex (β: 1.15; 95% CI 0.05; 2.2; p = 0.040) and after adjusting for various sociodemographic, lifestyle and anthropometric variables (β: 1.17; 95% CI 0.02; 2.31; p = 0.046). The pulmonary function parameters improved more in the intervention group; however, no significant differences were observed between the two groups. Conclusions: A nutritional intervention based on a dietetic-nutritional education program resulted in a significant increase in adherence to the MD. However, some evidence suggests that an MD dietary intervention can improve lung function, but in our study, we were not able to demonstrate this. Further research is needed to obtain more robust data and confirm a possible benefit of the program before it can be extended to general practice.
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Affiliation(s)
- Patricia Salamanca-González
- Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-SALUT), Facultat de Medicina i Ciències de La Salut, Universitat Rovira i Virgili, Sant Llorenç, 21, 43201 Reus, Spain; (P.S.-G.); (R.M.V.-Z.); (A.P.-F.); (R.S.-A.)
- CENIT Research Group, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain; (M.S.-A.); (A.S.-A.); (R.-E.C.)
| | - Rosa Maria Valls-Zamora
- Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-SALUT), Facultat de Medicina i Ciències de La Salut, Universitat Rovira i Virgili, Sant Llorenç, 21, 43201 Reus, Spain; (P.S.-G.); (R.M.V.-Z.); (A.P.-F.); (R.S.-A.)
| | - Anna Pedret-Figuerola
- Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-SALUT), Facultat de Medicina i Ciències de La Salut, Universitat Rovira i Virgili, Sant Llorenç, 21, 43201 Reus, Spain; (P.S.-G.); (R.M.V.-Z.); (A.P.-F.); (R.S.-A.)
| | - Mar Sorlí-Aguilar
- CENIT Research Group, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain; (M.S.-A.); (A.S.-A.); (R.-E.C.)
| | - Antoni Santigosa-Ayala
- CENIT Research Group, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain; (M.S.-A.); (A.S.-A.); (R.-E.C.)
- Department of Primary Care Camp de Tarragona, Institut Català de la Salut, Doctor Mallafré Guach, 4, 43007 Tarragona, Spain
- Departament de Medicina i Ciències de La Salut, Universitat Rovira i Virgili, Sant Llorenç, 21, 43201 Reus, Spain;
| | - Roxana-Elena Catalin
- CENIT Research Group, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain; (M.S.-A.); (A.S.-A.); (R.-E.C.)
- Department of Primary Care Camp de Tarragona, Institut Català de la Salut, Doctor Mallafré Guach, 4, 43007 Tarragona, Spain
| | - Meritxell Pallejà-Millán
- Departament de Medicina i Ciències de La Salut, Universitat Rovira i Virgili, Sant Llorenç, 21, 43201 Reus, Spain;
- Research Support Unit Camp of Tarragona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Camí de Riudoms, 53-55, 43202 Reus, Spain
| | - Rosa Solà-Alberich
- Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-SALUT), Facultat de Medicina i Ciències de La Salut, Universitat Rovira i Virgili, Sant Llorenç, 21, 43201 Reus, Spain; (P.S.-G.); (R.M.V.-Z.); (A.P.-F.); (R.S.-A.)
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan XXIII, Doctor Mallafré Guasch, 4, 43007 Tarragona, Spain
| | - Francisco Martin-Lujan
- CENIT Research Group, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Gran Via de les Corts Catalanes, 587, 08007 Barcelona, Spain; (M.S.-A.); (A.S.-A.); (R.-E.C.)
- Department of Primary Care Camp de Tarragona, Institut Català de la Salut, Doctor Mallafré Guach, 4, 43007 Tarragona, Spain
- Departament de Medicina i Ciències de La Salut, Universitat Rovira i Virgili, Sant Llorenç, 21, 43201 Reus, Spain;
- Research Support Unit Camp of Tarragona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Camí de Riudoms, 53-55, 43202 Reus, Spain
- Correspondence:
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Kuhail M, Shab-Bidar S, Yaseri M, Djafarian K. Major Dietary Patterns Relationship with Severity of Coronary Artery Disease in Gaza-Strip, Palestine: A Cross-Sectional Study. Ethiop J Health Sci 2021; 31:599-610. [PMID: 34483617 PMCID: PMC8365497 DOI: 10.4314/ejhs.v31i3.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/12/2020] [Indexed: 11/17/2022] Open
Abstract
Background The association of dietary patterns (DPs) linked to the severity of coronary artery disease (CAD) is little known. Therefore, this study aims to explore the relationship between major DPs and the severity of CAD. Methods This cross-sectional study was conducted among423 newly discovered CAD patients (both genders, aged 35–65 years), who underwent coronary angiography. The severity of CAD was assessed by the Gensini score. All patients were tested using a semi-quantitative food frequency questionnaire and other related data through face-to-face interviews. Factor analysis and logistic regression were applied by using SPSS version-24. Results By principal component analysis, two major DPs were identified: “Unhealthy” DP that characterized mainly by high intakes of sugar and sweets, soft drinks, salts, cooking oils, and processed meats, and “Healthy” DP that consisting high intakes of fruits, fish, poultry, vegetables, whole grains. After adjustment for confounding variables, the odds of severe CAD was significantly higher in the third (T3) and second (T2) tertile of the unhealthy pattern by 4.79 and 2.48 times more compared to the first tertile (T1) (OR 4.79; 95%CI 2.60, 8.83; P<0.001) and (OR 2.48; 95%CI 1.40, 4.39; P=0.002), respectively. However, the odds of CAD severity in the T3 and T2 of the healthy pattern was lowered by 0.24 and 0.38 times less compared to the T1 (OR 0.24; 95%CI 0.12, 0.47; P=0.002) and (OR 0.38; 95%CI 0.20, 0.73; P=0.006), respectively. Conclusion The severity of CAD was significantly increased by the unhealthy dietary pattern, while decreased by adherence to the healthy pattern.
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Affiliation(s)
- Mohamed Kuhail
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, International-Campus. Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional, School of Nutritional Sciences and Dietetics, International College, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, International-Campus. Tehran, Iran
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Kuhail M, Djafarian K, Shab-Bidar S, Yaseri M. Major dietary patterns and metabolic syndrome associated with severity of coronary artery disease: A structural equation modeling. Nutr Health 2021; 28:277-287. [PMID: 34151612 DOI: 10.1177/02601060211020655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The association of dietary patterns and metabolic syndrome with the severity of coronary artery disease (CAD) is little known. AIM This study aimed to explore the relationship between major dietary patterns and the severity of CAD among newly discovered patients by using structural equation modeling (SEM). METHODS In this cross-sectional study, we included 423 newly diagnosed patients with CAD, aged 35-65 years, who underwent coronary angiography. The severity of CAD was assessed by the Gensini score. All patients were tested by using a semi-quantitative food frequency questionnaire, international physical activity questionnaire, perceived stress scale, lipid profile, fasting blood glucose, and anthropometric and blood pressure measurements. Statistical analysis was performed using SPSS and AMOS version 24. RESULTS Two dietary patterns (DPs) were identified by principal components analysis and labeled as "unhealthy DP" and "healthy DP". The results of SEM analysis showed that the unhealthy DP has a significant positive direct association with the severity of CAD (β=0.304, p<0.001), which is indirectly mediated by the presence of metabolic syndrome (β=0.021, p=0.021), adjusted for age and perceived stress scale. However, healthy DP has a significant negative direct association with the Gensini score (β=-0.213, p<0.001), and an indirect association through negative metabolic syndrome (β=-0.019, p=0.022), controlled for gender, physical activity, and perceived stress scale. CONCLUSIONS The severity of CAD was directly associated with the unhealthy DP and indirectly mediated by the presence of the metabolic syndrome, while a healthy DP had a direct inverse association with CAD severity and indirectly mediated by the absence of metabolic syndrome.
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Affiliation(s)
- Mohamed Kuhail
- 48439Tehran University of Medical Sciences, Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, International Campus, Iran
| | - Kurosh Djafarian
- 48439Tehran University of Medical Sciences, Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, International Campus, Iran
| | - Sakineh Shab-Bidar
- 48439Tehran University of Medical Sciences, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, International College, Iran
| | - Mehdi Yaseri
- 48439Tehran University of Medical Sciences, Department of Epidemiology and Biostatistics, School of Public Health, Iran
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Schulz CA, Oluwagbemigun K, Nöthlings U. Advances in dietary pattern analysis in nutritional epidemiology. Eur J Nutr 2021; 60:4115-4130. [PMID: 33899149 PMCID: PMC8572214 DOI: 10.1007/s00394-021-02545-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 03/22/2021] [Indexed: 02/06/2023]
Abstract
Background and Purpose It used to be a common practice in the field of nutritional epidemiology to analyze separate nutrients, foods, or food groups. However, in reality, nutrients and foods are consumed in combination. The introduction of dietary patterns (DP) and their analysis has revolutionized this field, making it possible to take into account the synergistic effects of foods and to account for the complex interaction among nutrients and foods. Three approaches of DP analysis exist: (1) the hypothesis-based approach (based on prior knowledge regarding the current understanding of dietary components and their health relation), (2) the exploratory approach (solely relying on dietary intake data), and (3) the hybrid approach (a combination of both approaches). During the recent past, complementary approaches for DP analysis have emerged both conceptually and methodologically. Method We have summarized the recent developments that include incorporating the Treelet transformation method as a complementary exploratory approach in a narrative review. Results Uses, peculiarities, strengths, limitations, and scope of recent developments in DP analysis are outlined. Next, the narrative review gives an overview of the literature that takes into account potential relevant dietary-related factors, specifically the metabolome and the gut microbiome in DP analysis. Then the review deals with the aspect of data processing that is needed prior to DP analysis, particularly when dietary data arise from assessment methods other than the long-established food frequency questionnaire. Lastly, potential opportunities for upcoming DP analysis are summarized in the outlook.
Conclusion Biological factors like the metabolome and the microbiome are crucial to understand diet-disease relationships. Therefore, the inclusion of these factors in DP analysis might provide deeper insights.
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Affiliation(s)
- Christina-Alexandra Schulz
- Department of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Endenicher Allee 19b, 53115, Bonn, Germany
| | - Kolade Oluwagbemigun
- Department of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Endenicher Allee 19b, 53115, Bonn, Germany
| | - Ute Nöthlings
- Department of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Endenicher Allee 19b, 53115, Bonn, Germany.
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Oliveira A, Lopes C, Torres D, Ramos E, Severo M. Application of a Latent Transition Model to Estimate the Usual Prevalence of Dietary Patterns. Nutrients 2020; 13:nu13010133. [PMID: 33396483 PMCID: PMC7823363 DOI: 10.3390/nu13010133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 11/30/2022] Open
Abstract
Background: This study aims to derive habitual dietary patterns of the Portuguese adult population by applying two methodological approaches: a latent class model and a latent transition model. The novel application of the latent transition model allows us to determine the day-to-day variability of diet and to calculate the usual prevalence of dietary patterns. Methods: Participants are from the National Food, Nutrition and Physical Activity Survey of the Portuguese population, 2015–2016 (2029 women; 1820 men, aged ≥18 years). Diet was collected by two 24 h dietary recalls (8–15 days apart). Dietary patterns were derived by: (1) a latent class model using the arithmetic mean of food weigh intake, with concomitant variables (age and sex); (2) a latent transition model allowing the transition from one pattern to another, with the same concomitant variables. Results: Six dietary patterns were identified by a latent class model. By using a latent transition model, three dietary patterns were identified: “In-transition to Western” (higher red meat and alcohol intake; followed by middle-aged men), “Western” (higher meats/eggs and energy-dense foods intake; followed by younger men), and “Traditional-Healthier” (higher intake of fruit, vegetables and fish, characteristic of older women). Most individuals followed the same pattern on both days, but around 26% transited between “In-transition to Western” and “Western”. The prevalence of the dietary patterns using a single recall day (40%, 27%, 33%, respectively) is different from the usual prevalence obtained by the latent transition probabilities (48%, 36%, 16%). Conclusion: Three dietary patterns, largely dependent on age and sex, were identified for the Portuguese adult population: “In-transition to Western” (48%), “Western” (36%), and “Traditional-Healthier” (16%), but 26% were transient between patterns. Dietary patterns are, in general, deviating from traditional habits.
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Affiliation(s)
- Andreia Oliveira
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
- Correspondence:
| | - Carla Lopes
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
| | - Duarte Torres
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Faculty of Nutrition and Food Sciences, University of Porto, Rua do Campo Alegre 823, 4150-180 Porto, Portugal
| | - Elisabete Ramos
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
| | - Milton Severo
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (C.L.); (D.T.); (E.R.); (M.S.)
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal
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Melough MM, Foster D, Sathyanarayana S. Dietary Sources of Melamine Exposure among US Children and Adults in the National Health and Nutrition Examination Survey 2003–2004. Nutrients 2020; 12:nu12123844. [PMID: 33339272 PMCID: PMC7767253 DOI: 10.3390/nu12123844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/10/2020] [Accepted: 12/14/2020] [Indexed: 12/31/2022] Open
Abstract
Melamine is a high-production-volume chemical and a kidney toxicant. Diet is a key source of melamine exposure, yet little is known about which foods in the US diet may be contaminated. This study evaluated the associations of foods and dietary patterns with melamine exposure using data from 478 US adults and children from the National Health and Nutrition Examination Survey 2003–2004. Melamine concentrations were measured in spot urine samples. Dietary recalls were used to collect dietary data from the day preceding urine collection. Melamine was detectable (>0.09 ng/mL) in 76.2% of the participants’ urine. The geometric mean urinary melamine was 11.563 µg/g of creatinine (standard error (SE): 1.235). In adjusted linear regression models, each additional ounce of processed meats or whole grains was associated with 10.6% (95% confidence interval (CI): 2.7, 19.0; p = 0.007) or 17.4% (95% CI: 4.7, 31.7; p = 0.006) greater creatinine-adjusted melamine concentrations, respectively. A dietary pattern characterized by high fruit, whole grain, milk, and yogurt intake was positively associated with melamine exposure. In conclusion, processed meats, whole grains, and possibly other plant-based foods may be important melamine sources in the US. Future research should confirm these findings using more recent data and examine the potential health risks of chronic low-level melamine exposure.
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Affiliation(s)
- Melissa M. Melough
- Department of Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA 98101, USA;
- Correspondence:
| | - Deborah Foster
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98195, USA;
| | - Sheela Sathyanarayana
- Department of Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA 98101, USA;
- Department of Pediatrics, University of Washington, Seattle, WA 98105, USA
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Joo J, Williamson SA, Vazquez AI, Fernandez JR, Bray MS. The influence of 15-week exercise training on dietary patterns among young adults. Int J Obes (Lond) 2019; 43:1681-1690. [PMID: 30659257 PMCID: PMC6639161 DOI: 10.1038/s41366-018-0299-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 11/18/2018] [Accepted: 11/29/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVES Little is currently known about how exercise may influence dietary patterns and/or food preferences. The present study aimed to examine the effect of a 15-week exercise training program on overall dietary patterns among young adults. SUBJECTS/METHODS This study consisted of 2680 young adults drawn from the Training Intervention and Genetics of Exercise Response (TIGER) study. Subjects underwent 15 weeks of aerobic exercise training, and exercise duration, intensity, and dose were recorded for each session using computerized heart rate monitors. In total, 4355 dietary observations with 102 food items were collected using a self-administered food frequency questionnaire before and after exercise training (n = 2476 at baseline; n = 1859 at 15 weeks). Dietary patterns were identified using a Bayesian sparse latent factor model. Changes in dietary pattern preferences were evaluated based on the pre/post-training differences in dietary pattern scores, accounting for the effects of gender, race/ethnicity, and BMI. RESULTS Within each of the seven dietary patterns identified, most dietary pattern scores were decreased following exercise training, consistent with increased voluntary regulation of food intake. A longer duration of exercise was associated with decreased preferences for the western (β: -0.0793; 95% credible interval: -0.1568, -0.0017) and snacking (β: -0.1280; 95% credible interval: -0.1877, -0.0637) patterns, while a higher intensity of exercise was linked to an increased preference for the prudent pattern (β: 0.0623; 95% credible interval: 0.0159, 0.1111). Consequently, a higher dose of exercise was related to a decreased preference for the snacking pattern (β: -0.0023; 95% credible interval: -0.0042, -0.0004) and an increased preference for the prudent pattern (β: 0.0029; 95% credible interval: 0.0009, 0.0048). CONCLUSIONS The 15-week exercise training appeared to motivate young adults to pursue healthier dietary preferences and to regulate their food intake.
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Affiliation(s)
- Jaehyun Joo
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Sinead A Williamson
- Departments of Information, Risk, & Operations Management and Statistics & Data Science, The University of Texas at Austin, Austin, TX, USA
| | - Ana I Vazquez
- Department of Epidemiology & Biostatistics and Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI, USA
| | - Jose R Fernandez
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Molly S Bray
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX, USA.
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