Associations between dietary fiber intake and mortality from all causes, cardiovascular disease and cancer: a prospective study

An umbrella review of the association between dietary factors and hepatocellular carcinoma risk

Background: Several meta-analyses have summarized the associations between dietary factors and the risk of hepatocellular carcinoma (HCC). However, no research has comprehensively assessed the certainty of this evidence. Methods: PubMed, Embase, and the Cochrane Library were searched from inception to August 2024. The credibility of the evidence was assessed using the pre-specified evidence classification criteria, graded as convincing ("class I"), highly suggestive ("class II"), suggestive ("class III"), weak ("class IV"), or no evidence ("class V"). To evaluate the quality of evidence, the GRADE framework was applied, categorized as "high", "moderate", "low", or "very low" quality. This study was registered at PROSPERO (CRD42023417373). Results: In total, 22 meta-analyses describing 33 non-dose-response and 10 dose-response associations were included. In the non-dose-response associations, convincing evidence (class I) supported an inverse association between coffee intake [risk ratio (RR) 0.50, 95% confidence interval 0.42 to 0.59, GRADE = very low] and risk for HCC. Suggestive evidence (class III) supported the effect of fish (RR 0.81, 0.73 to 0.90; very low), fiber (RR 0.71, 0.61 to 0.84; low), and the Mediterranean diet (RR 0.67, 0.56 to 0.80; very low) in lowering the risk for HCC. Weak evidence (class IV) suggested the protective effects of ginseng, selenium, cruciferous vegetables, whole grains, and vegetables, against HCC, and the negative effect of saturated fat in increasing the risk for HCC. In the dose-response association, convincing evidence (class I) supported that an additional two cups of coffee per day (RR 0.71, 0.60 to 0.77; moderate) lowered HCC risk, and suggestive evidence (class III) indicated that an increase of 10 g day-1 in fiber intake (RR 0.83, 0.76 to 0.91; moderate) lowered HCC risk. Weak evidence (class IV) suggests positive associations between HCC risk and a 1% daily increase in energy from saturated fat and a 100 mg day-1 increase in cholesterol. Conclusions: Dietary factors, especially coffee, fish, fiber, and the Mediterranean diet, are associated with HCC risk. These findings provide a theoretical basis for developing and evaluating dietary interventions to reduce HCC risk.

Associations between carbohydrate quality and the survival of, and life expectancy with lung cancer patient: A prospective cohort study

BACKGROUND

Evidence now suggests that carbohydrate intake quality rather than quantity contributes to improved cancer survival benefits.

METHOD

An adjusted Cox proportional hazard model was used to investigate associations between carbohydrate quality index (CQI) and LC survival. We evaluated whether carbohydrate quantity modified associations between CQI and LC survival. We also assessed the association between life expectancy and CQI in people with LC.

RESULT

Totally, 316 deaths occurred during a mean follow-up period of 30.02 months (standard deviation (SD) = 18.76). A higher CQI score was associated with significantly improved survival among patients with LC (hazard ratio [HR] = 0.60, 95 % confidence interval [CI]: 0.44-0.81). Non-linear dose-response associations between CQI and LC survival were observed (P = 0.005). For CQI sub-indices, the higher solid/total carbohydrate ratio (HR = 0.68, 95 % CI: 0.48-0.96) was associated with better LC survival. Reversely, liquid carbohydrate intake (HR = 1.44, 95 % CI: 1.02-2.04) was associated with increased LC mortality. No significant interactions were observed between the CQI and carbohydrate quantity in terms of LC patient survival. At age 45 years, patients with LC who were in the highest tertile of CQI had an increase of life expectancy of 3.36 years (95 % CI: 0.57-6.16) compared with those in the lowest tertile.

CONCLUSION

High-quality carbohydrate intake was associated with improved LC patient survival. The protective CQI association with LC survival was mostly driven by the whole grain/total grain ratio.

A plant-based diet index and all-cause and cause-specific mortality: a prospective study

Background: A plant-based dietary pattern has been recently suggested to have health benefits. However, its relationship with mortality is not completely consistent in prior studies. We aimed to investigate whether a plant-based diet was associated with a lower death risk in a Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening study. Methods: We included 91 414 participants from the PLCO study. Dietary data were collected using a diet history questionnaire (DHQ). We used three plant-based diet indices including an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the Cox proportional hazard regression model. Results: During a median of 17.1 years of follow-up, we documented 19 456 deaths, including 5489 deaths from cardiovascular disease (CVD) and 6172 deaths from cancer. Comparing the highest versus lowest quintiles of the PDI, the multivariable-adjusted HR of all-cause mortality was 0.83 (95% CI 0.80-0.87, P for trend < 0.001). Those in the highest quintile of the PDI also had lower risks of CVD mortality (HR 0.87, 95% CI 0.80-0.95, P for trend < 0.001) and cancer mortality (HR 0.89, 95% CI 0.82-0.96, P for trend = 0.003) compared to those in the lowest quintile. Participants in the highest quintile of the hPDI had a decreased risk of all-cause and cause-specific mortality, whereas participants with the highest uPDI scores had an increased death risk. Conclusion: Greater adherence to a plant-based dietary pattern was significantly associated with lower all-cause and cause-specific mortality.

The impact of dietary fiber on colorectal cancer patients based on machine learning

Objective

This study aimed to evaluate the impact of enteral nutrition with dietary fiber on patients undergoing laparoscopic colorectal cancer (CRC) surgery.

Methods

Between January 2023 and August 2024, 164 CRC patients were randomly assigned to two groups at our hospital. The control group received standard nutritional intervention, while the observation group received enteral nutritional support containing dietary fiber. Both groups were subjected to intervention and continuously observed until the 14th postoperative day. An observational analysis assessed the impact of dietary fiber intake on postoperative nutritional status in CRC patients. The study compared infection stress index, inflammatory factors, nutritional status, intestinal function recovery, and complication incidence between groups. Additionally, four machine learning models-Logistic Regression (LR), Random Forest (RF), Neural Network (NN), and Support Vector Machine (SVM)-were developed based on nutritional and clinical indicators.

Results

In the observation group, levels of procalcitonin (PCT), beta-endorphin (β-EP), C-reactive protein (CRP), interleukin-1 (IL-1), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-α) were significantly lower compared to the control group (p < 0.01). Conversely, levels of albumin (ALB), hemoglobin (HB), transferrin (TRF), and prealbumin (PAB) in the observation group were significantly higher than those in the control group (p < 0.01). Furthermore, LR, RF, NN, and SVM models can effectively predict the effects of dietary fiber on the immune function and inflammatory response of postoperative CRC patients, with the NN model performing the best. Through the screening of machine learning models, four key predictors for CRC patients were identified: PCT, PAB, ALB, and IL-1.

Conclusion

Postoperative dietary fiber administration in colorectal cancer enhances immune function, reduces disease-related inflammation, and inhibits tumor proliferation. Machine learning-based CRC prediction models hold clinical value.

Dietary carbohydrate quality index and incidence of obesity-related cancers in the "Seguimiento Universidad De Navarra" (SUN) prospective cohort

PURPOSE

The quality, rather than the quantity, of carbohydrate intake may play a major role in the etiology of obesity-related cancers (ORCs). We assessed the association between a previously defined carbohydrate quality index (CQI) and the risk of developing ORCs in the "Seguimiento Universidad de Navarra" (SUN) cohort.

METHODS

A total of 18,446 Spanish university graduates [mean age 38 years (SD 12 years), 61% women, mean BMI 23.5 kg/m2 (SD 3.5 kg/m2)], with no personal history of cancer, were followed-up. Baseline CQI was assessed summing quintiles of four previously defined criteria: high dietary fiber intake, low glycemic index (GI), high whole-grain: total-grain carbohydrates ratio and high solid carbohydrates: total carbohydrates ratio. Participants were classified into tertiles of their total CQI. Incident ORCs were confirmed by an oncologist using medical records and by querying the National Death Index blindly to dietary exposures.

RESULTS

During a median follow-up of 13.7 years, 269 incident cases of ORC were confirmed. A higher CQI was inversely associated with ORC incidence [multivariable-adjusted hazard ratio (HR) for the upper (T3) versus the lowest tertile (T1) of 0.68 (95% CI: 0.47-0.96), p for trend = 0.047]. Particularly, higher dietary fiber intake was inversely associated with ORC, HRT3 vs. T1=0.57 (95% CI 0.37-0.88 p for trend = 0.013).

CONCLUSION

In this prospective Mediterranean cohort, an inverse association between a better global quality of carbohydrate intake and the risk of ORCs was found. Strategies for cancer prevention should promote a higher quality of carbohydrate intake.

Exploring the association between dietary fiber intake and hepatic steatosis: insights from NHANES

PURPOSE

The link between dietary fiber intake and Non-alcoholic fatty liver disease (NAFLD) is under exploration, yielding inconsistent findings. Considering the limitations of previous research and the significance of dietary fiber in hepatic steatosis, this study investigates the association between dietary fiber intake and Controlled Attenuation Parameter (CAP) among 5935 participants from the National Health and Nutrition Examination Survey (NHANES).

MATERIALS AND METHODS

Multivariable regression was used to evaluate the association between dietary fiber intake and CAP. Smoothed curve fitting and threshold effect analysis techniques were applied to illustrate non-linear relationships.

RESULTS

After adjusting for other variables, a negative correlation emerged between dietary fiber intake and CAP. Subgroup analysis by gender and race/ethnicity revealed a sustained negative association between dietary fiber intake and CAP among females and Whites. Additionally, an inverted U-shaped relationship was observed between dietary fiber intake and CAP among women and other race, with inflection points at 13.80 g/day and 33.45 g/day, respectively.

CONCLUSION

Our research indicates that in the majority of Americans, there is an inverse relationship between dietary fiber intake and hepatic steatosis. This relationship exhibits an inverted U-shaped curve in women and other race, with a threshold effect. The findings of this study hold potential significance for clinical nutrition interventions, personalized dietary guidance, and advancing research into the diet-disease mechanism relationship.

Higher insoluble fiber intake is associated with a lower risk of prostate cancer: results from the PLCO cohort

Studies regarding the relationship between fiber intake and prostate cancer (PCa) have conflicting results. Therefore, this study examined the relationship between fiber intake and the risk of PCa by using data from Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. A total of 54,336 participants in the United States, consisting of 6,414 patients with PCa, were included in this study. Multivariate Cox regression models were applied to estimate adjusted hazard ratios (aHRs) and corresponding 95% confidence intervals (CIs). Compared with individuals in the lowest quartile, individuals in the highest quartile of insoluble fiber intake had a significantly lower risk of PCa (aHR, 0.87; 95% CI, 0.78-0.98). By contrast, no significant associations were detected between total fiber intake (aHR, 0.90; 95% CI, 0.80-1.01) or soluble fiber intake (aHR, 0.90; 95% CI, 0.80-1.02). Subgroup analyses showed that insoluble fiber was related to a decreased risk of PCa in subjects with the following characteristics: age > 65 years, nonsmoking or former smokers, education level ≤ high school, non-Hispanic white ethnicity, or without a family history of PCa. In addition, significant combined effects of insoluble fiber intake, age and family history of PCa on the risk of PCa were observed, but no combined effects of smoking status and insoluble fiber intake were observed. In addition, total fiber, insoluble fiber, and soluble fiber intake had no influence on the mortality of PCa patients. These results show that all 3 measures of fiber suggest a protective association, but insoluble fiber may have a stronger association with the risk of PCa. Future studies are warranted to further investigate these relationships.

Gut microbiota determines the fate of dietary fiber-targeted interventions in host health

Epidemiological investigation confirmed that the intake of dietary fiber (DF) is closely related to human health, and the most important factor affecting the physiological function of DF, besides its physicochemical properties, is the gut microbiota. This paper mainly summarizes the interaction between DF and gut microbiota, including the influence of DF on the colonization of gut microbiota based on its different physicochemical properties, and the physiological role of gut microbiota in destroying the complex molecular structure of DF by encoding carbohydrate-active enzymes, thus producing small molecular products that affect the metabolism of the host. Taking cardiovascular disease (Atherosclerosis and hypertension), liver disease, and immune diseases as examples, it is confirmed that some DF, such as fructo-oligosaccharide, galactooligosaccharide, xylo-oligosaccharide, and inulin, have prebiotic-like physiological effects. These effects are dependent on the metabolites produced by the gut microbiota. Therefore, this paper further explores how DF affects the gut microbiota's production of substances such as short-chain fatty acids, bile acids, and tryptophan metabolites, and provides a preliminary explanation of the mechanisms associated with their impact on host health. Finally, based on the structural properties of DF and the large heterogeneity in the composition of the population gut microbiota, it may be a future trend to utilize DF and the gut microbiota to correlate host health for precision nutrition by combining the information from population disease databases.

Differences in nutritional profile by chronotype among 12-h day shift and night shift nurses

Acute care nurses may suffer substantial fatigue if working night shift or if assigned a shift contrasting their preferred sleep-wake patterns, called chronotype. Nurses are at higher risk for diet-related, metabolic diseases compared to other healthcare professionals. Yet, the impact of preferred chronotype and mismatch to assigned shift on nutritional intake and risk for metabolic disease among acute care nurses is unclear. This observational study analyzed dietary data from 52 acute care nurses. Participants completed the revised morningness-eveningness questionnaire which gives a total score between 4 and 26. Lower scores (<12) were flagged as evening type (E-type), higher scores (>17) defined as morning type (M-type), and scores between 12 and 17 were categorized as neither types (N-type). N-type participants were considered chronotype matched when assigned to either shift, whereas E-types were only considered matched if assigned to night shift, and M-types matched only if assigned to day shift. Participants also recorded all dietary intake for 7 d (reflecting a typical workweek) in the MyFitnessPal phone application. Findings indicated that eveningness nurses had markers of MetS, including a significantly larger body mass index and waist circumference than N-types (p < 0.05). E-types also consumed, on average, more calories than other chronotypes (m = 1833.7 kcal), although this was not a statistically significant finding. Mismatched day (n = 7, 13.4%) and night (n = 5, 9.6%) nurses in our sample consumed, on average, more calories (m = 1935.1 kcal, m = 1981.2 kcal, respectively) than matched day (n = 24, 46.2%, m = 1642.6 kcal) or night (n = 16, 30.8%, m = 1599.1 kcal) nurses, although this finding was not statistically significant. Mismatched day nurses consumed significantly less fiber than day matched nurses (median = 10.9 g versus median = 18.5 g, p = 0.04), while night mismatched consumed significantly more fiber compared to night matched (median = 21 g versus median = 12.2 g, p = 0.05) nurses. Participant diets overall did not follow recommendations by the United States Department of Agriculture (USDA), who consumed a higher percentage of calories from saturated fats and a smaller percentage of calories from fiber, habits which increase risk for metabolic syndrome. Further research surrounding nutritional pathways utilizing larger samples is needed to uncover relationships with metabolic syndrome especially for eveningness-type nurses or if working a shift mismatched with preferred chronotype.

The Global Burden of premature cardiovascular disease, 1990-2019

Aims

Premature cardiovascular disease (pCVD) definition varies in literature, with age cut-offs ranging from 50-65 years. While there is some literature available on pCVD in North America, comprehensive data on its global burden is still lacking which hinders the development of efficient strategies for early detection and prevention. In this study we aimed to investigate the global trends in pCVD related morbidity and mortality from 1990 to 2019.

Methods

The 1990-2019 Global Burden of Disease (GBD) database was utilized to examine global trends in cardiovascular disease-related total mortality, mortality rates, and Disability-Adjusted Life Years (DALYs) within individuals aged 15-49 years. The findings were further analyzed based on factors such as age, sex, and Socio-Demographic Index (SDI).

Results

From 1990 to 2019, the number of global annual pCVD deaths increased by 25%, from 992,067 (95% UI 1,042,261 - 946,383) to 1,241,484 (95% UI 1,339,193 -1,146,252). The rate of associated mortality decreased by 13%. Metabolic conditions were the most significant risk factors for pCVD mortality. Ischemic heart disease and stroke are the leading causes of death across all age groups. pCVD mortality presented progressive widening between high and low SDI regions. Additionally, sex-specific disparities in CVD mortality were significantly greater in the premature age group as compared to all-age groups.

Conclusion

pCVD is an increasingly significant global cause of morbidity and mortality that disproportionately affects males and individuals living in less privileged regions. Furthermore, ischemic heart disease and stroke were identified as the main drivers of pCVD global burden.

Mung bean as a potent emerging functional food having anticancer therapeutic potential: Mechanistic insight and recent updates

Cancer is still a major challenge for humans. In recent years, researchers have focused on plant-based metabolites as a safe, efficient, alternative or combinatorial, as well as cost-effective preventive strategy against carcinogenesis. Mung bean is an important nutritious legume, and known for providing various health benefits due to various bioactive phytochemicals and easily digestible proteins. Regular intake of mung bean helps to regulate metabolism by affecting the growth and survival of good microbes in the host gut. Mung bean has also been reported to have anti-inflammatory, antioxidant, antiproliferative, and immunomodulatory properties. These properties may possess the preventive potential of mung bean against carcinogenesis. Bibliographic databases for peer-reviewed research literature were searched through a structured conceptual approach using focused review questions on mung beans, anticancer, therapeutics, and functional foods along with inclusion/exclusion criteria. For the appraisal of the quality of retrieved articles, standard tools were employed. A deductive qualitative content analysis methodology further led us to analyze outcomes of the research and review articles. The present review provides recent updates on the anticancer potential of mung bean and the possible mechanism of action thereof to prevent carcinogenesis and metastasis. Extensive research on the active metabolites and mechanisms of action is required to establish the anticancer potential of mung bean. Keeping the above facts in view, mung bean should be investigated for its bioactive compounds, to be considered as functional food of the future.

Higher intakes of fiber, total vegetables, and fruits may attenuate the risk of all-cause and cause-specific mortality: findings from a large prospective cohort study

BACKGROUND

Although studies have reported an inverse association between fruits, vegetables, and fiber consumption and all-cause and cause-specific mortality, the issue remains incompletely defined in the Middle Eastern population.

AIMS

The current study aimed to investigate the association between dietary fiber, fruit, and vegetable intake and all-cause and cause-specific mortality.

METHODS

A total of 48632 participants (mean age = 52years), 57.5% (n = 27974) women and 42.5% (n = 20658) men, were recruited from an ongoing large-scale prospective cohort study (the Golestan Cohort Study (GCS)), in the north of Iran. Using a validated semi-quantitative 116-item food questionnaire, dietary intakes were collected. Hazard ratios (HRs) and 95% confidence intervals (95%CIs) of all-cause and cause-specific mortality were reported.

RESULTS

After approximately 14 years of follow-up, 10,774 deaths were recorded. In the fully adjusted model, compared to those in the lowest quintile of intake, those in the second and third quintiles of dietary fiber intake had a 7%-10% reduction in risk of all-cause mortality, and a 15%-17% reduction in the risk of mortality from other causes. Increasing consumption of fruits was also associated with a decreased risk of mortality for all-cause mortality by 9%-11%, and all cancer by 15-20%. Further, those in the third and fourth quintiles of vegetables intake had 11%-12% lower risk for CVD mortality.

DISCUSSION

The results from the GCS further support the current recommendations on following a healthy diet containing proper amounts of fiber, vegetables, and fruits, as health-protective dietary items.

CONCLUSIONS

Higher intake of dietary fiber, fruits, and vegetables has the potential to reduce both overall and cause-specific mortality rates. However, additional cohort studies with larger sample size and long-term follow-up durations are required to establish these findings.

Dietary intake of total vegetable, fruit, cereal, soluble and insoluble fiber and risk of all-cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of prospective cohort studies

Objectives

To conduct a systematic review and meta-analysis of prospective cohort studies to investigate the association between total, vegetable, fruit, cereal, soluble and insoluble fiber intake and risk of all causes, cardiovascular disease (CVD), and cancer mortality and quantitatively assess the dose-response relation.

Methods

Eligible studies were identified by searching PubMed, Embase and Web of science before August 2023. Random effects models were used to calculate summary relative risk (RR) and 95% confidence intervals (CI) and restricted cubic splines to model the linear/non-linear association.

Results

The summary RR for all-cause, CVD and cancer mortality of dietary fiber was 0.90 (95% CI: 0.86,0.93), 0.87 (0.84,0.91), 0.91 (0.88,0.93), respectively. Significant association was observed for all-cause and CVD mortality with fruit, vegetable cereal and soluble fiber intake and cancer mortality with cereal fiber intake. No significant association was found for insoluble fiber, vegetable or fruit fiber intake and cancer mortality. Dose-response analysis showed a significant non-linear relation of dietary fiber intake with all-cause mortality, and linear relation for others.

Conclusions

Higher dietary fiber including different type and food sources of fiber intake were associated with lower risk of mortality. Our findings provide more comprehensive evidence on dietary fiber intake with mortality.

Systematic review registration

https://www.crd.york.ac.uk/prospero, identifier: CRD42022338837.

In-depth insight into correlations between gut microbiota and dietary fiber elucidates a dietary causal relationship with host health

Dietary fiber exerts a wide range of biological benefits on host health, which not only provides a powerful source of nutrition for gut microbiota but also supplies key microbial metabolites that directly affect host health. This review mainly focuses on the decomposition and metabolism of dietary fiber and the essential genera Bacteroides and Bifidobacterium in dietary fiber fermentation. Dietary fiber plays an essential role in host health by impacting outcomes related to obesity, enteritis, immune health, cancer and neurodegenerative diseases. Additionally, the gut microbiota-independent pathway of dietary fiber affecting host health is also discussed. Personalized dietary fiber intake combined with microbiome, genetics, epigenetics, lifestyle and other factors has been highlighted for development in the future. A higher level of evidence is needed to demonstrate which microbial phenotype benefits from which kind of dietary fiber. In-depth insights into the correlation between gut microbiota and dietary fiber provide strong theoretical support for the precise application of dietary fiber, which elucidates a dietary causal relationship with host health.

The effects of pomegranate peel added bread on anthropometric measurements, metabolic and oxidative parameters in individuals with type 2 diabetes: a double-blind, randomized, placebo-controlled study

BACKGROUND/OBJECTIVES

The aim of this study was to evaluate the sensory properties of antioxidant-rich bread made by adding pomegranate peels and their effects on anthropometric measurements and metabolic and oxidative parameters of individuals with type 2 diabetes after consumption.

SUBJECTS/METHODS

This randomized, double-blind, placebo-controlled study was conducted with 22 individuals aged between 19 and 64 years who had been diagnosed with type 2 diabetes for at least 5 years, used only metformin, did not lose more than 10% of their body weight in the last 6 months, and had a body mass index of ≥ 25.0 kg/m². While the study group (n = 11) consumed bread containing 500 mg pomegranate peel daily for 8 wk, the control group (n = 11) consumed standard bread. Anthropometric measurements and metabolic and oxidative parameters of individuals were evaluated at the beginning and end of the study.

RESULTS

Decreases were detected in the waist circumference, waist/hip and waist/height ratios, body fat percentages, blood pressure, and serum insulin, triglyceride, and total cholesterol levels in the individuals in the treatment group, compared with those in the control group (P < 0.05).

CONCLUSIONS

Pomegranate peel consumption by individuals with type 2 diabetes may have positive effects on anthropometric measurements and glycemic and lipid parameters.

The association between adherence to diet quality index and cardiometabolic risk factors in overweight and obese women: a cross-sectional study

Background

Obesity and overweight status increase the risk of cardiovascular disease. Diet quality can also predict the risk of cardiovascular diseases in obese and overweight patients. Therefore, in this study, we sought to examine the relationship between diet quality index (DQI) and cardiometabolic risk factors in obese and overweight women.

Method

A cross-sectional study was conducted on 197 Iranian women with a Body Mass Index (BMI) > 25, 18-48 years, and recruited from 20 Tehran Health Centers. Nutrition intake and DQI were assessed using a 147-item semi-quantitative food frequency questionnaire (FFQ). Additionally, anthropometric measurements, body composition, biochemical evaluations, and cardiometabolic risk factors were evaluated.

Results

There was an association between DQI and waist-to-hip ratio (WHR), atherogenic index of plasma (AIP), and CHOLINDEX in obese women, after adjusting for potential confounders. Whereas, there were no significant associations of the tertiles of DQI compared with the first tertile in other cardiometabolic risk factors, before and after adjustment.

Conclusion

This study provides evidence that dietary intake and DQI are associated with cardiometabolic risk factors and that dietary modification may be a predictor for reducing WHR, AIP, and CHOLINDEX. However, more research is needed to develop a DQI that reflects changes in cardiometabolic risk factors by considering women's eating habits and patterns.

Associations of dietary fiber intake with chronic inflammatory airway diseases and mortality in adults: a population-based study

Objective

The objective of this study was to investigate the potential association between dietary fiber intakes and the prevalence of chronic inflammatory airway diseases (CIAD), as well as mortality in participants with CIAD.

Methods

Data was collected from the National Health and Nutrition Examination Survey (NHANES) 2013-2018, with dietary fiber intakes being calculated as the average of two 24-h dietary reviews and divided into four groups. CIAD included self-reported asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). Through December 31, 2019, mortality was identified from the National Death Index. In cross-sectional studies, multiple logistic regressions were used to assess dietary fiber intakes associated with the prevalence of total and specific CIAD. Dose-response relationships were tested using restricted cubic spline regression. In prospective cohort studies, cumulative survival rates were calculated using the Kaplan-Meier method and compared using log-rank tests. Multiple COX regressions were used to assess dietary fiber intakes associated with mortality in participants with CIAD.

Results

A total of 12,276 adults were included in this analysis. The participants had a mean age of 50.70 ± 17.4 years and was 47.2% male. The prevalence of CIAD, asthma, chronic bronchitis, and COPD were 20.1, 15.2, 6.3, and 4.2%, respectively. The median daily consumption of dietary fiber was 15.1 [IQR 10.5, 21.1] g. After adjusting for all confounding factors, linear and negative associations were observed between dietary fiber intakes and the prevalence of total CIAD (OR = 0.68 [0.58-0.80]), asthma (OR = 0.71 [0.60-0.85]), chronic bronchitis (OR = 0.57 [0.43-0.74]) and COPD (OR = 0.51 [0.34-0.74]). In addition, the fourth quartile of dietary fiber intake levels remained significantly associated with a decreased risk of all-cause mortality (HR = 0.47 [0.26-0.83]) compared to the first quartile.

Conclusion

Dietary fiber intakes were found to be correlated with the prevalence of CIAD, and higher dietary fiber intakes were associated with a reduced mortality in participants with CIAD.

Increased dietary fiber is associated with weight loss among Full Plate Living program participants

Introduction

Prior studies have demonstrated that an intake of foods rich in dietary fiber is associated with a favorable impact on health status and body weight. However, the association between fiber intake and weight loss has not been well-studied in employer settings. This research aimed to assess the relationship between dietary fiber and weight loss among individuals participating in the Full Plate Living (FPL) program.

Methods

The 16-week plant-predominant fiber-rich eating program was delivered to 72 employers, primarily in the Southwest U.S., over 3 years (2017-2019). Participants received weekly video lessons, FPL materials, and additional online resources. A retrospective analysis of repeated measures was conducted using participant data obtained from 4,477 participants, of which 2,792 (62.5%) reduced body weight. Analysis of variance with post hoc analysis was used to assess the statistical significance of the changes between baseline and follow-up measures of dietary fiber intake in each of the food categories, specifically the relationship between changes in individual and combined (composite) daily servings of fruits, vegetables, whole grains, beans, and nuts on body weight measures among three groups at follow-up: those who lost, maintained, or gained weight. Multilevel modeling was used to test the hypothesis that increased intake of fiber was associated with greater weight loss.

Results

The mean weight loss for the weight loss group was 3.28 kg. As compared to the two other groups, the intake of whole fiber-rich foods at follow-up was significantly higher among the weight loss group with fruits (2.45 servings), vegetables (2.99 servings), beans (1.03 servings), and total fiber composites (9.07 servings; P < 0.001). A significant increase in servings of grains was also noted (P < 0.05). Multilevel modeling demonstrated that a higher total fiber composite (Model 1), as well as higher intakes of either vegetables or fruits (Model 2), resulted in greater weight loss.

Discussion

Our findings indicate that the FPL program can be a part of a lifestyle medicine approach to healthy eating and weight loss. Delivering the program in clinical, community, and workplace settings can increase its reach as an effective and low-cost offering.

Dietary Inflammatory Index and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Prospective Study

The Energy-adjusted Dietary Inflammatory Index (E-DIITM) is a comprehensive, literature-derived index for assessing the effect of dietary constituents on inflammatory biomarkers and inflammation-related chronic diseases. Several studies have examined the association between E-DII scores and mortality, with results that vary across populations. Therefore, in the present study, we aimed to investigate the potential association between E-DII scores and all-cause, cardiovascular disease (CVD), and cancer mortality using data from the Prostate, Lung, Colorectal and Ovarian (PLCO) Screening Trial. E-DII scores, calculated based on a food-frequency questionnaire, were analyzed both as a continuous variable and after categorization into quintiles. A multivariate Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 101,832 individuals were included, with 24,141 deaths recorded after a median of 17.0 years of follow-up. In multivariable-adjusted analyses, the E-DII score was significantly associated with all-cause mortality. The HR (95% CI) in the highest E-DII quintile compared to the lowest quintile was 1.23 (1.18–1.29). The E-DII was also statistically related to CVD mortality (Q5 vs. Q1; HR, 1.30 [95% CI, 1.20–1.41]) and cancer mortality (Q5 vs. Q1; HR, 1.14 [95% CI, 1.06–1.24]). Similar results were obtained from sensitivity analyses and subgroup analyses. In conclusion, the inflammatory potential of the diet, as calculated by the E-DII, was significantly associated with overall and CVD- and cancer-specific mortality risk in the PLCO study.